11/27/2007

Tuesdays With Buzz and Millie- Dying With Dignity?

Okay, it's Nursing Home day. You know what that means...I've been to see the old guys and life at the end of the line is not rosy.

Millie wants to die.

Millie is new to me but I get the impression life hasn't been easy for her- not that she'll tell me about it. She doesn't know me. The mere fact that I arrive in her room and announce myself as her new social worker doesn't mean she's going to unzip her heart and share all of her secrets. Millie's going blind. She thinks everyone's out to get her. When the man across the hall screams at night, she thinks he's coming for her.

Two months ago, she could manage. She's on dialysis with end-stage renal disease but that didn't keep her from going to bingo and church in the dining room on Wednesday nights. But when the vision in her only good eye began to go, Millie began to vanish as well. She pulled inside herself and stopped going out of her room. Sometimes her nurse would find her quietly crying, but she wouldn't talk about it.

When I mention Millie's seemingly supportive family, the nurse scoffs. "Yeah, they care about taking her money, that's about all."

Now Millie is saying she won't go back to dialysis. "She says all she sees is black when they do the dialysis," her nurse says.

I find Millie sitting in her wheelchair listening to her new flat-screen TV. "In the Heat of the Night," is on. I'm interrupting but Millie agrees to talk to me for a few minutes.

"The social worker here is worried," I begin. "She says you want to stop dialysis."

Millie nods. "I'm tired," she says softly. "I can't see. I can't do anything anymore. What's the point?"

An aide stops in the doorway and thrusts a plastic-wrapped sandwich at Millie. I know that girl knows as well as I do that Millie can't see the damned sandwich but I wait to see what the girl will do. "Your sandwich. Here," the aide says dumping the two thin slices of bread into Millie's lap. "She doesn't like her lunch," the aide tells me.

Millie fumbles with the plastic wrap, feeling for the end that opens and sighing her impatience with the task.

"I'm just tired," she mumbles. "And I'm not going back."

No damned wonder, I think.

Finally Millie tells me that "they" were talking about sending her for a consult with a specialist a while back but "then they didn't mention it anymore."

Millie doesn't know why and she hasn't asked because she knows it's pointless. If they're not going to pursue it, there's no way she'll get in to see a specialist.

She also doesn't understand why she should go to the meeting "they" are holding on Thursday to decide whether she can stop dialysis or not. "I don't want to go."

And I find out later- "they" haven't even planned to include her!!!

The doctor and the dialysis staff haven't consulted with the nursing home staff either, or me. They will just sit down and, I don't know, pull straws?

I tell the social worker and the nurse we need to get Millie to a specialist, find out about antidepressants, find out about getting someone in to help Millie learn to negotiate her world as a blind person. "We're not talking about Helen Keller here," I say. "We have come a long way. We can help Millie."

We can, I think, but will we? The social worker will fight, I know that much but will anyone listen? Millie is "of sound mind." She has a right to make her decision about whether or not she stops dialysis- but have we done our part by trying to find alternatives to her hopelessness?

I leave her room and go to meet my next new patient.

At first Buzz is reluctant to talk to me. He answers my questions in short, brusque snaps...until I somehow begin to win him over by discussing my lame knowledge of football, Carolina football in particular. I told him my son was pals with the third runner up quarterback and this seemed to do the trick.

I know I'm in when I start to leave and Buzz asks if he can sing me a song before I go. He proceeds to sing me a tune about "Preacher Nancy," who goes out hunting on Sunday and eventually gets treed by a bear. "Lord, if you won't help me," Pastor Nancy wails, "Please don't help that bear!"

Buzz grins at me with a devilish twinkle in his bright blue eyes, delighted when I clap and grin in response.

Buzz isn't even 70 years old and his doctor says he will be dead of bone cancer within the next three to six months.

Sometimes I feel like a tiny ant in a very large universe, or one of the billion angels who dance on the head of that proverbial pin. But I am not alone.

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