Sometimes the name they give you is all wrong. My paternal grandmother’s name was Nava, which, in Hebrew, translates to “beautiful.” In the biblical Song of Songs, it says, “Thou art beautiful [nava], O my love, as Tirzah, beautiful [nava] as Jerusalem, terrible as an army with banners.” By the time I met my Nava, she wasn’t quite beautiful, or terrible. She was essentially a shriveled up little raisin in a modest, tweed skirt and thirty-five-year-old glasses. She was certainly sweet and cute, and raisiny, but I’m not sure she was beautiful. I suppose at one time she was—her husband certainly thought so anyway.
One day my father and I were talking about names, for some reason, children’s names; what you name your children. I asked him if, when my mother was pregnant with me, he’d ever brought up the idea with her about naming me after his own father. He exploded at me.
“Gabriel! What are you, fuckin’ stupid?!” he asked, rhetorically, I hope.
“Well, Dad, I mean, you…” I began.
“Look Gabriel; having a child is a huge responsibility, okay? You can really fuck a kid up right from the beginning if you call him the wrong thing,” my father explained to me. I protested.
“The ‘wrong thing?’ Dad, you know, he was your father.”
“So?” he frothed. “He’s still my father, and you are my son, and it’s a terrible name so why would I do it to you? MoRAD?” he roared, punching out the last syllable each time like a veteran heavyweight. “You think I wanted to name you MoRAD?! Next you’ll say I should have named you after me. Efraim,” he said contemptuously of his own identity. “Another fuckin’ retard name!”
My father, finished for the time being, got up from the dining room table, randomly announced that he was going to “The Camera Shop” and left.
I didn’t know what the hell was the matter with him. His bombastic, Israeli rants are a product of the desert from which he came, and are just meant to be endured and accepted. He blows up all the time, like a rear-ended Pinto, but locating the catalyst usually proves a superhuman investigative feat. I didn’t figure this one out for a while.
A few days ago I was sitting on my wife’s futon leafing through her Hebrew/English Dictionary. This is the type of book I’m pleased that she has because it is also the type of book I would never spend fifteen cents on myself but that I secretly find interesting. I, like any mature, serious-minded beneficiary of higher education, immediately looked for the translations of the words “penis” and “vagina” only to be thoroughly disappointed that this particular dictionary did not even list words at all, though the editors did, apparently, believe earnestly that the translation for “abundant breasts” (khazeh) shofe’a was a pertinent and necessary inclusion. I looked for the translations of our names. There was nothing for Gabriel and there was nothing for Efraim. Then I remembered. Him. MoRAD. I turned to the “M’s” and there it was:
(ba) MORAD (adj.): “on the way down.”
I closed my eyes and put my hand to my head. He was right. My grandfather never had a chance. He was fucked over, as my father had put it, right from the beginning.
Despite Nava’s beautiful name and in-step with Morad’s pessimistic one, they both suffered gravely from a type of psychosis known as vascular dementia before they mercifully died. They lived in Australia and I lived in Pennsylvania, so I never saw their pitiful and piteous decline and descent into the dark. In fact, I never met my grandfather. My grandmother I was fortunate enough to meet when she was still basically together. Like I said, she was very small.
The two of them fell ill and expired prior the beginning of my career as an Emergency Medical Technician. Because of this, I suppose, my perspective on their illness was not one formed by repeated exposure to these kinds of psychological destructions, but was a raw, emotional and desperate view, the view of an uneducated boy losing his grandparents. After their diagnoses, I watched my father peerlessly for signs of forgetfulness, inattention, listlessness, wandering and confusion. Although I know now that vascular dementia is not hereditary, I watch for changes in my own mentality, too. I worry when I feel my brain losing focus, glazing over or getting fuzzy about one thing or another. Maybe I’ve just been an intellectually unstimulated EMT for too long.
Since I’ve started this job and have seen all kinds of age-induced dementia, the thought of watching my own father lose his mind still petrifies me. The thought of going crazy myself, however, I no longer find troublesome. I read an article in a magazine just the other day about a physician who specialized in gerontology. In his vast career, he had examined and diagnosed thousands of patients with Alzheimer’s. Recently, he wrote, he had been having memory and attention lapses himself and, after these problems worsened, he self-diagnosed Alzheimer’s. While he saw another physician to have his suspicions confirmed – which they were – he already knew. Worse infinitely than knowing the diagnosis; he knew the future, his future, and it’s not pretty. Anything that involves peeing yourself and failing to recognize your children never is.
