Time, whose side are you on?

I don’t cry much, but when I do, it’s usually because a truck full of Cub Scouts just drove by in a 4th of July parade. It gets me every time.

I didn’t cry when Dad died. The tears appeared months later heading down the street to my doctor’s appointment at St. Thomas Hospital. I thought of the conversations Dad and I had on the way to visits with his primary care physician, and a hole bored through the middle of me. There’s no way to fill that kind of hole. It’s best to just let it scab over and scar.

Mom dreaded this appointment with the cardiologist. At her last visit six months ago, he’d told her to cut out salt entirely and lose some weight. Mama can’t stand for anybody to be unhappy with her. He was just doing his job when he told her to mend her behavior. She hadn’t seen him in a year, and she had suffered congestive heart failure while vacationing in California. He legitimately wanted to curb any fluid retention. She thought he would surely give her a talking-to this time since she hadn’t lost a pound, nor had she completely cut salt from her diet.

On the way to I-65, I tried to make light of Mom’s worry about her encounter about to happen. I told her, “Don’t let him rattle you, Ma. Just say, ‘uh-huh’ and ‘I’ll do better next time.'”

“Or,” I added, laughing, “when he says you didn’t lose any weight, you tell him, ‘Well, you didn’t, either!'” We’d noticed that last time he’d picked up about twenty pounds. He’s always been a natty dresser, and he still looked good in his yellow plaid jacket and blue pants, but we were sure he’d had to purchase some new ones.

St. Thomas is not known for the easiest parking arrangements. There was no space in the semi-convenient open-lot parking downstairs, where we would normally take an elevator up three floors and walk down a long hallway. We had to park in a multi-level garage across the street, walk down a long skybridge connecting the garage and hospital, then directly into the other end of the Heart Institute. In my mind, the distances are fairly equal. There is a small difference, though. That skybridge is ever-so-slightly uphill.

I offered Mom one of the hospital wheelchairs waiting just outside the skybridge doors.

“No, that was way too much trouble the last time we did that. I can do better with just my walker.”

“Okay,” I said. “We can rest along the way if you need to.”

She needed to rest several times. Fortunately, the hospital designers saw the need for padded benches built into the windows every twenty feet or so. The seats are chair-height, so I tried to get her to sit in her rolling walker. She wanted to sit on the bench. Getting up and off the bench to grip the walker’s handlebars was difficult and required assistance.

When we finally reached the entrance to the Heart Institute, the nurse screening for Covid-19 waved us into the large waiting room.

“Go ahead and get her seated up in the front,” she said. “Then you come back and I’ll check your temperature.”

Mom sat on her walker in a section of chairs near the registration desk. I had pre-registered the night before but was still expecting more paperwork, or tablet work, once we got there. To my surprise, there was nothing more to do.

I sat down beside Mom. She was spent and breathing too heavily to talk. She looked pitiful.

When the nurse called Mom’s name from the doorway to the exam rooms, I quickly stood and met her at the doorway to say, “She can hardly make it. This might take a minute.”

I turned back toward Mom. Deborah called out, “Did y’all just walk across the skybridge? Oh, God love her. Keep her right there. I’ll bring a wheelchair.”

“I’ve never seen her so exhausted.”

And right at that moment, I saw my usually lively little mama grey-faced, eyes drooping, and so short of breath that her mouth was halfway open. Maybe what shook me was some form of pre-grief. The Universe suddenly reminded me that I won’t have her with me always.

I know that in my head, but this knowing, this moment of sorrow, was a gnawing in that hole in my middle, maybe opened just enough to make me break. I could not let my mother see me crying.

Mom was relieved to scoot onto the wheelchair seat. The nurse quickly wheeled her to a room, helped her into a chair, and rolled the wheelchair into the hallway. The room is small. I stood just outside the door.

“If you don’t mind, I’ll take her back to the garage in this chair. I can come back and get her walker.”

She answered, “Honey, you just relax in here with her, and we’ll take care of the rest.”

The doctor arrived in about fifteen minutes. He seemed so happy! He began by cheering Mom’s blood pressure, her stable weight, and her obvious (to him) sparkle in her eyes. He directed a question to me.

“Don’t you think she’s doing well?”

I nodded. “But wait, what’s that on your mask?”

He answered, “I was just about to tell your mom that we have a new addition to the Blair family tree.” (His grandmother was a Blair in Texas, and he has always insisted we’re all related.)

He pulled his pictures up on his iPhone, turning it this way and that to make sure both Mom and I got a good look at this little six-month old in snazzy yellow plaid overalls, blue jacket. and a matching bowtie on his white shirt.

“Oh, what a cutie!”

“Isn’t he a handsome young man?”

He answered, “Oh, that little fellow has us all wrapped up in him. Oh, my.” He closed his eyes and moved his head from side to side. “His name is Walter.”

“Walter!” Mom said. “My husband’s Grandfather Blair was named Walter.”

After the baby talk, the doctor said, “You’re doing well. I think, and let’s see if you agree, that we should see you again next year. Of course, you can always call if you need us.”

“I guess I’m doing well for my age,” she said.

“You’re doing well for any age,” he answered.

Mom and I got the giggles when he left the room, bemused by the way Walter captivated this cardiologist-surgeon, and relieved that no one seemed unhappy today.

“He was just too enthralled with that new grandbaby to fuss at me,” she said.

The nurse appeared. “Diana, I’m going to take her to your car. You just bring the walker.”

I lifted the walker into the back of the van, backed out, and stopped at the elevator doors.

Mom thanked the nurse and closed the van door.

“Next time,” she tol me, “I’ll take that wheelchair at the beginning.”

We pulled out of the garage. “Ahhhhhh, sunshine!” I said.

“And thank God for Walter,” Mom answered.

***

The Last Best Place on Earth

For Dad, it’s Alive Hospice, Murfreesboro, Tennessee.

The Nashville facility was full and the admissions nurse so determined that Dad needed to be there that she sent him to the Murfreesboro campus at midnight Friday.

Daddy rests in a large room halfway between the nurse’s desk and a family room containing comfortable chairs, recliners, and couches that flip into beds. There are several family rooms here, one with a dining area in front of a wall full of windows. The light streams in as if on cue.

