Time Out Of Mind

“You must be my doctor, though I don’t know what I’m here for.  I don’t feel sick.  Still, it’s good to meet you all the same.”  The two men, one tall and young wearing a white lab coat and wire-rimmed glasses, the other a good bit older with thinning white hair slightly unkempt, shook hands.

Doctor Robert Wilson smiled.  “Please, Mike, have a seat,” he said as he gestured at the chair.

Mike nodded as he took his seat.  “Thanks, Doc.  You don’t mind if I call you that, do you?  Some doctors, well, they take it personally and all, and I don’t want you to think that I’m being disrespectful or anything like that ’cause I don’t mean to be.”

Wilson sat down and adjusted his desk calendar as he took his pen in hand.  He held his pen between three fingers then gestured towards Mike.  “Don’t worry, Mike.  I don’t mind being called ‘Doc’ at all, if anything it should make my job easier because saying ‘Doc’ is more personal than ‘Doctor.’  The older doctors here, they might take it more personally, but I won’t.  Low man on the totem pole here, basically.  Plus, it establishes a better rapport between us, and that benefits both you and myself.”

Mike nodded as Wilson spoke.  “You’re right, Doc.  I had a feeling, I knew you’d understand.  The doctors I usually see, they’re so stiff, so impersonal.  I like you already, you even have pictures on your wall.”

Wilson half-turned in his seat and looked at the picture of his wife and two daughters on the wall.  He nodded slowly.  “My family.”  He scrutinized the picture for another moment or two.  “Taken when we were on vacation at Disney World about two years back.”

Mike scowled.  “Disney World?  Is that like Disneyland in California?  I’ve heard about that, are they the same thing?”

“Just about.  Disney World’s in Florida, though.”

“Oh, I’d never heard of it.”  Mike paused and looked out the office window.  “Doc, was I in a coma?  Unconscious or something?”

“No,” said Wilson in a puzzled tone.

“Oh,” said Mike, with a sense of confusion entering his voice.  “Shouldn’t it be summer?  Why is there all that snow on the ground?”

* * *

Wilson turned slightly towards the bartender, flicked a slight salute and dropped a tip in the jar as he took up his beer.  He looked out across the bar, searching for a familiar face.  He was about to give up his search when he caught sight of Kent VanderStaay, an older doctor at the Veteran’s Hospital.  His beer in hand, Wilson set off for VanderStaay’s table, working his way past the waitresses and customers in the darkened bar.  After a close call with a waitress carrying a tray of food, Wilson arrived at VanderStaay’s table.  “Kent,” he said, smiling.

VanderStaay looked up and gestured at the seat opposite.  “Robert, please, have a seat.  Good day?”

Wilson took a seat and shrugged.  “Fair, I suppose.  Meeting some of the new patients today.  Not just tiring, but emotionally draining.  Some of the patients, they have problems that I thought I’d never see, problems that I can’t solve, that can never be solved.  Times like that, I question why it is that I became a neurologist, to deal with patients with mental dysfunctions that I can’t solve, sometimes even diagnose.”  He took a drink from his mug.  “I just don’t know, I really don’t.”

VanderStaay nodded.  “I know the ward, I know the routine.  They’re a tough bunch, some good people and some bad.”  He took a swig from his glass and set it down.  “It would be the same in any neurological ward.”

A waitress emerged from the shadows and drifted over to the table.  She looked at VanderStaay and asked, “Another drink, Kent?  The usual?”

VanderStaay shook his head.  “Not quite, my dear.  Scotch on the rocks.”

The waitress made a note on a napkin and said, “You’ve got it.”

VanderStaay turned back to Wilson.  “Beer?” he asked, gesturing at the mug.

Wilson smiled slightly.  “Naturally.  Killian’s Red.  Developed a taste for it in college.  Everyone else drank what amounted to piss water, but I prefered a beer that you couldn’t see through in a mug because it was so dark.  Plus, it has a smooth, almost ale-ish quality, something that no other beer has.”  He shrugged.  “And I like it.  Can’t get much more personal than that.”

