Curtis and The Critical Cog

He turns the creature almost imperceptibly, with the slightest tremor. His fingers steady as he brings the knife to its throat. He now is intently focused, and fails to register as the first, second, third droplets splatter into the folds of his trousers.

Gradually, it becomes. It ain’t about speed, Pop pounded home time after time. Careful strokes, the pare, the push, the pull; let the grain, the knots, the imperfections guide you.

Mr. Bronheim?

It’s one of THEM, the one who brought him the dry chicken, the yellow gravy, the peas, the pills. The big one. Behind him, an Indian got up like a doctor. Dot-not-feather, He chuckles. The big one just stares as he takes a step into the room.

The other colored guy places a hand on his arm, gently pulls him out of the doorway. There’s a gun on his belt, like Pop’s keepers at Joliet. His gnarled fingers tighten on the knife.

Mr. Bronheim. This time, it’s the Swami. What have you made there? He’s dropped it on the spread, and now displays it, thumb and forefinger.

Amazing work. Did you do the feathers yourself? May I see, please? Where did you learn such a thing?

It’s about supper. Big Jim now. You want me to put your tools away so you can wash up?

He smiles, flips the jackknife the way Pop taught him, safety first. Am I going home?

The smile vanishes as the second colored fellow again restrains the bigger man and steps in. Nice knife, right? ‘RB’?

My Pop. Warily, but He allows this one to examine the Case Redbone. That’s when he spots the blood, on the spread, on his trousers, on the fake wood next to his bed. He inspects his calloused hands for cuts – Pop would have whupped him good for such carelessness. Despite blood turning to rust in his whorls and creases, He’s uninjured. Relief floods his face as the colored man carefully tucks the knife into a plastic bag with gloved hands. Then anger flushes his features.

That’s mine, He says, voice trembling now, adding a single word meant to draw the thief up, to let him know who was running things around here.

The man only glances up with a smile. Luckily, a policeman, white, enters the room, and He wobbles up to get the blood off his hands and some food in his belly. Chicken today, He seems to recall.   

**

“I thought it’d be like therapy,” Jeff Bronheim mumbled, trying to shrink into his broken green recliner. “Whittling always seemed to, uh, to calm him down, and maybe it might help his memory, though it’s pretty much moths flappin’ around up there these days. I just didn’t see any harm…”

“In giving a man who can barely remember his own name a knife in an Alzheimer’s center,” Curtis said.

The banty little redneck had that expression Det. Mead had seen a thousand times before, as grand marshal of Millington’s glorious and endless Parade of Felons, Fumblers, and Fuckups. Stunned surprise that inevitable consequences had landed on schedule; vague guilt tempered by calculation, bloodshot eyes darting about looking for a legal, a moral escape hatch.

“Your dad stabbed the man in the next room, went back to his own room and carved a bird out of a block of wood the same genius who supplied the jackknife probably gave him.”

“It was Granddad’s.”

“Ah, backstory,” Detective Mead nodded. “So your dad, he’ll probably get sent to the Packard Center in Springfield. You, now – if bone stupid’s not a mitigating factor, you could be facing negligent homicide or involuntary manslaughter.”

Bronheim the Younger looked to his sweating Code Red Dew for illumination. “So, who’d Dad kill?”

“Nice you should ask.”

**

“Have you ever read Elizabeth Kubler-Ross?”

“Five stages of death lady,” Curtis supplied, courtesy of Final Jeopardy. “Denial, anger, depression, acceptance, and I missed one, didn’t I?”

“Bargaining. Usually happens between anger and depression – you try to barter with God, fate, the universe for another year, another month, another week.” Dr. Saraj Patel eased back in his office chair. “You get the same stages with dementia patients. But in the case of our residents, it often manifests in more complex ways. Many hopscotch through the stages out of sequence as memory flickers in and out. Mr. Bronheim transitions on an irregular cycle between cheerful denial, unresponsive funk, and colorfully racist rage.”

Curtis smirked. “And Mr. Sheppard?”

