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Heart - 14. Cynthia - Guardian

Cynthia goes above and beyond for both Vladimir and Tyson, bringing her into conflict with the formidable Edith Belmont-Lovett.

The first thing Dr Cynthia Elicott saw when she bypassed the airlock style system of locked security doors into the adolescent wing of the psychiatric ward made her smile. Since they arrived in the same place on the same day, Tyson from the Emergency Department and Vladimir from the high-dependency unit, the two had been nearly inseparable. Both looked a bit drowsy from their medications - she had recently changed Vladimir's antipsychotics to a different branch in hopes of getting his aggressive hallucinations under some sort of control and increased Tyson's antidepressants and benzodiazepines to keep him from actively trying to hurt himself. It was powerful stuff, and she was not surprised at all to find them dozing on their favourite spot on the couch by the common room television. Tyson was fast asleep, his head resting comfortably on Vladimir's shoulder, but the fifteen-year-old was more alert and waved at her.

She'd quickly grown fond of both her young patients, she reflected as she buzzed herself into the nurse's station and made her presence known. Vladimir she was treating for no charge, organising an affordable team of trusted colleagues to take over when he was discharged from the unit. She skimmed through his file, her eyes picking up on an incident yesterday in which the teenager's psychosis flared up.

"Hi, are you Vladimir Tchaikovsky's primary carer?" Cynthia asked an older woman whose name she could not remember.

"That would be me until the night shift, Dr Elicott," a young man with a babyface, short hair and oval glasses piped up. "I'm Evan."

"Hi, Evan!" Cynthia shuffled over and had the nurse examine the file with her. "Vladimir had a bad day yesterday - can you tell me about that?"

"Ahh. Auditory hallucinations spiked, and delusions too, I believe, but I was elsewhere during the worst of it. Janet was looking after Vladimir yesterday," he pointed out the woman's signature with his thumb. "One of our pencil sharpeners went missing from the education unit, and Vladimir had some strong delusions that a monster stole it so it could hurt Tyson Belmont-Lovett."

"Who took it?" Cynthia frowned. It was evident to her. It must have been obvious to the nursing staff as well.

"Officially, it was accidentally taken and anonymously returned," Evan explained with a soft, calm voice. She decided she liked him.

"That Tyson boy," the older woman broke in. "Neil covered for him."

"Why would he do that?" Cynthia asked, cogs turning in her head. This was a serious incident, and she should have been told about it, but where could she go from here?

"Search me! I've seen that man return an extra Kit-Kat because two of them came from the vending machine," the woman rolled his eyes. "He's so anally retentive I wonder if he'll suck up the toilet one day."

"Violet!" Evan was covering his mouth as he giggled, but the woman shrugged and left the nurse's station through the door to the high-dependency unit. "I was Tyson's nurse earlier yesterday. He seemed to be doing very well when I handed him over to Neil."

"You have to be careful with him," Cynthia warned, biting her glossy bottom lip. "He's in a cycle of self-harm and what can come across as a good mood can mean he's pleased about finding a way to hurt himself. He's a good boy at heart, I really believe that, but he's also very bright and resourceful, and he can be incredibly manipulative if he's looking to hurt himself. Watch him with both eyes, okay?"

"Do you think he played me?" Evan asked, the omnipresent smile on his face. "Do you think he planned it?"

"I wouldn't say he played you," Cynthia reassured him, leaning against one of the empty desks. "But I've never met someone his age so determined to kill themselves. He has a history of making plans with dangerous intent and always following through on them, and his ability to spot and seize opportunities that most people wouldn't think of... frankly, it scares me."

"Should you transfer him to the back, then?" Evan asked her, and while it was a reasonable question, she didn't like it. "If he needs total supervision, that's the best decision for him. That's what the high-dependency unit is for, after all."

"I don't want to separate him from Vladimir," Cynthia admitted, speaking quietly. "If I take any more of his freedoms away, particularly the only friend he's ever had, then he'll never trust me again."

"If it's for his own safety, wouldn't it still be the best option? He'll come to realise in time that you did it to help him."

"Well, maybe that's the case, but it's not just about that. I don't have the time to rebuild a relationship with him if we go down that road," she explained wearily. "If I have any chance of keeping Tyson afloat, then I need him to have faith in me because any day now his mother's going to drag him out of here by his ear and the whole cycle starts all over again. That woman is killing him and she doesn't realise it. Or she doesn't care."

"We'll take care of him," Evan noticed that she was frazzled and upset. "Vladimir, too. When his delusions and hallucinations peaked during lunch yesterday, Janet gave him oral medication and took him to the sensory room. Ron stayed with him one on one. He was out in no more than twenty minutes - still shaken and a bit out of sorts, but if that's any indication, then you're right, and we don't need to place him in seclusion."

"Oh, that is some good news!"

