Dr Blake smoothed breezeblock grey strands of wilting locks back from his forehead with fingers purposely boned for paperwork only. Adjusting the silk bow tie his mother-in-law had presented him with at Christmas to the angle a windmill might pause in a westerly wind he strode across the vintage marmalade colour floorboards of his office and clanked along the corridor towards the Gents. Pockets full of change.
Before seeing a client (formerly known as patients) he liked to practise facial expressions in the spotless oval mirror above a far too small, in his opinion, sparkling white basin. The facial expressions were not for the sake of the client; they were for the sake of the client’s companion. Head on one side with a little cluck showed sympathy. A set mouth with staring eyes disapproval. Chin in; nose down and eyes lowered suggested deep thought. He had a complete intellectual dictionary of non-verbal communication to rival any modern TV pseudo Doc.
Eyes to the left consideration, eyes to the right disbelief, eyes heavenward total distraction when he needed time to think. When he clasped his insignificant knuckles he hoped it showed sincerity and when he scratched the side of his long nose he inadvertently revealed he was feeling anxious so he tried to avoid that one. Also it drew attention to burst blood vessels, a sign of age to be detracted from like so many others.
Today’s client had been complaining that his wife found him forgetful, distant, down right obstreperous at times. They’d chuckled about how usual all these traits were in any man who likes to avoid his wife. His wife had not joined in the joke. This chap didn’t seem too bad to Dr Blake, a bit of a fantasist perhaps but retirement often made chaps feel redundant and if they could elaborate on a mediocre past it made them feel, well more important. Dr Blake couldn’t see much wrong in that. He liked to exaggerate a bit himself at dinner parties,
with the fellows in his private club, to the young bit of crumpet who dug her apparently sharpened fingernails into his ever stiffening back muscles. Ego and Id, perfectly normal, whatever normal was supposed to be. Hah.
They’d had a wonderful chat about cricket at their last meeting. Dr Blake enjoyed a man’s man. His chosen career seemed a bit of a minefield these days, so much political correctness, so many lawsuits, it hemmed in all the stuff that seemed like plain common sense to him. If a ‘client’ cried these days, he was not permitted to offer a hug, a pat on the shoulder, a squeeze of the hand, should it be misconstrued. Misconstrued for God’s sake, how times had changed.
Ridiculous programmes on television, over-analysing every thought, deed and deviation to distraction, lawsuits American style, stress blamed for every last ill while mental patients roamed the streets knocking off heads with Samurai swords apparently trusted to ‘care in the community’. What could psychiatrists do in a world gone mad?
Dr Blake chuckled without humour. Madness would perhaps be the last refuge for a man like himself. He’d seen all the horror of man’s inner mind, the turmoil of torture submitted to the human brain thanks to genetics, chemical imbalances, the evil of others, guilt, abuse, inadequacy, low self esteem, blame. The causes were endless, the cures intermittently effective and often difficult or impossible to administer if a cure was possible to give at all and at many times it was not.
Ah the blame for lack of success. While he had a brilliant mind, those who did the day to day caring did not. While he could write endless academic reports making suggestions and analysing conditions, neurosis, personality disorders et al he could not take the mind of the carer and mould it to necessarily understand the mind of the patient, oops client. Some were good. Mabel Clarke had been marvellous, a matron who in the seventies had created a
mental health ward in which he would have happily resided himself. Mabel had been rare enough to take the most heinous condition and create something positive through understanding those who were beyond understanding. More rare than the most expensive truffle was dear Mabel. Unfortunately she met her end at the hands of a paranoid schizophrenic who took exception to the shape of her nose. Even those who try to understand cannot expect the unexpected. Dr Blake sniggered without mirth.
