Doing Battle With Demons

Yesterday I sat for hours with a man who is dying and worried that God won't understand the things he did during World War II.

He has been having flash backs and episodes of panic so intense he seems unreachable.

As I sat beside him, holding his hand and listening, he took me with him through, I believe, every major battle fought during that war, with the exception of those fought in the Pacific Theater.

He was 18.

My eldest boy is 18 and I can't imagine him facing the horrors my patient had to withstand.

He was tapped to be in the 101st Airborne and placed in Intelligence and Reconnaissance. It seems this boy from North Carolina had a gift for spotting tanks and airplanes on aerial maps. He was also fluent in French and German- a by-product of his German heritage. His reward was to be the youngest of 76 men selected to parachute behind enemy lines, to record and scout out enemy activity, to lead men years older into battles that resulted, a lot of the time, in their death.

He was forced to do things that I know many soldiers have to do- but rarely tell upon their return to civilian life.

As I sat beside him, he was there again, the years melting away as he screamed out in flawless German, begging the unseen before him to put down their weapons.

My man is the sole survivor of the 76 men he went to war with and he tells me it will not be long before he joins his brothers. He is terrified that when he dies, their memories will die as well- they will vanish like the men who died in battle, and not be remembered or understood by anyone. He is worried that no one will believe what he is saying is true, that it could have really happened.

I ask him if he would like me to write down their stories.

Wrong move.

"No, those are my stories! Mine alone! No one can have them, do you hear me? No one! You must never tell what I am telling you!"

I soothe him, reassure him that his stories, his memories, are safe, locked away inside me in a place where I keep all the atrocities that my patients need to set free. I am the landfill for trauma so unfathomable sometimes I have to create conscious rituals to cleanse myself before I can return home to my family.

I pretend I have been in an operating theater, gowned, gloved and masked. When I leave, I am soaked in blood, but I strip off my gloves, throw away my gown and toss the mask in the trash on my way to the car.

I will not tell his stories. I want to, oh I really want to, because for every commercial glorifying the Marine Corps or the Army, there are the walking wounded who return, their lives unalterably changed and not for the better. They have been told to put the war out of their minds, not to speak of it to anyone.

My man obeyed the rules but at a terrible price.

We will spend whatever time he has left trying to cut the thick chains that hold him hostage. We will try to let go of these terrors so he can die without feeling so afraid and ashamed.

He is a brave and loving man, a father, a grandfather and a great-grandfather. He loves, no adores, his wife...and none of his family know what he is carrying.

He looked at me before I left, still holding my hand tightly in his own. "You know," he said, his eyes piercing through me. "I studied Psychology. I got to be a fairly good judge of human character and I have learned- there are those you can tell things to and those you know to avoid. I told you things today I have never told anyone."

I squeezed his hand, an unspoken promise for our future talks, and told him I would be back on Thursday.

I didn't want to run out of the nursing home yesterday. Days like yesterday are the reason why I haven't quit yet.

I Want to Run Away From The Home...

Working in the nursing homes is getting to me. I can tell by the way I drag over to each home now, as if I, too, am growing older with each visit. It seems the staff cares less than they did when I started but how can that be?

Maybe it's that the good ones always leave- the lively, energetic, happy, save-their-corner-of-the-world helpers always leave. And now, secretly, I want to go too.

I hate the paperwork. I hate that every tiny piece of it is analyzed with far more scrutiny than my patients ever receive.

I found Bunny in her room, reading her Bible this morning, trying not to cry.
She points to a splint the physical therapist just put on her arm. "She told me my arm ain't never gonna move no more. Ain't nobody ever told me that. How am I gonna get out of this place, I can't move my arm? Oh, Lord," she moans, her head heavy on the cheap, polyester pillow. "They ain't never told me that."

I want to beat the insensitive therapist. How dare she take away Bunny's hope? Why couldn't she say, "Your left arm just isn't following our plan, now is it, Bunny? But don't you worry, we're going to work extra hard on your right arm. Then we can get you strong enough to pull yourself up in bed. Once we do that, we'll work on the next step."

Was that too much to ask?

So I ask Bunny, "I thought you were working on walking with them?"

"I was," she says, sounding miserable. "But my knee hurt me so bad. I tried it twice but it still hurt and then they gave up on me."

Bunny tells me she's got problems with her blood pressure too. "They're supposed to take it every day, but they don't."