Cynthia returned to Vladimir's file, reading about the incident and the timely, and most importantly humane, method of resolving it. Her blood boiled when she remembered some days ago when she officially took over as Vladimir Tchaikovsky's primary doctor. Sedated, isolated and restrained to a bed for most of the day when his agitation was brought on by nothing but confusion and terror. Alice, Neil and Sue hated using such restrictive interventions on him, Cynthia knew, but when it was Dr Shrubb's directive, they had little choice but to comply. Vladimir was a tragic boy. The symptoms of schizophrenia did not often arise until at least early adulthood - it was rare in children and teenagers, yet Vladimir had his first psychotic breakdowns at the tender age of six. Since then, the public system had been dropping the ball on him, letting him fall into relapse after relapse until the boy burned down the entire science wing of the school he attended, believing that it was his chance to slay "the three-headed man" that allegedly caused his friend's death.

Ironic, she thought as he closed the file and thanked Evan for his input on her way back to the ward. Chase Lovett aims to defund the mental health service if elected the state premier. Even as his son is triggered into repeated suicide attempts, he has little faith - or understanding - of what it is we do and how necessary we are.

"Hello, boys," Cynthia greeted her patients once more, joining them by sitting with them on the couch, her clipboard and attached pens in her lap. "What are we watching?"

"Survivor," Vladimir replied with a smile as his hand gently stroked Tyson's dark curls. "I have no idea what's happening, but they like to complain."

The physical closeness the two shared violated the rules of the AIU - or any inpatient facility. Consensual, yes, but it was inappropriate for patients to share physical contact. Cynthia believed, however, there were exceptions to every rule. A loving touch was something Tyson had not experienced before, and the budding relationship was beneficial to both boys, in her opinion. Cynthia had attempted to petition the administration to make specific allowances - within reason of course, but she found that the nursing staff had already agreed to turn a blind eye to the innocent stuff. Clothes on, no inappropriate touching or kissing, no entering each other's rooms. After seeing so much anger, pain and distress marking Tyson's face for such a long time, it was a relief to see him looking so peaceful and... happy. How could anyone look at that and decide it was a bad thing?

"I never liked Survivor," Cynthia grinned. "I like Judge Judy. She's my guilty pleasure." Vladimir chuckled, and she beckoned with her head. "Come and have a chat."

She giggled as Vladimir tried his best to slither his way out from under the younger boy without waking him. He didn't succeed. Tyson seemed to know immediately that his friend was heartlessly abandoning him and stirred, tightening his grip.

"No," he ordered.

"I have to see Cynthia," Vladimir defended himself, trying his best to detach his friend's fingers from around his arm. "Stooop!"

"Fuck Cynthia," Tyson grumbled, not entirely out of the dream realm just yet.

"You're not off the hook either, Tyson!" Cynthia shocked him by speaking with him, amused by the sleepy boy's words. "I'm coming for you next after you wake up a bit. We've got a review to get through, and Mum's coming in."

"Oh. Oh!" Tyson's head swivelled, and he realised she was right next to him.

"Oh, oh!" she mimicked him in good humour, standing up and following Vladimir outside. He liked to have his appointments outdoors, and Cynthia was growing to look forward to sitting in the swing chair by the garden as well. "How are you, Vlad?"

"That depends! Are you asking about my mood or my voices?"

Vladimir was always so chipper and sweet during their appointments. He was polite, courteous and honest by nature, and it was unfortunate that the boy's diagnosis and reputation would likely overshadow the purity of his soul in the eyes of many people, especially with the work Tyson's father was doing to drive fear of the abnormal into his constituents. It was great that the Tchaikovsky family supported Vladimir wholeheartedly. He deserved nothing less, and he was optimistic about his recovery.

"First tell me how you're feeling today, then tell me about any voices you're hearing."

"I'm good, I suppose. A bit down. I don't like the new pills very much. They make me so tired, and I'm sick of being tired. And tired of being sick."

"Yes, Abilify can throw you around a bit while you get used to it," she explained, enjoying the way he gently rocked their seat back and forth with his foot. "Is it the same as the other times you've begun a new medication? Or is this worse?"

"Oh, it's no different to the usual," he admitted with a chuckle. "I'm just having a bitch."

"Hah!" She grinned. "Well, that's good news. Keep me updated, alright? The heavy stuff has been effective at unscrambling your eggs when you've had rough days, so I'd like to stick it out for at least a few weeks and the side effects will get easier to deal with. How about the hallucinations, Vlad? Are you seeing, hearing or feeling anything?"

"I hear things a lot," Vladimir shrugged, looking up at her. That he frequently made eye contact was a good sign. "Sometimes it's like an episode of The View. Mostly it's just Her."

"Her. Yes. She's the one who sings to you so often," Cynthia confirmed, scribbling down on her pad. Gosh, my writing's illegible, she thought. In the unlikely event someone breached her files, they wouldn't understand a word of it. "But since yesterday in particular, I mean. What has it been like for you? Do you feel things and see things that aren't there or is it just the voices?"

"I... I don't really know," he stammered. "I get confused because there are all these people talking at once and they all have their own opinions and ideas and facts and theories and nobody ever agrees on what the truth is!"

"I don't know is a perfectly acceptable answer," she reminded him gently, aware that he was getting agitated. He spoke about his illness so candidly with his friends and family, even to the nurses, but he was skittish with her. She guessed it was largely thanks to Dr Shrubb's criminal overuse of keeping Vladimir caged like an animal when his symptoms worsened. "There aren't any right or wrong answers, Vlad. You can't get in trouble for telling me the truth."

