By Fred Guggenheim, M.D.
Darrell and Donald, the Schwartz twins, are the last of the Schwartz’ eleven children. Donald would sometimes brag, tediously, that “I am older than Darrell, by six minutes.” A mohel performed a bris milah, ritual circumcision, on their eighth day of life. Parents Herman and Sadie Schwartz always dressed the twins differently to help them distinguish which was which. Even through college, the twins remained so similar in appearance that their dates, at times when stoned, could not tell one from the other.
The twins were never apart at night until they were eleven, when Donald, but not Darrell, went for a sleepover. Darrell and Donald did their bar mitzvahs at Detroit’s Downtown Synagogue. But after that, the twins became non-observant, to the consternation of their Orthodox parents. The twins kept using their secret language through elementary school. They graduated from high school with highest honors. Then, Darrell went to Stanford while Donald matriculated to the University of Michigan.
As adolescents the Schwartz twins were a muscular athletic pair, with curly brown hair, Schwartz brown eyes and Paul Newman good looks. Identical twins often have subtle differences in personality: Donald, usually the leader, Darrell the follower. Donald the risk-taker, the dominant one, while Darrell is more of a stay-at-home, submissive type.
The twins were the responsible ones of their peer group. They were doers, not much interested in just meditating or “being” for its own sake. They were potential Chief Operating Officers, not visionary CEOs. Darrell’s and Donald’s interest in computer science stemmed not from their interest in mathematics, but rather from their interest in finances. They followed Willie Sutton’s law: “Why rob banks? Because that’s where the money is.” Darrell and Donald were always competing, if not with each other, then with their peers. They both saw themselves as winners amongst their talented friends.
Darrell began dating Madeline Goselin when they were Stanford sophomores, both majoring in computer science and taking core classes together. Maddie is tall and slender, fair skinned, with blue eyes, fine blond hair hanging loosely past her shoulders, and generous cleavage. They often tried sitting next to each other in lectures and seminars. Like an extension of classroom work together, they soon began dating. They enjoyed sharing ideas, and sex added to their pleasures.
Then, while attending Stanford’s graduate program for their Ph.D.’s, Darrell and Maddie enrolled in similar, complementary programs. During this time they seemingly mutually decided to live together. Actually, Maddie invited Darrell to live with her in ways that were so subtle that he thought it was his idea. She would eventually marry Darrell.
About Maddie, she now is a lapsed Unitarian, far away from her high church Episcopalian roots. She grew up in Washington, D.C., and attended the National Cathedral School for Girls. In prep school, she played field hockey and lacrosse. She had a wide circle of friends. She never drank or smoked. She was not one of her class’s rebels. She was achievement-minded and became her senior class’s president and valedictorian.
Maddie is an only child. Her father had a high-profile position at the National Security Agency, so he wasn’t around the house much as she was growing up. She loved him, but hardly knew who he was. Then, when she was sixteen, he rapidly succumbed to lung cancer. Maddie didn’t let her grieving for him, which was brief, interfere with her school activities.
Maddie received a full merit scholarship to Stanford, which helped out with family finances. Then in her junior year, her mother, a dedicated middle school math teacher, suddenly died of a heart attack. With this death, at least Maddie was able to cry at the funeral, but most of the time she tried to put her mother’s “absence” out of her thoughts. After all, she’d been on her own in college. Her mother’s lawyer told her that she would now have a small trust fund that would allow her to maintain her independence for a few years.
Maddie was fascinated by mathematics, and the beauty of mathematical proofs, whether in geometry, calculus or in astrophysics. By nature, she was not competitive, since she knew she could always win if it was important to her. So, Maddie and Darrell were complementary, not like Bonnie and Clyde with their similar outlaw ways, but rather in letting each do his or her own thing without interference. They were pleased that they were both working in similar, but not overlapping, fields of study.
