Not so long ago, I was known as the Oxygen Guy. Everywhere I went on my job, I would hear, "Hey, it's the Oxygen Guy", "There's the Oxygen Guy". I would reply, "That's me, your breath of fresh air"; a corny retort, I confess, but isn't that how everyday interaction goes? I worked for an oxygen company, delivering tanks, respiratory supplies and equipment to nursing homes, as per the job description now typed upon my ever-busy resume.
Now, you may be thinking that oxygen delivery must be the most eventless, routine job possible with nothing to tell besides mundane technical details that bores even the most sleepy-minded simpleton. However, there is nothing eventless nor routine about the nursing home environment. There, you meet every walk of life, all personalities of the spectrum, and witness every possible behavior known to man.
These homes have names like Quiet Grove and Shady Acres. Yet, there is nothing quiet about the treacherous rapids that are the hallways of the home, the jungle on drugs that is the cafeteria, not to mention the House of Horrors with its' dark surprises awaiting any an unsuspecting Aide within any random residential room. A quiet grove it is not. Shady, however, indeed it is, thanks to the protocols of the Medical Industrial Complex.
Nurses take a lot of heat these days because of the medical cruelties administered upon our weaker members of society. I certainly encourage all of these critics to shadow a nurse on any given day and see with your own two eyes the limitless responsibilities placed upon the nurses' already buckling shoulders.
It's bath time for the bariatric patient whose contours reach beyond the edges of the mattress, hundreds and hundreds of pounds of dead weight formed over the bed like some perverse Jello mold. It takes eight staff members just to roll her over. Meanwhile, there's another resident who has intentionally fallen from his wheelchair for the sixth time this morning, yet now with wounds that must be assessed, treated, an incident report filled out, family members called, no legal way of restraining this self-harming resident, all while a million call lights flicker before the sun has even completed its' rise. Betty is begging for another cup of coffee. Henry is complaining that he never received his medicine that he previously threw on the floor ... and Harold is attempting a leap from his God damned wheelchair to the floor yet again!
This is all taking place in an understaffed system, although the home continually increases census. When one resident checks out, two more take his place. And the Admissions Director makes no discernment. All deranged drug addicts, violent offenders with felony warrants, and psychopathic dementia patients are welcome and able to mingle with all the others who are just trying to remember their own names and find their way back to their own beds. Along with them come the bed-ridden with ulcers so gaping you could place your fist inside without getting it the slightest bit wet. Not to mention, there were three trach patients admitted last week, while this facility has not one respiratory therapist and has not trained anyone to know what to do when a trach tube has been pulled out by the patient, leaving staff scrambling in a panic. This is not their fault. This is not their field of training.
So, mistakes get made. Things can go bad in a hurry. Everyone points a sharply flexed finger at the overworked, under-rested, under-supplied staff. All the while, there is the faceless voice echoing down from on high, changing protocols from day to day, increasing duties, and enforcing harsher policies while never having stepped foot inside the butchers' doors to smell the rotting meat that he has caused through his precious data sheets of profit that pass all law in this business. Yes, BUSINESS! The business of dead ends and, today, dead ends are the new hot cakes.
This faceless voice comes from Presidents, CEO's, and pencil-pushing yes-men who would never place their family in their own facilities, not for a second. Hell, they would not dare dirty the soles of their Italian leather shoes stepping a toe anywhere near the parking lot. They certainly have never worked a med cart during the bustling hours of drug-addled, brain-fogged senility cluttering the halls with interrupting questions of the time every two minutes, asking when her mother will be here to pick her up; her mother who died 20 years ago at the age of 85. One resident sneaks to the phone, calling every number in the book while another pulls the fire alarm.
Most people like to think of nursing homes under the influence of warm fuzzy feelings with grannies baking cookies and distinguished old gentlemen smoking pipes, debating politics. This couldn't be further from the truth. The system is certainly to blame. Still, it must be recognized, though a hard pill to swallow, that there are some terrible residents. Not all senior citizens are saints. Abuse and molestation by residents is simply seen as an occupational hazard. Residents attack, violate, and even sometimes rape other residents. If a person is evil their entire life, growing gray hair and wrinkles doesn't suddenly change them into a sweater-sewing sweetheart. In fact, some residents are placed into long term care because of the family's need for final retribution or, more innocently, relief from the terror.
This burden is passed on to inflict stress, pain, and total exhaustion upon nursing home staff and elderly victims. Still, the not so Fun House with its' warped mirrors reflecting a strange reality of modern institutionalism does have its' rays of laughter that trickles down from the cracks in the ceiling into hearts of the defeated. I've heard it. I've felt it. Although it may be brief, it lingers in mind and soul, resonating back through the chest at times least expected. Truly, he who laughs lastingly lives a moment of immortality--a rhapsody worthy of paradise.
