Have you seen my brother standing in the shadows?

A lack of services and the intractable nature of mental illness make for a bleak scenario.

By Sarah Dusseault

January 5, 2014

My brother John called me last summer to tell me that he had finally figured out our family secret. I was his mother, he said.

I am not, of course.
My brother is 38 years old, but I will always think of him as he was in his early 20s, when he was diagnosed with schizophrenia. His good looks landed him work as a model, and he was a math whiz.
Today, he is still attractive and wickedly smart at times, but his skin is weathered from years of homelessness and he is missing half of a finger on his right hand from one of his "stays" in a county jail. He is unmistakably homeless but still charming enough to persuade passersby to give him clothes or a beer, or to play a game of pool.
His homelessness always starts with stopping his medication. Eventually he gets into trouble, usually from self-medicating with alcohol, and bounces from incarceration to forced hospitalization. It has happened over and over. He spent Thanksgiving locked up in Twin Towers for stealing a $4 strawberry Budweiser.
His latest round of homelessness began last spring after his landlord lost his apartment building to foreclosure and all of the tenants were evicted.
John had stopped taking his medication a few weeks before he lost his home, blaming the fact that yet another Valentine's Day had passed without someone to share his life. Since then he hasn't accepted offers of help because he has stopped thinking rationally.
Not being able to help him is immensely frustrating. In my professional life, I have worked to build housing and create programs to end homelessness. But the system is broken, especially for homeless people with severe mental illness, like my brother. My family and I just keep hitting dead ends trying to get him help.
It's not that money isn't being spent on him. Study after study from across the country has demonstrated that the cost of dealing with people like my brother, who ricochet from the streets to hospitals and jails and back, is exorbitant. I estimate that, in the last year, the federal government, several counties, the state and local communities have spent more than $1 million on John.
And all of us — taxpayers, my family and John — are getting nothing for that money. The government could have bought him a cute single-family home in Pasadena with a full-time social worker and spent less.
My older brother Steve has tried to get appointed as John's conservator, but each time the matter has come before the court, John has convinced a judge that he is capable of managing his own affairs. John passes his days in conversation with imaginary people, but he is still capable of repeating a few memorized sentences that a judge accepts as proof he can care for himself.
For weeks at a time, he goes missing. Then he turns up in an emergency room, police station or hospital. He's been picked up for throwing himself at cars or belligerently talking to himself. He spent July in a hospital where he imagined that family members were with him. The hospital released him to a board-and-care facility, claiming he'd been stabilized, but he stayed only briefly before leaving.
In September, a friend found John asleep at my house. I called an outreach worker from Housing Works to try to get him help. They came and worked out a plan with John for housing and healthcare, but he changed his mind later in the day, walking away from the social worker, back into homelessness.
I found him again but couldn't persuade him to accept help. He says that I don't understand his profound loneliness and that my "options" are not what he wants. His appearance has deteriorated. He is thinner and his skin is blistered from sun and cold. I tried to feed him, but he wasn't able to sit still long enough to eat much.
A few days later, he was forcibly hospitalized for a couple of weeks but wouldn't allow the social workers to contact me. I again lost track of him until I checked the police records on his birthday, Nov. 13, and found out he was in jail.
There are programs that work to interrupt this kind of cycle, but there are far too few of them, serving far too few people. As a result, stories like my brother's are not unique.
I know from my professional experience that progress has been made to end homelessness. But I have also seen firsthand the overwhelming failures in parts of the system. Discharge plans after imprisonment or hospitalization are required, but they are rarely useful. And gaining access to programs that work remains extremely difficult. For most of the chronically homeless mentally ill, we waste large sums of money on ineffective interventions.
My family and I live in dread that one day we will get "the call" informing us that John has lost his life. But my brother never gives up hope that he will find a girl/job/apartment.
We had breakfast together recently.
He had been released from jail the night before and walked through the night to Pasadena. He called at 6 a.m., and I went to meet him.
We made big plans about getting him a place to live and connecting him with services. I left him at a barbershop about to open because he wanted to get cleaned up. I went back after dropping the kids off at school, thinking things might get better. But by the time I returned, he was gone.
For the next few days, I drove around with a full duffel bag of clothes and supplies looking for my brother. I found him eventually. His medication had been stolen and he was holding on to a brick wall, talking to himself, on Colorado Boulevard.
Sarah Dusseault was a senior policy advisor to Eric Garcetti when he served on the City Council. She was deputy mayor for housing and homelessness in the administration of Mayor James Hahn.

