Free Reaching Down the Rabbit Hole by Allan H. Ropper Page B

“but there’s no brain module that creates nonsense. The question is: Could this be the result of the degradation or absence of some other function? Is it a problem with the connections between brain modules?”
    “My theory on all of this will straighten it all out for all of you,” Gordon interrupted. “You want to know why?”
    “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,