Unfinished Story Stuff

Dementia - Two of the Author’s Experiences from Interning at Grady Hospital in the Late 70s

“Now what we have here is a classic case of dementia.”

Dr. _______ gestured to the patient sitting behind one-way glass, and resumed lecturing. There were about twenty of us, all interns, all hungry for experience. Young, naïve, idealistic when it suited us, we were going to change the world.

For the moment, however, we were restless. Tired of long lectures and bored
with observing, we milled about in our lab coats and listened. I was in the back of the group, leaning against a wall of windows and fiddling with the loose change in my pockets. The jingling of the coins sounded musical, a rhythmic chorus that was a welcome break from the clinical dryness of hospital life.

Behind the doctor was a large glass window, in which sat a patient of the mental-ward, gazing outwards with dead, hollow eyes. Her hair was stringy, brutally chopped and lifeless, a diadem celebrating the death of vision. She was wrapped in a straitjacket, a grotesque pillory where she was displayed to the curious and the repulsed.

Dr. ______ opened up the patients file and read the notes in a clinical, detached voice. "The patient exhibits paranoid ideation, loose associations, with poorly organized thought patterns. Has a delusional recurrent thought patterns in which she is being poisoned, others are trying to control her thoughts, and she fears loss of control of his own behavior. Believes she can communicate with ships offshore. Her delusional world is highly organized and fiercely held as the truth. Logical discussion gets nowhere. Denies suicidal or homicidal thoughts or impulses."

His voice droned on, comparing the patient to other psychotics and various case studies. The patient had, in her medical history, showed the signs of a shocking amount of disorders: the Fregoli Delusion, where to the patient all people seem to be the same person in various disguises; Cortard’s Syndrome, where the patient believes that she is dead or non-existent, the self becoming dark, obscured, illusory; Stendhal’s Syndrome, a curious one indeed, where exposure to art can bring on anxiety and panic attacks; False Memory Syndrome, where the patient’s past is fabricated and illusory, and often diametrically opposed to the sufferer's real past. I wondered what it would be like to be afflicted in this manner, possessing not one delusion but many, causing your vision to twist in new ways daily. Different days would bring new absurdities, like having your perceptions controlled by some Dadaist villain, intent on fragmenting the rational world.

During a pause in the case reading an intern spoke up, asking a question which had been bothering many of us. “Dr. _______, what has caused the patient to manifest such a wild variety of mental disorders?”

The Doctor smirked, looking away for a moment through the glass, and cocking his head as he gazed at the patient. With his finger he tapped a few times on the glass partition. He got no response from the patient, and, turning back, he looked at us and shrugged. “Who knows – substance abuse, genetic quirks, trauma, a traumatic childhood – this patient reflects no causality, no clear path or easy answers. If it can be blamed on any one thing, which it most likely cannot, I would choose to blame the modern condition, whatever that is.”

He then went back to lecturing, and as he talked he moved his hands wildly and emphatically, a strange contrast to the utter stillness of the patient. I daydreamed and watched the city outside, and his voice faded into the background. It was early morning, and the city was alive with cars and people walking, and it seemed to me that everything I had learned in school had failed to reflect that outside world. It is a damnable act of hubris to attempt to graph man's charts and graphs onto the world's ebb and flow. As if textbooks embodied logic and order, and the real world was too hectic, too full of flux, to ever imprison in such a flimsy wall of words.

Then I saw her. The day’s boredom crashed into a more immediate, more visceral, mode of existence. She appeared like a vision, making the air feel electric and setting my eyes to fire. There she was, poised on a windowsill, her arms extended outwards, looking to the heavens. She wore a nurse's white gown, which glowed in the morning light. She paid no mind to the ground eight stories below.

She jumped.


She jumped and it was a thing of beauty. A dive, perfect and graceful. An act of surrender as well as of final victory. A culmination. A sacrifice to the alter of inconsistency. Her hair caught the morning light and was sun-kissed into a halo. For a moment I thought that she was going to rise upwards, defiant and peaceful, ascending to the heavens and leaving behind all things concrete and metal. But just at that moment, when she was held between the sky and her descent, when I saw her as a sculpture evolved out of the city, her flight arched downwards.

My eyes followed her all the way to the bottom.

By this point people began to realize what happened, and they rushed around me, shoving me into the glass their faces pressed against with eyes hungry and leering. All talk of boredom, of the day’s slowness, was abandoned. The mutterings stopped, and the moment was piercing in its silence and stillness, as if that were somehow the proper course of action when exposed to the city's anomie. They all stared downwards, and so did I. We were absorbed in the spectacle, in the cinematic suddenness. A woman next to me crossed herself, hoping the apotropaic lines traced by her hands could protect her from the day's unnameable evil.

