The Brilliant Boy Billionaire - 7. Misery in Missouri

The good news was that I hadn’t been sent back to Indiana. The bad news was that I wasn’t free. I’d wanted to visit Hannibal because it was the boyhood home of Mark Twain. I’d wanted to see the sites that formed the basis of his wonderful books. It was on my way, so why not stop? Of course, I needed a place to stay, and there was a lovely park, Riverview Park, right on the west bank of the Mississippi. There weren’t any campsites, but I didn’t need a campsite. There were public restrooms, and there were plenty of places out of site where I could pitch a tent. Unfortunately, the weather didn’t cooperate, and the heavens let loose not long after I set up camp, and the ground quickly turned to mud. A cold rain in late February isn’t something anyone should be out in, so I packed up my tent and sleeping bag as quickly as I could and headed for the closest picnic shelter I could find. It didn’t provide much protection as it was open on all sides and the roof wasn’t fully waterproof, but at least it got me out of the rain, and there was a public restroom nearby.

My tent was soaked but would dry out fairly quickly. My sleeping bag was a different story. It was a good one with insulation designed to remain effective even when wet, but who wants to sleep in a soaking-wet sleeping bag? I opened my pup tent under a picnic table so that it wouldn’t blow away and left it open to dry out. I opened up my sleeping bag completely and draped it over another picnic table. Without anyone else in sight, I stripped completely and spread out all my clothes on another picnic table, so they would dry overnight. Finally, I got dressed in dry clothes, bundled up in multiple layers and did my best to create an acceptable place to sleep on top of another one of the picnic tables.

I awoke in the early morning light to find a police officer looking down on me. It was surreal. I was disoriented, and for a moment, I couldn’t even remember who I was, let alone where I was. The officer didn’t wait for me to come to my senses, shouting at me and insisting I tell him what I was doing sleeping in Riverview Park in the middle of a rainstorm.

All I could do was respond, “Riverview Park?”

“What the hell are you doing here, boy?” he shouted at me.

“Doing here?” I asked. I was still disoriented, having just woken up from a very deep sleep.

“Never mind,” he responded. “We’ll let Juvie sort it out.” That sure woke me up.

“No!” I practically shouted. “I’m fine. Really.”

“Ten-year-old boys don’t spend their night sleeping in a public park,” he replied.

I looked young for my age, but I did not look like I was ten. Indignantly, I responded, “I’m thirteen!” Unintentionally, it came out as confrontational, which was the last thing I wanted.

“An even better reason to take you to Juvie,” he replied. “Where are your parents?”

“They’re both dead,” I replied. That much was true.

“Then who’s responsible for you?”

“No one,” I replied.

“Where’d you get such a fancy bike?” he asked.

“It was a birthday present,” I replied, also honestly.

“Sure, it is,” the officer responded. “Probably stolen. Let’s go.”

As the officer started dragging me to his car, I shouted, “Wait! What about my stuff?”

“How do I even know it’s your stuff?” he asked. “If it’s yours, we can come back for it later.”

“It won’t be here later,” I complained.

“Not my problem,” the officer replied.

God dammit. I hadn’t even bothered to lock my bike up. Who would steal a bike in the pouring rain with the owner just a few feet away? Shit, I’d even left the pannier case open. By the time everything was sorted out, all my stuff would be gone. It would take a huge chunk of my remaining Applazon gift cards to replace everything. If only it had been that simple. Replacing my stuff turned out to be the least of my problems. I never did get to see the sites in Hannibal, but that too, was the least of my problems.

Taken to the local jail, I was actually booked, photographed and fingerprinted. I refused to give them my name, so they simply listed me as a ‘John Doe’. With my fingerprints in the system, there was a huge risk of being sent back to Indiana. If my dad’s body had been discovered and they dusted our house for prints, they could easily match my prints to the crime scene. I had to get out of here as quickly as possible, but how? And even if I could get away from here, where would I go? Without my bike, how could I get very far?

One thing was certain. I couldn’t contact Larry back in Springfield. Now that my fingerprints were on file, there was a very real risk of being tied to my father’s death, and I couldn’t let Larry and Greg get pulled into it. As Larry himself pointed out, he didn’t have the resources to defend himself in court, let alone defend me. I couldn’t let them lose everything because of me. Not after all they did for me. I’d spend my life in prison before I’d let that happen.

