By Joel Warner
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He is dumbfounded by the news that his sister called. After all, he explains to Lewis, he was just at her place two days earlier, babysitting his niece while J.J. was out grocery shopping, and then later, when she went to pick up Israel's nephew from school.
Lewis asks Israel about his gun. Israel says that after his apartment was burglarized a few years ago, he bought the gun for $50 at a pawnshop. He says he never takes it out.
The hospital is running the blood and urine tests. If Lewis feels Israel won't harm himself or anyone else, she'll let him go--that's another reason to remain calm, Israel thinks. If not, he'll be forced to stay. If he tries to leave, they will restrain him.
Israel is scared. He asks to use the phone to cancel his dinner date. Lewis says she'll arrange it, then leaves. He doesn't get to make the call.
A new nurse enters with paperwork for him to sign. The form states that Israel will pay for the tests and treatment he's receiving. But Israel's health insurance at work hasn't kicked in yet. "I'm not signing this," he tells the nurse. "I'm here involuntarily."
"It's just standard procedure," the nurse says.
Israel's resolve holds. "No, I don't think so."
A counselor from West Pines, the behavioral health center at Lutheran, enters to ask Israel some questions. She asks if he knows what day it is, where he is, and who the president of the United States is. She asks about his family.
The family is not close. His mom, Israel says, has been addicted to Valium for as long as he can remember. They don't get along, and he's spoken to her only twice in the last few years. His dad was a compulsive gambler. Of all his family, he is closest to J.J. He says he's never been treated for mental illness or had medication prescribed. Yes, he was down during the holidays, and yes, he does have a few beers and play some pool with his friends at the end of the week, but he's not crazy, and he's no alcoholic.
The counselor has also talked to Israel's ex-wife, Karen Barrett, who says she thinks he may be depressed. Israel says they've been divorced for ten years; she doesn't know his personal life at all.
Still, he passes up a chance to give the counselor the names of friends who can vouch for his character--he's embarrassed and doesn't want to bring them into this. He keeps quiet, but in the back of his mind he's thinking about "getting on someone's legal ass" when this is over. The counselor asks him if he wants some food. He says he'll wait. He thinks he'll get out of here sooner rather than later.
The West Pines report finds that Israel exhibits certain manic/hypomanic symptoms--irritability, racing thoughts, distractibility and impulsivity--and that he is suicidal and has homicidal thoughts about his ex-wife. According to the report, his posture is tense, his facial expression is angry and his attitude is evasive, angry and suspicious.
The male nurse returns with the results from Israel's blood and urine tests. They are negative. Now Israel's sure he's on his way home, until a patient's rep comes by with a "right of patients" form, which lists the right to have an attorney at any time and the right to make and receive phone calls. He tells the rep everything that's happened. The rep looks surprised and says she'll check it out. Israel doesn't see her again.
Lewis returns and says she's confused about the conflicting stories presented to her. Nevertheless, she tells him they are going to ship him over to the VA hospital (Israel was a boatman's mate in the U.S. Navy from 1985 to 1988) for a psychiatric evaluation. On what grounds? he asks. She says that based on the comments of his sister and ex-wife--both of whom have said that Israel is given to mood swings and hallucinations--he should be held until a full psychiatric evaluation is performed at the VA.
Lewis writes in her medical report, "The patient was initially placed on the mental health hold by myself. I explained to him the disparity in the two stories that I was receiving was somewhat concerning and that I felt that we could only err on the side of caution."
Her impression: Questionable mood disorder. Questionable alcohol abuse.
Lewis goes on to note that Israel "essentially consented" to the hold. Israel, however, is thinking about how he can't miss work. Lewis offers to write him a note and tells him to let the VA figure things out.
Israel asks for a lawyer. He's scared and he's pissed. He doesn't want to go to the VA. He's told he can ask for a lawyer at the VA.
The paramedics enter; they'll take him by ambulance to the VA. They're the first to address him with the slow, exaggeratedly clear speech people use when speaking to the hard of hearing, the elderly and the mentally ill.