Maddie preferred to wear long skirts and Birkenstocks. Darrell would have been wearing Dockers khakis, a white button-down shirt with Gucci loafers if he wouldn’t have been mocked by his peers. So, he conformed to the Silicon Valley dress code of black jeans and a black T-shirt without a brand name. Darrell thought it was he that initiated sexual activity, but Maddie was almost always the quiet instigator. He was the predictable, responsible one; she was the serene maverick, marching to her own drumbeat, when it served her purposes. When Donald visited Darrell in San Francisco on some college vacation breaks, Maddie and Darrell often double-dated with Donald and whomever they fixed him up with. Back then Maddie had lots of sexual fantasies about each of the twins.
In their last year of graduate school, Darrell finally told his parents about his attentions towards Maddie, “I am going to marry her. You need to know that she does not want to convert to Judaism, but I have chosen her as my life partner.”
“Marry her, and we disown you!” his father, Herman Schwartz, cried out over the telephone in dismay, and then hung up. When the couple did marry at graduation time, parents Herman and Sadie Schwartz refused to attend. Maddie and Darrell chose the bare-bones ceremony available at San Francisco City Hall. Bachelor Donald flew in from Ann Arbor to witness and to be Darrell’s best man.
Soon after Darrell and Maddie secured their Ph.Ds., they land lavishly paid positions in Cupertino’s Apple Park. They hastily buy a condo nearby to work. She begins working in computer software, mostly consumer electronics. He starts off in Artificial Intelligence.
That’s when their troubles begin. Eighty-hour work weeks. Vacations planned, vacations cancelled. Meetings here, meetings there. Darrell begins a long-term plan to get in shape for Hawaii’s Iron Man Marathon. The couple does not have much overlapping bedtime. Copulation was almost athletic, especially after fighting. To the statement, “Why don’t you break up?” they would have answered “Because the sex is so good!” But after two years of lessened time for pillow talk, they even found themselves thinking of separate vacations.
Darrell leaves on a late spring bicycle vacation in Hawaii. “Bye, I’ll miss you,” says Darrell. “Good bye, go!” Maddie spits out angrily. Reluctantly, she stays behind.
Anyway, she is burdened with deadlines for Apple’s next Operating System update for cell phones. For the past three months she has been feeling somewhat distant, even some disdain, with guilt, rather than love. Now she begins to think, “Is he just one more significant person in my life that has abandoned me? Has he been using me at his convenience? Is the problem, maybe, that I’m not very emotionally available to Darrell?”
Darrell had been in Hawaii for a week when his parents call Maddie in the middle of the night. She has not spoken to the Schwartzs for two-plus years. Herman makes sure that he is talking to Maddie. “Is that you? I must be the first to tell you bad news. My son Darrell, he has been hurt. Bad, very bad, it was a hit-and-run driver. You hear that? He was on his bike, on Oahu. They just called me from the hospital. The only identification he had on him was a letter that Sadie and I had just written him. Anyway, we’re in the airport now on our way.”
Maddie is stunned. She thinks about getting airplane reservations, but is unsure what to do, as she imagines how both of the Schwartzs will be hovering over Darrell. Maddie spends some of the next morning hours pacing back and forth, then, paralyzed, she decides to go to work, which she does in a perfunctory fashion, not speaking to any of her colleagues. Back home, and long past her dinner time, it is Herman calling again. “Is that you? The neurosurgeon tells me my Darrell is as good as dead. They warn me they really should be taking my son off life support.”
Then mother-in-law Sadie Schwartz, always the quiet one, this time forcefully speaks up over the telephone in a plaintive tone, “The least you can do to honor my Darrell is to allow his body to be sent back to Detroit. My family has a plot in B’nai David Cemetery. All my family is buried there since 1903.” Herman Schwartz gets back on the telephone, “The Kahuku Medical Center will FedEx you some papers to sign.”
After a sleepless night, Maddie stays home, awaiting the papers, which duly arrive next morning. Maddie quickly signs the forms, not even reading them. She drives over to the local FedEx office to send their Rush Envelope back to the Kahuku Medical Center.
