• Bonnie E. Carlson

"Tough as Nails"

“I would urge you to get here as soon as possible,” the hospital psychiatrist said. “How soon would that be?”

It was already late morning. How would she get there? Should she fly or try to drive? Questions pounded her brain. She’d never been to LA, with its legendary traffic. If she flew, wouldn't she still need a car? Wouldn't it be better to have her own? Could she make that seven-hour drive by herself? My god, she was pushing seventy. She dreaded the next forty-eight hours.

And what about Rylee and the animals? She’d need to make some arrangements for them. It didn't make any sense to bring Tucker with her, much as she would have liked her pooch’s company. But Rylee? No, she was staying home, too. She had school.

Meanwhile, Dr. Choi waited on the other end of the phone. “Sorry, I've been trying to think about how quickly I can get there. There's no way I can get there today. I have to pick Shelby’s sister up after school and make arrangements for the dog. But can I talk to her on the phone?”

“She’s still pretty out of it right now, but by tomorrow we're hoping she'll wake up.”

“Okay, I'll get there tomorrow, but it’ll probably be late afternoon. Will you be available then?”

“Yes. Have them page me when you arrive.” The psychiatrist left details for how she could find Shelby's room at the City of the Angels Medical Center.

Thirty minutes earlier, on the Wednesday after Labor Day, Elin Bergstrom had gotten a phone call that turned her life upside down—again. She cursed Ian for the hundredth time for leaving her with this mess to deal with. How was she, having never been a parent, despite her years of teaching children, supposed to deal with crises like these? Really, it just wasn't fair. Fair. Hah! Who said life was fair? Isn't that what Ericka always said?

Well, she could whine and mope or she could get busy figuring out what she needed to do to get over to LA.


She drove to Rylee’s school and got into the long line of cars waiting to pick kids up. God forbid a high school sophomore take the school bus home in fancy schmansy North Scottsdale. As she waited in the pokey line inching forward, she thought about what to tell Rylee. How much could that poor kid be expected to deal with? As she approached the pick-up spot, she spied Rylee talking to a group of kids, both boys and girls. So cute in her skinny blue jeans and white tank top, long red hair pulled back into a sleek ponytail. When Elin arrived at the spot, she opened the passenger-side window and yelled “Rylee.”

“Gotta go,” she heard her say, waving goodbye to the other kids. Was she finally making some friends?

“Hi, Grandma.”

“Hey. How’d school go today?” Although it took all of her self-control not to blurt out the bad news about Shelby, she’d decided on small talk for the drive home, waiting until they were eating their snack to tell Rylee about her sister.

“Okay, I guess. Same old, same old, really.”

Why did adolescents have to be so difficult to talk to? “How was soccer practice?”

“Pretty good, actually. I scored two goals. When does it cool off here?”

“Not ’til the end of October. Two goals are great. Are you enjoying soccer again?”

“Starting to. It’s easier when you know the other girls, I guess. The group’s hard to break into. They’re pretty tight with each other.”

“Yeah, you’ve mentioned that before. I’m sure it’s been challenging being new to a group that’s been together for a while.” Rylee still resented having to move in with Elin, away from all her friends and the life she’d had in Bethesda, MD.

“Did you get your hair done today? It looks nice.” Elin had made a trip to the salon earlier, to have her newly gray hair cut into a stylish bob. As a gift to herself after Ian died she’d let it go gray. So what if it made her look older?

They arrived home and Elin pulled the Audi into the garage. As they walked into the house Elin said, “Rylee, after you put your stuff away, before you get started on your homework, let’s have a snack. There’s something I need to talk to you about.”


Elin walked into the kitchen, waiting for Rylee. What could they have as a snack? She should have something healthy, struggling as she was with her weight, but she wanted something carb-y and bad for her.

A few minutes later, Rylee walked in and took a seat at the granite island in Elin’s large sun-filled kitchen.

“Okay, so here’s our snack options. Yogurt, fruit, guacamole and chips, cereal, a smoothie—”

“I vote for guac and chips.”

“You got it.” The closer she got to starting the conversation, the shakier she felt.

“So, Grandma, what’s going on?”

