He taps his chest. His heart. That’s my answer. The answer to my question. That’s where he feels the pain: in his heart.
I nod and give his arm another gentle squeeze.
I understand.
Mr. Davidson nods back solemnly, and promptly bursts into a cataclysm of coughs.
There’s nothing wrong with his heart—well, not physically, anyway. What’s physically wrong with Howard Davidson is his brain. As far as Howard is concerned he’s a thirty-two-year-old man trapped inside the body of a seventy-eight-year-old. He woke up three weeks ago with no memory of the last forty-six years of his life. In his mind he left his house in 1973 and woke up here, an old man. What’s wrong with Howard Davidson is visible only on a scan. Large sections of his neocortex have atrophied, died. All the memories stored in those areas are gone; a huge portion of his life, to his mind, never happened. Three weeks ago, he was fine, pottering around his garden, walking his dog, reading, deep in the flow of his own life, enjoying his retirement, but that old man is gone now.
Howard Davidson was found wandering down the middle of a four-lane highway near Shepherd’s Bush, and brought to the emergency room. After we ascertained from his relatives that he had no history of Alzheimer’s, that up until that morning he had apparently been quite happily enjoying the life of a retired MP, an MRI scan was taken.
The atrophy present in the brain scan was found to be indicative of vascular dementia, specifically single-infarct dementia. A single stroke had instantly killed off a massive portion of his hippocampus.
Forty-six years of life and memories erased in the blink of an eye. He has no recollection of having had children, or running for office, and he still believes he lives with his young wife, Ginny, near Goldhawk Road. All long-term memories end there.
I pour him a glass of water from the jug beside his bed. He takes it with a shaky hand. Then I turn to face the ragtag lineup behind me, looking for some kind of explanation for Mr. Davidson’s current state, although I already have my suspicions.
His son catches my eye. Simon Davidson and I have met before, briefly, on the day Howard was admitted.
I’ll let you in on a secret they tell us at medical school: Sometimes things can’t be fixed. Sometimes things must be lived with. Adapted to. Simon Davidson didn’t want to hear that.
I’ve been in this profession long enough to trust my instincts in situations like this, and right now my instincts are telling me that Simon is almost definitely the issue at fault here. Doctors and nurses don’t tend to make grown men cry. Well, not in a professional setting at any rate. So I give the medical team a nod and they shuffle, gratefully, out past Simon.
“Simon, would it be possible to talk to you outside briefly?”
Simon’s eyes widen slightly at being the only person singled out. “Er, yeah. Yes. Sure.” He gives me a pragmatic nod and starts to leave.
“I’ll be right with you in one minute.” I offer him a reassuring smile as he pushes out the door, but he’s frowning, unconvinced. However, I need to settle Mr. Davidson, my actual patient, before I can deal with his son.
I watch the door softly puff closed behind him.
“Who was that horrible young man?” The voice comes shaky from behind me.
I turn and take in Mr. Davidson’s frail form, his crumpled features, his kind eyes. I feel an ache of sadness in my chest. He means his son, of course. But the thing that really gets me is the caution with which he asks me the question, the caution for me, in case he offends me, in case the horrible man is a friend of mine.
“It’s all right, Howard, it’s just me and you now,” I reassure him. I move back to the bed and take his delicate wrist in my hand, counting off his pulse. Elevated but fine. “Did the man who was just in here upset you, Howard?”
I know the answer already. This isn’t the first time this has happened since Mr. Davidson’s been here, not by any means, nor is he the first patient who’s reacted in this way.
Howard Davidson shifts to sit a little higher in the bed. “That young man. Not the other doctor, the small man. He told me that Ginny had died. My wife.Ginny. And I don’t know who he was or why he’d say a thing like that. I mean, why would he say it?” He studies my face, a fallen toddler unsure yet whether to laugh or cry. “And the way he said it, so strange. Just ‘She’s dead,’ plain and simple, when I asked when she’d get here, just like that, like it was nothing. My Ginny dead.” He thumps his fingers against his chest; he’s agitated again at the memory. “Why would he say that?” He peers up at me, watery eyes panicked. “Ginny’s okay, isn’t she? She was fine when I left the house. The other doctor wouldn’t tell me. She’s all right, isn’t she? I should never have left the house.” His frail hands become fists now on the bedsheets.
Ginny died eleven years ago, at sixty-two, from thyroid cancer. To be fair to Howard’s son, he was probably just trying to remind his father, but no doubt would have done so in that slightly weary way people tend to reiterate facts to dementia patients.
“Is Ginny all right?” Muscle tremors flutter under his eyes. He’s tired.
I take his hand lightly. “Yes, Ginny’s perfect, Howard. She’s very good. She sends her love, and she told me to tell you that she can’t make it in this afternoon but she’ll see you first thing tomorrow.” I say it because he is my patient and it will make him feel really good, and he won’t remember I said it tomorrow.
He smiles and squeezes my hand as hard as he can, eyes filling. “Thank you. Thank you, I was so worried about her. I don’t know what I would do without my Ginny. And if I didn’t even get a chance to say goodbye, well…” Of course, he did get a chance to say goodbye—eleven years ago, at her bedside, in this very hospital.
Mr. Davidson will not be able to remember the words of this conversation, but he will remember the feelings it brings up.
I’m not lying to him. I’m just not being an asshole.
We can’t inform Howard that his wife is dead every time he asks us, it would be beyond cruelty. Why repeat the worst day of this man’s life every day of his life?
—
Outside in the hallway I try to explain this to his defensive son.