Madeline’s regular routines are blown akimbo. “I can’t believe it. I can’t believe it. Why?” She finds it difficult even to cry. She stops everything, including going to work, leaving a message on her boss’s cell phone, “I feel badly, I won’t be coming in to work for now.” Nothing more. She is barely eating. She is crying much of the time, agitated, ill. Her sleep is fractured, occasionally non-existent. She ceases going to the gym, and makes no effort to apprise her regular social contacts of the catastrophe that had just occurred. She keeps on ruminating, “If I had been there with Darrell, he’d still be alive. I’m so angry at him for deserting me.” She has no more telephone calls from the Schwartzs.
Maddie realizes that hers is a very complicated grief. Her feelings for Darrell are highly ambivalent. She hates him, she misses him, and she blames him for taking a vacation when she was not able to go with him. She is unable to put to rest her raging conflicts and can barely sleep.
The next morning, she makes an important decision, “The only way I can manage my grief is to get rid of all the images and remembrances of ‘the late Darrell Schwartz.’”
She flushes a pair of goldfish, named Maddie and Darrell, down the toilet. She begins singing: “I’m going to wash that man right out of my hair.”
A frenzy of activity. She knows Darrell’s passwords: She deletes his Facebook, Twitter, Instagram, Gmail and other app accounts. Deletes his Word files on Cloud, his backups with Carbonite. Pays off and closes out his charge accounts. She throws away his written work files, diplomas, toiletries. She puts all Darrell’s clothes, shoes, boots, tennis racquet, and Leki hiking poles into large plastic bags, with plans to drop them off at Good Will on the way to the airport. Takes off bed sheets, washes them and all other sheets and towels, also puts them in another plastic bag for Good Will. Orders new sets of bed sheets and towel from Amazon. Cleans out the refrigerator. Puts Darrell’s baseball cards, and his watch collection in a small Ziploc bag in back of her closet, out of site, to be dealt with later.
She gives Darrell’s 17-inch MacBook Pro to a neighbor she just met in the elevator of their condo. Calls the local NPR station, KQED, to donate their classic old BMW, that they’d bought together in graduate school, leaving the ownership papers, keys and location of that car with the condo’s concierge.
Yet she keeps on having the recurring dread that he will return to be with her, that he might reappear after she had trashed his mementoes, to chastise her for not grieving in the right way. She anticipates a generous bereavement package from Apple, although she lacks the energy to examine the fine print of her recruitment package. Then she leaves a message for her boss at Apple, “It’s because of my husband. I apologize for taking a leave on such short notice. It’s best for everyone.” No more details than that.
Maddie makes an overly simple plan for her near-term future. “I’m off to Paris!” She has never been there before. Since she will have rid herself from any remembrance of Darrell, “I’ll now be able to look at my life in perspective, do whatever grief work is supposed to be. Hopefully I’ll be able to re-establish my sense of self without Darrell.” She decides to be completely out of touch with her former world, except for her charge cards, which she expects will generously fund her stay.
Four-day supply of clothes in a large backpack with wheels. Sun glasses. Sun screen. Charge cards, $26,000 limit on each, passport and Kindle loaded with her ten favorite books. Over the internet, she purchases an open return-trip ticket to Charles de Gaul airport from the San Francisco. She will buy a Vespa and helmet when she gets to France. “I’ll spend down my charge cards until I’m ready to come home. No advance plans for me about cathedral-tripping, chalet-visiting, museum-marching, or pick-up sex.”
Puts her own MacBook Pro in a desk drawer, turned off. Same with her cell phone, on which she does not change her old answering message. Does not reorder her birth control pills. Tells concierge, “I’m to be away, probably for three months. No forwarding address. Just put my mail and packages in the front hallway.” Finally, after accomplishing all that, she drops off Good Will items and returns her own auto with its soon-to-be-expired lease, to the dealer. She gets to the airport by Uber.
By the time Maddie returns to San Francisco three months, and many two to four-star hotels and restaurants later, always as a solitary soul, she has maxed out her Visa Card. She is thankful for her MasterCard.
