Reaching Down the Rabbit Hole (7 page)

“Please.”

“Because none of you care. And if you
do
care, it’s going to go to the other place. And you can move this way or that way, or upstairs, and then you’ll see, probably, a dog. Probably got a nice little dog, a smart dog. It’s intelligent enough. Mostly, the dog will curl up for you.”

Gordon Steever’s mind flitted like a waterbug across the surface of his life’s experiences. There was no depth. His speech lacked any internal logic. Not even schizophrenics talk like that. It was almost as though we were looking in on a performance.

“Are you happy?” I asked.

“Pardon me?”

“Are you feeling happy now?”

“Ah! I would be happy if I’d seen it.”

“Ho, boy!” I said to Hannah. “You can’t argue with that. He’s like a philosopher, but he’s talking Martian. I don’t think there’s any emotional valence under there. When I ask him something, he responds. It’s not a waking dream, it’s usually nonsense, but he keeps returning the ball. How does he do that?”

I turned back to him and said, “Gordon, let me ask you something: Is it warmer in the summer or the South?”

“The South? It’s hot.”

“Okay, good. Then tell me, Gordon, do helicopters eat their young?”

“It is true,” he replied blankly, with no indication that he had processed the question at all.

Gilbert the medical student cocked an eyebrow. “Helicopters?”

“It’s almost diagnostic,” I explained. “I’m just talking to the confused brain on its own terms. If an aphasic patient gets the joke, it probably means he’s faking.”

“So Mr. Steever’s not faking?”

“No such luck.”

“Instead of saying good luck,” Gordon suggested, “you say good ruck. Think about that!”

“Okay, I will.” I turned to Hannah. “Does he have alcohol in his history?”

“His wife says no,” she replied.

“Are we sure this has never happened before?”

“Per his wife he was managing a bowling alley.”

“It doesn’t have the mad cow feeling to me at all. It’s some kind of encephalopathy. Has he been poisoned? Is he in status? We decided he wasn’t, right?”

“Correct,” Hannah said.

Status
is short for
status epilepticus
, a state in which a patient is constantly seizing. In this case, without physical convulsions, it would properly be called nonconvulsive status epilepticus. But Gordon wasn’t seizing. The Haldol, an antipsychotic, had made him worse, suggesting that he was also not psychotic.

In the course of our inquiries, we would discover that Gordon had three grown children, possibly stepchildren, none of whom visited him. His wife, either estranged or ex, was undergoing chemotherapy, and also did not visit, although we did manage to reach her by phone. In time, Gordon would become a ward of the hospital in order to facilitate medical decisions he was unable to make on his own.

“Gotta look for good ruck, good ruck, good ruck to all,” Gordon said to no one in particular, and added, “I can remember coming down in college. I turned out to be sitting there talking and so forth and so on. Oh, yeah, he was a hippie or a bippy. What’s the difference? It’s not going to make any difference, so you can turn right around.” And with a wave of his hand, Gordon gestured everyone out of the room. But to his consternation, we stayed.

“Mr. Steever,” I said in a last stab at a clinical exam, “can you show us two fingers?”

And he gave me the finger with both hands.
“Right! He’s got good comprehension.”

Saying “Go fuck yourself,” as Gordon did to me on several occasions, was not inattentive. It was ornery, irascible, and rude, but not entirely irrational, and certainly not inattentive. Gordon could be extremely focused on the details of our comings and goings in his room. Our presence pissed him off, and he let us know it, yet day after day he could not tell us his address, how many children he had, or what kinds of jobs he’d held. And not out of obstinacy, because he was fine with other details. He was disoriented and did not know where he was or why he was here. Gilbert the medical student recorded this as “orientation times one,” again that unfortunate and unenlightening phrase. But Gordon also had his moments of lucidity. On good days he could tell us where he went to college and the name of the bowling alley where he had worked. He could, on occasion, be quite congenial.

During the three months of his stay at the Brigham, we performed every conceivable test on Gordon Steever, and they all came up either negative or inconclusive. He became very popular with the staff, less profane, but no more oriented than on the day he arrived. When he finally ventured out of what Hannah referred to as his man cave, he enjoyed tossing a tennis ball across the nurses’ station to anyone who seemed willing to field it. Eventually, he was transferred to a psychiatric nursing home, and we lost touch with him for six months. He was a ward of our hospital, and the best we could do was fob him off on a place where he would languish, and quite possibly die of neglect. He was gone but not forgotten. It was not clear where his confusion came from, but for now we knew where it was going to take him: Saugus, the only town in which Hannah could find a facility that would offer a bed.

In the room next door, Wally Maskart sat awake through most of the night, as he did night after night, frantic. In his sleep-deprived,
hyperactive state, he would write for hours on end, collecting his disjointed thoughts and memories in a loose-leaf notebook, producing up to twenty pages a night, and each morning, Hannah would photocopy some of the more interesting pages and insert them into Wally’s medical notes. Hannah was searching for clues. One night she found one.

