AND THEN WHAT COULD YOU DO? By Maureen McCafferty

AND THEN WHAT COULD YOU DO?
by Maureen McCafferty

The doctor stood behind her desk, offering a steady hand and smile, as if Maeve had come to open a checking account.  As if Maeve could— her account at Greyhaven Savings was laughable, which, of course, hadn’t stopped her landlord from raising her rent only days after she’d left him a message about the front panel falling off her rusting air conditioner, making a perfect home for the small gray mother bird and her two featherless babies nesting there now.  Maeve worried.  She didn’t want birds making their way into her apartment, but she didn’t have the heart to disturb them, wishing a kindly repairman would appear to gently transfer the nest to a tree. . . .  

God, had she just told the psychiatrist about the birds?  Or about her rent going up?  God knows what the medical bill for this hospital would be.  The clinic might be free, or what hospitals considered free, but this doctor looked pretty polished.  Maeve shook the doctor’s steady hand, offering her own sad smile while hoping this woman could fix whatever was going on with her mother.  Fix it fast.  Time was money, especially if you didn’t have either.

“Please have a seat, Ms. Walsh.” 

Maeve sat, sad smile still there as she worried a bit, more than a bit, that this doctor was older and a lot more put together than she’d expected.  She wasn’t sure why either would be a problem.  Except when she was a kid and her mother was ill like this, all those doctors at Greyhaven Clinic had been young and rumpled with stains on their ties.  What was this rather sophisticated seeming doctor doing here?  Also, Valerie Shaw already seemed sure of something, which Maeve knew from experience wasn’t always a good thing.  But probably better not to mention that or ask why this well put together, smart doctor was seeing them separately, as if Maeve didn’t already know: get the stories and compare, like the police.  She slumped down in the plastic orange seat, feeling too tall, an easy target.

“Tell me what is going on.”  The doctor sat there as if she had all the time in the world, and you could take what you needed.  Some therapists were like that, not many, not usually the psychiatrists.  Top of the mental health ladder.

“Well, my mother is very confused.”  Maeve stopped.  What had Gracie already told this doctor?  Better just to stick to facts.  “My mother called me this morning, very early.”

“Yes?”

“She wanted me to go to her house, so I did.”

“And?”

“Yes, and when I got there she was very upset about something.  She has a hard time, with things.”

“What things?”

“Everything.  She’s an anxious person.”  The doctor waited.  Maeve hated the waiting.  Waiting multiplied worries fast as insects in a hot attic.  But there was nothing to hide here, was there?  “My mother said her eighty-five-year-old neighbor was taping her conversations and had trained the birds outside to spy on her.”  There, fix that.

The doctor was nodding, a comforting gesture meant to reassure, disarm, draw you in.  Meant to have you reveal all sorts of things you probably shouldn’t.  Like wanting to live somewhere where no one knew you, which of course Maeve didn’t, not all the time.  Better not to mention that either.  Just be careful, because if you weren’t, before you knew it, you could be sitting here going on about Mrs. Jacob or Aunt Budgie or how sometimes it felt as if you’d made a wrong turn somewhere and now you were stuck in a life you never meant to have.   Maeve smiled.

Dr. Shaw didn’t, looking serious as she picked up a beautiful, old-fashioned fountain pen rather than one of the cheap plastic hospital pens everyone here used, and deliberately, unhurriedly, unscrewed the cap to write something in a file.  Maeve knew she would.  Spying birds had to be noted.  “Tell me, Ms. Walsh, has your mother ever had an episode like this before?”

Maeve shrugged, wondering how much that fountain pen cost. 

“Has she?”

“Once or twice, a long time ago, when I was a child.”

Valerie Shaw’s light brown eyes peered over her rimless reading glasses, the sort of glasses that disappeared on your face, the sort nuns wore.  Nuns knew how to stare and wait too. 

“My mother battles anxiety and depression.”

“And paranoia.”

“No, not usually.”

“What happened the last time your mother had an episode like this?”

“I don’t really know.”

“Tell me whatever you can remember.”