In Dad’s room, we keep the lights dim. The room is quiet and peaceful; so is Dad.

He only stayed at the skilled nursing facility less than two days. We knew it was not the place for him, and when his kidneys began to fail Friday, the attending nurse practitioner recommended an immediate move.

With the help of the SNF’s social workers and nurses, Alive Hospice Nurse Gail ordered an ambulance for 11:00 P.M. They arrived at 11:45, two youngsters in ball caps reading Medic One.

“I’ll be riding in the back with him,” the smaller one said. “I see his diagnosis here is dementia. Has he ever become combative or kicked or punched a nurse or tech?”

I hesitated. “Yes, he did at the hospital, but that was when he was in complete psychosis. He’s not doing that now.”

“Well, I just wanted to let you know that if that happens….”

Big Guy butted in. “No, no,” he told his sidekick. “If something happens, you just let me know and I’ll pull over to the side of the road and come back there to help you get him calmed. We want to be very soft…soft.”

I could actually imagine a scene like that.

I left before the ambulance. The ramp to I-440 was closed, probably because of a fatal accident earlier in the day, but when I turned around to go the opposite direction, there were cars making left turns onto the interstate so I followed them.

I met Shirley, the night charge nurse, the techs, and the front door security guard. Shirley went over the care plan, medications that they’d be using, and ways they operate. She said the doctor would see me on Saturday. I told her it was already Saturday.

A nurse stuck her head in the room. “I am wondering what is taking that transport so long. Did you leave a long time before they did?”

“No, I was right in front of them, but I bet they got to that closed ramp and found another route.”

Turns out, that’s exactly what happened. They were automatically re-routed.

Dad was awake. Shirley explained what was happening.

“Ernie, we’re going to give you some pain medication and then we’ll give you a bath first thing and get you all freshened up.”

Two techs and two nurses busied themselves over him. He talked to them in slurred speech and from an altered state, but they caught about every third sentence.

“You are a handsome man,” one said. Another asked him about his 72-year marriage. “What’s the secret?” she asked.

“Let each other be free to grow and develop” is what we think we heard. I confirmed that he might have said that.

Then came the washing of the private parts.

“Ernie, we are going to have to wash you down there. Normally, we’d just let you do it, but you have some leftover bm there and we want you to be clean, okay?”

“Ah, you girls just want to look at me,” he said. “All the time.”

We all laughed at him.

“No, we don’t, but I’m going to raise your gown and clean you up and then we’ll put a fresh pad and gown on you.”

He picked up a towel a tech had left beside him. “Then I’m just going to put this over my face,” he said, and hid his whole head from the offending eyes.

We laughed some more, but they got him cleaned up and bundled up in his new bed.

***

Dad now gets a pretty stiff cocktail of haldol, morphine, and a valium-like drug. The dosage is small but repeatable. If he is not calm twenty minutes after the last offering, the nurse starts the routine again, or she slightly increases the morphine.

He lies quiet in the bed most of the time but when the meds start to wear off, he twists, grimaces, and mumbles.

The grandsons and families came to visit yesterday, including Jaxton and Savannah, ages 5 and 3. Neither was upset by Grandpa’s condition. Savvy said hi to him several times, anxious to get an answer from him.  Mom was glad to see the little ones.

I stayed last night. I played music to him and sang to him, hoping something might connect. In the middle of the night, I heard him say, “Diana.” I wasn’t sure of that until I sat up and waited for him to call me again. It’s like what happens when you try to say my name without being able to move the tongue.

“Lie-ah-uh,” it sounds like.

“What, Dad? What do you need?”

He grasps my hand. I kiss him on his old bald head.

“You’re in a really good place,” I tell him.

 

Trying hard to leave.

My daddy hovers, sometimes thrashes, naked, his mind somewhere along an invisible jagged line between his tiny spot of time and space on earth and the ultimate reality of Infinity.

His heart beats so fast sometimes that we fear stroke. Doctors get his heart rate down and his blood pressure goes up. Get the blood pressure down too low and some other wheel falls off the old bus.

He fell in his bedroom sometime very early a week ago Tuesday morning. Before we found him on the floor with a bloody gash on his head,  he’d pulled shirts, belts, and a bootjack from his closet. He told us he’d ducked into a shed for shelter from the rain and realized he’d stepped into some man’s corn crib. Then he couldn’t get out of the field and had crawled through rough straw for miles.

Dad did not get confused because he fell; he fell because he was already confused in the night and hallucinating. We’ve seen a slow slide toward dementia for about three years, but since last Christmas the disease has tracked him like a cat, consistently and with increasing speed. We’ve watched a wretched auto-immune disease rob him of the ability to enjoy food and then to swallow well. His legs grew weaker and weaker, so often he could not stand, even with his walker.

In the emergency room after the fall, he fought with three cats, two black and one black and white, that kept pouncing on the bed. Every time he kicked them off, they came back.  I shooed them away. He re-told the corn crib story with variations and repeated an earlier adventure stripping tobacco with two youngsters who would not talk to him. He was pretty sure they could talk, they just wouldn’t. The ER physician called a hospitalist to provide overnight observation.

Once in the room on the fifth floor tests began, including an ultra-sound on his legs. The technician came in Wednesday morning, made it through the scan of one leg and then Dad refused. He kicked at the machine operator. She dodged and moved the equipment. He kicked some more. When nurses arrived to rescue the tech, he doubled his fists and slapped at them.

I said, “I don’t think you’re going to get that next one.”

She smiled and said, “I’m pretty sure of that.”

Within a few hours, the a-fib grew worse and Dad grew so wild and combative I wished for restraints. They came quickly. He did not sleep–not one wink-– for four days.  One night, I bent over to pick something up just under the edge of his bed and even though his hands were tied, he grabbed my hair. It took a few minutes to pry his hand loose.

My dad’s wild mind fashioned a scary story with escalating horror. He gave me the base plot as he dressed me down. I was trying to kill him, leading a band of nurses are my followers. He kept saying that he can’t believe I would do this for money.  “Greed. Evil. You are no daughter of mine.” I stood stark still, as if at attention, stung and disoriented. The words might have attached themselves to a deep sorrow if I hadn’t heard a voice. “This is not your dad.”

