- Jan 23, 1993, 6:30 a.m.

My room is a 4 bed ward, lodging two others and myself.
One is Harvey, a man in his late sixties or early seventies, in because of a hip injury. His mind is gone. He seems to be in a stupor most of the time, caught in some dream-like state, from which I overhear one-sided conversations, either from active dreams, or glimpses and flashes from his memory.

None seem to be oriented to specific topic or subject. It seems as though they are quick snapshots or mini-vignettes. It appears that they are from every day conversations. For example, he may say something like "Let's just move them over to that side." or "hammer it down tight." or What's her name? what's her name? what's her name? Are they flashes from memories, or is there a series of contiguous events rolling through his head? I think they are just flashes in a stupor. These utterances, carry on through the day and night, usually lasting for about five to ten minutes, interspersed by what I take to be sleeping periods.

The other man is Joe. He is in his eighties, tall, thin, and frail. He is what one would consider "bald-on-top". His hair is long, white and flowing on the sides of his head, and he looks like a bedazzled professor. He is here because someone tried to mug him and he fought back. His hip was fractured, he arms bruised where he was grabbed. After the attack, while being treated for his injuries, Joe suffered a stroke, most likely as a direct result of the efforts to repair his hip.

I talked to Joe during the evening that I arrived. He is sharp, but because of the stroke, is sometimes confused. He is an attractive person, in that one wants to talk to him, to gain the wisdom that age brings.

He was beaten by some thing which lives among us disguised as a youth or young man. I find it hard to even think I could understand how someone could be rough with such a beautiful old man. The mind of the mugger could not have had an ounce of love in his whole being, not even a gram. I find it almost impossible to believe, but yet know that people like that really do exist, and I wonder how they became that way, and what the world looks like from the inside of their head.

It is interesting to be in a room with these two men, because I get a chance to ponder what is going on in all of our heads. Harvey does not initiate communication, but will react to it, but the span of attention is short, and centres around the immediate issue, such as feeding, or changing a dressing, or turning him in his bed. He is most direct and clear when he either in pain, or thinks that what the nurses are doing might cause him pain. Then he speaks in full sentences, saying things like " NO, don't turn me... leave me alone.. you’re hurting me.

Joe initiates conversation, seems to drift in and out of himself. He is concerned about his confusion, and admits that he sometimes forgets where he is, he says that sometimes he thinks he is in Timmins, or Kapuskasing, or Kirkland Lake.

I'm not sure if he remembers the attack. In our conversations, I have asked him how he was hurt. He says he fell, and he will move to a description of the injury, it's a fracture, and then he trails off into himself with a puzzled look on his face. Only once did he acknowledge that he had been attacked, and it was in a statement of amazement and disbelief that someone could do such a thing. It seems that he cannot believe that anyone could do this to him. It may have been so terrifying that he does not want to deal with it, or the stroke could be the cause of the confusion.

Sometimes during the quiet parts of the day, and at night I hear him crying silently to himself. I don't know if he is afraid, or if this is just sadness as he remembers his life. I want to go to him then, but resist because I don't want to embarrass him. I usually talk to him later and let him go where he wants, sometimes directing the conversation, other times exploring by prompting. Yesterday he had solid food, the first time in a long time. He had been on clear fluids, Jell-O, and ice cream. Since he has eaten, he seems to be more in the real world, although I did not spend any real time with him yesterday because I had just come out of surgery, and I had visitors. I will talk with him today.

I learned a lot during this stay, I never knew how alone one could feel, being wheeled on a gurney to an operating room. There is a short period of time when someone new, someone strange, walks in the room pushing the gurney, and asks you to get on. There is a short period before a personal relationship exists where both the patient and the staff are nothing more than beings, or machines, animals. That is when the loneliness appears, because one is being taken into the unknown, by an unknown, and there is the silence of impersonal jobs and job functions being carried out. There is also a sense of complete loss of control, that you are totally not responsible for yourself, that your life is truly in the hands of those in the operating room. It is then for a brief second or two that you realize that there really is a possibility of these moments being your last awarenesses. I also found where my thoughts went on becoming conscious; they went to my children, Laura and Allan.