There was some memory tucked away here, wasn’t there?  Valerie Shaw knew there would be.  Even if you sat here thinking about fountain pens, the doctor knew that was just to cover some tucked away memory waiting for its chance to crawl out of the darkness.  Because no matter how much you didn’t want to remember or reveal some things you had to:  “I remember once my mother was afraid someone had put a camera inside the walls of our house.  She was afraid cameras were in the walls, watching us.”  This seemed new and very old at the same time, which Maeve would say, if any of this were supposed to be about her.

“I see.”

“What?”

The doctor made another note.

“This is so sudden.”  Maeve meant the memory.  The memory was sudden and strong, a riptide dragging her back somewhere she didn’t want to go.  So, she wouldn’t.  She would pay attention to whatever Dr. Shaw was talking about now, even if she should probably explain to the good doctor that it was the memory that was sudden, not her mother’s latest episode, because it was never sudden with their mother, if you paid attention, which Maeve hadn’t.  She pulled herself up in the plastic orange chair, her legs too long.  Always the long, skinny one.  Five-feet in fourth grade.  Try fitting in when you’re eight-years-old and as tall as a lot of kids’ mothers.  Taller than your own mother.

“Ugly tall,” Brenda Crawford had said the first day of fourth grade.  She was small and pretty.  “You’re ugly tall, Maeve Walsh.”  Standing in St. Pete’s playground with a group of girls, pretty little Brenda Crawford had smiled so sweetly who could believe she was so mean?  “You’re big and ugly, like the witch’s tree,” she’d laughed, pointing to the ugly tree in the schoolyard everyone called the witch’s tree.  Struck by lightening years ago, nothing ever grew on it but stories of witches and hauntings. “Ugly, like the witch’s tree,” Brenda had said, other things too, worse things.  You could never tell what was going to change your life, till it did, and then what could you do?  Did this doctor with the steady stare and very precise manners have any idea?  Any idea how you could undo things, your own or anyone else’s?

“What happened that time?”

“When?” 

“The time your mother imagined cameras were in the walls.  What happened then?”

“Oh.”  And there it was: that three o’clock dismissal from St. Pete’s, Mrs. Jacob waiting at the chain-link fence, the twins beside her, Gracie in her carriage.  Their mother gone.  “I was eight.  It was a long time ago.”

“I understand this is difficult, Ms. Walsh, but it would help, you see, if I knew something about your mother’s history.” 

“Yes, I’m sorry, history.”  But it wasn’t her mother’s history Maeve dragged around with her.  Mostly her mother’s history was dark, like some shadow Maeve lived inside without knowing the life that cast it.  But the good doctor was waiting for history.  Maybe Maeve should just stick to the Second World War, how her Irish-born father, barely more than a boy, had come to this country for adventure, never intending to stay, here about a week when he got more adventure than he’d ever imagined: drafted into a World War he was barely back from and still in his American Army uniform when he met and quickly, too quickly, married the beautiful Kathleen Delaney, of Greyhaven, Queens, New York, who really was so much more, and less, than she seemed.  Shadows.   Think you can choose?  Or maybe what mattered was the day they moved from that cramped Spencer Avenue apartment into their new house on the other side of Greyhaven, their father promising,“This will feel like home, Kathleen.  This will be a real home,” hoping the way you do when you don’t know what to do if this doesn’t work.  Should she mention that?

Or how pretty little mean Brenda Crawford, who had said Maeve was like the ugly witch’s tree and other worse things, had died in a car accident in high school, driving around with a bunch of friends, laughing and happy, not paying attention to the road?  Terrible accident.  Did the suspiciously stylish doctor with the steady stare and gentle voice need to know how you could be at a funeral and supposed to be sad and praying for eternal peace but really you were remembering being in a playground and hating someone?

“If you could tell me, for instance, what doctors your mother saw— ”

“Yes, of course. . . .”  Maeve wanted to get up and retrieve her handbag from locker 17 and show Valerie Shaw the black-and-white photo of her and her mother on the courtyard steps of their Spencer Avenue apartment building, the photo she’d found among her father’s insurance papers and old passports.  She smoothed and smoothed the unsmoothable wrinkles in her black woolen skirt, demonstrating how uselessness seldom stopped her.  The black wool matched her mood, if not the season.  Probably better not to admit that.  “Umm, my mother’s history.  Well, there was Dr. Lutz, but that was years ago, in the beginning.”