And did she mention she's having problems with her vision? "Sometimes the wall is down there on the floor and the TV's on the ceiling. That happened to me before. I think it's a pill they changed but they don't tell me nothing."

I tell her I think I need to go read her chart. I tell her she knows her body better than anyone else and if she says something changed two months ago, I trust that.

I start reading. I try to make sense of the jargon, the medications I know nothing about, the test results. I'm not sure what's going on. I'll need to talk to the staff. I know I'll never see her doctor, but I don't think much of her anyway. It requires a lot of digging...and I only get paid for face to face time, so the digging is pro bono. For whatever time it takes, I'll make, no joke, about $15.

If I wasn't a single mom, it wouldn't matter but on days when the rent is due, I hate to admit it, but it matters. Not enough to stop me. Today.

I do find one note I understand in Bunny's chart. It's from the physical therapist. It says Bunny's knee hurts because she has gout. It says the doc is putting her on a new gout medicine and they'll re-evaluate her in two weeks.

That was 2 months ago and it never happened. That I can work with. I tell Bunny and promise her I'll tell the social work department. I tell them. I see them write it down. I tell them what they said about Bunny's arm and they look disgusted.

The social workers, I am learning, are young wild asses. They tell me great stories about their men and their take on getting their needs met. They work all day to take care of others but they have no problem getting men to line up to tote their freight after hours. "Honey," one tells me. "Always pay part of the rent. That way, if he gets stupid, you can say 'Hey, I paid my portion!'" She looks at me. "Note, I did not say my half. I said my portion."

I know they will kick some physical therapy ass.

So Bunny is at least going to get on the right road...for today.

I am almost ready to leave when Tabitha, the business office manager, burst in. She closes the door behind her, sits down, clearly agitated and angry.

"Tashya, if you don't help me and Mrs. Winters, I swear somebody's gonna get hurt!"

They put the social work department in a windowless closet on the second floor. The room is no bigger than 6' x 9'. There are three of us now, closed up in this tiny room. Tashya rolls her chair up to Tabitha's and looks right into her eyes. I sink back down into the folding chair, trapped because the two women are between me and the door and I am too interested/nosy now to leave anyway.

"What is it?" Tashya asks Tabitha.

"All Mrs. Winters wants is to get out of her bed. She's hurting so bad, I can't stand it!" Tabitha's eyes well up with tears. "You know how I am about my Mrs. Winters!"

"I know, baby, I know," Tashya soothes.

"That damned aide says they can't get the Hoya lift for her because it's up under Mrs. Smith and her husband says they own that lift. They don't own that lift! I'm gonna beat somebody they don't straighten it out so I came up here to you so I don't get fired for beating somebody's ass!"

I have not been this happy in one of my homes in maybe a year. This is energy. This is concern and caring. Okay, so it's raw and unrefined, but damned if it isn't energy and therefore, hope.

Tashya is itching to leave for the day, but she doesn't. She says, "I'm gonna fix it right now." And she takes Tabitha with her, so she can see the situation get fixed.

I get sidetracked with another problem but as I'm leaving, I see the physical therapy aide leaving the social work closet and she does not look happy. This makes me even happier because I know she just got called down for hurting Bunny's feelings and not following through on her care.

But I still want to quit.

I don't want to watch any more people hurt or cry or give up. I don't want to lose any more of my friends. I don't want to wonder why someone died.

I go to the next home. It is awful. I think about the things I find and correct but I worry more about what I never see, or suspect but can't prove. I wish I were a doctor so I could tell when medical problems aren't handled correctly.

I stop beside Lawrence...the little old man who looks like a plucked, beakless chicken. He is not my patient but I love him. He is mumbling to himself, lost in Alzheimer's, his eyes so rhumey it seems he is always crying.

I touch his bony shoulder, squat down and take the hand he offers. "Hey, Lawrence," I say, as soft as a kiss on his cheek, as if I can convey every touch and hug he needs in a single phrase because I'm fairly certain Lawrence has lost the ability to understand language. "How are you?" I ask.

He gives it right back to me, the same loving glance. He mumbles unintelligibly...but it sounds like "Better." I hold his hand and smile at him. I look into his eyes for a long moment. "Yes," I whisper. "I know, Lawrence, I know."

When I am walking away I hear him, as clear as day. "I love you," he says. "Yes, I do. I know."