“Mr. Sheppard was actually a quite pleasant man –he was in his own way philosophical about his situation, what he could understand of it. He told me more than once we were but small cogs in the universe, that our fates were not our own. I believe he was at a stage of acceptance.”

“On less metaphysical grounds,” Curtis murmured, “where were your folks when the existential Mr. Sheppard was getting murdered?”

Patel sighed deeply. “It doesn’t happen often, but we’re guessing a visiting family member must have accidentally supplied a resident the front-door keypad code, and we were forced to call a Code Gray – an emergency patient count and an all-hands search for Mrs. Dalby. Marcus personally looked in on both Mr. Bronheim, who was napping, and Mr. Sheppard, who was absorbed in a Cubs game. All I can suspect is that in the ensuing, well, chaos, Mr. Bronheim for whatever imaginable reason stabbed his neighbor. We’re now reassessing emergency protocols.”

“Prudent.”

**

“Shit, I lost it with every old racist in this place, I’d wind up, well, here,” Marcus Compton barked, peering in the breakroom microwave. Satisfied the burrito was on a trajectory toward success, he turned back to Curtis. “Now, Wilton – Mr. Sheppard – he’d get flustered when he’d get ‘lost,’ you know? But he was friendly, didn’t order me around like it was 1825, didn’t bitch about the food – fact, said he liked it, which to each his own, you feel me? Patel would freak out if he heard a nurse tell you this, but I really do think he was getting better. He’d start talking ‘bout the Cubs, remembering things from his childhood, I guess. Said he didn’t eat too well, didn’t get enough veggies and shit. Which is sorta weird, because he was like kinda rich, right?”

Curtis frowned as he sipped his inadvertent cold brew. Keurig hadn’t reached this rung of the health care system. “Sheppard Appliances. Daughter runs things now.”

“Yeah, ain’t seen her so much lately,” Marcus said neutrally. “The husband seems more like blood – even watches a game with the old man once in a while.”

“Mm. What’s your take on Bronheim? You ever see the two of them go at it?”

“Nah, maybe they argued in the dining room one time, probably over the Cubs. You saw what the old guy carved – cardinal. Probably a St. Louis fan at some point. They talked sometimes, but then Wilton had his fall, and after he got back from the hospital, he kinda stayed to himself.”

“Hospital? When was this?”

“Oh, maybe three weeks ago. Didn’t break anything, but he coded at the St. Mark’s ER. Caused some kind of ruckus there, I guess. Trauma and hospital craziness adds a whole other level for these folks.”

“And you said Bronheim was sleeping and Sheppard was watching the Cubs when they called the code on the Dalby woman? Sheppard say anything?”

“Back was to me – into the game, or just dozed off.”

Curtis perked. “Any idea who gave Mrs. Dalby the passcode out?”

The nurse shrugged. “Ever heard the expression, herding cats?”

**

“I’d call it a deathbed declaration, even though it turned out premature.” Dr. Grolson was cordial — only one of the ER stalls was occupied. She nonetheless continued to peek toward the LED clock over the nurse station.

“Mr. Sheppard was aggravated when they brought him in, but calmed down pretty quick when we explained he only had a sprain, and one of the other patients had an episode while we were waiting for family. When the LPN came back, she found him circling his chart.”

Curtis nodded at an old woman with a purple blossom over half her face. A grimace emerged through the bruises. “What did he circle?”

“The whole thing — the whole form, and when Terese, the nurse, tried to take it away, they got in a tug-of-war. Then, a few minutes later, he suffered a cardiac episode, and while we were trying to get the cart in place, he started yelling. Same things over and over -- ‘table,’ ‘leader,’ and, oh yeah, ‘eagle.’ Delirium, I’m guessing. A distressed brain in aggravated distress..”

“But his recovery went all right?”

“Shipped him back to Sunrise Center after four days of bedrest and monitoring.” The physician winced. “Didn’t mean that to sound so insensitive. About to go off a double shift, and I guess my brain’s a little distressed, too.”

Curtis felt her.

**

The truck was stationed on the fringe of the Kohl’s lot today, and social media and a recent network reality show had attracted a swarm. Curtis as always got table service, and as A Little Bite of Soul’s lunch line winnowed out, his nephew dropped a second order of burnt ends on the aluminum table and his butt on the bench opposite.