“Tell me about the beginning.”

“Four kids in a one-bedroom apartment, my father working overtime at the warehouse.  It was just too much.  That was the beginning.  Who wouldn’t want to escape?”

“Did your mother talk about escaping?”

“She left.”

“What happened?”

“My mother was there, then she wasn’t.”

The doctor waited.

“So, we went to Mrs. Jacob’s house every morning and after school, and then after a while my mother came back.”  That’s how the story went and Maeve didn’t have or want another.

As if sensing this, Dr. Shaw seemed to put aside her own ability to crack such reluctance and merely asked, “Do you remember the name of a hospital or doctor— ” She glanced down at her notes.  “Dr. Lutz?  Do you remember the doctor’s first name?”

“No, it was a long time ago.”

“A man?”

“They were all men.  There were lots of doctors, but I don’t remember any in particular.  My mother wasn’t in a hospital.  She just left.”

“Where did she go?”

“I don’t know, she didn’t send postcards.”  Maeve straightened up in her chair.  “I’m sorry.  I don’t mean to be rude.  All I know is that when my mother came back we went to clinics for her medicine.” 
“I see,” the doctor said.

“What do you see?”  Maeve smiled, the pain behind her right eye splintering into a strange rolling light that was making her sick.  Right now passing out seemed like a good way of this.

“There may be hospital records— ”

“My mother wasn’t in a hospital.  We got medicine at the clinic after she came back, but she wasn’t in the hospital.” 

Dr. Shaw looked through papers.  “I see your mother lives in Queens.  Is that where you were living then?”

“Yes, Greyhaven, Queens.”  Maeve remembered the note on the kitchen table: These are my daughters, please take them in. . . in her mother’s careful script on the yellow kitchen table by her father’s brown mug of tea.  She’d only seen the note for a minute before he had come back in the kitchen.  Why hadn’t he kept it?  Why wasn’t that note in the little gold cigar box that held her father’s Irish passport and his American Naturalization papers, his Army dogtags, the nearly forty-year-old newspaper clippings of President Kennedy’s inauguration and the President’s funeral, with the grainy/gray newspaper photo of the horse-drawn casket?  That old black-and-white photo of Maeve and her mother on the courtyard steps was there too in the cigar box, but not the note.  Why hadn’t her father kept it?  Also, her mother’s name was Kay, so why was that note signed Vivienne?

“Would that be all right?”

Maeve leaned forward as if maybe she could catch up with what the doctor had just said.  “I’m sorry, would what be all right?”

“I may need your mother to release her medical records.  Would that be all right with you?”

Had Gracie agreed?  Why couldn’t she ask?  Hiding confusion just made you seem confused, didn’t it?  And something about that slight elegant inflection to the doctor’s voice seemed an invitation of sorts that made her seem kind, or maybe just made you imagine kindness in the story you were telling yourself about Valerie Shaw.  Because you had to reconcile, did you, what someone as polished as good silver was doing in the dreary plastic orange clinic?  If you were going to trust her.  As if they had a choice.

“Ms. Walsh?”

“Yes, medical records, I suppose that’s okay,” she said, not sounding like herself.  She was so decisive at work, not that anyone acknowledged such a thing, except occasionally Malcolm Berman, who had been crammed in their small office with her.  He knew how much Maeve had to decide every day, all sorts of things she had no right or obligation to decide, but what could you do?  Especially if there was no other way to keep your job, because if she let her dim boss decide things it wouldn’t be him—son of a founding partner—who would be out of work.  And some job, even an inadequate one, was better than no job, at least till you found another, which Maeve had been intending to do for years, and would as soon as she had time or, whatever it was you needed to get a better job.  Did the good doctor know?  Probably not the time to ask that either.  They were talking about her mother’s medical records, weren’t they?
 
Maeve smiled, hands neatly folded in her lap, the way nuns taught you, because they knew what the world thought of sloppy, distracted children.  She and Gracie were the children here.  That’s what was wrong: children don’t decide for parents.  “I didn’t know it was this bad.”