I am smiling as I walk away, wishing I didn't want to quit, wishing I didn't have the urge to run right out the front door every time I pass it.

I know I do good here. Last week, when I complained about Bessie's no-account son refusing to get her hair done, two people (okay, Mertis and Marti)immeadiately offered to fund her hair-do cost for a year. It's a small change, I know, but they are making Bessie's life a happier one. That's good.

I know I am being the change I wish to see in the Universe.

I just wish I didn't want to run out that front door and never come back.

Happy Mother's Day From Your Devoted Son...

When Bessie first came to the nursing home she was a nervous wreck.

Whenever you're anything at the nursing home other than demented or deleriously happy, they call me in, the psychiatric social worker. It's my job to help you find happiness, or at least get you to shut up about whatever it is that's bothering you.

Truly, sometimes that's what all it boils down to. Call in the social worker and make this problem go away.

Only I don't do that. I can't. First of all- Come on, if you were in a nursing home, would you be happy about it? Secondly, if someone's not happy, it's flat out wrong to recommend medicating them into a stupor so no one's bothered by your painful transition into Happyville.

So I try and figure out what's the worst part of being stuck in Hell, then try to see if I can't turn the flames down enough for my people to bear their new situation. Sometimes, more often than I'd like, there is nothing I can do. But when Bessie came to stay in her new home, I was able to help.

All I had to do was get her quite wealthy son to agree to come up off $12 a month so she could get her hair done. The sad thing was- this was no small feat.

Do you know that if all that stands between you and the street is your Medicaid check, the nursing home takes all but $30 bucks of it in order to cover your stay? Now, in a lot of cases that check doesn't go very far at all. Five hundred and something bucks to provide care, room and board...give or take $70 for an aspirin.

So there you are with $30 every month to clothe yourself and get your hair done. The hairdresser costs $12 a pop to wash, trim and set your hair.

When Bessie's son said his mom didn't need the services of a hairdresser, Bessie nearly lost her mind. You see, Bessie worked hard in the tobacco factory all of her life, raised her children without benefit of a father or child support, and still managed as time went by and the children left home, to get her hair done every Saturday morning.

The nursing home social worker and I went round and round with the man just to get him to leave enough of the $30 in her account for her to get her hairdone at the home once a month! Finally, the activity director flat out told the man the $30 belonged to his mother to spend as she wished and she would be getting her hair done every other week.

But it's been two years and Ms. Bessie has forgotten the struggle. She sighs and says it would be nice if she could afford to have her hair washed and set once a week.

Her cousin, who already comes over and dyes her aunt's hair once a month, shakes her head. "He's loaded," she mutters.

And now this ingrate son won't float his mom for two extra hairdos a month! $24 bucks.

"I bailed him and an even dozen of his friends out that time they got in trouble," Bessie says, giving her visiting cousin a knowing look. "Lost a week's wages goin' with them to court and God knows how much money bailin' him out. And one of them boys was the preacher's son, too!"

Bessie's cousin looks at me while Bessie searches through an old black and white composition book to come up with her current bank balance. "He's an idiot!" she mouths.

You think?

I spend a half an hour consulting with the billing department only to find out later from the activity director that the son takes all of Bessie's extra money. This is why the cousin buys Bessie's clothing and snacks and why a grandson takes her home with him on Christmas.

Bessie even set this child up with his own business when his job got too physically demanding.

When I say I have to go, Bessie says "Oh, don't leave! Just stay here all evenin' and set with us." Her new dentures, a size too large for her mouth slip from side to side as Bessie struggles to smile and talk without losing her upper plate.

I hug her, remembering one of the past social workers telling me that Bessie's son now has a lovely vacation home in the mountains. I want to kick his ass.

Instead I come home and pause for a few moments in the doorways of each of my sons' rooms.

"Listen," I say. "If you two strike it rich and I, God forbid, wind up in a nursing home and want to get my hair done and it only costs $12 bucks a week, please don't be such a tight-ass you can't spring for a once a week cut and curl!"

"Huh?" they say.

"I mean it," I say. "Do you really think a measly $12 is too much to ask after all we've been through? I mean, I get my hair done now in the outside world and it costs about a hundred bucks so I really don't see that..."

"Why do you pay a hundred now?" the practical Youngest Unnamed One asks.

