Free Delusion by G. H. Ephron Page B

was trying to build a manger in her garage, screaming at her husband that the innkeeper wouldn’t give them a room. Mr. Smetz was frantic. Brought her in to the emergency room at the Carney. They shipped her to us.”
    I took the file from the rack and opened it. “Seventy-five years old.” I scanned the admitting report. “No psych history,” I said, noting that she’d never been treated for mental illness.
    â€œGradual decline?” Kwan asked. That’s what you’d expect if it were dementia.
    â€œNot that I can see.” I offered him the file.
    He flipped through it. “Odd, the sudden onset. The admitting doc put her on an antipsychotic, Zyprexa. That may make a difference. Has it?” He looked to Gloria.
    â€œNo. She’s driving staff crazy—asking where the manger is. She’s not redirectable or cooperative.”
    Roger, the postdoc, spoke up. “We just sent off her labs.”
    â€œAn intriguing puzzle,” Kwan said.
    After the meeting, we visited Mrs. Smetz during walk-rounds. She was a stout woman with a plain face the color of a burlap bag. Her hair was dyed red. We found her pacing up and back
in her room, leading with her right shoulder and muttering to herself.
    â€œMrs. Smetz?” I said as we entered the room. “I’m Dr … .”
    She lurched to a halt. Her face lit up. “At last!” She clasped her hands together. “The wise men are here. And one of you is a woman!” She beamed at Gloria. “How delightful.”
    I went along. “We’re here to see how you’re doing.” She smiled at me. “I hope it’s all right if I ask you a few questions.”
    â€œBut you’re the ones who have all the answers,” she said.
    â€œEven the wise can learn. You’re not at the inn?” I asked.
    â€œNo. I’m in a hospital.” That was unexpected.
    â€œDo you know why?”
    â€œThe innkeeper won’t give us a room. So we had to come here. My husband …” She glanced about the room, momentarily confused. “Oh, yes, he went to get me some apple juice.” She lowered her voice, “You mustn’t tell him”—she patted her stomach—“about this.”
    A tired-looking older man in a blue plaid shirt and a zippered jacket came into the room carrying a paper cup. He smelled faintly of tobacco. “Joseph!” Mrs. Smetz said.
    He handed her the cup and gave us a weary look. “Bill,” he told us. “My name’s Bill Smetz. Been married fifty-three years, and all of a sudden she can’t remember my name.” He harrumphed. “Thinks she’s Mary, mother of God.” He seemed to be making light of it, but his eyes told another story as he searched us for an explanation, looking for words that could make it all go away.
    I explained that we were there to give his wife a mental status exam, and that he could stay if he wanted. He took a seat. I invited our postdoc to take over.
    Roger began by talking to her informally, putting her at ease. That was good. A mental status exam needn’t feel like an interrogation. Then he asked her if she knew the date.

    â€œMay”—she thought for a moment—“eleventh.” Close enough. It was actually the twelfth. Then she gave the correct year.
    He asked her to repeat numbers. She had no problem. Then words and phrases. Again, no difficulty. She was able to spell words forward and backward. And she remembered three items after five minutes. Attention, concentration, immediate and short-term memory—all seemed unimpaired.
    When he got to, “Do you feel safe here?” a guarded look dropped over her face. She gave an anxious glance toward her husband. “Oh, no,” she said. “The innkeeper doesn’t like us, and the soldiers are looking for us.”
    â€œMrs. Smetz …” Roger began.
    â€œYou can call me Mary,” she