“You have recently lost your father.  You and your sister are also grieving.”

Gracie must’ve told her that.  Should she let the good doctor think grief made a difference?  That she hadn’t spent her whole life gauging her mother’s mind and moods carefully enough to have known this was where they were headed?  All mixed up, Maeve, all mixed up.  One of Kay Walsh’s chants.  Of course it was all mixed up because Maeve hadn’t bothered . . . for three days.

“What hospital has your family used over the years?”

“Greyhaven General in Queens.  We came into Manhattan today because someone recommended we see you.  Dr. Lisa Berman recommended we—  I work with her brother, Malcolm.”

“Oh, yes, I know Dr. Berman.” 

Maeve straightened up again in the uncomfortable plastic orange chair, hands clenched.  Sometimes nuns could tell you just what to do, but sometimes they knew absolutely nothing at all about the real world.  “We used to take my mother to Greyhaven General’s psychiatric clinic once a month for prescriptions.  After she came back, there were lots of prescriptions.  I was about nine, I guess, when that started.” 

“That sounds like follow-up care.  Most likely your mother was hospitalized years ago.”

“No, my father would have said something.”

“You were a child.”

“I was the oldest.”  That wasn’t exactly true, but Maeve didn’t want to think about or explain that now either.  There were a lot of unsaid things piling up here, and now she was telling the doctor about housekeeping:  “I cleaned, did laundry, made sure we had milk in the house.  There’s never enough milk with little kids.  The twins were only four, and Gracie was just a baby.  Did Gracie tell you that?  My father couldn’t do everything.  Mrs. Jacob watched us at her house, not our apartment.  I took care of— I don’t know why I’m telling you this.  I just mean, if my mother had been in a hospital, my father would’ve told me.  I wasn’t a baby.”

“You were a very responsible child, but still a child, and probably feeling too responsible.”

That felt like a criticism, one Maeve didn’t want to know about.

“People often think silence is better than disclosing events they, themselves, find troubling, Ms. Walsh, especially when children are involved.”

“No, my father would have told me.  That isn’t what happened.”  You couldn’t just change what happened because you wanted to.  Even if you were a very smart doctor with a genteel voice, you couldn’t just change someone else’s life, at least not the past.  Of course, The past is never past, someone had warned.  Einstein?  Faulkner?  Years studying literature, not medicine.  How did that help?  Did Valerie Shaw know? 

“It would help now, you see, to know your mother’s past diagnosis in order to determine if . . . . ”
  
Maeve realized that a moment ago she would have welcomed the possibility of some real past or present diagnosable hospital craziness underneath their lives.  But a moment ago that was just an idea, not a terrifying thing actually staring you in the face, scary as that scratchy noise in the wall suddenly scurrying across your kitchen.  How would Valerie Shaw like to be let in on that image?  Also, could the good doctor possibly tell her why Mrs. Jacob’s stories about her kids, Louise, Eli, baby Lenny, or about Mr. Jacob dying one morning while on the phone to his friend Izzy Gunther, seemed to matter again?  Maeve didn’t even know why it all mattered so much and she had been there.

*

Their mother’s scared eyes stayed on Maeve as she and Gracie came back into the doctor’s office.

“I’m going to ask you a few questions, Mrs. Walsh.  Is that all right?”

Their mother didn’t answer, eyes still scared and on Maeve.

“We are here to determine the best choice for you,” the doctor was saying, not realizing that their mother didn’t believe in choice.  In fact, Kay Walsh believed in little other than her husband, Franklin Roosevelt, and Jesus.“Think you can choose?” she used to ask her daughters, who knew not to answer.  “Think you can choose anything in this life?  Well, you’ll see.  Just wait till life stops you in your tracks.  You’ll see.”

“Just a few questions.”

“My daughters are better with questions.  Ask them.”

“Do you know why you are here today, Mrs. Walsh?”

“Something about insurance?” 

“Do you know what day it is?”

Their mother looked at Gracie, then Maeve, and then at her hands tightly folded in her lap.

“Who is the President of the United States?”

“He’s dead.”

“Who?”

“The President,” their mother said as if the doctor were dim.  Maeve considered mentioning Roosevelt, but it probably wouldn’t help.