“You think?” Anton inquired, wiping a spec of sweet and spicy off his glasses.

Unable to articulate for the moment, Curtis nodded vigorously. The cop swallowed, and jerked his chin toward the freestanding whiteboard menu. “Little pricey for scraps, maybe.”

“Lowball the customer, they feel like they’re getting scraps. We’re As Seen On TV now. Which speaking, saw you on 25 last night, at that nursing home on West. Some grizzly shit, huh.”

“Memory care center,” Curtis said, pulling the fresh brisket cuttings closer. “Yeah, got some problems there. Chris – our tech, you met her Labor Day? She says from the angle of the knife thrust that killed Mr. Sheppard, the blow was from behind. Over his shoulder and backward thrust straight in between the ribs while he was watching the Cubbies. Remember how tall Sheppard was on those old commercials?”

“‘At Sheppard’s Appliances, we never forget a customer!’” Anton declared.

“Yeah, irony wasn’t lost. So, did you see Bronheim, the suspect?”

“Looked like one of those Keebler elves – ooooohh…”

“Yup. Lemme give you a word association test. What do ‘eagle,’ ‘leader,’ and ‘table’ mean to you?”

Anton took a sip of his Coke, squinted toward the one remaining mall anchor across the lot, and snapped his fingers. “Eagle Leader. It’s a game – you remember Cousin Marcus, was in the Navy? He plays that shit. Like, NATO against the Russians or something.”

“Didn’t strike me as a gamer.”

“One of those games you play with yourself. All kinds of cards and strategy maps and modules and stuff. A table game,” Anton said significantly. “Your little homicidal elf strike you as a gamer?”

“Marbles, back in the Depression, maybe,” Curtis suggested. “Hey, you call your grandma lately? She asked last week.”

“Took her some lunch at the nursing home Sunday. Where you think I got the idea for the whiteboard? Though theirs was three days off.”   

**

“Yeah, sure,” the doctor conceded, a little too briskly, a little too loudly, with more than a hint of exasperation. Curtis smiled patiently. “There are other potential physical causes, though dementia isn’t uncommon in a man of Wilton Sheppard’s advanced age. An abnormal buildup of cerebrospinal fluid in the brain, nutritional deficiencies, exposure to toxic lead levels, Huntington’s Disease, Creutzfeldt-Jakob...”

“Mad Cow?”

Curtis could swear he heard the pharma pen crack slightly in Patrick Logue’s plump pink fingers. “Bovine spongiform encephalopathy is also a prion disorder, but a separate condition. We’ve also seen a few cases of chronic traumatic encephalopathy, but mainly in cases of more extreme elder abuse. Mr. Sheppard’s daughter and her husband have been dedicated caretakers. Terry – the son-in-law – accompanied Wilton to his appointments and took meticulous notes, which I have to say is unusual for a non-blood relation, and Jana and I have gone through every detail, from exercise and diet to routine self-maintenance. There were positively no signs of parental abuse, and it’s not exactly like they live in some… hovel…with lead paint or old pipes.”

“You check that other stuff? The Huntington’s and the brain fluid, any of that?”

Logue took a heavy, meaty breath. “You’ve certainly heard of HIPAA. Patient confidentiality doesn’t end with the patient’s death, you know. You can get a court order if you want…”

“Or we can just talk in theoreticals or whatever language makes you most comfortable and helps me figure out what happened to your patient. Under ordinary circumstances, with a man of Mr. Sheppard’s advanced age and, uh, situation, you run all the traps? I can go right ahead and get that court order, you wan—“

“Look,” the physician finally appealed, quietly. “I ran a standard cognitive test that pointed to more rapid memory deterioration, and I proceeded from there. There were no indicators for Creutzfeldt-Jakob or history of Huntington’s. Detective?”

Curtis blinked. “Sorry. Wonder maybe you could walk me through that memory test you gave Mr. Sheppard? My mom’s getting on, and I’m curious.”

Dr. Logue seemed relieved by the transition, and drew a sheet of blank paper and a pen from his desk. “Gladly. So first, I’m going to give you three words to remember...”