Right away, he remembered who he was talking to, and he seemed to relax and stretch out, letting the warmth of the sun wash over him. Better not be out here too long without sunscreen, she thought.

"I see Alexey a lot," he spoke when he was ready. "He's always angry at me for letting him die."

"Alexey Ivanova," Cynthia confirmed.

When Vladimir was severely psychotic some days ago and suffering from schizophasia - his thinking was too scattered to form intelligible sentences - he muttered about seeing Alexey. Witnessing his death. Causing it. After she rescued him from the seclusion room and personally calmed him down, she investigated for herself. Masha Tchaikovsky, Vladimir's mother, had a lot to say.

He's had these fits ever since he was around three years old. I thought he just had a wild imagination - you know, imaginary friends and playing pretend. I didn't realise until he was five or six that it wasn't normal - that he wasn't able to come out of these make-believe worlds, and he thought his imaginary friends were real. We did what we could, but he needs care that we can't afford. Please help him, Dr Ellicott. He's the apple of his father's eye, and everyone in our community adores him, especially his three brothers. Sometimes he loses control and we need to bring him to the hospital, but we managed - until the accident. Alexey Ivanov was Vladimir's best friend growing up. They loved each other. More than friends. I knew it before they did. And Alexey was so good for my son. He was patient and understanding, and I loved him like my own. But when Alexey fell from a bridge into the river and drowned, Vladimir lost it. He blamed himself, and then he blamed a demon. He always had trouble with his eyes and ears playing tricks on him, but never like this. I don't want to lose him, but nobody in this whole wretched system seems to care about him.

It was Tyson who begged Cynthia to take on Vladimir as a patient, even though his family was unable to pay her fee. It surprised her. Tyson showed genuine empathy that day, asking about schizophrenia and what it might mean for his friend, and then asking if she could spend her time with Vladimir instead. The selfless gesture was an unexpected and surprising one, and there were three reasons she did not refuse him. Firstly, she wanted to encourage Tyson's cautious steps away from the toxic foundations his parents built him on. Secondly, she was a sucker for a tragic story, and hearing about Vladimir's endless loop in the public sector pulled her heartstrings. Thirdly, it was never about the money. Rich people paid her to 'fix' their misbehaving children quite often. When someone needed her, she was not going to refuse them.

"Do you see the man?" She asked him after a long pause. "With three heads?"

"I did yesterday, but not today. He laughed at me last night, but that's all. I have not seen him," Vladimir explained.

"That's a step in the right direction," she smiled at him, and he chuckled and looked at his hands. "Now, I want to know everything the voices have been saying. She, the main woman, is she giving you orders? Or is she just singing?"

For the next fifteen minutes, Vladimir told her all about the things he heard, the things he saw and the things he felt. She listened carefully, pausing him to elaborate on certain things, and the two engaged in a healthy dialogue. As a person, Cynthia was sad that the poor boy was so far removed from reality, but as a professional, she found him fascinating. Auditory hallucinations were very common, and visual hallucinations popped up frequently as well, but tactile hallucinations - touch - were rare. To top it off, Vladimir experienced all three of them! The visual and tertiary tactile hallucinations were consistent with the trauma of losing his friend and the delusion that a monster was attempting to harm the people Vladimir loved, and to a point, same with the voices - but there was a lot more going on with his auditory hallucinations. They were inconsistent. The dominant voice Vladimir referred to only as "She" was often comforting, although she was paranoid and easily frightened, instructing the boy on who his friends and enemies were. The monster spoke as well, as did Alexey, and occasionally a few other whispers Vladimir did not recognise, sometimes speaking with each other or with him. The poor lad had good reason to be confused and scared!

"How much of this are you comfortable with me discussing with Masha?" Cynthia asked as they concluded their session.

"Oh, you can tell her anything," Vladimir beamed, and Cynthia was happy to hear that. Open, trusting communication between a patient and their parents was healthy. "Just... please don't tell Tyson."

"I'm not legally allowed to, even if I were inclined to do so," Cynthia reminded him with a handshake. "Whatever you wish to share with him is up to you."

With Vladimir's appointment concluded, Cynthia sighed as she returned to the nurse's station and returned the file she'd borrowed for reference, and she took Tyson's. She needed to be prepared for this. A psychiatric review was standard every week or so, to sit with the patient and their guardians and discuss progress, concerns and goals. She wasn't new to children who made life difficult with their refusal to comply, nor were intolerable parents uncommon. But Tyson and Edith... this was going to be a nightmare.

When she found Tyson in his room, he seemed to have smartened himself up in record time. He looked sharp and alert, and he'd also changed into a nicer, creaseless shirt and neatened his curls. He wore black pants and laced up shoes on both feet, even though he still put minimal weight on his injured one. Cynthia wished he would accept painkillers - but he was addicted to the pain, in a sense. It reminded him of the only freedom he ever truly had - to inflict harm on himself. It was a release. A comfort. That was something Cynthia hoped to change - if Edith did not snatch him from under her.