http://www.latimes.com/opinion/commentary/la-oe-dusseault-homeless-brother-20140105,0,4599082.story#ixzz2qBPfrfJY

LA Times Opinion pages answering "Have you seen my brother standing in the shadows?"

Re "Have you seen my brother standing in the shadows?," Opinion, Jan. 5

Sarah Dusseault's story about her brother' struggle with mental illness and homelessness was heartbreakingly familiar.
My sister with schizophrenia has been repeatedly homeless, jailed and hospitalized. We were fortunate, though, to have guardianship and conservatorship awarded in New Mexico. There is no guarantee of stability, but we have some leverage to help her.
Simply from a state expense view, keeping our mentally ill out of jails and hospitals saves money. But from a human standpoint, who is better to help, support and advocate for the broken? We definitely need the state's help, but its workers have office hours and large caseloads. The state needs the families' help too. Can't we all just work together?
Dusseault's efforts to help her brother sound tireless.
I know she can never give up. I hope her brother finds someone, maybe in group therapy, who understands loneliness.
Diane Wetherbee
Dana Point
Dusseault's estimate of $1 million in public money spent in vain on her schizophrenic brother in just one year is an eye-opener.
The decision made decades ago in California to empty our mental hospitals and basically dump sick people on the streets has led to this mess. Community mental health clinics and counseling to take care of these people have clearly not worked.
Homeless advocates have fought long battles against committing these people to mental hospitals where they actually could be taken care of. Being in an institution would mean that people like Dusseault would know that her brother was not in jail or wandering lost on the streets — and was instead safe and taking his medication.
Robert Newman
West Hills
For those of us who have a loved one with schizophrenia or bipolar disorder, Dusseault's poignant essay was hauntingly familiar.
It is difficult enough to help a child with a mental illness, but when he reaches adulthood, forget it. The courts and other parties, as Dusseault demonstrates, tend to favor his rights, to the frustration of his family.
Despite the incredible setbacks that Dusseault's brother has encountered, he "never gives up hope that he will find a girl/job/apartment." That line put a lump in my throat and a tear in my eye.
How can we sleep at night when our homeless brothers and sisters with mental illness wander the streets, withering away, as they rifle through trash cans for food?
David Tulanian
Los Angeles

http://www.latimes.com/opinion/la-le-0107-tuesday-mental-illness-homeless-20140107,0,2689256.story#ixzz2q84xmOdm

Teens' Mental Disorders Often Untreated in U.S., Study Finds

Posted on 2013-11-22 02:00:28 UTC
-- Robert Preidt

Shortage of child psychiatrists partly to blame

THURSDAY, Nov. 21, 2013 (HealthDay News) -- Less than half of American teens with mental health disorders receive treatment, and those who do get help rarely see a mental health specialist, a new study indicates.

The findings underscore the need for better mental health services for teens, said study author E. Jane Costello, associate director of the Duke Center for Child and Family Policy in Durham, N.C.

"It's still the case in this country that people don't take psychiatric conditions as seriously as they should," Costello said in a Duke news release. This remains so, despite a wave of mass shootings in which mental illness may have played a role, she and her colleagues noted.

The analysis of data from more than 10,000 teens aged 13 to 17 across the United States also showed that treatment rates varied greatly for different types of mental health problems.

