It is the end of a busy day interrupted by the realities we continue to wrestle with for our girl, María. There has been an ongoing push and pull with the hospital where she is hospitalized about medications. As her guardian I am charged with approving any med changes and I know too much now to approve blindly. This time, I was fortunate that her regular psychiatrist provided some guidance and recommendations for the conversations about med changes. But over a three day period, there were all kinds of misunderstandings that I had to spend time and energy sorting out.

We also had to accommodate a very unusual set of circumstances in her regular residential program—the administrator of BARC and the nurse director were out of town in training, the hospital’s psychiatrist and another person directly involved in her care rightly took time off to observe Yom Kippur. Yet another person was int he midst of receiving family and making preparations for her father’s funeral today. That made it impossible to make any plans for María’s discharge, though stays in a psych unit are very counterproductive for our girl and the sooner we can get her out, the better.

To my horror, late yesterday, I was advised that María was being discharged at 7:30 last night. Another round of anxiety, another round of calls that included being left on hold for what felt like endless waits, and we finally worked out that Maria would not be discharged at least until Monday. That was extremely fortunate; in the past, her insurers have forced discharges before an adequate plan for the transition was in place and there’s been hell to pay.

The good news is we get to put a plan in place. The bad news has to do with what happens to her inside the unit. She has to have been deemed ‘stablized’ enough to be discharged yesterday. And today she has been so agitated that three times she had receive a shot to sedate her. That may keep her in the unit longer than Monday. This endless loop of complications, steps forward and steps back…I’ve done better this time around, drawing some boundaries, understanding the limits of my capacity to make a meaningful difference in this situation. And it is also still true, that after a call like the one I received about today means I have to glue the pieces of a broken heart back together again.

She is safe. I have meaningful—make that beautiful—work I get to do in the morning, Sherod and I had a good day today. One day at a time. One step at a time. One breath at a time.