For several hours, there was a huge farm machine loose on his farm. We–the nurses, Jade, John, and I–had already destroyed the farm with this wrecker/excavator. We knocked down trees and ran through the shallow creek, breaking the flat limestone into small pieces. We were going to let it run over him, and then it was somehow above him and we were preparing to let it fall to crush him. One hour we were setting him afire. Another time, we were trying to poison him.

He disowned me, then started yelling again. I tried to slip a dry mouth lozenge in his mouth but I wasn’t quick enough. He can’t bite since he has no teeth but he clamped his jaws shut, turtle tight. Then he said to the air on his left, “Jameson, look at your mother. This is the kind of mama you have.” Jameson is my grandson, not my grandson, and he is safe at home in his own bed.

Dad got back to serious yelling. “Where is Mom [my mother]? She’s the only good person around here.”

The student nurse asked, “Does he like music?”

“Yes!” I said. “I can’t believe I haven’t thought of that. I should have brought in a player. There’s no music channel on the TV.”

Wait, I thought. I could stream from my laptop.

I grabbed my almost-dead HP from my bag and began the frustrating process of hooking up to the hospital free-for-visitors wi-fi. It’s a finicky network. I spent twenty minutes and then gave up.

Dad changed the venue. “Help! Come on, we’re down here in the bottom by the creek. They’re trying to crucify us all.”

The last time he had mentioned crucifixion, the nurses were attaching restraints. I watched him pull at the cords and thought of rodeos and roped calves. I remembered a pig bound and hung for slaughter at my grandfather’s farm, and of holding my dog Murphy for an injection.

That night, I left him praying. The words were plain and the sentences cohesive. “Lord, thank you for this life I’ve been given. And if you want me to die now, I’ll come. I ask you to forgive Diana and all these evil persons who are doing this to me. They know not what they do. Take care of their little children.” I walked out of the room, on down the long hall to the parking garage.

The next time, he was on the hill at the farm in Smith County. He called for his mother. “Mama, come on here. I’m up on the hill. They’re about to kill your last son. Don’t you see the smoke?”

He did not remember that seventy-two years ago on the same day, Halloween, he and my mother took a long taxi ride to Georgia and married. He was seventeen, she “fourteen-almost-fifteen,” they said.

My mom waits at home, not really worrying, just pondering. She is dressed in blue matching pants and top, her curly hair neatly combed back, and her ensemble accessorized with the usual rings, earrings, bracelet, and necklace.

After two days and several doses of psychiatric drugs, the restraints were removed. He was still agitated but not trying to hurt anyone. He rolled his sheet and blanket into a wad and tossed them to the floor. He pulled his arms through his gown, easing the heart monitor through a sleeve. The gown and a couple Chux pads found the floor. I heard a pop, pop, pop as he removed the leads to the heart monitor. He seemed pleased that he had wires to untwist. He repeated the process several times.

He slid down the bed and pounded the foot rail in a surprisingly steady rhythm. He called for my mother, yelling louder than he’s been able to in years.

I told him, “Dad, Mom is not here.”

Sometimes, for a minute or two, he believed me when I told him, “You’re in the hospital, Dad.”

“In the hospital? What am I doing here?”

I told him, “You have to stay for a while until you get better, and you are getting better.”

“Am I in South Carthage?”

“No, Dad, you’re in Nashville. At St. Thomas.”

At times, it connected and he said,  “Oh-h-h-h-h-h.” Another time he added, nodding his head, “So that’s the problem!”

One afternoon, he asked, “Did you know the cats are back?”

“No,” I said. “What are they doing?”

“Oh, they’re just lying around down there at the foot of the bed.”

I said, “But you’re not trying to kick them off.”

“No, I got used to them.”

From time to time, the psychiatrist Dr. Le Coguic stuck her head in the room to ask a few questions with telling answers.

She: What year is it, Mr. Blair? He: 2017. She: When were you born? He: Five, twenty-nine, no. Five, nine, no. Twenty-five. She: That’s good enough! Now who’s the President? He: Truman. She: Hmmmmm.

I snuck in a word there. “He really knows. I asked him myself yesterday and he said Truman and I said, ‘No, it’s Trump, Dad,’ and he said, ‘Yes, that’s who I mean so just pretend I’m saying Trump when I say Truman.'”

Dr. Le Coguic laughs out loud. “Good enough!” she said.

The next time she asked him, he said, “Oh, that damn Trump. Truman.”

The morning of November 7, I walked into the room where a soft-spoken chaplain introduced herself to me as Gail. She was asking Dad if he was a spiritual person. She didn’t understand him, but he answered her, “I suppose so. I’ve got a Master’s of Divinity from seminary.” I translated a few sentences to her until Dr. Chris MacMurdro from the Palliative Care Department stepped in. Because Dad was still talking with Gail, Dr. Mac asked if we might step down the hall to talk.

“Call me Dr. Mac or Chris,” she said and explained her specialty.  After several minutes of discussion about what I might expect or anticipate or decide, Dr. Mac told me with his refusal to eat or drink, Dad would likely be gone in two weeks. It’s too early for hospice, she said, but you will need them. If Dad goes to a skilled nursing facility, he might get a few days.

Just as Dr. Mac and I were ending our conversation, Gail approaches us from the doorway of the family waiting room. “Your dad,” she said, and placed her hand over her heart. “Oh my. And thank you for helping me understand what he was saying. I could understand him after that.”

“Good,” I said.

“This is the first time a patient has prayed over me,” she said.

“He did?” I asked.

She teared up. “I asked him if he would like me to pray with him, and he took my hands and said, ‘I’ll pray for you.'”

“And he did?” I said.

“Yes, and now I have to go sit down somewhere and cry.”

***

1105181807a
Still a small smile.

Later that day, when I told Dr. Mac the evening Zyprexa seemed to make Dad more agitated instead of less as it was supposed to do, she wanted to revisit his history of hallucinations and his increasingly weak legs. “Let me go back and look at his chart again,” she said. “I’ll call you back.”

“Dad,” I said, “would you drink one of your protein shakes? I have a cooler over here with three drinks in it. Which one–chocolate or vanilla?”

His eyes lit up a little. “Chocolate!”

I rolled the bed up and offered him the straw in the bottle. He tried to take the bottle.