Elin focused on opening the guacamole container and getting the chips out, still unsure how to begin. “I got a call from a psychiatrist at a hospital in LA a little while ago.”

“About what?” Rylee dipped a blue corn chip into the guac and shoved it into her mouth. “Do we have any diet coke?”

“In the fridge.”

As Rylee got up to get her drink Elin said, “She called to tell me that Shelby is in the hospital—”

“What’s wrong this time?”

“She’s in the ICU following a drug overdose.” Elin grabbed a handful of chips and put them on a napkin, waiting to see Rylee’s reaction.

“Shit, really? Is she okay?”

“I’m actually not sure. From what Dr. Choi said, it sounds serious. I have to drive over there tomorrow. I’m not looking forward to it.” Probably shouldn’t have said that.

“Did you talk to Shelby?”

“I asked to but the doctor said she’s in a coma—”

“A coma! Shit, she’s really fucked herself up this time.”

Elin gave her a warning look about her language. Her parents Drew and Meredith had been very permissive with both girls when it came to language, and both had potty mouths.

“Sorry, Grandma.”

Something about her apology caused Elin’s eyes to fill. Rylee noticed right away.

“Grandma, I’m sorry about my reaction, I am. But I’m tired of Shelby’s antics and screw-ups. I lost both of my parents, too, you know. And you don't see me—”

“I know, sweetie. It’s just that I’m really worried. Did you know she was using drugs?”

“Weed, of course. But not anything more than that. It was always her drinking that Mom and Dad were worried about . . .”

Elin knew about the booze. Two years ago, when Shelby was a freshman, her drinking had landed her in the emergency room, leading to a twenty-eight-day rehab. Marisa had told Ian about it, but she was pretty sure they never told Rylee, wanting to protect her. Just one of the many secrets festering in that family. Apparently, rehab didn’t take.

Rylee ate another corn chip slathered with guacamole. “Did the doctor say which drug?”

“Fentanyl, synthetic fentanyl.”

“O. M. G.! Are you kidding me? They just talked about that in our health class. That’s crazy. It’s supposed to be, like, a hundred times more powerful than heroin or something like that. Why the hell would she ever take something like that?”

Elin wondered the same thing, having followed some articles in the newspaper about it. Even before her parents were tragically killed, Shelby seemed to be teetering on a precipice. Elin knew when she agreed to be guardian that Shelby would be a handful, already out of the house and running wild since high school, but she could never have envisioned something this scary.

“Here’s the thing, Rylee, I need to see what’s going on, and I’ll be gone at least a couple day—”

“No problem, Grandma, I’ll be fine here by myself.”

Nothing doing. “No, I don’t think that would be a good idea.”

“Are you saying you want me to come with you?”

“No!” Elin said, too sharply. “I mean that we need to figure out where you can stay for a couple of nights.” Even as she said it, she realized this was going to be a challenge.

“Is there anybody you can stay with for a couple nights, any friends at school?”

“Nobody. If I was at my old school . . .”

A sore point. When Ian’s son and daughter-in-law were killed in a terrorist attack outside of DC, Rylee had to move to Arizona. Elin had just lost Ian to cancer six months earlier, and was still grieving herself, as well as recovering from a year of heavy-duty caregiving. She reluctantly agreed to serve as guardian for her two granddaughters, but she wasn’t willing to move across the country. So Elin had made Rylee—and Rylee made it clear it was coercion—move to Arizona and change schools. Change her whole life really. That had been almost a year ago. The move had been brutal for both of them. Tears all around. Learning to live with a teenager wasn’t exactly a picnic for Elin. Since that time, they’d forged a fragile truce, Rylee gradually starting to adjust to Scottsdale. But Elin saw Rylee’s loneliness. And anger. And then there was Shelby . . .

“How about this?” Elin proposed. “How about if my friend Greta comes and stays here with you. You’ve met her. She’s nice. She’ll leave you alone. Just make sure everything’s okay. Take you to school. That way you can stay with Tucker and Chessie and Boots.” When Rylee moved, she brought Drew and Meredith’s two cats with her. Elin wasn’t sure how they’d get on with the dog, but Tucker was okay with them. And they were a great comfort to Rylee, sleeping with her every night.