For example, teens with attention-deficit/hyperactivity disorder, conduct disorder or oppositional defiant disorder received mental health care more than 70 percent of the time, while those with phobias or anxiety disorders were least likely to be treated.

The researchers also found that blacks were much less likely than whites to be treated for mental disorders, according to the study, published online Nov. 15 in the journal Psychiatric Services.

In many cases, teens received treatment from pediatricians, school counselors or probation officers, rather than mental health specialists. This is because there are not enough qualified child mental health professionals to handle the demand, said Costello, who is also a professor of psychology and epidemiology at Duke University.

"We need to train more child psychiatrists in this country," Costello said in a university news release. "And those individuals need to be used strategically, as consultants to the school counselors and others who do the lion's share of the work."

As many as one in five children living in the United States experiences a mental health disorder in any one year, according to a U.S. Centers for Disease Control and Prevention report.

More information

The American Psychiatric Association has more about teen mental health.

              

Eddy - The Mayor of Montauk Manor

By Beverly Maher

I had just closed my chicken and rib restaurant. I am not a person who enjoys sitting idly. I found an ad in the paper to be your own boss and sell a product that was advertised to be the best product for your skin. The company was Newskin. I liked the idea that I may be able to work from home. I contacted the promoter, he invited my partner Bob, and I to come to his home, meet his wife, and see what the company could offer me to promote the product. They were in West Babylon, not far from my own family. When we pulled up to the house, there was a farm stand just to the left of the house. It was dark, so we were not able to see much. They were a nice couple. Joe was younger than Joanne was. He was promoting Newskin she was supporting his venture. In our conversation, Bob and I learned the farm stand was a mutual venture. We were also informed; Joanne owned and operated five adult homes on Long Island as well. Ambitious and interesting people. I liked the product. I told them I would try it and signed up. I had been doing it for a few weeks when I mentioned I was looking for part time work to supplement my income between sales. Joe mentioned his wife was looking for an administrator for one her homes in Lindenhurst. I called Joanne and she told me to come down the next day to find out the details. We walked around the huge house and she told me what she expected of an administrator. I met the residents they seemed gentle enough. They greeted me with smiles. The cloud of smoke that greeted me was surprising. The main door, which was actually the back door, enters into the smoking room. They had coffee cups and there was not much conversation going on. Most of them looked disheveled, whiskers on their chins. Some could use a shower. Joanne explained how the state regulated the home and everything had to be to the state's standards. The state regularly visited the home to ensure the safety of the residents. The house had a capacity for 29 beds, meaning 29 residents could occupy the home at one time. Joanne had 24 filled and it was very important to fill the rest. That would be the administrator's responsibility. I met the cook, who doubled as the aide, and I met the housekeeper. It was a good feel. I wanted to take on the challenge and asked Joanne when I could start. I had not mentioned to Jim or Joanne that I was leaving Bob. I was considering living in Suffolk County to be near my family already. I was waiting for the School year to be finished for Lauren, my special needs daughter. I started the next Monday. The last state visit was posted on the wall and I took it to my desk. There were 80 violations on it. I knew that would be my priority, both to learn the violations and to fix the violations. I left the door open to be able to listen to goings on outside my door. The smoking room was right outside the door. While I was reading, I heard a faint knock at my door. A man's head peaked in and asked if I had a minute. Sure, come on in. "I'm Eddy." He stated. "I'm Beverly, come in and have a seat, I replied." Eddy went on to tell me how he became a resident of Montauk Manor. His substantive demeanor was impressive. I certainly was curious as to why he was here. He was a man of about 60. Too young to be one of the elderly residents. Montauk Manor was diversely mixed with elderly residents, some Vets that were elderly, but most of the residents were mentally ill. Eddy told his story.

