Saturday, May 2, 2015


IT’S ALWAYS something.
     Someone’s going to need to go to the bathroom halfway through and all you can do is let them excuse themselves, even if it means you have to stop what you’re saying and rearrange the furniture so that they can wheel past you.
     Someone’s going to keep blurting out the same question you’ve already answered, and you have to either ignore it, and maybe that will be the last time, or else you have to answer it and try redirecting the group’s attention back to the matter at hand, for example, back to the color of the tea they’re drinking.
     Someone’s going to fall asleep and snore really loudly, then suddenly wake up and start cranking the adjustable tables, shifting the bamboo placemats and nearly tumbling your Russian glass teacups over.
     Someone’s going to have an intense muscular spasm and grimace and gasp for air.
     It’s hard to hold the collective attention of any group of people for fifty minutes, but holding the collective attention of a group of brain-injured people — it’s always something.
     You learn to be nimble. You go with the grain of it. Last week I stepped out of the classroom for not even ten seconds, and when I stepped back inside Mr. Robin was holding a bag of coconut oolong, munching a mouthful of the dry loose-leaf tea like it was popcorn. All I could do was offer him a glass of water. He claimed it was delicious.
     Awkward interruptions, bathroom breaks, intense spasms, flammable dispositions — I’ve learned a few tricks in the seven years I’ve been leading the group, and I always somehow manage to keep it together. Not this week.

LOOKING BACK it’s clear that Mr. Park’s angry entrance was the spark that set the slow fire in motion, but I didn’t recognize it at the time. Have you ever heard a door slam open? That’s how he entered the classroom. And when he banged the light switch off it gave us all a good scare. I turned to see what the commotion was about, and he gave me his stiff middle finger. “White n*gger!” His eyes were wide and blue and he was screaming as loud as he could. “White n*gger!!!” When he slammed the classroom door closed the ceramic lid of my ceramic teapot rattled. We were all rattled. But once he was escorted away I thought we’d moved past it.
     I should have smelled smoke when Mr. Robin started asking to go home before the water had finished being poured. The group begins in earnest with the pouring of hot water. I ask the group for a moment of silence as my assistant pours hot water gently from the electric kettle into the teapot, and we listen to the tinkle it makes. How long does that take? Less than a minute. It’s at the beginning of the group, when everyone’s attention spans are at their freshest, so we’re usually able to make it through the pouring without any questions or interruptions. But the pouring had barely begun when Mr. Robin started asking to go home. 
     He was wearing a large medical bracelet explaining where he was, why he was there, and why he couldn’t go home, but he was still in the twilight state that can persist for months after awakening from a coma, and his memory was so poor he couldn’t remember he was even wearing a bracelet. He was genuinely confused. I tried steering the conversation back to the tea being brewed, back to the sight of the steaming red teapot. I had him feel the ceramic teapot’s warm belly and that seemed to get us back on track. I should have smelled smoke, but I didn’t.

IT DIDN’T HELP that it was Mr. Brown’s first time attending the group. He’s been a patient of mine for five years, but his behavior has been too volatile, until recently, to participate safely in the group. He was so unpredictable the whole first year after he was transferred to our care from a state-run psychiatric facility in an Appalachian state that he couldn’t be left alone, not for one second. He’d knock a toilet over on its side and try to cut himself open with a jagged shard of porcelain, for example, or bang his head against the floor. It’s taken years to get him to where he is today. He’s better now, much less combustible, but still extremely excitable. He snaps his fingers and squeals with delight every time he sees me and bounces up and down in his wheelchair. This week he was in my group for the first time, and his euphoria was like dry straw, kindling. Did I mention he loves fluids? If we didn’t limit his fluid intake he’d drink water all day long. Here he was about to have his fill of tea.
     His enthusiasm spread, suffusing the whole space of the classroom, rippling through the other participants and coloring their moods. Was it a spasm that kicked Mr. Lake’s anxiety into overdrive or was it Mr. Brown’s highly palpable euphoria? I’d just served a second pot of tea — an earthy pu-erh — when he started grimacing and gasping for air. I waited for the gasping to subside, then I asked him which tea he preferred. He’d lost his ability to speak and both of his legs when a burning building he was attempting to extinguish collapsed on him and his colleagues two years ago, and he can only swallow tea one teaspoonful at a time these days, but he can make his preferences known by holding his clenched-closed left fist toward one cup of tea or another. He pointed to the oolong.
     Perhaps I should have stepped in when my tea assistant started mixing his two teas together, but the way Mr. Lake giggled at the sight of the strange connection — I went with the grain of it. I figured I could hold things together for the last ten minutes.

IT WASN’T UNTIL I’d stepped away from the table to hold the door open for Mr. Lake’s nurse to wheel Mr. Lake to the bathroom that I noticed the temperature seriously rising. Mr. Robin was piping up again about going home, and my assistant was trying to tell him he was going home at three o’clock. “Three o’clock,” he told Mr. Robin. “You can go home at three o’clock.” What my tea assistant didn’t realize — he has his own cognitive impairments — was that Mr. Robin was asking about returning to his home home, not to his home-away-from-home here on campus, where indeed he would be returning at three o’clock. “Are you serious? I can really go home at three o’clock?” His eyes lit up and sparkled and he started rolling his wheelchair into the table trying to turn it around.
     I knew I had to get him out of the classroom pronto. He could explode at any moment. Calm words and gentle redirection would not put out the growing blaze. It had to be a change of scenery. So I rolled him away from the table and headed for the back door. I thought he could cool off on the back porch outside. It never dawned on me to watch his hands as I wheeled him past the fire alarm. By the time I realized what had happened, he’d already pulled the lever.
     Your first impulse in that situation is to try to undo the alarm. It’s blinking and shrieking and you think somehow you might be able to just lift the lever back up and call the whole thing off. But of course, once a fire alarm’s been tripped there’s no untripping it. Of course you have to immediately evacuate everyone in the building, all sixty-something people with varying degrees of dysfunction, many with walkers or in wheelchairs, some who have no idea where they are, some of them totally blind yet lucid in other ways.
     Funny, I’d never noticed that fire alarm before. I know exactly where it is now.