“There is that, indeed.”  VanderStaay paused, looking out into the crowd to see if the waitress were coming with his scotch.  Not seeing her, he looked down at the table for a moment, then back up at Wilson.  “Which patient was it today?”

“How could you tell?”

“I’ve been at this a long time, Robert.  A very long time.  So, which patient?”

“Out of the six I saw?  One or two don’t bother me.  But there’s one particular patient that makes me wonder what it is we’m doing.  If we’re on the side of right or wrong here.”  He took another sip of his beer.  “I’m not sure I have the answers to those questions.  And I’m not really sure that I want them.”

Wilson looked up as the waitress set VanderStaay’s scotch on the table.  “Would you like to order anything?” she asked, looking at him.

Wilson shook his head.  “No, not at the moment.”  He paused.  “What’s your name?”

She smiled, her teeth twinkling brightly in the subdued lighting.  “Vicky.  If you need anything, let me know.”

“You’ve got it,” he said as she slipped into the shadows.

VanderStaay scrutinized Wilson’s face.  “Robert, how old would you take me for?”

Wilson thought for a moment and said, “Fifty.  Fifty-five.”

VanderStaay smiled.  “Almost seventy.  I’ve been with this hospital for, what? forty years?  I know the ward, I know the patients.  They’re good people, but they have their problems.  That’s what we’re here for, to deal with those problems as best we can.  That may mean that we can’t solve them, but we can at least do our best for them.”

Wilson looked up at VanderStaay and nodded slowly.  “That’s why I decided to become a doctor.”

“Then you came to the right place, because this hospital can use your talents.”  He picked up his scotch, took a drink, and grimaced as the scotch went down.  “I never could stand the stuff.”

“Then why do you drink?”

“Why does anyone?”

* * *

“Tell me, Mike, how do you feel these days?  Is there anything we can do to make you feel more comfortable, any books you want to read?”

Mike shook his head.  “Naw, I was never much into reading books, but maybe some magazines.”  He paused.  “Am I gonna be here long, Doc?  Shouldn’t I need to get back to my post and all?”

Wilson shrugged slightly.  “I’m not sure, honestly.  That decision goes to my superior, based on my recommendations.  But I can’t make any recommendation yet, as this is just our first meeting.”

Mike smiled.  “You’re right, Doc, of course you are.  You’ll end up putting me on my best behavior, just so I can get out of the hospital as soon as I possibly can.  The bottom feeders, like you and me, we do all the work but don’t make any of the big decisions.  But whatever you can do, that’d be good.  I know you’ll do your best, Doc.”

Wilson nodded and made a note on his file.  “I’ll certainly try, Mike.  In the meantime, would you mind performing a little experiment for me?”

Mike scowled.  “Experiment?  I don’t like no experiments.”

Wilson smiled and made a calming gesture.  “No, it’s nothing like that.  I have a box here,” he said as he reached beneath his desk, “and I just want you to list what’s in the box.”

“That’s all?”

“That’s all there is to it, Mike.”

Mike scowled in a puzzled manner.  “What kind of experiment is this?”

“It’s a test of your perception.  Just to test your vision.”

“Oh,” said Mike, his comprehension dawning.

Mike took the box and opened it.  With the notepad he had been given, he listed the five objects within, two balls, two blocks, and twine.  “Done,” he said.

Wilson made another note.  “Sign your name at the bottom, and write the time just below it.”

“Sure, Doc,” said Mike as he looked over at the clock on the wall behind Wilson’s desk.

* * *

VanderStaay downed his scotch and set the glass down loudly on the table.  “One particular patient, wasn’t it?”

“What’s that?” asked Wilson, looking up from the crowd at VanderStaay.

“The patient’s that bothering you.”

Wilson took a drink from his beer and swirled the glass around.  “Mike.”

VanderStaay took a deep breath and nodded once slowly.  “Ah, yes, Mike.  I had noticed that he had been readmited yesterday.  An interesting case, his.  What’s your take on his condition?”

“Korskakov’s Syndrome, obviously.  A degenerative brain disorder due in part to alcoholism.”

VanderStaay sighed.  “Not exactly.”

