- © 2004 Canadian Medical Association or its licensors
“I was sure it would happen one day but I never thought it would be so soon,” Mrs. Barrie explained. “My son is not talking to me!”
![Figure](https://www.cmaj.ca/content/cmaj/170/13/1943/F1.medium.gif)
Figure. Photo by: Fred Sebastian
She walked slowly but firmly, avoiding the weeds that were sprouting through the cracked pavement. Her deteriorating health was not evident to the eye; one had to listen to her chest and feel her tender liver to realize that her days were rapidly dwindling.
She had been imploring me for months to go to her house to visit her son. It was an unusual request, and I wondered if it would be wise to extend this special courtesy to a patient in a small town where everyone knows everyone else's story. But, given Mrs. Barrie's failing health, I felt I could hardly refuse. Besides, it would give me insight into how the people of Nowhere lived. I had been living there for less than a year and was starting to enjoy the strangeness of the place — its remote location, natural endowment and the relative freedom I had from the tedium of the big city I had left locked inside the rear-view mirror of my car.
Mrs. Barrie was a hairdresser, retired now for three years on account of her health. She lived in a house in the centre of town. I knew there was a son, but she had evaded my questions about him during her first appointment with me. Her husband had left her years ago. She was a beautiful woman with emerald eyes and a face lined by years of contained frustration. Her hair, once blonde, was now a cloud-grey with a few golden streaks that advertised its former hue.
Mrs. Barrie never talked much about her son during her visits, but over the past two weeks had been full of stories about him. Most were about his early years and how close they had been. The day of our visit was no exception.
“A good heart, Doctor, he has a good heart. As a boy he was tall for his age, but he was never a bully, you know. He took care of the other children in his class as if they were the brothers and sisters he never had. How I regret not giving him a brother or a sister ... It might have been different if he'd had someone to talk to, someone closer to his own age. Of course, we talked, but after some time it all turned into one-word conversations, you see. But now … nothing.”
What could I tell a heart full of regret?
But she was not waiting for my answer, and so did not realize I had little to offer.
I felt she knew she was very ill and wanted to find some rapprochement with her son. Who wouldn't?
After some time she ran out of stories. We walked for a few minutes in silence, until she gave me a sideways glance.
“What year were you born?” she asked
“1979,” I said rather sheepishly. Like many new graduates in this serious business, I hate to be questioned about my age.
“My son was born in 1980,” she replied, turning her head away for a moment. “But he never got as far as you did,” she continued, recovering herself. “He dropped out of school in grade 11. He hated school.”
“Well, Mrs. Barrie, I didn't like high school, either. I wanted to travel, to be a piano player in a progressive rock band and tour the world.”
“Progressive rock?” she asked, making me feel a little stupid.
“It's a type of rock music with complicated and wonderful harmonies,” I tried to explain, as if we were discussing a forbidden matter. Her beautiful eyes looked at me with a mixture of content and amusement.
I stumbled on. “As it turned out the band never did anything worthwhile. The drum player got mad at the bass guy who owned the amplifiers and … this must be boring you.”
“ Oh no, please, I've always liked hearing young people talk about what interests them.”
Inwardly, I winced. However, she read my mind. “Doctor, it is a blessing to be young and strong. Experience is a highly over-rated asset, you see. Don't let the old hags like me intimidate you with their stories of times gone by. They are envious, really. They feel betrayed by life and wish they could go back to former years. So we cover ourselves with the shawl of experience and wisdom to hide our fear and sagging flesh. Look at yourself. You have people who respect you and seek you out. You would be a good catch, you know.”
“Has my mother been talking to you, Mrs. Barrie?” I asked.
Her laugh was true and clear. It was hard to resist. I saw a glimpse of her “what-had-been” years and wondered how many hearts she had broken.
But at last we had arrived at her house. I was sure I was going to see the architectural equivalent of her poor health.
Her house, an old-fashioned bungalow, was in good repair, if a little dusty. The furniture had none of the dreaded Louis XIV style, no plastic coverings, no embroidery. All was functional.
I thought her son must be a handyman, as I could not imagine her doing all the work needed to keep the place the way it was.
There might be some hope for these two if the son is devoted enough to his mother to help her with the heavy chores, I thought.
“So where is your son?” I asked.
“His room is downstairs,” she said.
We proceeded through the kitchen and to the basement stairwell.
“Alexander?” she asked timidly.
“I am home and I brought a visitor,” she called.
“See?” she whispered. “He used to be so attentive. He would always come upstairs to greet me …”
Now I felt a clinical curiosity.
“Alexander?” I called out, “this is Dr. Taylor. Your mother asked me to see both of you. She seems to be concerned about you. May we come down?”
Good technique, I thought. Establish rapport through respect and give the patient space to react. My supervisors would be proud of me.
“Alex, please say hello to Dr. Taylor.” We were still standing at the edge of the staircase.
“How long has he been this way?” I whispered.
“Two weeks,” she said, her voice losing life with each syllable.
Finally, I decided to take the lead and went downstairs.
Alexander was as handsome as his mother was beautiful, and they shared the emerald eyes. He wore his hair short and his clothes were outdated. I could not tell how tall he was.
The photograph showed his face and upper torso in close-up. It was perched on the mantel next to an urn. Astonished, I looked back at Mrs. Barrie.
Her eyes anxiously waited.
“Doctor, did he talk to you?”
I had no idea what to say.
She looked at me, expectantly, almost begging to be validated in her hopeless denial of a painful reality.
Mrs. Barrie of the many visits, the many requests to be heard. What could I do?
“Mrs. Barrie, I am sorry to tell you, but Alexander is de…”
I stopped.
Who was I to deprive her of a few months of a delirious pseudo-reality that provided her with a modicum of company.
“Alexander is … deaf,” I said.
She looked at me, surprised.
Did she know I was lying? Were those eyes showing pity for me? She smiled and quietly said, “Of course, how silly of me, how sad.”
Those emerald eyes finally extinguished themselves three months later, after a long fight against cancer, as her obituary said.
However, I knew she had died of a broken heart.
Abraham H. Snaiderman Director, Neuropsychiatry Clinic Toronto Rehabilitation Institute Toronto, Ont.