When S first walked into the room, I took her for a woman around the age of fifty. Later, when I told her that, she said she would have preferred to look younger, like her younger sister who people said looked at least a decade younger than her actual age. She also clarified that I had not offended her. After all, she had always believed she looked older, much older than her age —a seventy-year-old? at least sixty perhaps? Illnesses, numerous illnesses, forced her body to age prematurely. “On the inside,” she would tell me, “I am hundred-years-old, two-hundred-years-old. A poorly maintained statue from the British era, or whatever is as old. A statue with arthritis.”
What difference would arthritis make to a statue? She was terrible with examples, many of which were inherited from her parents and relatives and other people she knew. She would often start with “My mother used to say…” or “we were too young to remember, but mother used to say…” In our conversations, I tried to correct this habit of hers. I would try to change the course of her memories, asking her what did you feel when your mother would “say”. She would not understand. She would dart her eyes. In those moments she was younger than her younger sister, but not in a good way. She was eight or she was ten, not ages we want to revisit.
This is S for you. S. That’s how I choose to address her.
S came to me as someone who was losing herself. The process had just started. Little by little, S told me once, she felt she was shedding her skin. But what comes after this skin? And was there ever a before?
“Tell me how you felt when your father asked you to give up studies after you failed to clear the eighth standard?”
“Did you feel happy? Did you feel sad? What did you feel—did you feel relief?”
I do not do this with my patients. I do not put words into their mouth. But with S, I feel I have to give options. Multiple-choice questions.
S had started forgetting. It had started with words and then extended to things like the difference between sugar and salt. In time, this included the difference y between happiness and sadness. The past became a mishmash. So many things, so many memories, but a head with no control over which one to pick when.
I give S a glass of water. She drinks it looking down at the table. She looks scared. I ask her to talk to me looking down at the table and tell me how she feels. She tells me she feels “bad”. I ask her what her father was like, she tells me he was an angry man, honest and angry man, honest and good and angry man.
“Were you scared of him?”
“He was very… strict. He believed in modest living. He made sure we grew up fine, with the right kind of values. Never in his life did he lie. Never in his life did he borrow anything from anyone. Never in his life did he take bribe.”
“What happens when we borrow from people?”
“We become indebted.”
“What happens when we take bribe?”
“We become corrupt.”
“What happens when we lie?”
S tells me she never lies. She has only given and given without ever getting anything back. What does she want back? She wants to be loved. She wants to be respected. She wants to be loved by her husband and her son.
“Why does it matter?”
“Because they are my world.”
“What happens if they do not love you back?”
“My world has no meaning.”
Those two questions were her first writing exercise. I was still getting to know her as a patient. Something told me her answers were more prepared than I wanted them to be. Short and precise, that wasn’t her manner. I do not doubt that they were her answers. They told me what I wanted to know.
The case of S is not unique, which makes my involvement, the extent of my involvement, a little strange. But I have known women who have stood at their windows and escaped. No fear of falling. A flight of fancy. They look at their image in the windowpane and see an entire history. A past they have been constantly living, revisiting trauma with each movement. I say this from personal experience. I tell you this dreadful chapter from my personal life. When you speak a trauma, revisit it again and again, it opens up pores of your skin. However, speaking also lessens the impact of the event. The very fact that you can speak it ‘out’ now makes it less of a burden, the guilt loses as much significance. Lila and I were seeing each other. It had been seven years. It felt like a century. Even now when I look back, I can see us doing the same things again and again. Lila is lying on the bed by my side. I am talking to her and she is talking to me, almost at the same time, our words overlap without the worries of listening, or we are too cynical now and believe we can have no audience for our ramblings. We say things like do you remember? It starts like this and ends in tears.