“No, not exactly, but close.  Patients with Korskakov’s tend to be alcoholics.  Given the high caloric content of alcohol, some patients wouldn’t eat sufficiently or in a well-balanced manner, and this would lead to various vitamin deficiences.  In particular, with Korskakov’s patients, a deficiency in vitamin B-12 manifests, a vitamin needed for the normal functioning of the substantia nigra, the brain structure that regulates memory function.”

VanderStaay nodded.  “And because of the impaired function at first and ultimate destruction later of the substantia nigra leads to impaired memory function, causing the patient to lose access to large blocks of long-term memroy, leaving his mind trapped in the past.”

Wilson nodded.  “Right, and the loss of the substantia nigra prevents new memories from being written into long-term memory.  From the patient’s perspective, then, he lives life in ten or fifteen minute blocks, with yesterday being years in the past.”

“This bothers you.”

Wilson grimaced, then took a drink from his mug, draining it.  “A little, I think.  No, a lot.  I keep thinking about Mike and how he got to be the way he is.  And the more I think about it, the more I think how much it was his own fault; he didn’t have to be an alcoholic, no one forced him to drink.  Maybe I think too much about personal responsibility, that we all have only ourselves to blame for our faults and not someone else.  Is that so wrong?  But then I look at someone like Mike, and I find it hard to fault him.  He seems to kind and easy-going that I can’t understand how his life went so wrong that he became an alcoholic.”

Vicky drifted by the table and looked at the empty glasses.  “Another drink, gents?”

VanderStaay nodded.  “A scotch, and a Killian’s for my friend.”

“Right,” she said, and she faded into the background of the bar.

VanderStaay and Wilson sat in silence for a few moments, then VanderStaay spoke.  “Your job, if it were possible in a case such as this, would be to find the reason why, but how can you probe the memories of man who has no memories of the past thirty years?  Perhaps they are there, but even if they are, he cannot find them within himself.  More importantly, how can he remember a conversation from ten minutes before, without the conversation entering his memory?  The answer, sadly, is that you cannot.  All you can do is talk with him, one on one, every day or two, make sure that he’s comfortable, and hope for the best.”

Wilson sighed.  “There is no best.  Imagine talking to a man that can’t remember the last time we talked, a man that can’t even remember the beginning of a conversation.  It’s frustrating because I can’t really understand his world; he lives in a world thirty years gone and touches on our own tangentially at best.  I can talk to him, but I don’t know how I can help him.”

VanderStaay put his hand on Wilson’s.  “Oh, but you can help him.  Is there hope for a cure?  No, we both know that there isn’t; the damage to the substantia nigra was long ago and irreversible.  Can we make his life comfortable?  I would certainly think so.  Mike is one of those anomalies in that he exists in a world that we can only barely touch and then not for long.  To bring him out of that world, to thrust him into ours would be cruel, to him and to us.”

The waitress set the drinks down on the counter and moved on.  Wilson took his beer and took a large drink.  “I don’t know that I understand.”

“Consider this.  What does he know of the last thirty, thirty-five years?  Nothing.  Imagine the shock he would be in if he could only remember and understand the world today.  What was the world like in the 1960s, and how different is it today?  There are differences, major and minor, and though I know the differences, I wouldn’t notice them instantly because I changed as well.  Mike, he exists completely thirty years ago, and the changes of the past thirty years would be incomprehensible to him.  If he could understand, just for a moment, I have no doubt that that would be the greater harm.”  VanderStaay took up his scotch and drank.  “There are barriers in his perceptions of time that we cannot begin to fathom.  He has become truly innocent in the ways of the modern world.”

Wilson smiled, the first time since he sat down at VanderStaay’s table.  “Kent, are you always this deep?”

VanderStaay shook his head.  “Only when I’ve been drinking.”

* * *

Wilson adjusted his glasses enough to rub the bridge of his nose with his forefinger and thumb.  “Mike, you said you thought it was summer.  Why?”

“Me and some of the guys in my unit, we got leave and went for a picnic with some of the German girls not too long ago.  Last week, maybe, two or three weeks at most.  Just between you and me, we even got the girls to go for a swim with us, skinny dipping like I would’ve done back home in Kansas.  And then I look outside here and I see snow on the ground.  It don’t fit quite right, no it don’t at all.”