I sigh. "It's a long story," I say. "And I don't do it often, but mainly it's because I tried to do it myself for so long it took extra just to repair the damage and really, that's beside the damned point. Just promise me you won't let it come down to not even getting a $12 wash and set."

"Mother," the Oldest says, sighing the word in his best, long-suffering tone. "Of course we wouldn't do that!"

He is mentally telegraphing his brother the phrase I have heard him say again and again, "Just agree with her. It's easier. You always get all up into the details and then she goes on and on!"

I stand between their two rooms, looking at the backs of their heads because they are both on the computer while having this serious conversation with their sainted mother. I am trying to decide if it's worth the energy to walk into each boy's room and whop him upside the head like I usually do for emphasis.

But I am too tired to put forth the effort.

Besides, I am probably just being irrational.

Again.

One Week Without the Unnamed Ones- Day 5

The truth is, I get as much done when the Unnamed Ones are home as I do when they're away...The only difference is, I just plain miss my boys...and now, it's worse because I even miss the Witch!

But...I did finish cleaning out and putting back the office closet and its contents.

And I wrote about 11 pages. I'm trying a new way of writing for awhile. It's called the "Don't plot it- just put the people on the page and see what happens next."

Darlene, my Flea Sister, was with me up in D.C when the approach came to me. Of course, as you may remember, I was sick and stuck in amongst 3500 therapists at a psychotherapy conference. I think the therapists helped. For one thing, if one of the presenters hadn't bored the living poop out of me, I wouldn't have started writing- inventing 2 characters to entertain me as I went along.

Secondly, I think the influence of 3500 therapists shows very clearly in this new writing technique. I put the characters on the page and try to figure them out as I type along after them.

I know...get to the good stuff, Nance, you're boring us....




All right. I went to pick up my massive quantity of jelly beans, all tucked snug in their little beribboned jelly jars. Bessie was nowhere in sight but the rest of the crew was gathered in the activity room, waiting for the afternoon's storytelling session.

As near as I could tell, they all appeared to be sleeping, or at best in a post lunch stupor.

Milly, a white-haired lady with blood-thinner bruises all over her arms and a lap rug covering her legs rolled up and squinted up at me through her glasses.

Most days she smiles and says "There you are, honey! I've been looking everywhere for you!" But not today. Today Milly rolls up, raises one eyebrow and says acerbically, "Well, it's about time! I haven't seen you in forever!"

"Well, Milly," I said, "It was only yesterday, remember?"

Milly ignores this in order to get right down to what's on her mind.

"Are you gonna clip my toenails, or what?" she demands.

Now, usually I'll go along with whatever they throw at me but I have this thing about feet- I don't let people play with mine and in return, I won't play with theirs! So before I could stop myself, I'd said, "Heck no, I won't clip your toenails. I love you, Milly, but you'd better save that for the podiatrist."

"Humph!" Milly snorts, like "what good are you then, girl?!"

The activity assistant is sitting in her office, reading the paper, probably stalling story hour until she feels inspired.

"She knows you aren't the podiatrist," she says, never looking up from her paper.

But Milly's had enough of our foolishness. She starts rolling out of the room, headed down the hallway.

"Milly!" the assistant calls. "Milly, where you goin'?"

"I'll be back!" Milly calls over her shoulder...but the assistant knows better.

"Aw, she's goin' back to her room and gonna climb up in that easy chair of hers," she grouses. "She loves her some chair!"

But I know the real truth. I've let Milly down. Not only was I not the podiatrist, I didn't even have the sense to help her save face by pretending to be the podiatrist.

I walk back out to the car, put down the top and drive away with my jelly beans. I know Milly will have forgotten all about my betrayal by the next time she sees me, but I won't.

Getting old, losing bits and pieces of your memory and your life, is terribly hard. It's full of pain and misery and the grief of losing your future and your past.

Compared to that, becoming a podiatrist is the very least I can do.

One Week Without the Unnamed Ones- Day 4

Okay, I've made so much progress left to my own devices, I decided to send myself to work- in hopes maybe they could do some thing with me.


Nope. I got as much accomplished there as I did here at home!

However, I learned a lot more about my old guys than I usually do...just by resolving to sit absolutely still and see what happened...

I learned:

Mild, sweet-mannered Mary was bad to fight in high school. She didn't like it when folks got "snobbish."