While most of his jottings were gibberish, Wally had moments of lucidity during which he displayed a practiced prose style. In one burst of creativity, he wrote a brief memoir of the summer of his twelfth year, when his parents sent him to stay with his uncle, a fisherman in Nova Scotia. He didn’t understand how or why an East Boston kid like himself wound up on the open sea, hauling halibut into a dory, but he reveled in every day of it. The sight of baleen whales surfacing every morning beyond the bay, he was told, was the result of their being driven closer to shore by the German U-boats that infested the waters. It was 1943. The summer culminated in a village tradition, in which the fishermen and their families came together on the water to haul in a large co-op net trap, some hundred meters across, containing a large school of pollock. As the depth of the massive net was drawn to within six feet of the surface, the water came alive with the thrashing of thirty-to forty-inch-long fish, and the fishermen and women scooped them into the dories using pole nets. In the process, fish scales flew like sleet, covering everyone from head to foot, leaving only the whites of their eyes showing. Wally recalled being assigned a spot next to a young girl wearing a yellow slicker that gradually turned silver under a spray of glistening scales. Hannah decided that this was the most serene moment in Wally’s long life: standing next to a cute girl, being waist-deep in thrashing fish, living in a safe place among strong, stoic, caring people, covered with fish scales. It was probably the last time that Wally was at peace with the world and with himself.

When she showed me the journal, Hannah said, “It reminded me of something Gordon said the other day. I don’t know why it stuck with me. He said, ‘Do you want to know the best days? Look here!’”

That’s when it hit me: graphomania (the obsessive writing), alliteration (the Sanjay Sanjanista business), and the biggest red flag of all: the tinplate locomotive. Only a wealthy collector buys a $2,000 locomotive, and then only to put on display, not to run it on his setup.

“Did we get a family history for Wally?” I asked Hannah.

“More or less. We talked to the son.”

“Which one?”

“He has more than one?”

“Yes.”

Wally did indeed have two sons. The first one who visited had provided the family history that the residents had relied on: no history of psychoses, no similar events in the past. His confusion had come out of the blue. Except that it hadn’t. We had talked to the wrong son. The other son, Wally’s
bipolar
son, who showed up a week later, painted a very different picture, one in which a history of psychosis ran deep in the family, deep in his own past, and deep in his father’s past. Wally had snapped under the pressure. He’d had a nervous breakdown, something, as we would discover, that had happened before. That’s when we knew he would probably be okay.

Psychosis is a special type of confusion with its own reality, an internal reality that is consistent only with itself. It does feature a connected, ever-flowing “stream of thought,” to use William James’s term (not a stream of
consciousness
, a phrase that James came to dislike). In his
Principles of Psychology
, James claimed that all of us carry on a virtually continuous internal conversation. While a psychotic’s internal stream may seem bizarre and disconnected, it has its own internal logic. Anyone could follow it, according to James, if they were standing in the waters of the stream. Wally Maskart’s thinking might have been crazy (in fact it
was
crazy), but it wasn’t stupid. My job was to step over the boulders and out into the middle of the current, and try to lead him back to shore.

That wasn’t possible with Gordon Steever. Gordon was severely confused, but not psychotic. During his stay in the hospital, and increasingly
during the weeks leading up to it, he lived in a fog, in a miasma in which there was no connection between one moment and the next, no continuous stream of thought, no path of return. Wally, on the other hand, was caught up in a very different struggle. He was delusional but he could connect. Even though he insisted that I was both Dr. Ropper and Dr. Sanjanista, he was not detached from all reality. A confusion of this type is in most cases a reversible state because it is a reflection of the dynamic functioning of nerve cells. If the causes are addressed, the patient will get better. It just takes time. If the causes are not addressed, the confusion takes over.

When I was a boy I had a Jimmy Piersall baseball glove. Piersall was my favorite ballplayer, and he was famously nutty. He made his major league debut with the Boston Red Sox in September 1950. Before he stepped up to the plate, he turned his bat upside down, and with the knob end made an X in the back right-hand corner of the batter’s box, something he would continue to do throughout his career. Wally Maskart saw Piersall play right field at Fenway Park many times during the ’50s, and watched with passing interest as Piersall’s life fell apart due to a bipolar disorder.

Piersall was a local boy from Waterbury, Connecticut, and he became one of the best fielders in the game, but he was plagued by a past that included a deeply troubled mother who had been institutionalized, and a demanding father. Frequently involved in brawls, bizarre on-field stunts, and tantrums, Piersall racked up a score of ejections over the years. In his autobiography,
Fear Strikes Out
, he tells of being admitted to a psychiatric hospital in 1952 after a nervous breakdown. “I ran away,” he recalled. “I had just gotten so wound up that I lost all control of my memory.” Treated with lithium, he would last seventeen years as a player, and many more as an instructor and broadcaster. As he once admitted, “Probably the best thing that ever happened to me was going nuts. Who ever heard of Jimmy Piersall before that happened?” No
baseball fan would ever forget him after he hit his hundredth home run at the Polo Grounds in 1963, and ran the bases facing backward.

Although I would never again see Gordon Steever once he left the Brigham, I did visit Wally Maskart three weeks later at the psychiatric hospital where Hannah had managed to place him.

“I feel much better,” he told me.

“Are you oriented? Is your mind clear?”

“What used to take ten minutes now takes a few minutes.”

“Are you writing in here?”

“Yeah, I’m writing my life history.”

Among his topics were accounts of Mrs. G’s code blue, a summer cottage he had bought in Mattapoisett thirty years ago, and his time working for Polaroid in the 1970s. He looked much better, sounded much better, his memory was improving.