Wilson twirled his pen around his finger.  “You were stationed in Germany?”

Mike looked puzzled.  “Well, yeah.  Since April of ’62.  Got assigned to a supply dump outside Bremen.  Wait, maybe I shouldn’t be telling you that.”

Wilson raised his hands in a calming gesture.  “It’s alright, Mike.  You’re not in Germany anymore; this is a Veteran’s Hospital in Vermont.  You’re back in the United States.”

“Back in the States?  That’s don’t seem right, I know we have hospitals in Germany.”  Mike paused, his face scowled.  “What’s wrong we me, Doc?  What’s goin’ on, I know you can level with me.”

Wilson made a hushing movement with his hands.  “Mike, please, there’s no need to be upset.  The accident was severe enough that the decision was made to transport you back to here.  That’s all.”

Mike calmed down slightly.  “What kind of injury was it, Doc?  I don’t feel hurt, I feel good, real good.”

Wilson shrugged unconsciously.  “It was a head injury.  You suffered a head injury.”

* * *

Wilson took a drink and swirled the beer around his mouth before swallowing.  “Did you ever deal with Mike, on a one-on-one basis?”

VanderStaay nodded.  “Once, four years ago when he was first admitted.  The condition wasn’t as chronic then.  His wife thought he had Alzheimer’s, but tests suggested Korskakov’s.  He was referred to me by his physician, and by then the condition was much progressed.  The memory loss wasn’t as severe then, but it was certainly growing day by day.”

“What was he like then?”

“Why do you ask?”

Wilson shrugged.  “I don’t know, really.  My predecessor, Doctor Adams, had him keep a diary.  It’s still in his file, and I read it through this afternoon.”

“What did you think?”

Wilson sighed.  “I don’t know, I honestly don’t.  I can’t relate to his worldview, and in reading his diary, I can see that he can’t either.”

“What do you mean?”

Wilson gestured aimlessly with his right hand.  “He didn’t keep the diary for very long, about three weeks from what I could gather, because there aren’t any dates in it.  But I took the twenty entries or so to correspond roughly to a day’s worth of thoughts, though for all I know all twenty entries could have been written the same day; given the Korskakov’s and the fact that he lives life in fifteen minute increments, the entries don’t link to one another in any real sense.  I can see in reading them that he did read the previous entries, or at least one or two, and found them confusing because they talking of things he couldn’t remember doing, but even then the diary wasn’t significant because his memories stretched back fifteen minutes at most.”

Wilson paused, took another drink, and continued.  “But the odd thing of it is that sometimes he didn’t even finish what he started writing, that the beginnings and endings didn’t connect.  He might begin with a story about his parents and then end with his thoughts on the nurse that just walked past his door His writing was disjointed so much as random.”

