by KT Sparks
Diagnosis: Possible transient ischemic stroke or strokes.
NOTE: Add to file, article from July New England Journal of Medicine, Armengard P.W., Situational Dementia: Coronary Causes, Pathological Presentation (Done!!—Nurse Treble)
Recommendations:
*Referral to Mayo for CT scan, possible endarterectomy. Explained limitations of imaging technology, carotid artery surgery for past cardiac events. PATIENT REFUSED REFERRAL.
*Referral to University of Illinois Bartolucci Brain Injury Center for speech and physical therapy. PATIENT REFUSED REFERRAL.
*Referral to Pierre Nurses-on-the-Go for in-home therapy and assistance with D. Oliphant (ductal carcinoma, radical mastectomy, 6.28.85, Swinehurst Hospital, Dr. Sumner Fensterwald attending). PATIENT REFUSED REFERRAL.
*Discussed care options with son Martin, who will coordinate henceforth. Weekly home visits for patients C. and D. Oliphant scheduled. No further medical intervention required at this time.
Transcribed by Nurse Treble, 8.26.85
5
“Situational dementia brought on by a small stroke, maybe several small strokes.” Dr. Broad closed the file marked “Carroll Oliphant” on its outer cover in red Magic Marker. Martin shifted, and the white paper pressed between his rear end and the exam table crackled. Sunlight from the window behind his shoulder bounced off the bell of the stethoscope clipped to the pocket of Dr. Broad’s white coat and shot into Martin’s left eye.
“Can we talk someplace else?” Martin said. He didn’t like the way his legs dangled. He felt seven years old. He’d come here for his annual physical ever since he could remember. He would strip down to his skivvies and sit cold in this exact place, waiting for Nurse Treble, a bulldog who smelled of sweat and peanuts, to burst in and jab him with a horse needle. Dr. Broad would show up after the initial scream and proffer a clear bowl full of plastic rings and toys. They were cheap trinkets, inferior to what he could have procured for a nickel in the machine at Zitta’s Five and Dime. But back then, Martin, and every kid he knew, would rather have one of those crappy rings than a bag of real gold. They signified an escape from pain and terror for one more year, FDR’s promised freedom from fear.
Dr. Broad held that bowl now. It was only about a quarter full, and it occurred to Martin that it might not have been topped up since he was in elementary school. It looked to be almost all rings, none of the tiny red sedans that had once been there.
“How about I sit up there with you?” said Dr. Broad. He hopped on a metal footstool, swiveled himself next to Martin, and bounced the bowl on his leg.
“Should Mom hear this?” said Martin.
“She said she’ll wait for you out front. She also said she knows perfectly well what’s wrong with her husband, exhaustion. I don’t think she is willing to take in any more, and I don’t recommend telling her more in her current condition. Your father said he was going back to work. That hasn’t been a problem? Driving, working?”
“No. He hasn’t been home a week and he’s already closed on a stockyard in Stevensville and a Far-Out Jeans Emporium in South Bend,” said Martin.
“Increased proficiency is often a symptom of situational dementia,” said Dr. Broad.
Martin felt his back sweat. “Situational dementia,” he said. “I’ve never heard of it.”
“The brain is an amazing thing,” said Dr. Broad. He hooked a purple ring on his right pinky and twirled it. “We ran several tests. In some areas—Frank’s tennis career, your father’s own work with struggling small businesses, the rankings in the Pro-Am Western Challenge for the last thirteen years—your father’s mental function is not only sufficient, it’s first rate. And in other areas…” The doctor paused, shook off the purple ring, dug for something near the bottom of the bowl.
“Like my mom,” said Martin.
“Like your mother,” said Dr. Broad. “In such areas, he’s almost one hundred percent demented.”
“What does that mean?” said Martin.
Dr. Broad abandoned his search and looked at Martin. “I read about a case in which a stroke patient couldn’t recognize, or comprehend in any way, any of the cruciferous vegetables. Not cabbages or radishes or even Brussels sprouts.”
“But this is my mom, his wife.”
