by Jo Owens
It occurs to me that Victoria is a very small city.
I wish I’d been nicer.
It’s too late to be nicer to the people in my past: the teachers, the checkout clerks, the butcher, the baker, the candlestick maker. That ship has sailed. But it’s not too late to appreciate my girls here. Mama Molly. Lovely Lily. Michiko the Warrior. Stella the Grande Dame. Fabby, neat and tidy, with her big belly stretching out in front of her. Even Blaire with all her cares. The night nurses. The casuals.
Christmas is coming. I have to find a way to get Chris to help me.
* * *
I’m worried that I’m going to forget. By the time Chris comes on Saturday I’ve fretted myself into a tizzy and everyone knows it.
“Your mom’s got something on her mind,” Michiko tells Chris.
“Oh? What’s going on? Is it the Degree of Intervention? Because we’ll get to that, I promise.”
I shake my head furiously.
“She’s been trying to write something all week. But. You know. She kinda can’t.”
Michiko shows him the list I was trying to make. Squiggles on a page, nothing more. My face burns with shame and I snatch the paper from Chris’s hands and scrunch it up, glaring.
I try so hard. I squeak and flap and Chris tries too, but I end up in tears and he gives up. It’s the worst visit we’ve ever had.
“I don’t know what you want, Mom. I’m going now; I’ll come back when you’re calmer.”
I’m not sure I’ll ever be calmer. I think I might explode.
* * *
By a stroke of luck, Alice’s daughter Josie brings Alice a small box of good chocolates. She leaves them on Alice’s bedside table, and after Josie leaves, Alice sits on her bed, warming the chocolates in her hands and smearing them all over everything. When Michiko walks in, I swear her hair doubles like a cat’s tail bristling.
“Oh my God!” she shrieks.
Molly comes running.
“Oh no. Someone’s been digging. And painting.”
By this time I’m laughing so hard that tears are rolling down my cheeks. Michiko gives me a dirty look.
“What say you wash her up, Francesca!” she huffs, taking Alice by both wrists, and gingerly raising her hands.
“Chocolate! Oh, Molly! I thought we had a major Code Brown!”
“Oh my God. So that’s why Frannie is splitting a gut over there! You are so naughty, Francesca! But it’s still a mess.”
We all laugh hard together, releasing our tension. Michi walks Alice to the bathroom, washes her hands and changes her clothes while Molly strips the bed and remakes it.
I point to the empty box and beckon.
“You want that, Frannie? It is kind of pretty. Let me wipe it for you, it’s a little sticky. But it smells like chocolate!”
We giggle again, and I put the box carefully on my table, under my calendar.
I’ve got a plan.
* * *
When Molly gets me up the following Saturday, I have the chocolate box in my hand.
“What the heck, Frannie? You want that?”
I have to let go of the box to get my hand through my sleeve, but I make Molly give it back and I clutch it while she hoists me through the air.
“Okay Frannie. Whatever,” she says.
Chris looks a little tentative when he comes in, so I give him my best smile and the thumbs-up. Then I show him the chocolate box.
“What’s that?”
I make a circle with my hand.
“Chocolate?”
Thumbs up.
Chris looks uncomfortable.
“Mom, you can’t eat chocolate.”
Oh brother! Geez! I know! I bang the box on the arm of my wheelchair.
“Here we go again,” mutters Chris.
I take a deep breath. Okay. Okay. Okay.
I put the box in my lap. I point at it. Then I point, as though at a crowd: you, and you, and you, and you. Then back at the box. I pick the box up and shake it. Make a circle with my hand. Point at the box again.
“Chocolate for everyone?”
Thumbs up! Big grin. Now it’s easy. I rub my fingers across my thumb—money—and point at myself. Another circle.
“You want to buy chocolate for everyone?”
Bingo! Oh my word, what a relief! I want to leap out of my chair. Bang, bang goes the box against my wheelchair while I gurgle and grin, undignified as a goose.
“Chocolates for everyone.”
I nod, grinning.
“Because…?”
Thumbs up.
“Because you’re happy here?”
Oh.
That wasn’t really it.
How would I answer that, anyway? Because the aides work hard? Because we poop everywhere and they clean us up? Because of sundowning and wandering and all the other challenges of a normal day here? I look at Chris. This isn’t working. I’m not making myself clear.
I’m not getting into a big snit over it. I give up. Shrug my shoulders. What does it matter, as long as I get my chocolates?
“I don’t know if I’ve ever seen you happy, per se, Mom. Funny place to start feeling that way.”
I would love to retort.
“No point getting fierce, Mom. But sure. I can get you chocolates.”
I point to the calendar, and Chris brings it. Flip to December, find the twenty-fifth.
“You know that’s a ways off, Mom.”
I nod. I know.
“Alright then. Chocolates for everyone for Christmas.”
This time, we both grin.
* * *
Chris brings a copy of the Degree of Intervention form so that we can go through it together.
“We did do this, after your stroke, you know, Mom.”
