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Every month More Voices invites readers to contribute short nonfiction prose pieces of 40 to 400 words on a healthcare theme.

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Raymond Abbott            


Donald Wyatt. I have written of him before and did not plan to write about him again. Then, just today, something happened.

I was slated to meet him at the usual place. We've been having lunch together once a month for more than seven years. Not coincidentally, it's been exactly that many years since I last worked as a social worker for a local mental-health agency. Donald was one of my clients. When I was about to retire, his mother asked me if I would have coffee or lunch with Donald once in awhile.

"Sure," I said, never thinking it would go on for so long.

Donald is a slight, brown-haired man just past fifty who suffers from both Asperger's and Tourette's syndromes, and other ailments as well. I've known him now for thirteen years. I didn't realize that it had been that long, but one day I asked Donald.


"Thirteen years," he replied without any hesitation.

I never question Donald's numbers; his facility with figures is uncanny. He knows, for example, significant numbers and dates in my daughter's life (she's married and lives in St. Louis): her exact date of birth, when she graduated college, her wedding date. These are all dates I mentioned once, when he asked, but surely only once. Donald is equally sharp when it comes to dates involving my mother (now deceased)--her date of birth and so on. You get the idea.

But today I learned something about Donald that I didn't know before, and it was a bit unsettling, truth be told. It rather worries me.

We were to meet at 2:00 pm, but I completely forgot about it, even though Donald had called twice in recent days to remind me. (Repeating is said to be part of the Asperger's condition.)

In the past, his calls were much more frequent, but I gently discouraged the excessive telephoning.

"It's just too much, Donald," I said to him one day, and he stopped. At least I think he stopped. Now I get calls--not a lot of them--in which there's no voice on the other end. They never come late at night, and they're not frequent, but somehow I think they come from Donald. I don't have caller ID and have not otherwise tried to determine their source. Given the range of possibilities, I prefer to believe they're from Donald, harmless Donald.

So I forgot our appointment this particular day, but by chance I went to our diner anyway; it's close to my home, and I'm a regular customer. Walking through the door, a little after 11:00 am, I remembered that I was supposed to meet Donald there at 2:00. I decided to have a coffee and review the local newspaper, then go home and return at the appointed hour. I took my usual table, sat down--and saw Donald approaching.

For a moment, I thought that it must be a chance encounter, but I soon realized that he'd arrived three hours early in anticipation of our lunch. That spooked me a bit.

"I didn't have anything better to do, and I can wait here just as well as at home," he said. (His home is not close by.)

He said all this a bit nervously, as if arriving early was somehow wrong.

I quickly assured him that it was perfectly fine getting there at 11 o'clock, but inwardly I wondered if he'd been doing this for the past seven years.

Could very well be, I thought.

You need to understand too how much of a nonevent, from my perspective, is lunch with Donald. Here's how the engagement usually unfolds: Donald orders a sandwich and iced tea, sits at my table, wolfs down his food and is soon on his feet, ready to leave. He hands me a paper that states when next we're to meet, on a Thursday thirty days hence. Then he's gone. Lunch doesn't last even a half-hour, often only fifteen minutes.

I sometimes try to enlist him in conversation, asking him about his doings and recent activities. Today I asked if he missed the regular contact with the mental-health agency where he used to come and see me as my client.

"Not at all," he replied.

I wonder, though. When I was working at the agency, he used to come to our offices at least once a week, usually on a Monday, and he called frequently thereafter. Because of budget cutbacks, all of that has ended.

Now, every ninety days Donald sees a psychiatrist, his prescriber of medication. That's it. He now handles his own meds, and his money as well, and I suppose he's capable of doing this--yet the routine, and the socialization that went with it, are totally gone. Although he said that he doesn't miss it, and that he doesn't miss having a social worker, either, I have my doubts.

During our lunches, I always remember to ask after his mother and stepfather, and his reply is that they're okay, but I know that he worries about their health. His mother is over seventy (as I am, by the way), and his stepfather, also.

Today I asked him, for no particular reason, how often he speaks to his mother.

"At least twice a day," he replied quickly. I suspect that it's much more often than that. She's not well, and that fact has to worry Donald a lot. And he's not the only one who's worried.

So what happens when she dies? I wonder. His stepfather is a fine fellow, I'm led to believe, for I've never met him, but I suspect that his level of concern for Donald is less than that of Donald's mother. She has been there for her son for more than fifty years, his entire life. What happens when she's no longer here?

I have to wonder, too, what becomes of my role when Donald is completely alone. More than I care to take on, I can tell you that much. Unbidden, the thought arises: What have I gotten myself into?

In the name of reform, and economics, the country as a whole has closed facilities that once served the poor. That includes mental hospitals, to be sure, but other services, too. Social workers and psychiatrists in considerable numbers have applauded and supported these major changes, largely in the name of new treatment approaches within the community. Books and movies--think of One Flew Over the Cuckoo's Nest--are cited as reasons for such policy shifts.

On the other hand, some in the mental-health world say that Cuckoo's Nest alone has set back mental-health treatment decades. And I can see where they're coming from, for closing the nation's mental hospitals has not been a plus--at least, not for the very poor population I served.

Increasingly, the patients and caregivers who are left to deal with such so-called reforms--and before long I could well be one of the latter--see rather plainly what we're approaching in the years ahead.

And it's not pretty.


About the author:

This is one of a collection of twenty-five stories entitled The Unique Boarding Home, yet to be published, by Raymond Abbott, a licensed social worker in Kentucky whose works have appeared in Pulse, The Washington Post, Hospital Drive, KevinMD and elsewhere. "I have been writing for many years on just about every subject."

Story editor:

Diane Guernsey

Comments   

# Julie Evans 2016-03-13 10:32
Mr. Abbott you had me spellbound with your story of Donald. Your writing brought him, and his plight, to life. When you stepped out of what was happening and wrote about the current state of health care it was rather an abrupt ending to the marvelous story of the two of you. I understand your motivation and would perhaps just move some paragraphs around so the story remains the center of the piece.
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# Pris Campbell 2016-03-11 18:40
I share your concern for Donald. I'm a retired psychologist and ran treatment units for the state snd VA when 'deinstitutiona lization' was beginning to speed up. Many patients could never survive on theur own without care. This meant that as units closed, they went to state run nursing homes, several to a room, tv blaring all day, chairs snelling of urine, never cleaned. The staff was minimal. Others took to the streets, no place provided to go to for meds. How this could be seen as improvement is beyond me.

In the late eighties I visited the huge VA complex shere I had worked, outside of Boston. The buildings were empty and shut doen. That hospital had housed a state of the art unit for spinal chord injured vetersns, Where did they go?? Where were the others who relied on programs there for support?

Thank you for this article! It is very much needed.
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