“Kohlrabi, arugula, turnip, rutabaga, tatsoi.” Dr. Broad looked over at Martin, seemed surprised to see him there.
“What do we do?” said Martin. “I’m supposed to go back to school next week.”
“This is a difficult situation,” said Dr. Broad and offered the ring bowl to Martin. He picked out a yellow taxi he had spotted while the doctor was doing the roll call of the crucifers.
“You know,” the doctor said, “your mother doesn’t have tennis elbow. Or she might, but it’s the least of her worries right now.”
“How bad?” said Martin.
“Bad,” said Dr. Broad. “We’re talking weeks.” He sighed and snagged a mood ring, cupped it in his hand, huffed on it. “I’ve talked to your mother about getting a nurse. She flat out refuses, says it’s a waste of money. And I talked to your father, just now. He flat out refuses. Won’t pay medical bills for a stranger.”
“I’m supposed to go back to school,” Martin said again. And his mom was dying. This he could not say out loud.
Dr. Broad nodded. Dug a small grave in the plastic toys, lowered the mood ring in, mumbled something, perhaps a little prayer? Martin thought of the poem on the page tucked in his wallet. “A Prayer for Mother.”
I thank You, Lord, that I am placed so well,
That You have made my freedom so complete;
That I’m no slave of whistle, clock or bell,
Nor weak-eyed prisoner of wall and street.
Just let me live my life as I’ve begun
And give me work that’s open to the sky,
Make me a pardner of the wind and sun,
And I won’t ask a life that’s soft or high.
Martin mouthed the words. He knew them by heart, spoke them every night before bed, every morning when he rose. But today, this minute, was the first time he really understood why Beaufort had put them in his column for Jimmy Sneedle’s newsletter, a message surely meant for Martin. He thought back to his hours in the barn, how Beaufort had insisted that Martin practice pronouncing “pardner.” Martin, in his denim Dockers and checked yoke shirt with the mother-of-pearl snaps. Martin who came no closer than ten feet to a horse all that week. Martin who was, when it came down to it, afraid of horses. He had been since Buster’s death, before that, too. He claimed allergies— dangerous, throat-swelling, eye-bloodying, anaphylactic-shock-inducing allergies. But it was fear, just fear. Beaufort must have realized, and yet he had gone all Henry Higgins on Martin—“Paaah-dner, Paaah-dner, one more time, boy”—even though the old rancher had to have known, Martin was not a pardner, not a pardner at all.
But maybe there was still time. The poem was a life rope, wasn’t it? Beaufort had tossed the lasso, locked it around Martin’s bull head, was pulling him out of the rapids and into the salt cedars at the river’s edge. Because Martin was in danger. In danger of sweeping unconscious through the University of Chicago’s common core and (very fine) political science research curriculum until he washed up in some grey fabric-covered cubicle at a think tank with a name like The Center for Applied Thought Metrics. Beaufort had been trying to save Martin from a life that’s soft or high. But Martin hadn’t seen it. Forgot all that hard-won wisdom shared through coffee-brown teeth and whiskey-scented whispers. Forgot the words of the cowboy poets passed down voice to voice, hand to hand, and for one half of one fine week, to Martin. He had forgotten it the minute he got back to school, the minute he marched back through Cobb Gate with its gables and gargoyles. Ridiculous! Gothic garnish on Chicago’s South Side—land of Johnny Lee Hooker, Muddy Waters, and bad, bad Leroy Brown, not Louis the Sixth. But he ma
rched in without hesitation, glazed eyes and willing heart, an eager slave of whistle, clock, or bell. He marched through the last six weeks of the trimester, high on Aristotle’s Metaphysics and Marx’s manifestos; high on Sammy’s watered-down Stroh’s and joints from the used-bookstore guy who was in year twelve of his Ph.D. in Eastern Religions; high on the fog of all that classics-fueled, academically charged, self-indulgent, abstract certainty. Certainty that he, and those like him, knew the most, thought the deepest, comprehended the world at its center, and would, like Plato’s philosopher kings, one day rule with undeserved benevolence over the fit and fatuous masses who made up everyone else.