“Do you remember, Lila, when we got together we wanted a house in the hills. We filled it with books in our imagination. Every room overflowing with books on expensive bookshelves that we can’t yet afford. We have too many books and we often consider opening a library but do not because we are bad at dealing with too many people and bad at sharing our books. We do not tell this to anyone because we do not want to look boorish. The house overlooks a field where children come to play with their sheep, like the ones we saw on the only vacation we took together. Our favourite will be the room with a lot of light that we will call our study. I propose we have canvasses on aisles though neither of us can paint. We will write quotes on them and hang photos of writers we admire. The room will be a mess. And when you come in or when I do, we will have to guess where the other is sitting. With a cup of tea in hand, you will look for me, as I pour over my writing. It will annoy you but not in a bad way. You will be happy that I write. You will also start writing. You have read enough books by now. Do you remember the book I got you on your last birthday? We will discuss it and I will hear all the wonderful ideas you have gathered. I will, as I cannot help, look for myself in your stories about the stories and hope you will write wonderful things about the two of us and our enduring love which will see us through this difficult time.”
Today I have big fight on my husband. He does not accept guilty. No one accepts there guilty only I. I have learned from parents. That is why good manners is necessary. My son also does not accept guilty. I think he has got that from his father’s side. They are not good people my in-laws. If it is not for the values I am having I will not be living in this house this long. I will be having a divorce. I do not forget. I remember each and every incident. I can write a very sad book of my experience and it will sell and make people cry. What have I not done for them my in-laws? From taking his mother’s nokhra, tolerating her taunting, to working for his brothers and sisters. Their parents only gives birth. They gives births like cows and goats and no responsibilities. I had sacrifice my food for his brothers and sisters to eat. They come without telling. No one asked if there is extra food, or how I managing the food.
I met my cousin Sabita after this long time period. She was not living at this city. We are childhood friends. We are making house of sands in the afternoons when my parents is sleeping. When I tell my maa she tells she does not remember: kita kobe? She is not knowing. But she does not remember always so it is okay. We meet and we talking about husbands and children. Her child is Montu same age. He is learning engineering. He will quickly get a good job and take his parents with him. He is buying a house. Montu is not taking us. He is not a good boy. He is not hearing to us. He corrects my English. I tell I am learning. There are so many mothers who is not knowing English. He is always staying outside. I am not liking his friends, shob kulangar. They also is not knowing good manners. They do not behave with there parents. I am afraid for Montu. He is getting influence. He is in that age. His father does not tell anything. I am feeling helpless.
My headache is not going away. My skin allergy is not going away also. My health is not ok from marriage. It was going to happen. The astrologer tells that. Shob kopaal. But I am happy to have a husband like this husband. No other thing is getting ok in life. I am never feeling happiness. Not in my parents house not here. Everyone is careless for me. Only he is caring. My son does not hear to me. He tells me mad. He is becoming very very very angry. I cannot control him. Kemne jaibo jibon. I was not like this in same age. My in-laws tells my husband was also not like this. Then where from Montu getting his anger? His father is not telling anything. He is telling you must save your respect. What if Montu is telling back, or make big eyes? What if he beat you? Ei din dekhtam ni.
There is bad shadow in this house. I feel very very very fear. In morning I was cleaning sink. I am hearing my name calling me. When I tell “yes” no one is telling something. I remember no one in the house. It is morning so no one. When I tell my family they are not believing. They smile loud and loud. I am mad? They are making me mad? It is my mother’s calling. I know the voice. I remember. My mother doing name calling loudly and silently. If in dream I will tell something to her. Maa, amar naam kemne jaano? In reality I know my mother is dead. If she was not dead, why is she name calling like this? My mother lost memory. She tell stories with no meaning. In her stories people fly, fishs talk. It is like she was a child. Not a child of good manners. A child like Montu. Very very very difficult for handle. She will not eat if she tell no. She will not sleep in night and sleep in day. If I tell what will you do in night? She will tell to be a watchman. What will you watch? I tell her always. She is telling my face because she forgets. Old woman. God do not mind. She will not remember my father then what I am?
