When I reach Bertha's hospital room, she's sleeping. A tiny figure in a big bed, hooked up to machines that blink and flash with each beat of her heart or intake of breath. I slip into a chair beside her and watch her lips purse into a small "O," then puff out soft, pillowy exhalations. It's not fair, I think. Not fair to have Stage IV Lung Cancer, with a tumor the size of a cantaloupe sitting on top of her heart, only to fall and fracture her pelvis- And all because she wanted a bit of macaroni salad before bed.
Her hair is growing back since they stopped the chemo. It sways in wiry, gray tufts like new grass atop a dying hill. I have known and loved this frail woman for what seems like an eternity but is only a few minutes of her lifespan. I made my entrance when the six children were raised and gone, the husband finally sober and the trailer as elderly as its inhabitants.
Two weeks ago she brought me a hymn she'd written and taught me to sing it. She sang it, she said, at her sister's funeral last year and at a granddaughter's funeral six years before that. She wanted me to write down the words and the music so it wouldn't be lost. We both knew why she wanted me to learn the song but neither of us mentioned it. We sat in my office and sang- her voice a creaky whisper and mine soft and faltering as I tried to match her melody note for note.
Today we were supposed to be learning a second hymn but instead the call came about her fall, so I found myself wandering through the long corridors of an unfamiliar hospital.
Bertha fell asleep with her glasses on, so when she wakes up, startled by the arrival of a dinner tray, her dark brown eyes are magnified pools of confusion and anxiety.
"Is something wrong?" She whispers.
Her aide and I assure her everything is fine. The aide tells her she fell asleep staring out the window at an approaching thunderstorm and slept right through the thunder and lightning. The aide is perky, young and cheerful. She wants Bertha to eat some of her all-liquid supper and bustles around peeling open lids on the soup and juices. Bertha pushes the containers aside and says "Wait a minute. I've got to see..." But she isn't looking at the food. Her gaze travels around the room. She looks up at me, then at the aide. "Is everything all right?" she asks.
I tell the aide we can manage without her, turn back to reassure my frightened friend and find her staring up at me, her brows furrowed.
"You're sure everything's all right?" She asks again.
I smile my most reassuring smile. "Yes, it's fine. You are fine. I mean, you broke your pelvis but you're okay."
Bertha nods, unconvinced. She's still scanning the room. When her eyes return to my face, she studies me for a long moment. "So, I'm okay," she says in a tentative whisper, "but am I dead? Is this...Heaven?"
She is no doubt disappointed to find Heaven has a 18" TV mounted on the wall above her head, playing a rerun of "Bones."
When I tell her no, she's not dead, her confusion doesn't entirely vanish.
"I'm sorry," she says, giving me an apologetic smile. "But I can't quite place who you are." She keeps looking behind me, like she's expecting someone or something to be standing there.
I give her my most reassuring smile and reintroduce myself, like I think it's completely normal to forget someone you've seen every week or two for four years.
"Oh!" she cries, suddenly clear. "Oh, I see you now!" She grabs my arm and pulls me down into a tight hug. "You must think I'm crazy!"
I tell her of course I don't, she's on a lot of pain medicine and was startled out of a deep sleep. She nods yes, this must be the case, but when she thinks I'm not looking, I see her craning to look at my back again. I turn and show her my backpack purse, still attached to my shoulders and she laughs so hard it ends in a spasm of coughing and choking. It's a full minute before she can speak again, her voice coming in short, breathy gasps.
"Oh, honey, here I thought you were telling me everything was all right because I was dead and you were an angel!"
Posted by Nancy at 9/11/2015 09:18:00 PM
His forearms are tanned, the kind of tan that's lifetime-lasting, the kind that comes of hard work done outside in all seasons. The tattoos are World War II vintage, faded navy blue and bleeding into the fine lines of his skin. He's 85, toothless and sitting ramrod straight in his high-backed wheelchair. He is my "just-one-more-please-if-you-could" before the holiday weekend sucks me out the door of the senior center. He's the new guy.