* * *

My parents married in December, about two weeks after my mom’s birthday.  I looked outside and saw the snow on the ground, it must be near their anniversary.  I don’t much care for their anniversary, never have, ’cause I realize my mom was pregnant with me when she got hitched to my dad, three months I think.  My parents, they never talked about it, about their courtship, I don’t know if it was a shotgun wedding or not.  I always figgered it was.  My best friend when I was growing up, Bennie, his parents were Catholic and really strict, he would tell me how my soul would go to Hell cause my parents weren’t married when my mom got pregnant.  I don’t know that it matters much now, there was this girl in Frankfurt that put out three times one time on leave, but I saw nothing wrong with that.  Was her name Glenda or Hilda, I wonder.  Wish I could remember, now, but I wonder if I ever knew what her name was.  Germany is a nasty country, they hate us, they do, and we faught against them twenty years ago, and they still remember.  You can walk down the stret and see the hatred there still in their eyes, the old ladies who lost their husbands and sons.  I might hate me, too, in their shoes, the war then was bad, really bad, and the Germans did awful things that they shouldn’t have ever done, and they blame us, I know they do.  They can’t help but blame us, for what we did, bombing their cities and towns, but they started the fight and we were right, saving the world from their evil, and now they hate us for protecting them from the Commies.  Shit, they might be happy if the Commies came in and took ’em over.  I don’t know what they think, they make no sense sometimes, and even my company commander doesn’t know, Sgt. Stuart, and he’s been here five years now.  He married a German girl, her dad was a Nazi back during the war, in the SS I think.  She’s a pretty girl, about twenty-five or so, and hates what happened back then.  I wish I could really disagree, but what happened had to happen.  Sometimes I hear steps out in the hall, doctors I guess.  They walk back and forth, all the time, back and forth.  I saw a nurse today, she was pretty, like the German girls but with long black hair.  A girl like that, she’s probably married, living with her husband and a kid or two out in the country, with not a care in the world because of people like me.  I’m out there, in the field, protecting people like her and do they ever think of that; I wonder sometimes but then I never know.  If I asked them they wouldn’t appreciate what I’m doing, but then if I didn’t ask they wouldn’t know what it was that I’m doing out there in the field, serving as the first line of defense against the Commies.  One of my best friends in the Army, he told me once that he had buggered a cow when he was a teenager.  I don’t know if he was joking or not, but he was from Arkansas, and he said there weren’t any women out there that he could bang.  I wonder if he was just making that up because I couldn’t imagine something like that if I wanted to, because normal people aren’t perverted like that.  And then there was the girl in the box, that I saw in Munich one time.  I think she might have been a street performer, but she couldn’t have been, because there wasn’t anyone there taking money.  She was in a box, a cardboard box, and she was screaming and moaning.  I’d better put this away, the nurse is coming in the room, and she shouldn’t see what I wrote about her.

* * *

“And did you gain an insight into Mike?”

Wilson shook his head.  “No, I don’t know that I did.  I so wanted to, because of what I had done to him.”

“And what was that?”

Wilson looked past VanderStaay and into the distance.  “He knows he’s in a hospital, though he doesn’t know why, he can’t remember why.  I don’t even know that he would understand if he could remember.  He asked me today why he was here, and the best I could come up with was to say that he’d suffered a head injury.  I suppose it’s true in a sense — Korskakov’s is a head injury, physically destroying part of the brain — but it wasn’t the kind of head injury that he took me to mean.  I know he thought I meant a blow to the head or somesuch, and I let him think that, because I don’t trust his understanding of his situation.  Because I know that even if he could understand, that understanding would last fifteen minutes and no more.”

“You’re sure of that.  The fifteen minutes.”

Wilson nodded.  “I ran a memory test on him, a little experiment.  Just to test his memory.”

“And?”

“It went just as I’d expected.  But knowing that doesn’t make me feel any better.”

VanderStaay took a drink from his scotch and set the glass down.  “What kind of experiment was it?”

“Give him a box of objects within, have him list the objects, take the box and list away, and talk to him for fifteen minutes.”

VanderStaay nodded.  “I see, to see if he had forgotten about the box and the list in that time.”

“Exactly.”

“And how did it go?”

“Exactly as I thought it would.”

* * *

“Tell me about your parents, Mike.”

Mike frowned.  “My parents?  I haven’t seen them in a few years, not since I joined the Army.  Haven’t heard from them, either.”

“Oh?  Why is that?”

Mike shrugged.  “They didn’t like the idea of me joining the Army, they wanted me to stay home and work the farm.  But my dad, he fought in the War, he served his country.  And I needed to serve my country, because my folks raised me right, morals and values and all.  It was what I had to do, and my mom, she understood, but my dad, he didn’t.”

“I don’t understand.”

“It’s my dad, he fought the Japs, and they did some horrible things.  He went into their tunnels and saw his friends killed by the traps they’d laid.  He was there on Iwo Jimo, you know, where they raised the flag?  He don’t think the war was wrong, but that we don’t need the Army now because we don’t have no enemies, really.”

“What about the Russians?”

“Oh, they’re out there, and we always have to face the Commies, but they’re not gonna do anything stupid because if they did, we’d bomb them and destroy them all.  Kennedy, he was right to stand up to the Russians on the missiles in Cuba, because if he hadn’t we’d look weak and we’re not.”

