The Bill from My Father (23 page)

“What did you and your son do in the waiting room?” Dr. Montrose asked. She locked him into eye contact. And so the evaluation began.

“My son read the
Ladies' Home Journal
and I made the mistake of noticing out loud, for which I got my head chewed off.”

She turned to me. “Were you reading the
Ladies' Home Journal
?”

I looked at my father when I answered. “It's not like I subscribe,” I said.

Dr. Montrose took this as a yes.

“And do you recall what magazine you were reading, Mr. Cooper?”

“No.”

I thought of intervening because I knew my father meant he hadn't read a magazine, not that he couldn't recall which one.

She leaned forward, elbows on her desk. “Have you been having any difficulty remembering things recently?”

“I'm fine.”

“I'm sure you are. But if we test you today, we'll have a baseline to compare against future tests.”

“Future tests?” He looked as if he'd tasted something sour.

“What about that upsets you?”

“What about what?”

“About what I just said.”

My father went pale. “What was it you said?”

Dr. Montrose jotted a note. “I'm going to ask you several questions,” she continued, “and I'd like you to answer them one at a time.”

“How else would I?”

“How else would you what?”

“Answer them, for Christ's sake!”

“Calm down, Dad.”

“I'll calm down when I'm good and ready.”

“We'll be working from what's called the Mini-Mental State Examination,” said Dr. Montrose, “and I'll score your answers as we go along.”

Dad adjusted his Miracle-Ear. “So test me, already.”

The doctor retrieved a sheet of paper from her desk drawer and began to read aloud. First, she asked my father to tell her the date. He got it right, whereas I'd silently answered along and was off by a couple of days. Was my lapse symptomatic of a larger cognitive problem? I scooted my chair closer. Now I had to prove to myself that there was nothing wrong with me by answering every subsequent question correctly. I also had to face the fact that I felt competitive with my father, as though we were opponents on a quiz show hosted by Dr. Montrose. She held the sheet of questions in such a way that light streaming through her office window turned the paper translucent, and I wondered if my father could read the correct answers from the other side. Then I realized there
were
no
correct answers to this kind of test, only variable replies. Was there any way to cheat on a mental competency exam? None that I could think of, which may or may not have been a good sign.

“What country are we in? … State? … City? … Hospital? … Floor?”

Not until Dr. Montrose whispered, “Bernard,” did I realize I'd been muttering answers under my breath. There was no way my father could have heard me from where he was sitting, so it wasn't as if I was prompting him. And anyway, I got them right. Dad, on the other hand, didn't know what floor we were on, but if
he
had been the one to push the elevator button instead of me, he probably would have known it was the third. The mechanics of recall are delicate, so iffy and contingent.

As for calling this hospital “Saint Sinai,” if Dr. Montrose had thought about it for a minute, she would have realized that his answer combined the names of two major medical facilities, Saint Joseph's and Cedars-Sinai. His guess was as logical as it was wrong, but since the testee wasn't given credit for near misses or whimsical hybrids, why explain his error's fine points? Besides, I'd already been caught talking to myself, and Dr. Montrose must not have thought me the most reliable advocate for a man who's rapidly failing his Mini-Mental. Sensing he'd made a mistake, my father lowered his head, laced his fingers together in his lap, and stared at one hand meshing with the other. He had the shamed, inward look of a man who knows he's blundered but doesn't know how, and therefore can't correct himself or offer an excuse.

“Mr. Cooper,” asked Dr. Montrose, “are you ready to continue?”

Still staring into his lap, my father nodded. His head seemed heavy, as if with answers that would soon elude him.

“Spell
world
backwards,” said Dr. Montrose.

Dad looked up and unclasped his hands. His glasses slid down the bridge of his nose. “Why?” he asked, peering over the rims. “Why
world
?”

Because the world
is
backwards, I said to myself. Laws are repealed. Iron rusts. Logic unravels.

“I suggest you don't overthink the questions, Mr. Cooper. Just try to relax and let the answers come.”

My father poked his glasses back into place. He deliberated on every letter. “
D … L … O … R … W
?”