Her name was Margaret, but everyone called her Marge. Some called her Large Marge because she seemed to think of herself as big and bad--small dog syndrome perhaps, for she was tiny, fragile, wheelchair dependent, and 90 pounds soaking wet in steel-toed boots and a led cap. Yet, she was only feeble at outside appearance. On the inside, she was full of grit, spit, piss, and vinegar. She was scrappy. She was feisty. But, man O man, was she a beautiful person.
She would sit in her wheelchair by the nurses' station entertaining anyone who walked by with her hilarious complaints, grievances, and flirtations to any passing man. She believed any man who talked to her to be her boyfriend. I was one of them and every Monday I looked forward to seeing my ornery yet breathtakingly gorgeous girlfriend, Large Marge.
I remember it well. One Monday, I met Marge. She introduced herself. I introduced myself. She asked to shake my hand and wouldn't let go. Good God, did she have a grip! She gave a few flattering compliments that I returned in kind, complimenting her dress and the bow in her hair. The following Monday I arrive to hear the nurses blurting excitedly, "Hey, it's the Oxygen Guy!" One nurse tells me that I'm Marge's new boyfriend.
I went to Marge and asked her, "So, I'm your new boyfriend, aye?"
She grinned and said mischievously, "That's right, so buckle up, cowboy!" The nurses were all listening in, laughing hysterically.
Marge was a real mystery woman. She never had any visitors. Nobody seemed to know how old she was and Marge wasn't telling. She just seemed to be older than time, itself. Nobody knew from where she hailed and, again, she kept this a secret. She had an indistinguishable accent that seemed to change with every sentence. The biggest mystery of all, however, was just how many other boyfriends was I competing against?
One Monday I was giving Marge a hug, as I did every time I saw her, when she pushed me away. She said, "Sorry, not now. My new boyfriend's coming". A man approached from down the hall carrying a clipboard, seemingly lost, clearly new to his job. As he was passing, Marge winked at him then asked, "Where you going, sexy?" He stuttered, not knowing how to react, obviously a virgin to the nursing home dynamic, and picked up his pace in fleeing the awkward scene while Marge stared him down lustfully. Shaking her head, she said, "Damn, I love watching him go!"
I jokingly scolded, "Marge, I thought I was your boyfriend".
She chuckled and said, "You're my one-hundredth and now I'm watching one-hundred and one get away".
I sadly said, "You're breaking my heart, Marge".
Looking at me sympathetically though impishly, lowering her voice to a most sincere tone, she answered softly, "I'm a heartbreaker, kid. Get used to it". As always, the nurses laughed hysterically at their station, busily charting in tears of hilarity. Marge had dementia, had lost most memories, but she certainly never lost her quick wit.
One Christmas, I brought cookies for the staff, as I did for my favorite homes. As the receptionist chomped away at my personal favorite--a thin crispy sugar cookie with hardened icing--she said in a comical undertone, "Your girlfriend just got kicked out of the Christmas party". My heart leapt for joy, ready for such a great story, but when I asked what had happened, the receptionist told me I'll have to ask Marge.
I did just that and Marge sat slumped in her wheelchair two sizes too big for her, chuckling that infectious chuckle of hers, not saying a word. I coaxed, "Come on, Marge. Why'd you get kicked out of the Christmas party?"
Marge beckoned me in closer and spoke directly into my ear, saying, "Let's just say, Santa Claus is a real son of a bitch!"
This moment became yet another mystery of Marge's until finally much later when I learned that she had tried to fight Santa. Apparently, she became rather disgruntled by the fact that she never won any Bingo prizes. I was never given a full report of what transpired, although I'm certain that a particular man in a fake beard never saw it coming and is probably much more generous these days.
When you work around nursing homes long enough, you recognize it as a visitation of the end of the liners. When loss hits, you expect it, so that it hits lightly; more as a cool brush over your shoulder into the past. One day a person is there, the next day they have turned to the gust and their sail catches wind as they drift out of view. They were just here squeezing our lungs of laughter and now are an apparition in the haze of the working shift; a lesson in life's evanescence and the invaluable moment within every tick of the clock.
It was a few Mondays of not seeing Marge at her usual post that I knew. I didn't have to ask. You can sense these things instinctively in such a line of work. Yet you don't grieve at all. You smile and are happy for her. Somewhere out there she's smitten with number one-hundred and three and he has no clue what he's in for, but he sure as hell better buckle up!
Some people fight death to the bitter end. Some never see it coming and go peacefully. Still, others welcome death and beg for it. I've seen all of the above.