“I want to drink it. Myself.”

“Well, okay.” I grabbed some Chux pads and tucked one around the top half of his body. I helped him hold the drink, with him struggling to wrest it from me, until I knew he’d had enough that he wouldn’t immediately pour the stuff all over himself.

He drank almost all of the eight ounces. He drank almost ALL of the EIGHT OUNCES, the most food of any kind he’d had since more than a week ago. 

Dr. Mac called.  “Diana, this is not Alzheimer’s. I’m thinking more like Parkinson’s with Lewy bodies. That would explain the reaction to the Zyprexa. Do you know much about Parkinson’s?”

“Enough. A lot,” I said.

She said he wanted to confer with the hospitalist, Dr. Meadors, about switching him over to something like Valium, which would be much more effective if we were treating Parkinson’s.

Sure enough, the Valium (or whatever it was) helped calm him. Dr. Mac called to say that Dad appeared now to qualify for in-patient hospice, and she had arranged a meeting with Rosie from Alive Hospice downtown. She explained her wish for inpatient hospice.

“The Parkinson’s thought changes everything. His medications seem to be headed in the right direction. He could use the meds management at inpatient to get them all tweaked to the point that you could manage him at home with the help of home hospice.” She fears for my ability to physically manage him at home right now and for my mother’s emotional health as she watches Dad decline.

I made her promise that she will always work toward our goal of getting him home. She repeats to me all the information I’ve given her, including the DNR and comfort care directives.

End of day, Wednesday, November 7.  Dad slept peacefully almost all night.

Yesterday morning, he knew me when I arrived. He smiled and said, “Hello, honey.” Dr. Mac called to discuss the latest strategy since he has improved enough that he probably does not qualify for inpatient hospice. “We’re thinking we can send him over to the rehab facility.”

Dad and I sat in quiet most of the day yesterday. He was tired. He thought he might want sausage and eggs. I tried. He drank a bit of milk shake. I tried again. I massaged his aching hands with cream, swabbed his gums and washed out his mouth.

“You’re going to make me bald,” he said when I rubbed his head. That’s a little joke we have. Not long after that, we both dozed at the same time.

When I told him I was leaving for the day, he said, “Be careful driving home. Is it still raining?”

I said, “No.” It did not rain all day yesterday.

Just as I started to exit the room, he called softly but firmly, “You are going to call Red Blair to help you get that big machine off the hill, aren’t you?”

“I sure will,” I promised.

*****

 

 

 

 

 

Ins and Outs, Part 1

I have two mental lists of “Things that indicate that I’m old”—even though I’m not. Old.

List #1-Visible Signs:

  1. Chin hairs. Need I say more?
  2. Wrinkles. I don’t have many, though—because I am plump.
  3. The way I get up out of a chair after sitting for a while. I tend to walk like Fred Sanford for the first few steps.

I’m sure there are more items that might be added to that list, but I don’t pay much attention to those external things. Oh, wait… I have to admit I’m death on chin hairs. Chin hairs are out with just about everybody I know.

It’s this item on List #2-The Way People Treat Me that widens my path to so much indignation:

  1. “Sweetie”.

Now, all us good Southern girls call each other—and people we don’t know—Honey. Honey is a versatile salutation. Rarely do I hear the word used in any offensively condescending way, but when I do, I can usually overlook the idiocy of the sexist sales clerk or forgive the sweet Yankee girl who just wants to fit in.

But, now, there’s that “Sweetie” thing. I just never hear that word used in a nice way—ever. It makes my eyes squint and my short neckline itch. It’s, at the least, patronizing, and, at the worst, condescending.

So, everybody listen up: “Honey” is in, “Sweetie” is out.

Mom and I got a few lessons on Ins and Outs in the last couple of days.

Several weeks ago, after a routine ultra-sound, Mom’s cardiologist, Dr. Scoville, ordered an angiogram on her carotid arteries. An angiogram is an X-ray of dye injected into the blood vessels. We presented for this outpatient test twice and, each time, Mom was sent home because her creatinine levels were high, an indication of poor kidney function.

Upon each rejection, we received apologies and the explanation that “we have to make sure her kidneys can get rid of the dye”. We understood, after that second rejection, when Dr. Scoville said she needed to see a nephrologist. Scoville has been in for a long time; in fact, he’s the most in of any of Mom and Dad’s doctors. Scoville is the reason they choose St. Thomas Hospital over several others in Nashville.

One day, we traipsed into Nephrology Associates to see what Dr. Vito Rocco might suggest. Dr. Rocco never once called Mom “Sweetie”. I think the phlebotomist might have, but whatever she said was overpowered by Dr. Rocco. He talked to Mom as if he were talking to a non-physician peer. It doesn’t hurt that he sat down and crossed his legs as if he had all the time in the world, and that, according to my 81-year-old mother, “man-oh-man, is he ever easy to look at”.

After careful investigation and deliberation, Dr. Rocco’s recommendation was to admit her to the hospital one day about 10 o’clock, hydrate her intravenously for the rest of the day and night, and do the angiogram the next morning. Dr. Scoville’s office ordered the admission and his nurse gave us instructions. “All you have to do is walk in on Monday and get admitted. They’ll start a drip, they’ll do the test Tuesday morning, and then you can go home.”

We left for the hospital at 9:15. Mom was waiting in the driveway, dressed in a navy blue pants suit with pink embroidery trim, her hair arranged and her makeup applied well. Her jewelry was subdued–for Mom. She wore pink rhinestone earrings and a silver-tone watch. She carried a few items in a zippered tan nylon tote.

Getting in was not quite as simple as Dr. Scoville’s nurse had projected. Mom got a number immediately, and she was called to speak with the admissions clerk right away, but then we waited for someone to come with a wheelchair to take her to her room. And we waited…

I went to the desk once to ask if things were progressing and a second time to ask if there was a chance of falling through cracks.

“No,” the handsome guy at the desk said (both times), “They’re cleaning a room for her.”

Mom went to see the handsome guy, too, and he told her of this intensive cleaning project.

“That room must be some kind of mess,” she told him and sat back down.

We were getting tired—and hungry, and somebody (we didn’t know who) was on their way to being out with my mother. After she sat down that time, she joked, “Go up there and tell him we’ll go up there and clean that room for them if they’ll buy us some lunch.”

