Wednesday, April 29, 2009

What do I get out of it?

This question was asked of me: What do I get out of hospice volunteering?

I get to meet people like Fred and Cecil and Dorothy, and their families. I get to hear their stories, if they want to tell them, and I get an opportunity to keep a part of them with me when they’re gone, an amazing gift that I’ll always have wherever I go, whatever I do. I get to know that my life isn’t all about numbers and taxes and doing things that in the end don’t amount to much. I get the opportunity to help people when I’m most needed, and that helps me too.

Sometimes, it’s the little things that mean the most, because they’re not little after all. Letting someone know that even at the end of their life they’re valued helps me as much as it does them. A few hours a week can change a life. Mine.

Tuesday, April 28, 2009

“Help! My Wheelchair’s Been Stolen With Me In It!”

April 8, 2009

Or so I imagine Dorothy was saying today. I met Dorothy today for the first time, and she came to me without instructions. Or, I should say, I went to her, and she had no instructions. I knocked on her door at the assisted living facility at the appointed time, but no one answered. An elderly lady wandering the hallway asked if I was looking for Dorothy, no doubt because I was looking confused. When I said yes, she pointed me towards Dorothy, who was parked in the lobby in the wheelchair in front of the tropical fish tank. I saw no handler with her, so I walked up to her and said, “Hi, are you Dorothy?”

The 91 year old looked up at me as if I had two heads. I tried again, a little louder, because I do know she doesn’t hear very well on one side. “Dorothy, hi, I’m Monique.” I smiled.

Dorothy looked at me as if I still had two heads.

Just to ensure I was talking to the right Dorothy I went to the front desk and explained my predicament to a member of the staff. “I was sent here to see Dorothy. Is that her? And did they leave any instructions?”

Turns out it was Dorothy, and no one had mentioned to the front desk that a stranger was going to come in and look after Dorothy for a few hours. However, there was a big binder in Dorothy’s room that might offer some information.

And so it did. It had meticulous notes on what Dorothy had eaten every day for the past five months, and the times she’d been prayed over, and when she slept. It didn’t really tell me what they wanted me to do.

So I went back out to the lobby and asked Dorothy if she’d like to go for a walk. I meant I’d walk and she’d sit, but I didn’t think I needed to explain that. She tried to say something, and though I couldn’t understand what she was trying to say, it didn’t sound like a protest.

“Okay,” I said, “We’re going outside for a walk!”

It may have been a look of terror in Dorothy’s eyes. I’m not really sure. It was there, and then gone again. Besides, I couldn’t see from my position behind the wheelchair.

One of the residents sitting in the lobby waved to us as we left. Friendly bunch of people. I could have been kidnapping Dorothy, and no one would have noticed. I could have loaded her in my car and driven away, and several hours later perhaps someone would say, “Has anyone seen Dorothy lately?”

I’m sure Dorothy was wondering how much money her family could get their hands on quickly for the ransom, but she didn’t complain too much. Then again, I’m not sure she could have complained at all, so perhaps internally she was screaming for help. I got us stuck going through the doors only once, when the wheelchair wouldn’t go over the doorframe, but I backed up and tried again. I couldn’t bang her around too much since she has a problem with pain, as in, she feels a lot of it, so I made some attempt at being gentle.

I steered her down the sidewalk and around the building, attempting to make small talk. “Nice day out today.”

Dorothy: “Aaahhhhh?”

“Yes, I think it’s very nice out. How do you feel today?”

Dorothy: “Eeek.”

As we rounded the last corner Dorothy spoke up, with real words: “Upstairs.”

I repeated, “Upstairs? You want to go upstairs?”

Dorothy: “Upstairs.”

We went back in the front door and I stopped at the front desk again. “Dorothy says she wants to go upstairs. Is there anything going on up there?”

The desk attendant said, “Noooo, maybe she just wants to look around.”

So Dorothy and I took the elevator up to the second floor and wandered the hallways. She pointed at one doorway in much excitement, a resident’s room, but I couldn’t tell what she wanted, or if she wanted anything, or if she just liked the looks of the place. One resident’s room had a nameplate saying “Fred Astaire.” I’ve often wondered what happened to him.

Then I sat down next to Dorothy and tried to figure out what we should do next. She looked at my nametag and said, “Monique.” Wow. She said my name! And she smiled! I think she was getting used to the concept of being kidnapped.

