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Immediate relations?

Albert shook his head at the doctor. No relations.

Then allow me to invite you to join us here at Camelot, said the chief resident. Albert stared back at him. None of the nurses laughed. The chief resident’s hapless witticisms were an endless source of embarrassment for him, yet he couldn’t stop himself, and he thought of the ways he’d injure himself later, when he was home alone with his alligator clips and lighter. Admit ’im, he said, before thudding off to another failed interaction with the rest of the species.

Once the hands went away, Albert tried to bring his thoughts into focus. If his brain was a collection of millions of tiny light bulbs, and if certain bulbs lit up in sequence to indicate certain actions that were to take place, the series of bulbs in his brain assigned to light up when it was time to enact his plan were, at best, faulty. All his bulbs were faulty. Their sockets were rusty, their filaments carbonized. They lit erratically, if at all. By the time his comedic failure of a doctor admitted him, half of his bulbs were burned out. The other half could barely get it together long enough to form an unbroken beam pointing to the Hudson River, his final destination.

The problem with so many bulbs having burned out was that the bulbs that did work had to pull double-time, which meant that when he tried to remember his plan, bulbs that had nothing to do with the plan lit up, just trying to help out. Lying there on the examination table, he wondered: What happens next? And, seeing that the plan bulbs were as dark and unexcited as jars of molasses, the bulbs in charge of remembering a case he tried in Germany in the 1940s, just pitching in, just trying to be good neighbors, would light up, and he’d be back in Nuremberg, time-warped, which was not where he wanted to be at all.

Constant use had preserved a few of the most important bulb sequences, but he was down to only a handful of those, which meant that the same old memories kept coming back to him no matter what he was trying to think of. The most common was the memory of his grandson, and when that sequence lit up, it pointed at the first step of the plan. That first step never failed to light bright and true. It was a bulb that said it was time for Albert to die.

From there he could piece the plan together, but it was a laborious process, and because of his rusted-out jalopy of a brain, he’d have to re-create the plan from scratch every single time the memory of his grandson relit, which was about fifty times a day. Thus, for the last week he’d spent entire days conceiving and reconceiving the plan. Sometimes he’d think to write the plan down, but even an hour later, the sequence of events would make no sense to him. Oddly enough, from one reconception to the next, the plans were strikingly similar.

The plan was this: Escape the Apelles, where the doormen were paid extra to hold him captive, by introducing an irresistible force in the form of a medical emergency. He would then escape the hospital. Finally, he’d make his way to the Hudson, where he would drown himself.

Albert had several bathtubs in his apartment. With minimal effort he could have drowned himself in any one of them. He also had at his disposal an assortment of curtain rods, doorframes, and an exposed hot water pipe that ran parallel to the ceiling in the kitchen from which he could have successfully hanged himself. He had drawers full of knives. Merely by asserting that he was having trouble sleeping, he could have accumulated enough sleeping pills to finish himself off. And while the doormen would not allow him to take the elevator down and exit through the lobby of his building without a minder, no one would stop him from taking the elevator up, accessing the roof through one of several fire doors, and effecting his best swan dive onto West End Avenue. But no. He intended for his death, an escape from the comfort of forgetfulness, to meet certain requirements, topmost of which was that he die as his grandson had died.

Besides, remember that his plan, so heavy on escape and deception, was formulated in a brain with half its bulbs burned out.

Operationally speaking, so far, so good. He was wheeled out of the ER, down a bright hall, and onto an elevator. His shirt hung open still, and as the car shuddered up the shaft, he endeavored to close it, blindly feeling his way up and down the placket and inserting buttons into whatever hole he happened across, in the process creating an innovatively disordered pattern in the fabric, something out of a differential geometry textbook or a dressing guide for drunks. To Albert’s right was a nurse, to his left an orderly, a skinny white man with a lump of quartz for an Adam’s apple. The nurse looked down at Albert briefly, looked at the orderly, and moved her mouth at the corner to register amusement. The veins in the orderly’s ropy forearms bulged against his muscles and ligaments, vulgar, penile. Albert turned his face away. Obviously the man was an addict. The elevator hitched at the seventh floor and the doors rattled open. The orderly rolled the gurney out, and here Albert took care to mark the location of the elevator, the nurses’ station. One wheel was doing that damn spinning thing, floating millimeters from the linoleum, catching, pirouetting, catching, pirouetting. Concentrate, Albert thought. They entered Room 733 and the orderly docked the gurney alongside the bed. Albert pushed away the man’s awful veined hands when he tried to facilitate the transfer to the bed.

Do you need help? the nurse said, holding out an oversized wafer of green paper. The druggie left with the gurney.

I do not, Albert said, snapping the gown from her hands. Whether due to his brief and harsh childhood or unbalanced neurological chemistry or a simple unwillingness to part with the warm comfort of selfishness, his reaction to offers of help had always been the same: a petulant outburst, a denial of his own human needs, a refusal to admit that he found comfort comforting, or that he experienced helplessness, or that vulnerability of any stripe could survive in the arctic environment of his heart. Such had been the state of his existence. Offers of union to which he responded with rocket fire. Kind words torched as they floated, delicate as butterflies, from the lips of admiring young associates. Gestures of friendship splashed with acid.

He couldn’t keep up with his thoughts anymore. He was flailing, drowning in a sea of his own worst impulses. He’d nearly lost his ability to strategize.

Nearly. It hadn’t disappeared entirely. He stopped his hands, yet again working at the buttons on his shirt, as it had occurred to him to make an ordeal of the task. He plucked weakly at one mother-of-pearl disk until the nurse moved to help. Again the hands, oh, the hands. A flash from a memory that had not yet rotted away: He was eight and his cousin Sadie was absently scratching the back of his head while they sat out by the edge of the field watching dust devils, his scalp buzzing beneath her fingernails. That she meant nothing by it transformed the act into an exquisite experience, and he understood even then that her disinterest lent her touch all its power.

The shirt’s cuffs had three buttons each, thin nacreous disks that required the nurse to cup his hand against her wrists while she manipulated the closures. Getting all six securely closed was among Albert’s daily triumphs. The cuffs required a wife, or else ambidexterity on the order of a card sharp. Her hands lingered as she struggled with them. Her bottom lip disappeared between her teeth. Well, I don’t know about this, she said, shaking her head. Albert was in ecstasy. Then she caught on to the method, a crumpling of the fabric that opened the eyelet enough to push the button through, and the cuffs were open.

There we go. Up now.

He rose slowly from the bed, venturing to rest his hand on her shoulder as she helped him off with his pants. He was wearing white cotton boxers with blue pinstripes, and when he inserted his thumb between the elastic and his bony hip and began to pull them down, she said, It’s not that kind of party, Mr. Caldwell.