She returns from the San Francisco airport by Uber to her Cupertino condo. That late afternoon Maddie stops by a nearby stationary store to buy a batch of elegant paper invitations, with a detailed party list. The store also provides postage stamps and will mail out her invitations. It also will send out email party invitations to those on her list. Maddie wants to invite close personal friends, and work friends, to her Reintegration Cocktail Party.
Returning home, Maddie remembers “Oh shit, I haven’t paid my mortgage or my condo fees! Now they’ll be late charges,” for the one bedroom, one bathroom $850,000 condo. She forages in her very untidy desk, and is able to retrieve her check book, which does have an adequate balance to pay those burdensome overdue condo bills, but not sufficient to pay off what’s owed on her credit cards. New worries. But at least she isn’t obsessed with grieving. For the moment she puts her complex, strong feelings of anger toward Darrell in the back of her mind. She still occasionally ponders what is more than a theoretical question, “Was Darrell really my soulmate or was he just a handy solution to a complex set of issues in an unsettling time?”
Before the catered party, several days later, she realizes that “If I serve Dom Perignon Champagne I’ll be over the max for my second charge card.” Low on her priority list is recharging her abandoned cell phone and her personal computer.
Among those invited is Donald Schwartz. “I doubt he’ll turn up. I hope he does. I still do have some sexy thoughts about him…I’m still too bummed out to announce that my party is a memorial to Darrell.” She does use a magnet to pin a somehow-remaining photo of Darrell on the refrigerator.
As the Saturday late afternoon party begins, seeming hordes of her favorites invade. She is so busy hugging her first guests, she doesn’t even see late comers enter. It is a forty-person, crowded party full of busy conversations fully saturating her 850-square foot home. “I’m not sure who has come in, or who is yet to come. So what. Will Donald Schwartz arrive?” muses Maddie. An hour into the party, she hears the chime of her door bell, and, breaking off a conversation with a friend, she goes to answer it.
Maddie opens the front door. There appears a gaunt, slender, tired, dirty man, with some facial features strikingly similar to Darrell Schwartz. He has arrived, unannounced, ringing Madeline’s door bell. His head is partially shaven, with a blue-blackened area under his left eye. There is a drooping of his left facial musculature and his lips on that side. He is limping and using a cane to support his right leg.
Looking down at a piece of yellow sticky note paper clasped in his trembling right hand, and reading from it, without looking at Madeline, Darrell slowly stammers out, “Hello, are… you… Mrs. Madeline…Schwartz… at 204…88…. Stevens Creek …Boulevard?”
Totally surprised by the ghost of her suddenly non-dead husband, Madeline let out a blood-curdling shriek, and, for the first time in her life, she faints. Her guests, startled, are suddenly silenced. Donald, who had come in without greeting his hostess, rushes to the front door. He glances at bandaged, banged-up Darrell while racing towards the fallen Madeline, who gradually recovers her wits. Darrell, confronted by the unfamiliar, stands stark still, a pillar of stone, waiting for something to happen.
As Donald helps an ashen-pale Madeline to sit up, he glances up at his twin. He had known, unlike Madeline, that Darrell was indeed alive. But the hospital had not specifically informed him of any of Darrell’s discharge plans. Indeed, only his parents had known when Darrell was to be discharged to his spouse. Since Maddie had been off-line and unconnected, she has had no warning of Darrell’s imminent discharge plans.
Wordlessly, Darrell, Donald and Madeline leave the front door and go into on the living room where the party-goers as a mass have moved out of their way. Within five minutes, the celebrants have all quietly exited, leaving their plates and glasses where ever. The trio sits down in chairs not littered with dishes, trays, bowls, and wine bottles. Soon Darrell penetrates an unbroken silence, admitting “Can I use the bathroom? I really need to go.”
Maddie whines to no one in particular, “I guess I’m supposed to know what to do. I haven’t the vaguest idea of where to start, no inclination. What an ambush. I’m broke, I don’t know if I still have a job. The mortgage and condo fees are due soon. I don’t have a car. I’ve thrown away Darrell’s passport, driver’s license, credit cards, his passwords, his everything. And now this!”
