Chapter 6 - THE MEDICATION
Anna’s original admission was not psychiatric.
That surprised me.
Emergency department first.
Severe confusion.
Agitation.
Tremors.
Memory disturbance.
Possible medication toxicity versus encephalitis.
The hospital records came through court-authorized production after Helen filed an emergency petition to inspect the conservatorship history.
I sat with a physician named Dr. Lena Morris who specialized in neuropsychiatry.
She translated.
“Anna had been prescribed a medication for migraines?”
“Yes.”
“Topiramate?”
“Yes.”
“Records show she also had benzodiazepines in her system.”
“What are those?”
“Sedating medications. Anxiety, seizures, several indications.”
“She wasn’t prescribed any.”
“Correct.”
My skin prickled.
“Where did they come from?”
“We don’t know.”
Anna’s toxicology also showed another sedating antihistamine at high levels.
Not necessarily poisoning.
Could be accidental combination.
Could be self-medication.
Could be someone giving pills.
No assumptions.
Then tests changed the picture.
Autoimmune markers.
EEG abnormalities.
Inflammatory findings.
Final diagnosis:
Autoimmune encephalitis, probable antibody-mediated.
I stared.
“What does that mean?”
“Her immune system was affecting her brain.”
“So the paranoia?”
“Could be part.”
“Confusion?”
“Yes.”
“Behavior?”
“Yes.”
“She wasn’t abandoning us.”
Dr. Morris stopped me.
“Medicine can tell you she was profoundly ill.”
Right.
Not intention.
Then the treatment list made sense.
Steroids.
IVIG.
Anti-seizure drugs.
Temporary antipsychotic medication for agitation.
Anna had not “lost her mind.”
May you like
Her brain was inflamed.
And while I thought she was choosing distance, she had been in a hospital bed.
