We've Never Had This Day Before

I remember the moment I figured that out. I couldn't have been more than four or five at the time. I was on the back porch of my grandparents' cottage, hanging out with my grandfather. By "hanging out," I mean "prattling about things that are perfectly obvious to everyone but five-year-olds while Nonno was trying to read the paper." Nonno and I "hung out" a lot in those days at the cottage: I was younger enough than my siblings and cousins that having to include me probably sucked the fun out of whatever it was that they got up to, and I had a range that I wasn't supposed to stray beyond without being with someone else. The beach and the local candy store were outside my proscribed range. What was left was digging through the basement for interesting toys discarded by my older cousins and bothering my grandfather. (Now that I think about it, I don't know where all the other adults would have been at the time -- I guess if all the kids and cousins were busy entertaining themselves, they were probably napping. I wonder why Nonno never found refuge in a nap? Maybe because I was bothering him. If he were still alive, I'd ask him.)

Anyway, I was left with a lot of time to think things over as a little kid, and I remember the day on my grandfather's back porch when it occurred to me for the first time that even though it was Tuesday, it wasn't the same exact Tuesday as last Tuesday, and that next Tuesday won't be the exact same Tuesday as this one. I remember sharing this with Nonno, really marveling at my new, more sophisticated understanding of the universe, and being sort of disappointed and frustrated at how underwhelmed he seemed. "But Nonno, it's a totally different Tuesday!" trying to impress upon him that I had just figured it out. Right that minute. All by myself!

We never had this exact day before.

I remembered this at some point during my day today in the Nuthatch for a couple of reasons. First, hospitals run on routine. The cast of characters may change, but the order of show does not. Everyone -- staff and patients -- depends upon it. So it's pretty easy to become inured to the fact that this is, actually, not the exact same Saturday as the one before. It's a new day and new things can -- and do -- happen every now and again.

But also, in that moment on the porch, I actually had made a pretty important step in my cognitive development. It was an instance of very ordinary genius among many, many instances of ordinary genius that about every healthy, normally developing child will make. My understanding of the universe had actually become more sophisticated and my five-year-old self was probably right to be impressed that growing human brains stumble upon this sort of wisdom each and every day all by themselves.

Adults in many ways are just big children, and maturation isn't something you just do once and are done with -- it comes and goes with the circumstances. One of the ways we assess mental health is by trying to observe how mature or sophisticated or flexible someone's reasoning is (which is why you should be concerned if someone in a white coat starts asking you questions about things like what you would do if you found an addressed, stamped envelope on the ground near a mailbox). Assessing cognition against a developmental yardstick can give you some clues about someone's mental health at that moment.

This is why you don't hear a lot of patients in psychiatric hospitals make jokes. Not because psychiatric patients don't have senses of humor, or because they are too morose or catatonic, but because the ability to form and then tell a joke (as opposed to simply saying something humorous)is a pretty sophisticated maneuver, cognition-wise. And if you're in a state of decompensation that requires you to be locked in a psychiatric hospital, your sense of the relationships between things and between people is not likely to be as finely-tuned as it might. It's so rare, that I can think of only one time, in six or seven years, when a patient told an actual joke.

Until today. Given all of the above, I hope you'll forgive me that I laughed out loud at this from a guy in a wheelchair, "Hey, I'm a sit-down comic!" after a few of us chuckled at something merely funny that he had said. And, as my laughter subsided, he turned to leave, saying, "That's my time -- you've been great! And don't forget to tip your waitress."

Ok, he didn't actually say that last part, but I really wish he had.

(Bonus points to careful readers -- Hi Mom! -- who remember that I've already posted about the other time a patient made an actual joke. I'm repeating myself, I know. No need to point it out.)