One of the helpful people who worked there wandered by, and the two of us engaged Dorothy in a conversation consisting of the following:

“Do you want to go back to your room?”

“Urrgghh.”

“Are you tired?”

“Ahhhhh.”

Then the helpful staff person said to me, “She usually just sits in her room all day, so she might be tired by now.”

Well, yes, thanks for mentioning it. We’d been out exploring the entire facility and now they tell me she doesn’t get out much? I don’t care. We had fun.

I returned Dorothy to her room, and called for an attendant to put her back into bed. You don’t want an inexperienced volunteer picking up a frail 91 year old who’s in considerable pain. They’ve got experts for these sorts of things.

Dorothy slept. I fielded calls from hospice. The family had called and asked if I could feed her when lunch arrived. Like did they think I’d stand by and refuse to feed her? What kind of kidnapper do I look like?

Lunch arrived and I didn’t wake Dorothy up. How could I wake her up? She was so cute, sleeping.

Once she did wake up it took us an hour to have lunch.

“Would you like some juice?”

“Eeeeek!” With a hand up to ward off demons, or bad juice.

“Want some of this?”

“What is it?”

Like I knew. Some sort of beef with pasta. But once she tried it she liked it. I’d either feed her, or load the fork with food and she’d try it herself. Cauliflower also received the “Eeeeek!” raised hand sign, and so did the cranberry juice. Occasionally she’d stick her hand in the plate. I don’t know why, or what she was trying to tell me, but I’d remove her hand and wipe it clean. Once she grabbed my hand and held it, and smiled at me.

Then she coughed and spit up food all over herself.

How cute is that?

When I left I thanked her for letting me visit her, and I think she breathed a sigh of relief. It’s always good when the kidnapper leaves without making good on their threats.

"Damn Dummy!"

Today’s hospice patient, just a fill-in, a one-time thing, is not shy about expressing his feelings.

His wife greeted me at the door, a seemingly cheerful woman in her sixties, and when I walked in there he was, in the hospital bed facing away from the door, and he craned his neck around to see who was coming in.

“Hello,” I said to him, though I’d been warned he wouldn’t talk to me, and if he did, he would most likely yell and call me names.

He kept looking at me as if he were seeing a bug he might recognize, but isn’t sure.

I ask, anyway, “How are you?”

No response, just angry eyes from the man with the white hair and beard. He bears no relation to Santa Claus, not being the least bit jolly. An unhappy Santa, perhaps.

His wife said, “He doesn’t talk, unless he wants something.”

I smiled back at her and told her it wasn’t a problem. She showed me around the tiny little house. Showed me where the supplies were, should they be needed, what to do should he need to relieve himself. He’d need help, of course. I hoped he wouldn’t be needing anything during my stay. I really really hoped. The television was on, and she said he liked to have it on to distract him, but that I could change the channel. Nope, not me. I change nothing that seems to be working. Besides, I always bring a book to read and a book to write in, and my G1 for texting.

The wife left, after thanking me again for staying with old sourpuss.

That was mean of me. Strike that.

I sat on the couch, which faces the back of the house. His hospital bed also faces the back of the house, fortunately, so he didn’t have to look at me. And he slept.

Occasionally he’d move a bit, lift a hand up and examine it, as if looking for something. Then it’d fall back down, and he’d fall asleep. Or ignore me. I could usually tell when he was sleeping because his breathing would change.

Once, during one of the afternoon judge shows, he laughed. I thought it was a laugh, but I could be wrong. Maybe it was a snort. Maybe it was disgust with the human race. Then he fell back asleep.

I looked at the pictures on the wall. Framed photos of husband and wife, the wife always smiling, the husband, not so much. Pictures of children, but whose? The wife has no support from anyone other than hospice. There is no family to help, no friends. I’m told he drove everyone away with his anger. Maybe he wasn’t always like this, maybe the brain tumor isn’t helping matters much, but I don’t think he was ever much of a people person.

He’s just mean.

He woke up after a couple of hours and threw off his covers. In my experience, which is, admittedly, limited, this does not lead to good things. He then said something that sounded like his wife’s name, Sandra. I got up and went over to his bed where he could see me, and I told him, “She’ll be back in about half an hour.”

“Who are you?”

“I’m Monique, I’m here to help you while she’s gone.”

“Who?”

“Monique. Is there anything I can get for you?”

“I want Sandra.” I think that’s what he said. It was a bit . . . muffled.

“I know, and she’ll be here in a little while.”