“You know, I do think I’ll ask him if we can go downstairs to lunch,” I said. “It would at least pass some time. This is ridiculous.”

“No,” he said, “I’m just afraid they might come to get her and you wouldn’t be here. But you could get lunch right around the corner at one of the sandwich bars and bring it back here to eat.”

“I don’t want Subway,” Mom said.

“I don’t, either, but let me go over there and see if I can find a little snack to tide us over.”

I brought her Captains’ Wafers with Honey-Peanut Butter and a bottle of apple juice.

“Oh, this is good,” she said. “I think these are the best crackers I’ve ever had. I’ll have to remember this. The honey is just the right touch on that peanut butter.”

More talking and snack finished, Mom raised up from Dolly the Rollator’s seat and just as the handsome guy hurried around us, back to his desk. Now he was wearing the jacket to his suit-pants.

“Where are you going?” I asked.

“Going to talk to him,” she said, nodding toward desk. I knew better than to try to stop her.

“Hello,” she said just as he approached his chair. She was not too quiet but she had such sweetness in her voice. “I’m not going to wait any longer. It’s time…”

He never really got sat down. He jumped up from his almost-made-it position.

“Oh, no,” he said. “They haven’t come after you yet…Oh no. I am so sorry. I thought you were gone. Okay, I’m going to take you myself, that’s what I’m going to do. Wait right here. I’ll get a wheelchair.”

Mom turned her head and smiled at me, triumph in her eyes. I grabbed our bags.

“Here, you’ll have to take Dolly,” she said, assuming her queenly reign in the throne of  a wheel chair.

“I’m just so sorry,” he said as he opened the footrests. “We went to lunch, and we’ve got contract people doing this job now and …”

“You mean the transporting?” I asked.

“Yes. We just never know.” He paused. “Y’all, wait right here. I have to get you a gift.”

He trotted in and out of his office and handed me four little cards. “These are meal tickets for the food court,” he said. “They pay for everything. Y’all please enjoy.”

He wheeled Mom through the large room of benches, chairs, and short couches. The name on the sign now says Reception Area. The old name seems more appropriate—Waiting Area.

“We did you wrong, Sweet Pea,” he said to Mom.

“Sweet Pea,” she said. “I know you didn’t know that my nickname when I was a kid was Sweet Pea.”

“Really? Like a sweet-smelling flower,” he said with a big grin.

“Well, actually, I wasn’t named after the flower. This little neighbor boy said I frowned just like Sweet Pea in the comics.”

“Nooooooo,” he answered. “I can’t believe that. You’ve been pretty patient with us.”

The handsome guy handed us off to an arriving transport person at the elevator. She needed him to help solve a problem back at the admissions desk.

“Bless you, Sweet Pea,” he said just before he hurried back across the Reception Area.

We both called after him, “Thank you so much”—and we meant it.

We were IN. Mom sat on the side of the bed. “Well, I would change my clothes,” she said, “but I don’t see a gown. I’m ready to eat.”

“Okay. Maybe I’ll just go on down to the food court and get us some lunch with our freebie tickets. I’m not sure what it’s going to be. That hot lunch line is different every day.”

“I don’t care what it is. I’m hungry,” she said. “And I need to take that Flagyl. I brought it with me.” She had about four days left of two antibiotics for last week’s case of diverticulitis.

“I wondered what they would do about that,” I said. “I know they’ll give you all your regular meds, but it seems silly for Medicare to pay for more Flagyl and Cipro here when you have just enough. We need to ask them about that.”

“There’s a wet spot on this bed,” she said.

“Now where did that come from?” I asked.

Two nurses appeared with a gown; the first introduced herself and her shadow. Number 1 was the nurse and Number 2 was in training. We got acquainted. They were both the same age, 25. Nurse graduated from Tennessee Tech in Cookeville; Trainee got her nursing degree from Belmont and a Master’s in Public Health Administration from Vanderbilt. We liked both of them.

“We’re glad to see you,” Mom said. “It took us two-and-a-half hours to get in.”

“What in the world?” Nurse said. “Were they just backed up? This room has been ready since 11:30.”

“There’s a wet spot on the bed,” I said.

“Now, where did that come from? Would you get a change?” Nurse asked Trainee.

“We’re going to start your IV, Sweetie,” she said, “and then Somebody will be in to do your admissions paperwork.”

The two changed the draw sheet and pad on the bed and then discussed veins.  Mom told them they usually had to do the left arm. She has bad veins. They considered the hand but decided that Trainee would work the IV into a tiny little vein in the crook of Mom’s left arm. Nurse told her she did not need to squat on the floor, and that she needed a better angle. Trainee said she could do it better in the lower position, but she rose a bit and corrected her angle. Mom winced and I worried while she wiggled the needle. After a few minutes, and several unsuccessful tries at re-positioning the needle so that it moved blood into the line, Nurse took over. I held Mom’s hand and tried to distract her.

“Oh, Sweetie, I am so sorry,” she told Mom as she probed. “Did you bring your medication list?”

I answered. “No, I didn’t realize you’d need it. I was thinking that this was just an observation admission. Dr. Scoville’s nurse sort of said just walk in.”

“Well, actually, it’s an admission to hydrate her so that she can have the dye tomorrow. We want to make sure her kidneys can handle it. That’s why they have her here. The dye is hard on the kidneys.”

“Yes, we know why she’s here,” I said.

Mom added, “I’ve had this test done several times. I know all about it.”

“I can do a medication list for you,” I said.

“Yeah, we need that,” Nurse answered.

She stood up and claimed a victory. “It’s in,” she said, and then added, “But it’s not in the way we’d like to see it. I’m not sure it’s going to stay in. I think you’re going to have to hold this arm pretty still, Sweetie.”

“I can do that,” Mom said.
“Can you eat with one hand?” I asked.

“Oh, yeah. Just watch me. I need some water,” she said to Nurse. It was the second time she asked for water.

“Can I also beg you out of something to drink?” I asked. “Anything diet would be fine.”

“Okay,” I said to Mom as they left the room vowing to bring water and two Sprite Zeroes, “I’ll go get lunch.”

“Oh, boy,” she answered.

