Collateral Damage Chapter 3

Rotation Day 2

Jon got a text at 5 AM from Dr. Martell asking him to meet him at his office at the University of Westeros Medical School. Anything was better than going to the Alzheimer’s wing alone. 

“Jon, you have worked life and death situations in the ER. I know you can do this.” Sansa encouraged as she packed their lunches during breakfast. “And you have leftover pizza for lunch! I promise to be home early and we can cook a good meal tonight. Veal chops and a healthy spinach salad?”

“Give me a kiss that I can hang onto all day.” Jon said pulling her to him before he left. He held on to her so tight, like she could challenge this reality. Their kiss was long and deep, cherishing every second their lips prayed each other’s name into breath and desire. Desire that would have to wait.

Jon arrived at Dr. Martell’s office and was surprised to see him already deep in charts and data.

“Good that you decided to join me, Dr. Stark.”

“It’s an honor, Dr. Martell.”

“Don’t worry about honor right now. It’s hard work. In the mornings, we will work on creating a genetic profile or series of genetic profiles beyond the PSEN 1 and PSEN 2 markers. Essentially, I would like to parse out the Familial Early Onset APP marker from this early onset of unknown origin. I would like to find out if there is even a genetic marker. Of the total Alzheimer's population only 5% is Early Onset. But, 5% is significant. We could make a discovery of some importance, you realize.”

“Yes, Dr. Martell, I do. I’m not afraid of hard work. When I return to Winterfell, it will be all hard work.”

“You come from a most distinguished family, young man. That is why I choose you, not just for this rotation, but to work with me on this study. Now, in the afternoons, we will be working to develop a protocol to ameliorate, if possible, some slight portion of the confusion and agitation of Sundowning.”

“I understand sir.”

“You have only had one day on the wing. I doubt that you do from more than a clinical perspective. Any decrease in Sundowning behaviors is just as much for the families as the patients. Not only is it disconcerting for family members, many of whom visit daily after work, but it deprives our residents of positive interactions. Imagine, coming to visit your family member after a long day at work and they are caught in the Sundowning effect. They are in such full on perseveration over some minor detail from the past that they cannot focus on their visitors. Then at bedtime, they become agitated or depressed and unable to sleep without medication, because they don’t remember the visit. It is a vicious spiral. Anger, guilt, depression. I could go on and on.”

“So what do you want me to do?” asked Jon.

“Observe, interact, make notes. Make environmental changes, change the lighting. Keep it daytime bright, that is my first thought. And talk. Talk and relate to our residents. Look for triggers and changes. Do what ever it takes. Every day from 2 to 6 PM. Then go home and clear your head and your heart.”

At lunch, Jon reheated last night’s pizza. Sansa had left a ziplock filled with fruit and a napkin with a pink lipstick kiss on it in a separate snack size ziplock. When he opened it to press his lips to hers, he caught her lemongrass, mandarin and sandalwood essential oils mix that she smoothed on every night after her shower. He was the luckiest man alive and he knew it. He put the special ziplock in his pocket for the long afternoon. He was going to need it. 

Jon arrived at the Alzheimer's wing and stood in front of the keypad to the locked unit.  It was like going through a magic portal to another world. He keyed in the magic numbers and the latch on the other side clicked. He took a deep breath and stepped through the Tardis door.

He headed straight to the nurse’s station to speak with Ms. Tyrell.

“You came back, Dr. Stark. I had faith in you. Not everybody is ready for all this. Sensory overload. Mental health overload.”

“How did you know?”

“That’s how I felt too. Only difference is I went through this with my Grandmother. We kept her at home as long as we could. I can still see my father changing her diapers. Huge tears rolling down his cheeks. All the while, she kept hitting him and yelling rape.”

“I’m sorry. This is all so new to me. It’s all been textbooks and lectures before now. I’m so thankful that my family is healthy.”

“It's ok. Grandmother Olenna is the reason I’m here. There are no heroes. Just people doing what they know they have to do. Please call me Marg. We try to avoid titles here. Just more confusion. You’ll see.”

“I thought about that. Yesterday, I just introduced myself as Jon. But, I was overdressed. I thought maybe khakis and a polo would work better. It didn't penetrate at the time. Then this morning, I realized you were wearing a pretty flowered dress instead of scrubs.”

