“Trouble finding us?” Maureen sat on a plastic chair to the right of the door, flashing me one of her toothy, sweet smiles. She wore khakis and a long sleeved T shirt. Her dark hair was in a tight bun. Her blue eyes sparkled a much needed welcome.

“Yes, I couldn’t believe this was the right place.” Approaching the meeting place, I noticed how small the trailer was that Koko lived in. As I entered, the warped aluminum door closed with a hollow bang, emphasizing its fragility.

“This is all she needs.” Typical, pragmatic Maureen, composed and constrained.  I, on the other hand, was on unfamiliar territory, exploring; literally, since I just had moved to the West Coast, and figuratively, just having graduated from training and working now as an attending physician in Developmental Psychiatry. I attributed feeling hot and disquieted to the brisk mile walk in dry heat to find Koko’s residence. Ending up in this stuffy trailer made me feel even hotter, more aware of my shirt, tie and blazer, my attending physician’s armor, out of place, compared to how Maureen was dressed, looking relaxed and comfortable. In her capacity as a nurse on the psychosomatic unit, she managed difficult clinical situations with a persistent no nonsense approach. Her presence was calming, a message she passed on without necessarily saying a word.

I came with an ambitious agenda: to show how language, especially symbolic language was the centerpiece of being human. For some time I had immersed myself in Ludwig Wittgenstein, to counterbalance Sigmund Freud’s clinical wizardry. They both struggled with similar questions. Wittgenstein wanted language to be a science, a logical edifice as we search for life’s meaning. Freud introduced the idea that language was as necessary as a stethoscope for the practice of medicine, that humans sometimes hid their suffering in symbols and that doctors could heal by cracking secret codes. Meeting Koko was a way for me to show that this line of reasoning was sound. She, by default and I, by positive proof, were going to show how language makes humans unique.

In preparation for this psychiatric exam I had studied all the material on the examinee I could find: papers, TV clips, photographs. There was a lot. She was famous, no question. But deservedly so? She had about 19 expressions in her own language, which I did not speak. She also used American Sign Language (ASL). Maureen, having worked for years with developmentally disabled children, was an expert in ASL. She was willing to translate my questions and the ensuing answers. “I am ready. Where is she now?”

“Oh, she is right here, taking a nap.” Maureen pulled back a flowery curtain. Indeed, there she was, sitting up, looking out a small window with a wistful look. Her arm rested on some chain linked fencing, separating her space from the rest of the trailer.

As Maureen opened the curtain completely, I suddenly found it difficult to breathe. Koko looked much bigger in real life. Maureen noticed me flinching. She turned to Koko, signed and spoke simultaneously. “Koko, this is Hans.”

Koko leaned back and looked at me with what seemed like a fierce stare. Then she signed and grunted. Maureen translated: “He is not gorilla. He smells good.”

My sweat, I thought, that brisk walk over here in the heat! “Maureen, please tell her I am a doctor” – my ultimate shield.

Maureen shook her head. “Koko just had a physical last week. I would not remind her of that. She had to be strapped down.”   

Turning back to Koko, Maureen signed and spoke: “Koko, Hans is going to ask you questions, ok?”

Koko answered with a grumbly belching sound. Then she signed something with very sloppy movements, which looked nonsensical to me, but Maureen translated: “OK, ask me.”

I thanked Koko. She let out that grumbly belch again.

Maureen giggled and said, “This is the sound gorillas make when they hang out with the group and are comfortable. Koko is ready for you. And we know she likes you.” Maureen smiled.

Really? I wanted to believe Maureen. I already knew most of Koko’s history from my preparation. She was rejected by her mother, then adopted and saved by a Stanford graduate student, who taught her languages from very early on. I could get straight down to business.

“Koko, please answer my questions best you can.” Koko leaned forward closer to the fence. Could this fence really contain her? I felt uncomfortable, but went ahead. “What is your name?” 

She signed ‘KOKO’, lifting both her arms over her head and pointing down to it. She then pointed to her image in a mirror. I did not expect this sophisticated response, even for a child.

It was hard to think of Koko as a child. Koko’s head alone was enormous. When she yawned, she exposed a set of teeth that surely could chew and tear just about anything. Her lips were a giant suction cup. Her broad, flat nose was eminently mobile, collecting scents from all directions. What gave me the greatest pause were her long, extremely fast and muscular arms – they surely could bend cheap steel fencing and visiting doctors to her will at any time. I quickly brushed aside the image of me crushed in Koko’s arms.

Maureen noticed the sweat on my brow. “Can I get you some water?”

I squawked “Yeees….”, and gratefully took small sips. This settled me down.

Now I noticed that Koko was a gentle, playful creature. She picked up a cockroach from the floor. She had it crawl on the back of her hand. When done, she set it down and let it scurry away unharmed. Looking at me, her golden-brown eyes seemed to illuminate, as if to say: “Go on, ask me more”. Turning my way, she slowed down her muscular movements. I felt encouraged to give her all the standard tasks for the exam of children.

Koko enjoyed the exercises: “Where is your head? Point to your ears! How many fingers are these? What is this color?”  Koko understood and responded much like a 4-5 year old. Maureen beamed with pride and rewarded Koko with a banana.

I felt emboldened. “Can I test her ability to abstract?”

Maureen, without hesitation said: “Sure, she is still patient”. This was the crucial moment. How sophisticated was this mind of hers? Was Koko able to grasp figures of speech?  

I said: “Ask her, what this means: ‘Sometimes even monkeys fall out of trees’. ” I could have picked any of 10 other questions like this, which psychiatrists use to test ability to abstract. But Ludwig Wittgenstein in me chose this one that I blurted out before I knew it. Maureen translated.

The response was swift and decisive. Koko jumped to her feet, took a banana from the chair in her cage and flung it through the fence in my direction. Pureed, it sprayed all over me. Then she emitted a massive wail, which needed no translation. I later learned that was gorilla speak for “Back off!” Koko’s slit like eyes under her massive epicanthus made that clear. I hastily waived and exited – actually more like bolted – from the trailer. I believed the exam was finished.

Once outside, I stopped. I could not simply run off. The flimsy aluminum door flew open and crashed shut. It was Maureen, not Koko, chuckling as she came towards me.

“How did it go, Dr. Steiner? Did you get what you wanted?”    

I took a deep breath. “Maureen, I wanted Koko to be just an animal. I also thought that you were deceiving yourself, always telling me how kid-like Koko was. Seeing you in action though, I now appreciate the relationship you have built with Koko. I am amazed. I treated her like a specimen. You treat her as a treasured charge. Koko does have language, does act like a kid, loves and reads people. She could read me, not like a book, but like a ….well like a human. She has empathy. She knew I was anxious, she tried to settle me down – like the display of the cockroach? But I think she also picked up that something in me was trying to show her up. That’s when I got the banana treatment.”

Maureen nodded, “You passed the Koko exam, but I won’t give you an A.” I resisted my first impulse to defend my choice of metaphor as just another psychiatric test. Instead, I said: “I learned something. Sometimes gorillas teach humans about language and teach psychiatrists about development”.