The story of S begins at home, where all our stories begin. S saw two homes in her life. She called them homes, they endowed her with responsibilities, shelter, and company, like homes do. In both places, she thought at least once that time was not linear, and that at times it was the same time day after day. When she looks back at life she tries to find that exact moment when this realization happened, and she returns to her childhood where she has just woken up and it is evening, but she moves with the confidence of someone who has woken up in the morning, early morning, unaware that there’s a night coming soon after. Because she has woken up, she prepares to go to the washroom and brush her teeth. Her cousin asks her why is she brushing her teeth. No one in their family brushes their teeth at such odd hours. Her father picks her up and takes her to the window and it is night. No one believes that it is her morning. No one except her mother who is too scared to assert such judgement, any judgement. She who often in her kitchen mixes up salt and sugar, how would she know the difference between nights and days? Everyone laughs at her.
When S got married she wasn’t particularly happy about the arrangement, she tells me with some hesitation. She always thought she would marry a banker, someone who would start from a cashier and then rise to the level of a manager, branch manager, and finally, who knows, maybe even a general manager. She believed in straight lines. She thought the world to be fair. She was more optimistic then. Before she knew this isn’t how life works. When she did not know that she would have to settle for a stenographer, who would also gradually rise, but in a trajectory quite different.
It helped that he knew shorthand. He was quick with noting down dictations. He listened less and noted more. He knew how to sieve out important information. He knew what must be ignored to go on living a life. And so he dragged his family along, their lives only interrupted by the sound of his typewriter. Typing requires mindfulness, he said. More than computer. If you mistype a world, if you aren’t paying attention, you need to tear out whole pages.
S likes waste. She likes dirt and dust. She believes they give her life a purpose. This is why she keeps looking for them. She says she has a huge appetite for waste. She swallows it all up. She is the queen of garbage. After all, she says, what will housewives do if their houses are already clean? She says she can write books on housewives and house cleaning. To them, houses are never clean. Something or the other is always on the floor. If nothing else, they will find strands of hair. There’s also a theory about housewives and hairfall. There’s a another theory about the size of the houses. Housewives, she says, like smaller houses. But not because they want less in life. Not even because they have less cleaning to do. It is because they like walls closing in on them from all sides. Housewives also prefer apartments to independent houses. Not because they are modern or practical, but because there’s less chance of looking out unless through the strategically placed balconies Those views seldom look back at you, like a view of a pond or a swamp through your window does. Housewives, S says, like living in boxes. For days they do not look at themselves. She has a theory that they are scared of themselves. In apartments, there’s less chance of running away.
I tell you a story of a very very very old woman. Daini buri. She lives in house of chocolate. Dairy milk, milky bar, cadburys, you find all in wall. They are like red bricks but they are not red. They are brown and white. Outside there are grass but not green. Grass are pink like old woman hair that children eat on melas. The house is very sweet. So sweet. It can give diabetes. The floor made of chikki. Water taps made of lollypop with jalebis at top. It is a quite house. Home sweet home. No one makes shout. You can feel no one living inside. But old woman living inside. Old woman is 100 years old. She is making sweaters from wools of shewai. She is not wearing them. She is not eating walls or grass also. She lives in sweet so it is too much she feels. Also if sweetness go away how she will living? She is old so she understand life. She is also sad. She is always staying inside never going out. She is not remembering when come inside. She only remember she was some other place when young. But she is loosing memory. Not remembering how to go back there. What way is there. What road necessary. But her home sweet home is very beautiful. It is also very tasty for children. Children come eat chocolates. She locks children there using key and lock of sweet. Not making them go. Thinking they are her age when she come here so they know way outside. This is giving bad names to her. People tell don’t go to the house. But children are children and she is she. Old and forgetting and not having anything on way to tell how going back.