This physician, still in the beginning of his descent, wrote lucidly and placidly about the disease and its effects on the brain and on the body. He talked wistfully about the damage it had started to do to him, and he was candid with the reader and with himself about what it still had left to do. I envied him as much as you can envy anyone with Alzheimer’s because I wanted to be as at ease with Fate as he. But I wrestle with illness and death in the daylight and the dark and becoming an EMT in no way helped exorcise those demons. In many ways, they made them all too real. In the realm of Alzheimer’s and dementia, though, perhaps my experiences with the geriatric psychiatric patients served to allay some of my fears about insanity. Many people would argue that dementia isn’t funny, and, of course, when it’s you dealing with the demented parent or spouse, it’s not. However, from the detached view of the EMT on a psych transport, when your elderly, female patient is demanding that you stop the ambulance “in the name of the United States Government and the Continental Congress,” it’s difficult to keep a straight face in the moment, even though you’re confronting real human tragedy. I hope that finding that funny doesn’t make me a monster; I hope it makes me human.
As I write this, the date of my marriage to Ali is a mere fifty-odd days away. Approaching this date of sublime happiness, there is also an element of sadness. We are melding two families, and both have a history of mental illness. One or both of us could wind up losing it, and that is frightening to me. The children that I hope to make with her could wind up losing it, too. I have seen what happens to people when they lose it. It gets, well, lost. I think about our vows. We vow to love each other and help each other through sickness and in health, through it all. We promise to love and honor and respect each other no matter what. But what happens when you pledge your love to someone eternally and then, one day; he or she is not that person anymore?
Ben was lying facedown on a small sofa at Macomb Hospital’s Behavioral Health Unit. He was wearing a gray tracksuit, though it was highly unlikely that he was going to be participating in a marathon anytime soon. His gray hair was strewn this way and that and it stuck to the pillowcase once he sat down on the stretcher. He had bits of egg and what looked like syrup – at least, I hoped it was syrup – on his jacket front and crystallized eye-boogers encrusted his eyelids. It was two fifteen and he’d probably been sleeping all day. And why not? Nothing else to do. There was Scrabble in the Unit’s game-room, but I didn’t observe any potential companions that looked up to a Triple Word Score anymore than Ben did.
We were taking Ben to a very upscale facility that specialized in “eldercare” and so this piqued my interest a little bit. I am a very nosey person and, when I know we’re taking someone to a retirement home that has a yearlong waiting list to get in, I want to know a little bit more about the individual we’re taking there. Maybe he married money, maybe he’s a war profiteer, maybe he’s a former member of the Johnson administration; I just want to know, that’s all. Because Ben didn’t speak to me, I could snoop through his file. I had no compunction about doing this. Occasionally there was something in there I actually needed to know.
There was the usual bullshit: medications, allergies, lab results, safety checks, vital signs, nursing notes. I usually skip all this if I’m reasonably sure the patient isn’t going to croak during the ride. I flip and flip through the pages until I get to what I’m really after: the physician’s narrative report. Ben’s physician’s report shocked me so much that I pulled out my journal and copied it verbatim. Sue me.
“Ben ****** is a seventy-six year old Caucasian male with advanced Alzeheimer’s-related dementia. He is essentially non-verbal and is currently incontinent of bowel and bladder. Born and raised in England, apparently he was very smart as a child and got a full scholarship to the Sorbonne University in Paris. After he graduated, he became and engineer and eventually came to the United States in the 1950s and became a Chief Executive for a company. The patient retired when he was 60, at the beginning of his dementia. The patient used to enjoy playing tennis and reading books. Apparently at one time he could read forty books in one week which is, of course, quite an achievement.”
Now going two hours without soiling himself would be “quite an achievement” for Ben. I became deeply depressed after reading, and copying, the physician’s narrative. The report went on to say that Ben’s wife was “quite active and independent”. I wondered briefly how exactly that was relevant and it annoyed me that the physician had put that in there, almost as if to mock Ben and his deplorable mental condition. I surmised that the doctor who wrote the report was probably schtupping Ben’s wife. I resented being exposed to this information and paranoid fantasy. I felt ugly, like an intruder, like this was something nobody was supposed to know. Now, of course, that I knew what he had been and now that I knew what he had become, I wanted to know more and more and more. I wanted to know about the first moment double-breasted, pinstriped Ben fucked up in the office or at a high-power meeting. I want to know the first time he looked at Bob but said, “Jim”. I wanted to know the first time the phone rang and he answered the stapler. How did this Goliath get taken down? By a little neurological atrophy? It didn’t seem possible. If it got Ben, if it got Reagan, if it got my Morad and Nava…
It got Sally, too. Actually, her name was “Edwina” but sometimes the name they give you is all wrong, so she asked to be called “Sally.” I guess, if my name was “Edwina” I’d ask to be called Sally, too. Sally looked ancient. If you were traveling in an unsafe neighborhood with Sally as your companion, you could hide all your spending cash in the lines in her cheeks and no mugger would ever find it. Her forehead creases looked like the ridge around a piecrust. The fact that Sally weighed under a hundred pounds didn’t help her appearance much. If you passed wind near her, she’d probably disintegrate; not to mention get a little indignant.