"You should have just let me go home and die from the start," he muttered when he saw her, and she noted the fear and misery in his eyes.

"Is that what you want, Tyson?" She asked him gently, leaning against the door. "To go home today and die?"

"... No," he replied meekly.

It was jarring to see him shift from Tyson Belmont-Lovett to just Tyson. Dropping the elements of himself that were moulded by his parents left him open and vulnerable, and he was always so shy and scared of the parts of himself he likely did not know existed until recently. He was a good boy. A conscientious boy. But as far as she could understand, he did not even realise how traumatised he likely was from his upbringing thus far. His brain was protecting him from itself. Though, he was making some good progress since she took him from the toxic home environment. Helping him think for himself and slowly learn to feel and process his emotions in a healthier way, rather than repressing his feelings and letting them spew out in fits of rage and aggression.

He believed the problem was his home environment, and no doubt he was correct to a fairly large degree, but she thought it ran deeper than that. Much deeper. Simply removing him from his home environment would not be enough. The first and only escape Tyson identified was to commit suicide - that was a much bigger problem than mere desperation. Early in his treatment, he reported that he was addicted to hurting himself - addicted to killing himself. There was far more trauma to unpack and process before she believed he would be able to break the cycle rather than temporarily stray from it. Tyson, thanks to years of cognitive dissonance, was an amalgamation of complex and conflicting learned behaviours and responses - his narcissism went yin and yang with his self-hatred, his reliance on his privileged background cast a shadow of guilt and unworthiness. The combinations were inherently unsustainable, and as far as Cynthia was concerned, it was a miracle he'd managed to hold himself together for so long.

But this was a delicate process - not something that could be solved with a week or two in a hospital unit. Cynthia's fight wasn't with Tyson - it was with the environment that created him. She could help him. She wanted to help him. No, she needed to. But this wasn't something that could be fixed with a prescription and some time away. Edith Belmont-Lovett wanted her son back as soon as she could. Cynthia was not inclined to give him to her. By her prediction, Tyson would likely be dead within the month. He was far too smart for his own good in that regard. That could not happen. That would not happen! But where was she to go from here? As an adult, Tyson could consent to inpatient care when he needed it, and Cynthia could provide treatment and support in a safe environment. The problem was that Tyson was a minor - that meant that his treatment was in the hands of his parents.

"So what do you want?" She asked him, and he bit his lip.

"I dunno," he shrugged again. "Until yesterday I wanted to die. Now I don't know what I want."

"To go home?" She asked, and he tutted in exasperation.

"No. I won't do it," he told her angrily. "I'll just hurt myself until I come back."

"I'm on your side," she put up her hand to slow him down. Tyson tended to get carried away when he was emotional. "I'll take care of you, alright? I promise."

Edith was already there in the interview room when Cynthia and Tyson arrived together. Her wavy black hair touched her shoulders, and she wore a three-piece business suit with a skirt despite the heat outside. A power move, Cynthia thought, her eyes meeting Edith Belmont-Lovett's. The woman exuded privilege, entitlement and ambition. This is a woman who would do anything to further herself, even at the expense of her children. It was Cynthia's job to be objective, but it was challenging when she was seeing how hard it had been on Tyson to indulge his mother's unforgivable selfishness.

"I've been waiting for quite some time!" Edith snarked, not beginning with a hello. Not even to Tyson, as he sat down opposite her at the table.

"We're fucking early," Tyson snapped back at her.

He's right, though.

"Enough of that attitude, Tyson. I'm not in the mood for it," his mother raised her hand at him and directed her attention to the doctor, who attempted to sit on the side of the table so she did not appear to be taking sides. "Get on with it, Dr Ellicott. What do we need to review?"

"Hello, Mrs Belmont-Lovett, and thank you for taking the time to come today," Cynthia ignored her frankness and decided to remain as a professional. She would not come undone by this woman's attempts to snatch the control of the meeting. "So, Tyson has been staying at the adolescent acute inpatient unit for three weeks now, and our team has been using this time to try and stabilise our immediate concern, which is safety."

"And?"

Cynthia cocked her head. "We have made progress, yes. However, I think it would be beneficial for him to stay with us a while longer."

"Honey, nobody cares what you think," Edith snapped at her, leaning forward in her seat. "When can I discharge him?"

"I'm not coming home!" Tyson broke in, refusing to be ignored.

"Yes, you are," Edith did not bother to so much as glance at him, her eyes firmly kept on Cynthia. "You've had your fun. It's time for you to come home and stop making such a fool of yourself."

"Ugh! I really fucking hate you!" Tyson shouted at her, but Cynthia had to stop this.

"Okay, we need to slow this down," she interjected with a firm voice. "We have to establish much better communication here, or we're never going to get anywhere. Do you understand, Tyson?" Tyson nodded, his face twisted into a monumental sulk. "Mrs Belmont-Lovett?" Edith eyed her off, but she did not speak, so Cynthia took that as a positive. "Tyson has expressed to me his reluctance to return home at this stage."

"I won't do it!" Tyson broke in, and Cynthia paused to let him speak. "If you make me come home, I will kill myself. I will, Mum. I hate it there! I hate you and I hate Dad and I can't go back because I will kill myself!"

