‘This smell must be the myrrh that they sing about at the Christmas concerts,’ she said, and sang a bit of the star boys’ song in falsetto. ‘And they hastened to offer him precious gifts, gold, frankincense, and myyyyrrh. And myyyyrrh.’
Siiri was happy that Irma was in a good mood, and sang along without embarrassment. There were so many bizarre people on the tram that two singing grannies fitted right in. She knew that on a sunny day like today, Irma loved going down Bulevardi, the turnaround at the Hietalahti flea market and then the route around the block along the seashore.
Irma spoke of her admiration of the old buildings on Bulevardi, which were a bit too imposing for Siiri’s tastes. Simple structures pleased her more, and there were only a few of those on Bulevardi. One of them had such wonderful broad balconies.
‘You mean that dirty green functionalist thing? But it’s so dreary!’ Irma exclaimed, then sighed when she saw the old red opera house. She hummed the Cherubino aria until they got to the market square. She thought the Helsinki College of Technology was finer than the presidential palace, and wondered why the president’s official residence was called a palace, when it was just an ordinary building.
‘Oh, no!’ Irma cried. ‘Have they turned the Hietalahti market square into a car park, too?’
‘Yes. And they don’t sell food in the market hall any more, just antiques.’
‘Have you noticed how silly antiques have got? Perfectly ordinary dishes and stools sold as antiques. But I love Wenzel Hagelstam’s antique show. I hope they never take that off the air. I’d call up and complain. But they probably have a different host now. Such a pity.’
Irma talked the whole way there and back. They switched from the number 6 to the 10 again, and then to the number 4, at the stop by the old tram halls. Irma admired the tram halls so much that there was almost no end to her praise. Earlier she had criticized – unnecessarily loudly – the dirty walls of the old conference centre and the trashy black make-up that two girls were wearing. Luckily the girls had earphones in and were listening to loud rock so they didn’t hear Irma’s criticism.
As they passed the school of nursing, Irma was quiet for a moment. She looked at Siiri and said: ‘I’m sorry – who are you?’
Siiri didn’t understand what she meant, and said she was a home-care nurse and a close relative of Napoleon, but Irma didn’t laugh at all, she just looked distressed and asked where they were taking her.
‘Home, Irma,’ Siiri said, and felt with a painful clarity her heart beating out a poor rhythm. She started to sweat. In her panic she took hold of Irma’s hand and tried to sound calm. ‘I’m your good friend Siiri Kettunen, and I’m taking you back to our home at Sunset Grove.’
‘“Grove of Tuoni, grove of night”,’ Irma answered, from the Sibelius dirge, and a smile returned to her eyes. ‘Döden, döden, döden.’
She was herself again, and resumed blurting out whatever came into her head. Siiri wasn’t listening any more, she was wondering with horror if Irma’s unexpected moment of confusion was a normal part of ageing, the kind of thing that happens to everyone, or if it was something that she should be worried about. And how would she know if that sort of thing started happening to her?
Chapter 14
Irma and Anna-Liisa made Siiri go to the doctor. They thought her dizzy spells were far from harmless and ought to be looked at. Siiri thought it was unnecessary. Even if the doctor did find a heart defect, she would just feel relieved. She ‘d rather die of a heart defect than cancer or Alzheimer’s disease. And under no circumstances would she agree to any sort of procedure in the hopes of spending her one hundredth birthday at Sunset Grove and getting a rose and a hug from Sinikka Sundström. That’s what they did there when some poor soul reached that advanced age. Last week one utterly muddle-headed hundred-year-old was caked and flowered even though nobody there even knew her name; neither the residents nor the nurses – nor even the woman herself.
But Irma had become very suspicious about everything and she thought that Virpi Hiukkanen was meddling in some way in all the residents’ affairs, including their health.
‘You should get an advocate,’ she told Siiri. ‘Senile old ladies whose relatives aren’t up on the situation are fair game at Sunset Grove. If Virpi says that you have dementia, your daughter will believe her. After all, she lives in a convent on the other side of the world. Do they even have telephones there? An elder-care advocate can look out for your interests. It said in the paper that every old person should have one.’
‘Do you mean you think I should be put under guardianship?’
Siiri was a little offended, although she tried not to take Irma’s talk too seriously, since Irma herself was often confused. She also remembered reading that paranoia was a part of Alzheimer’s, and was distressed at Irma’s increasing symptoms of dementia. But Irma was hard-headed and wouldn’t back down about the doctor. She thought their complaint about the neglect of the elderly needed a doctor’s report on Siiri’s arrhythmia, otherwise no one would believe their story. She made her case quite persuasively and Siiri found herself wondering how she ‘d become so well-versed in filing complaints.
‘Oh, I’ve filed them before,’ Irma said. ‘Two complaints to the Uudenmaan County Administrative Board. But they have a new name nowadays, since they’re probably going to abolish the counties. How can you abolish something like that? Imagine if one day they announced that the county of Savo no longer existed. That would be pretty funny.’
Siiri was surprised about the complaints to the county board because Irma had never mentioned them before. Irma said she had complained about an unnecessary billing and about the constant changes in the nursing staff too.
‘They’ve got new girls every week in this place. The newest ones can’t even speak Finnish. And besides, the place is completely understaffed so they’re overworked, with one girl having to be in ten places at once,’ Irma said, then a sudden odd instinct told her the new name of the Uudenmaa County Administrative Board. ‘The ETE Centre, that’s what it’s called! Now there’s a meaningless name. What genius thought that up?’