He hated the Victorian mental institutions he visited. He hated the smell of desperation, of hopelessness, of fear. He hated the smell of a society that cannot deal with illnesses that have no end until death. Human beings cast into what amounted to cells with greying walls, high windows and echoing floors. We know not what to do with them, he thought with a beleaguered frown, so we hide them in vile places, then one by one we shut the places down saying it is better that the community deals with those that we cannot. And there bedlam begins and ends with tragedy after tragedy with no lessons learnt.
Such heavy thoughts for a Friday afternoon, he raised his eyebrows and expelled a long breath releasing the stress, the perpetual exhaustion of a lifetime spent trying to help others.
“They’re running late.” Maggie, her fleshy open mouth, all he ever seemed to notice of her, shaped the words he knew were coming before they tripped along the airwaves in her soft Scottish lilt. Soon to be followed by “would you like some tea Doctor?”
Dr Blake smiled, regularity, repetition, predictability, all could lead to depression. The security of knowing what was to come had a double-edged flow. Knowing what was to come could alleviate uncertainty or become as monotonous as the white dot that used to signify the end of programmes on TV. Smiling as he stretched his legs, Dr Blake eyed his secretary with weariness from too long an association. How to break the mould? He couldn’t help
himself. “With a dash of whisky?” Seemingly Maggie always found this to be a huge joke, though he wondered.
“Oh doctor, you can’t be serious. It’ll just be your usual splash of milk I’m afraid, no whisky in the workplace sir!” She tittered as if she hadn’t heard his mischievousness a billion times before. And for the billionth time he waited until her sandy corkscrew curls had disappeared from view before opening a drawer and taking a swig from a malt-filled hip flask. Medicinal purposes hah!
So, he would wait, good thing he had no other appointments today. He curled up a piece of paper with a fingernail, Mr Sanderson. No face fitted the name only a vague recollection of pleasant reminisces. Scribbled notes, dates, neurological reports, letters from a GP somewhere in East Grinstead, blood tests, no brain scan yet, perhaps he should request that though the fellow had seemed pretty much on the ball to Dr Blake when last they met.
He got up and walked over to the long narrow window he relied on for scant natural light. The courtyard outside was over grown with clematis, ivy, shrubs that never got trimmed, a slimy moss rugged the paving slabs. The wall and railings separated it all from the gravelled car park, which so far was empty. He didn’t know if Mr Sanderson, and Mrs Sanderson he supposed, would arrive by car. He waited there in case they did, he liked cars, you could sit in a car and no one could reach you. His new Mercedes felt like the womb, cocooning him from the outside world, shutting off the sound, taking away the intrusions of daily life. The Mercedes would glide along the streets and no one could talk to him, interrupt or annoy, the car was safer than even the study at the top of his townhouse.
No car came and he glanced at his watch. Only ten minutes had passed.
Jingling change in his pockets he decided to call his daughter.
“Hetty dear, you are there.” He paused as if this were a doubtable fact when she had answered the phone so obviously was there. He cursed his own habits. “Had a few moments so I thought I’d see how you are. Good, you got back all right. Journey down? Ah yes, of course, what’s his name, yes I remember, Martin, drove you down of course. Lovely.” Martin, the boyfriend he supposed. Couldn’t picture him, he could only see the face of Ray, Hetty’s Grammar school boyfriend all ruddy from soccer, giving him nervous glances, as if he were some kind of ogre. “Yes well I suppose I’ll see you this evening, Ma is cooking lamb I believe. Oh Martin’s a vegetarian; mmm… well you better tell…ah she already knew that. Good. Well until later then.” As he dropped the receiver back down, Maggie appeared again with such silent stealth he twitched.
“The Sandersons, they’re here.”
Mrs Sanderson, round with middle age, sherry and jam doughnuts, didn’t feel nervous, didn’t feel relieved, didn’t feel. This had gone on and on and on, this merry-go-round of not knowing what was wrong with Mr Sanderson. She knew, sitting here right now he would smile, nod and make appropriate responses as and when required when he saw the doctor. She had made sure his clothes were clean, his shirt tucked in and that his socks were not odd.