“Twinkle twinkle little star” is nursery rhyme of my son when he is little. You must be acting when telling “Twinkle twinkle little star”. You making your hand signs to show stars and shining and diamond. I like diamond, I also like star in night. Star make sky shine. Now very little star on the sky. Before that when I am little there are many stars. The sky of by childhood is more blue. Some days I am sitting and looking and looking on the sky of my childhood in the day. It is not very hot there in the day. In night when light is not there I go out and see many star. Star make me feel less afraid. I look on the sky when I walk outside house. Now, star on the sky is less. But if I try to depend on star in night. If I keep looking on sky and walk and walk. They make me blind. Too much light. Sky is pulling. It is maybe it want me to be diamond on the sky. I think sky is jungle. Star is tree. Big tree. Many tree. Too many tree place in night is very very very dangerous.
I am thinking a very very very big man. Brohmodoitto. You are not knowing. Brohmodoitto is a ghost. It is a very very very big ghost. It is a brahmon ghost. It is getting respect on ghost places. All ghost thinking he is important ghost. Brohmodoitto is a ghost but so very very very scary. I am coming to school and it is standing in the road. Big big big ghost. Big big big legs. Thigh is like pillar of this house. I am getting afraid. I am doing shi in pants. Then thinking my mother will beat. I am controlling. Brohmodoitto is tiring it looks. It is hot. Sun is in his head. He is touching sun. He is asking who is I. I am telling I am… I am not telling more. He is asking who. I am telling I am… He is asking. I am telling… I am not knowing. Baapre okhon kita. I am very very very afraid. But I am not knowing who am I. I am telling I am his wife now. He is telling who is he? I am telling I cannot tell name. He is getting angry on me. Look in his eyes it is all red. Is you also mother? He is asking. I am telling yes yes yes. What is your son name. He is asking very loudly asking. I am afraid. I want to tell. But I am not telling… why I am not telling? There is big parting under his two legs. I am thinking bhaag bhaag bhaag. Go there and run. My legs not moving. I am there not lefting. I am not telling.
Lila knew how to listen. We were a very happy couple. It did not start suddenly. I had known her for three years before we started seeing each other. She was a fierce idealist who would put her opinion out without fear of repercussions. I had my disagreements with her, of course. There were days when she would just go on about what she knew and believed and I found her too aggressive. I wasn’t used to people telling me things. That’s how I had grown up.
Those qualities, though, also inspired love in me. She seemed like someone beyond my reach. I used to think of all the intellectually stimulating conversations I would have with her. I liked to be led. I never had the hesitations of a man who doesn’t think of women as his equal. In that, I was different from my friends and most of the menfolk. Those were the days when I saw literature as my end goal. I saw her as a perfect aggressive foil to my nuanced narratives about people who mix up their identities and autobiography of a death. I had an innate inclination towards words. I never had to put much effort into writing, which is why in my heady days of idealism, I also aimed, I also aimed to mentor people who were struggling to express, which explains my gradual turn towards psychology in its clinical form. It was no different with Lila. I had already planned for her all the wonderful things she could do if she toned down her aggression and use her political felicity with a more nuanced outlook.
I wanted to sit by her and watch her grow. Given the historical oppression of women, even if we can help one of them flourish, it would be a huge service to the idea of equality. I believed in allowing her complete liberty. She could wear what she wanted to wear and go wherever she wanted to go. If we ever wanted to get married, not that I cared much about the idea, we would do it in a private ceremony. We would live away from parents. Away from social structures that close in on us. We would live away, up and away in the hills. Ours would be a lone house at quite some distance from anything that moves. We would scream the names of each other, we would find our home scream it back at us from as far: ‘Lila’…‘Shekhar’. I hadn’t thought of how our lives would change. I wasn’t prepared for change.
Often in my career, I have dealt with cases that drain you emotionally. We are human beings after all. If you keep listening to people quietly all the time, you expose yourself to their miseries. Their grief becomes yours. It isn’t just the relatability of it, but the energy that they carry. An emotionally overwhelmed person can fill your entire room with sadness. Sadness creeps into your chair, your desk, your sofa, your voice, your hands, your entire body. You see the furniture bulge. When you are alone, you feel they will consume you because they are constantly expanding from within. Then the heaviness takes over and you cannot move anymore.
