The only thing that distinguished this particular examining room from dozens like it was the huge wall chart of hearts in all manner of disease and disarray.  The rest of the room was familiar and predictable – high narrow table sitting cattycorner, white enamel cabinets with boxes of disposable gloves and canisters of gauze in their proper places, a blue HazMat trashcan towering over a silver cylindrical stepcan, and pictures of steam locomotives on institutional mauve walls. My husband sat frozenly on the edge of the examining table, slowly putting the second button into the third buttonhole, his suspenders crumpled beside him like the useless straps of a window washer’s platform at the end of a shift.  I was squeezed into the single plastic chair wedged into the only available corner.  The cardiologist perched on the cabinet, casually swinging his custom-clad foot in time to an imagined beat.

 “Do you drink coffee and sodas?  Not any more!”

“Do you eat out? Not any more”

“Do you snack on nuts and chips?  Not any more”

“Do you eat ice cream after supper? Not any more.”

“Do you eat French fries and onion rings?  Not any more.”

The litany beat in my eardrums like an African drum warning of approaching danger.  What was the doctor saying?  Words were exploding like firecrackers around me. I couldn’t breathe.  The diseased hearts on the chart were sucking all the air out of the room.

“Stop.”  My voice was quiet but firm and it carried decisively into the continuing chant.

“Do you eat Mexican food? Not any more.”

“Italian?”  Not any more.”

“Do you eat bacon and sausage with your … Yes?  What is it?  Speak up.”

“Please tell me what’s happening?  Why are your telling us everything we can’t do?”

The doctor breathed a long, slow, trying-to-show-how-patient-he-was sigh. “Mrs. Payne, your husband has four major blockages in his arteries and unless he follows my orders, you’ll find him dead on the golf course some day. Now, you go back to the waiting room while we make the arrangements for surgery.” And he motioned for the nurse to escort me back to public spaces.

Random questions spun like whirligigs in my mind.  Was enjoying a bowl of rocky road after supper every night the cause of my husband’s heart disease? What about the hamburger I put down for enchiladas?  Should we cancel the birthday party with friends at the Chinese restaurant? Weren’t nuts healthy? And what was this nonsense about finding Bob dead on a golf course? He’d never set foot on a driving range in his life and he wasn’t about to take up that fool game at sixty-five. Vivid images pushed out the questions – my father’s death when bypass surgery succeeded but fragile arteries couldn’t handle the increased blood pressure; TV hospital dramas with Code Blue cutting through the background music as scurrying feet and menacing machines filled the screen: the middle-of-the-night phone call announcing the 4 x 4’s collision with a patch of black ice that totaled the truck and broke Dirk’s shoulder; the look on the faces of two parents as their child was taken behind heavy fire doors munching on a Mounds bar during my training as a counselor at the Orthogenic School in 1957.

****

The carousel horse smiled enticingly from one corner while the 10-foot Steiff giraffe peered wisely down its long neck from another.  A pillow encrusted couch and two stately wingback chairs crouched between the animal sentinels. Mother sat primly in the chair closest to the horse, twisting a linen handkerchief with a tatted edge nervously in her hands. Father paced rigidly back and forth in front of the fireplace located on the opposite wall. Although both hands were firmly clasped behind his back, the right one would occasionally escape his steely grip to slide horned-rimmed glasses up his patrician nose. A small, shrunken boy in blue shorts and striped tee shirt was standing quietly in front of the giraffe. His clothes were immaculate and not a hair was out of place. Even his fingernails looked spotless. One tiny hand reached out tentatively to touch the giraffe’s front leg.

“Peter, don’t touch. Come sit here beside me.”  The mother moved in slow motion to the couch and patted one of the pillows.

“Son, you heard your mother, now move!”  boomed the father, his hands thunderclapping in front of his body.

“Nonsense!” boomed from the doorway. “Let ze boy touch vat he vants to touch.  Dis room iss frrr de kinders as vell as frrr de parents.”  Dr. B. had made his appearance.  He must have looked like a troll who ate unsuspecting goats at they crossed fairy tale bridges. His body was bent from the atrocities of Buchenwald and Dachau.  Glasses with inch-thick lenses magnified his piercing blue eyes. His thick Viennese accent was commanding. Bruno Bettelheim was renowned among his professional colleagues for his pioneering work with autistic children, but he was viewed with considerable trepidation by parents seeking help for their deeply disturbed youngsters.

