Look out! It's the incredible shrinking brain!

Over the years, I've become a bit of a connoisseur of waiting rooms (as this recent string of columns has illustrated). And I stand by my long-held conviction that nothing can top a neurologist's waiting room. The neurologist's waiting room always has that sense of doom and mystery hanging over it. Lots of other waiting rooms?for cancer and AIDS patients, say?may have a corner on the doom market, but it's that aura of mystery, of the unexpected, that makes brain-doctor waiting rooms special. You never know what you'll encounter.

Most of the people sitting around me that Tuesday afternoon in early April were elderly, there to check on the progression of their Parkinson's or their Alzheimer's. Most all of them, to hear them tell it, were aching to die. But I tell you, even the kids who come in?the ADD cases, mostly?have that unmistakable stink of doom about them. And everyone lets everyone else know it.

Me, I was there to get some test results, but I wasn't much worried. I certainly wasn't expecting any bad news, despite all the ominous hints and dark glances that various brain techs had shot my way in previous weeks.

I'm glad I wasn't concentrating on my own impending doom that afternoon. It gave me a chance to pay closer attention to the events around me. That was a good thing, because that afternoon it was much more than a mere brain-doctor waiting room?it was a Land of Adventure.

There was seating for about 12 patients in there, maximum, and I had snagged one of the last chairs available, right next to the office door. Beside me sat an older woman who had shown up two and a half hours late for her appointment because she "couldn't get out of the hospital."

From out in the hallway, I heard a man singing, accompanied by tiny scraping sounds on the thin green carpet. I thought it was someone from the maintenance crew sweeping the hall until the hulking man in the wheelchair rolled slowly through the doorway, then toward the reception desk. He had a thick, black beard and resting in his lap was a white paper cup.

"This the office for women?" he asked. "You got all women here?"

A middle-aged man there with his mother asked, huffily, "Whaddo I look like, a can of tomato soup?" He put the emphasis on "tomato," and as I pondered this particular choice on his part, the receptionist informed the man that no, it was a neurology office.

"Yeah?" The man in the wheelchair said. "Good. I could use my nerves examined? Can I make an appointment?"

The receptionist seemed anxious. "What kind of insurance do you have?" she asked him. (It was a trick question for which there was no correct answer. It was fast becoming clear that the man was homeless, and the receptionist had no intention of making an appointment for him).

"I got Medicaid," he told her.

"Then you'll have to go across the street to the clinic. We don't accept Medicaid here."

"So I can't see a doctor here?"

"No."

"Ohh," he said, his tone turning cynical, "so you gotta be a rich son of a bitch to come here, huh?" Immediately the tension in the room ratcheted up about five notches. "Not someone like me. That's the way it is, huh? I'm a poor black man from a poor black land!"

To look at the faces of the other patients, you'd think he was waving a gun around?or that they had already been shot. But even as he was saying his piece, he was rolling himself backward toward the door, past me, and out into the hallway again.

"Don't bother me none!" he shouted, as he rolled down the hall toward the elevators. "I'll be just fine!"

Immediately upon his departure, the office was abuzz with voices, all of them complaining about the lack of security, the need for more security, how he could've shot somebody if he'd wanted to, why weren't there any guards downstairs, etc.

We are living in sad times, I thought.

The receptionist picked up the phone to call the security office to find out why nobody was around in the lobby, and the old woman next to me let loose with a high-pitched cackle for no apparent reason. Nerves, maybe.

"He was a nut," one old woman whispered to another.

"But at least he wasn't a nut nut," the other one replied.

As the conversation continued throughout the room, I heard the same scraping sound in the hallway that I'd heard before. I said nothing, knowing what was about to happen.

As the biddies kept yapping about how crazy he was and how his type needs to be kept out of buildings, the man in the wheelchair silently rolled back into the office. It took a second before anybody noticed, and all the voices fell silent. Some stared, some gazed down at their hands.

The man in the wheelchair said nothing, merely looked around the room (perhaps recognizing that he'd been here before). Then he backed himself out again.

