The nursing staff had submitted the referral on a Tuesday, three days after the change. They described it as: different. He had been vocal about his atheism throughout the illness, not hostile about it, just clear. The clarity had shifted. They could not be more specific than that.
Fren had been doing this for twenty-one years. She could read the signatures before the instruments confirmed them. She had learned this the way she had learned most things in the work: by being wrong early and noticing the shape of the wrongness.
The man was seventy-seven. He was thin in the way of the long ill, not recently, but over time, the body revising its priorities. He was awake when she arrived. He watched her set up the instruments without asking what they were for.
She ran the assessment. It took eleven minutes. She had run faster assessments and she had run longer ones, but she was not in a hurry and she wanted to be certain. She had learned, also, to be certain when the result was this one.
The signature was genuine. She would have known performance: she had seen it many times, and it had a particular quality of effort, a reaching toward something from outside. This was not that. This was something that had arrived from the inside and settled.
She told him.
He was quiet for a moment. Then he said: I didn't choose this.
She said: no.
He said nothing more. She sat with him for another few minutes, in case he had questions. He did not seem to have questions. He seemed to be sitting with something he had not yet learned the shape of.
She filed the assessment. Outside, the rain had stopped.