Gingerly lowering himself to Peter’s level, Dr. B. focused his entire attention on the forlorn child.  “It’s OK to touch.” His voice was suddenly as rich and mellow as a vat of chocolate. “Giraffes don’t speak, you know, but dey make very good listeners. Ze giraffe und I vill listen a bit. Zen, ven you vant, I get Helga to show you your new home.”

Without a moment’s hesitation, Peter hugged the giraffe’s foreleg with both arms slipping into the safety zone under the animal’s tummy. His hands followed the tree trunk legs up above his head to caress the soft underbelly. Suddenly, the timid boy, noted professor, and stately giraffe were sprawled in a giggling tangle in the middle of the oriental carpet.  Without thinking, the father grabbed the boy in one huge hand and tried to stand the giraffe upright with the other.

“What did your mother say about touching things,” he growled. “Now see what you’ve done.”

“Leafv de boy alone.” thundered Dr. B. “Don’t you hear his laughter? Tell me, ven did you last hear your son laugh?”  And a single tear cut another scar in his wrinkle-lined face.

“Zer, zer, Petre, it’s OK. Ze giraffe just vants to play vit you. Shall ve help him stand up so he can have a snack?  “With one hand, Dr. B. pointed to the green and blue leaves that seemed to grow on the ceiling and cascade down both sides of the corner where the giraffe lived. He stretched his other hand to the boy in friendship and assistance. Together they sank into the prone giraffe and pushed themselves to their feet. Then, with Peter firmly attached to the giraffe’s leg as anchor, Dr. B. slowly and steadily raised the new ally to his majestic height.

Turning to the father, he explained, “At ze Ortogenic School, ve do not touch kinders vithout zer permission.”   The glance to the woman almost lost in the couch pillows was accompanied by a curt, “Most mudders don’t cry ven their sons laugh.”  He returned his attention to Peter and the two were soon lost in an animated discussion of food that giraffes ea, and food that little boys eat, and how to guard against poisons.

At the precise moment when Dr. B. was reassuring Peter he could appoint his counselor as a taste tester, Helga appeared in the doorway.  She was an unimposing, pillow-soft woman in her mid-twenties with soft curls tumbling in twenty directions and eyes that matched the earth tones in her corduroy jumper. Around her neck was a hand-strung necklace of beads clearly created by a child and in her arms was a lacquered tin box piled high with miniature candy bars.  Nodding to the parents, she moved as silently as a giraffe to crouch beside Dr. B. and Peter.  “Hi Peter,” she crooned. “I’m Helga. I’m one of the people you might choose to be your taste tester. What a royal sounding title that is!  I don’t think I’ve ever been given such an important job before. Would you like to choose a bar of candy for me to test now?”

Peter cocked one wary eye toward his mother, his small hand making its way resolutely toward the Mounds bar just peeking out one side.  “No, Peter,” was the whisper-soft response.”  You know you’re not allowed to have candy before lunch.”

“Silence!” came the whipcrack.  “No laughter? No treats to help make a strange place more velcoming? Helga, I tink it’s time to show Peter vere he’ll live and learn the vorld is a pleasant place for kinders.”

Both parents stood, stunned with shock and disbelief, as Helga and Peter left the room sharing bits of Mounds bars and Hershey kisses.

****

I hadn’t thought about Dr. B. and my experiences working with autistic children for years – and now this painful scene – an example of the most controversial of his actions replayed in full Technicolor and Surround-Sound? Before I could begin to understand how this might be connected to my situation now, the door to the back offices opened and my beaming husband appeared.  His shirt was buttoned correctly, color had returned to his cheeks, and he was vigorously pumping the doctor’s hand.

“Sounds like a plan,” he agreed. “Next Thursday I go in for an angiogram and then we look at the repair job we have to do on this faulty pump of mine. I’ll bring that book on the mechanics of hydraulics I mentioned.  I think you might find it interesting.”  Turning to me, he beamed and said, “Ready to go?”