“Of course we’re not.  Your father, does he understand?”

“I guess he does, back in his mind, but way back the Russians were our allies and I guess he still thinks that in a way.  But really, it’s about the farm, and he wanted me there.  But I know the world’s a big place and I wanted to see it because I think I’m capable of bigger things than working my dad’s farm for the rest of my life.”

“Of course you are, Mike.  Of course you are.”  Wilson paused as he reached beneath his desk.  “Mike, have you ever seen this box?” he asked as he placed the box squarely in the center of his desk.

Mike shook his head.  “Should I have, Doc?  Come to think of it, this is probably the first time I’ve ever been in this here office.”

Wilson shrugged.  “You’re right on that; I didn’t meet you until a few moments ago.  But go ahead and open the box.”

Mike reached over and took the box in hands.  He pulled up the lid and looked inside.  “A couple of balls, some blocks, a ball of twine.  Kid’s stuff, Doc.”  He looked up at the picture behind Wilson’s head.  “Your children’s stuff?”

Wilson nodded.  “My daughter Brittany’s, as a matter of fact.”  He then took up a sheet of paper lying on the desk.  “Take a look at this.”  He passed Mike the paper across the table.

Mike studied the paper for a moment or two.  Written neatly on the paper was a list of the objects in the box.  “I don’t understand.  This is a list of the stuff in the box here, and it says I wrote it, but I’ve never seen this before.  What’s goin’ on here, Doc?  This is my handwritin’, but I didn’t write this.  I couldn’t have, I don’t remember writing this.  What’s happening, Doc, what’s goin’ on?”

“It’s alright, Mike.  It is.  You have a form of amnesia, and we’re trying to help you.”:

“Amnesia?  You mean I forget stuff?”

Wilson nodded.  “That’s right, Mike.  You forget things.”

* * *

“What happened next?” asked VanderStaay.

Wilson sighed.  “I told him the truth, or at least as much as he could understand.”

VanderStaay finished off his scotch and set the glass down.  “And how much did he understand?”

Wilson looked down and shook his head.  “Not much.  In the end, I convinced him his memories would come back, but I know they won’t.  They can’t.  They’re in his mind, but he can’t find them.”

“A dangerous move, Robert.  It could easily have gone in the wrong direction.”

Wilson nodded.  “Perhaps.  I was trying to understand what it must be like for him, beyond his diary, and I really can’t.  What would that be like, to live life in fifteen minute blocks, each unconnected to the next?  I can’t imagine that, and I wish that I could.  I wish that I could understand how he came to be this way, I understand the process, but I don’t understand how he became an alcoholic, how he came to this point, and I’ll never know.  I will never know, because he can’t tell me.  He doesn’t even know or remember anymore.  His parents, his job, his family?  I’ll never know.”

“You could ask his wife.”

“I’ve tried.  I called his this afternoon, but she wasn’t interested in talking.  I think she’s too far gone, too emotionally drained from having to deal with him, that even she doesn’t understand any longer.  And that’s the tragedy of the whole situation, that so much can’t be known.  That we can’t truly understand.”

“Perhaps those such as you and I are not meant to understand.  He lives in a world that we can only touch, tangentally at best, and never truly enter.  He looks about himself and sees the same world that we see, but this world disappears and is replaced by the same world, only he doesn’t know that the present has slipped away into the past.  This is the key to those such as Mike, Robert.  They live entirely in the present; the past exists not as a reality but as a concept, and they can never make the leap from concept to reality.”

Wilson pondered that as his finished his beer.  “I didn’t take you for a philosopher, Kent.”

VanderStaay smiled.  “I’m not.  But I need something to do in my spare time.”  He paused.  “So, when do you meet with Mike again.”

Wilson thought for a moment.  “Thursday, I think.  Two days.  I can never keep track of time.”

They stood and shook hands.  “Good luck with Mike, then.”

“Thanks.  I don’t know that I’ll need it.”

“Luck?  You can never have too much luck.”

* * *

“You must be my doctor, though I don’t know what I’m here for.  I don’t feel sick.  Still, it’s good to meet you all the same.”