Turn of Mind

No problem! She turns to a girl, this one in an olive smock. Here. Take Jennifer to the kitchen for some hot milk. And make her take her meds. She refused at bedtime. You know what will happen tomorrow if we don’t get them into her.

Not milk. Coffee, I say, but no one is listening. That’s the way it is here. People will say anything, promise anything. You can ignore the words, even on the days when you can retain them, because you need to keep your eyes on their bodies. Their hands most of all. The hands don’t lie. You watch what they are holding. What they are reaching for. If you cannot see the hands, that is the time to be concerned. The time to begin screaming.

I study the face of the girl walking me to the dining room. My prosop-agnosia, my inability to distinguish one face from another, is getting worse. I cannot hold on to features, so when a person is in front of me, I study them. To try to do what every six-month-old child is capable of doing: separate the known from the unknown.

This one strikes no chords. Her face is pockmarked, and her head brachycephalic. She has an overbite and her right foot is slightly in-toed, probably due to an internal tibial torsion. Enough work there for many expensive medical specialists. But not for me. Because her hands are perfect. Large and capable. Not gentle. But this is not a place where gentleness thrives. Natural selection takes care of that, for both the caring and the cared for.

It’s a much-used word here, care. He needs long-term care. She is not qualified for home care. We are currently hiring more caregivers. Take care of her. Be careful with that. The other day, I found myself repeating the word over and over until it was meaningless. Care. Care. Care.

I asked one of the male attendants for a dictionary. The man without the beard yet who is not clean-shaven, the one whose face I remember because of the hemangioma on his left cheek.

He came back later with a piece of paper. Laura looked it up online for you, he said. He tried to hand it to me, but I shook my head. That was not a reading day, very few of them are anymore. He held up the paper and haltingly spoke, stumbling over the words. He is from the Philippines. He believes in the Holy Spirit, the Lord and Giver of Life. He makes the sign of the cross in front of the statue of the haloed woman on my dresser. He has asked me several times about my Saint Christopher medal and clearly approves of me wearing it.

Care: a burdened state of mind, as that arising from heavy responsibilities, he read. Watchful oversight. Assistance or treatment to those in need.

He paused and frowned, then laughed. That’s a lot of definition for such a short word! It sure makes my job sound hard!

It is hard, I said. You have the hardest job. I like this one. He has a face I approve of, in spite of—or perhaps because of—his birthmark. A face you can remember. A face that makes my anguish over my prosopagnosia dissipate a little.

No, no! Not with patients like you!

Stop flirting! I told him. But he got a smile out of me. Something this girl with the good hands is not going to do.

We reach the dining room, and she deposits me in a chair, leaves. Another will take her place. And another.

As with my patients at the free clinic I volunteer for every Wednesday: I focus on the symptoms, ignore the personalities. Just this morning I saw a case. If not for the puffiness around the hands and ankles, I would have simply diagnosed a mild case of depression. He was irritable. Unable to focus. His wife had been complaining, he said. But the inflammation made me suspicious, and I ordered tests for endomysial and anti-tissue transglutaminase antibodies.

If I’m right, a life of deprivation to follow. No wheat. No dairy. No bread, the staff of life. Some self-dramatizing, self-pitying people would see being diagnosed with celiac as a death sentence of life’s pleasures. If only they had known what lay in store for them, what would they have done differently? Indulged more? Or restrained themselves sooner?

My milk arrives, along with a small cup of pills. I spit into the milk, hurl the pills so they scatter under tables, into corners.

Jen! someone says. You know that’s against the rules!

People start bending, going down on their hands and knees to retrieve the red, blue, and yellow pills. I resist the urge to kick the one closest to me in the backside and instead head back to my room. Yes. I will break every rule, transgress every line. And I prepare myself for battle as reinforcements begin arriving.

Something nags. Just out of reach. Something to be shuddered at. Something bloody but unbowed by my resistance. This dark shame. A pain too lonely to bear.

Visitors come and go. When they head toward the exit, I always follow, I quietly move in, ingratiate myself with the person or persons leaving. When they pass through the door, I will too. It’s that simple. No matter that I’ve always been stopped. One day it will work. No one will notice. No one will realize until mealtime. Then I will be long gone. I will eventually make it. Next time for certain.

There is a woman here who is always surrounded by people. Visitors, night and day. Beloved by all. She is one of the lucky ones. She doesn’t know where she is, she doesn’t always recognize her husband or children, she wears diapers, and she’s lost many of her words, but she is sweet and serene. She is descending with dignity.

The Vietnam vet, on the other hand, is alone. No visitors. He continually and loudly relives his glory days or his nightmares, depending on the day or even the hour. He either did or did not participate in a massacre, one of the famous ones. Some of the details ring truer than others. Heaving a goat carcass into a well. The way blood mists when slicing a vein. Like me, he understands that he is incarcerated for crimes past.