"Tyson," Cynthia spoke calmly. ""Do you really want to die?" She was hoping he would admit to his mother that it wasn't just an intense desire to escape, but that it was a desire to escape his circumstances.

"Yes! B-because I know I'm only gonna c-c-come b-back and-and..." The teenager finally lost his ability to speak, and he shamefully hid his face in his hands as he began to sob.

That wasn't exactly what Cynthia was hoping for, but it did convey the idea that he might not be desperate to hurt himself if he did not have to return to the environment that broke him in the first place.

"Oh, stop this rot!" Edith snapped, utterly unmoved by her son's display. What a cold-hearted bitch! "You're not a child, so don't act like one! You've had your pity party, now get a grip and act like a Lovett. You're not only hurting yourself behaving like this, but you're hurting me and you're hurting your father. Stop being so bloody selfish."

"Alright, I'm calling it," Cynthia resisted the urge to punch Edith in the face and stood up. "Mrs Belmont-Lovett, we'll need to talk alone. I'm going to take Tyson back inside."

"No, you are not!" Edith stood up as well. "Who do you think you are?"

"I'm the woman saving your son's life," Cynthia replied coldly, and she handed Tyson his crutch. "Wait for me here, if you please."

She took a weeping Tyson out of the room, fighting to keep herself calm, and she walked with him at his hobbling pace to the common room. Out of nowhere, the door was thrown open, and Edith followed them.

"My son comes home with me right now," Edith barked, getting the attention of the nurses and the young patients in the area. "I'm done playing your games and I'm done indulging his attention-seeking behaviour. Pack your things, Tyson."

Cynthia couldn't have this argument here. It breached Tyson's confidentiality rights. Thankfully, the staff were quick to react. Evan and Geraldine, two of the nurses, responded and made their way over. Evan took over with Tyson, and Geraldine put her no-nonsense attitude to great use with the woman causing a disturbance.

"Miss, if you're not invited into this part of the hospital, you cannot be here," the ugly woman told her in no uncertain terms, and Edith looked at her with fury in her eyes. "I have to ask you to leave immediately."

"Fuck off and don't presume to speak to me that way," Edith replied loudly, her voice echoing off the walls. "You have no right to keep my son from me!"

"With all due respect, this has nothing to do with your son," Geraldine shut her down as quickly as she could. "You are disrupting a mental health ward, and if you don't return to the interview room or leave, I will have security escort you out. Now!"

Cynthia sensed that the situation was only going to get uglier, and looking around, she saw at least three scared and traumatised children trying to pretend it wasn't happening - including the poor boy who always hugged his pillow. With Evan escorting Tyson away from the situation, she turned her attention back to Edith.

"Come with me. We'll talk about Tyson."

She didn't mean to make the words sound as menacing as she did, but between that and Geraldine's threat, it was enough to coerce Edith to stop the relentless pursuit of her child and follow the psychiatrist to the interview room. Cynthia folded her arms, and Edith slammed the door behind her.

"If you don't surrender Tyson to me right now, I will have a team of lawyers destroy you," she flared, her pretty face twisted in anger. For a moment, Cynthia was alarmed at how her expressions, her mannerisms, and her aggression were all so similar to her son's. It was clear where he learned that kind of behaviour. "Do you have any idea who I am? Do you know who my husband is?"

"I don't give a damn if you're the Queen of England. You're the mother of my patient," Cynthia did not back down - rather, she took a step closer and looked down at the shorter woman. "Call every lawyer you want, Mrs Belmont-Lovett. While your son is at risk, I have every legal right to keep him in the acute inpatient unit indefinitely, and your behaviour today has confirmed my suspicions that he is not safe in your hands. Your son, who has attempted suicide four times, has told you repeatedly that if he goes home, he will do it again - and you want me to release him into your care?"

"I will fire you and bury you with lawsuits! Do you think I can't do it?" Edith shrieked in her face.

Tyson was right when he called her a cunt, Cynthia thought.

"The only thing any lawsuit will accomplish, Edith, is to confirm that I'm doing my job," Cynthia explained, doing her best to maintain a professional attitude. "If you attempt to take Tyson out of hospital care before I believe is ready, I will stop you."

"Is that so?" Edith narrowed her eyes. "Then you're fired."

"That's your decision in the end, but I don't recommend it," Cynthia was ready to play her trump card. "Tyson used to tell everyone how his Mum would have the staff members fired every time he didn't get his way, so I've been prepared for this. Let me be frank. If you fire me, then I will launch an investigation on you and Mr Lovett. Abuse, endangerment, cruelty, neglect - and that's off the top of my head. Your husband's career will never recover from headlines like that, and that's not taking into account whether the two of you avoid criminal charges."

Edith did not have a response to that. For what must have been the first time in the woman's life, she was speechless. Cynthia could not deny that she experienced a keen feeling of schadenfreude as she held her adversary over a barrel. Edith had a look of outrage and shock on her face as she debated her position. Cynthia, though, was restricted by confidentiality laws. Acting on her words would definitely have distasteful consequences for her career. She hoped the threats would be enough to force this woman to back off.