She waited to see Rylee’s reaction. “That would be a huge help to me,” Elin added, putting a little pressure on her to agree. She really didn’t have too many options here. And she still had to get Greta to agree.

She could see Rylee’s hesitation. Finally, Rylee said, “All right. If it’ll make it easier for you.”

“Thanks. Let me call Greta.”


The drive to LA across I-8 was long and boring, the desert desiccated and brown at the end of a long hot summer. Feeling sorry for herself, Elin couldn’t help but think that a woman her age shouldn't have to be doing things like this alone. As if the long drive weren’t bad enough, then she had to face LA traffic and unfamiliar roads and doctors and a messed up twenty-year-old who was angry and lost. What had happened to that adorable little girl she had loved to read books to? To play dolls with?

She had planned to talk to both Ericka and Greta in the car on the way there, bringing them up to speed and getting their input on how she should approach her first meeting with Shelby. She tried her sister Ericka first. Had to leave a message explaining why she called. Couldn’t reach Greta either. Crap. In the meantime, to keep herself from obsessing too much, she turned on some upbeat bossa nova music.

An hour later, Ericka called back. Elin related what had happened with Shelby and that she was on her way to LA to see her in the hospital and talk with the psychiatrist.

Before she could even get her take on how to approach Shelby, Ericka said, “I told you not to take that on. I knew those girls would give you nothing but headaches. How come you never listen to me?” Ericka was the older of the two, very bossy and controlling. She’d been opposed to Elin assuming responsibility for Rylee and Shelby from the beginning.

“It’s not as though I really had much choice, Ericka.”

“Of course, you did. There’s always a choice. You could have said no. Your husband just died and you couldn’t handle it. They’re not even technically your granddaughters.”

She wasn’t even going to take that one on. Of course, they were her granddaughters. The fact that they weren’t biologically related to her was immaterial. She had been in their lives since they’d been born. She’d held them when they weighed six pounds. Touched their silky skin. Changed their diapers. Sung them to sleep. Read them Goodnight Moon. Loved them. She was the only grandmother they’d ever known. “And who else would have done it?”

“Not your problem their parents were killed and nobody younger was available to take over.” Ericka could be heartless.

Andrew was Ian’s only son. His mother, Ian’s ex-wife, had died from metastatic breast cancer twenty years ago, right after Shelby’s birth. And Drew’s wife Meredith had been estranged from her parents for years. Moot point since they were both dead now.

Ericka wouldn’t stop talking about how stupid it was for Elin to think she could take care of two teenagers and how she should call the lawyer back and say she’d come to her senses and changed her mind. How Elin had aged ten years since taking on this responsibility. “You look seventy years old, for god’s sake!”

She was almost seventy years old. What was she supposed to look like? Finally, she said, “Enough Ericka! This isn’t helping. I made a commitment to take care of these girls. And that’s what I’m going to do. If you can’t at least be supportive then I don’t want to speak to you.” And she hung up. Ericka would be pissed, but tough.

By the time she got off the phone with Ericka she felt even more rattled. Not only had the conversation not helped, it had made Elin feel worse. Why should she feel guilty for taking on the responsibility of caring for these girls? Of course, it wasn’t ideal. In fact, it was the last thing she would have thought about doing after losing Ian, but there just weren’t any other decent options. Those poor girls didn’t ask to have their parents killed. They needed someone who loved them to be looking after them, not some stranger. She switched to new age music in the hopes of chilling out as the traffic got heavier.

Then Greta finally called back. “Hey. Thanks a million for agreeing to stay with Rylee. I just got off the phone with my sister.”

“How’d that go?”

“About as badly as you might expect. She just thinks I’m a sucker for having agreed to be guardian to Rylee and Shelby.”

“Nonsense. I’m over at your house right now. Tucker says hello. We’ll all be fine here. So, how’re you doing?”

“I wouldn’t say I’m a mess, but yesterday was a pretty hard day. I just don’t think I’m cut out for all this drama. Maybe Ericka’s right . . . It’s not a coincidence I never had kids, you know. I’m just not any good at this kind of stuff. All I want at this point in my life is peace and serenity. I had enough drama with Ian’s ups and downs. And then Drew and Meredith were killed . . .” She could feel the tears stinging her eyes. “You know what? I am a mess, a total mess. I’m trying to keep it together for Rylee and this meeting with the psychiatrist, but I’m not doing a very good job.”