The creaking chair in Dr Blake’s waiting room made her grit her teeth. Glancing at her husband she fingered the strap of the dark leather handbag in her lap and thought of it as a noose. Not for him, but for her.
Mr Sanderson shuffled his feet; he stared at his shoes intently, as if he’d never seen them before. They shone, rubbed and polished to perfection; he could see a face in the reflection. He eyed it with suspicion.
Mrs Sanderson watched the Scots receptionist return all smiley nice and reassuring.
“Follow me.” She chimed, as if they were off to a party.
“Gerry!” Dr Blake grinned, revealing cigar stained teeth. Firmly shaking Mr Sanderson’s hand he gestured for him to take a seat in the bay of the window. “Less formal.” He gave Mrs Sanderson a brief dismissive nod then remained standing for a moment. It was time for small talk. “Lovely day out there, quite spring like don’t you think?” He kept the tone light and airy, fun and free. “Suppose the traffic was dreadful, always is. I try to get in before the jams start and leave late enough to avoid them but these days the roads are clogged up pretty much all the time.”
Gerry smiled at this tall friendly fellow “quite so, “ was all he said.
Dr Blake perched himself against the window ledge. Mrs Sanderson didn’t notice that it was well polished, no dust, no dead flies. She thought instead of how she’d had to forcibly pull her husband out of his car a week ago to stop him driving into town. A few days before that his erratic driving; overtaking on bends, speeding in a residential area, failing to spot a child run out in front of the car, had caused her to grab the wheel to avert an accident.
“So how have you been Gerry?”
“Very well thank you, and you?”
“Blasted arthritis plays me up sometimes but that’s a curse of growing older I suppose. That and too many tackles on the playing field no doubt. Play any sports yourself Gerry?”
Gerry smiled “oh yes, cricket, tennis, football. I love tennis, but I only watch now. Great game that Borg plays, loved to have had a shot at him all the best players seem to be foreigners.”
Ignoring Gerry’s error in time, Borg was of another era, Dr Blake clucked in agreement. “So how is work?”
“Oh busy, tiring, you know.” Gerry frowned and folded his arms.
Mrs Sanderson glanced at her husband. The groove at the bridge of his nose had deepened through the years, a subtle measure of time’s toll. Her husband had been blessed with handsome features, though never vain always well groomed, his resplendent silver-dappled hair brushed back from his face, shone with health. Outer health, inner sickness, the outer belied the inner.
“Any problems at work?” Dr Blake asked the question as if it were of no importance whatsoever.
“No.”
Mrs Sanderson shifted in her chair and Dr Blake gave her a look as if silently commanding her to remain still. “So coping all right then?”
“Coping? Yes of course.” Gerry grunted somehow confused by the question.
Yes, he was coping all right, thought Mrs Sanderson; he was just fine and dandy. He would leave at the usual time and turn up at a completely different office to the one at which he
was supposed to be working. She’d get calls from a secretary who spoke to her in whispers. And she didn’t know what to do. She shook her head.
“Your wife doesn’t appear to agree.” Said the doctor giving her a look, not of understanding but seemingly of pure indifference.
It seemed so disloyal to speak up, to humiliate her husband in front of this apparently affable man who had barely acknowledged her existence so far. How to tell of the way her husband sat at dinner, not speaking much when before he’d been such a chatterbox. What to say about his snapping at Jessica and Andrew when they tried to ask him questions, everyday questions that he should have understood. His wandering off to places his parents had taken him as a child and not being able to explain why he felt the need to do this. He would return even more confused. How could she put all the changes in Gerry’s behaviour into easy, uncomplicated sentences when they twirled and twisted in her head, unrelenting in their confusion? What was the cure for all this disarray? Did this fellow with his daft bow tie and ‘old boy’ mentality have any idea what she might be going through? He appeared to be treating this meeting as some kind of pleasant afternoon social occasion.