Because I refused to give them a name or tell them where I was from, they transferred me to the Bruce Normile Juvenile Justice Center in Kirksville, more than an hour-and-a-half drive away, where I was kept under lock and key. I was assigned a social worker, and she met with me every day, but my situation didn’t change. I asked what charge I was being held on but was told I wasn’t under arrest. I asked for an attorney, but was told I wasn’t entitled to one, ’cause I wasn’t accused of a crime. I asked to be transferred to a group home and was told that would happen as soon as I cooperated, or I could even be placed into foster care, but I had to tell them who I was. I asked to be released and was told that as a minor, I could only be released to the care of an adult.

The bottom line was that Missouri could hold me in juvenile detention indefinitely so long as my social worker deemed me to be a flight risk. Only later would I realize they’d taken advantage of my ignorance. Unless they charged me, they could only hold me for 72 hours. After that, they either had to release me or place me in the care of CPS, with or without an identity. They were only making it easier on themselves without regard to my welfare. Hence, the weeks passed me by as I continued to refuse to answer their questions. I assumed they were keeping me isolated from the general Juvenile population as a form of punishment, and only later realized they didn’t want a roommate informing me of my rights. They did enroll me in school as required by law, however – seventh grade, based on my self-reported age. The last thing I wanted to do was let them know I was really a high-school senior ’cause that would’ve given them a critical clue as to who I was, and so I suffered through coursework that I’d completed years ago. Even more difficult was making it look like I was learning it for the first time so as not to arouse suspicion.

In time the visits by my social worker became weekly rather than daily, and my life became routine. However, as March came to a close, it dawned on me that my Applazon gift cards would all expire if I didn’t escape – and soon. In fact, at least one of them had already expired if I wasn’t mistaken. Although I’d memorized the serial numbers and PIN numbers for all of the cards, internet access to Applazon was blocked from any of the facility computers. Hence if I was to prevent any further loss of funds, I had to get out of there. Not even accessing an outside computer would be sufficient in the long run, as I could only transfer funds from one card to the next. Eventually I’d be down to only one card, and when it expired, I’d lose everything.

Then there was always the possibility that Dad’s body would be discovered and my prints matched to those at the scene. I had to distance myself from the prints obtained when I was brought in. I had to escape. Period. But how? We were all on lockdown, and even our medical care was provided on-site. However, then one of the other boys was sent to the hospital for an asthma attack that didn’t respond to medication. I formulated a plan that very night.

Two days later, I talked one of the nurses into getting me a couple doses of bismuth for the diarrhea I claimed I was having. Normally they’d use a pill, Imodium, I think, but I told her I get episodes of diarrhea sometimes, and bismuth is the only thing that works. It was also something I knew she could get me without contacting the doctor. Further, because bismuth should be given after each loose bowel movement, I could take it back to my room without the nurse watching to make sure I took it. Now, I just had to be patient.

I waited nearly two weeks until we were served spinach with supper. I made sure to take seconds and thirds of the spinach. It wasn’t one of the more popular items, so I had no trouble getting extra portions. That evening before going to bed, I took both doses of bismuth, swallowed each small cup of the pink liquid and leaving not a trace of it to be discovered. I could only hope it worked as well as it did in the book I remembered, where the main character escaped from a mental hospital by using the same trick.

In the early morning hours, I woke up with stomach cramps, just as I was hoping I would. I took a dump and sure enough, my shit was jet black. I called for help and when someone finally came, I rapidly said, “My shit’s turned black, and my stomach feels awful. I think I’m bleeding inside. I need to get to the hospital.”

“Whatever it is, I’m sure it can wait until the morning,” the guy said, so I elaborated.

“No, you don’t understand. I have always had stomach problems and was warned to go to Emergency if my stool ever turned black. I was told it was a sign of internal bleeding and that I could go into shock and die within a few hours. This can’t wait. I could be dead by morning. Call the nurse. She’ll confirm that black shit’s a life-and-death emergency.”

