I Have Been Assigned the Single Bird

by Susan Cerulean

  I felt the anxiety of the pair who tended this nest, standing up the hill. If I were willing to invoke restraint, perhaps I could be almost an equal sensory partner. Our roles were so very different: I was the one who watched and wanted to know, and they were the objects I studied and counted and adored. Perhaps a relationship could be created if I agreed to curb my desire to be close, to back away, and to honor their subjectivity. It could be borne if I acknowledged their moral agency and the fact that they were engaged in the serious business of continuing their kind on the planet. I intuited the moment when I had nearly exhausted them with my insistence on being in their space. I felt their signal: Go now! they said.

  My kayak scudded back to the ramp on the luck of a rising tide. The wind helped too, shoving into a line of black clouds building upriver. Glancing back, I watched a lone oystercatcher, an ember on the beach, keeper of a third nest I’d found. I knew the waypoints to return to her home: a single white post; an enormous log wedged into the sand; and a spread of white morning glories, blooming and perhaps scenting her long incubation with the company of their lovely orbs.

  CHAPTER 9

  Divine Counting

  I felt proud: within the first three months of Dad’s move to Tallahassee, his life had returned to good order. We’d distilled the physical goods of all his previous homes, and even his identities, into a small but pleasant space. I’d found a wonderful occupational therapist who had told me: “Your dad is too high functioning for a lockdown memory unit. Bob is still very able to rise to expectations.” She confirmed my hope that assisted living could work out for him. We’d visited a dermatologist, an eldercare lawyer, an eye doctor, a podiatrist, the dentist. Two molars beyond repair had been excavated, and his teeth had been cleaned and polished.

  “I like how my mouth feels now!” Dad slid his tongue over his teeth as we drove home from the dentist. He was ebullient, so much so that he raised the subject of the gracious manager of his previous nursing home.

  “Hell, I’d marry her, if Bobbie would let me!” I let that pass and steered my car beneath the shade of an overhanging oak. With the windows rolled down, we mimicked the conditions of an outdoor picnic as best we could, unwrapping sandwiches from a favorite deli and listening to an interview of an Irish writer on public radio.

  “We can do this, Dad.” I smiled at him from the driver’s seat of the car. I wanted to believe that as much as he did.

  “Yes,” said Dad. “But Sue, I’ve got too many sets of pants on.” He plucked at the waist of his sweatpants.

  “No, look,” I said, walking my fingers through the layers of clothing around his torso. “These are your sweatpants and this is your underwear.” I didn’t mention the word pullup or adult diaper. “You’ve wearing just the right things. Perfection!”

  “You mean perfection incarnate?” Dad chuckled. We dialed up Bobbie on my cell phone to report on lunch and the day.

  “Girls, you have done an unbelievable job helping me get settled in Tallahassee,” he exclaimed. “But then, I gave you something good to work with, didn’t I?”

  But what was next, now that we’d caught up his health care?

  Several days later, I joined my father in the foyer of his facility. “I’ve been trying to remember the words to ‘Old Dog Tray,’” he said. Sun streamed from the high, east-facing windows, lighting our faces. Eyes wide open, he warbled, not performing, not looking for anyone to join in. Just singing. “Old dog Tray’s ever faithful / Grief cannot drive him away / He’s gentle, he is kind; I’ll never, never find / A better friend than old dog Tray.”

  “You girls used to like that one,” he said.

  Not many people were home at the facility. A bus had taken the spryest on an outing to the Junior Museum. One resident, a tall, white-faced woman named Mrs. Smith, sat at her assigned place at a table one full hour before lunch would be served. Two high school girls flanked her: they were shadowing the work of a caregiver for Career Day. They’d been assigned to keep Mrs. Smith company but instead giggled at each other behind their hands, unable to imagine how to interact with this woman who had lost her mind.

  “Nurse. Nurse. Help me please.” The old woman’s voice was a reedy instrument. Her litany rarely varied. She knew she needed something, but what? The high school girls exchanged glances.

