Collating

"Shonna? Are you all right in there?" It's been 10 minutes since she went into the emergency room toilet, and I'm concerned. Her affirmative answer reduces my anxiety very little. There is something terribly wrong with my twenty-one year old first born. Less than two hours ago, I met a plane carrying her out of Nigeria so we could seek Western care for her condition, whatever it is.

Only three days earlier, I had put her on a plane for Lagos so she could spend another summer interning at the American embassy where her father worked. She had enjoyed the work so much the year before, she could hardly contain her excitement to rejoin her dad and his wife.

Awaiting her at the embassy were long lines of Nigerians hoping to immigrate to the United States.
Most of them were standing in line with fake paper, fake stories, and fake relatives in the US.  Her job was to present the rules and consequences and discourage these desperate people from telling their lies. Of the hundreds of people she saw, maybe one or two would actually be taken beyond the doors to discuss immigration with officials. She told me she hated that part of the job, the liar part.  She really enjoyed the rest of the four month stay. It was great to be with Barbara and her dad again. The people she met , the countryside, the Marine guards, the water taxi to their compound on the island, it was an exotic and bizarre existence, so different from her studies at the university.

Preparations for this second trip had included securing the new visa, getting new pictures for the old passport, getting the physical and the shots and starting the anti-malarial drugs, and shopping for clothing that was more practical than the things she had taken the year before.  Then, we had her birthday party and the extended family came to celebrate our 'first of all the cousins' to turn twenty-one.  We sent her off with the heartiest best wishes, hopes for her future, and congratulations, a new young adult could enjoy.

As I stand in the hallway outside the restroom, I realize there were some signs of her illness before she left. I had chalked them up to the impending trip, the hustle of getting ready.  She had seemed over-the-top excited, giddy, and, slightly short with her brother and me, impatient really! Nothing too worrisome, just Shonna going through her self-centered, modern girl syndrome. At her party though, it had been noted and caring individuals had come to me to ask.  "What's up with Shonna?"

What do you guess about the slightly manic, slightly obsessive, self-guided adult missile who is talking a mile a minute and seems a little dilated?  Is she experimenting? Drinking? Drugging? She's an adult!  No matter whatever her attitude springs from, (hormones? excitement?) it's hers, and she is smart enough to handle it herself. When I ask, she sees nothing odd in her behavior. She's not 'experimenting'. Whatever it is, the next four months will change it without a doubt!

The call from her Dad's wife came less than two days after she left. Shonna is in bed with a cold, or flu.  She missed her first day at the embassy. There was a birthday party when she got there and she has been sick ever since. They will be taking her to the doctor. And, there's something else... She is acting crazy! When left on her own at home that day she unpacked and rearranged all the cupboards in their kitchen. She made pyramids of the canned goods, She isn't talking like herself. They can't get her to focus on their questions....might it be a reaction to the mefloquine, the anti-malarial?

Oh, no! That was what had affected my son the year before when he visited his dad.  He came home with suicidal thoughts and odd feelings toward his sister.  We had him in therapy for eight months after which he was fine.  But, Shonna? this was her second exposure to the drug.  We didn't notice anything adverse the year before but it could be.  It was a clue.  What I now recognize as indicators had begun when she started the pills two weeks before leaving.

At the airport I waited while the passengers cleared customs. Finally I saw Barbara.  She greeted me with a wan smile.  The plane ride had been tension filled for her, she explained.  The doctors at the embassy had given Shonna Valium and another sedative to keep her subdued. They weren't sure what she might do. She didn't seem to understand they were going back to the US and thought I was coming to meet her in Nigeria.  The medical evacuation order was incomprehensible to my daughter's new mind. "So, where is she?" I'm so anxious to see her for myself and evaluate whatever this is. "She's right behind me", Barbara replies. I still don't see my vivacious, beautiful, blonde daughter. And, then I see the haggard and drawn, black abaya wearing woman who has been standing and fussing with her luggage while I've been talking.. She has not looked at me and doesn't now.  But, I recognize her. Her blond hair is completely covered with the traditional black scarf.  She seems stooped and small.She has lost weight. Why? She's not eating, I'm told. But, she is not Shonna. Will she ever be Shonna, again?

In the car on the way to the hospital,  I try to chat with my daughter...but, she'll have none of it. "Be quiet! I can't think", she demands. She is trying to determine what day and date it is. To do this she has been counting aloud 1,2,3,4, and then starting over... I tell her it's January 2nd. "Don't tell me," she shouts. "I can figure it out for myself...1,2,3,4." I watch her try to get a grip on the thought processes that have never failed her before. "Let's see," she begins again.  "Monday, Tuesday,...!" When I attempt to ask other questions or introduce something to jog her out of this obsessive rut, she stops me, sounding a little like herself, "Mom, I'm busy!  Can't you see I'm collating?" She 'collates' for the next forty minutes.

"Shonna?" Inside, behind the locked door, I hear movement but she's not answering. "Shonna, let me in". I'm a little panicky now.  A glance at the clock shows she's been in there over twenty minutes.  She's not answering. I'm about to get a nurse when I hear the lock click and the door opens. As I enter the big square wheelchair-friendly room, her back is toward me and she is busy at the sink. I glance at the toilet seat and understand what has occupied her all this time, a two foot tall construction , made from toilet paper and trash from the wastebasket, a lovely white pyramid balanced above the water in the toilet bowl.  It is tall and balanced and an engineering feat, a marvel really!  And she is building another one with beige paper towels over the sink!

When she is seen by the ER doctor and what we know is explained to him, he is surprisingly quick to agree with our layman diagnosis. He just had a fellow doctor return from India after taking a course of mefloquine.  She is a surgeon and it took her eight months to recover from this brain splitting reaction to the drug.  She is so well that she has begun operating again. Eight months, he predicts, and Shonna will be herself.  In the meantime, she will be admitted to the psychiatric care unit for ten days.  A regimen of treatment will include therapy, drugs, intensive counseling and, eventually, outpatient services. It takes five days before the obsessive organizing, and counting of her things fades and she no longer prefers her 'collating' over our visits.  It's another five days before she emerges, a timid, hesitant shell of her former self.

After a quarter off , she returns to the university, insecure in her own ability to make sense of the written word, unable to approach people, and certain she will never get the grades she had before. Each day, however, a little bit more comes back and our worries over her eventual success fade until, eight months later, she is herself. She graduated the next year. I've not heard her say 'collating' since.




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