But they didn’t make up everyone else, did they? There were the cowboy poets too. Men like Beaufort and the barn hands and Jack Thorpe and Ben Arnold and Henry Herbert Knibbs and Badger Clark. And Ginger. Women like Ginger. Men and women who had embraced him for the best four days of his life.
Let me be square and generous with all.
I’m careless sometimes, Lord, when I’m in town,
But never let ’em say I’m mean or small!
Make me as big and open as the plains,
As honest as the hawse between my knees,
Clean as the wind that blows behind the rains,
Free as the hawk that circles down the breeze!
Christ, how careless he had been. How consumed with returning to his libraries and his books and his endless thinking without doing. He was needed here. Here, where the woman who had given him life lay dying. And he, Martin, was the one, the only one, to shepherd her to a peaceful grave. So thank you to Badger Clark and your western God and Beaufort. And Ginger, always Ginger. Thank you to his mom, his poor, simpering, status-addled, fading mom. Thank you even to Dr. Broad and his bottomless trove of cheap plastic rings. Martin had again, here, thigh to thigh with the doctor, realized the gift of cowboy poetry, of the hope of a life in which the only lexicon was action, the only emotion, earned. Free as the hawk that circles down the breeze. He had received the gift before, at Jimmy Sneedle’s, received it and walked away. And now, on this narrow bench, the sanitary table paper starting to tear under Martin’s chinos, he received it again.
Martin hopped from the bench, snatched the bowl of toys from Dr. Broad’s lap, and headed for the door.
Martin settled Dottie in the front seat of the Oldsmobile, maneuvered to the driver’s side, and got in. He passed her the ring bowl. She mumbled something, the fish-gray tip of her tongue escaping out the right side of her lips every second syllable or so.
“How was your appointment?” said Martin.
She slumped and shook her head, picked through the bowl, slipped artichoke bands on every finger, fluttered them in front of her face, and hummed “Copacabana.” She didn’t give the bowl back until after they had pulled into the garage. Martin got out, squeezed to her side, and offered his arm. She spread her bedecked hands, two green plastic starbursts, and hissed, “At the Copa, don’t fall in love.”
Inside, the house had smelled as it had all summer: burnt ramen noodles, Pledge, and that sickbed stink—artificially sweetened urine and iodine—that clung to his mom’s belongings no matter how often Martin laundered them. But underneath all that, he could sense a shift in the prevailing winds. Horse manure, desert night, pine. He yelled to Frank that they were home and to make sure Mom got some dinner. He ignored the yelps of “wait” and “cold” from Frank’s bedroom and headed back to the garage. His mom would be fine for a few hours. But right now, Martin needed to be with men who worked with their hands.
The early ’80s had been kind to neither farm nor factory, and Pierre, Michigan, sat on the border between the rust and fruit belts. In such a town, men drank at four o’clock, an hour after the three o’clock whistle, not that there had been a three o’clock whistle for years. At three, they would rise up from the plastic–covered couches and Formica kitchen tables where they’d been having a coffee, reading that morning’s Leader Telegram, resisting the urge to turn on the boob tube. They would rise to the unblown whistle like dogs to a silent call, pull on their tan car coats, leave notes for their wives to find when they returned from shifts at the Holiday Inn. At the Buck, they would scribble. Back for supper.
The men were already hunched over the scarred pine bar at half-past four when Martin, still clutching the ring bowl to his chest, entered the smoky haze of the Silver Dollar Saloon. He extracted a stool from between two of them, both in pale yellow polo shirts and bent over half-full mugs of boilermakers. Martin signaled the bartender, Hank, a pink bowling ball of a man with perfectly round eyes and a perpetually surprised oval of a mouth. Hank puckered his lips and flared his cheeks.
“What’ll it be, son?”
“A beer, I guess,” said Martin, wishing he had the guts to order one with the depth charge of whiskey, a boilermaker, like the regulars did. He wondered if that were a universal working man drink, one that a cowboy poet might slug down after a day walking the fence line and chasing reluctant dogies out of aspen stands. Or was it just a Midwestern drink, a drink for guys who trafficked in steel, carburetor parts, assembly lines, and tires?