“I’ll be right back with the nurse,” he responded and then locked the door and left. I must have waited nearly an hour, and the stench from my shit was overpowering, but I needed to be able to show it to the nurse. I was about to start banging on the door when, finally, the nurse came. I showed her the shit in my toilet, and she took me straight to the infirmary.

What happened next wasn’t unexpected, but it certainly wasn’t pleasant. Suffice to say, it involved a gloved hand, lubricant and a stool-sample test card. I could tell from the look on her face that the test for occult blood was strongly positive, as I’d hoped it would be, ensuring a trip to the hospital. There, they wouldn’t find anything wrong and would probably do a series of tests, but I’d have a chance to escape.

In the book, I’d remembered the main character used exactly the ruse I’d just carried out. At first, he tried to get iron supplements, ’cause in high doses, they mimic the signs of internal bleeding. The main character, however, was unable to get his hands on iron tablets, so he concocted the plan I’d just used.

Spinach is very high in iron, and a large serving can result in a false-positive result on tests for occult blood in stool. The problem is that spinach turns shit a dark shade of green. It doesn’t look like the black tarry stool you get with digested blood from internal bleeding. That’s what the bismuth was for. Bismuth turns shit black.

They took me to Northeast Regional Medical Center, which was near the juvenile facility. Unfortunately, they sent someone in the ambulance with me to ensure I didn’t try to escape. That would make it more difficult, but I was determined. I’d be long gone by the time they realized I was missing.

Since the state still listed me as John Doe, I was admitted to Emergency under that name, with the medical history unknown. They checked my vital signs, put me in a cubicle with only a stretcher and a chair for my babysitter to keep watch on me, and had me get undressed and put on a hospital gown. Not that I was wearing much to begin with – just the state-issued jump suit we all had to wear in the juvenile facility. At least it wasn’t bright orange like the ones you see on TV. The sitter wasn’t even gonna let me have privacy to get undressed – I had to ask her to step out so I could undress.

One thing that struck me when they took my vitals was my height, which they measured at five-foot-eight inches. The last time I’d checked at home, I was five-foot three. Apparently, I was in the midst of a growth spurt and was gonna be tall like my dad was. Maybe now I really could pass for sixteen if I could escape from my prison. The trouble was, my voice hadn’t yet started to change, and I was still pretty much hairless everywhere except on my head. I knew some kids were late bloomers, but it’d be pretty hard to pass for seventeen next year if my voice still hadn’t changed.

After changing into the hospital gown and stowing the prison garb in the plastic bag they gave me for my personal belongings, such as they were, it took more than an hour before someone even came to check up on me. It wasn’t even a doctor, but a physician’s assistant. She listened to my heart and lungs, which was pretty worthless, and finally she had me lie flat and listened to my stomach. She pressed all over my belly and elicited a deliberate groan from me when she pressed down on my stomach, which I knew was in the upper center and left portion of the abdomen. She then simply walked away without even asking me any questions or tellin’ me anything about what was goin’ on. Didn’t she need to know when the pain started, what made it better or worse, did it come and go and had I ever had the pain before? Those were the sorts of questions my Medicaid doc at home would’ve asked.

It was at least another hour before someone else came to check up on me, and it was just the phlebotomist, who drew six tubes of blood. What did they need with six tubes? I could see maybe four tubes – chemistry, cell counts, coagulation and type and cross for possible transfusion. What else could they need? Then the obvious came to mind – toxicology and drugs, but given that my symptoms pointed to internal bleeding, why were they taking it so slowly? If I were really bleeding, wouldn’t I have bled out by now? Come to think of it, they hadn’t even started an IV. Wasn’t that the first thing they usually did in Emergency? If I really was bleeding internally, I’d be dead by now.

It wasn’t until three hours later, I think, that someone came to see me. “Hello, John, I’m Dr. Margoles,” she began. “The good news is that if you lost any blood, the amount wasn’t significant. Your hemoglobin is fourteen and your hematocrit is 43. Your white count is mildly elevated at 11.3, which might explain the source of the diarrhea.” Actually, it was the spinach, but I couldn’t tell her that. “Your stool occult blood test was strongly positive, however, so you do have internal bleeding, and that has to be worked up.”