“Have you been having a hard time by yourself?”  Valerie Shaw sounded concerned, as if she were Kay Walsh’s best friend, as if their mother had friends.

“Such is life.”

“A hard time keeping your thoughts clear?”

“No, no,” their mother insisted, sensing trouble.  “My thoughts are very clear, very clear.  Aren’t they, Maeve?”

“Do you pay your own bills, Mrs. Walsh?  Are you able to manage that?”

“Pay the bill, Maeve, so we can get out of here.”

“My father always took care of that,” Gracie explained.  “My sister and I do it now.”

Carefully, Dr. Shaw removed and folded the delicate wire stems of her rimless reading glasses the same way Sister Catherine used to, then sat a little forward at her desk.  The good doctor’s eyes were so light they seemed almost golden, like Linda Vinn, Maeve’s best friend after they moved from Spencer Avenue to Greyhaven Boulevard.  Easy to think someone with eyes like that was gentle and good and cared about you, too easy.

“We will have to do some tests,” the doctor was saying.  “There are many possible causes of dementia.  From what you have told me, this is most likely severe clinical depression, triggered by grief.  But without tests, we cannot dismiss the possibility of small infarcts—strokes—causing memory loss and confusion, or even the onset of Alzheimer’s.  We can only tell over time.”

“Alzheimer’s?” Gracie gasped, as if the doctor had just suggested they cut off their mother’s head to see if that helped.  “How can my mother have Alzheimer’s?  She was fine last week.” 

“Alzheimer’s is difficult to detect in the beginning, Mrs. Garafola, for the person affected and for the family, very difficult.”  The doctor’s voice was still as soft and slow as a Savannah summer, at least as Maeve imagined such a sun-dappled summer, apparently losing her mind or wanting to, because the gentle voice was telling them such ugly things: “If your mother were accustomed to depending on your father for everyday things, for shopping, driving, paying bills, for instance, it would be difficult to appreciate initial deficits.  Since you and your sister are doing these tasks for her now, diminution would be difficult to detect.”  The doctor paused, giving them a chance to swallow this much.  Psychiatrists had a way of gauging how much you could digest before shoveling in more bad news.  Then the good doctor switched purpose.  It was a subtle shift but Maeve recognized it, even before Valerie Shaw looked at their mother and said, “I do want to tell you, Mrs. Walsh, that we have an excellent geriatric unit at this clinic.  That is why Dr. Berman suggested you come here.”

“Who?”

“I advise you be admitted for observation.”

“What does that mean?  Maeve, what does that mean?”

“It’s all right, Mom.  We’re just trying to figure out how to help you.”  Weren’t they?  “Just get on the bus, Mom.  Just get on the damn bus and go to Gracie’s.”  Did Dr. Shaw need to know that’s how Maeve had spoken to her mother yesterday?  Of course, her mother hadn’t mentioned spying birds yet, but if you paid attention you knew those birds were on their way.

“How long would my mother stay here?” Gracie asked.

“What do you mean stay here?  I want to go home NOW.” 

“A minimum of two weeks.  We need time to identify and evaluate real deficits, to establish— ”

“What are you talking about?  What’s going on, Maeve?”

Two weeks to figure out their mother?  Maeve wanted to laugh.  This couldn’t be right.  This couldn’t be what their father would do.  She and Gracie needed to explain that, but how? You couldn’t just blurt out every damn thought that wandered into your head, or you would end up talking about relatives you hadn’t seen in years, or going on about the time your mother had taken you and the twins to Central Park and lost you all or herself for hours.  You’d end up confessing how you never told your father about getting lost, because it wasn’t just your father who didn’t mention things like hospitals and illness, was it?  Because if parents sometimes said nothing to protect their kids, sometimes kids had to protect parents too.

“I don’t know why I’M in trouble,” their mother snapped, still scared but angry too.  “That old woman is the one spying on me.”

“Do you suspect this, Mrs. Walsh, or are you certain?”

“I know what the old woman’s doing.”

“I see.  We have a small unit here.  I am the attending physician.  At the moment, there is space, but there may not be tomorrow. . . .” 

