Locked Ward

Paul Lewellan

“I don’t have a Winburn on our schedule,” the admitting clerk told us.

Michael’s anger flared. He reached for her computer monitor. “Let me see that!”

I touched his arm to stop him. “Maybe she’s misspelled our name,” I said to sooth him.

I turned to the tiny Hispanic girl. “It happens all the time. People write W-i-n-b–u-r-n, instead of W-i-n-b-e-r-n.”

She corrected the spelling. “Yes, that’s it. Here you are,” she said to Michael. “You’re here for tests.” She forced a smile. “It will be just a few minutes. Before the illness, Michael was a patient man, slow to anger. Now, standing at the admitting desk, he pulled at the buttons of his red plaid shirt and fumed. The book of Father Roselip’s poems he’d brought along was damp from his sweating palms. He suspected the delay was somehow his fault.

I worried about the outbursts. Violent behavior usually comes in the later stages of Alzheimer’s. Michael’s cousin, Maxine, threw plates at her husband before she was institutionalized. Michael’s brother Milt pinned him against a Coke machine in the lobby at Vet’s Hospital the night we committed him. It took two security guards to restrain him.

The young woman finished his paperwork and instructed an orderly to take us to Section E. I told her, “Just give us a map.”

“You’ll need an escort,” she said softly.

When we got to the gray metal door marked Section E, the orderly removed a key card attached to his belt and unlocked it. He let us in, and the door clanked shut behind us.

The nurses took Michael’s razor, his nail clipper, and his belt. They took his charts from me. As we passed through another set of locked doors, I became unglued. I snapped at a male nurse. “He’s here for tests!”

Michael touched my shoulder. “It will be okay.” The nurse smiled through his long sandy brown mustache. I imagined him going back to the ward desk and checking the charts to make sure Michael was the patient, not me.

They put us in examination room H. When Dr. Welsh entered, he saw we were agitated. The locked ward was part of his daily routine. “You’ll get used to it,” he told us, but I never did. As the disease progressed, though, the locked door lost its symbolism for Michael. All doors in his world were locked.

Dr. Welsh wore a bright floral tie, white shirt, khaki pants, a lab coat, and brown wingtips. He had delicate hands and a reddish beard. Michael was a like a Kodiak bear. He unloaded meat trucks before dawn to earn extra money. He chopped and delivered firewood on weekends. He tilled people’s gardens. Raising five children on a teacher’s salary would have been impossible otherwise. By the time he died of pneumonia three years after he was institutionalized, Michael was reduced to a shuffling reed of a man.

Dr. Welsh tried to relax us. “Don’t jump to any conclusions. Diagnosis is difficult.” Michael and I nodded. We knew; we’d read the articles. The early literature said the lower limit of the disease was forty. I took comfort in that, although I suspected it was wrong. I believe Michael’s cousin died from Alzheimer’s in her early twenties, although no autopsy was performed to verify it. The literature now confirms the lower limit is closer to twenty.

Michael began investigating the illness in his family history shortly after his mother died. His dissertation on Dryden verse dramas gave way to research on family trees, medical records, and death certificates sent us by relatives.

I’m the researcher now that Michael is dead. I look at Libby, Julia, and the boys and I worry what will happen to them if no answers are found. The statistics work against them. Four of five will succumb to this illness.

Michael researched the family history for two years before we found ourselves on the locked ward. Dr. Welsh studied the family history that Michael had gathered. That’s how our bond with him was formed. That’s why his diagnosis was so cautious. He feared false assumptions simply because the evidence was so compelling.

“The symptoms could stem from Michael’s drinking,” Dr. Welsh told me on the phone when I’d called him a week earlier. The drinking became a problem the last summer. He’d forget things, and later he’d say it was the beer. We argued. The kids had never heard that before. It got worse.

“It could be stress from teaching high school,” Dr. Welsh added. “I wonder how Michael functions in the classroom when he isn’t doing well at home.”

Of course, he wasn’t functioning in the classroom. Jerry Smisek, the principal, met with Michael in December. There’d been complaints about getting papers back. Michael told him he always had trouble getting papers back. I knew it was more than that.

Michael no longer spoke about his students or events at school. Students didn’t stop by the house like they did when he first started teaching. When I told Dr. Welsh, he said, “See if he’ll talk to someone, maybe your parish priest.”

A few weeks later, toward the end of April, Michael came home from school early and went right to the refrigerator for a beer.

“I called Dr. Welsh,” I told him.

“Why?” He opened the bottle.

“Because I’m concerned about the drinking.”

“Dr. Welsh didn’t specialize in drinking.”

I sighed. “Michael, we don’t have time for games.”

He put down the beer and looked over to me. “It’s time for me to stop teaching.” The principal had called him in again. He’d heard that Michael was repeating himself in class. He forgot some assignments he’d made, and assumed he’d made others that he didn’t. He lost things.

So we arranged to go to Minneapolis for tests. It was like a weight lifted off him. We talked about what had been unspoken. We agreed that if we got good news, Michael would make a career change to get away from the stress. He held out that hope.