“Yes, I want my people to feel comfortable. I’m just a friend dropping over for a visit to see how they are doing. A pretty girl in a pretty dress can get her way. Especially with the men, but that’s another story for another time. I have to continue my med rounds. Thanks for coming back, Jon. I’m here if you need me.”

Jon changed his clothes and walked into the large day room as lemonade was being served. Residents were sitting at round tables, some chatting at each other in non sequiturs and some chatting to the air.

“Bartender….” called a well groomed white haired man. Jon made a mental note to learn the names of all 20 residents immediately, if not sooner.

“Yes sir.”

“Lannister’s the name. Mayor of Lannisport, to you. Enough of this sweet shit. Get me a drink. Let my wife drink her lemonade, I need a scotch neat.”

“I do my best, Mr. Lannister.”

“And bartender, don’t let my wife catch you. She doesn’t want the children to inherit any of my bad habits. She doesn’t indulge.”

Jon walked quickly out the door and when in search of Marg. How did they deal with inappropriate and impossible requests? He was already fucking up.

“Marg, Mr. Lannister asked for a scotch. What am I supposed to do? He called me, bartender. What will happen if I tell him we don’t have any?”

“That’s your basic introduction to Mr. Lannister. He calls all the men bartender around this time in the afternoon. Oh, I don’t mean to laugh. We mix up some Diet Coke, a dash of bitters, and tamari sauce. Don’t forget he wants it neat! You’ll find the ingredients in the staff fridge. And be quick about it or he’ll be yelling for the bartender.”

“Thanks so much.” he said running off to attempt to create this concoction. He still had to pass it off to Mr. Lannister. 

“Mr. Lannister, here is your drink. Sorry for the delay.” Jon handed it to the old man with a shaking hand hoping it would mollify him.

Mr. Lannister swirled the drink around and then took a sip. “You pour a fine drink, young man. I shall keep my eye out for you.”

“Thank you, sir.”

Jon took that as his dismissal. He turned quickly and walked away. He had not seen Mrs. Gary in the day room. He hoped that she wasn’t sitting in her room waiting for her husband and baby. But, he had to go find out. He walked slowly down the hall to her room. With each step, he was seized with the idea of turning around and getting Mr. Lannister another drink. That would be easier.

Mrs. Gary’s door was slightly ajar. He knocked anyway.  Light was streaming in from her window and she was sitting in the rocking chair again. She made eye contact with him immediately and smiled. 

“Mrs. Gary, may I come in?”

“Of course. Tell me, has the crib arrived?

“Why no ma’am, it hasn’t. You selected such a special crib that it is still on order. Perhaps, tomorrow.”

“Oh, I hope so. My husband will be arriving soon and where will we put the baby?”

Jon looked around for the ottoman to the rocking chair so he could continue their conversation face to face, rather than tower over her. His goal was to be reassuring not imposing. It was against the far wall. He pulled it over and positioned it in front of her and sat down.

“Not to worry.”

“You know, when we first brought him home from hospital, I had to empty out a drawer and line it with towels. Now that we’re going to be back in Westeros for a while, nothing but the best will do.”

 “Have you been out of the country for a long time?”

“Just under 2 years. I insisted that our son be brought up near my family.  So here we are. Rather, here I am waiting. So much bureaucracy and paperwork.”

“Everything will work out.”

“Yes, I have a good feeling.”

“I realize you’ve hardly had time to settle in, I was wondering if you have made any friends?”

“Just you, dear. And the landlord’s daughter. She’s been so sweet. Such a lovely young lady. Dropping in to see how I’m getting on with unpacking. Are you the landlord’s son?”

“No ma’am. Just the caretaker.”

“Well,you are doing a fine job helping me out. Can you tell me how I can get telephone service? I have one in the bedroom, but there is only static on the line. I want to call my father. He doesn’t know I’m back. I want to surprise him. Especially, with the baby.”

“I’ll check on it right away, Mrs. Gary.” Jon responded carefully. He wasn’t sure how much of the delusion he should feed into. She was happy and he was determined not to say or do anything that would alter that. He had to check with Marg.

“I have to finish my daily inspection, so I must go. I’ll be back in a bit and I hope to have an answer for you.” 