"I was married for 25 years. I got depressed a lot. I kept losing jobs. One day I broke down and did not want to do anything. They put me in a hospital and put me on Lithium. It started to get better, but my wife did not want me back. We had a daughter. She is such a good daughter! She lives in the neighborhood!" His voice had a pitch, one you would hear if someone was from the city. "I go to her house and I get to see my grandkids, we have dinner together, it's great!" "That is nice Eddy." He was clean, he was shaved, his matching outfit seemed out of place at Montauk Manor. I found out the residents called him the mayor. I could understand why.

For the next couple of months I was very busy. I found a book for case management and found out that I would have to write about all the residents and keep up to date any and all issues corresponding to them. I would take some time out of my day to leave the office and talk to the residents. I informed Joe and Joanne that I lost interest in selling Newskin. I was excited about the new venture. Rob was 25 years old. A handsome young man. He was clean and never had to be reminded to take a shower. He wore very nice clothes. As I would learn he would receive a package from Florida, where his parents lived. His mother made sure he had everything he needed to keep up with his appearance. Rob was one of the few residents who did not need to borrow money for cigarettes and coffee right after they received their allowance. That was a common theme. I would see this throughout my adult home experiences with the exception of Merryville. Merryville was an adult home that specialized in Alzheimer's and Parkinson victims. Rob paced; he walked with a tempo. He did not speak. He knew how, he just chose not to. He would answer if spoken to, but only single syllable answers. He would awaken at around 8am, have breakfast and start pacing. He would go to his room walk to the end, turn around and walk to the living room. He would get to the end, turn around, and walk to the smoking room. He would have a cigarette standing and start pacing again. He did this all day long only stopping to eat and nap. His mother would occasionally call to speak to him. He simply answered in one syllable, yes, no. I spoke to his mother on a few occasions before I handed him the phone. She told me the medication he was on now was a miracle med. He used to be uncontrollable, at least now he was calm.

Josephine was a gas. She would walk all over town. All she wanted to do was work and earn money so she could buy coffee and cigarettes. She worked for Joanne. Joanne had a flower stand right next to Montauk Manor. When she needed Josephine at the farm stand next to the house, Josephine would walk the distance and work for the day. She was very small and frail looking. Her work ethics were extraordinary. She had the ability to work long hours even on hot days. Josephine was outgoing, very friendly. My sister came by once with a couple of her daughters and they loved Josephine's banter. She told them how beautiful they were. She shared a few funny stories with everyone. We all chuckled. Josephine was on medication for depression and anxiety. At that time, she was compliant with her medication and she was able to function in her day-to-day life. In private, she would tell me stories of her many mood swings and why her family was not anxious for her to live with them.

We had a few vets in the house. They were sweet, soft spoken and polite. They smoked and drank coffee throughout the day. The aide had to guide them to take showers and change their clothes. She would also shave them when she was not cooking. The housekeeper was good. Montauk Manor was a mansion and she was expected to keep up with all the residents' rooms. I discovered through the violation sheet how important it was to make sure the residents were not doing anything like using extension cords irresponsibly. The cook and I would help Helena, the housekeeper in the afternoons, after lunch. Helena would assist with the lunch. After we changed all the curtains in the living room and had it painted we started tackling the bedrooms. If they needed painting, we had Joanne set up the painter. We would do curtains and drapes, depending on the need. Before we knew it, Montauk Manor was looking like a real home.

That summer I decided to create a garden and grow the vegetables for the residents. Joe came over and roto tilled the grass covered area that would be our garden. I chose the area in the back, outside the smoking room window. I wanted the residents who did not go out to watch the progress of the garden. I worked hard to clean out the grass and get the soil ready. Eddy would be smoking his cigarette and watching me. The vets would be outside watching, smoking, drinking from their dirty Styrofoam cups. Eventually the garden was ready for planting. I planted tomatoes, peppers, eggplant, string beans. I planted anything we could use in the day to day cooking. The garden started to look like a vegetable garden. The plants were growing and we were all able to see nature grow. Eddy was watching me pick the weeds one afternoon and he announced, "We have a real victory garden!" His daughter was picking him up that day and while he was waiting, he said, "I am going to buy you a new pair of sneakers. Those sneakers you are wearing are all worn." I smiled at his thoughtfulness. I always wore white keds in those days. 

