Four Days After the Letter ~ Truce ~ Deb

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"I was alone, staring over the ledge, trying my best not to forget."

I reach the top of the stairs and continue down the hallway, toward the music coming from the bathroom.

"How it mattered to us, how it mattered to me, and the consequences," Mirna sings out.

"My, my, you're in a good mood." I step through the door and study Mirna's reflection. Her eyes meet mine through the mirror, and then she gazes back at her own reflection and lets her hair out of the curling iron. "Mmm, is that perfume I smell?" And she's wearing a jean skirt and a light blue t-shirt, a new top that I've never seen before. Mirna sways to the music and moves her mouth to the words: "Baby, did you forget to take your meds?"

She's wearing make-up too, and her hair is half up in an elaborate updo with spirals all over. I love her dark chocolate hair.

"I haven't seen you get this dressed up in months. Everybody will wonder what the occasion is."

"Everybody?" Mirna puts the curling iron down and looks at me through the mirror.

"At group," I say.

Mirna's eyes go wide. She puts her hand over her open mouth. "Oh, no, I forgot. I can't go, Deb. I made plans."

Can't go? "Mirna!" I put my hands on my hips. She can't seem to look at me anymore. "You're leading the workshop tonight. You can't just blow off the meeting."

"But Deb—"

I feel an argument coming. "Mirna," I interrupt.

"I never have plans anymore. It's just one meeting—"

"You're part of the meeting. I'm sorry you forgot, but you can't just skip it. Life doesn't work like that."

"Oh, right. I forgot. My life doesn't work." Mirna rips the curling iron cord out of the outlet. The plug hits the faucet with a loud crack! She swipes her phone off the counter and storms out of the bathroom. Seconds later, I hear the slam of her door down the hallway. That girl ... she has the shortest fuse. I hope she doesn't do that at school.

If she wants to keep her plans that badly, then we'll figure something out. But she'll need time to cool off before we can strike up a truce.

I go back down the hallway, take the stairs down, and go into my office. I sit behind my desk, open my briefcase, and take out a thick medical file.

Kaden Hastings. The newbie Gabe referred to me. The Code Purple from yesterday. I flip through the medical records, suddenly motivated to do something to help this boy.

I go back to the first page and move more slowly through the records this time. The seizures are idiopathic, but they started so suddenly, there has to be something that caused it. The EEG records are really just a mess, completely disorganized. I'm no expert at correlating patient histories either. I decide to go straight to the most recent diagnoses ... Juvenile Myoclonic Epilepsy, huh? I could see that, with the age of onset. He's been on Depakote, Tegretol and now Klonopin. Tegretol ... carbamazepine?

I wake my computer up and go online to epilepsy.com.I find carbamazepine in the list of seizure medications and go to theprofessional tab to look up contraindications.

I find carbamazepine in the list of seizure medications and go to theprofessional tab to look up contraindications

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There, I knew there was something about carbamazepine. It does make other seizure types worsen. That explains why his seizures worsened when he was on it, but it doesn't account for the daily seizures now.

After immediate onset, Kaden was put on Depakote and went seizure free ... until he developed side effects and they switched him to Tegretol. Because they found secondarily generalized patterns on the EEG. This must have exacerbated his myoclonic seizures, so he had another EEG and was diagnosed with JME. Klonopin won't treat secondarily generalized seizures, which could explain the daily seizures now.

I put a star next to the second EEG on his records, jot down my conjectures, close up the file, and put it back in my briefcase. Time for the truce meeting.

I leave my office, climb the stairs, and walk down the hallway to the linen closet. The white flag is right where I left it, wedged between the vacuum cleaner, shelves, and the wall.

Music blares from behind Mirna's closed door. I tap the door with the handle of the flag in time with the music, slowly and softly at first, then faster and louder—

The door flies open and Mirna stands there, glowering at me. I wave the flag. "Ready for peace-keeping negotiations?"

She fiddles with the door. Good, instead of slamming the door on me, she's thinking about it. "This better be good," she says finally.

"I want you to go to the meeting; you want to keep your plans. So, tell me about your plans."

Mirna's mouth pops open and her eyes trail off. "I made some new friends ... We met in art class." She shrugs.

New friends, that would be so good for her. "Tell me about these new friends."

"They just moved here. They're brothers."

Boys? My goodness, Mirna, what are you thinking?

"Don't look at me like that," Mirna says. "They're boys, but we can still be friends."

"Mirna, you are a very beautiful young woman, and boys are going to like you no matter what you do ..." I hold my hand up like I want her to give me something. "So what exactly are you doing with two boys on a Sunday night?"

"Just hanging out."

"You have no specific plans?" I ask.

She shakes her head no.

"Well, then. Why don't you just invite them to the meeting? It would be a great way to tell them more about yourself, and then you can decide if you even want to be friends."

Mirna sighs and stares past me. She crosses her arms and purses her lips in a grimace.

"I know you don't need me to remind you," I say, "But you don't want to have another Drew fiasco, do you?"

"...Fine, I'll ask them to come. But I'm blaming you if they freak out on me." She turns away and goes back to her bed.

I resist the urge to tell her that someone who freaks out on her wouldn't be worth theeffort. It must be so tough to gamble on a new friendship like this. SuddenlyI'm reminded just how brave Mirna is, and how stubborn.

 SuddenlyI'm reminded just how brave Mirna is, and how stubborn

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