She recorded his score. “Now, please repeat the following list of items in the order I read them to you: apple, penny, table.”

Dad cocked his head and thought a minute. “Did I get it right?”

“You haven't repeated the items yet.”

“Not those,” he says. “
World
. Did I get it backwards?”

“Ask me at the end of the test.”

“Suppose I forget?”

“We should move on to this next question,” insisted Dr. Montrose. “It's important to administer the MME as methodically as possible. I don't want to rush you, Mr. Cooper, but once we've established the pace, digressions are only going to interfere with your concentration and skew the results. Now, kindly repeat after me: apple, penny, table.”

“You can't tell me now?

“Penny, table, apple,” she persisted.

Was it me, I wondered, or did she get the order wrong?

My father probably couldn't see well enough to read the spines of the books lining the shelves behind the doctor's head:
The Aging Population. Dementia and Its Consequences
. The titles would make me nervous if I was trying to prove my mental acuity.

Dr. Montrose waited, with perfectly calibrated neutrality, for my father to recite the list. She'd been schooled in being patient, had practiced it the way one practices the piano, striking every octave of calm, every note of analytic distance.

“Apple,” he said at last. “The rest I forget.” He dismissed his insufficient recall with a wave of his hand, but he looked at me to gauge how he was doing. I smiled noncommittally back.

Next, she asked him to repeat the phrase, “No ifs, ands, or buts.” Without missing a beat, my father drew himself upright, gulped the necessary air, and spit out the words with a force that caused his face to redden like a fanned coal. He pounded his fist in his open palm.
He was good at ultimatums. Ultimatums were his forte. No ifs, ands, or buts about it, he was ready to resume.

“Can you tell me what this is?” she asked, holding up her pen.

“A ballpoint,” he said. “Does it have your motto on it?”

Dr. Montrose informed him that men and women in her profession didn't, as a rule, have mottos. Then she noticed that there were, in fact, words printed along the side of the pen. She held it horizontally and squinted. “Hot Water Management Service,” she read. “Where could this have come from?”

I suspected this question wasn't part of the test, but it was hard to tell where the Mini-Mental left off and idle curiosity began.

Dad said, “Pens are everywhere these days. People need pens to make lists, what with all the rushing and the doing and the coming and the going. What I'd like to know, though, is what the hell is a Hot Water Management Service?”

He'd posed a blunt yet provocative question, one resistant to statistical norms, to pre-and postmodern theory. Was the need to manage hot water greater than the need to manage cold or lukewarm water? Was it managed through a system of pipes and valves? Was the service a private enterprise, or government run? We hadn't a single answer among us, not a guess or speculation. The doctor continued to gaze at the pen, holding it at either end and slowly turning it between her fingers as though she might find still other phrases inscribed on its side. Beyond the hospital window, the sky above Oxnard deepened into dusk. A couple of pink clouds glided across the horizon and for a moment it seemed as if the building was revolving while the clouds stood still. As we tried to unpuzzle the message on the pen, the office's walls and furniture dimmed, our faces growing vague. A clock ticked loudly on the doctor's desk, and I felt a certainty down to my bones that the three of us, second by second, were drawn toward a vast and eventual forgetting. Nothing we could do or say would stop it. No matter where we turned we couldn't turn back. One day this room wouldn't ring a bell for anyone now sitting within it.

*  *  *

Dr. Montrose explained that my father's score revealed a mild-to-moderate cognitive impairment. She addressed Dad directly, telling him it would require several more tests, both physical and psychological, to discover whether his condition was temporary.

“You call this a condition?” he asked, moving his arms and legs as if his aspirin-enhanced mobility made further tests unnecessary.

“I think we should schedule an MRI for you later this week.”

“I just took it!” he protested.

“That was the MME. There are so many acronyms in our profession. It's confusing, I know.”

“It's ridiculous, is what it is. It's alphabet soup.” If my father grasped the ramifications of scoring poorly, if he gleaned from Dr. Montrose's gentle voice her wish to buffer the news that his faculties might decline over the coming months, he didn't let on. He was as upset as he would have been had he lost a round of gin rummy, tossing his cards onto the table, ready to try his luck again.

