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97 Chapter 8 Sam On an ordinary day in June 2011, I met fifteen-year-old Sam and his mother, Susan, for coffee. Sam is an ordinary boy; a little brighter and a lot less contemptuous of adults than I, with my limited teenage experience, was expecting, but he liked ordinary things, like riding his bike, cooking, and watching movies. He worshipped his two older brothers and wanted to be a doctor when he grew up. In fact, unlike my outings with Jonah, where I feel we’re under constant public scrutiny because of his clapping, bouncing, shrieking, spinning (and my constant refrain: “Jonah, don’t touch that! Jonah, get back here!”), I bet not one of the dozens of people who walked past our table at that sidewalk café noticed us, we were all so ordinary. They would have done a quick double take, however, if they had overheard our conversation. Especially the part where Sam spoke of the paranoid delusions that used to keep him from leaving his house. “I thought people were listening and watching me,” he said softly, embarrassed despite Susan’s gentle reminders that his symptoms were in no way his fault. “I would spend hours adjusting the blinds. There was one perfect position where no one could see in, but some light could still come through.” This was the most benign of Sam’s episodes ; the others—in which he tried to jump out a second story window , or believed the character from the Burger King commercials was going to come to his house and rape him, or stayed awake for four days straight—his mother had to tell me about. Like many patients, Sam didn’t remember much from his psychotic periods. Although he did remember enough to add, “It doesn’t feel like paranoia when it’s you. It feels like real fear.” I sipped my coffee, trying not to intimidate Sam with my barely containable excitement. I’d met several boys over the past year whose lives had been transformed by ECT; unlike the others, though, Sam is completely neurotypical. He doesn’t suffer from autism or any other developmental delay that would keep him from talking about his ex- Each Day I Like It Better 98 perience. Susan is an unabashed supporter of ECT, crediting it with saving her son’s life. But I was dying to know: What was it like for Sam? Sam’s symptoms first appeared when he was in sixth grade. Initially, Susan and her husband, Rick, assumed it was the difficult transition to middle school that had left their son so depressed. School had never been easy for Sam, whose social and academic struggles had earned him an ADD diagnosis as early as first grade. Combined with his slight stature and shy demeanor, Susan and Rick wondered if Sam had become a target for his middle school peers, who, Susan acknowledged, “weren’t always very nice.” But when Sam’s general sadness deteriorated into fierce crying jags and suicidality, when he all but stopped eating and sleeping, Susan and Rick knew Sam was suffering more than growing pains. “We’re not ashamed to seek help,” Susan told me. “Those are our jobs.” Susan is an ER nurse and Rick, a psychotherapist. After their son lost a quarter of his body weight, it was obvious to both of them that he needed more than their unconditional love and support. Sam’s three-year experiment with psychotropic medication began with a partial hospitalization. The goal of such a program—in which patients spend their days at the hospital, then go home to sleep—is to make rapid medication changes while under daily doctor supervision . But Sam never felt comfortable in the program. “The other kids weren’t like me,” he explained. “They were violent. Most of them were there for drug use or skipping school.” And although Sam’s symptoms improved slightly, Susan waited in vain for him to “get to a place where he was functional and well.” Sam’s continued instability was exacerbated by brutal side effects from his medication. The worst was akathesia, typically described as feeling as though you have “ants in your pants.” But when I echoed this phrase back to Sam, he interrupted me. “It’s much, much worse,” he said. “It’s torture.” The akathesia made him agitated and caused pacing, rocking, and scratching Sam had no control over. He continually poked himself with a pencil. His doctors responded to...

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