Monday, December 17, 2012

doctor tea





The moment the woman who savored birdsong was wheeled into the classroom she asked me if we were going to be listening to birds again. It had been three weeks since we’d listened to my mockingbird and bluejay recordings, and the experience had clearly stuck with her, because from that point forward every time I saw her she greeted me with a plea for more birdsong. Last Thursday was no exception.

This was a woman who couldn’t remember what day it was ten minutes after being told, who couldn’t remember whether it was a pink or a yellow balloon that popped in front of her face yesterday, but who could remember that I played some bird calls for her three weeks after the fact. I said, “Nope, no birds today. Just tea and music.” Then I began the group the way I always do: “My name is Dr. Theriot. This is Peaceful Habits.” Then I stopped talking, and I started making tea. I pressed the green ON button at the base of the electric kettle.

There were three of us that day — me, the woman who savored birdsong, and the man whose leg was so horribly broken its remaining pieces had to be pinned back together and held in place from the outside by a stainless steel orthotic for the better part of a year. The small group, three people, was an ideal size for teaching tea-making, so I invited the man whose leg was so horribly broken to assume the tea-making duties while I stood by to instruct and assist him. I asked him to take the top off the teapot, and he took the top off the teapot. I asked him to put in four spoons of loose tea, and he measured the tea out mindfully.

“Let’s sit quietly,” I said. “Listen. The water’s starting to boil.”

We turned our ears toward the kettle and listened, and it wasn’t long before we heard the water begin to bubble and burp. We saw tiny droplets of steam condense on the inside of the kettle’s clear lid. We watched the kettle tremble. And when the kettle dinged, the man whose leg was so horribly broken lifted it from its cradle.

This was a man who had to get around in a wheelchair, one leg bent, the other leg enclosed in a metal cage spiked with skin-piercing screws, stiff and unbendable, for over two hundred days, and who, delirious from brain injury and pain medication, hallucinated shrimp in his air conditioner vents for almost as long. The metal device — an external fixator — couldn’t be removed until the shattered remnants of his leg bones had fused back together, and his bones couldn’t fuse back together until he started putting weight on his leg, but he was in terrible pain and extremely depressed, and he just didn’t feel like walking, so the cage around his leg stayed put. Medications weren’t helpful in regulating his mood. Mostly they just worsened his hallucinations. 

To add insult to injury, scans showed a dangerous amount of fluid around his brain. A brain shunt could relieve the swelling, which might ease his dark depression and restore his will to walk, but as long as there was metal screwed into his leg there was the possibility of a lingering bacterial infection spreading by blood to his brain, and any brain surgery, even a routine shunt procedure, was too risky to undertake. His neurosurgeon wouldn’t operate unless the external fixator was removed. But the external fixator couldn’t be removed until his leg bones had fused. He was trapped in a kind of purgatory.

Then things took a turn for the worse. He left for an appointment with his surgeon one afternoon, hoping to finally be free of the external fixator. Instead the surgeon outfitted it with a new appliance — the bones just weren’t healing properly — and when he returned, the external fixator was larger than it was when he left. The man whose leg was so horribly broken was emotionally devastated. He wanted to stay in bed all day. He had completely given up. At his lowest point I had a conversation with his surgeon about whether or not to consider sacrificing his leg. It wasn’t getting better, I argued, and it was keeping him from the shunt surgery he needed to spare what was left of his brain. But the surgeon was confident that it in a few more weeks he’d be able to remove the external fixator, so we agreed to stay the course. And his horrible leg got better.

He started putting weight on his leg, and with each step his bones healed a little bit more. His external fixator became smaller and smaller until one day, eight months after it had been screwed into his leg, he was rid of it at last. Once he was on his feet again, the hallucinations stopped, and his mood grew optimistic. The swelling around his brain resolved without any intervention. I’d smile when I saw him walking along the road that winds through Touchstone, one leg shorter than the other, a five-inch lift in his left shoe, shuffling behind a walker unevenly. Then, seven or eight weeks ago, he started coming to my group. And last Thursday, instead of wondering whether or not his leg should be amputated to spare what was left of his brain, I was wondering whether or not he could pour boiling water safely into a teapot. 

“Let’s listen to the sound of water being poured,” I said, focusing their attention on the thin stream falling from the kettle. The note the tinkling water sounded rose slowly in pitch as the teapot filled with liquid. “How many minutes on the timer?” I asked the man whose leg was so horribly broken.

He said, “Depends if it’s a green tea or an oolong.”

“It’s an oolong,” I said.

He said, “Four.”

He was correct. I told my smartphone to count down four minutes.

While waiting for the tea to brew, I asked the woman who savored birdsong to name the five senses. I’d asked her the same question the Thursday before last Thursday, and the Thursday before that as well, and she still had trouble naming more than one or two of them on her own.

I pointed to my eyes. I said, “What do you do with your eyes?”

She said, “See.”

I pointed to my ears. I said, “What do you do with your ears?”

She said, “Hear.”

I pointed to my nose. I said, “What do you do with your nose?”

She said, “Smell.”

I pointed to my mouth. I said, “What do you do with your mouth?”

She said, “Taste.”

I held my hands up in the air and wiggled my fingers. I said, “What do you do with your fingers?”

She had no idea what I was doing.

She couldn’t name the five senses, but that wasn’t the point. The group wasn’t about sitting around a table and naming the five senses. It was about sitting around a table and using the five senses. This is why the birdsong had made such an impact on her. She had sensed them directly. She had experienced them first-hand, as it were. She didn’t hear about them. She heard them. She grasped them for herself. They were tangible, concrete, and she held on to them for weeks. The timer on my smartphone sounded. Time for tea.

The man whose leg was so horribly broken lifted the white teapot and tilted its spout delicately toward the nearest teacup on the tray while I held a strainer over the cup to collect any leaves that might pour through. We listened to the sound of tea being poured.

“What does it smell like?” I asked the woman who savored birdsong. She smelled her cup of tea. She paused. She smelled the tea again. “I don’t know,” she said, “but it smells wonderful.”

“Does it remind you of anything?” I asked the man whose leg was so horribly broken. He shook his head. “Taste it again,” I said. “Does it taste like anything?”

“It isn’t jasmine, is it?” he said. “Tangerine? I know it’s not jasmine.”

“How about a hint?” I said. He nodded.

I said, “It’s a common tropical fruit. You might find one on an island in the middle of the . . .”

“Coconut!” he said. “Now I can taste the coconut.”

Meanwhile, the woman who savored birdsong couldn’t stop smelling the saucer of coconut oolong leaves I’d prepared for exactly that purpose. A peaceful smile came over her face. I pulled a sheet of Kleenex from the box on the table and emptied the saucer into it, then I folded the corners of the tissue over the dark green bundle like a sachet of potpourri, and I gave it to her to hold.

When we’d finished enjoying our tea, I hooked up my smartphone to a pair of portable speakers and opened up the player to Sakura, a collection of ambient music by composer Susumu Yokota. Sakura means “cherry blossom” in Japanese, and the spirit of the cherry blossom haunts the electronic fabric of this music. Saku, “bloom,” the first track on the record, evokes the image of a cherry tree in bloom, poised on a timeless landscape, its gracefully arching branches glittering in the daylight of springtime, sprinkling pale pink blossoms on the picnickers in its shade, blanketing their faces and their picnic baskets. We heard the peaceful music and practiced letting go, soaking for nearly six minutes in the bubbles of the cherry blossom.

I closed the group the way I always do. I handed out prescriptions. We filled them out together. And I told them I’d see them next Thursday.