She was sprawled out against the ground. Torn, crumpled, a painful vision of the failure of the quest towards flight. A pool of blood was from her brokenness, and I imagined that if I were close enough I could see it all by reading the auguries contained in that redness. The reflection of the city, undulating as the blood rolled through the grooves and fissures of the sidewalk; the reflection of us looking downwards and secretly rejoicing in our supposed sanity, feeling the near-sexual buzz of survival in a dangerous environment; the mirroring of the sky which paid no notice, only drifting above, being reflected but never reflecting, offering nothing but a model on which to base your failings.

We stood there for a stretch of time, no one talking, no one looking away. Eventually Dr. ______ turned back to face into the building, clearing his throat, and wiping the sweat of his hands onto his lab-coat. The sweat left long drifting handprints, looking like someone had begged at his feet for penance and mercy. He spoke. "Now that, gentlemen, is exactly what we were speaking of."

***

“Don’t you see baby? I’m no sicker than anyone else on this Earth, it’s just that I show it more. That’s why they can stick me in here while all the real crazies run free.” She spoke from beneath thick cotton blankets, the darkness of her old hands gripping the rails which lined the bed. Ms. Edith was the sweetest, oldest soul that I was ever given the pleasure of helping. A welcome change from the surly drunks suffering through the D.T.s and the insouciant meanness of the superannuated. She was all laughter, full of tough-but-sweet sayings, and her voice crackled like the old records she kept in milkcrates beneath her bed. I would come--early in the morning or late at night, usually utterly tired and stumbling mechanically through my routines, so drained of everything that I must have begun to fade from color--would come to give her medicine and record her vital signs, and she would grab my wrist and say, “It’s okay, sit down for a minute or two, I won’t tell nobody. You need the rest.” She would dig into her collection of ancient 45s, stuff like Billie Holiday, Charlie Parker, recordings of tracks written by Buddy Bolden, old gospel songs and other bits of Americana, and would play them for me and laugh and smile.

I suppose that I can’t get around mentioning that there was something special about Ms. Edith, even apart from her unusual kindness. This became clear to me one night as she lectured me about Bolden, who she claimed was the inventor of jazz. “Old Buddy,” she said, “He was very much a genius--yes sir, he had the for sure.. But I guess that gift hung to heavily on the poor boy. He burnt out too young – seems like that happens to a lot of boys like that. Still, I always liked him, thought he was sweet, even if his eyes shone in the darkness. But he went mad at thirty-one, spent the rest of his life in a mental hospital. Sad story, just like a lot of stories.”

"There's one thing I can't help but wondering about, " I said. "You talk like you knew him, but that's impossible, since you yourself said that he was born in 1877."

She shrugged. "That don’t matter none. I knew him just the same.”

Ms. Edith may have claimed some very wild things, and even though they were shocking, what some would say were the tell-tell markings of dementia, the truth of her claims never interested me. Working at Grady Hospital I had seen more than enough of insanity, and no matter what was said about her, I knew for a fact that Ms. Edith was the sanest person that I had ever met.

Of course, the fact that I accepted her stories could very-well signify my own slipping mental state, for she claimed to be over two-hundred years old.

Once I asked her if she thought she would even die. She laughed, patting my hand like I was a child who had just asked a question to which the answer was obvious. “Of course I’ll die, sugar. Haven’t met a person yet who escaped that end. It’s just I’ve taken a longer time dying than most, that’s all.”

She would sit and tell me stories of her childhood or of the long stretch of her middle-age, and she spoke of amazing things. Impossible things. Beautiful things. She talked of when her shanty-town was hit by a flash flood which filled the streets with water for weeks, causing everyone to row around on pieces of driftwood or seated in washbasins. She said that one morning she woke up to see that the waters had left, and that the street’s cobblestones had all been replaced with gold. Her eyes shone as she described how the street’s wetness glittered in the light of that new morning, as if the gold of the sun and the gold of the street were dancing the day into being.

She told me many more stories, but I will not retell them here. Instead, I will keep them hidden, like a small boy clutching his favorite marbles, or like a card-shark with an ace up his sleeve. Her tone, throughout all she said, was never less than one of complete understanding, of humility, of mortality, of beauty and grace. A smoky, jazz-hall voice that never judged, never condemned, but which one of celebration--her voice a rapture, her words a dance. I remember one late night, just days before I was to leave for a new hospital and job, we were sitting listening to her records and talking of the things we had seen. That night, just as as Charlie Parker wailed in the cramped room, Ms. Edith died, holding my hand. At that moment I saw her story spread out before me, echoed in every tract of skin, in the grooves of her face. Her life was written in bruises and wrinkles across the fragile parchment of her skin. I think by that point she had ceased to be anything but stories, just a forgotten woman trying to remind us of what all is possible. So I sat for a while, listening to Charlie Parker bring some nightclub audience to their knees, riffing on his saxophone like it was all he had left, bringing something new, something alive and vibrant, into the city drabness. All the while I held her hand, feeling the heat leave and her fingers stiffen.