"I don't think anyone needs this situation to get any further out of control. Especially Tyson," Cynthia finally spoke again, once she was sure her words had sunk in. "Rather, you can let me do my job. I can help him, Mrs Belmont-Lovett. But with respect, if you can't be part of the solution, then you remain part of the problem, and I'm an excellent problem solver."

"Nobody threatens me," Edith poked Cynthia in the chest with a sharp finger. "I will be back, and next time, I'll be bringing in my husband."

She went to leave, and Cynthia was more than happy to let that situation end the way it did without adding more accelerant to the blaze. When the woman was officially out of the unit, behind the locked doors, it was as though the whole hospital breathed a sigh of relief. She found Tyson, who was looking disconsolate on his bed, twisting his sprained ankle. She knocked on his open door, and he looked up at her, and instinctively took his hands away from his foot as though he'd been caught masturbating. He knew he wasn't supposed to be doing that.

"Hey, Tyson! Good news," she advanced and sat down at the end of his bed. "You're not going home just yet. Mum and I have had a talk, and we've agreed that it's best that we work things out for a while longer before you go."

When Tyson's sad brown eyes lit up in hope, and his often sulking mouth began to smile with relief and joy, Cynthia knew immediately that it was all worth it.

Thanks for reading! ❤️
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Stories posted in this category are works of fiction. Names, places, characters, events, and incidents are created by the authors' imaginations or are used fictitiously. Any resemblances to actual persons (living or dead), organizations, companies, events, or locales are entirely coincidental.
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Well done Cynthia! That lady has got balls  - which I guess are appropriate for dealing with a 'see you next Tuesday' lady :lol:

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Cynthia followed up like a professional. Unless those rooms are recorded, which I'd think they wouldn't be for privacy - however maybe they are as part of the treatement record - she managed to his Edith the only way that seems to matter to her - headlines. Reputation.

I've come to like Vlad more than Tyson, which is odd on the one hand - both are as they are do to situations beyond their control. Vlad has chosen how he will respond to that, with the support of his family. Tyson doens't have support, but chose to react to the world as his most hated foe does - his mother. I wonder if it will ever occur to Tyson that Vlad sees the world differently, even though his problems are literally inside him?

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Wow that was intense! :o I would actually like for Edith to come with her husband and try to fire Cynthia, just so Cynthia would expose them to the world.

The situation with Vlady is much smoother since he actually wants to participate in the treatment and doesn't have morons for parents. I have faith that he will get better, but I think Cynthia will have much more trouble with Tyson.

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In the present chapter, Cynthia demonstrates how she interacts with Vlady, Tyson, and Edith, sometimes together and sometimes separately; and she also shares some of her insights.

I love her entrance into the adolescent wing of the psychiatric facility: The grimness of the situation is emphasized by her use of the sally port--the “airlock style system of locked security doors”--but her first view inside the locked unit is of two sleepy teens cuddled together.  (The contrast is beautifully done.)

Cynthia acknowledges being “scared” of Tyson's ability to plan and execute a suicide attempt, but she still refuses to transfer him to the high-dependency unit: "'I don't want to separate him from Vladimir,' Cynthia admitted, speaking quietly. 'If I take any more of his freedoms away, particularly the only friend he's ever had, then he'll never trust me again.'" She is willing to break the rules, as it were, in the interest of a better outcome for her charges. In fact, she feels that the boys’ physical closeness is beneficial to both--another rule broken in the interest of successful treatment. 

Cynthia is able to see Vlady for the sweet, open, and honest person he is, as separate from his disease process, and her view is contrasted with the fearmongering of Tyson's father (for anything “abnormal”) and Dr. Shrubb's view that major episodes should be treated by “caging” the sufferer. Vlady's sunny disposition is reflected by his wish to have his session out-of-doors, and Cynthia (who could have refused) indulges him.

Cynthia does an excellent job of recapitulating all her insights regarding Tyson's issues:  First, “the only freedom he ever truly had [was] to inflict harm on himself,” leading to his “addiction” to suicide.  Second, many of his antisocial behaviors are “elements of himself that were moulded by his parents”--in other word, learned behaviors (which Edith still has in spades).  Third, he demonstrates “fits of rage and aggression” as a byproduct of having to repress his true feelings. Fourth, perhaps because of the “good” Tyson beneath the bad, his apparent “narcissism went yin and yang with his self-hatred, his reliance on his privileged background cast a shadow of guilt and unworthiness.”  To sum up his situation, “Tyson, thanks to years of cognitive dissonance, was an amalgamation of complex and conflicting learned behaviours and responses,” and only by teasing these issues apart and then addressing them in gestalt can Cynthia hope to show him a new way. She is certainly aware that part of the solution is to keep him out of his parent's clutches--to stop the mental torture--and to “[help] him think for himself and slowly learn to feel and process his emotions in a healthier way.” (While she is aware that Vlady and Tyson are good for each other, she does not seem to realize--at least at this juncture--that Vlady is the actual reason that Tyson no longer wishes to suicide.) I love that Cynthia realizes that her “fight wasn't with Tyson - it was with the environment that created him.” I also love that Cynthia makes clear that she will be Tyson's champion:  "'I'm on your side,' she put up her hand to slow him down.... 'I'll take care of you, alright? I promise.'"