For most families there is only a tendency toward the disease. If one member gets the disease, the chances for later generations are increased. Michael’s family, my children’s family, is different. Dr. Welsh and his colleagues found eight families in American for whom it’s hereditary. No family’s incidence is as high as Michael’s. That’s why originally we couldn’t get local doctors to consider the diagnosis. The disease wasn’t supposed to work that way. They looked for Huntington’s or Pick’s because those diseases start out the same way. Now with Dr. Welsh, we hoped to find answers. And behind all our fears was the fear for our children. What would their future be if our suspicions were true?

“We’ll do a battery of tests and some blood work.” Dr. Welsh told us in his office that morning. “We need to eliminate everything else. If it isn’t everything else, then it’s what we fear.” The doctor arranged for Michael to stay on the ward so tests could begin the first thing in the morning. I was at a local motel. Dr. Welsh had a nurse show us to Michael’s room.

Most residents of University Hospital’s locked ward were short-term patients suffering severe depression. Few ever spoke until a nurse or orderly took them in for therapy. Some of the patients were mirrors of Michael’s mother. With their heads tilted downward, they shuffled more than they walked. Some rocked in chairs and mumbled. Michael’s roommate was oriental, Vietnamese or Cambodian, around twenty-eight years old. For two days, he lay in a fetal position.

Dr. Welsh scheduled four hours of tests for the afternoon we arrived and ten hours the next day. I went to group meetings. I met Edith. She’d worked as an editorial writer for the Minneapolis Tribune. Even after her symptoms appeared, the paper let her come in a couple days a week as a proofreader. Now in her sixties, she’d been robbed of her mind and could no longer work.I met Bob. I thought he was a family member like me until during introductions I learned he was a resident. “How long have you been here?” I asked him. “Too long,” he said noncommittally. Bob told me about his service in the CIA. We talked about his years in Europe. He believed Jimmy Carter was still President. Bob didn’t know the name of the hospital, and he didn’t know that the woman seated beside him was his daughter.

While Michael stayed in the locked ward, we were able to eat lunch and supper together. In the lunchroom I met the woman the orderlies called Crazy Carie. She was in her seventies, but she behaved like a mischievous six-year-old. She came up to me the first afternoon and said, “You want to see something?” She had tucked things into her bra: books of matches, scraps of paper, socks she’d taken from the laundry room.

I asked her, “Where did you get those matches?” Her eyes twinkled and she put her index finger to her lips to indicate they were a secret. I told one of the nurses about the matches, but she reassured me that Carie had no idea how to use them.

Crazy Carie took the dishtowels from the kitchen and wiped the lunchroom tables, which I thought was good. It gave her a purpose and channeled her energy. Then I saw her take the dishtowel and blow her nose. She went back to wiping the tables off with the towel. After that I got permission to take Michael downstairs to eat.

On the third morning, a nurse came for me in the family lounge. When I got to Dr. Welsh’s office, Michael was waiting. He reached out his hand to me when I sat down. We held each other nervously, until Dr. Welsh arrived. “It’s not good,” he said. “I’m frightened for you.”

He told us it was Alzheimer’s. And even though I knew it was true, even thought I’d known for almost a year that the diagnosis would come to this, still it seemed unfair. I was angry, but I didn’t know whom to blame, whom to take the anger out on.

Dr. Welsh said Michael still scored above average in I.Q. even with his troubles. But he did poorly on the memory tests. The doctor would tell him, “I’d like you to remember three words: a chair, a table, [then some unrelated word like] a football helmet.” They’d talk about something else for a moment, then the doctor asked what the three words were. Michael might remember chair and table, but couldn’t remember the third. As the disease progressed he wouldn’t remember any.

“As long as you doesn’t need that short term memory,” Dr. Welsh told him, “as long as there’s someone there to help you, you should be able to function for a long time.”

When Ronald Reagan was diagnosed with Alzheimer’s I remembered all the times Nancy had been at his side, reassuring with her touch, whispering in his ear. That’s the way it became for Michael and I. I was his short-term memory, his defense against panic or fear or confusion. I remained at his side, at least until the violence came and he could no longer he controlled by a gentle word. That’s when he became one of those shuffling ghosts on the Alzheimer’s ward of the VA, and I became a daily visitor rather than a wife.

At the moment Dr. Welsh confirmed the diagnosis, I imagined all that would come next. There was no way I could go on, no way I could accept all that. But Dr. Welsh said there could be many good years left. There were things we could do, like avoid large crowds and keep Michael in familiar surroundings, familiar routines. We should leave his physical surroundings unchanged.

Dr. Welsh said he could put Michael on Colein. It’s the one element that’s missing when they do an autopsy. “I recommend twenty pills a day. The brain has like an invincible barrier, that’s why you have to take so much. We want to be sure some gets through. Only alcohol gets through easily. That’s why it’s so important not to drink.” Dr. Welsh turned to Michael. “And you should get you out of the classroom.” Michael just nodded. He knew that before we ever left home.

He asked if we had questions, but we didn’t. What was there to ask? We’d done our homework. We knew what the diagnosis meant. Michael had watched his mother and his brother go through it. He’d watched his aunts and uncles. We just wanted to leave. So an orderly gave him back his razor and his belt and escorted us out of the ward. As we neared the exit, Michael’s roommate came shuffling down the hallway. He saw us and asked, “Do you get to go home?” And I said, “Yes, we get to go home.” He looked at us and asked, “Is he all better?” I smiled a reassurance and nodded that, yes, he was. I don’t think he saw my tears as Michael and I were escorted out the gray metal door.

rindliterarymagazine.com