“Remember the fall? All about it? When did it happen?” Conrad’s always doing that, all the questions thrown on the table at once, like a card player in a tantrum. Game called on account of earthquake!
Hugh takes a breath, stays calm. “I fell off a ladder.” He hates being medicoed. Especially by a bullet-headed lunatic with a machine-gun voice and a sense of godhead.
Conrad swivels back to the computer to enter the data. “When?”
“Monday morning. And then I fell down some stairs, on Monday night.”
“Two. Ah … And how long were you out?”
“Well, three or four hours. Dinner, then the party at Pink’s, and then I walked home—”
“No, out. Unconscious.”
“Oh.” Hugh thinks. Swings his black leather stool right, left.
“Were you alone?”
“Yes. I don’t think—I don’t know if I was out at all. I might have been.” He can’t figure out whether the safe answer is yes or no. “I don’t think I was out at all. Just winded. I thought I was having a stroke.”
“How far did you fall?”
Twenty feet. “Maybe ten feet.”
“Stupid.”
“I have put up those lights every year for ten years.”
“Here’s a piece of medical advice, I give you gratis, for free, thrown in on the public dime: don’t climb a ladder without someone there to hold the legs.”
“Okay.” Hugh does not wish to hate anybody else in this town. Conrad means well.
“Did you vomit?”
“No.” Then remembers that he did, didn’t he? He threw up red wine, all over some sink or other. He looks out the window.
“You’re not taking warfarin, by any strange chance, are you? Double-doctoring?”
“What for?”
“Oh, it’s a blood thinner, also a rare treat for the rats. Poisons them dead, I promise you.”
“No.”
“No allergies, and you’re not a bleeder.” Conrad gets up from the computer and comes at Hugh, flashlight pointed. “All righty,” he says, jabbing the light in each eye repeatedly. “Sore neck? No? Honestly, I can’t think you need a scan, you’re talking well and it’s been what, three days. Why didn’t dear Ruthie send you in sooner?”
Hugh remembers the casual formality of his old roaming days, when doctors hardly knew him, when they did not sit on arts boards with him or report to town council on the downtown rejuvenation project. When there was never anything wrong with him.
Conrad presses his head all over. Gentle fingers, taking his time, like the children’s aid nurse with her freshly picked toothpick going through his head for lice, or Ruth’s fingers, washing his hair in the kitchen sink. His own fingers, rubbing his mother’s head when she was forlorn. When she lay on the bed sobbing quietly or frantically, the only thing that soothed her was a slow, repetitive pulling of fingers, combing and combing through her pretty hair. Hugh passes a hand across his eyes, waiting for Conrad to finish.
“No bumps. Good job, you. If you notice a bump coming up in the next month or so, come back and see me. That’ll be serious. The thing that worries me”—Conrad spins Hugh round to face him— “is that second fall.”
Hugh is surprised. “Oh, that was nothing. Five steps, maybe. Conked my head against the wall, but it was a carpeted landing. Soft.”
Conrad shakes his head. “It’s twice in one day. Two falls, ten times the danger.” His eyes are sharp, so Hugh struggles to perk up. “Some subtle problems don’t show up right off the bat. Memory deficit, changes in cognition, obsessing … personality changes.”
Hugh nods, looking away.
“Experiencing violent tendencies lately?”
“Well obviously Ruth told you about the other night. I can only assure you, doctor, that Burton had it coming.”
Conrad nods. “I’ve met the man.” His lips pooch out, pooch in. “Look. What I’m worried about with you is PCS, persistent concussion. In some, the symptoms of concussion last. Past six weeks, those patients are almost always treated with antidepressants. In my own view, I’ll tell you what, they were depressed already, their brains already in a depressed condition. The standard thing is to put someone on antidepressants and bedrest, absolutely no exercise. No exertion, no excitement; no snakes, no ladders.”
Hugh thinks of last night at Ivy’s window, the old ladder wobbling as he went up, shaking badly as he went down. His feet cramped as he reached for the ground.
“If you ask me, Hugh, your brain was—you were already, before the fall, the two falls—already a candidate for antidepressant medication.”
Hugh swings his black leather stool back to looking out the window.
“As we discussed, last time you came in.”
The leaves, fading from the first red down to burnt-out cinders, to yellow ash.
“But you refused.” Conrad taps his pen on his table. “So what’s the unbearable part of it? Why are you here now?”
I think about suicide all the time, with longing, he wants to say to Conrad. I can’t let myself yet—but after my mother dies, I can. She can kill me and herself. Like a leaf detaches, slips to the ground. Autumn is what happens. Everything dies.
But you don’t say those things out loud.
“Can’t sleep,” Hugh says at last. “Not sleeping. Never more than three, four hours. I’ve gained weight. Ruth nagged me till I agreed to come.”
“Headaches too?” Conrad puts the pen under his nose, a black moustache. He twirls it.
“Okay, no, I don’t have headaches. I just can’t sleep.” That sinking feeling, quite literal, as he falls asleep—sinking into the pillow, the pit full of all the things he doesn’t let himself think about all day. So many!
“I can give you sleeping pills.”
“I don’t want pills.”
“Fine, I’ll give you ten of them.”
Hugh takes the scrip, pockets it. He is very, very tired.
“So no exercise, no stimulants. No alcohol. Nothing. No ladder climbing.”
Conrad adds, now jovial: “You’re old, Hugh. You don’t want to let this get out of hand.” As the nurse comes in, Conrad shouts, so that the whole waiting room must hear. “There’s nothing shameful about being depressed. If you’d broken a leg, you’d fix it.”
“Not depressed,” Hugh says. To the room.