A couple of weeks later Helena ran into my office. She told me that Eddy looked sick and to come immediately to his room. After seeing Eddy, I called 911. They rushed him to the hospital. His daughter called and kept us abreast of his progress. He was having thyroid problems because of taking Lithium and would no longer be able to take it. When he returned to Montauk Manor all were very happy to see the mayor home again.

The state came in and inspected our home. I received a few violations and I had fixed all the old violations. One of the violations was that I was not a licensed administrator. I applied for my administrative license. I had all the qualifications except one. I did not have the experience in adult homes. This was my first and only experience. I would need five years to fulfill that goal. I was at Montauk Manor for one and one half years. I counted this towards my license. I had a long way to go.

I worked in a number of adult homes after that. Some hired me to assist with bookkeeping or general assistant to the administrator for helping with correcting violations. One hired me as a coordinator because they would not replace the incompetent administrator they had. Sometimes I worked as an aide, just to get the time in.

Two years after my time at Montauk Manor I was visiting my own daughter in Brunswick Psychiatric Hospital. Lauren had started exhibiting signs of schizophrenia while I was at Montauk Manor. It was difficult to find the right medication to keep her from experiencing the strange world of mental illness. As I walked to the back where the entrance was, I saw a man sitting on the stone bench with the sun beating down on him. He was squinting and I kept staring to see why he looked familiar. As I got closer, a smile started forming on my mouth. He was covering his eyes with his hand to block the sun, but it was unmistakable. As I got closer, I noticed he had at least a week of growth on his face, his clothes were dirty and he looked disheveled. He was wearing a pair of sneakers. They had no shoelaces; they were well worn and dirty. He noticed me. We smiled together, when our eyes met. "Hello Eddy." "Well hello there!" he said with that pitch in his voice. I did not ask why he was here. "Nice sneakers Eddy!" I said. He looked down at the white keds and said, "They're yours, I bought them for you that day I went with my daughter shopping. Do you want them?" "No thank you Eddy, you keep them for me.""Ok" he replied "Take care Eddy." I answered. I walked into the hospital to visit my daughter, my eyes starting to well up. He was gone when I came out. It is a sad world for the mentally ill.

The Community Mental Health Act of 1963

FILE - In this Oct. 31, 1963 file photo, President John F. Kennedy signs a bill authorizing $329 million for mental health programs at the White House in Washington. The Community Mental Health Act, the last legislation that Kennedy signed, aimed to build 1,500 mental health centers so those with mental illnesses could be treated while living at home, rather than being kept in state institutions. It brought positive changes, but was never fully funded. Former U.S. Rep. Patrick Kennedy will host a conference on Oct. 24, 2013 in Boston, to mark the 50th anniversary of the act, and formulate an agenda to continue improving mental health care. (AP Photo/Bill Allen, File)

PROVIDENCE, R.I. (AP) — The last piece of legislation President John F. Kennedy signed turns 50 this month: the Community Mental Health Act, which helped transform the way people with mental illness are treated and cared for in the United States.

Signed on Oct. 31, 1963, weeks before Kennedy was assassinated, the legislation aimed to build mental health centers accessible to all Americans so that those with mental illnesses could be treated while working and living at home, rather than being kept in neglectful and often abusive state institutions, sometimes for years on end.

Kennedy said when he signed the bill that the legislation to build 1,500 centers would mean the population of those living in state mental hospitals — at that time more than 500,000 people — could be cut in half. In a special message to Congress earlier that year, he said the idea was to successfully and quickly treat patients in their own communities and then return them to "a useful place in society."

Recent deadly mass shootings, including at the Washington Navy Yard and a Colorado movie theater, have been perpetrated by men who were apparently not being adequately treated for serious mental illnesses. Those tragedies have focused public attention on the mental health system and made clear that Kennedy's vision was never fully realized.

