Duane

Duane had some tumors removed from his head. They also took out part of his ability to contain his impulses. This caused him to launch pre-emptive strikes at the first sign of perceived (or misperceived) threat ..as well as anything that violated his standards of appearance. If the strap on the back of my cap was showing, he’d abruptly stop what he was saying, mid-sentence, and demand that I cut it off saying it was distracting and made me look silly. He would then get up and start searching the room for a pair of scissors. At Trader Joes, heaven help the unsuspecting shopper blocking his way. He would ram them with his cart. When behavior therapy helped bring his physical outbursts under control ..he learned to gently pull the offending shopper aside and scold them for being rude and inconsiderate ..letting them know that they’d been making his life miserable, not only that afternoon, but their whole insignificant life, which was so far beneath his, they didn’t even rate being this close to him. He stopped coming to the support group and I lost track of him ..until he wound up in jail. Highway patrol pulled him over for speeding and running red lights. They found him rambling incoherently. When I heard this, it surprised me because his verbal outbursts had always been pretty articulate. Anyway, they told me he’d been cooperative, showing them his license and registration and everything, but just not making any sense, so they brought him in as a precaution. He blood-alcohol level barely registered so they put in a call to me (my card was in his wallet) and Atascadero (state mental hospital). He could not tell them what month or what year it was. Nor could he say where he was, or why he was there. He was, however, ranting about his civil liberties and the rights of an Englishman. When I got there, I shouted at him to tell me the name of that thing in the corner ..and pointed to the chrome toilet. I got the name of some car parts and surgical instruments. So much for trying to get him ‘grounded’. The cops just shook their head like, see ..we told you so.

I tried one more thing ..I wrote down a list of words and asked him to pick out the ones that best described his predicament. He correctly pointed to ‘jail’, ‘police’ and ‘traffic stop’ He even found the word ‘john’ somewhere down the list without me asking, and looked at me like .. ‘see, you asshole’. He wasn’t crazy, he knew exactly where he was and why. Somewhere he had acquired an ‘aphasia’, or a problem finding words or the names of things. I sort of suspected that because it’s related to impulse-control. Word searches also require the ability to constrain choices. Mess with that action and word choices become creative and sometimes barely relevant. That’s when expressions like ‘civil liberties violation’ pop-up in place of ‘traffic stop’. It gave the impression he was talking around the subject. Anyway, it also kept him out of a mental institution and got him into the hospital much faster. Last time I saw him he was speaking well ..but still telling me how silly I looked.