At the nurses’ station, I asked all the appropriate questions, and some inappropriate questions, about the patient. These included her last set of vitals, her overall disposition and, of course, her favorite color. I never do anything with that information, I just like to know. The charge nurse made a big deal about the fact that Edwina likes to be called “Sally.” I asked why.
“Who knows? Everybody likes to have a nickname,” the unit clerk said.
“You mean like ‘Whitey?’” I asked. The unit clerk stared at me. She was black. Whoops. “No, I mean—like Whitey Ford. The baseball player. Not—I mean—not, like… you know.”
“Cracker?” she offered.
“Right. Not like that.”
The transport was uneventful. Sally, fortunately, was communicative, so that made it at least a little more interesting. We were able to chat a bit about this and that; she was even somewhat coherent. She told me that she used to be a first grade teacher. For forty-six years. I told her that Ali used to teach pre-school.
“That’s a nice age,” Sally said. I agreed. I had met all of Ali’s students each of the three years she taught at a Quaker school. I liked these kids. It was a great age. Much better, I hasten to add, than eighty-six. If you asked Sally I’m sure she’d tell you so.
“Why do they call you ‘Sally’?” I asked, because there was a lull in the conversation. Because I wanted to know.
“Everybody asks me that,” Sally said, smiling a crinkly smile. “When I was a little girl, there was this popular song called ‘Pretty Little Blue Eyed Sally’. That became my name.”
As an EMT, you don’t often look into patients’ eyes. You look at their charts, you look at your paperwork, you look at their ankles for signs of edema, you look at their chest to make sure they’re breathing. You watch their jugular vein pulsing in their neck to make sure blood’s still flowing. If you look in their eyes, it’s a cursory glance to check pupil size and response, to make sure the patient isn’t stroked out or coked up. You look in patients’ eyes, but you don’t look into them. That’s too weird. But, after Sally told me she got her nickname from a song called “Pretty Little Blue Eyed Sally,” I looked into her eyes. Blue Topaz couldn’t hold a candle to these eyes. It’s kind of a strange feeling, being twenty-six and saying that about a woman who’s sixty years your senior, but it’s true. They were sharp and strong and clean and bold, and it required no stretch of the imagination whatsoever to put those eyes into the head of a precocious eight year old, or a coquettish sixteen year old, or a scholarly thirty-one year old, or a wizened sixty-five year old. Uncomfortable, I looked away.
“It must have been a nice song,” was the stupid thing I thought to say.
“Oh, yes,” she said. “And so that became my name. I never remembered the name Edwina until I started parochial school and the teacher called out ‘Edwina!’ Well, she was looking at me,” Sally said, in mock astonishment. I smiled. “I said, ‘That’s not my name.’ When I got home that day I told my mother, ‘I’m not going back to that dumb school—they didn’t even know my name. My mother asked ‘What did they call you?’ ‘Edwina’ I said.” She said it as if it were a curse word. “‘That’s your name,’ my mother said. Well, I didn’t know that. I don’t especially like Edwina either. So I go by Sally.”
When I got home from work that day I went to the computer and did a search for “Pretty Little Blue Eyed Sally”. While I couldn’t find any song from that era with that exact title (she does have dementia after all) I was able to find two versions of the song “Blue Eyed Sally”, and the one that gave her the nickname that stuck for over half a century was either recorded by the duo of minstrel performer Al Bernard and ragtime legend Russell Robinson in 1926, or by Vic Meyers, a ukulele performer of the same vintage. Regrettably, I wasn’t able to find any lyrics. So the words “Pretty Little” aren’t in the title. So what? Maybe that’s how Edwina sees herself: as little. As pretty. As Sally. And who am I to say anything about that anyway?
There are still days when I get scared about going off the deep end and winding up in the Behavioral Health Unit myself. I fret and fuss about whether it’s going to be Ali visiting me, slumped over in the glider or me visiting her, slumped over in the glider, or whether we’ll occupy the stain-resistant loveseat together, crapping ourselves and muttering about the nurses as we drool on each others’ sweater vests and hold gnarled hands, our orange blossom wedding bands barely clinging to our deteriorating fingers. I don’t know what happened to Ben, the tennis-playing, book-devouring CEO, and I don’t know what happened to Sally or to Edwina, and I don’t know what’s going to happen to us. I just hope that, when it comes time for me to go on the stretcher that the EMT in the back cares just enough to snoop through my file or look into my eyes to maybe find out who I was before I started on the way down.
Gabriel Nathan is an Emergency Medical Technician who worked for a private, for-profit ambulance company that contracted with hospitals and other facilities to transport, among others, patients with emotional disturbances. He lives and writes in Philadelphia.