Just as I returned with baked chicken, sweet potatoes, squash with broccoli and peppers, and apricot cake with citrus glaze, the admissions nurse arrived, pushing her laptop on a rolling stand that also afforded a seat. We liked her. Somehow, we all got started on her show dog, a Rhodesian Ridge-back. I wrote the name in my notebook. She showed us a picture on her phone. We re-constructed the medication list from what was in Mom’s record. I asked if she should take the Flagyl and Cipro she brought in.

“I can’t answer that,” she said. “That’s their job. I don’t step on their job. They’ll let you know.”

“I didn’t get you anything to drink,” I said, and as I was opening and arranging the food boxes, Nurse and Trainee arrived with the drinks. They breezed right out.

“Here, Mom. Take this Flagyl. I forgot to talk to them about it.”

We loved our lunch. Mom ate the whole thing with her one free hand (fortunately, the right); she didn’t spill a morsel.

“Let’s take a nap,” she said after I cleaned up. “I think I could nap.”

“So could I,” I said. “And I put your Flagyl and Cipro in the pocket of your bag.”

“Okay.”

I packed my bag to leave for home around 4:00. I promised her I’d stop by Ross to see if they still had a pair of sandals she tried on but didn’t buy on Saturday. I called Dave just before I pulled out of the parking lot to tell him I was on my way with one stop.

Mom called about 7:00. “Bring my medicine tomorrow. They told me I need to take my own or they’ll have to order it and I’ll have to pay for it myself and you know how outlandish that would be.”

“Really. That’s interesting. Then this really must be what they call an ‘observation’ admission.”

“Who knows,” she said. “And they also told me it’s not a sure thing I’ll even have the test. They said they’ll do blood work first to see if the IV’s work.”

“So you don’t know when they’ll do the angiogram.”

“Nope. I guess I’ll know tomorrow. If they do it. Did you see your father tonight?”

“Yep.  He’s fine. Tired. He was down in the ravine today, clearing vines and chopping brush. He got my chair.”

“The one the wind blew down in the ravine?”

“Yeah. I don’t know how he got it but he brought it up and tied it down.”

She laughed. I told her I hoped she could sleep okay. She said she’d call as soon as she knew something about the test.

“Goodnight, Sweetie,” she said.

I didn’t mind. She’s still in with me.

Tune in for Part 2.

***

The Old Folks Go on Vacation

Mom and Dad are going to Nevada on Saturday and they’ll be gone for three weeks. I find that I am sad—not exactly worried, or anxious, but just sad to see them go, sad to wonder “What if they don’t come back?”

I remember having the same wigglies in my stomach and gnawing in my chest when my sons left for camp. There was this same question “What if something happens to them?” but I could talk myself out of worrying about the kids easier than I can convince myself to give it up about my folks. After all, Dad is 82 and Mom is almost 80. They’re closer to heaven than they’ve ever been before.

Mom had emergency gallbladder surgery on September 19. We’ll keep a follow-up appointment with the surgeon this Thursday, just two days before she and Dad board Southwest Airlines for a direct flight to Reno. She’s not 100 percent yet, but her zigzag, one-day-good-one-not-so-good recovery has propelled her to at least a healthy A-minus. She tires very easily and still has some discomfort in her abdomen. And she’s going to ride across country in an airplane. Is she really, really, really ready to go…

Dad is cleaning off the bank of the ravine in back of the property. He devised a clever system of laying a tall ladder on the bank with the bottom rungs and feet anchored against a big tree. Then he shinnies down the ladder with his tools. The trees and undergrowth support him as he makes his way across the bank, felling scrub trees and pulling heavy vines. When he gets tired—actually, he says when he is “about to get tired”—he crab-walks back to the ladder and climbs back to the yard.

The second day he went down the bank, I took his picture. He looks like a strong-as-an-ox 70-year-old farmer, maybe even younger, in worn overalls, a faded blue bandanna wrapped around his bald head for a do-rag. I hear him hacking through the brush as I write. He is happiest when he is working outdoors. I can’t help but wonder “Will he come home in as good a condition as he is now?”

My brother Denny and his wife Bev will host this trip. They don’t know—can’t know—all the “little things.” They are borrowing an SUV for Mom and Dad’s ride, and I hope they realize the need for a step-stool of some sort to get on the running board. They’ll have some bourbon for Dad and some wine for Mom, and I hope they aren’t surprised that Dad only has one drink per day—at 5 o’clock—and that Mom rarely drinks anything alcoholic these days. They’ll try to feed Mom and Dad well, and I hope they know that neither one eats much at any given meal but Dad has two or three bowls of ice cream every day (cookies and cream, or chocolate chip cookie dough) and Mom has to have her daily grapefruit.

We only have four more days to get ready for this trip. There’s a battle to be won with the Medicare Part D carrier that decided that Dad only needs one Protonix pill per day instead of the two that his doctor prescribed. Mom and I have waxed and colored and coiffed. We’ve discussed luggage and purses and outfits. Dad has made the wire cages that I need to winterize the roses and we’ve decided that I need to go buy the pansies pretty soon but wait until he comes home to plant them in the barn wood planter boxes. They’ve both given permission for use of the apartment for a guest house while they’re gone and they made me promise to find someone who needs the entire turnip green patch; after all, Dad sowed another one that will come in just about the time they get home.

This morning, Dave and I went to Waffle House for breakfast. A fire engine turned through the intersection and we followed it like two old people (or maybe like two teenagers). It pulled in the parking lot of the bank on the corner and the paramedics ran up a small hill to a dumpster. As we proceeded through the Wal-Mart parking lot to the restaurant, we saw the old man slumped over in a wheelchair wedged against the dumpster. A uniformed man, I think from the auto parts store next door, stood waiting for the EMT’s.

“Is he dead?” Dave and I asked each other. And then, “Why is he out here alone?”

“He’s obviously homeless. And it was cold last night.”

“And nobody cares for him. I don’t mean ‘cares about him.’ Nobody cares for him.”

It was cold last night, uncharacteristically so for this time of year. The ambulance followed shortly behind the fire truck.

Dave said, “I think that ruins breakfast.”

When we left Waffle House not too long after, the fire truck and the ambulance were gone. The empty wheelchair was propped against the dumpster.