The social worker told me "He and his wife got into it and she says she's leaving him. She called up here cussing and yelling." Linda rolls her eyes. "Apparently it's not all her. We've had two aides quit cause he cussed them. He's given almost everybody a hard time. I haven't been on the receiving end yet but I'm sure it's coming." She gives me a "poor thing" smile and says. "He was really close to his daughter and she died of cancer a few months ago. She was his caregiver most of the time and he's having trouble adjusting I think."
I wheel him into a nearby office, slide my bag behind my chair and tell him, "No, really, I'm in no hurry. I wasn't going anywhere," because already his eyes are red-rimmed and he's twisting his hands nervously and...well, how could you leave him?
"They want to put me in a rest home," he says. "Me and my wife been together 86 years. We don't want to be separated."
I don't correct how many years they've been together because I'm sure it does feel like his entire life plus one.
"We fight and argue one day, make up the next. But they don't understand that here. My wife called 'em up and talked out of her head. She was just upset. We was fine the next day. It's always been like that. She's tired. I bet she ain't slept a wink since my daughter died. She don't even try and sleep in the bed no more. She can't. She's on the couch in my son's room."
His son, it turns out is quadraplegic and living at home with John and his wife. "He was the kinda boy, if he was a driving down the road and seen an old person mowing, he'd stop his truck and go mow their lawn." John gives a short, disgusted snort. "I was mowing out near the road and the dang mower flipped over on top of me, still running, and people just rode on by. That's how folks is these days."
His eyes well up with tears as he tells me his son had a series of strokes that left him on life support. "When the doctors took him off of that tube, he just kept right on a breathin' and then he woke up. They wanted to put him in a nursing home but my wife said, "No you don't. Not my boy." And we brought him home. He's been there ever since. Thirty-seven years. That's why my wife sleeps on the couch. If he coughs he's gotta be suctioned right then or he'll die. She's the only one can do it now. When my daughter was living, she was helping but then she got sick."
He tells me about the pain she was in, the way she suffered but tried to keep going. "The doctors up at the hospital said the day she died they was a in there with her and the nurses and she was just a laughing and a cuttin' up with 'em and said they left for just a minute or two, walked back in and she was dead."
Tears are rolling down his cheeks. "Now it's just the three of us. My wife gets short with me. Who could blame her? She's just tired." He leans toward me, his voice husky with tears and urgency. "Ma'am, please don't let them take me away. I can take care of myself. They send a boy to help me three mornings a week and I can take my own medicine. I told him, just roll me out the front door and I'll wait til the bus comes to get me. It won't be no more than a half hour. I can do that."
It takes me awhile but eventually I have all the pieces to realize there is an aide coming to bathe his son and help with his care three mornings a week, the same mornings John's new aide comes to get him ready to come to the senior center. Their house is so small, John can't leave without going through the room where his son is. He doesn't want to compromise the small bit of privacy his son has left by rolling through the room with an aide in tow, so John wants his aide to roll him outside early and let him wait for the bus that comes to pick him up.
I imagine a house so small the only hallway is "four by five feet."
"He's a good boy," John says. "He lays in his bed and sings along with the radio. He knows all the old country songs. He's got a pretty voice. I mean, you can't understand the words but I know what he's sayin'." He is pleading with me to understand. "I can't leave my wife. We've never been apart except a few times when she left cause I was drinkin' and a runnin' around like men do before they settle down. But we love each other. She can't take care of that boy all by herself. If they'd a let me in that room over yonder," he says nodding toward the physical therapy suite, "I could get on that bicycle they have where they can strap your legs in so they stay put and I told that doctor woman I know I could get stronger. Maybe I could even walk one day. And my arm will get stronger, so see, I can take care of myself."
I tell him not to worry, that I understand his wife doesn't really want him gone and that I will talk to "them." He apologizes for being hard to understand but says "They're getting me some new teeth and the dentist said I'll be able to talk real good then. He says I'll look like normal."