  “Someone please help me. Can you help me? Please tell me.” I’d seen how Mrs. Smith’s thin repetitions annoyed her neighbors. Sometimes I’d see her seated in the sunroom next to one of the resident courting couples. When Ashley was out of earshot, the pair would yell at Mrs. Smith: “Stop that! You stop that right now!”

  “Shut up!” Mrs. Smith would reply, her blue eyes snapping. A brief anger, a sense of injury would replace the pleading that looped in her brain like a necklace of prayer beads all her waking hours. The tall woman, once imposing, now wandered and wandered, lurching through the halls, looking for what she had lost, but it was her mind that was gone and it would not be found again.

  I couldn’t bear to think of Dad evolving into Mrs. Smith. And I really did not know how his disease process would unfold or what I could do to mitigate it. How I wanted order, and to taxonomize the process, and give the end of Dad’s life some form and predictability. To know where we were: whether the beginning, middle, or end. I remembered how in the first year after Dad’s diagnosis, I had studied the bible for families with dementia patients, The Thirty-Six-Hour Day. My dad had taught me well—now I was repeating his way of solving problems, no matter how intractable: Think, read, ask for help. Ask for help, think, read. I had tried to make Dad’s illness fit into a timeline, and a stage (7c: Can no longer walk without assistance; 7e: Can no longer smile; etc.). I was looking for structure and certainty in a brain that was falling apart. Moreover, as I studied the disease online and in how-to books, underlining resources that might help and symptoms we might expect, I saw that I was studying Dad himself, objectifying my father and our relationship, just as I had the nesting oystercatchers.

  So I called on our friend Dr. Ken Brummel-Smith. “Aging is tremendously variable,” he’d once told me. “And much of that variability is under our own control.”

  We met with Ken in his spacious office.

  “So good to meet you, Bob,” said Ken. “Your daughter is a great friend of our family.” He bent to grasp my father’s hands in the wheelchair. And although he’d squeezed me into a quick hug, all of his focus was on my dad.

  “So what brings you here today, Bob? How can I help you?” His voice and manner were steady and direct.

  “Well, it seems that Alzheimer’s disease is sitting on the sidelines, waiting to do bad things to me,” said Dad, opening like a blossom under Ken’s warm attention. He paused, not sure what to say next, and looked to me for support.

  “We’re hoping you can advise us,” I said. “To tell you the truth, we wonder if you’ll have a different interpretation of Dad’s condition than we’ve heard so far.” There it was on the table, our tenderest, biggest hope.

  Ken scanned the papers I pushed across his desk: the diagnosis from Dad’s neurologist in New Jersey, today’s vital signs from Ken’s nurse, a list of medications.

  “Bob, I’d like to run you through a few assessments of my own, if that’s okay,” said Ken.

  “Sure,” said Dad, gripping the arms of the chair. He so wanted to please this doctor.

  “Stand up for me with your walker and come on over to this chair beside my desk,” Ken instructed. He kept up a steady chat while Dad moved slowly across the room. In silence, my father concentrated on his assigned task. I was on the edge of my seat. When had my father lost his ability to converse while walking, I wondered? Was this part of the test?

  “Raise your eyebrows?” asked Ken. Dad did. “Stick out your tongue? Shrug your shoulders up toward your ears?” Those simple physical requests seemed reassuringly easy and Dad complied.

  “Let’s try a few questions. Bob, can you tell me today’s date?”

  “May 16
,” Dad’s words tumbled out quick and strong.

  “That’s right, what year?”

  “Nineteen . . . ?” Now my father fumbled to respond.

  I found myself straining forward, wondering why knowing the date should matter. “Two thousand eight, two thousand eight, two thousand eight,” I chanted silently to myself.

  “I don’t have any idea,” admitted my father.

  “Try this,” Ken spoke kindly. “Can you spell world?”

  “W-o-r-l-d,” said Dad. I nearly clapped my hands.

  “Now try that backward,” asked Ken. But Dad shook his head no.

  “Here’s another,” said Ken. “Subtract seven from one hundred, what do you get?”

  “Ninety-three,” said Dad.

  “Good, keep counting backward by sevens.”

