f a i t h * i n * f i c t i o n: Kenn Allan - "The Last Patient"

f a i t h * i n * f i c t i o n

Thursday, December 30, 2004

Kenn Allan - "The Last Patient"

For the third year in a row, I drew the Christmas Eve shift at the mental health clinic. This irritated me--not because I actually had anything better to do, but due to the common perception that people without families should willingly surrender their holiday for those who do. Therefore, I found myself once again commanding an office staffed by others either too young or too dedicated to take advantage of the freedom offered by domestic bliss.

It had been a slow day, the monotony only broken by the usual cases of holiday depression and one bona fide schizophrenic. Most of my time was spent gazing out the window at the fresh layer of snow covering the city and wondering how long it would take to dig my car out of the white mess at the end of my shift. I was about a half-hour from finding out when the intercom on my desk crackled to life.

"Dr. Simons?," came a static-filled voice. "There is a patient here to see you."

Drat. There went my chances of slipping out early. "Very well," I replied, translating my disappointment into a severe plunging of the intercom button. "Send them in."

I wasn't quite prepared for the person who shuffled through the door. It was a woman, diminutive in stature, wearing the customary street garb of oversized overcoat and woolen scarf tied over her head. Her eyes, although set deep into her weathered features, were bright and clear. A soiled shopping bag was clutched tightly in fingerless gloves, swinging gently against her sagging stockings as she approached the desk. Her entire appearance held a strangeness which was hard to identify--as if a character created by Hugo or Dickens was suddenly brought to life.

"Merry Christmas, doctor," she croaked, flashing a toothless grin. "May I sit?" Without waiting for an answer, she plopped into one of the two chairs situated in front of the desk.

It has become my habit to try and guess a person's complaint before the initial interview begins. This woman appeared too cheerful for depression and too cognizant for drug or alcohol abuse. Her attire, although somewhat faded in places, was clean and in good repair which ruled out dementia. Generally, she appeared to be a well-nourished elderly woman in no acute distress. I was stumped.

"So, how can I help you today?" I asked.

"Oh, look at it snow!" she sang, pointing at the view outside my window. "I think God created snow just for children, don't you? Grownups think it's a nuisance, but it is truly magical stuff if you look at it through a child's eyes."

Aware she had ignored my question, I opened my lower desk drawer and pulled out a copy of the standard mental status test. This one would have to be done by the book. "Do you know your name?" I asked firmly.

The woman looked startled. "Of course I do. My name is Lena."

"Very good," I murmured, recording her answer. "Do you know where we are?"

"Why?" she asked innocently. "Are we lost?"

It was my turn to ignore her question. "Do you know what day it is?"

"You certainly ask silly questions," Lena said, frowning. "It's Christmas Eve"

It was clear this approach wasn't going to work either. I jotted 'Uncooperative' across the top of the test and pushed it to one side. "Lena, I can't help you unless you tell me why you are here," I appealed in my most compassionate tone. "You must trust me."

Lena studied me long and hard, as if trying to decide if I was worthy of her trust. After a full minute, her face relaxed. "It's sugarplums!" she blurted. "You have to do something about those sugarplums."

I was both startled and dumbfounded by her unexpected outburst. "Sugarplums?"

The old woman nodded vigorously. "Every night it's the same thing. Visions of sugarplums a-dancin' through my head."

"Are you telling me you are experiencing visual hallucinations?" I asked.

"Naw, not hallucinations. Mainly gingerbread men," Lena replied. "Although candy canes and gumdrops do drop in occasionally."

"I see. And have you experienced any auditory hallucinations?"


"Do you hear anything when you see the gingerbread men?"

"Music," Lena admitted. "Tchaikovsky, I think."

"How long have you been seeing and hearing these things?"

The old woman leaned back and stared dreamily at the ceiling. "Since I was a little girl, every Christmas I can remember," she said. "They'd arrive 'bout the same time as the Christmas tree and disappear with the last remnants of ribbon and wrapping paper. But they always came back the next year. And the next." Lena paused and looked directly into my eyes. "You understand what I'm talkin' about, don't you?"

"No, I'm afraid I don't."

"You mean to tell me your head never filled up with such things as a boy?"