“No! Now, I want her now!”

He was quite adamant.

“I know, and she’ll be here soon.”

“DAMN DUMMY!” He twisted his head to give me the full on effect of his anger and continued, “I want Sandra NOW!”

And dog help me, for I like to think I’m a compassionate and kind person, but I started to smile, because as much as he might yell for Sandra, she’d get back when she got back, and not a moment sooner.

“Well, she’ll be here in a while.”

I walked back to the couch and sat down, and tried to maintain my composure, no giggling at the patients. There wasn’t much point in continuing the conversation, since all he wanted to do was insist on the immediate appearance of his wife.

The man is dying, there’s one person present who can help him if he needs help, get him whatever he asks for, and he calls her a damn dummy? I’m used to, much too often, calling myself similar epithets, but when a 68 year old dying man calls me that it only amuses me.

Apparently unsatisfied with my performance, he began to moan and groan. “Ahhhhh, ooooooh, arrrgghhhh.” If it were anyone else, I would ask if there was anything I could do, but I’d already tried that. So I continued to watch Judge Joe, or Cops, or whatever was on at that moment, and he continued to moan and groan. It had no effect on me. I checked my email. Sent some texts.

I’m heartless.

When Sandra came home she said the doctor told her she needed to lose weight. Her husband, ever helpful, said, “Better get started then!”

When I left she thanked me for sitting with him, and I wanted to tell her something, but I wasn’t sure what. Good luck? I’m sorry? I hope your entire life with this man hasn’t been a living hell? Instead I told her it was no problem, which it wasn’t. I’m not the one who has to be there all the time, after all.

This patient is the polar opposite of my favorite patient, Fred, who’s still hanging in there, and having me write down the life stories he always wanted to write. We do a little bit at a time because he runs out of air quickly. But does he like to talk! Fred likes everyone. In his stories, he’s always saying how nice people were, how grateful he is, and how much he appreciates everything he’s had.

The Exit Industry

When I walk in to the hospice facility the air is still, as if it daren’t even move in a place where people are preparing to die. I pass by rooms with empty beds and think this is good – most people are kept at their homes as much as they can be, but sometimes it’s not enough, and sometimes they come here for respite care and then they return home, and often they don’t return home at all.

Fred was moved here on Thursday for respite care, an event he does not recall but it must have happened all the same for here he is, in room 109. A nurse points me in the right direction but then adds, “But I think he just went to sleep.”

No problem. Fred’s wife, Jenifer, is standing in the hallway, and when she sees me she squeals as only a 49-year old woman can, and goes into Fred’s room, saying, “Monique’s here, she’s here!”

I walk in and Fred’s eyes get big and light up while he holds out both arms for a hug. (This is not unusual. I am often greeted like this when I walk into rooms, assuming there are people in said rooms.) He looks like nothing so much as an imp, or an impish elf, though an impish elf in need of a shave.

We hug, and I ask how he is. What a question. I always ask it anyway though. He asks how I am, and I tell him I’m good.

Jenifer tells us the temperature has gone up two degrees, and neither Fred nor I know what she’s talking about. At first I think she means Fred’s temperature, but then she says it went up to 72, so I’m pretty sure it’s not Fred she’s talking about. Turns out she means the room temperature. Jenifer is great at keeping track of weather and temperatures and important calendar dates, like daylight savings time. Every time I see her she reminds me when to change my clocks. Fred says that of course the room temperature went up, once I showed up. That Fred.

We discuss the relative merits of Ensure. Chocolate is the only flavor that’s at all digestible, in case you were wondering. Don’t even worry about the other flavors, just stick with chocolate.

We discover how he came to be there, which he doesn’t remember. It was by ambulance. Shame to have an ambulance ride and not remember it, I tell him. After all, how many opportunities do you get for that?

I ask Fred if there’s anything I can bring him when I come see him again, and he says, “Bring a piece of paper. On it write, ‘Release Fred . . . ‘” and I laugh and say, “Sure, I’d e happy to, but I don’t think they’ll listen to me.”

Jenifer explains that the doctor has to make that decision, which both Fred and I know, but we let her explain the process.

Fred is tired, so I tell him I’ll see him in a couple of days. He’s planning on being well by Monday to go back home, and I tell him he better get some sleep then. He grasps my hand firmly in his and tells me it was nice to see me. I tell him it was nice to see him too.