In a humble little facility called Morrow Manor, I was in charge of weekly tubing changes--that is, swapping out all oxygen tubing, humidifier bottles, nasal cannulas, and nebulizer masks. It was not exactly the most romantic part of my job if it weren't for the fact that I went room to room meeting and conversing with so many residents. I heard so many tales, learned so much important information just by taking an interest in their decorations, photographs, or hobbies, asking questions, being curious of their many decades of air breathed. To many a resident, my visitation was the highlight of their week, as I, unlike the staff, had plenty of one-on-one time to lend an ear. How much we undervalue open ears until we've grown deaf with age, ourselves.
As I would change the nasal cannula on an unused concentrator stuffed into the corner of the room, per state regulation, I leant my ear to Carole, a bed-ridden woman as frail as a sun-scorched flower petal in the dry dust. From her bed she told me about her family, her grandchildren in college, and even her belated husband and the days she spent waiting for him to return from the war in their first years of marriage. She would take me by the hand every time before I departed, her fingers like brittle twigs, and one day she beseeched of me in deepest earnestness to pray for God to take her.
I didn't know what to say the first couple times that she made this request. The third Wednesday of my return, I felt her pain and desperation to my core. My marrow ached, my spine trembled, my viscera throbbed with anxiety. I told her a hesitant and quiet, "Yes, I will pray", and she cried in jubilation.
I'm not a praying man, but I'm not dishonest either. So, I did pray. I prayed hard. I wanted her relief. And, the following Wednesday, her bed was empty. She had passed. Passed what? I do not know, but I know that she has voided her spirit of material misery. She passed an unknowable point from here to there. The better place. The upper room. So, I prayed again to thank God. She, for months, sent invitations to the Grim Reaper and finally he knocked on her door.... She answered with open arms.
This is the experience of the nursing home. It's all mixed emotions. We've been conditioned to never let go; to cling to life at all costs; to beat dead horses back to life just for the sake of one last trot through the field that never happens. This is the pharmaceutical marketing structure playing tricks on our wants and needs. Life is not a Great Pyramid. It is a sandcastle in the rising tides. We have been brainwashed into thinking that going into the light is a bad thing. When is light a bad thing? Should we fight tooth and nail for a continual return to darkness? Or can we accept? Can we let go of hands too weak to hold onto us?
Whenever my Grandmother would speak of death, she would say things like, "When God calls me home, I'll happily go marching in with the saints, for O how I want to be a part of that number". She accepted the prospect of releasing her temporary form. She had no rejection of the afterlife. In fact, she embraced it religiously. She evolved in tougher times and tougher times evolve sensitivity to the other side that weaker times avoid aggressively. Hearing her talk like that, as a child, bothered me greatly. I didn't want to consider my Grams' death. Yet, growing older, I realized her old school approach--an open, honest, non-fear perspective on kicking the proverbial bucket--helped me in accepting the day of her actual demise. As I've grown even older, I've learned that if you cannot tolerate loss enough to evaluate its' gains in appreciation, then you've already lost the plot, for where else is the greatness of the hearts' fondness than in absence?
A frigid day in Cincinatti, Ohio, I enter through the nursing home doors shaking off the snowflakes from my shaggy bangs of hair tickling my eyelashes. As I'm pulling my cart past reception filled with boxes of oxygen supplies, a resident in her wheelchair halts me, asking in a weak, timid voice, "Is there spaghetti in those boxes?" Clearly, she was not in a right state of mind. I could tell this from her faraway eyes. Still, as a professional, one makes no immediate assumption of mental state.
I answered her properly, "No spaghetti. Sorry, this is only medical supplies".
She asked, "Do you have any spaghetti?"
Sadly, I had to tell her the truth that I did not, but she was persistent, as she implored, "Can you get me some spaghetti?"
At this point, I turned to the chuckling receptionist and joked, "Good God, can somebody please get her some damn spaghetti?"
I left thinking I had found another fun, interesting resident. I decided that one of my Friday visits I would surprise her with spaghetti, meatballs, and garlic bread, absolutely blowing her mind and making her whole year. Yet, unfortunately, it was not to be. My next visit, the receptionist informed me that "Spaghetti Lady" had died. I asked if she had a chance to eat some spaghetti before leaving. Regrettably, the answer was no.
These things we take for granted. This being that soon will have been. How quickly a world of 'I have' can become 'I have not'. In the end, what does a bird in the hand even mean if it has to be returned to the bush anyway? What in Gods' name is a bowl of spaghetti worth in the long run? Is it better when craving it or in having finished the last bite? Isn't that most of the spaghetti experience? Before and after?
Fleeting ... so uncontrollably fleeting. Temporary ... so fucking temporary. Confusing ... O yes, how amazingly, magnificently, stupefyingly confusing.... C'est la vie....