Before he could get up, Mrs. Gary reached over and patted his knee. Her grey eyes met his and he could see the thin lines that were beginning to form at the corners of her eyes. He couldn’t tell if she was going to laugh or cry. She smiled.

“You just get going with your duties. I don’t want you to get into trouble for me. I’ll be right here. My husband will be arriving soon. And he’s bringing our son. Finally a family again. Thank you so much Jon.”

“I’ll be back, I promise.” he said and left the room pulling the door back into its original position. 

Wow, that was intense. The conversation sounded so normal and casual. Except that it wasn’t.

He headed back down the hall to the day room, where he heard a commotion. It was Mr. Lannister. This time he was not alone. He had a visitor. Must be one of his children. The man was tall and blond and had similar features. They were having a strenuous conversation.

“Bartender, where did you disappear to? That was the best scotch, I’ve had all day. Bring me another and one for my brother.”

“Dad, I’m Jamie. Not Uncle Kevan.” said the man. 

Jon didn’t want to hear that. He didn’t want to intrude on their conversation. Unfortunately, he would be documenting all of it in his clinical notes. He told himself to keep it in the professional folder on the doctor’s desktop he had created in his mind. He didn’t like to bring things home. Even though he could share anything with Sansa. He was teaching her how to set up her mental doctor’s desktop. She was better at compartmentalizing things than he was. He was fine on the spot and kept calm in the middle of any catastrophe. However, he was so self analyzing and critical of himself. Could he have done better?

“Bartender, our drinks.” Mr. Lannister was yelling now as his son tried in vain to get him to lower his voice.

“Father, please!”

“I’ll be right back with your drinks, gentlemen. Jon made a mental note to introduce himself to Mr. Lannister’s son. He didn’t want him to think that he was actually bringing him scotch. Well, he would realize it, when he returned with the concoction. He headed for the staff fridge and mixed up another drink. In the other glass he only poured Diet Coke.

“Here you are, Mr. Lannister.” He placed the Diet Coke in front of the son.

“I’m Jamie Lannister, much to my father’s objections.” said Jamie extending his hand to Jon.

“It’s a pleasure to meet you. I’m the new resident here on this wing.” he began and then corrected himself when Jamie gave him a quizzical look. “No, I mean….” Jon continued as he leaned in to shake hands and lowered his voice, “I’m Dr. Jon Stark. I’m finishing my residency working with Dr. Martell on his study.”

“I get it. You are just the kind of bartender we need at this establishment.” replied Jamie with an extra pump in his handshake. “Thank you for the scotch. My father is right. It's the best scotch I’ve had all day.”

“Fantastic. I’ll leave you men to your conversation.”

Jon went in search of Marg again. What was the answer to the telephone question? He could just picture Mrs. Gary trying to key in an old phone number. Of course, there would only be static. Or worse, the number was probably recycled to another landline and it would just ring and ring and ring. Nobody ever answered a landline anymore, if they still had one in their home. They didn’t even have one in their apartment. He knew that Uncle Eddard and Aunt Catelyn had actual phones at home when they were growing up. He and Robb had Bat phones in their rooms as kids. Wonder what ever happened to those prize possessions?

“You need to figure that one out for yourself, Doctor.” Marg laughed. “Besides you don’t have to give her an answer today.”

“I promised.”

“I don’t mean to sound harsh. She isn’t going to remember what she asked you today and she is going to ask you again tomorrow and the next day and the day after that. It's just the way Alzheimer's works. You’re going to have to make a paradigm shift. You have to get into their sideways world and make your responses accordingly.”

“Then, I can just tell her the truth about the telephone. It will take a few days to get any phone company to come fix a phone, ha!”

“You’ve got that right, just try getting new cable service….. maybe an appointment in 2 weeks.” laughed Marg.

Jon returned to Mrs. Gary just before he left for the evening. There was a tray of dinner, barely touched. She was watching some generic movie on TV.

“You came back to see me.”

“I promised I would.”

“So few people keep their promises. Even little ones.”

“I found out that the phone is going to take a few days to get fixed. Appointments and everything.”

“That’s ok. I’m not going anywhere. I’m waiting for the crib, Remember?”