It’s a 45 mile drive back home (45 miles there too – merely a coincidence?) and I find myself thinking about the Exit Industry. This is an industry that isn’t going to get smaller, only bigger. Demand will only go up as more and more of us get old. Not me, of course, but some of the others of us. Could be a big money maker, or at least a secure career field.

Also, not only is it a wonderful business opportunity, it would make a fantastic musical. One of those elaborate Busby Berkeley affairs with chorus girls and precise geometrics, with the previously decrepit dying singing and dancing as if they’d already ascended to heaven. Perhaps they could rise up against a particularly evil offshoot of the Exit Industry and enlist others to their cause. There could be a tragic-comic romance between two or more cast members, dying or not, it doesn’t really matter, as long as they can sing and dance, and at the end the entire cast does a number that brings down the house.

So fascinated am I with this scenario that I pull in at a convenient rest stop (for once, there’s one where I need it), pull out my notebook, and start writing it down. Is this not a fabulous idea? Now I just need to find some backers to invest. Beat the rush and send your check now.

Eggs for Fred

Jenifer, Fred’s wife, tells me, when I arrive at Fred’s today, that he wants me to wake him up so I can make him something to eat and put cream on his Agent Oranged arms and legs. I go into his room and he has the covers pulled up over his head, a self-made mummy. I start to talk to him to wake him up, and Jenifer comes in behind me, turns on the lights, and bellows, “Wake up!” Hers is not the gentle approach. She’s with him every day though, and I am only here a few hours a week.

Fred rouses himself enough to pull the covers off his head. He’s listless. He looks tired and frail and insubstantial, as if he were turning into a wraith. Can he be getting smaller? I’m not sure how.

He asks for eggs with cheese. I ask if he’d like some toast, too, and he says yes, half, cut in quarters.

Out to the kitchen I go, Jenifer trailing behind me. Her mother should be along to pick her up anytime now, and until then she will watch every move I make, as if not trusting my ability to scramble a couple of eggs with cheese.

I can’t fault her for that. For Jenifer, rules and procedures are the most important thing. It’s how she retains information, it’s how she learns. She’s not very likely to do things out of order, and she expects that I too will follow this order

I get out the eggs, break two into a bowl. Put a pan on the stove, turn the stove on, and put a bit of margarine in the pan.

“The non-stick spray is in the pantry,” she tells me, expecting me to follow the rules. I thank her for letting me know but do not move towards the pantry.

“It keeps things from sticking,” she tells me, since I obviously haven’t caught on. I agree with her that indeed it does, and then there’s a car outside, honking for her to come out and go to church.

I scramble the eggs with milk and Velveeta, salt and pepper to taste. My taste, though I don’t taste it. Toast a piece of bread, put margarine and a bit of sugar-free strawberry jelly on it, and cut it into fourths. I arrange the toast triangles around the edges of the plate and put the eggs in the middle. I’ve used the first plate on the top, a blue speckled plate that could be army issue for all its decorativeness.

I take the plate, a fork, and a napkin back in to Fred’s bedroom.

Fred has pulled the covers up over his head and gone back to sleep.

“I have eggs for you,” I say, and start to pull the covers back from his face.

His eyes blink, open slowly as if not sure what I want with him. Then it comes back to him, and he reaches for the bed controls to raise himself from laying to sitting, at least sort of. He blinks a few times in an effort to clear the sleep from his eyes. I swing the table over the bed, the plate of eggs now in front of him.

He picks up the fork, trembling, his hands engaged in their own rhythm. He brings a forkful of eggs to his mouth and looks, for at least a moment, happy, as if the eggs meet all his expectations. Perhaps they do.

He reaches for his coffee, cold now, and I worry about the possibility of him spilling it, so much does his hand shake. The table is in the way, so I pull it away so he can drink, then help him set it back down and move the table close in to him so it is right beneath his chin.

I sit on the porta-potty, lid down, by the bed while he eats, repeating the table maneuvers when he wants a drink. He eats all the eggs and half the toast, then says, “I don’t know where, but there’s some applesauce . . .” and I finish for him by saying, “I’ll get you some.”

I bring a small bowl of applesauce back to him and he eats it all, but declines any more.

“I’m eating like a pig,” he says, “Everything that gets put in front of me.” He makes a face to indicate how ridiculous this must be.

“That’s good,” I say, “You need to eat. Eating is good.” He smiles at me.