  Dad was stymied. “I’m a loser at this one,” he murmured.

  “No worries.” The doctor was cheerful. “We are just trying to get a full picture of what’s happening in your brain.”

  He passed Dad a pen and paper across his desk.

  “Write me a sentence that describes how you feel, Bob. Anything at all.”

  Dad took up the pen, he who had written thousands of letters and reports in his lifetime. I peered over his shoulder as he worked. His cursive characters were small and crabbed, a line of miniature jagged peaks on the paper. Nothing intelligible to my eye.

  “Can you read that out loud to me?” asked Ken. It was beginning to feel like torture in that office.

  “Every so often I become frustrated,” my father read off the page. Tears started in my eyes. I thought I saw a glimmer in Ken’s, as well.

  The next afternoon, I went to Dad’s room to ready him for a follow up conference with Ken and my siblings. I found him deeply asleep in his armchair, without his glasses. I knew he’d had lunch: there were drops of something like brown gravy on his sky blue shirt.

  We sat together, Ken Brummel-Smith, Dad, and I, with my sister Bobbie and brother, Doug, on speakerphone to confer about the previous day’s exam.

  “First of all, Bob, let me say that you’re not the typical Alzheimer’s patient,” said Ken. “Most people don’t respond to the medications that are given to enhance brain function, Aricept and Namenda. You are one of the lucky few.”

  “But is it true that I can’t do anything to improve my ability to drive a car?” interjected Dad.

  “Well, Bob, one thing I notice is that you have a lot of difficulty knowing where your body is in space,” remarked Ken. “We call that magnetic apraxia. And I see that your left side is more affected than your right.”

  Dad nodded in agreement.

  “So I don’t recommend you driving, truthfully,” said Ken. “What I hope you concentrate on, to slow the progress of this disease, is exercise. And mental stimulation. These are the things that will delay your brain’s deterioration. You need to be walking a good deal more than you are now.”

  “Driving was a big part of my life,” Dad sighed. “I’m not hearing anything very optimistic in this report so far.”

  Ken directed his voice to my siblings, who hadn’t been present for yesterday’s exam. “Your father tells me he sees himself living another six to eight years. A reasonable question is: should he be taking medicines that won’t contribute to the quality of his life? I don’t see anything really egregious on his list of medications,” he explained. “But let’s see if we can simplify what he’s been taking. I’d like to set up Bob with a new primary care doctor in town, Dr. Mervin Wallace, and get his opinion.”

  “Next, let’s talk about advanced care planning,” said Ken. “There is medical technology that can keep your body alive, Bob, even after you can’t do anything for yourself, including swallow food and water.”

  “I can’t bring myself to think about that happening to me,” said Dad.

  Ken plunged ahead. “The brain function that controls swallowing eventually goes away. Tube feeding doesn’t extend life and it carries risk of complications. And at that point in the disease, many patients need their arms restrained. I don’t recommend that path.”

  Our father was speechless, and I was taking notes as fast as I could. We had to reckon with the facts: the chances that Dad could return to the fullness of the life he loved were zero. In fact, he would never return to any previous baseline. What Ken was telling us boiled down to this: don’t confuse care with treatment.

  In the days that followed, Dad reported nightmares in which he was forever trapped in his body, immobilized in his bed. Bobbie too dreamed of our family, all of us driving in a car with Dad at the wheel. That was her nightmare. My sleep had been marked by a happy vision of our family driving off into a western sunset as we so often had done in my childhood. Warm sunlight slanted on canyons and mountains. Both of our parents piloted our journey in the front seat of a big, old American car, driving into a beautiful evening sky. Which of our subconscious visions would come to pass?

  When Christmas came round again, David flew home for the holidays and I was happy. Every night, we’d walk up to the garden and harvest the makings of our family’s dinner. Bouquets of broccoli, spreading and gorgeous; Chinese greens and collards; lacinato and curly kale; parsley, cilantro, and the last of the peppers. All of these we stir-fried together, and it was as if my son had never left. I made big salads for lunch, composed of five kinds of garden lettuce, arils of pomegranate, and stems of Swiss chard, all Christmas red and green.