An office employee closed the door.

"If he'd done anything," one old woman told the receptionist, "I couldn't have helped you."

"I would've liked to," her husband offered, "but I got this bad back?"

Suddenly the room was abuzz again, this time with personal excuses for why nobody did anything, and with more calls for beefed-up security. The receptionist picked up the phone and called the security office again.

Then the door flew open?but instead of a crazy homeless man in a wheelchair, what burst through the door was something far worse?that afternoon's entire roster, it seemed, of ADD appointments.

There might've been 30 of them, or it might've just been two. I'm not sure. But they were everywhere, in everything and on everything. The father?clearly at the end of his rope?tried to control them as best as he could ("?don't do that, honey! Why did you turn on the water? Sweetie, no?use a cup?"). The mother, meanwhile, sat down across the room and began calmly explaining to an older patient all the drugs they'd pumped into their kids these past few years, from Ritalin on up, with no effect.

"The Ritalin just made him act weird. He got moody and had crying jags and became very unpredictable? I couldn't stand that." Today maybe they'd try some new drug.

I sat there and listened to her, and suddenly felt a deep sympathy for those kids (who had since taken off, screaming down the hall toward the examination rooms and doctors offices, the father in distant pursuit). Listening to the mother, no wonder they acted the way they did. I had to have a little pity for the father, too.

Mostly I was glad I never had kids.

The receptionist called me to the front desk in order to answer a few insurance questions (I won't go into why that threw me into a cold sweat).

Two minutes later, questions answered, I turned to sit down again, only to find that my chair was now occupied by a squirming pile of ADD cases.

I sighed and leaned against the wall as the father screamed, "Look at how a big boy sits! LOOK AT HOW A BIG BOY SITS!!"

Then, in the nick of time, the brain doctor called me in. As I followed him down the hall, the noise around me faded into a dull and distant roar.

"It's a world of adventure out there in your waiting room," I said, as he closed the door to the examining room.

"Yeah, we just moved in here a couple months ago," he told me. "We used to be in a much smaller office, with a much smaller waiting room? You should've seen it then."

He opened my file and told me that the tests had mostly come back clean. No obvious signs of any new seizure activity. That was good news, I suppose, though it still left me without an answer as to what brought me in there in the first place.

"There is one thing the MRIs showed, though," he said. He looked a touch too serious for my taste. "There's been some clear brain atrophy?uh, shrinkage."

"Goodness sakes," I said, not knowing what else to say to such odd news.

"Now, this in itself is not that unusual," he went on, "but what is unusual is that we wouldn't expect to see it to this degree in someone your age. Normally it would only happen to someone much, much older."

I guess I shrugged. "You know," I said, "that doesn't surprise me in the least."

I didn't explain why.

"Something like this could be explained by a number of things," he said. "Excessive drug use, even if you stopped a long time ago?or a serious blow to the head, or drinking too much over a long period of time."

I shrugged again. "So what's it mean?"

"Not much, really. Not now. It's just strange to see it happening in someone your age."

"Uh-huh."

Then he hit me with a rubber hammer, poked me with a stick and told me to go see an endocrinologist.

I left the examining room desperate for a drink, filled with visions of my brain shriveling to the size of a tennis ball or a walnut. For some reason, it really didn't bother me all that much. "Brain atrophy," I thought, Jesus. Fuckin' typical.

By the time I got back out to the waiting room, it was completely empty, except for the old woman who'd been cackling next to me earlier. She stood at the desk, chatting with the receptionist. Then she turned to me.

"Can I please have some of your hair?" she asked.

Jim Knipfel's latest book?and first novel?The Buzzing (Vintage, $12) has just been released. Here's what Thomas Pynchon had to say about it: "The Balzac of the bin is at it again. With this paranoid Valentine to New York?and to a certain saurian colossus noted for his own ambivalent feelings about large cities?Mr. Knipfel now brings to fiction the welcome gifts which distinguished his previous books?the authenticity, the narrative exuberance, the integrity of his cheerfully undeluded American voice."