He’s worn himself out with eating, and he tries to remember what else it was he wanted. I stand, egg plate in my hand, while he starts to talk. He tells me there was a meeting, about him, in this room, with everyone wanting to know how to make him comfortable. He talks about his caregivers, how good they all are to him. He counts me among them but I do not, not really. I’m just the Sunday volunteer, filling in on a day no one else is available. It is always just Fred and I alone; I never see anyone else involved in his care, just notes they may, now and then, leave behind.

“Cream,” he remembers, “Have you put cream on my legs?”

“No, but I certainly can.”

I put on the white plastic gloves I wear when doing personal care. I pull up the covers at the foot of the bed to reveal two thin little legs, the skin so brittle it looks like thin parchment paper, so dry I don’t know how it stays on his body at all.

I rub cream into his shins, the skin is so frail and dry I worry about tearing it. Can it tear? I don’t know. I’m an accountant, and we’re not taught much about these things in accounting school. I rub cream on the shins and the calves, carefully.

It’s cold to him, and so I cover the frail legs back up and tuck the covers in neatly around him.

He adjusts the bed so he’s laying back down again, and I tell him to get some sleep. He pulls the covers back over his head, making himself into a mummy again, and I turn out the light on my way out.

I wash the dishes and pan I’ve dirtied, steal a piece of bread and toast it. I hadn’t eaten yet today and after I got here Jenifer told me she’d be late. It’s not like me to take food from a patient’s house, but I rationalize away one piece of toast.

Then I sit in the living room, only the sound of the oxygen machine saying anything at all, and I write this out in longhand in the book I always carry with me.

And this is where I am now. When I get home this afternoon I will type this out, and then post it. You will come along and read it, and think, perhaps, that you are glad it is not you who is dying. I hope so. Fred would tell you to live now, enjoy yourself now, because we don’t know what tomorrow will bring.

A Hospice Story - Cecil

This morning I find myself wondering if Cecil has made it through the night. Last night, when I sat with him, he was in the process of dying, and it was progressing as active dying does.

I met Cecil last night, when I was asked to provide a couple of hours of respite care so his daughter could get a couple of things done. He was in a recliner when I got there, deceptively sitting up as if ready to get up and go somewhere, but when I took his hand in mine it was slack, and he didn’t seem to know I, or anyone else, was there. His breathing had already become more shallow and pained, the “death rattle” present.

His daughter and I talked while we waited for her brother to make a couple of phone calls, and she briefed me on his condition. Just several days ago he was ambulatory and verbal, old but not dying, and then he suddenly declined. That was when hospice got involved. She had moved here less than two months ago to be close to him, since there was no other family in the area. She’d been in the habit of picking him up at the assisted living facility every day and taking him to her house, where she’d make him lunch. On Sundays they went to church. Cecil was Salvation Army, she told me.

Cecil sat in the middle of the small living room in his recliner, his daughter in a chair on one side of the room, I on a couch on another side, and I kept glancing at him to make sure he was comfortable, at least as far as I could tell. She told me that he’d started becoming more affectionate in the past few days, suddenly going in for hugging and such, which had never been the case with him before. A couple of days ago he’d brushed his daughter’s face with his hand and said, “I love you,” something he’d never said to her before, not in over 60 years.

She told me that if the other brother, Cecil Jr., came back, not to let him in. He’d been volatile earlier, and he had some issues. He’d never fully recovered from Vietnam either. I told her I would lock the door and keep Cecil’s environment calm.

It’s difficult to know a person who’s in the process of dying. Cecil wasn’t speaking, or tracking, and all I had to go on was what his daughter told me. We talked about death and dying and how difficult it is, whether or not one’s ready. It doesn’t matter, because you can never be quite ready for it. Cecil had asked her, back when he was voicing these things, for an overdose of something so he could get it over with. He was ready to go. But of course that’s illegal. Sometimes they’re ready to go but don’t know how.

His daughter warned me that while they were gone Cecil may want to move to the hospital bed in the living room, or that he may even want to move to the bed in the bedroom. He might want to take off his clothes, which consisted of shorts and a shirt, and that the shorts stay on. If he gets into the hospital bed without his shirt, keep the blanket from touching his skin by hanging it from the metal bars that keep him from falling out. An attendant brought his dinner. If he wanted to eat, he’d probably want the fruit. He’d had all his meds for the time being. I looked at Cecil. He hadn’t moved since I’d gotten there, hadn’t uttered a word, and I couldn’t, for the life of me, imagine him doing any of the things she said he might do.