I think about the tiny house and the woman struggling to keep from losing another child and the man fighting to keep his world from blowing apart and I tell him I understand every word he's said.
Posted by Nancy at 7/03/2015 09:41:00 PM
Bertha is dying. Full-on, Hospice dying or as she calls it, "Transitioning."
“Whenever I call one of my relatives to tell them I got lung cancer, they want to know what stage am I in.” She shakes her head softly and waits for the small, portable tank at her side to pump enough super-oxygenated air into her lungs to make another sentence. “Finally, I got so sick of it, when the next one asked I said, ‘What stage am I in? Why, all the world’s a stage, honey. We’re all just a playin’ on it!'”
She chuckles at her own joke, then lifts her tiny, bird bone shoulders in an understanding shrug. “I shouldn't a done that. They only want to know so they can plan when to take off work to come to my funeral, that’s all. And I can't tell them that answer. Nobody can. All I know is, it’s not time yet.”
Posted by Nancy at 6/14/2015 04:49:00 PM
The man with no legs keeps a pink pan by his side in the narrow hospital bed. It contains what's left of his life- a church leaflet with his name listed as a member to pray for, a paperback romance someone left behind, three, small yellow legal pads filled with illegible notes he's made about his day-to-day life and two rolls of Scotch tape.
"What's the tape for?" I ask.
He doesn't miss a beat. His eyes twinkle as he says, "That's how I keep it all together!"
When I chuckle and say "Yeah, sure," he shrugs, smiling as if I've seen through him and he's conceding defeat.
"Or maybe," he says, "I use it to patch my broken heart."
Posted by Nancy at 5/13/2014 10:25:00 PM
When the social worker came into his room to do her quarterly assessment, she asked him what the date was today. He raised up on an elbow, glared at her and said "If you don't know what f**king day it is, what the hell are you doing in my room? Go look on a g**damned calendar!"
The nurse practitioner says she thinks he's depressed but his nurse says "There's nothing wrong with him. He's just a grumpy old man, that's all."
I look at the chart. It says he can't walk because he has sores on his heels that won't heal. He's diabetic. He has dementia and he's only in his early 70s. His demographics say he has a graduate degree and worked in accounting.
The social worker says "Good luck!"
The first time I walk in his room, he's asleep. A frail, white-haired man with baby-smooth cheeks and a death-pale complexion.
They bring his lunch tray but he doesn't wake up.
I circle the hall. I walk in on one of my patients and find him covered in feces, his colostomy bag split open. It's all he can do to press his call button and I wonder how it is his lunch tray can be so recently placed before him without anyone noticing his distress.
I talk to another patient who tells me he's been shot in Korea and is a prisoner of war.
I visit a man who's lost his wife and hopes his daughter will sign a release to let him leave the facility to have lunch with his buddies. "She's a little over-protective," he says, sighing.
I walk back into the grumpy old man's room and find him awake, staring at me with intense gray eyes, his expression unreadable.
I adopt my cheerful fairy godmother face. I'm just here to check in and see how he's doing. He stares at me, gives me a quarter-smile so phony and angry it takes my breath away. So, I cut the crap.
"Are you depressed?" I ask.
A simple "yes."
Every time I ask a question there's a long, empty space before the words come out, as if he resents himself for humoring me.
He liked to read before he came into the nursing home. He enjoyed mysteries. "A forensic writer," he says. "I can't remember her name."
I get my first somewhat genuine smile.
"She went to Davidson," he tells me.
"No. I couldn't afford it."
"So, where'd you go to graduate school?" I ask. I'm not so much needing to know as I am out of gas. Part of me stands there talking while the rest of me just wants to run out of the nursing home and never, ever come back.
"Union Seminary," he says.
Seminary? He's a Presbyterian minister...really?
"Were you ordained?" I stumble.
Long silence. "Yes."
"Did you have a church?"
Another long pause. "Yes."
I nod. Okay. He's been where I am. He's been where all of us are and now he's on the other side, stuck in a bed while unhelpful helper types pigeonhole him and patronize him with questions about his hobbies and today's date. No f**king wonder he's angry.