I shake my head. I don’t remember.
“It’s not surprising that memory is gone. You were in a bad way; we had no idea how much you’d recover. Essentially I did this for you based on what you’d told me about your wishes in the past.” Chris looks guilty. “I did read it out to you, but you weren’t responding much.”
Except for the comment I made about preferring death over living in extended care when Chris was in grade school, I don’t remember any conversations or even comments on the subject of my health care wishes.
But Chris is moving right along.
“…so I hope you’ll forgive me if any of the choices I made were…um…wrong.”
Oh. So that’s it. Absolution. For acting like I was gone when it turned out I wasn’t. Well, that’s understandable. I reach over and pat Chris’s hand.
The questions aren’t that difficult. I get a little mixed up over the word “intubation,” which refers to a breathing tube, not a feeding tube. Good Lord, “No!” to that. I blithely say no to CPR; I only want to die once. I like the expression “comfort care only.” There’s a pleasing rhythm to those words.
It all seems very distant and academic until we get to the final designation. Do I want to be transferred to the hospital if my needs cannot be met here? That’s an easy no, but the inference is that death is expected.
Of course death is expected. But…what if it was now?
Chris lets me take my time to think. “You are allowed to change your mind at any time, Mom. If you get sick and you decide you want us to do…uh…everything we can to save your life, you’re allowed to change your mind.”
I am still, and there is empty quiet in my head.
“Actually, as your health care decision maker, I can change my mind to respect what I know to be your wishes.”
No! That sharpens my thoughts. I want to decide; I need to decide now, while I’m well enough to participate.
When it’s time to go, I’m going, and that’s final.
* * *
; Ruby has been wheeling herself up and down the halls looking for the exit. From my bed I watch her scooting back and forth to our room. Molly tries to redirect her.
Where are you going, my angel?
Oh, it’s my turn to serve lunch at the church. I’m afraid I’m going to be late.
Molly bends down, bringing her face level with Ruby’s.
Ruby, you’ve been exempted from that responsibility because it’s too challenging in a wheelchair.
Oh, I’m not in a wheelchair. I always serve on Wednesdays.
Well, darling, it’s Friday today.
It is?
Yes. And I think you should come down to the dining room because I’ve made a cup of tea for you.
Well, that sounds lovely, but I really do have to go.
You have time.
Molly wheels Ruby away, but ten minutes later she’s back, searching through her side table for her purse.
“I’m meeting Connie and Gordon for lunch at the hospital,” she tells me. “Gordon has been unwell, you know. I don’t want to be late. Where is my purse!”
Ruby spends another ten minutes looking for her purse, which is tucked next to the rail at the side of her bed. She can’t find it, and when she starts to cry, I ring my bell.
Ruby, what’s the matter?
I can’t find my Bible!
Oh, darling, it’s right here. In the top drawer. Here it is, sweetheart. Have a tissue.
I know I’m going to be late.
Darling, you could never be late. You’re always just on time. Come with me. The light in the sunroom is lovely right now, and I’ve got beautiful music playing, and you can read your Bible and settle yourself. I have a special drink for you too.
I won’t be late?
I promise I’ll come and get you when it’s time.
I feel like my friend has disappeared.
* * *
Michiko gets her basin ready for Nana and pulls her curtains while Molly prepares for me.
Is it my imagination or is Ruby a little more confused than usual?
A little? She’s totally wack. I’ve been running after her all morning.
I bet she’s brewing a little UTI. Has anyone done a spec on her?
I’ve got a collection hat in the toilet right now. But it’s kind of hard to push fluids on her. She’s not a good drinker. She thinks she’s going to have to pee all the time.
I know, I know. When you’re dehydrated like that, the more you drink the less you have to pee, but naturally they just can’t wrap their heads around that one; it’s counterintuitive.
Unfortunately she’s not the type to be tempted to drink more just because I put a straw and a little umbrella in her glass, either.
Michiko laughs.
You know all the tricks, Molly.
Well, none of them are working for me today. Frannie, lift your arm for me, would you?
Michiko calls out from behind Nana’s curtain, her voice sharp with alarm.
Moll, come look at this!
Oh dear. How long has this been going on?
I don’t know! I don’t remember seeing it yesterday, but I didn’t specifically check either.
Her hair could have been covering it.
No, wait. I put her hair in a bun yesterday, and it was fine then.
Oh right. With the polka-dot dress.
How the heck are we gonna heal that? I can’t keep her on her back; the coccyx is this close to breaking down. And if I put her on the right side, the hip breaks down.
I know. There’s nowhere left to put her.
Call the nurse, will you?
Maybe OT can get her a donut.
A donut?
Yeah, you know. A pillow with a hole in the middle, so there’s no pressure on that ear.
Oh God. So you’ve seen this before.
A bedsore on the ear? Well, sure, Michi. Don’t beat yourself up. We should ask the hairdresser to trim her hair back a wee bit, though. I’m sure that’s why nobody saw this coming.
Poor Nana.