Then I had a crazy thought that was so out of left field, it might actually work. “Could my normal blood counts be due to dehydration?” I asked.

“In other words, if we gave you fluids, would the dilution lower the numbers?” Dr. Margoles caught on. “Although there might be some dilution, your BUN and creatinine were normal, telling me that any dehydration is minor. By the way, your blood type is O-Positive, the most common blood type. You might need to know that someday.” Little did either of us know how right she was about that.

“I’m going to have Dr. Narayana come see you,” she continued. “He’s a gastroenterologist, which is a stomach doctor. He’s going to talk to you about the next steps to evaluate this, and then you’ll be free to go home.”

“What?” I exclaimed in surprise. “You’ve gotta be fuckin’ kidding me. I was told the last time that I needed to get to Emergency right away if I ever had black shit. They told me I could bleed to death and die.”

“You mean this has happened before?” Dr. Margoles asked. “Why didn’t you tell anyone?”

“Because no one asked,” I replied. “No one even let me tell them my story. I’ve had problems with stomach pain since I was maybe ten.”

“Well, that does change things, but this is still something that could be worked up as an outpatient, John,” she responded.

“I’m sure you have fine people here and that Dr. Narayana is a fine gastroenterologist, but how many kids my age has he scoped?” I asked. “How many pediatric specialists do you have on staff?” I continued. “Do you even have a pediatric radiologist?

“Look, I’ve had unexplained stomach pain for years now, and I’m only thirteen. I’m no expert, but I’ve read enough stuff to have some Ideas of what could be goin’ on. If it’s some sort of cancer, it would be very rare in someone my age. If it’s an ulcer, there’s something very wrong for me to have gotten symptoms when I was ten. If it’s something more obscure like a vascular abnormality – I think it’s called an AVM or something like that – I doubt that anyone on your staff has dealt with something like that in someone my age. I need the workup that can only be obtained at a major teaching hospital, and that isn’t gonna happen here.”

“No, I’m sure you’re right about that,” Dr. Margoles replied. “Ultimately, we’ll have to send you to a tertiary-care hospital, but we can certainly look for the basics here.”

“Can you?” I asked. “If I were still bleeding actively, I’d probably be dead by now. Not that you did anything wrong, but you’re not used to a case like mine, and I could’ve bled to death before I showed any signs of shock. No offense, but kids look fine until they don’t, and by then it’s usually too late. I read that in a medical thriller once. If I need to be scoped, I’d rather it be by someone who’s done it hundreds of times in kids.

“I may seem calm, ’cause that’s how I act when I’m scared,” I continued. “Actually, I’m freakin’ out here, and I don’t want to be sent back to that facility to die. For what it’s worth, I’m not there because I did anything wrong. I’m there because there’s no one to take care of me and they haven’t been able to figure out what to do with me.”

“You’re obviously very smart,” Dr. Margoles responded. “So, you probably realize this is out of my hands. It’s up to your social worker to arrange for something like a transfer to St. Louis.”

“Then get her on the phone,” I admonished the doctor. “Tell her there’s something potentially very wrong with me and that there’s a risk I could die if you send me back there. Tell her I need to be worked up in a tertiary-care medical center and that I need to be transferred today.”

The doctor looked intently at me, and so I said, “Treat me the way you would if I was your son instead of some abandoned homeless kid. At least give me that much.”

“I’ll see what I can do,” she replied, and then she left.

Hours passed and I still hadn’t heard from my social worker. They weren’t permitting me to eat or drink anything, just in case I needed to have an emergency endoscopy, and I was beyond starved and thirsty beyond belief. Finally, after much begging and cajoling, they relented and let me have a clear-liquid diet, so I had the pleasure of eating a supper consisting of clear chicken broth, apple juice and lime gelatin. The meal was so wonderful, I asked for seconds. Well, I was hungry.

My social worker, Ms. Hollister, finally showed up at 7:30. I was beyond exhausted by then. I’d been up since the early morning hours and of course there was the stress of not knowing what was gonna happen. I was shocked to see her when she finally entered my room.

“Good evening, John Doe. Still not willing to share your real name with us?” she asked.

“The way I feel tonight, I’m not sure I could remember it if I tried,” I responded.