“Yes, you are! Not completely falling apart with all that’s happened in the past couple years is defined as a good job. A very good job. I wish I could do more. It pains me to hear the tears in your voice.”

“Staying at the house with Rylee is a huge help, really.”

Elin explained as much as she knew of what happened with Shelby—not much—and the upcoming meeting with the psychiatrist.

“Have you thought yet about what you’re going to say to Shelby?” asked Greta.

“Been obsessing about it. I’m so pissed off at her I could spit.”

They talked a bit longer before the traffic got so heavy that Elin finally said, “Greta, I’m gonna have to say goodbye. I need to pay attention to what I’m doing here. These California drivers are the take-no-prisoners type. I should be there in an hour. I’ll call tonight when I know more. Thanks again.”

After getting lost a couple of times, she finally found the medical center, grateful that Rylee had showed her how to navigate using Siri on her iPhone. She parked—twenty bucks!—found the nursing station on the eighth floor ICU, and asked to have Dr. Choi paged.

While she waited she tried to compose herself, wishing she had brought a written list of questions with her. There was a lot going on around her, what with constant announcements paging doctors and people in green scrubs rushing here and there, everyone in a hurry. That antiseptic smell made her queasy and took her right back to those anxiety-filled days of Ian’s illness. Her heart rate quickened the moment she walked in. Then she heard her therapist’s voice in her head saying, “Close your eyes and take a few long, slow deep breaths” and closed her eyes.

She was startled when she heard a voice say, “Are you Mrs. Bergstrom?”

“Yes, sorry, I am. I was just trying to . . .uh . . . center myself. Are you Dr. Choi?”

“I am. Let’s find a quiet place with some privacy.”

Dr. Choi escorted her down a wide hallway to a small, windowless room that said “Consultation” on the door. There was a ratty sofa and a single red vinyl-covered chair. “Have a seat.”

“Before we get started,” Elin said, “I have a question. Why a psychiatrist, rather than a doctor with a medical specialty?”

“When the EMTs brought Shelby to the emergency department, after they revived her, the only words she said indicated that she was disappointed to be alive after her overdose. So it appears that the overdose may have been a suicide attempt.”

She stopped when she saw Elin’s quick intake of breath, letting her absorb that information. “So we have a lot of questions about Shelby that we hope you can answer. We need to decide where she should go from here. Were you aware of her drug use?” Dr. Choi, whom Elin assumed was Korean, spoke almost unaccented English.

Her head bowed, Elin forced herself to take long, deep breaths to try to get a handle on her rapidly escalating anxiety. “I’m not sure where to begin. Shelby is my granddaughter, whom I assumed guardianship over about a year ago after both of her parents were killed in that terrorist attack in DC.” It had been all over the news for weeks afterward, so Elin assumed Dr. Choi would be familiar with it. She pulled a tissue out of her purse, buying time, trying to decide what to say next.

“Oh dear, that must have been very traumatic for her, especially with the constant news coverage in the aftermath.” Dr. Choi wore a white coat over a red dress. Her straight, jet black hair was pulled back into a bun. Very put together and professional.

“It was. Both girls—her fourteen-year-old sister Rylee moved in with me—were pretty traumatized and both are very, very angry. I think Rylee’s doing okay. I insisted on counseling, which she resisted, but she’s still going.” She blew her nose, struggling not to cry. “Shelby was another story. She was already at college, living away from home, and already pretty wild. I tried to get her to come and stay with me this past summer, when she didn’t have classes, but she refused.

“I knew she had an alcohol problem—her parents had sent her to rehab at the end of her freshman year—but I wasn’t aware of drugs, other than pot, which I assume they all use—”

“Actually, not everyone, but continue.”

“I’m not sure what happened after that rehab. Her parents kept it very hush-hush—Rylee didn’t even know, for example. I’m afraid they assumed rehab solved the problem. She lived back at home that summer, but some things came out after her parents’ deaths to suggest they were fairly preoccupied with their own issues right before the attack and not paying much attention to the girls.”