“Oh, no,” I said. “That wheelchair won’t be there when he comes back.”

“He’s probably not coming back.”

“I wish somebody would take care of him.”

I wondered what happened to his children, or his nieces, or the grandchildren of his neighbors and friends in the old days, the ones who might worry now about his ice cream and his prescriptions and his ride. I wondered why none of the gazillion faith communities in South Nashville couldn’t adopt him as, I don’t know, Honorary Grandpa or something like that.

Mom and Dad will do fine, and Dave and I will, too. There are lots of us to care for Mom and Dad. Out there in the West, they’ve got Denny and Bev; grandkids Jim and Wendy, Angie and Joe, Jena and Mike; and seven great-grands who can’t wait to see Grandmama and Grandpapa. Please put the accent on the last syllable—Grand MaMA and Grand PaPA. The great-grands decided on those names for Mom and Dad several years ago.

***

Having a Bad Day

Carl, Dad’s physical therapist, motioned to me just outside the elevator door. He was bringing Dad to his room after his morning session and he wanted to talk to me.

I sat down in the activity room across the hall and waited for Carl. (By the way, Carl is a made-up name; the rest of the names in this piece are aliases, too.)

“He’s just not himself today,” Carl said. “He likes to work out hard, but today I had to sit him down. He just couldn’t do it.”

“Do you mean today he didn’t want to do it?” I asked.

“No,” Carl said. “He felt dizzy and sick. I had to sit him down to rest. And after a while, I said, ‘Mr. Blair, let’s go to your room’ and he didn’t even hear me. I got down on my knee in front of him and said, ‘Ernie, Ernie, let’s get you back to your room.’ Then he turned his head and looked at me and said, ‘What? What? Oh! Yes!’ and I got him up and we just came back.”

“How is he now?” I asked.

“I think he’s okay, but he’s just not himself.”

“Carl, my dad has had unexplained fainting episodes for years. That’s not on his chart, is it?”

“No, I haven’t seen anything like that. What do they think causes it?”

“Well, he’s been diagnosed two or three times with possible epilepsy. In fact, he took Dilantin for several years a long time ago, and that made him sick. Last time he saw a neurologist, he put him on some new anti-seizure medication, but he just couldn’t tolerate it. Diagnosis was ‘unexplained fainting.’”

“Now, he didn’t faint…And I took his blood pressure. It was low, but not real low. It could be all sorts of things, maybe low blood sugar. Could be something he ate. Or maybe he’s just having a bad day. Or… maybe he was having a near-fainting episode.”

“I’ll talk to his nurse. If that thing isn’t on his chart, it should be,” I said.

“Yeah, I think so, too. Don’t get too alarmed, though. It may be just a bad day. We see that a lot.”

Carl is Dad’s favorite therapist. He’s a Nazarene youth director; he and his wife moved here from Wyoming. Carl seems to like Dad, too. I like Carl.

“Hey, Dad,” I said, “What’s going on?”

“Oh, I’m just having a bad day,” he answered. He didn’t look good, either. He was too white. He needed a haircut, a beard trim, a bath. I had the barber shears and clippers in my bag, but this was Tuesday; the bath was scheduled for Wednesday after dinner.

“Maybe we should wait until tomorrow for your haircut,” I said.

“Ohhhhh, no,” he said. “I’m getting that haircut today. It will make me feel better.”

“Your shower is tomorrow, though. You’re going to have hair all over.”

“No, I’ve talked to my nurse and she says I can get a bath after supper today since I’m getting my hair cut.”

“Okay, but what happened down there?” I asked.

“Oh, I tried to pass out. Had to cut it short,” he answered.

“Do you still feel faint?” I asked.

“No, I’m better. I just needed to rest for a while. You’re going to have to get a towel.”

“I brought a sheet to put around you. Now where are we going to do this?”

The wing nurse swept into the room; she disappeared behind a dividing curtain to check on Dad’s roommate, Kenneth. Jean looks rough; squatty, blonde, a smoker. She’s always been friendly to me.

“I’m going to cut his hair,” I said. “Where shall I do this? They just cleaned his room. Is there a better place?”

“Oh, don’t worry about that.” Jean pulled the curtain back. “Just call housekeeping and they’ll clean up afterwards. I think I’d do it in the bathroom.”

“If I can just get a broom, I’ll clean up,” I said.

“There’s no need for you to do that,” she said as she left the room.

“Cut it pretty short, Sis,” Dad said after we got all set up. “And then you can put my extra blanket over the bed so that I don’t get hair all over it until I can get my shower.” He’d thought this through.

“Did that wear you out?” I asked after I helped him back to bed.

He laughed. “Yes, it did, but I’m sure glad to get it done.”

I cleaned up the bathroom floor with wet paper towels.

“Dad, you go ahead and get a nap. I’m going to see if I can talk to the nurse.” If there was no information on these “unexplained fainting episodes” on his chart, someone needed to know.

There was no one in scrubs in the hall. I walked on down to the nurses’ station.

“Can I help you?” a young clerk asked.

“Yes, I need to talk to Dad’s nurse.”

“I’m not sure where she is right now, but I’ll tell her.”

Forty-five minutes later, I returned to the nurses’ station.

“I was trying to talk to Dad’s nurse,” I said.

“Okay,” a different clerk said. “I’ll leave her a note.”

“Do you know what time she’ll be on the floor?”

“She’s working now, but she’s just with another patient.”

“Okay.”

Dad was awake and sitting up on the side of the bed. He had good color and said he felt good.

“Except…I need you to look at this place under my arm,” he said.

Once, at the hospital the week before, he had complained that there was a little place under his left arm, “toward the back,” that felt as if it had a small cut. It burned, it hurt, it felt “like somebody stuck me with a knife.”

“Okay. That place is still bothering you?” I asked.

“Yeah. It is painful. Feels like somebody stuck me with a knife,” he said, pulling his arm out of his grey waffle-weave shirt.

I poked and felt around until he flinched.

“That’s it, right there! What does it look like?”

“Doesn’t look like anything much, but I think I can feel a little rise of sorts,” I answered.

“I’m going to get somebody to look at it. The nurse is supposed to talk to me anyway.”

“Sometime this afternoon,” I added, to myself.