In the minutes while Darrell is in the bathroom, Donald and Madeline update each other about what has transpired in their lives over the past months. Maddie indicates briefly, “Three months on a Vespa in France, off-line.” Donald shares, “My parents are furious at you for not responding to their emails and text messages about what to do for Darrell. They had no way to know that you must have been off-line during all that time.” Indeed, she had given no one warning of her unavailability. “I figured you might have just stashed away your cell phone in a fit of pique, or maybe sorrow, and moved on.”
But what to do? Donald comes up with some tentative proposals, “I’ll postpone my flight back to Ann Arbor for a few days. I can sleep in your apartment on one of the sofas, while Darrell can sleep on the other. Since I still have my Honda rental car, tomorrow we can take Darrell to the Apple HR office, to get him new identification papers, badges, and check out his insurance coverage.”
After Darrell rejoins them, Donald’s Google search reveals that there is a nearby rehabilitation facility. “We can go there for an evaluation by a physiatrist (a physical rehabilitation physician). Then Donald adds quietly, “Darrell has been sent packing, discharged, without being given any future plan of care by his Hawaiian general hospital. We need to know, what are the plans for his recovery?”
Maddie adds, “Me, I still need to find out if I have any pending Apple salary, or do I even an Apple job?” And she starts to think to herself, “What do I do about our marital relationship?” That’s the 800-pound elephant in the living room that no one could even approach.
Maddie was never much into being a social worker, a nun, or a selfless caregiver. She was not even sure if she wanted to be a mother. Donald is still a bachelor, although a highly pursued one. He is not in a committed relationship at the moment. He has a good IT/AI job in an Ann Arbor start-up. But his skills are immediately transferrable to many firms in the Silicon Valley. He still has warm feelings for Maddie, but that would have to wait. He wonders, “What kind of recovery can we expect for Darrell?”
No one talks much. It’s getting late. Donald opens Darrell’s carry-on suitcase and lays out Darrell’s pajamas and toiletries. Donald then tells his numb-appearing, quiet brother, who had been sitting in a chair in another part of the living room, “It’s OK to go to the bathroom. You can change into your pajamas there, and be sure to brush your teeth.” Which Darrell does, leaving his clothes in a pile on the bathroom floor. No initiative, just doing what he was told, automatically, as long as there is no more than two instructions at a time. Three simultaneous instructions would be too much.
Donald picks up Darrell’s clothes, folds them neatly, putting them on a chair in the living room. He goes to a living room closet for bedding, then spreads out a clean bottom sheet, a blanket and a pillow with a new pillowcase on a sofa. “Darrell, this will be your bed for the night.”
Maddie comes out to see how “the boys” are doing. She has never seen her formerly muscular, now scrawny husband in pajamas, as he had never worn them when they lived together.
Maddie, shaken, goes back to her bedroom, while Donald tucks Darrell in, saying “Good night, dear boy. I love you. I’m sleeping near-by and I’ll see you in the morning.” Darrell smiles a sweet smile, gets into bed, again without a word, and quickly drifts off to sleep.
Maddie, in the meantime, quietly sobs in her bedroom. She sits, still dressed, on what used to be her side of the bed. Paralyzed, ambivalent, scared, troubled. You name it: any negative-seeming verbs with an “ed” ending would probably be a good fit for her. After a few minutes, she calms herself.
A short while later, she hears Donald tucking Darrell into bed. Maddie comes out into the living room to observe, not to do anything for, Darrell. In a far part of the living room, she starts tidying up, putting dishes and glasses in the sink, taking left-overs that need containers and placing them in the refrigerator. A bottle of tequila has special appeal: she pours herself a hefty glass full, offering the same to Donald, who declines. Plopping down into a chair, she initiates a conversation with Donald. They discuss their perplexity. “Summing it all up,” she says, “Not much going on there,” looking at a sleeping Darrell.