“But you do know that you’ve had stomach problems for years, since you were ten?” she asked.

“That’s right,” I replied.

Sighing, she continued, “Your doctor tells me you need a thorough workup for a GI bleed, and that you’re afraid of going back to the facility for fear you could die there. She says we don’t have the resources to provide an adequate workup for your condition here and that you require hospital admission, given your active bleeding and your anxiety. I think we both recognize that her decision’s a bit, shall we say, tenuous?”

“Let’s just say I’d rather not die here,” I replied.

“And you think you’d be better off in St. Louis?” she asked.

“Not better off in general, but they have real children’s hospitals there. Shriner’s is renowned,” I responded.

Nodding her head, she acknowledged, “It is, but it’s not in network with the state, nor is the St. Louis Children’s Hospital, which is part of Washington University. I can send you to Mercy Hospital—”

“I’ve never heard of it,” I interrupted.

“Let’s just say it doesn’t have the reputation that the others do and leave it at that,” she went on. “You’ve made a lot of extra work for me, but at least I’ll have you out of my hair and you’ll be someone else’s responsibility. Sending you to St. Louis means transferring you to a facility there, and that alone might make you want to reconsider. St. Louis is a tough city with one of the highest per-capita murder rates in the nation. There are two Juvenile justice facilities in greater St. Louis. In one of them, you’d be one of the few white faces, and it might be dangerous for you. The other, across the Missouri River in St. Charles, would be a better choice if we can get you in there.” Shit, I’d been avoiding St. Louis like the plague for good reason, but I thought I’d have a better chance of escaping there and disappearing for a time, until it was safe to buy a new bike or to catch a bus out of town. However, if my plans didn’t work out, I might be jumping from the frying pan into the fire.

“Columbia’s a university town,” Ms. Hollister continued. “I think you’d be much happier there, and it’s significantly closer. Women’s and Children’s Hospital may not be Shriners, but It’s in network, and I need to consider what your life will be like once you get out of the hospital.” That did sound more promising, but I got the impression there was something she wasn’t telling me.

“What about Kansas City?” I asked, thinking of the ease of crossing right into Kansas from there. “Do you have something in network there?”

“It’s nearly a three-hour drive from here,” Ms. Hollister cautioned. “It would be taking quite a risk transporting you there if you’re bleeding starts up again, but yes, Kansas City’s an option. The only trouble is that Children’s Mercy’s main campus is on the Kansas side of the state line, and technically we’re not allowed to send you out of state. They do have a campus in Missouri that’s part of the university medical center, and the hospital’s renowned, but if they need to send you to the main hospital for a procedure, we’d actually have to get a court order for you to do so.” By the same token, if I managed to slip across the state line on my own, Missouri couldn’t come after me. That was worth everything.

“Why don’t you see if you can get me into Kansas City?” I responded.

“The Hilltop School would be a good place for you,” Ms. Hollister suggested. “I’ll see if we can transfer you there. Alternatively, there’s Clay County if we can’t. However, I’ll have to get authorization to send you by ambulance, and I might not be able to get it, period. If that’s the case, you’ll have to stay right here until you’re stable enough to travel in a state vehicle. I’d have to obtain a release from your doctor so that we can transport you to Kansas City and have you worked up as an outpatient.”

“I’d feel safer going directly to the hospital by ambulance,” I replied, “but if the alternative is to be worked-up here, then we’ll do it your way.”

“I’ll make the arrangements either way,” she replied, and then after a pause, she asked, “Judging from your vocabulary, you’re not really in the seventh grade, are you, John?”

“I’d rather not comment on that,” I replied. Shit, she was onto me!

“Don’t worry about it, John,” she continued. “I’m not going to press the issue, although I suspect you could tell me the arctangent of one.”

“Forty-fi—” I started to answer without thinking.

“You couldn’t resist,” she laughed. “Trig’s at least a junior-level course, but I suspect you mastered it some time ago, and maybe calculus, too. Your country accent makes it easy for you to hide your exceptional intelligence. You’re someone else’s problem now, and as far as I’m concerned, this conversation never happened.”

I felt dumbfounded as she left. She’d picked up on my extensive vocabulary, so from now on, I was gonna hafta watch it.