  Near the end of his break, I sat cross-legged on the floor of David’s room, helping him fill three cardboard boxes with goods to ship up to college. He packed a set of red headbands to wear during sweaty workouts in the gym, and I noticed how his shiny brown hair curled around his ears and down his neck. “I’m keeping it long until school is out, and then will cut it all off for summer,” he said. He asked me to take a look at the seven-page application he’d been working on for a summer job with Outward Bound, but mostly I got my cues about how his life was going visually, not so much by talk. I watched him reach for a bottle of organic shampoo, triple bag and seal it with a twist tie. Just in case the shampoo leaked, he placed the eight-pound bag of super-nutty granola in a different box, with a white ultimate frisbee disc and his navy blue winter coat. I could see that he was taking care of his domestic life down to the sponges and coffee filters and vitamins. What I wouldn’t see was the snowy Connecticut campus he’d be returning to, nor any of the ultimate frisbee games or practices he loved, nor his new girlfriend from California.

  Terns, gulls, plovers, willets, and other shorebirds flock to rest, regroup, and care for their feathers. Photo by David Moynahan.

  At the intersection of Saint Augustine Road and Blair Stone, stopped at a red light, David said: “I will miss Tallahassee. I’ll have to make myself at home again up north in Connecticut.”

  It was the fifth of January, and we were headed east to the Amtrak station in Jacksonville, first through the smoke of a prescribed burn, then under a cloudy sky. We listened to David’s music and I found myself trying to memorize every moment, the name of each group he enjoyed. Who is this person? What pleases him?

  Meditation teacher Jon Kabat-Zinn says that it is helpful to look at our grown children as if we were seeing them for the first time, being with each one not as a newborn but as a new being. Any moment together, even on the telephone, is a new chance to be present, to build trust, to attune to them, to be sensitive, to be empathetic—to accept them as they are and to ponder their sovereignty.

  David spoke: “I’m looking forward to making the name tags for the freshmen who will be on my hall this year. I’ve got a dinosaur theme in mind. Each new student a different dinosaur.” David’s love of dinosaurs as a small boy was something I had known firsthand. No one could take that from me, how I knew him. I smiled to myself.

  As we pulled onto 1-10, David looked over at me in the passenger seat and said, “Now, don’t stress out on the big roads, Mom!”

  “I won’t if you don’t drive
over seventy-five!” I tried to mean what I said. But we were moving so fast into new territory. I wanted more time to molt this mother role and grow into what would come next.

  It’s difficult to advocate for something if you don’t know how it is faring. If people or beings can’t tell you with their voices how they are and what they truly need, how are we to understand how to help? No one outdid me in my passion and love for wild birds, but I was not among the most expert listers. Still, I knew that bird counting was important.

  I took part in my first Christmas Bird Count, in South Carolina’s Aiken State Park, in 1976. I remember garlands of American robins in the trees and cold approaching frostbite on my feet. My job, thirty-five years later, was exactly the same: to find and tally as many kinds of birds as possible in a single day on my assigned territory. It’s supposed to be a census, but of birds, not people. On today’s Christmas Bird Count—the 115th consecutive event—we were among seventy-two thousand citizen scientists observing the numbers of wintering wild birds. One of my territories extended from the junction of 30A and Cape San Blas Road, and Stump Hole, on the St. Joe Peninsula. My favorite stretch, and the most productive birdwise, was the beach.

  It used to be—just a year or two ago—that you could not drive a vehicle all the way to the tip of Cape San Blas (that ever, ever changing point of sand). You had to carry your fishing poles and your beach gear either from parking places at Stump Hole or all the way from the houses near Money Bayou. Not too many people did, so wild birds thrived there, and you could usually find a great variety resting and rearranging their feathers.

  But the protective barriers are gone now. With a cheap permit from Gulf County, area residents can motor the whole length of that beach.

  As a result, I was a distracted Christmas bird counter. I should have been moving briskly, ticking off species and numbers of species, but I found myself obsessing about the impact of the cars and the people they ferry.