“One hundred!” Bumi shouted. “That is the wrong number.” He shook his head.
Fourth, a woman who conducted an elaborate series of ritual body movements associated with life’s simplest activities: walking down the road, entering the house. If she did them wrong she would get stuck.
“Crazy,” Bumi said.
“It’s kind of like you, though,” I said, more easily than I could have to my sister. “With avoiding all cracks and the thing you do with your chin and elbows.”
He smiled awkwardly and I pressed forward to what I expected to be more controversial: a man who was convinced he would be blamed for crimes he did not commit and a woman so obsessed with environmental contamination that she had a plastic seal placed over every millimetre of her home and refused to go outside. She had supplies delivered by her husband through a series of sealed antechambers.
“Totally nuts,” Bumi said.
“They don’t remind you of yourself?” I asked.
“The first two, yes,” he said, his voice cracking slightly. “I thought I was the only one.”
Bumi’s acceptance that he might have OCD came easily, and his desire to learn more and treat it was strong. The obstacles that remained were his lack of legal status and his legitimate fear of deportation. “I have no health card,” he said. “No ID. No nothing, here or anywhere. I am dead at home, illegal here.”
“A lot of illegals, I mean people without status, get medical help here.” I told him about the Don’t Ask Don’t Tell campaign to ensure that non-status migrants living in Toronto got the services they needed without any risk of government interference. “I’ll ask Lily about it. We can trust her.”
He nodded assent. Lily’s advice was simple and unhelpful. “You work in the health care sector, not me,” she said. “Ask someone in the know at your work. Someone you trust.”
IT’S FUNNY HOW WITH CERTAIN PEOPLE, NO MATTER HOW LONG you know them and have effective, friendly relationships with them, you never really learn anything about them. Sherry was one of those people for me. No matter what questions I asked her or what she revealed everything came back to the same basic biography: she was a hard-working, patriotic East Yorker, total health care practitioner who loved her hubby and kid, hated mornings and was very finicky about written reports. Even when Sherry introduced me to new contacts, her relationships with them always came back to the same basic facts.
I, on the other hand, had carefully extrapolated pieces of my own life to present her with the story of how I had come to know Bumi, the link to my own familial past and even some of the discontent being stirred by this man’s presence in my life. I explained that he had no legal status in Canada and, based on his previous difficulties with official powerdom, feared seeing a legitimate, state-certified doctor. Sherry coolly wrote down a name and number on a blank recipe card and handed it to me. “I’ll let him know to expect your call and not to ask any unnecessary questions,” she said.
The name on the card was Dr. David Biachari. “How do you know him?” I asked.
“He was part of the anti-amalgamation campaign,” she said. “He’s a good man.”
If it hadn’t been the campaign, he would have been a friend of her husband’s or a colleague from another health centre. Sherry either ran in very limited, well-trodden circles or she kept a great deal of things to herself.
DR. BIACHARI MET US AT 7:00 AM, WELL BEFORE HIS POSTED office hours. My expectations of a dim, empty room with sliding panels and secretive eyes were quickly replaced by the reality of a standing room only waiting area filled with the sounds of Spanish, Italian, Korean, a variety of African languages and English in various accents.
Biachari’s receptionist took Bumi’s first name, handed him a questionnaire and asked us to sit once a seat became free. Trying to read the form, Bumi muttered, “I concur, I concur.”
I took the questionnaire from him and waited a minute until he stopped muttering. I read the questionnaire aloud and my voice joined the cacophony in our patient ghetto.
“Do you have any of the following concerns?” I asked.
He did.
“Do you have any of the following compulsions or repetitive behaviours?”
He did.
“Are you unable to stop these thoughts and/or behaviours?”
He was.
“Do these thoughts or behaviours interfere with your working, social or private life?”
They did.
“Do you spend more time and energy fighting these thoughts and behaviours than you would like?”
He did.
DR. BIACHARI WAS A TALL, SLIM MEMBER OF THE BABY BOOM generation with designer spectacles and an artist’s goatee. He spat short sentences with a thick West African accent. “Please, have a seat.” His voice was a smooth tenor. He sat across from us and took Bumi’s form, perusing it with one long “mmmm-hmmmm.”
“How often do you wash your hands, Bumi?” he asked.
Bumi washed his hands and arms for about three hours in the morning and three hours at night under running hot water, for which practice his employers and landlord deducted fifteen percent of his pay for hydro bills. This loss in pay translated to an extra year and a half Bumi would be away from his home and family, but he couldn’t help it. Better to extend his leave than succumb to the vile germs and viruses that hunted him. After washing, Bumi shoved his hands into a pair of thin gloves for around the house. In public he left his hands bare to avoid attracting scrutiny. Scrutiny was as bad as germs.
He took great care to avoid exposing the vulnerable flesh of his hands, where most disease enters the body. He used his elbows to open doors. Upon arrival at work he immediately slipped into a pair of rubber gloves, which were removed only during household deliveries. He gave his hands a quick wash upon return to the restaurant before returning them to his gloves, which were off limits to all others and were stored in a sealed zip-lock bag. Any fool joker who dared break that seal would suffer Bumi’s considerable agitation.