It was more of a statement than a question but I sat glued to my seat in total shock and disbelief. Here I had him at death’s door and he was talking mechanical engineering with the doctor.  In a corner of my mind, I was stopping at the grocery store to get chicken and some fresh salad greens for a healthy supper to prolong his life for a few more days and he was ready to race me down the stairs.  Slowly, painfully, I pulled my bones out of the too-soft couch and walked in a trance through the door he held open for me.  As we waited for the elevator, he continued to pepper my consciousness with words that barely made an impression.

“Yessir! I’m certainly glad Dr. C. sent us here.  This Doctor D. is a no-nonsense man who says what he thinks and knows what he’s doing. No namby-pamby hand-holding and equivocating around the bush. He comes straight to the point and tells it like it is. It hurts, sure it hurts, but it’s a nice, clean, sharp pain like the cut from a newly honed knife. And that means it will heal quickly too.  All a matter of physics, my dear.  Now, what’s for supper?”

****

What was I doing?  What could I be doing? I was pacing aimlessly through the quiet house, unable to sleep, unable to write, even unable to lose myself in my favorite books.  We’d stopped at the grocery store, fixed the chicken with wine and fresh rosemary so it wasn’t totally tasteless, read all the handouts the cardiologist had provided, and talked until the wee hours of the morning. Then Bob punched a spot for his head in his pillow, rolled over once, and started snoring his gentle little rolling gurgle. I breathed deeply and acknowledged each exhalation, imagined myself sitting beside a mountain stream, counted my blessings, and still couldn’t find a shred of relaxation much less the comfort of sleep. In quiet desperation, I finally got up to roam the house searching for answers. Now I was wearing out the carpet in our tiny living room. I shook the cat awake and answered my questions with a vehemence I didn’t realize I possessed.  I was working at holding my fears at bay so they didn’t overwhelm him and leaving our comfortable bed so he could get a good night’s sleep. Where was I in all this mess? Mary Ann: wife – confidant – lover – friend – where were they?  Left out.  That’s where I was – alone and lonely. I was lectured about what I could no longer do, patted on the head like a good dog, rewarded with pamphlets, and banished to the sterile waiting room while Bob and the doctor formed a relationship over charts and diagrams.  Was I supposed to pretend I wasn’t affected by this turn of events?  Go on with life as usual even though my internal world was pitching as violently as our house did during the Whittier quake?

The cat looked at me with her all-seeing eyes.  She was used to these nighttime disturbances and knew it the price she paid for living with an emotional human.  She blinked once and lifted her neck to be scratched. I stopped pacing and huddled under the down snug sack in my slightly sagging but oh-so-comfortable recliner.  My feelings were still frozen but tears were promising to break away. I was back in the doctor’s waiting room, humiliated at being excluded, too shocked to be angry, alone with my frightening thoughts.  Detail after tiny detail flashed before my eyes and then I was once again in the living room of the Orthogenic School in 1957.  I saw the connection I had looked for earlier.

This time I wasn’t the impartial observer watching from the doorway.  This time I was inside the parents’ skin. I was feeling their fear, their anger, their sadness, and their helplessness.  Wave after wave of mind-numbing emotions washed over me, tossing and turning my mind like a beach ball caught in the tide.  This time I was feeling the agony of seeing someone I loved walk away to a place where I couldn’t follow.

I remembered one night at the Orthogenic School with Dr. B. presiding.  Staff were crammed into double rows of chairs and couches squeezed into the tiny off-duty room for the weekly late-night meeting, resident counselors dressed in bathrobes and curlers.  Those of us who had just come off duty rubbed the sleep from our eyes, stretched sore muscles, and took off our shoes.  The environment was informal but the meeting was far from casual. Every eye was trained on Helga, Peter’s taste tester, who was alternately weeping and raving.

“I think he stayed awake just to manipulate me. He knows I have a staff meeting and he could probably guess I wanted to present tonight. He was just being mean and spiteful and refusing to go to sleep.  And after all the trouble I’m having choosing anniversary gifts for him. I just wanted him to _____”.

