The Little Box In The Front, Or, The Story of H________

As we come to terms with my diagnosis in my family, we’re starting to understand my brain better and some sources of conflict.  One such argument happened last night.

My wife is beautiful, smart, and multi-talented (and in no way required me to write that before I could write about an argument we had).  She went out with her friend the other night, which I am totally okay with; we both go out with friends on our own and understand that we need that time away to be sane.  Anyway, our youngest son was ill, and she said if he was wheezing or coughing he needed a nebulizer treatment.  There are two medicines we use with the nebulizer, and I can never remember which was which.  I was sitting on the couch reading and she showed me in the hall closet where she had put the nebulizer and the medicines.  She said “give him the H________ not the L_______.” (I can’t remember the names; they may have something to do with those letters.  I don’t know.)

I looked at her funny, knowing that I wouldn’t remember which was which, so she said, “It’s the small box in the front.”

That was perfect for me.  Later, he did need the treatment and I gave him the appropriate medicine.

Later, we had this “discussion.”

I had told her I gave him a treatment because he was really hacking away.

“You gave him the H________ , right?”

“Yes, the one you showed me.”

“But it was the H________ .  You read the box, right?”

“No.  It was the little box in the front, like you showed me.”

“But why didn’t you read the box?”

“Because I can’t remember the name.”

“You should have written yourself a note.”

“Why?  It was the little box in the front.”

“But we’re talking about giving a child medicine.  You have to read the box.”

“No.  There are two boxes.  The big box in the back, and the little box in the front.”

“But why won’t you read the box?  This isn’t an ADD issue.”

“Yes it is,” I said.  “The name doesn’t stick in my head.  I don’t remember names.”

“But it’s important.  This is your son.”

“It doesn’t matter.  If I have a student come see me, I look at his name on his paper, I see him two or three times a week, and five minutes later, I can’t remember his name.  It doesn’t matter how important it is.  In fact because the medicine is important, I was sure to give him the little box in the front.”

We talked it out some more, and realized that while the two of us are similar in many ways, we are very different in the way we remember things.  She can remember all her lines from the plays she did in high school.  I have favorite poems that I have read hundreds of times, but I cannot recite them: “Two road diverged in a yellow, um, forest?”

I remember things spatially and conceptually.  She does not trust herself with spatial arrangements, so for her to be sure, she would memorize the name.  In fact, she is quite the opposite of me in this regard.

One of the household duties that seems like the biggest chore for her is putting away the clean dishes from the dishwasher because she gets stressed about remembering where everything goes.  For me, that’s the easiest task because everything has its place; I can see that clearly in the cabinets.  For me, loading up the dishwasher with dirty dishes is the hard job, because how you fill the dishwasher depends on what kinds of dishes and pots are dirty, and the plan might change partway through.  It takes me three times as long as her.  So I empty, she fills.

One of my many frustrating habits is my poor memory for lists and names.  She used to think I just didn’t care.  In fact, when I care a lot, it is harder for me to remember things sometimes because of the added anxiety.  (I can’t even remember my own phone number or birth date at the doctor’s office.)  So I learned to use strategies to compensate.  One of which would be to remember the medicine is the little box in the front.  The other is to write notes.

Session One

I had my first meeting with the diagnostic team this week. The kids were in school so my wife and I drove the hour down to the BRAINS Foundation in Grand Rapids together. The office was in the building at the back of a professional park. The building had a craftsman style exterior, but a sort of wood-panel art deco interior. It felt expensive inside, confirmed by the rate sheet the receptionist handed me. Glad I have good insurance.

The thing about going to mental health facilities is you never know what kind of crazy is inside. In the few I’ve been to, I can’t help look around and say I wonder what’s wrong with these people? (Though I should probably look in the mirror first.) Indeed, my wife went to find the bathroom and a woman talked her ear off while they were waiting in line. We were directed to a narrow staircase and I kept flashing on the hospital scene from Jacob’s Ladder: going down, down, down. In a Kafkaesque moment, an institutional metal fire door opened to what felt like a hotel lobby with another waiting area. After a few minutes, my doctor found me in the waiting area and led me to her spacious office.

The doctor turned out to be the smart/warm/receptive type. She began to take a history. She asked me “What seems to be getting you caught up?” and I let fly. I’ve had lots of practice in the therapy game, so I did the stream-of-consciousness download for her. I was eager to talk, probably too eager, and at times started to give too-complicated answers.

She asked me if I had migranes or headaches, for example, and I said something like,

Well, yes and no. I used to. Sometimes I would get, I would call it the “perfect storm” headache, you know, a combination of neck strain and sinus pressure and yeah, I would have that can’t-stand-light kind of headache, but I haven’t been getting them since I started doing yoga, even though I don’t do that too regularly I do try to do yoga at least once a week (I take a class) and since then, yes I do get headaches, but not bad ones because yoga has fixed my neck strain, which was due to my bad posture because of the way my back is put together.

Probably something like “I used to, but not since I started yoga” would have sufficed. The doctor was kind, however, and let me talk. She asked good questions too, for example, about the difficulty I have managing finances and the pressure being, for the most part, the sole income earner for the family. She also asked about what sort of consequences I had experienced from having trouble with work in the past.

She asked me about medication, and I said, “Load me up!” I had taken antidepressants for several years to good effect. The problems that continue pale in comparison to the bad old days of a decade ago.

So what we set up was the possibility that I have ADD (she used the old term) and that in two weeks I would return for two and a half hours of testing, as she said, “to figure out what’s going on in the way your brain processes things that will help us decide if you do have ADD.” Two more weeks of waiting for my tests, and then another follow-up appointment to figure out where to go next.

Back in the car, my wife was happy to hear that the doctor thought the B-12 and krill oil supplements were a good idea (because they were her idea). I felt relieved that the appointment was over and that it went well and we went for a great lunch at a Chinese restaurant we used to go to when we lived down in GR. Awesome rangoons!

Later that night, after dinner, we were talking about the day again and my attention started to drift and some worry surfaced. My wife, used to the drill, asked, “what’s the matter?”

“I’m worried that I was supposed to pay the co-pay on the way out. I mean, no one said anything about it.” The doctor said I could set my final follow-up appointment on the way out, but I got a bad vibe from the upstairs desk and there was a line of people and I just wanted some air so we left.

“No, they always have to work out the insurance,” she said. I didn’t look relieved. “What are you worried about?”

I smiled at my foolishness. “I want to make a good impression. You know, be a good patient?”

She laughed. “You went to the looney bin today, and you’re worried about your manners?”

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