The legislation did help to usher in positive life-altering changes for people with serious illnesses such as schizophrenia, many of whom now live normal, productive lives with jobs and families. In 1963, the average stay in a state institution for someone with schizophrenia was 11 years. But only half of the proposed centers were ever built, and those were never fully funded.

Meanwhile, about 90 percent of beds have been cut at state hospitals, according to Paul Appelbaum, a Columbia University psychiatry professor and expert in how the law affects the practice of medicine. In many cases, several mental health experts said, that has left nowhere for the sickest people to turn, so they end up homeless, abusing substances or in prison. The three largest mental health providers in the nation today are jails: Cook County in Illinois, Los Angeles County and Rikers Island in New York.

"The rhetoric was very highfalutin. The reality was a little more complicated, and the funds that were provided were not adequate to the task," said Steven Sharfstein, president and CEO of Sheppard Pratt Health System, a nonprofit behavioral health organization in Baltimore.

"The goals of deinstitutionalization were perverted. People who did need institutional care got thrown out, and there weren't the programs in place to keep them supported," said former U.S. Rep. Patrick Kennedy, the president's nephew. "We don't have an alternate policy to address the needs of the severely mentally ill."

He is gathering advocates in Boston this week for the Kennedy Forum, a meeting to mark the 50th anniversary of his uncle's legislation and an attempt to come up with an agenda for improving mental health care.

The 1963 legislation came amid other changes in treatments for the mentally ill and health care policy in general, Appelbaum said. Chlorpromazine or Thorazine, the first effective antipsychotic medicine, was released in the 1950s. That allowed many people who were mentally ill to leave institutions and live at home.

In 1965, with the adoption of Medicaid, deinstitutionalization accelerated, experts said, because states now had an incentive to move patients out of state hospitals, where they shouldered the entire cost of their care, and into communities where the federal government would pick up part of the tab.

Later, a movement grew to guarantee rights to people with mental illness. Laws were changed in every state to limit involuntary hospitalization so people can't be committed without their consent, unless there is a danger of hurting themselves or others.

Kennedy's legislation provided for $329 million to build mental health centers that were supposed to provide services to people who had formerly been in institutions, as well as to reach into communities to try to prevent the occurrence of new mental disorders. Had the act been fully implemented, there would have been a single place in every community for people to go for mental health services.

But one problem with the legislation was that it didn't provide money to operate the centers long-term.

"Having gotten them off the ground, the federal government left it to states and localities to support," Appelbaum said. "That support by and large never came through."

Later, during the Reagan administration, the remaining funding for the act was converted into a mental health block grant for states, allowing them to spend it however they chose. Appelbaum called it a death knell because it left the community health centers that did exist on their own for funding.

Robert Drake, a professor of psychiatry and community and family medicine at Dartmouth College, said some states have tried to provide good community mental health care.

"But it's been very hard for them to sustain that because when state budget crunches come, it's always easiest to defund mental health programs because the state legislature gets relatively little pushback," he said. "Services are at a very low level right now. It's really kind of a disaster situation in most states."

Sharfstein points out that most mentally ill people are at a very low risk of becoming violent. He said it's unthinkable we would go back to the era when people were housed in "nightmare" conditions at overcrowded, understaffed and sometimes dangerous state hospitals.

"The opportunity to recover is much greater now than it was in 1963," he said.

But for those who do not take their medication, don't recover from their first episode of illness and don't seek treatment and support from professionals, they are vulnerable to homelessness, incarceration and death, he said.

Linda Rosenberg, president and CEO of the National Council for Behavioral Health, counts among its 2,100 member organizations many of the original community mental health centers that were built under the 1963 legislation.

"Whenever you pass a piece of legislation, people would like to think that you've solved the problem," she said. "It did some very important things. It laid some ground work. It's up to us now to move forward."