Dr. Biachari nodded. “How many times do you check your alarm clock at night, Bumi?”
The number of times he checked his alarm at night was one thing Bumi did not count. He estimated a checking rate of once every ten minutes for however long it took him to fall asleep, maybe two to three hours. Bumi slept anywhere from one to six hours a night, depending on social commitments (i.e. Sarah and me), shift length and the strength of his obsessions that day.
“How often do you engage in counting rituals, Bumi? I mean, how often do you count to 33 or recite the name of a loved one thirty-three times and so on?”
Bumi recited the names of loved ones and people he wanted to protect thirty-three times for each time he committed an infraction of the rules, such as stepping on a bad place on the ground or thinking an evil thought such as killing Robadise or abandoning his family, taking the easy way out or doing himself in. These recitals were mostly in his head but he was occasionally conscious of mumbling out loud in the presence of people with whom he felt comfortable such as Bang or myself.
The internal chanting was an almost constant part of Bumi’s thought process and he had become somewhat adept at compartmentalizing his brain so that a separate section could engage in other thoughts such as work and conversation.
“Bumi,” Dr. Biachari said. He scratched his goatee. “I need you to tell me more about your obsessions. You are very concerned about germs and so on. What about environmental contaminants? Poisons. Do these concern you?”
Bumi was concerned that four children living in his neighbourhood had died from environmental contamination in the canal, but he couldn’t be sure that was how they died. He was concerned that maybe he had been responsible because he worked for the company that may have caused the possible contamination. Others thought that he had used black magic to kill the children, but that was absurd.
“Really?” Dr. Biachari asked. He stroked his goatee with two frantic fingers. “People blamed you for the children’s deaths?”
They had.
“Were charges pressed?”
Bumi looked at me for guidance. He had kept his past within a very tight circle. Now this white-frocked man in a back-door office with unknown qualifications wanted the kind of information that kills.
“Bumi didn’t kill those children,” I told Dr. Biachari, daring him to reveal the nature of his interest in Bumi’s past life. Sherry had promised no unnecessary questions.
“Forgive me for asking,” Dr. Biachari said. "In order to make a correct diagnosis I need to understand the circumstances where your obsessions take hold of you. We need to separate realistic concerns from any possible obsessive concerns.”
“I was arrested, Doctor,” Bumi said. He lowered his chin and pupils toward the white linoleum floor.
“Bumi, do you think you were guilty of killing those children?” the doctor asked.
Bumi did not know. He had no specific memory of killing them but remained haunted by the possibility, sceptical of his memory. Maybe he had not performed his rituals, his ablutions, faithfully enough. Maybe his critical thoughts about his neighbours, about his society, had reaped a hideous punishment on the victims of his judgment. Or maybe he was somehow responsible for the fire, the leakage into the canal, the poisoning. Maybe his powers, his understanding of the need and means to implement order in a world of chaos, had escaped him in the form of the dark arts, and done those children in. None of these things could be completely disproved, no matter how hard his ingenious mind worked on the matter. He was too far from the material evidence now. He lived with the guilt of a survivor.
“Bumi, what was the evidence against you?” the Doctor asked.
“There was none,” Bumi said. He still stared at the floor. “But no evidence in favour neither.”
“Have you had any concerns about harming others since you arrived in Canada? Or about being blamed for things that go wrong here?”
Bumi suffered thoughts of vengeance on Robadise for sending him here, even though it probably saved his life. For these he repented by saying Robadise’s name thirty-three times, a tortuous process that often self-replicated. The name singed his heart and he vowed vengeance again, repented again and so on.
His greatest fears were for his family back home. He hadn’t heard from them at all. He was afraid he’d be caught and deported before he repaid his debt—only three years to go—and lastly that he would not be allowed to escape the grasp of the Chang brothers even if he did repay his debt.
“Thank you, Bumi,” Dr. Biachari said, still stroking the goatee. “I know this was hard for you. Do you have any questions for me?”
Bumi shook his downcast head.
Dr. Biachari wrote a prescription and handed it to me. “It seems likely that he suffers from clinical obsessive-compulsive behaviours with fears of harming others,” he said, “fears of being held responsible for something going wrong, concerns with dirt and germs, possible excessive concerns about chemical or environmental contamination, excessive concerns with numbers and patterns and compulsions to wash, check and count. Since Bumi forgot his identification papers, I have written the prescription in your name.”
I took the paper with a trembling hand. “That’s it?” I asked.
“Under the circumstances, yes,” Biachari said. “Unfortunately, Bumi can’t access the true experts without a health card. So, it’s a bit of trial and error, isn’t it?”
I glanced at Bumi and saw him staring back at me. “Is that safe?” I asked with my eyes on Bumi.
“This is for an anti-depressant with a high success rate for OCD patients. One pill a day. Causes drowsiness so it is best taken in the night, just before bedtime. Other side effects can include dry mouth, fatigue, constipation, tremors, loss of sexual appetite, impotence and excessive sweating. To be perfectly frank, Sir, although I am not an expert in this particular disease, I am familiar with it. I have seen it many times, and there is always an element of trial and error in its treatment. In one way Bumi is very lucky. If you or I had this disease we would likely start with our family doctors, who would be perplexed, send us to another doctor, who would send us to another and it could take twenty years until we saw the right specialist and got the right diagnosis.
