Alice LaPlante - Turn of Mind

I’ve been listening to the rise and fall of her soft voice, paying attention to the cadence. Wondering who she is. This brightly colored bird in my kitchen. This beautiful girl with the face of an angel who is leaning over to brush her lips against my hair.

The boy is looking amused. You’ve always been sentimental, he says.

And you’ve always been an ass.

She gives him a little push as they walk toward the door. The end of an epoch, I hear the boy say as he closes it behind him.

The end, I echo, and the words hang in the now-empty house.

TWO

The woman with no neck is screaming again. A distant buzzer and then the muffled sound of soft-soled shoes on thick carpet hurrying past my door.

Other noises emerge from other rooms on the floor. The calls of incarcerated animals when one of their own is distressed. Some recognizable words like help and come here but mostly cries that swell and converge.

This has happened before, this descent from one circle of hell into the next. How many times? The days have morphed into decades in this place. When did I feel the warmth of the sun? When did a fly or mosquito last land on my arm? When was I last able to go to the bathroom at night without someone materializing at my side? Tugging my nightgown down around my hips. Gripping me so hard I look for the bruise after.

The screaming, although subdued, hasn’t stopped, so I get up. I can stop this. Prescribe something. One of the benzodiazepines. Or perhaps Nembutal. Something to relieve the anxiety, stop the noise, which is now coming from all different directions. I’ll order a round. Drinks are on me! Anything to prevent this place from descending into true bedlam. But arms are pulling at me, not gently. Heaving me to my feet before I am ready.

Where are you going. To the bathroom? Let me help. In the dim light I can barely make out the speaker’s face. Female, I think, but I find that increasingly difficult to tell. Unisex white scrubs. Hair short or tightly pulled back from the face. Impassive features.

No. Not the bathroom. To that poor woman. To help. Leave me alone. I can get out of bed myself.

No, it’s not safe. It’s the new meds. They make you unsteady. You could fall.

Let me fall then. If you’re going to treat me like a child, then treat me like an actual child. Let me pick myself up when I fall.

Jen, you could really hurt yourself. Then I would get into trouble. And you wouldn’t want that, would you?

It’s Dr. White. Not Jenny. Absolutely not Jen. And I wouldn’t care if you were fired. Another would just take your place. You’re interchangeable enough.

Dozens of people come and go, some lighter, some darker, some speaking better English than others, but all their faces blending into one another.

Okay, Dr. White. No problem .

She doesn’t let go of my arms. With a grip that could subdue a 250-pound man she pulls me to a standing position, puts one hand on the small of my back and the other at my elbow.

Now we can go together and see what’s happening, she says. I bet you could be of service to Laura! She sure needs it sometimes!

Still holding on to my arm, she walks me into the hall. People are milling aimlessly, as if after a fire drill.

Oh good, see, all over! Would you like to go back to bed now or have some hot milk in the dining room?

Coffee, I say. Black.

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!