“What’s that, son?” said Hank. “I’m a little hard of hearing.”
“Um,” said Martin.
“Over here.” A voice floated from the far bend of the bar.
Martin looked in its direction and made out a gnarled branch of an arm swiping at the smoke clouds. “Martin Oliphant, join us.”
Martin did, leaving Hank muttering to the two regulars.
“Mr. Lattner,” Martin said. “Hi.”
Bob Lattner was the doggedly alcoholic and violently bitter editor of the Leader Telegram, which, every morning, brought the 8,000 or so residents of Pierre “local news of national import through a global lens.” Or so claimed the paper’s motto, featured in the boxed ear to the left of the masthead. The slogan was mostly aspirational. Editorials on the bravery of the Lake Michigan Polar Bear Club or in-depth interviews with that year’s acne-scarred Cotillion Grand March leaders were typical of the paper’s fare. Only occasionally did the editorial staff, which consisted of Lattner and a revolving roster of recent college English grads, venture into issues such as AIDS or Ronald Reagan’s second term. Martin had never spoken to Lattner before but knew who he was. Pierre was a small town, and Lattner’s presence was a given at any event of even the slightest significance. If not beloved by his many readers, he was tolerated as a necessary piece of public infrastructure.
“Master Oliphant,” said Lattner, “what’s your pleasure?”
Martin wondered how long the newspaperman had been at the tavern. “A beer?” Martin said, then added, “A Stroh’s?” inspired by the aqua neon sign behind the bar. It bathed Flip, the donut shop proprietor sitting next to Lattner, in an undulating blue light.
“A fine choice for the young prince. A Michigan beer for a Michigan man,” said Lattner and yelled to Hank, “One Stroh’s with a Jim Beam chaser. On me.”
“Stroh’s is piss water,” said Flip. “Coors is what you want. But you can’t get it here. My brother’s gonna bring me a case when he comes out. It’s the water out West. It’s pure. Don’t catch on fire and shit, like Lake Erie do.”
“You are a victim of advertising and corporate manipulation, my friend,” said Lattner, “a shill in the three-card monte game known as manufactured scarcity.”
Flip nodded, as if he had known that all along. “How’s your mother doing?” he asked, lifting his drink with both hands and taking a sip. “Piss water,” he mumbled.
“Okay,” Martin said, horrified to hear his voice crack.
“Good to hear,” said Flip, burying his face in his stein and shutting his eyes.
“Excellent news,” said Lattner. He patted Martin’s hand, now flat on the bar, moved to do so again, seemed to think better of it, waved off a nonexistent fly.
The editor made a show of st
udying the Stroh’s sign while sneaking glances at Martin. In sympathy, perhaps. More likely concern. Concern that Martin might start blubbering. Martin understood. He shared that concern.
Hank arrived with Martin’s mug of Stroh’s and the shot of Jim Beam. He kept his hands in his lap on the bowl of rings and stared at the two glasses, the mug filled with bubbling liquid that was, Flip was right, urine yellow, the shot glass almost overflowing. Before Martin could stop himself, he leaned over and sniffed at it.
“Like this,” said Flip, snatching the shot glass from under Martin’s nose and dropping it into the beer. Bubbles followed the pony as it floated to the bottom of the mug. A thin layer of foam slid over the side and puddled around the base.
“Pretty,” said Flip.
Martin, as nonchalantly as he could manage, set the bowl of rings next to a crusty ketchup dispenser. He picked up his boilermaker by the handle and sipped, he hoped not too delicately.
The first taste was all beer. He took another sip, one he thought might even be described as a slug. This time a flicker of whiskey licked at his sinuses, cigar in its undertones, a bit of gunpowder on the tongue. He downed three quarters of the drink in one go. And hardly choked at all. Lattner laughed and pounded him on the back.
“Another here,” he called to Hank. “And one more for me as well. You’re okay, Martin Oliphant.”