With that, leaving for her bedroom, she suggests that Donald use the bathroom to prepare for sleep. The rest of the evening and the night passes quietly: Darrell apparently doesn’t have a clinical sleep disorder, what a relief. Both the Schwartz twins prove to be good sleepers, which was more than Maddie could say for herself that long night.
Breakfast proves to be a challenge, as there are none of the traditional makings yet in the kitchen. Maddie hadn’t thought about planning any meals after her Reintegration Cocktail Party. Donald, now in his undershorts, volunteers, “I’ll get breakfast fixings. I still have that rental car.” She waits impatiently as Donald dresses in the bathroom with the day-before’s clothes. Maddie gives him driving directions to a near-by Seven Eleven store. Donald’s departure leaves Maddie and Darrell alone for the first time since she first saw her battered husband at her front door, half a day ago. He says little when she asks, “Darrell, do you have any questions? I know there’s been a lot going on here.”
“No, I’m fine…just a little headache,” slowly replies Darrell. Nothing more.
The dearth of Darrell’s response leads Maddie to the conclusion that this is the first uncomplicated man she has encountered in years. “Here he is, at three months post bicycle accident. His thinking is concrete, simplistic.” She puzzles, “He seems to be trusting, yet he shows no sense of being capable of interest in future planning.” Maddie agonizes, “He’s zombie-like, a member of the walking dead, maybe more cognitively impaired than a kid with Down’s syndrome.” These observations remind Maddie that she probably didn’t want to have children anyway. “Darrell is nice enough, like a piece of furniture, but certainly not someone that can be my friend.”
After Donald returns, and breakfast is finished, Maddie announces, “Now it’s off to the Apple Personnel Office to see who has what coming to Darrell, and to me, if I’m still an employee.” After quickly cleaning up the kitchen, and taking bathroom breaks, they pile into Donald’s rental Honda.
They arrive at the Apple Human Resources office. There Nancy, about twenty-five, a slender cheery woman, dressed in jeans, a Grateful Dead T-shirt and Nikes, is very warm and supportive. She gives them the good news and then the other news. “Darrell’s generous disability insurance is ready to start with no mandatory 90-day waiting period. There will also be full health care insurance coverage including dental, with no co-pays. No more contributions to his 401c retirement account since he is now ‘retired.’ All applicable state and federal taxes will be automatically deducted.”
Turning to Maddie, Nancy continues, “Your job position here has not been refilled, but your salary was discontinued after six weeks of Family Medical Leave, since there was no application for its continuation. However, my notes indicate that you’ll be welcomed back if you wish.”
Then Nancy shifts to Donald, who has said nothing during the interview, and without missing a beat, Nancy says, “If you are interested in being hired by Apple, here’s a job application form.”
Next, off to San Jose and The Rehabilitation Center at Santa Clara Valley Medical Center. Maddie declares, “The best way to make an appointment is to be there, to see what is offered, what they can do. It’s just a ten-minute drive. This facility should be able to figure out what Darrell needs.”
As they drive to San Jose, Donald and Maddie, overwhelmed, quietly ask each other, in rehearsal, all those important questions, “Is Darrell capable of independent living? If not, what kind of living facility would he be best suited for?” “Would a person with a brain injury in recovery for three months get much better?” “Will medication help? Darrell’s on no medications now. Will he be susceptible to seizures later on?” “Should we apply for Social Security Disability Income now in addition to his private insurance disability payments?” “Could he be trained to do some useful employment?” “Would he be more likely to become violent or disinhibited later on?” “Is he competent to manage his own finances, or does he need some sort of guardian? How does one get a financial guardian, a legal guardian?” And Maddie thinks, but does not say aloud, “How does divorce work in California with someone who is mentally disabled?”
The front desk receptionist at the Rehab Center tells Maddie that, fortunately, “Dr. Peter Somoza, our highly qualified physiatrist, just had a cancellation for his eleven-a.m. slot.” The trio are led to his plaque-covered, comfortable consultation room to wait for Dr. Somoza’s arrival. He is a tall, dark man. Middle aged, mustached, dark tan, black hair slicked back. He is wearing a white coat, with a stethoscope around his neck and neurological hammer in one of his bulging white coat pockets.