Lauren has a unique personality. She has a way of saying things that make me stop, listen, smile often. Here are just three examples. 

Lauren was on the phone with Kourtney. They were discussing Lauren's jewelry business. Lauren always gets Kourtney to talk about her jewelry business. She has an interesting business acumen. She's a great salesperson.  Lauren is always coming up with ideas for her business, sometimes these ideas don't even pertain to her business or make much sense.  Kourtney is living in US St. John's as an archaeologist.  Lauren says to Kourtney " Kourtney if you could collect shells and send them to me, I can carve them to make jewelry! Don't you think that's a great idea!" I don't know what Kourtney's answer was but after they hung up Lauren came into the living room where I was on the couch. She didn't start talking to me directly at first, it was just a statement in general. "I think this the ticket to my career; Kourtney lives in the tropics!! This is my ticket to a great career don't you think Ma?!" she say's excitedly.

Another time Chyna and I are sitting on the couch,  Lauren is talking to no one in particular again "I'm talented, I'm really talented. I looked at Chyna and she is looking at me seemingly saying " well if you say so." Chyna is our dog, she is an adorable shih tzu.

 Lauren and I were discussing her living with Phillip. I personally do not think it is a good idea. She has more stability at home during the week. She spends the entire weekend with him, they go out to eat, they stay up late, they stay in bed all morning. They have a wonderful time together. I'm not against her freedom, I'm afraid of her forgetting to take her meds and such.  At home she has consistency. Anyway,

I didn't tell her how I felt, instead, i said "we'll see, maybe one day." She seemed to be satisfied with that answer and a few minutes went by and out of the blue she said " If i live with Phillip, I don't want to pay a left hand and foot for my website".  Lauren has a web site, she sells her hand made jewelry on line. I took the statement to mean she didn't want to pay and arm and a  leg. 

Kicked Out Of Friendly's
                          By Kourtney Donohue
                                   

We got a booth in the back of Friendly's Ice Cream restaurant.  The waitress was visibly irritated that she was serving five loud, giggly, pre-teenage girls ice cream sundaes that were bigger than their heads.  As we began to inhale our chocolate fudge smothered sundaes, Kristie, my sister, was reminded of something she recently heard, "Someone told me that chocolate and cocaine come from the same plant."  Lauren, our first cousin, stopped eating her sundae, stared wide eyed across the table at Kristie and demanded to know more, "Kristie am I eating cocaine right now?  Am I Kristie?  I'm eating cocaine?!?!"  Kristie realized what she'd done and began to stutter "uhh well, but it's-- no Lau, it's not the sa--"

Lauren interjected before she could finish, "Kristie tell me the truth, am I eating cocaine?"  Kristie said "No Lau!" but she giggled nervously.  I attempted to answer too, but I also began to giggle nervously.  Lauren continued to panic and she thought we were mocking her because we couldn't stop laughing, "Oh my God I'm on cocaine!  You gave me cocaine!  I'm on cocaaaaaaaaaaine!?!?"  Lauren slammed both hands on the table rocking back and forth screaming at the top of her lungs "OH MY GOD I'M ON COCAINE!!!!!  I CAN'T BELIEVE I'M ON COCAINE!!!!!"  We tried to stop her, "Lauren no you're not! shhhhhh! You are not on coca--". I couldn't say it with a straight face, I couldn't control the nervous giggle.  People were looking at us.  We were worried the waitress was going to come over.  Lauren wouldn't listen to us.  She wouldn't calm down.  She panicked even more.  She would not stop screaming. She finally stood up from the table and she screamed out to the restaurant that -oh my god, she was on cocaine!  I saw the waitress heading over to us.  We jumped up and shuffled Lauren toward the bathroom, dodging the waitress as she stomped over to address the big scene we made.  Lauren ran ahead of me into the bathroom, slammed the door and locked it before I could slip in with her.  She refused to let us in.  We were all banging on the door, "Lauren please let us in."  "Open the door."  "You are NOT on cocaine."  All we could hear was Lauren wailing from the inside, "I CAN'T BELIEVE YOU GAVE ME COCAINE!!!!  I CAN'T BELIEVE I'M ON COCAINE!!!!"    