Gerry looked at her, “well I’m not at home so much these days, and it isn’t easy for her looking after…” He faltered.
“Oh I see.” Dr Blake tried to help him out. “Got a few chores for you to do around the house I suspect.” He laughed. “That’s the trouble with us chaps we don’t know one end of a duster from another now do we? Egging you on to early retirement is she? Got a ‘To Do’ list eh?” His bony fingers tapped apostrophes in the air.
Mrs Sanderson thought she might like to snap those fingers off one by one. Dr Blake would wriggle in agony as she did it, then he’d feel how she felt every time her husband repeated a
question she’d answered twenty, thirty times before. The stabbing pain of impatience when she knew she had to be patient, it wasn’t his fault, but it wasn’t her fault either.
Gerry grinned. They were in the same club, he liked this jocular fellow who didn’t interrogate but seemed to understand. Maddy was always going on about something. Did it matter if his socks didn’t match or that he’d forgotten to shave, he supposed it did if he was off to work, but then he thought he had scraped his face with the razor that morning, black and blue socks can look the same in the half light of early morning. Not his fault, not his fault. Sudden tears welled in his dark eyes.
For a split second Dr Blake met Mrs Sanderson’s gaze. He had to do something so he shrugged. “Stress can affect us in so many ways, men have to work, to provide, it’s only natural. We are still cave men in many ways and we like to retreat there from time to time. Not physically of course but certainly in our minds. To escape the pressures of modern day living.” He stood up, folded his arms and moved his sharp jointed body to the window turning away from them both for a moment. “Funny thing the human mind, it can play tricks. We all forget things as we get older.” He turned suddenly. “Can you tell me what you were doing last Tuesday Mrs Sanderson?” He smiled as if he’d just told some great joke. Was she expected to giggle and agree? Of course she could not remember; well if she thought about it for a while she could, she could remember repeating to Gerry when he called, that dinner that night would be at seven, approximately eight times before he hung up.
Mrs Sanderson sighed and touched Mr Sanderson’s hand, he stared at her without comprehension but squeezed her fingers nevertheless. She looked directly at Dr Blake, who didn’t return her gaze, “look, you don’t seem to understand why we are here, it’s difficult to have to put everything into words, it feels so, well wrong, to talk about it to a stranger.” Her
throat squeezed shut, her tongue felt arid. Mrs Sanderson started to tremble, her knees giving involuntary little shudders.
“When we last saw you it was just forgetting names, little things like that.” She paused, hoping for Dr Blake’s recognition of her discomfort, silently begging for his help to continue. No response. “Now he forgets to shave, to brush his hair…” Such simple, apparently inconsequential deeds, the rudimentary behaviour of everyday living “Gerry is failing in such basic” she faltered with the word “tasks.” Swallowing the guilt in her throat she simply could not carry on.
Staring out of the window Dr Blake seemed not to hear. A few moments later he confirmed his inattention by turning sharply and moving towards his desk. “I think,” he said, cutting her off mid sentence, “that probably what is needed here is perhaps a little holiday, a break from all the pressures. Got anyone you can go off to see?” He smiled quizzically, blanking out her begging eyes; they reminded him of those of a dog, beaten for no good reason.
A holiday? Is he mad? Mrs Sanderson stared back in disbelief. Did he realise Mr Sanderson could barely remember where he lived without the upheaval of moving location to confuse things even further. “This is ridiculous, you’re not listening to me.” The words spluttered out of her mouth “we can’t go anywhere, let me tell you how it is.”
“Oh I hear you Mrs Sanderson, do not fear. Gerry here is probably under a lot of stress with work but what we’ll do,” he paused, wondering for a moment what to do, what to say to placate this lady, to stop her becoming irate, “what we’ll do, is a few more tests. Check things over. All routine Gerry no need to worry.” Fixing Mrs Sanderson with a firm stare, he sat at his desk and began to scribble some notes.