Indeed.
* * *
I suspect Ruby has been given an Ativan in addition to getting her urine specimen done because she’s relaxed and cheerful now. Molly tasked her with keeping me company, a very important job and her Christian duty. I’m fine with that. We are sitting in the sunroom enjoying a companionable silence when Alice toddles in to join us. She lurches over to the window, trips on nothing and goes down, smacking her head on the foot pedals of Ruby’s wheelchair.
Apparently head injuries bleed like crazy.
“Oh dear,” says Ruby. Gingerly she backs her wheelchair away, spins it around and heads down the hall calling, “Oh, Michiko. I need your help.”
“What is it, dearest?” says Michi as she comes into the sunroom. “Oh no. Not again!”
“Molly,” she calls out. “Grab the Maxi lift and call the RN. Alice is on the floor.”
Michi abruptly shoves my wheelchair away from the growing pool of blood. Gloves on, she cradles Alice’s head until the RN comes to do her assessment: a quick check for broken bones and dilated pupils. Even though Alice is light as the wind and I’m pretty confident Michiko could pick her up with her pinky, the RN and Molly use the portable lift to get her up.
Get her on the bed, says the nurse. We’re going to need some stitches, and I think we need to X-ray that arm.
So you’re going to send her out.
I think we’d better.
I stay put. That’s what I do best.
But when Molly and Michiko come to put me back to bed before shift change, they natter freely.
How many times this week?
This one is the worst yet.
She can’t remember to use her walker.
It’s too bad, though. They come in here because they’re falling at home…
Then they fall here too. We can’t stop them.
Tie them up, like in the bad old days.
Yeah. That’s worse. Way worse.
Better here than at home. At least we know how to pick them up.
We do. Nor do we guilt ourselves as much as family do.
Poor Alice.
I know! It sucks.
It really does.
* * *
We are all tucked into bed when Alice comes back from the hospital. Stella strides into our room, flicking the lights on without apology and rapidly turning down the bedspread and sheets on Alice’s bed. The ambulance attendants are right behind her. They lift Alice from the stretcher to her bed in one smooth movement.
Lady Alice, you’re the lightest load we’ve had in a long time!
And they’re gone.
Her arm is in a cast and the hair has been shaved a bit to accommodate her stitches. It looks to me like the eye is purpling too.
The RN comes in to take Alice’s vitals. Stella washes her face and hands quickly, and changes her brief.
They must have given her something good; she’s pretty sedated.
Yes, and I have orders for more, so if you think she’s in pain let me know. It doesn’t look like she needs anything right now.
No. I’m going to give her a hot blanket and hope she sleeps right through.
Which she does.
* * *
The sun is shining and my tree is glorious with fall leaves, but my stomach hurts. I look out the window and try to ease my belly, almost rocking, pulling myself towards the bar and letting go. When the nurse comes to hook up my tube-feed, I stop her hand, shake my head and thump the table.
“You don’t want this? What’s wrong? Your stomach? You’re going to vomit? Okay, I guess it won’t kill you to miss a meal but I have to give you a little with your pills.”
I acquiesce, and the nurse rolls my bed up to forty-five degrees.
Molly gets Ruby up early—she’s off to exercises—and right after breakfast Molly brings the bed flat, puts me on my left side, gives me a suppository, and then rolls the bed back up. Hopefully I’ll feel better soon.
The occupational therapist comes in with a standard wheelchair for Alice.
This will do for now. I’ll come back to see how well the chair fits her once you’ve got her up.
Okay, thanks.
I listen to Molly washing Alice in bed. When she flips the curtains back, there’s Alice, sitting up uncertainly with her pants around her thighs. I know the shirt Alice is wearing doesn’t belong to her. It’s loose and stretchy and Alice is swimming in it, but it accommodates her cast. Molly slips a sling behind her like a shawl, and runs the straps under her legs. It’s the same type of sling I use.
My stomach quivers. Does this mean Alice can’t walk anymore? Or is the suppository working? I feel sicker than ever.
Molly uses the lift to put Alice in the wheelchair. Alice is still dopey and passive, and her eye is decidedly purple and yellow.
Michiko sticks her head in the door.
Hey, can you give me a…what, you used the lift? She can’t transfer?
I’m sure she can but she hasn’t been assessed, and I just can’t be arsed to have my hand slapped so early in the week.
The nurse pushes past Michiko, who leaves without whatever she came for, and comes over to unhook my tube-feed. Molly wheels Alice over to the bar, and with one hand Alice grips it and pulls herself up while Molly pulls up her pants and removes the sling. I hear Alice sitting down hard.
I’ve belted her in and I hope she’ll stay. I know it’s a restraint because I’m pretty sure she doesn’t have the capability to get it off. I left the foot rests off. If she does get the belt off and she decides to stand up and make a run for it, I don’t want her to trip on her foot pedals. Plus, if her feet are on the ground, maybe she’ll be able to paddle herself around in a bit. Like, when the drugs wear off.