Posted by Nancy at 4/15/2014 08:55:00 PM
The new aide caught my attention when she poured the Tuesday "red juice."
The drink is a staple of the Snack Lady's visits. Every Tuesday she pushes a metal cart up and down the hallways of the nursing home, representing the charitable good wishes of the local Women's Club, church or whatever do-gooder organization it is that sponsors her. Almost a candidate for admission herself, this little woman trundles in to the rooms bearing cookies, candy and always, red Kool-aid.
For whatever reason, this week the Snack Lady was absent, so the job fell to the aides to dispense the juice sans treats. I was sitting behind the nurse's station desk, perched on a black, swivel stool, writing notes when the aide began to pour a cup full of the Tuesday liquid.
"You'd think they could do better than the same thing week after week," she muttered. "They're sick of it."
That got my attention. I looked up and saw the woman wrinkling her nose in disgust. She shook her head and looked at me. "I can't tell you how many of them have told me to get out of their room with this stuff," she said. "They say it's the same thing all the time- red juice. How much would it take to do something different for them?"
I stared at the offending plastic pitcher and nodded. "Yeah," I agreed. "What would it take to do orange or grape now and then?"
"It's hard enough being in here without this kind of mess," she sighed and I realized she was referring to the patients, not herself or her low-paying job.
"Do you work on this hall?" I asked, indicating the one behind us. "Do you work with Mr. Marsh?"
I asked because I'd overheard her being pulled aside by another aide who was clocking out and wanted to brief her about my patient before she left. I'd thought it unusual at the time because it seems only the nurses brief each other about patients but here were two aides talking with concern about a patient. It's rare. They're underpaid and overloaded. They just don't usually have the time or the energy.
At my question, the aide's eyes widened. "Oh, yes," she said and abruptly backed away from the desk. "But I'm new. I've only been here two days. I don't know anything- not really."
Before I could tell her I almost always valued the aide's opinion of how a patient's doing more than the nurse or doctor's, she'd practically run off down the hallway and left me to my pile of paperwork.
A few minutes passed and the 108 year old woman who rarely speaks wheeled up, cradling a baby doll and a stuffed black dog.
"Is this your baby?" she demanded of another resident, terrifying the elderly lady.
"Nooo," she answered, shrinking away.
"Well, is it mine?" the 108 year old barked.
The other woman wheeled hurriedly away and the 108 year old turned her attention to the stuffed dog and plastic baby in her lap.
"They don't do a thing for you around here. But don't you worry," she crooned to her little family. "I'll take good care of you."
Before I could get up from my seat, a physical therapist popped around the corner, wheeling a silver-haired man, two other wheelchair-bound patients emerged from the dining room and a traffic jam ensued.
"They're all crazy," the silver-haired man growled to his therapist. "You know, everybody tells me they don't know what they're doing, but look at this mess! I think they do it on purpose!"
I could've sworn the 108 year-old smiled.
Every Thursday I see an 83 year old grandmother who recites the events of her week in great detail. At the end of every session, without fail, she sighs and says, "You know, it's never the big things. It's the little ones that make or break you."
Posted by Nancy at 3/18/2014 06:36:00 PM
I'm trying to quit cake. Cold Turkey. Haven't had a bite since February 15th. I tell myself, if I can go three weeks without it- without a crumb crossing my lips, without looking at a new recipe or perusing pictures on Pinterest, I'll be in the clear. That's just two more days away. Everyone knows if you do something for three straight weeks it becomes a habit, right? I know this. It's a mantra I repeat every morning in the mirror and every night as I switch out the lights in the kitchen and head up the stairs to bed..."Three weeks," I whisper. "I can do anything for three weeks."
Then yesterday I read an article in the Huffington Post that said the Three Week Habit rule is nothing more than a myth.
I haven't stopped thinking about cake since.
Posted by Nancy at 3/06/2014 06:23:00 PM