“Tests? Tests for what exactly? Can’t you give us some idea now what is wrong with my husband.” The tortured housewife wrung her hands unable to stop frustration coursing through her veins, filling them fit to burst. Hearing her own strangulated voice she wanted to weep, to fall down upon her knees for mercy from this daily torment, tests meant waiting, possibly no conclusion, or even worse a terrible conclusion. But Dr Blake threw her such a look she felt her lips clamp shut like a trap door shutting on her woeful demands.
Gerry’s expression had become very blank. The dim light that briefly passed behind his eyes had gone, he stared ahead and made no sound.
Dr Blake glanced pointedly at his watch. “Do you know my daughter’s come all the way from Cardiff to stay for a few days? I have to get home for dinner and the traffic will be bad tonight, there’s that concert on in town, bound to be bedlam.” He smiled, “it’s dreadful of me to turf you out I know but I didn’t realise it was getting so late.” The couple before him appeared as two solitary heaps, defeated lumps unready to move. “So if you don’t mind…” His voice tailed off, at once hopeful and commanding.
Silence erupted around the room. Only Mrs Sanderson could hear the rushing flow of anger hammering her eardrums. What next? Who could help? Was this all on offer? An indifferent man more concerned with dinner than her deteriorating husband.
All that was left was pride; a desire to escape before desolation drew humiliating tears. Her face burnt and her head ached as she pulled her distant husband from his seat. Not even able to mumble another word in this idiot’s direction, Mrs Sanderson left Dr Blake’s office.
He watched them go, down the mossy path to iron gates that would swing with a clank, red rust flakes dropping in their wake, the slightly plump lady dabbing at her eyes as she led the tall stooping man away to a home no longer a haven.
It wasn’t so unknown to him. He knew, all too well he knew, that slowly with the drift of time, the man that woman loved would fall away cell by cell to nothingness. A blank unseeing stare from an emptied shell, devoid of emotion, comprehension, love and understanding, all that she had to look forward to, nothing. A loss of all they had known together.
All the idiosyncrasies a human being encompasses would become a parody of its very own nature. Repetitive phrases, trying to remember and failing, trying to climb back to the top, swim to the surface, breathe the air that he once knew but forever being pulled down, down and down to that empty space as the cells diminished. No way out, sinking sand with no stick offered to pull him back to dry ground.
Of course he knew what she was trying to tell him. He knew every word she wanted to utter, to explain, to beg his understanding, his help. Dr Blake snorted without humour, without scorn, without realising his own reaction at all. He knew he wouldn’t think about this for long. Soon he would pull on his beige wool coat, pick up his Italian leather case, bought so kindly for him as a sixtieth birthday present by his daughter, edge out of his office, call to Maggie to have a good weekend, stride to his gleaming motor, hear the reassuring clunk of the car door shutting and then he would be safe again.
There is no place for Mr Sanderson, he knew. No better place than his home, with a woman who cared to care for him in the coming twilight nightmare of his life, for better for worse, but nothing worse than this.
He could have offered sympathy, but what use? He could have patted her arm and clucked at her every worry but why? False hope he could not offer. No, she would cope with the incontinence to come, the inability to dress or care for himself, the repetitive behaviour as he
tried to remember who he once was. Community nurses would visit, they would listen to her, visit again, listen, visit again. How many years before the final release?
The only alternative was a nursing home; they would drug him to cope. Dr Blake didn’t approve of this behaviour; it would be more dignified for the man to have his wife care for him. Much more appropriate, this is what he would want for himself.
Driving home, he listened to Mozart, soothing orchestral sounds, slowly Mrs Sanderson’s pleading eyes drifted from his memory and he instead tried to remember his daughter’s boyfriend’s name.
If you would like further information about Alzheimer’s Disease or Dementia please visit http://www.alzheimers.org.uk
Copyright PetraKidd11