Dr. Choi said, “Were you aware of any suicide attempts before this?”

“No. Of course I’m shocked, but at the same time I’m not all that surprised, if that makes any sense.”

“Can you explain what you mean?”

“So you know what happened to her parents, and I’ve already mentioned the wildness—staying out all night, getting involved with unsavory boys and the like—and the drinking. And to top it off, not surprisingly, her grades were poor and she was always on academic probation, on the verge of being kicked out of school.” She stopped and sighed, twisting the tissue in her lap.

“So this young lady was not in a good place.”

“Not at all, and hadn’t been for a while.”

“Would you say she was depressed?”

“Probably, but she was so closed off it was hard to tell. Always sullen. Not once since her parents were killed have she and I had a serious conversation about what was going on with her. She’s resisted all of my attempts to get close to her. She resents that I control the trust fund her parents left—thank God for that—and don’t just turn the money over to her completely.”

Dr. Choi looked at her watch. “Okay, that information helps. Now we need to decide what’ll happen next when she’s discharged from ICU—”

“We haven’t talked about her medical status yet.”

“She’s stable right now, out of the coma. Her heart rate, blood pressure and breathing are almost normal, although she’s still very sleepy. The good news is that it doesn’t appear that there will be any long-term effects of the overdose. What’s not clear is whether she needs treatment for substance abuse. It would appear that she does. If so, we would want to make sure that wherever she goes has excellent mental health treatment available as well. This young woman needs intensive evaluation and counseling. I suspect she may be suffering from posttraumatic stress disorder as well as depression.”

Elin let out the breath she’d been holding. “In the past, she’s been very resistant to acknowledging that she has any issues. I’m concerned that she won’t be receptive to getting treatment . . .”

“What I’d suggest at this point is talking with her, seeing where she’s at, and how open she is. Then the three of us can meet and decide what the options are, maybe tomorrow afternoon.”

Elin tried to remember if there had ever been a conversation in the past she had dreaded more than this next one.


Elin walked into Shelby’s ICU room, where three other patients lay on beds hooked up to all kinds of machinery, just like Shelby. Lights of different colors blinked. She could hear faint beeping sounds. In the dimmed lighting, she could see Shelby propped up on pillows, her eyes closed, a clear narrow tube coming out of her nose. She had an IV attached to her left hand. Her dark hair had been dyed white blonde but had four inches of roots and looked greasy, dirty against her pale skin. She appeared to have lost weight. Was she sleeping? Should she wake her?

She pulled a chair up close to the bed, leaning her arms on the white, flannel blanket covering Shelby, bowing her head. This seemed like a good moment for a prayer or a conversation with Ian. Ironically, being here made her feel close to Ian, his last days spent in an ICU much like this one. She wished her racing heart would slow down.

She needed guidance, desperately wanting someone to tell her what to do. How to act. Even though she knew that “someone” didn’t exist. How could she have a clear head when so many different emotions ricocheted around in her brain?

“Is that you, Grandma?”

“It is, Shelby. How’re you feeling?”

“Very groggy. I’m sorry, Grandma.”

“For what.”

“You know what. For putting you through this.”

Elin considered saying, That’s okay. But it wasn’t. “The main thing is, we need to get you some help, Shelby, to figure out what put you in a place so dark you wanted to take fentanyl.”

No response.

Struggling to understand what had preceded and maybe caused this fentanyl overdose and possible suicide attempt, Elin said, “Shelby, you didn't come home this past summer so what did you do instead?”

“Your house in Scottsdale is not my home. I don't have a home. I'm homeless, Grandma. I lost my home when I lost my parents, remember? Plus, I hate the desert.”

Southern California is the desert too. Damn. This girl was still so angry.

“Okay. Bad choice of words. I ’spose my house isn’t your house, not yet.” When was she going to get over this anger? “I’m sure it’s hard not having a real home, but the question remains how did you spend this past summer?”

“I'm an adult and that's frankly none of your business.”

“Hah!” It slipped out before she could even stop it. Now her anger was getting the best of her. She couldn’t help herself. “An adult is someone who’s responsible and makes good decisions and financially supports themselves. Last time I checked you were doing none of those things.” She was tempted to remind her who wrote all the checks but decided against it.