The waitress came up behind us at the bathroom door and demanded to know what was going on.  I said, "Please give me a chance to talk to her.  You don't understand".  But I didn't know how to make her understand Lauren.  Lauren has a lot of fear.  She often overreacts.  Ok I'm exaggerating, she always overreacts.  She interprets things kind of like Amelia Bedilia, the maid from those children's books - she often takes things literally.  One time she read in a Cosmo magazine that dark eyelashes accentuate the eyes, so she plucked out all her blonde eyelashes, even though most of them were blonde!  And she is very in touch with her how she feels, whether it's good or bad feelings.  She is honest about those feelings, which is unlike most people.  Everyone in the family knows this.  That's why when Aunt Janine was getting ready to go to her 20th high school reunion and didn't believe us that she looked great she said, "I want Lauren's opinion".  Lauren said, "You look hot Aunt Janine!".  Aunt Jan persisted, "But does this outfit make me look fat?".  Lauren looked her up and down and said, "No way! Well hold on, turn this way, ok maybe a little bit from this angle but other than that you look fabulous Aunt Janine! You look fabulous!".  We spent the next hour convincing Aunt Jan to go to the reunion.  Everyone trusts Lauren's opinion.  Everyone loves her honesty (most of the time) and her unique enthusiasm for life.  But when she freaks out - she freaks out.  And not too many people understand it.  But who really understands someone else's perspective?  And how can anyone really explain another's perspective?  That is why we share stories, feelings, thoughts...so that we can get a little glimpse into the perspective of others.  But at the time - there was just no explaining Lauren's perspective to the Friendly's waitress.                

The waitress refused to listen to me, "You all need to leave" she ordered.  I pleaded, "No please, you don't understand, she is not on cocaine".  The waitress said, "Well it sure seems like she is!"  It didn't help that Lauren was screaming from behind the locked door that she was indeed, on cocaine.  I told the waitress that we have to calm her down to get her out.  Finally she let us do this and Lauren agreed to open the door a crack, but wouldn't come out.  I whispered to Lauren through the crack of the door, "Lau, the waitress is kicking us out of here.  Please tell her that you're not on cocaine."  Lauren opened the door a little more, looked at the waitress with tears in her eyes and cried, "YES I AAAAAAAMMMM! I'M ON COCAINE! I CAN'T BELIEVE I'M ON COCAINE! OH MY GOOOOOOD!" 

"That's it you're all out of here!" the waitress said, she was raising her voice and going to get a manager.  This was our opportunity, we pushed our way into the bathroom and drilled it into Lauren that she was not on cocaine, and eventually, she began to calm down.  We said, "Lauren we all ate the chocolate, we've been eating it our whole lives, we are not on cocaine."  She looked at us with softer eyes, "I'm not on cocaine?  You promise Kourtney?!"  "Yes Lau, you're not on cocaine."  She then howled her iconic loud Lauren laugh "AAAAAghgghhhhhahahaaahahahaha.  I can't believe I thought I was on cocaine!  Aaaahahahaahahahahaahah"  Mouth wide open, head thrown back, out of breath rocking laughter.  That's the Lauren we knew was in there.  Always able to laugh at herself.  Always keeping us laughing.  The waitress still didn't believe us, we tried to get her to let us finish our ice cream but she wasn't having it.  We were kicked out of Friendly's. 

 Outside we sat in the parking lot waiting for one of our parents to pick us up. Lauren
knew she wasn't on cocaine. We were all angry. Not at Lauren or the situation, 
but because the waitress didn't even let us finish our ice cream. Worst of all;
how dare she accuse our cousin of being on cocaine!