Both my father and I had hoped the results of the examination would be somewhat definitive, if that's not a contradiction, but the consultation added yet another ambiguity to our already extensive collection. Dr. Montrose implied that my father's mental acuity could go either way, or any way, or every way at once, which, as my father had said in the waiting room, was something we could have told ourselves.

Night had fallen by the time we left Saint Joseph's. Arc lights in the parking lot tinted white cars yellow, red cars brown. The world lay before us in a new, deceptive spectrum. We'd both forgotten where I'd parked and we wandered across blacktop still soft from the day's heat, sure we'd spotted the right make and model, only to discover, once we came closer, that we'd made a mistake.

The central wing of Saint Joseph's towered above us, a monolith of lit-up windows. On every floor, people waited with a terrible impatience for recovery, visitors, morphine, sleep. My father had narrowly escaped the place, and by the time we finally found the car, I couldn't get out of the parking lot fast enough to suit him.

After negotiating stop-and-go traffic along the commercial strip,
we passed fewer and fewer fast food restaurants and discount designer outlets, until we sailed through the outskirts of town, where distant lights lay scattered across the black landscape. The sky was more of the same, but higher.

I'd come by the trailer park earlier that afternoon to pick up Dad for his appointment and to drop off Brian for a private talk with Betty. The plan was that Brian would ask if we could pay her to continue living with my father until I could find a suitable retirement home or assisted-living facility. In broad day, the Siesta's trailers had been uniform in shape and painted drab industrial colors, sunspots glaring on their corrugated roofs. Not only were they similar enough to confuse a person with cognitive problems, they were similar enough to induce confusion in a person without cognitive problems.

Before Dad and I drove off to meet with Dr. Montrose, Betty drew me a map of the route between the trailer park and Saint Joseph's, and now, as my father and I returned after dark, he glanced at it repeatedly and warned me that her directions were wrong.

“They got us to the hospital,” I told him. “They ought to get us back.”

“You'd trust a bunch of chicken scratches?” Whether or not he could have pinpointed the source of his anger—Betty's refusal to let him borrow her car—it seized him each time he glanced at the map. “That woman couldn't find her way out of a paper bag.”

“It's
fight,
Dad, not
find
. She couldn't
fight
her way out of a paper bag. Or—wait—is it
punch
?”

Whenever he recommended that I make a turn or continue straight ahead, I grunted in compliance, then followed Betty's drawing. I was pretty sure we weren't lost, but between the charade of obeying my father's instructions and the endless bolt of open road unfurling in my high beams, we could have been inventing the miles as we drove along.

Siesta Trailer Park
was spelled out for passersby above the main gate, the sign's wooden letters all but invisible against the night sky. No matter how slowly I drove down the property's unpaved main road, a cloud of dust billowed behind the car. There wasn't a person
in sight, yet every window jittered with light from a television. A raucous pack of dogs materialized in my headlights, their teeth bared, eyes incandescent. Once it became clear that I'd slow the car but wouldn't stop, they yapped a last, collective protest and bounded away.

“Home again, home again,” said my father as we crept toward his trailer. “Jiggity jig.” He asked if I remembered him reading me
The Three Little Pigs
when I was a boy. “That,” he explained, “was why you decided to become a writer.”

“So you
did
hear my acceptance speech?”

“Speech?” he asked, baffled.

I shrugged. “Nothing.”

I put the car in park and told my father that Brian had stayed behind to discuss some important matters with Betty. Through the screen door to his trailer, I could see Brian and Betty seated across from each other at a small dinette table, talking intently. A neon fixture in the kitchen cast a bright, uncompromising light over the entire room. Brian leaned forward at the slant of active listening. Betty held a steaming mug with both hands, a wisp of damp hair clinging to her forehead. The glazed resignation on her face told me she'd grudgingly agreed to our plan, as ready as she'd ever be for the task ahead.