Here I am looking at a family that has done everything to get one of them back standing on their feet, drive her towards normalcy. Of course, this is also because they want to drive their own lives towards sanity, but their efforts cannot be underestimated. Montu and his father had to learn to deal with this crater-sized misery in their life. His father, the husband of S, liked having things under control. He liked being on the driver’s seat in life. But here was a situation he had no clue how to deal with. He had never seen this in his own family. From a house that seemed to organize itself, now they had to label everything. Not only as far as the arrangement of items in their house, but they also had to maintain signs for how to open the door, how to pull up the curtains, and how to flush the toilet. Their house had become a museum of sorts. Everything they knew was there, but everything was on display as if waiting for an outsider. Everything was there but in a distant memory.
It is on my advice that they joined an acting class. They had to learn to deal. I said, what better way then starting to listen? In the acting class, the father and son were taught patience.
It was a unique program for caregivers that helped develop communication with the patient. It taught them how to care by training them on what to say to the patient and what not to. When to stay quiet and listen. The program included meditation sessions that not only improved caregiving abilities but also made a great deal of impact on the overall personality of the pupils.
The pupils are moved to a projector room where they face a fullscreen image of the person they are caring for. They are supposed to look at her while talking to her in a soft voice with pauses and pauses. There’s an audio in the background that in a soft, soporific voice asks, “How do you feel?” Over and over again. In the subsequent weeks, depending on their progress, the pupils are moved to the second round where they are supposed to listen to a prerecorded message of their cared-fors—in which she says nothing of importance: daily inanities of when they woke up today, what they ate or did not eat, who they thought of, what reminded them of what, and even at times an entire grocery list of things their homes have run out of.
I have sent similar fathers and sons there before. It worked for them. Initially, I used to be a little skeptical about the procedure. They did not seem to believe in complete disclosure. That is something that goes against my practice. I always tell my patients the hows and whys of the course of their treatment. But the caregiving program believed otherwise. They would never tell you why they were teaching their pupils to be better listeners. They said they discontinued this practice after their initial unsuccessful attempts. The pupils to whom they had disclosed responded poorly to the program compared to those who did not know why they were all of a sudden supposed to listen.
I did not hide it from S when she was to sit for her MMSE tests. She knew what she was going through. Anyway, it could not have been hidden from her.
In an MMSE test or a Mini-mental State Examination, we begin by asking the patient where they are, what date it is, and what the season is. We then give the patient names of three completely unrelated objects, the names that they are supposed to memorize for when we ask them again. Thereafter, we ask them to count backwards in multiples of, say, seven, or ask them to spell a word backwards. We ask the patients to recognize two everyday objects that we show them. We ask them to repeat a phrase after us. We hand the patient a piece of paper and ask them to put it on the floor. We ask them to follow the instructions written on a piece of paper: it says, close your eyes. We ask them to write a sentence, any sentence, with a noun and a verb. We ask them to draw, by looking at a picture, two hexagons with a pair of intersecting angles. This test has a total score of 30. Anyone with education up till eighth standard must score at least 21 to be considered normal.
S started well. She told me her name without any hesitation. She told me the name of my clinic. She had always been good at reading signboards. She fumbled a little with the date but managed eventually. She knew the country and the state. She had scored 10 already. Among the three objects, she could remember the pen, could not recollect the salt container, and got the writing pad alright. She said she was always bad with numbers. 100, 93, 89… and dhur. She could repeat the phrase, she could fold the piece of paper. She seemed to shudder at the thought of closing her eyes. Her sentence was “I want to be the opening of the door”, which she wrote with some struggle. She looked up beaming. She thought she had it right. Poor S. I did not want to disappoint her, crush her victorious smile. But it made no sense. I would have done a disservice by lying to her. I tried to help. I asked her if she wanted to write “I want to open the door”. No, she said. Perhaps she was scared of admitting. She said she wrote what she wanted to write. That is what she meant. Inevitably, her hexagons did not meet. Not just that, an angle in one of them was missing. S ended with exactly 21.