After their pleasantries of greeting, Donald hands Dr. Somoza the copy of Darrell’s discharge summary from Kahuku Medical Center, which Dr. Somoza studies. The Kahuku medical staff had neatly tucked it into Darrell’s carry-on baggage. Then Maddie and Donald take turns, collaboratively, to detail what little they knew about Darrell’s post-discharge behaviors.
The initial quarter hour in Dr. Somoza’s office is devoted to background information gathering. Next, Dr. Somoza begins patiently, slowly, talking to Darrell, who, during all this time, had been sitting quietly in a corner of Dr. Somoza’s office, like a banged-up wooden chair.
Dr. Somoza begins by asking Darrell a thousand questions: “What is the day… date… month…year…what city are we in…which state?” Then comes a flurry of other questions, like “What was your most recent job? …What did you have for breakfast today, …dinner last night? …Did you make your bed this morning? …Where did you put your pajamas? …Who is the president of the United States? …Count backwards for 100 by 7s. …OK, since you’re having trouble with that, count backwards by 3s. …Can you remember this number, 86421? …Please repeat after me: 7439215. …Can you say it backwards? …Please draw a clock face to indicate the current time…How many animals or other creatures can you think of when their names begin with ‘A’? …I’m going to tell you a story about a man who lived in Cleveland and wants to get to New York City, and I want you to repeat it to me, so listen closely.”
At the end of Dr. Somoza’s cognitive exam, Darrell is exhausted, as the eleventh hour turns to twelve and even approaches one p.m. It’s time for everyone to break for lunch. Dr. Somoza tells them, “I will have a written summary available for you later in the afternoon. My schedule doesn’t permit our meeting face to face again today, since I’m all booked up. You’ll find many answers to your questions in my summary. We’ll see Darrell back here in a week, and you’ll need to set up appointments for neuropsychological testing, physical plus strength testing, and, after all that, with social services.”
Lunch proves to be another test of Darrell’s abilities, or lack thereof. The trio walk in tandem over to the patient and staff cafeteria at The Rehabilitation Center. Darrell can’t make up his mind amongst the choices of drinks, the salad bar, the grill for hotdogs, hamburgers, the pizza stand, and the three hot entrees with assorted vegetables. Donald places a hamburger, French fries, and a diet Pepsi on Darrell’s tray, while choosing other items for himself. Maddie has little appetite but munches on a pre-made chicken salad sandwich and lemonade.
Maddie is pleased to see that Darrell exhibits good table manners, including wiping some catsup off his lower lip. Maddie and Donald hide their disappointment at how poorly Darrell had performed on the brief mental status exam and in the cafeteria line. They know that there will also be a much more detailed evaluations later on in Darrell’s pending workup.
After more than an hour they return to the administrative assistant’s desk, outside Dr. Somoza’s examining room. She gives Maddie a copy of Dr. Somoza’s summary findings and recommendations.
The trio ride back to Maddie’s condo in eerie silence. Nobody says the obvious, “Well, what did you think about that?” in the car, but that’s what Maddie and Donald are thinking. Darrell stares out the window with a “never-have-seen-this-scenery-before” sort of amazement. He has an enviable ability to be in the present, with no memory of the past and no particular interest in the future. Not exactly a post-lobotomy case, but there are some similarities. Certainly not an Apple millionaire-to-be.
Back in Maddie’s condo, for the remainder of the tattered afternoon, it’s time to make long-term plans. That, of course, is impossible. Therefore, more calls to HR at Apple, to the Social Service department at the Rehab hospital, and to set up other appointments there. Both Maddie and Donald are questioning each other. Maddie wonders, “Darrell’s placement? Where? How can we get that covered financially?” Donald muses, “In the 19th century, if someone received an incapacitating head injury, family members would place that person in a back bed room near the kitchen or the fireplace. But this is the twenty first century.”
After mindlessly watching the 5:30 p.m. news, the trio heads out for pizza and beer. They all need a reward after so grueling a day. Nobody is fessing up to their feelings, or fears.