Cynthia's says of Edith, “That woman is killing [Tyson] and she doesn't realise it. Or she doesn't care." (Of course, the irony in Tyson's wanting to kill himself is that the father “aims to defund the mental health service if elected the state premier.”) Edith's treatment of Tyson actually leaves Cynthia thinking, “What a cold-hearted *****”; and after Edith threatens her with lawsuits, she says internally, “Tyson was right when he called her a ****.” After Edith tries to fire her, Cynthia shows her real mettle:  “If you fire me, then I will launch an investigation on you and Mr Lovett. Abuse, endangerment, cruelty, neglect - and that's off the top of my head. Your husband's career will never recover from headlines like that, and that's not taking into account whether the two of you avoid criminal charges." (If Tyson himself had called Child Protection Services [and who knows, maybe he did at one point], I doubt it would have helped him, in view of his parents’ standing in the community, his father's job in politics, and the subtle nature of the abuse [his parents, at least on the surface, appear to provide for his every need].  His parents would simply have branded him a thankless child, a brat, and the case would have been speedily closed.) It would take an adult of Cynthia's standing--as a third party with the appropriate psychiatric credentials--to initiate credible investigations by reporting to CPS and/or the police. While any adverse headlines that follow (if any) would not be under her direct control, at least the threat of such headlines is enough to make Edith leave and provide Cynthia--and Tyson--with more breathing room.

And Cynthia's reward:  A look of hope, relief, and joy from a young teen, and the knowledge that she's making a difference. 😊

Edited by travlbug
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Ordinarily, privacy laws benefit the patient; but in this case, they prevent Cynthia from going directly to the papers, as she would be putting her license at risk. (In the U.S., revealing confidential information would be a HIPAA violation.) Further, she is legally protected by reporting to CPS and the police, regardless of the outcomes of their investigations, but she would be at risk for libel if she goes to the papers and then, for whatever reason (e.g., political pressure, fear of repercussions), Tyson's parents are exonerated. If Tyson's father doesn't already know these facts, the family lawyers will.  Thus, while Cynthia's mention of career-threatening headlines is dramatic, it is far from certain that those headlines would ever come to pass.  Hopefully, the Belmont-Lovetts will be so afraid of the investigations themselves that they will not try to force Cynthia's hand.

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15 hours ago, Ivor Slipper said:

Well done Cynthia! That lady has got balls  - which I guess are appropriate for dealing with a 'see you next Tuesday' lady :lol:

Haha well she's managed to buy some time and temporarily scare off the C U Next Tuesday queen - that's the important thing!

15 hours ago, Wesley8890 said:

HOLY FREAKING CRAP! Cynthia is my spirit animal!! So we get to meet dad

The groundwork has been laid as such! I'm glad you appreciate our dynamic doctor! :)

13 hours ago, Dabeagle said:

Cynthia followed up like a professional. Unless those rooms are recorded, which I'd think they wouldn't be for privacy - however maybe they are as part of the treatement record - she managed to his Edith the only way that seems to matter to her - headlines. Reputation.

I've come to like Vlad more than Tyson, which is odd on the one hand - both are as they are do to situations beyond their control. Vlad has chosen how he will respond to that, with the support of his family. Tyson doens't have support, but chose to react to the world as his most hated foe does - his mother. I wonder if it will ever occur to Tyson that Vlad sees the world differently, even though his problems are literally inside him?

Nah no recording in the interview room - it would be very illegal without consent from all parties, I think.

Yeah, the major difference between the boys is that Vladimir's been hospitalised for quite a while so he's super keen to do what it takes to get out and additionally, he's been treated multiple times for most of his life. On the other hand, Tyson's entire world has been thrown completely upside-down in the span of eight days or so - it would be unfair to expect him to know how to handle things at this early stage. 

Good question, though! :) 

12 hours ago, ObicanDecko said:

Wow that was intense! :o I would actually like for Edith to come with her husband and try to fire Cynthia, just so Cynthia would expose them to the world.

The situation with Vlady is much smoother since he actually wants to participate in the treatment and doesn't have morons for parents. I have faith that he will get better, but I think Cynthia will have much more trouble with Tyson.

Cynthia done won the battle, but Edith's not so tunnel-visioned that she doesn't know when to retreat!

Vladimir has a clear goal and the path is there for him - with Tyson, though, we don't have actual light at the end of the tunnel yet. Cynthia knows that this situation is an unsuitable endgame. 

2 hours ago, travlbug said:

Cynthia acknowledges being “scared” of Tyson's ability to plan and execute a suicide attempt, but she still refuses to transfer him to the high-dependency unit: "'I don't want to separate him from Vladimir,' Cynthia admitted, speaking quietly. 'If I take any more of his freedoms away, particularly the only friend he's ever had, then he'll never trust me again.'" She is willing to break the rules, as it were, in the interest of a better outcome for her charges. In fact, she feels that the boys’ physical closeness is beneficial to both--another rule broken in the interest of successful treatment. 