We waited for the hospice nurse. She was bringing more meds and coming to check on his condition. By the time Eileen’s brother returned, ready to go, she still hadn’t arrived, and I told them to go ahead, and to take their time. “What if we get back after 8?” Eileen asked me, as if I’d suddenly disappear at the appointed time. “I’ll still be here,” I told them, “I have nowhere else to go tonight, so take your time, get some dinner. “

Her brother told me he’d talked to Cecil Jr., and he’d calmed down, and it was okay to let him in if he came back, and to please stay close by, but not necessarily too close. They left then, taking Zach, the Welsh corgi who’d been sleeping at my feet. I love assisted living facilities that let dogs in. Cecil’s previous one, the Waterford, hadn’t been as generous.

They left, and I turned on the television to the Blazers game just in case Cecil wanted to see it. It was the only thing he would want to see, if he were to want to see anything at all. I sat on the couch with my book and my journal, and I watched Cecil to see if he showed any signs of getting up and taking off his clothes. He showed no signs at all, just the slow hitched breathing.

The nurse arrived, apologetic and upset that she was so late, but she’d had a difficult intake earlier that had put her behind. I reassured her, with all my lowly volunteer authority, that it was quite all right. She wasn’t convinced, but she accepted my gesture in the spirit in which it was intended. She checked Cecil’s vital signs, which were showing signs that he was indeed dying, and she took off his socks to check his feet, which were indeed cold.

She asked me how I was. I told her I was fine. I have no fear of the dying. I can’t disappoint them, and if I do happen to do so, it’s not a lingering disappointment. I’m calm when I’m with the dying because they have enough going on inside of themselves as it is. I think of dying, in these cases, as a release, which is then not a bad thing. I suppose it’s surprising that I’m not scared of the dying because I’m scared of so many other things, but there it is.

The nurse gave Cecil Ativan to calm him, just in case he needed to be calmed. She watched him for a bit. She asked if I’d be okay if he died while I was alone with him. I told her I’d be fine. If he died, I knew who to call, and I’d sit with him while I waited for the professionals. It’s not a difficult job. She left then, after we hugged. I think she needed a hug.

A little bit later Cecil Jr came to the door, and after I introduced myself he sat down on the floor next to his father’s chair silently, saying nothing. I moved away so they’d have some privacy, but kept watching Cecil. It looked like his head was starting to slump forward, so I asked Cecil Jr to help me recline the chair a bit so he’d be more comfortable. We did, and it did look more comfortable, though Cecil was still not letting us know one way or the other.

The other brother returned after a bit, sans Eileen and Zach, who would be following along shortly. I told him about the Ativan, and that things were progressing as expected, and to feel free to call hospice at any time, and that hospice would be checking back with him of course.

Eileen called me later, after I’d gotten home, and wanted to know what the nurse had said. I told her everything I could, and when she asked if the nurse had said how long, I told her no, that he was actively dying, but no one knows how long it will take. No one knows. The nurse wanted to stop back in the morning, but then wasn’t sure if he’d last that long. I didn’t tell Eileen that, she knew. I was out of my depth, so I reassured her that things were progressing as they should, and to call hospice at any time and they would get right back to her. I told her to call me if she needed more respite or if there was anything else I could help with, and we made tentative arrangements for me to come back on Sunday afternoon for a couple of hours. The need for this seemed unlikely, but, like I said, no one knows, so I told her that I would be there if I was needed, and if she needed anything sooner, to let me know.

So now I wonder where Cecil is at. Is he here still, or is he there? I’m not entirely sure he was even here last night as it is, though physically he was. Perhaps he’s just a bit closer now. Or perhaps he’s gotten ambitious enough to get up and take off his clothes.

February 2, 2009

VISITING FRED

Every Sunday I visit with Fred. He’s still, as they say, hanging in there. He no longer travels from the hospital bed in his bedroom to the hospital bed in the living room, and the living room now has a big empty space where the hospital bed used to be. He was falling down too much, and even though he’s faded to 115 pounds, he’s still difficult to maneuver should that happen again. All his time is spent in his bedroom, in his bed, with his PlayStation and his VCR movies, all of which he’s watched several times.

Some weeks I make him something to eat, or I sit out in the living room while he sleeps or plays, or I rub cream on the increasingly fragile skin on his head and chest. I always wear gloves for this process, and I’ve mastered the art of getting the gloves on and off again without cross contamination issues.