I stuck my head out into the hall. No one there, but I did see the nurse practitioner at the nurses’ station. NP, I call her. I can never remember her name, but I know that NP is the highest medical person on staff; the Medical Director, a physician, makes rounds but is not onsite. I rounded the nurses’ station to place myself in front of her.

“Hi,” I said. “You’re the Nurse Practitioner, aren’t you?”

“I am,” she answered.

“May I have just a word with you regarding my father, Ernest Blair?”

“Yes. Have you talked to his nurse?”

“I have asked to speak with her but that’s been about three hours ago and I haven’t seen her. I’m going to have to leave soon,” I answered, with my voice trailing off.

“Okay, what is it concerning?” she asked.

NP is much taller than I am and she was looking over my head, down the hall. Sometimes she leaned her upper body to one side and then the other to look around me. I shifted and then turned to look down the hall myself.

I continued, “Well, there are two things. The first one is, he had a near-fainting episode in physical therapy this morning and I wanted to make sure that you all know that he has a history of unexplained fainting.”

She countered. “That’s what he came in for.”

“No,” I said. “You mean, from the hospital?”

“Yeah, that’s the diagnosis he came in here for,” she said.

“No, actually it was an internal bleeding thing that sent him to the hospital.”

I was going to continue but she interrupted me.

“Same thing. He fainted from the internal bleeding,” she said, still bobbing around me to look down the hall and then in back of her toward another wing.

“Yes, several times,” I said, “but they sent him here for therapy, to get back on his feet and also to treat a sore shoulder.”

I stopped. “I’m sorry, do you need to attend to something else right now?” I asked.

“Oh. Well, I’m trying to get this family’s attention. They’ve been trying to teach their mother to use the wheelchair and she’s down this other hall making wheelies and everything. They need to see this,” she said.

“Okay.” I didn’t know what else to say.

NP called over my head, “She’s down this hall, flipping wheelies and going all over the place!”

The family proceeded past the nurses’ station, toward the other hall.

“I’m sorry,” NP said. “Now, tell me that again.”

So I did.

“Same thing,” she said again.

“No, not exactly,” I said. “He’s here for therapy, to be able to get around again, and also for his shoulder.”

“Oh. Okay. What was the second thing?” she asked.

“He has this little place under his arm that is extremely painful, and I am able to find it. I want to show it to somebody,” I said.

“Have you talked to his nurse?” she asked. “Because you really need to talk to his nurse.”

“No. I’ve been waiting to talk to her but I haven’t seen her,” I answered.

“She’s right down the hall there in front of his room,” she said, motioning with the clipboard in her right hand.

And she was—in the hall—not in front of Dad’s room, but in his hall. She was distributing medications.

“Thank you,” I told NP. “I’ll just run down there and talk to her.”

By the time I got to the medication cart, Jean had ducked into a room. I stood by the cart to wait for her.

“I just need to tell you a couple of things,” I said.

“Okay,” Jean said. She looked at me, my signal to start.

“The first is that Dad had an episode of near-fainting in physical therapy this morning and I don’t think there is anything in his chart to say that this is his history. He has a history of unexplained fainting episodes,” I said.

“Oh, great,” Jean said. Was the tone sarcasm? “That’s good to know.”

“Well, yes,” I said. “And the second thing is that there is this place under his arm that I think you should look at.”

“Let me run in here and give this medicine,” she said, as she disappeared into Mrs. Taylor’s room.

I waited beside the cart. Jean and Mrs. Taylor talked about the weather, the kids, the floral bedspread.

When Jean came out of the room, she said, “Physical therapy never called me this morning.”

“Well, I know that the therapist took his blood pressure, and it was low, but it wasn’t that low…”

“Physical therapy is not nursing. They are not medical people. They cannot make medical decisions,” she said.

“I think they were just trying to make some immediate response. He said he had to sit Dad down, and they didn’t get to finish the therapy session.”

“They’re supposed to let us know, immediately, if something medical happens. I’m going to be calling physical therapy to have a word with them,” she said.

“Oh, you don’t have to do that,” I started.

“Yes, I do,” she said. “They are supposed to call us.”

“I was just trying to let you know, you know, in case Dad got woozy…You know, he took a fall the other day.”

“I know he did,” she said. “Let me give this medicine.”

She ducked into another room and came back out.

“The second thing is that there is this place under his arm, actually on the side of his armpit, that is painful, and he says it feels like somebody stuck a knife in it. I think someone ought to look at it. I can actually show you the exact spot,” I said.

“Okay, I’ll be down there in a minute,” she said.

That meant I should go to the room and wait. Jean passed me as she entered the activity room where Mrs. Smith and her daughter were visiting.

“How you doing?” Jean said to the daughter.

“Good. Good. Hey, I think Mom needs a change. She’s been out today for a long time and I’m sure she needs to be changed.”

“I’ll get you somebody,” Jean said. “How did the curtains turn out?”

“I think they look really good.”

I stopped listening. Jean handed the pills to the daughter along with a glass of water. The daughter handed the pills to her mother, one at a time, and her mother swallowed each one with a sip of water while the conversation continued.

Jean hurried by me into the room.

“Where is he?” she asked, just as we heard Dad click the paper towel dispenser twice.

“He’s just drying his hands,” I said.

“Then I’ll come back,” she answered, and she was gone.

Dad sat down on the side of the bed and we continued a conversation about Egypt’s upheaval.

“I think they’re just in for bad trouble,” he said.

“Yeah,” I answered.

“Sis, you need to get started home. It’s going to be dark pretty soon. I don’t like you girls being out after dark.”

I smiled back at him. “I know. I was waiting to see the nurse,” I said.

“Maybe you should start getting ready to go,” he said. “She’ll probably be in here in a few minutes.”

“Okay,” I said. I began to gather up Dad’s laundry, some cards he wanted me to take home, and the magazines on the table that I had brought to read while he napped.

As I passed the window, I saw Jean crossing the parking lot, pulling the hood of her jacket over her head in the rain. As soon as she crossed the street, she lit her cigarette and called out to the other woman joining her.

“Dad, I think I’ll go on. I’ll talk to the nurse tomorrow.”

“Okay, Darlin’. You have a good evening. Give Mom a kiss for me,” he said.

***