Ah, there was the threat, seductively sweet: May not be there tomorrow, this help, this last hope, better order now, supply limited. . . .  Maeve sat straight and still, hands folded, the way Sister Catherine had taught them.  She was younger than the other nuns.  Kinder.  There was something natural about Sister Catherine’s stillness, like an empty church, something profound, not imposed, just there. 

“Take me home,” Kay Walsh demanded.  “Right now.  YOU HEAR ME, Maeve?”

Hard not to, sitting two feet from her.

“Right now, YOU HEAR ME?”  Their mother was ready to fight.

Good, how else were they going to get out of this?  Everything in Kay Walsh was collapsing, would collapse into nothing, if she gave up.  But the scream was still there too, wasn’t it?  The scream so sharp it could slash off the top of your head in a second, like the first time Maeve heard it.  Her mother and father had been fighting all day, a hot summer day in that small apartment, her father finally yelling, “Selfish, Kathleen, that’s what you are, the most selfish woman in the world.”

“SELFISH?” she screamed back, fury crammed too long among furniture and kids and fear too.  Maeve had felt it then, how angry and afraid her mother was, as she watched her crumble.  “SELFISH!  YEAH, I’M SELFISH, JIM WALSH!  SELFISH ENOUGH TO GIVE YOU CHILDREN I DIDN’T EVEN WANT!” 

That was when the screaming stopped, and something else too, something between her parents, stopped at least for a while, the silence seeming worse. 

“Dementia . . . .” Dr. Shaw was saying.

There it was, no running around the word, no losing it, removing it, no turning it into eccentric or just fabulously exhausted.  Your mother is eccentric, exhausted, just fabulously lost without your father, Dr. Shaw was not telling them. 

“Your mother needs to be put on anti-psychotic, anti-anxiety, anti-depressant medicines immediately.  Delusions do not evaporate, not if you return to the same environment.  These are powerful drugs.  Can you provide your mother with supervision?”

“So much medication?” Gracie asked.  “Does my mother really need so much?  She was on stuff years ago that made her sleep all day or— ”

“I understand your hesitation, but current medicines are not as blunt.”

Maeve pictured a boulder.  More like smashed.  That’s what those medications had been like: no more screaming, no more anything.

“She is very ill.”

“Who is?” their mother demanded.

“Your mother will need supervision.  Can you provide that?”

“Tell the doctor you’re a nurse, Maeve.  Tell her.”

“I’m not a nurse.” 

“Well, she doesn’t know that.  Just tell her.  Tell her you can take care of me.  For Christsake, someone TELL HER.”

“You are right, Mrs. Walsh,” Dr. Shaw said.  “You need professional care.”

“Oh, my daughters are very professional.”

The doctor’s eyes moved to Gracie and then Maeve.  “I am sure you both realize that under these circumstances your mother cannot go home by herself.  If she goes home, one of you goes with her.”

Kay Walsh stood up.  “I don’t remember inviting any of you to my house.”

Already at the door, Gracie turned their mother around by the shoulders.  “Mom, sit down.”

“Sit down, sit down.  Nice way to talk to your mother, Grace Walsh.  Nice, very nice.”

“I guess we don’t have much choice,” Gracie said, or the doctor, or later Maeve thought she might have said.  She felt sick, like she’d been too long in the sun.  The doctor’s voice was still as slow and lovely as Savannah.  Such a lovely word Savannah.  She wanted to sleep.  For a very long time.

“Don’t leave me here, Maeve.” 

That was an order.  No mistake about it.  Later you might be able to pretend it hadn’t been.  Probably not three days later, but three years maybe, when you were still thinking about this.  Remembering how sick you’d felt.  And stupid.  Thinking what you should have done, should have said.   As if it mattered.  Try talking a fire out of burning.

About the Author:

Maureen McCafferty grew up in Queens, New York and has a doctorate in Creative Writing from Syracuse University.  Her short fiction and poetry have appeared in American Writing, Rhino, Clockwatch Review and the anthology A Patchwork of Dreams: Voices From the Heart of the New America.  Her first novel, Let Go the Glass Voice, was published by West Alabama University’s Livingston Press.