Cynthia's a bit of a maverick in her profession - which is a little sad in its own way. Rather than restricting Tyson to the HDU (as she realistically should have on his admission) and keeping the boys apart (as she should since it's technically inappropriate even if it's innocent and harmless) she elects to bend those rules - whereas Dr Shrubb's method of using seclusion, sedation and restraints to control Vladimir is more readily accepted as an intervention. Let's hope it doesn't blow up in her face. :o 

2 hours ago, travlbug said:

Vlady's sunny disposition is reflected by his wish to have his session out-of-doors

Haha yes! That was cheap symbolism on my part. ;)

2 hours ago, travlbug said:

(While she is aware that Vlady and Tyson are good for each other, she does not seem to realize--at least at this juncture--that Vlady is the actual reason that Tyson no longer wishes to suicide.)

Hmmm I don't have a solid answer to this - she does make a deal initially to treat Vladimir (The Promise) when she realises it was a viable avenue to getting through to Tyson (as there seemed to be no others) and he promises (albeit going back on his word) not to try and hurt himself (she'd be in trouble if he needed to be in the secure wing and he succeeded in hurting himself.) So while she's aware that Tyson's infatuation and desire to explore those feelings is a huge anchor to keeping him from self-harm, she likely underestimates the connection. 

2 hours ago, travlbug said:

To sum up his situation, “Tyson, thanks to years of cognitive dissonance, was an amalgamation of complex and conflicting learned behaviours and responses,” and only by teasing these issues apart and then addressing them in gestalt can Cynthia hope to show him a new way.

Yes! It's not just about putting a bandaid over an infected wound. 

2 hours ago, travlbug said:

(If Tyson himself had called Child Protection Services [and who knows, maybe he did at one point], I doubt it would have helped him, in view of his parents’ standing in the community, his father's job in politics, and the subtle nature of the abuse [his parents, at least on the surface, appear to provide for his every need].  His parents would simply have branded him a thankless child, a brat, and the case would have been speedily closed.) It would take an adult of Cynthia's standing--as a third party with the appropriate psychiatric credentials--to initiate credible investigations by reporting to CPS and/or the police. While any adverse headlines that follow (if any) would not be under her direct control, at least the threat of such headlines is enough to make Edith leave and provide Cynthia--and Tyson--with more breathing room.

There was no record of Tyson ever initiating such a thing - he skipped all avenues of help and went right for the suicide attempts. But you're right - it wouldn't have worked. Perhaps he knew that in advance! 

1 hour ago, travlbug said:

Ordinarily, privacy laws benefit the patient; but in this case, they prevent Cynthia from going directly to the papers, as she would be putting her license at risk. (In the U.S., revealing confidential information would be a HIPAA violation.) Further, she is legally protected by reporting to CPS and the police, regardless of the outcomes of their investigations, but she would be at risk for libel if she goes to the papers and then, for whatever reason (e.g., political pressure, fear of repercussions), Tyson's parents are exonerated. If Tyson's father doesn't already know these facts, the family lawyers will.  Thus, while Cynthia's mention of career-threatening headlines is dramatic, it is far from certain that those headlines would ever come to pass.  Hopefully, the Belmont-Lovetts will be so afraid of the investigations themselves that they will not try to force Cynthia's hand.

Okay you're getting too far ahead now. Settle down, pal. ;)

Thank you everybody for the comments! ❤️ It makes writing go from a hobby to an absolute pleasure. :) I hope I don't disappoint!

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You did an amazing job writing this chapter! You must be a bit schitzophrentic (sp?) to write the dialogue between Cynthia and Mom! 😉 There have been some subtle changes in Tyson recently. Maybe Cynthia will be able to keep Mom away and help Tyson more. Thanks.

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6 hours ago, JeffreyL said:

You did an amazing job writing this chapter! You must be a bit schitzophrentic (sp?) to write the dialogue between Cynthia and Mom! 😉 There have been some subtle changes in Tyson recently. Maybe Cynthia will be able to keep Mom away and help Tyson more. Thanks.

Thank you so much! Haha no no - I do have a little experience in similar settings, but I am not schizophrenic. I'm just eccentric! 😜 

Tyson has indeed been evolving! He's much more willing to participate in his treatment now - it's still difficult for him to commit because he believes that things won't change, but with Cynthia taking the hits for him, he might change his mind about that! 

❤️ Have a lovely day!

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Please make this better — for Tyson and us as readers. Truly difficult. You are pushing hard with your extreme boundaries.  And your readers’ boundaries. 

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20 minutes ago, re2 said:

Please make this better — for Tyson and us as readers. Truly difficult. You are pushing hard with your extreme boundaries.  And your readers’ boundaries. 

I appreciate that - I wrote Heart during a notably difficult period. If I were to rewrite, I would do a lot of things differently. :) Particularly the middle of the story, in which I would cut out a lot of the gloomy bloat. 

While I can assure you without spoiling the story that it does get better for both the readers and for Tyson, this story won't be edited any time soon & if so, it'd probably break the established rules of publishing on GA anyway.

Thank you for your feedback. :)

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