**

“It was all that talk about how we’re all just little cogs in the universe, in the scheme of things,” Curtis said. “I got to wondering what put that bug in the old man’s head. You ever hear of the Mini-Cog?”

A veiled spark only a seasoned cop might detect, though Det. Mead conceded nobody here was taking home an Oscar or even a Tony unless they broke into some Andrew Lloyd Webber real fast. “Not familiar. Only medical stuff I know is what I see on Good Doctor or Chicago Med.”

“Quickie Alzheimer’s test, mainly for short-term recall and how your brain’s processing, uh, stuff,” Curtis smiled. “Doctor named Soo Borson – S-O-O – came up with it. You ask the patient to remember three words, then have ’em draw a clock set to a specific time. When the patient gets done with their little art project, you ask them to recall their magic words.”

“Like I said, not familiar.”

“Yeah, I know. Here’s the thing, though. How’d you know the Mini-Cog was ‘medical stuff?’ Sounds more like something you’d go to the Ace for when the sump pump’s on the fritz. And you ought to know, because you sat in on your father-in-law’s Mini-Cog test with Dr. Logue. Shit, your wife asked the doc to do a dementia test during his exam. Dr. Logue said you were very attentive during the whole thing, thought you ought to get some kind of trophy for best son-in-law.”

“Well, he’s family,” Terry Erlach grinned. Self-deprecatingly. “Jana would do it for my mom or dad…”

“Seriously?”

“What?”

“You don’t recall the test that basically put Mr. Sheppard on the road to the Alzheimer’s ward?” Curtis inquired. “You kind of suck at this, you know?”

“Suck at what?”

“You didn’t recognize your father-in-law’s dying declaration? Well, almost dying declaration? Dr. Logue doesn’t like fucking with HIPAA, but when I played his little memory game with him, I think he saw where I was going. That circle your father-in-law drew on his ER chart? Gonna bet you that was a clock, and he infarcted or whatever before he could draw the hands and 10 and 5. Dr. Logue doesn’t like to tax his own memory, so he sticks to the same time – 10:25 – and the same three key words – eagle, table, leader. It was the most important thing to Mr. Sheppard at that point. He’d remembered.

“Now, why in the world was that important when for all the man knows, he’s about to shuffle off this mortal coil? A point of pride? The last word? Or maybe your father-in-law knew he’d been bamboozled, that you and Mrs. Erlach had hustled him into the Center on false pretenses. Now, I don’t know much beyond what I see on Chicago Med, either, but I can Google like nobody’s business. Exposure to lead levels, dietary deficiencies like a severe shortage of folate, Vitamin B9, from leafy greens and grains – lotta things can look like dementia or Alzheimer’s, and if you want to get an old man out of the way, lotta ways to fake a diagnosis.

“Personally, I’m betting on the folate thing – Dr. Logue said once you theoretically take Alzheimer’s off the table, Mr. Sheppard showed several symptoms that might be due to a deficiency. He seemed depressed and weak, talked about headaches, had a couple mouth sores, and Logue even spotted some warning signs for colon or pancreatic cancer. And his irritability, the anger – that’s another symptom you’re not getting your daily folate. Dr. Logue confirmed your father-in-law’d never had Crohn’s disease or celiac or anything like that can fu--, ah, impede your folate absorption. Prolly easy enough to tinker with his diet – when what’s good for you, well, tastes ‘good for you,’ you tend to not ask questions.”

“Why would I – we – why would his own daughter do something like that?”

“Damn. You about dislocated yourself there. And, again, seriously? Thing is, when the ER doctor told you what Dad’d done, what he’d said, you knew whatever you two’d done to him was wearing off. That somebody just might listen to what he had to say if he showed a miracle recovery. But what were you going to do in a hospital? You had to take your chances and wait ‘til they moved him back to the memory center to shut him up. Sunrise Center was understaffed, you’d seen Bronheim whittling his little birdies, so you created some chaos of your own and—”

“It was all Jana’s—”

“There it is,” Curtis proclaimed. “Hold that thought.”