But yesterday Fred just wanted to talk, so I sat on the portable commode, the only seat that faces Fred, and we talked. The seat was down on the commode, in case you were wondering.

Fred’s hoping for another six months, when his wife turns 50 and his passing will leave her with a bit more security. His wife and her mother tell him he has less than a month however. These things are wildly unpredictable of course. He has no pain, he tells me, and he’s breathing okay, though of course he’s on permanent oxygen. He says it’s more for the placebo effect of knowing it’s there than anything else. I’m not quite sure I believe that, but I go along with it.

Fred makes a lot of jokes and laughs a lot, even though he’s frustrated. He’s irritated that he can’t take care of himself, that his legs don’t work, that he can’t get outside and go anywhere.

He asks me if it’s true what he’s heard about the current economic crisis. He says he’d just heard about it, he had no idea things were that bad. How would he know?

He tells me he’s going to be buried in a veterans’ cemetery in Portland and that, oddly enough, his wife will later be buried on top of him. “I’m not sure I like that,” he tells me, “It’s too much like the Germans, digging trenches and piling people on top of each other.”

He’d rather just be cremated, but it’s not what his family wants, so he’s going along with it. He says it won’t matter to him anyway, once it’s gotten to that point. I tell him the story of Stew’s cremation and how we dispersed his ashes in the Sound last year, and that I still have some of them. Am I not supposed to talk about death with a dying man? Fred likes the story though.

Fred as a young man was a troublemaker, one of those boys who breaks into things and vandalizes because, as he says, “there was nothing else to do.” Likely excuse, I tell him, and he laughs.

He’s had a haircut recently, a good thing, since I was having trouble, on previous visits, with rubbing cream into his dry scalp because there was so much hair to work through. It’s now back to the short Marine cut that he’s had for so much of his adult life.

“Were your ears burning yesterday?” he asks me, and I ask if he’s been telling stories about me again. He laughs. I’m impressed with how well he’s holding up with the talking and laughing, though sometimes he searches for words and he can’t quite find them. But his energy level is high. He was talking to someone about the military yesterday, how he was, as a Marine, put in charge of loading an Air Force plane, and he had no idea what a pallet was at the time, and he would have just shoved everything in haphazardly, so he’d asked an Air Force sergeant to show him how it was done, and he learned all about pallets and loading planes. I like that about Fred, that he’s willing to ask how to do things he hasn’t done before. It seems a natural enough thing, but there are many of us who neglect to do that.

He starts to get tired eventually. No surprise there – I’m surprised he was this talkative. It takes a lot of energy, something Fred has in short supply. I ask him if he’s ready for a nap, and he lowers his bed, and I make sure he’s comfortable. He grasps my hand and thanks me for talking with him, and I tell him I enjoy it. “Don’t believe 90% of what I say, it’s b.s.” and he laughs, and I respond with, “Then it’s much like talking to my husband!”

I turn out the light and go out into the living room while Fred falls asleep. His wife returns home ten minutes later, and I tell her I’ll see them both again next Sunday. As I’m leaving she’s waking him up to take more medication. Structure is one of the ways she holds on.

December 7, 2008

SUNDAY WITH FRED

Fred looked good today, or at least as good as someone dying from emphysema can look, which is to say, he looked happy, and he’s as active as someone can be who rarely gets out of bed, and then only as a necessity. Though each week he looks a bit frailer, he still laughs more uproariously than someone on oxygen should, and he is always happy to see me.

When I got there today he was playing a golf game with his new Playstation. His last one finally quit on him, and for his birthday he got a new one. There are not many activities he can do anymore, so anything that keeps him entertained is good. His little television/VCR sit on a table close to his bed, but not so close that he doesn’t need help when he wants to watch a new movie. That’s one of the things I’m there for, to attend to whatever he wants while his wife is off at church. We have a good time together, Fred and I, and though sometimes he does nothing but sleep, he always feels like he should be entertaining me while I’m there, as if I’m some sort of special guest, and not a hospice volunteer. I’ve explained this to him, that I’m there to help him with whatever he needs, and if it’s sleep he wants, to just go right ahead. I can entertain myself quite well out in the living room while he does his thing.