"I know how they do! Black folk do it too," she cried. "Just like this other Mary I knew. She weren't nobody! I knew her from second grade right on up through high school. Then she started goin' with this man and acting like she all better than us! She used to pick on Blondell. We called her T.B on account of she was so little!"

"Why T.B?" I asked.

Mary looked at me like I was stupid. "I don't know! On account of she was small, that's all I know! Anyway, that bad Mary, she was pickin' on Blondedell,I mean, T.B, one day and I said 'Leave her alone!' And don't you know that witch turned and started to slap on me?!"

Mary snorts, balls up an arthritic fist and shows it to me. "I punched her right in the mouth! Knocked her front teeth out!"

"You did that? Mary! Not you!" I said.

Mary smiled. "Yeah, honey! I was a good fighter!"

"You know, that girl's dead now. That married man, he died, then his wife died and ole Blondell, she gone too, now."

At this point Bessie comes into the room. She's a frail little old lady, walking with a cane and holding onto a jelly jar filled with...jelly beans. She spots me from the hallway, sitting with Mary, and she knows I'm a sucker.

"Hey, lookit here," she says, wandering into the room. "Look what we made in activities!"

She gives me this smile that has been unnerving me every time she does it- at least for the past month or so- since Bessie got her new dentures. They're about 2 sizes too large and they slip when she talks or smiles, so when she's talking, you can't help but watch her teeth slide one way as her lips go the other way and well, just forget trying to be a good listener who makes eye-contact! It's all mouth with Bessie.

She waits until I've about drooled all over the jar and praised the beauty of her work before she sets the hook in me real good.

"We're sellin' 'um for our activity trips," she says. "You want one?"

I ask how much. She says $2, which seems like a stone cold deal to me, so I say, "I'd like 5."

"Five? Five!" Bessie clutches at her chest, starts hyperventilating (I kid you not- I couldn't make this up...) She backs up, out into the hallway where she stares anxiously at the activity room door, like she needs rescuing. "Oh, Lord! Oh, dear! They're gone. They went home! We can't make no more til tomorrow! Five! Oh Lord!"

I assure Bessie it's no big deal. I'll be glad to come back tomorrow and let the Activity director handle this monster order and, once she's calmed down, Bessie wanders off to get the nurse to give her another "breathing treatment."

Mary waits until she's wandered a few feet away before she says, "I'm so glad me and her made up."

I nod, remembering that for a short time Mary and Bessie were roommates but Bessie's a mite bossy and Mary doesn't want any old white ladies mistaking her for their maid or worse, their child, so the two parted ways...peacefully, I thought.

"Yeah," Mary says. "I was out in the hallway in my wheelchair and I just leaned over and took her hand and told her I was real sorry for the harsh things I said. And she said, Oh now Mary,we all say harsh things we don't mean when we're angry. I'm sorry too.'"

Mary smiles. "You know, she's in with a lady now, smells real bad."

Mary nods her head, like what goes around comes around, and adds, "I even let Bessie borrow my room spray to clear out the smell in her room. And to think I was going to get her. I really was."

Now, I must admit, I wasn't paying close attention when Mary said this. All I did was nod, until Mary said something about being in her room while the aides and her nurse were dressing her one morning and she kept telling them to hurry up. "I told them, I got to be ready before Bessie comes out her new room cause I'm gonna run her over! I'd heard enough of her mess, you know?"

I nod, thinking Mary wouldn't hurt a gnat.

"Them aides was all laughin'. But when Bessie came out her room, there I was! I dug in on the wheels and took off after her and if Katrina hadn't come flyin' down the hallway and grabbed my chair, I woulda nailed her! I surely would! I was this close!" She shows me a small 6" gap between her two hands.

Mary smiles, the same sweet little old lady smile she always smiles, only now I see the rotweiler in her.

"I think back on it now and I sure am glad that Katrina stopped me. I just think what they might've done to me if I'd hit Bessie. They might've kicked me out of here. Then what would I do?"

Note Mary doesn't say she might've hurt her dear friend, uh-huh, she's worried about her own ass!

"Yeah, that Bessie's a sweet thing," Mary says smiling softly to herself. She stares down at her hands and I know she's reliving the feel of her wheelchair's thin rubber tires as she pushed off, determined to murder Bessie. I wonder to myself what might've happened had Mary been left to her own devices!

I make a mental note never to turn my back on dear, sweet Mary, especially when she's up and out of bed, roaming the halls in her lightning fast wheelchair.