For just a moment, I allowed my mind to wander back to childhood memories of pine-scented rooms and twinkling lights. The air was filled with whispers of unknown surprises, and bedtime was a struggle between exhaustion and anticipation. And yes, I suppose at one time there were visions of sugarplums.

"'Scuse me, doctor, but I think you're hallucinatin'."

"No, I was just remembering," I explained, feeling somewhat embarrassed.

"Rememberin' what? Sugarplums?"

"Partly, yes."

"Well, I don't have to think so hard to remember mine. Where did yours go?"

Her simple question took me off guard. When did the magic of Christmas go away? During those cynical teenage years when rebellion was confused with identity? Or was it simply overshadowed by a burgeoning career as a respected psychologist? Either way, it was gone. More troubling is that it wasn't missed. Until now, anyway.

Putting my personal thoughts aside, I forced myself to become a psychologist once again. "The only way to solve a problem is to identify the cause," I lectured. "For example, have you been drinking more than usual lately?"

Lena furrowed her brow. "No, not really. A few glasses of water per day and some spiced cider before bedtime is 'bout all I ever need."

"I meant alcohol."

"Never touch it. Oh, 'cept I did have a glass of eggnog at the Senior Center Christmas party a few days back. Made me positively giddy."

"Very good," I responded with clinical precision. "Have you suffered a recent trauma to the head?" I flashed her an exaggerated wink. "You didn't fall and bump your head while decorating your tree, did you?"

Lena shook her head vigorously. "Don't have a tree, only a wreath on my apartment door." Her voice dropped to a whisper. "Least I did, until they took it."

"Who took it? The gingerbread men?"

Lena laughed out loud. "Don't be ridiculous. It were them boys that live down the hall."

"Ahh--and do you feel threatened by those boys?"

"Nope. They're good boys."

"Then why did they steal your wreath?"

"They didn't steal it. I gave it to 'em. Their folks are too poor to afford decorations of their own."

"So why are you telling me about it?" My head was beginning to pound.

"Because you asked. Weren't you interested?"

"No, I am only interested in possible reasons for your visions of sugarplums."

"Haven't you been listening?" she snapped. "I already know the reason. Christmas!"

Lena watched with interest as I retrieved three ibuprofen tablets from my desk drawer and swallowed them without the benefit of water. "Lena, what exactly do you want from me?" I asked, unable to hide my exasperation.

"Well, it's about time you asked me that," Lena sighed. "I need to get rid of those sugarplums. I was hopin' you could take 'em off my hands. Just for tonight, though."

"Why tonight?"

"'Cause I'm afraid they will keep me up late and I'll sleep late in the mornin'. I'm serving supper at the Hope Street Mission so there's lots of folks countin' on me for Christmas dinner." Her face suddenly brightened. "If you'll take the sugarplums off my mind fer tonight, I'll give you a Christmas dinner for your trouble tomorrow."

The very idea sent a shock of pride through my entire body. "I'm sorry, Lena, but I am certainly not in the habit of accepting charity."

"Oh, I see. You'll probably be sharin' Christmas with your family, is that it?"

"Well, no..."

"Goin' to church, mebbe?"

"No. I'll be spending a quiet day home alone."

"Humph," she grumbled. "Sure sound like a charity case to me."

I could almost hear the hiss of my stuffed shirt deflating. She was right, of course--I had nothing better to do than spend Christmas by myself. I spent the better part of my life striving for personal glory, while Lena worried more about the welfare of others than herself. The result? I was going to be alone on Christmas and she wasn't.

"Okay, here's the deal," I began. "I'll take the sugarplums tonight in exchange for dinner at the mission tomorrow. But only if you promise to take them back at the end of the day."

"You bet!" Lena agreed, her eyes dancing with excitement. "I couldn't face next Christmas without 'em." She slid from the chair and shuffled towards the door. "Noon, Hope Street and Fifth Avenue," she called over her shoulder. "Oh, one more thing..."


"Better bring an apron." The door quickly closed behind her.

The muffled chiming of a clock somewhere signaled the end of another day. However, I was in no hurry to leave--the view of the city being slowly covered by a blanket of white was too beautiful to miss. I watched the gentle falling of snowflakes until drowsiness overtook me, and the last few hours before Christmas were spent surrounded by dancing sugarplums.