Mental Status Exam: Please, Spell World Backwards

I’m going to share my come to Jesus work moment, wherein, Jesus is home and work was hell. After Hayley wrote about returning to work, I recalled my geriatric social worker gig, work re-entry, mid-divorce transition, from SAHM to professional, dressed up impostor.

Spell World Backwards

Three years ago I was working in a hospital as a geriatric social worker. Among other duties inside my windowless office, I administered Mental Status Exams. I was to determine whether glints of dementia, or early traces of Alzheimer’s resided within the minds of our patients.

The questions were hard: spell world backwards, count by sixes, twos, fours…repeat what I just read aloud, slowly and clearly, please. Please write a sentence…What county do you live in?  Who is the president, what season is it? 

I don’t know about you, but WORLD backwards blows my mind.

Mostly people answered me, insulted I’d asked the questions in the first place. And for those who found the questions challenging, I helped them along. I’d mention that Nixon was no longer president and now we had, O….ba…  in office. My hints brought people into the present, dementia avoided.

I’m a sucker for long term memory, I waved everything for people with long-term memory. I heard about weddings, illegal abortions, embezzlers, affairs, births, accidents and coming home from the Korean War. I was privileged to be shown the scraps of pure beauty and heartbreak that created lives.

My other duties, conducted with the door closed between clients, included managing my children’s schedules, receiving  hysterical calls from Sadie and tracking Gabe (who was in a particularly shady phase centered around  an abandoned field at the edge of an abandoned track on the abandoned side of town). They were not babies, they were big enough to get home and take care of themselves. I had at their ages. Why couldn’t they? While I sat day after day, listening to Sadie cry, and called around until I found Gabe, I realized I was slowly going crazy.

I also was dodging panic attacks. They were coming on faster than I could recover from the last. I’d stopped taking Celexa because I’d gotten chubby on the drug. And since I got chubby on a low dose, I didn’t want to take more, as my doctor wanted me to. I chalked my swinging emotions and bouts with asphyxia, up to divorcing, signs and symptoms of.

That Friday, unable to breathe mid-panic attack, I sat in my car and called my doctor. The same one I’d ignored when she recommended the higher dose of anti-depressant. I called her and begged her to refill my prescription. I drove to Rite-Aid and picked up ten milligrams of Celexa and began taking them in the parking lot. I decided, sun setting over the parking lot, like an ugly pink punch stain, Celexa lodged mid-throat, that I was never going back to the windowless- -what-county-do-you live in-job. Ever. I called in on Monday and said I was having personal issues. There were a few more calls to see if my issues had cleared up, and finally, they clearly hadn’t.

I’d abandoned my patients. I’d walked out on my job and left my office cluttered with the tools of my trade; underneath my desk, grey suede high-heeled boots, above my desk a shelf of smart books about moods, aging and activities to keep the mind agile. On a hand painted coffee table from home, a bowl of stones, worried patients played with, rolling them round their palms. On my desk top, a photograph of my children, on the wall, a framed picture drawn by Sadie of a heart. While I tried to sleep, patients, their stories and their faces floated behind my eyes. They’d all had losses and now I’d disappeared. I was mandated to stay consistent, to do no harm. And yet, I’d left them, unable to stay.

I was too much of a coward to go collect my belongings. I wondered what they did with them, who took the pictures? I had a phase when I thought it a breach in civility (never mind I’d left a job without giving notice) that my things had not been packed up and sent to me–hadn’t it been obvious I was having a nervous breakdown?! Or maybe, they believed me when I said I was having personal issues rather than the truth, that I was glued to the couch, chewing Celexa. Either way, I didn’t have the pictures of and by my kids.

Last month I saw my boss from the hospital. She was looking at end-of-summer hanging plants, parched and half price, outside Rite-Aid, same parking lot of the ugly sunset.

Finally, three years since I quit scoring are-you-losing-your-memory-exams, I’d come far enough to have a bit of compassion for the woman I was, in my car panicking. So, rather than duck and cover I walked past my former boss. She was bent over, picking through the pile of  brittle plants, and conspicuously not wearing my high heeled suede boots.

(Image: linzik.com)