I don’t often feel so defeated by the loss of a patient. S was disintegrating. I could see, but not help. Everything was normal yet nothing was. From here on it was just going to go downhill.
I felt terribly sad also for the caregivers who were looking at us with expectant eyes. You know the kind. You know when parents look at you in competitions. They want you to succeed more than you do. But they aren’t participants in the game. They are helpless. They can just watch. I must admit that I am no great at handling emotions. It helps me get by with my work. It is a boon then. My supervisors used to say this lack will take me far, and they were right. But still, there are days I feel I could perhaps have become better at communicating if I could emote. That day, I tried my best. All I could manage though was a failed attempt at giving the family a moment of happiness. I told S not to worry. I told her she is strong and she will manage. I looked at her husband and Montu. I looked at S. I told her she has a wonderful family. She wasn’t able to stop crying. S, of overflowing emotions. Look, I said, look at these two. They who make your world, as you told me. You still have your world. She seemed to be looking into space. You do recognize them, don’t you? I asked. Don’t you?
The writing seemed to be on the wall. I could not give the family a false assurance of a return. It seemed like they weren’t ready to give up yet. These are the times when you realize resilience alone isn’t enough to succeed. All the keeping at it that self-help books teach comes to nothing when faced with real life. There are times when giving up and accepting that there’s no alternative is the best decision one can take. This allows them the time to grieve and be prepared for the finality.
The family did not give up. Montu’s father told me they want to continue with their acting classes. He told me that he believes it is helping them. I argued otherwise. It makes no point spending more money on trying to listen when there are no sentences and only words. I told them because I believed it was to an extent my responsibility given it was me who had made them enrol. I believe all psychologists should know that there’s an expiry date to their efforts on particular cases. I am ethically against the practice of minting money of people’s miseries. However, I also understand the fragilities of caregivers. It is a great deal of emotional investment for them. Emotions counter rational thinking. Which is why I did not mind when Montu’s father accused me of sabotaging their hope. I did not mind even when he pulled at my shirt collar and told me I had failed as a doctor and stretched the treatment until it was too late. He told me he will find the best of the doctors. It is all fine. However, I did not expect them to be so desperate as to resort to Ayurveda. One jalebi with a cup of hot milk ‘before’ breakfast never cured anyone’s memory. What it can do is give someone diabetes. For sure. The ayurvedic sadhu would tell her to fold her hands and slowly bring together the tips of the fingers of her two hands: index on index, middle on middle, thumb on thumb. Then take them apart while looking at them, and breathing in and breathing out and counting. You can do it sitting, standing or walking. But it will not help. She will maybe look at the door and say she wants to be the opening of the door and her husband and son would forget to remember that it makes no sense and that she had said it before during the test.
“I want to be the opening of the door.”
“It is this way that are we going?”
They will rejoice in their collection of words. Their life would become a word game. They would perhaps compete with each other for piecing together words and then trying to make sense. They would form sentences that would be open-ended. There will be multiple interpretations of the same.
“Does she want to go?”
“Does she want to be the door?”
They sit and wonder, sit and wonder. They will look to meet near the feet of the giant, the house of the witch, or the starry skies. But always they will be faced with the debilitating sadness of the realization that perhaps from here on they will never be similar, never make up each other’s world.
“It is maybe it want me to be diamond on the sky. I think sky is jungle. Star is tree. Big tree. Many tree.”
I fear for them. I fear, of course it doesn’t seem natural, that they will be collectively “loosing” their grip over their lives and collectively forget to remember. That she will be the “opening of the door” and they will all be “lefting”. Lefting and not telling.
“Old and forgetting and not having anything on way to tell how going back.”