Conversations at supper are inconsequential, except Donald comments, “The décor and the professionalism of the Rehab Center are commendable.” Then back to the condo in Donald’s rent-a-car.
Maddie excuses herself to start going through her stacks of unopened mail in zip locked bags labelled “BILLS,” “PERSONAL” AND “BUSINESS” that are piled on her desk in a corner of the living room. She has already opened some of her Amazon packages, which is where they all had new sheets and pillowcases from the night before.
Donald and Darrell sit in another corner of the living room, with Donald trying to nurture an otherwise faltering dialogue with his twin. Donald keeps on trying to use open-ended questions, but ends up getting “yes,” “no” and “I don’t know” answers. Donald is the frustrated one, although he tries hard not to show it. Darrell is the complacent one, just shining in the fact that he has been re-united with his twin: words, transfer of information, they don’t really matter to him.
A small clock on the mantel piece ticks and tocks, as Maddie sweeps through months of mail, and Donald sits quietly with Darrell with their intermittent, then truncated conversations. After a mostly quiet two hours, Maddie suggests they all watch her favorite news channel for the 9:00 p.m. newscast on KOFY-TV, not that it makes a difference to any of the trio.
At 10:00 p.m. it’s everyone’s time to go to bed. Maddie takes bed sheets, pillows and blankets out of the living room closet, plus Darrell’s pajamas, plopping them down on the two living room sofas, telling the twins to make up their beds. She then goes to the bathroom. Donald makes up Darrell’s bed, then his own. As Maddie is finished with her bathroom activities, and goes off to her bedroom, Donald points Darrell toward the bathroom to undress and brush his teeth. When Darrell returns, Donald tucks his brother in for the night, makes up a bed on the sofa for himself, then he’s off to the bathroom for a much-needed shower.
Darrell nods off to sleep immediately. Donald comes back to the living room in his usual pajamas, that is, buck naked. He turns off the living room lights. He is about to get into his newly made-up sofa bed when, impulsively, he spins on his heels and heads for Maddie’s bedroom. No thoughts of boundary violations, nor of complications of the trio’s relationships. No, it was just one of those “If it feels good, do it!” moments.
Maddie is lying quietly in bed when this hulk slips quietly into her room, and creeps into her bed. Donald lies on his right side, on “his” side of the bed. He instinctively puts his left arm over onto Maddie’s chest, on top of her nightgown, with his hand cupping around her right breast. Maddie says nothing; she doesn’t move. Donald promptly falls asleep, and a few minutes later, so does Maddie.
At this time of the year, late Spring, sunrise in Cupertino arrives at 5:45 a.m. But dawn begins to stretch out at about five in the morning, which is when Maddie awakes to see clearly outlined Donald, nestled soundly asleep in her bed. Lifting the light wool blanket and top sheet, she kissed him. Donald turns, and returns her kiss. They made love gratefully.
Afterwards, “What are we doing?” gives way to “That was nice. Look at what we are doing!” Donald retreats to his living room bed, Maddie to the bathroom to shower and cleanup for the day.
Darrell is quite interested in their pending travels, but not in his future. What would you expect from a four-year-old? Donald is interested, too. But he is interested in other things. “Would I be a good match for Maddie?”
And Maddie is occupied, too with the thought, “Was this thing with Donald a ‘one off,’ a ‘benefits from a friend’ kind of thing, or is this the beginning of something serious?”
Fred Guggenheim, M.D., is a Professor of Psychiatry and Chair Emeritus at UAMS and an Adjunct Professor of Psychiatry at the University of Nebraska College of Medicine. After training in internal medicine, Dr. Guggenheim assisted in a research project at NIMH on identical twins discordant for schizophrenia. He came to UAMS several decades later as the second Marie Wilson Howells Professor of Psychiatry and Chair where he served for 15 years. He started the Friends of Psychiatry philanthropic program and Arts of UAMS, art shows still ongoing in the UAMS Library. He has previously published pieces in several other narrative medical journals.