Today he and his wife wanted to tell me how much they appreciated the birthday cards Fred received last week from people he didn’t know, people who wished him happy birthday, his 65th, and thanked him for his service in the Marines. “It brought a tear to my eyes,” said Fred. “Yeah,” said his wife, Jenifer, who’s learning disabled, “It did, make sure you thank them.” I told them I would. All I’d done was let people know that it was Fred’s birthday, and that if anyone wanted to send him cards, I knew he’d like that. And people, some of whom don’t even know me in real life, sent him cards.

Later, after Jenifer left for church, Fred told me that he so much appreciates how kind people have been, and that people, as a whole, have made up for the unhappy memories of coming back from Vietnam, a place he didn’t want to be in the first place, and being spit on.

I made Fred a bowl of oatmeal. He also likes my grilled cheese sandwiches and eggs with cheese. He wanted to finish his golf game and then finish a movie he’d been watching, so I told him he knew where to find me if he needed me. He laughed, and I said, “Well, don’t come looking for me! Just call me and I’ll be right here.” I sat in the living room with my MP3 player. It’s always peaceful at Fred’s on Sundays while his wife is at church with her mother.

After the movie ended, with what sounded like several loud explosions, Fred called me, accidentally saying “Monica,” instead of “Monique,” which he always apologizes for, and I always tell him it’s okay. “No, it’s not,” he says, “Your name’s Monique.”

He starts talking about Vietnam. The VA recently decided he was 30% disabled from Vietnam, from being exposed to Agent Orange or something, and Fred said, “I wish they knew it was all of me in those rice paddies, not just 30%!” But he’s not bitter, he says these things as an amusing anecdote. He tells me of terrible things he saw in Vietnam, things that may make some people uncomfortable to hear, but I’m not into censoring what people need to say. Sometimes things just need to be said and heard, even when it’s hard to say, and hard to listen to. I empathize, as much as someone who served 6 years in peacetime can. I hold his hand when he extends it, and I listen to his stories. “War criminals,” he tells me, “Some of them should have gone to prison,” and when they wanted him to run over someone’s head with heavy machinery he wouldn’t do it, but the POW talked anyway. Later they took the POW up in a helicopter and let him out, without a parachute. Fred can’t say he killed anyone, but he shot plenty, and he was an expert marksman, qualified for the Olympics, so there’s a pretty good chance he did, but it’s not something he wants to think about. But what bothers him the most, still, is the dog he had to kill. A camp mascot who was so sick, and the medic could do nothing for her, and suggested Fred put her out of her misery. There was no ammo, so he beheaded her. This is the worst thing he’s done, he tells me, and being a total dog person myself, I tell him he did what needed to be done, and I know it must have been hard.

He gets a tear in his eye again, when he tells me how grateful he is to everyone who helps him now, and how he hates relying on people (always making sure to tell me it’s not that he doesn’t appreciate everything everyone does for him, as if I’ll be offended), but he tells me it’s just watery eyes.

His conversation meanders, and I would get lost if I didn’t keep listening, for eventually he comes back around to his point. In the middle of a story he starts talking about cotton balls, and I come to understand he needs Caladryl on his shoulders and his neck. I get the cotton balls, put on my gloves (I touch him and hug him when arriving and departing, squeeze his hand now and then, all without gloves, but I’ve been trained to put gloves on), and dab on Caladryl on the dry red areas. His skin is so dry and fragile anymore. Then he wants the white cream on his scalp and face, and I dip into the container of white cream and rub white cream over his forehead and into his scalp, and along his cheeks and his nose. I make jokes about how I’m restyling his hair, it’s going to be spiked by the time I get done with it, which is easy to do when the hair is short and it’s full of white cream. I take special care to make it stand up, and I tell him how cute it is, the perfect look for him. We talk about using green food coloring next time, and I say that for Christmas I can use red too, so he'll be appropriately decorated, the perfect Christmas elf. He does have elflike qualities, he's small and growing frailer, and if there were a standard for elf eyes, Fred has them.

He keeps talking, about his time living in LA, about how he used to drink, way back then, about fun things he did, even in Vietnam, things that don’t involve killing or even war. He laughs now and then, and asks if I’m French, he knows some of the language. I tell him I’m not, and then I tell him where my name really came from, it’s still a family joke that my father was retelling as recent as last summer. Fred says it’s a good name, it’s musical, and I attribute this to the morphine.

When his wife came home we were still laughing, and when I said goodbye and that I’d see him next week, he said to make sure I told people thank you for making him feel special and appreciated, and he thanked me for coming. “I’m happy I could be here,” I answered, and went out in the pouring rain for my drive home.