“This is the right diagnosis, let me assure you. I’ve been at this a long while. The only question is whether this is the right drug for Bumi, and only time will tell us that.”
Bumi looked up from the floor and cocked his eyebrow at the doctor and me.
Dr. Biachari turned his attention back to Bumi. “It is a commonly used drug,” he said. “If it works for you, you will find that your thoughts and habits will slowly lose their intensity, and you will have a more normal life, Bumi. If you find the side effects too strong, you can come back and see me again. The prescription is for ten weeks. Come see me after you have taken the last pill and tell me if the drug has worked for you or not. Take them every night until they are gone, even if they are not effective. Only stop if the side effects are too strong. If you find these pills ineffective, we will try something else.
“The one unfortunate matter is that all the effective anti-OCD drugs are very expensive: six to seven dollars per day. With no health card or coverage, you have to find a way to pay for the medication.
“Also, you will need a behavioural therapist. That will also cost you.” Dr. Biachari explained that even if Bumi had legal status he wouldn’t be covered for therapy. He told us that behavioural therapists can charge high hourly rates and that behavioural therapy for OCD can be lengthy and tedious, involving hours with a patient counting how often and exactly when, where and how each ritual occurs. He wrote a name and number on a blank recipe card, just like Sherry had, and I wondered if the use of recipe cards was a technique secretly taught among the anti-amalgamation warriors.
“Give my best to Sherry, a remarkable woman,” Dr. Biachari added with the smile of an accomplished expert of the human mind.
WE BOTH HAD OUR DOUBTS ABOUT THROWING PILLS AT THE problem. Bumi worried excessively about everything he ingested orally or otherwise. But when he expressed his doubts I persuaded him to take the pills. Despite my own dubious perceptions of the medical establishment and pharmaceuticals it wasn’t like anyone had made up Bumi’s symptoms for him. There was a striking consistency to his behaviour and that of millions of other people, none of whom had ever heard of OCD before seeing a psychiatric doctor or a therapist. And if there was one thing that could assuage Bumi’s fear, it was a consistent pattern. Despite our concerns, medicine seemed Bumi’s best hope for peace in a very long time.
But Bumi lived in an almost cashless world. The bulk of his wages took the form of a slowly shrinking debt that was financial and temporal. Even if the drug failed I could at least prevent the deceleration of that all-important shrinkage. Without hesitation or consultation with Sarah, I coughed up the $420 for the trial run drugs, with help from a plastic loan shark.
Intellectually, Bumi was an independent sceptic in search of hope in a world that had been unkind to him. Practically, he never shied away from the help of someone he trusted, who had something to offer. I took his acceptance of my gift as a hard-earned sign of trust. I had something to offer. For a mere $420 I could make a tangible improvement in someone’s life. If the drugs worked I would have no need to make abstract connections between grant applications, revenues for the health centre, and outcomes in people’s lives just to prove my existence mattered.
Finding affordable behavioural therapy was more challenging. The man Dr. Biachari recommended was not generous with his time. I went from A to G through the yellow pages’ list of therapists before I gave up on altruistic health professionals. Sherry, on the other hand, continued to be an oil well of psycholo
gical health information. She handed me a recipe card for a Dr. Sangeeta Cherian. Cherian was an uptown, five-hundred-dollar-an-hour therapist whom Sherry had convinced to take part on a no-questions-asked, pro bono basis. I almost cried when the thin cardboard touched my hand. “I don’t know how to thank you, Sherry,” I told my boss, who had never seemed concerned with the world beyond East York, but apparently would do anything for the people who wandered with proper accompaniment into her catchment area.
“Just don’t miss any more deadlines,” she said. She smiled and winked with her usual pep. I couldn’t tell if it was a joke or a legitimate threat. “Dr. Cherian owes me for all the letters of recommendation I wrote for her when she was applying for grad school,” she added. She had really opened up. “She’s young, but very, very bright. And she has experience with OCD patients. It’s amazing how many rich people have OCD, actually.”
No one I knew, but if their experiences trickled down to help Bumi then he would finally have something to thank them for.
WHILE BUMI WAS AT HIS FIRST SESSION WITH DR. CHERIAN I reached my sister, after two weeks of busy signals and empty rings reaching not even an answering machine. Her ‘hello’ sounded like it was extracted from her larynx with hot tongs but even after five years it was unmistakably Michelle. Adolescence had murdered early morning Christmas excitement and all the prophets’ miracles would never revive it. She was a woman of the night when I had last seen her and change was not something she enjoyed.
I held my silence long enough to elicit a second gravelly hello, and a little longer as I toyed with the idea of vengeance: a silent little mind game for all those she played on me.
“Hi Michelle, it’s Mark,” I said.
“Mark who?” she asked, which hurt, widened the gulf. She always won the mind games without really trying. I waited to see if she would show any signs of recognition. If she did recognize her little brother, she made no mention of it.
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