“Stop.”   “Stop!”   The hand was raised like a policeman’s but the words were surprisingly gentle. “Vat is going on here? Vy should a little kinder like Petre vant to torment a nice girl like Helga?  And his third anniversary just a veek avay.  Come now, let us put our heads together and figure out vat is going on here. You know ze question– ven vould you act zis vay?”

The box of Kleenex had made its way to Helga and after saturating a half dozen she was able to answer between sobs.  “When I was mad at my folks.  When they didn’t get me what I wanted for my birthday. Then I’d get mad and throw a temper tantrum and stop them from getting what they wanted.  Oh, and now Peter is mad at me because I don’t have the slightest idea what to get him for his anniversary – and he knows that – and –.”

“Slow down. Slow down.”  Again, the cautionary had was in the air stopping the flow of words and emotions.  Zat is a possibility, true, but I doubt it.  After all, you’ve taken good care ov Peter up to zis time and he hasn’t opened his anniversary presents to see vat a faker you are.  Somvun else, anyvun else, ven would you stay avake ven you knew your parents vanted you to go to sleep?”

“When I was thirsty.”

“When I was scared of the monsters.”

“When I wanted to hear what they were saying.”

“When I need to go to the bathroom.”

“When I wasn’t sleepy:”

“When I wanted to finish the chapter.”

“Exactly, you stayed avake for your own reasons, not to torment your parents. Und all of zose reasons ver gut ones.  Ze all deserved to be treated seriously. And vat did you vant from your parents?”

“To be heard …to be cuddled … to be noticed … to be included… to …”

“And how did ze do zat?”

“By listening … by cuddling… by getting me a drink of water … by telling me they’d see me again in the morning … by looking under the bed … by …”

“Exactly, and now Helga, you’re a smart girl. You know zese answers. In fact, you’ve done all these tings and more, right?  Vy couldn’t you tink of zem tonight?”

“Because I was so tangled up in my worries about what to get Peter for his anniversary.  Because he HAD to go to sleep so I’d have time to talk tonight.  Because I HAVE to have answers about what to get him.”

“Your needs, not his, nein?  And so you try to get in your parents’ heads instead of trusting you own good, common sense.  So?  Ven did Petre go to sleep?”

“When I listened to him, and got him a drink of water, and sat beside his bed, and told him I’d see him tomorrow morning at breakfast.”

“So, you do know vat to do to help a child go to sleep peacefully. I said you vere a smart girl. Now, vat are you going to get Prince Petre for his anniversary?”

“How should I know? We haven’t had a chance to talk about it yet.  I need your ideas.”

“Vat?”  The word exploded in the air and sent visible shock waves through the staff.  “Ven vill you learn vat you already know?  I don’t have ze answers. YOU have ze answers. Tink – and  feel – and you will know vat is right for you to give Petre!  Staff meeting iss over.  Ve haff vasted enough time on your foolishness.”  And with that, Dr. B. moved determinedly from his chair to his office across the hall.

The room was quiet.  Anne Marie got up to get sandwich fixings and brownies out of the fridge, Stephanie set out coffee mugs for cocoa, and Helga wept quietly with her box of Kleenex. We knew better than to offer suggestions.  We knew Dr. B. had ears like our mothers’ proverbial eyes that could see and hear the tiniest movement or sound. On a deeper level, we also knew he was right. Only Helga had the answer to her question. Only Helga had established a tenuous but strong relationship with the silent boy who loved giraffes. Only Helga knew what would best express her care and concern to her young charge. Peter would recognize her love and be strengthened by it – and next year, the agonizing process of choosing the “right” gift would be easier.

The sun was peeking through the curtains. My box of Kleenex had soaked up the Nile, but I had learned again that the answers were within me. Bob was in good hands with a doctor he trusted.  He would be all right. I was a smart girl and I knew how to care for someone with love and respect. If I listened to myself, I’d know what to do when it was time to do it. I’d already fixed chicken a “heart healthy” way. I could fix French toast with Egg Beaters for breakfast. Then I’d throw out all the old cookbooks that didn’t have nutritional information and treat myself to the new one I’d been wanting to buy.  Next week, we’d go to The Thinnery and choose desserts we could enjoy with friends.  And next year, I knew exactly what I buy for Bob’s heart’s anniversary gift.