Complaining to various ‘centres’ seemed to be mostly a waste of time. Irma wasn’t the only one who had complained about Sunset Grove. The fat woman in A wing had complained that they were giving her insulin shots in a completely random fashion, but she died before she received a reply. And blind Mrs Kukkonen had complained because she didn’t get food every day, and when she did, it was always cold.
‘This boy would just come in and slam a box on the table and leave a blind woman sitting there alone. And now Mrs Kukkonen has dementia and is shut up in the closed unit,’ Irma said. She said that if a complaint reached its destination before the sender died or was rendered senile, the ETE centre or some other centre sent a friendly-looking lady inspector to have a cup of coffee with Sinikka Sundström.
‘Always the same woman – Ritva Niemistö! Look at that, I even remember her name. Then she writes a report that says the procedures at Sunset Grove are exemplary. They have her reports pasted up on the wall of the lift, have you noticed?’
Siiri had, in fact, sometimes seen the sticker there, never guessing that it was a report generated by a complaint from Irma. Her friend was a lot sharper than she appeared to be. Maybe these occasional spells of confusion were pure theatre – you never knew with Irma. And so Siiri promised to go to the doctor. She got an appointment surprisingly quickly, just two weeks away, when she told the appointment girl that it was a case of a ninety-four-year-old woman with a heart defect.
‘As if it were an urgent matter!’ she told Irma with a laugh.
Chapter 15
At the Health Clinic, Siiri Kettunen once more found a new ‘personal physician’ waiting for her. The doctor was so young that Siiri was moved to ask whether a little girl like her could be a real doctor at all, but that was a mistake. By the time she remembered that there had been a series of articles in the paper about fake doctors, the girl doc
tor had already taken offence.
‘Shall we get straight to business?’ the unknown personal physician said, after a brief lecture. She ordered Siiri to take off her blouse, then listened to her lungs with an ice-cold stethoscope that almost stopped her heart, and wrote a referral to Meilahti Hospital for urgent tests. Apparently, the stethoscope was an instrument that gave the doctor a sense of certainty, the way a blood-pressure cuff does a nurse.
‘I can order an ambulance,’ the doctor said, but that was a bit much, in Siiri’s opinion, so she thanked her politely for listening to her lungs and promised to catch the very next tram to the hospital.
When Siiri got to Meilahti, she waited for two and a half hours. She read some Donald Duck comics, solved seven sudokus, and learned two long articles from last year’s Health News by heart – one about sea buckthorn oil and another about dry mucous membranes – before she went in for her urgent tests. The handsome specialist figured out what Siiri already knew: she had a heart arrhythmia. He spoke in a strained voice and wanted Siiri to have more tests and have a pacemaker installed to reset her rhythm.
‘What rhythm will I be set for? I hope it’s not a waltz, although there is a song about a waltzing heart. It would be hard to use two feet to walk in threes.’ She was trying to lighten the mood, but this doctor was very serious.
‘Generator node and electrical impulse pathways, at which point the sinoatrial node and frequency limit, respectively . . . in which case, an elective surgery or micro-process, perhaps also a telemetry device – all in all a nearly risk-free procedure.’
Siiri listened for a while and then said that she was ninety-four years old and they weren’t going to make her live any longer by installing some gadget inside her.
‘This is a very small operation that’s done under local anaesthetic. The pacemaker is placed under the skin and the electrodes are threaded through a vein to the heart. It will remove the unpleasant symptoms and increase your quality of life,’ the doctor said.
‘Are you sure about that?’ Siiri asked. ‘What kinds of things do you think would give an old person’s life quality?’
‘Well . . . studies show that, for the aged . . . after all, good health is the first step to a quality life. An untreated heart arrhythmia can be life threatening.’
‘You mean that, in the worst-case scenario, I could die?’ Siiri said, feeling very brisk and strong. ‘You’re still a young person, so maybe you don’t know that getting old is mostly unpleasant. Days pass slowly and nothing happens. Your friends and relatives are dead and gone, and your food has no flavour. There’s nothing worth watching on television and your eyes get tired when you read. You feel sleepy, but sleep doesn’t come, so you end up lying awake all night and dozing off all day. You feel all kinds of aches and pains, constantly – small pains, but still. Even the most ordinary tasks become slow and difficult. Like cutting your toenails. You can hardly imagine. It’s a huge, all-day operation that you do almost anything to put off.’
The doctor glanced nervously at his watch and promised to write Siiri a referral for a pedicure, for which she could request state health compensation. He turned his back to her and became absorbed in his computer screen.
‘As far as the pacemaker is concerned, studies show that these small matters affecting health can be crucially important in increasing well-being, not to mention the fact that a pacemaker would go a long way to increasing the length of your life. According to Current Care Guidelines—’
‘In that case, the answer is clear,’ Siiri interrupted with relief. ‘Install the pacemaker in someone younger, some fat person who makes the mistake of thinking he’s fit enough to go for a run and gives himself a coronary. Even my sons have died. And Reino’s son. And a lot of other people too. We old people can’t seem to die from anything, even if we want to. Sometimes at the nursing home we talk about how you doctors don’t seem to understand that death is a natural thing. Life ends in death, and there’s no sense in offering longer life to someone my age and denying me sugar for my coffee. It isn’t a failure of medicine when people eventually die of old age.’
The doctor turned around and looked at her in surprise. ‘But you’re a lively person in good health. Why in the world should you die? Current Care Guidelines—’
‘Because everybody has to die,’ Siiri said. She squeezed the doctor’s muscular hands, holding them in her own wrinkled ones, so that he would understand that guidelines and studies and pacemakers can’t change this fact about the world.
‘One day you’ll die, too. And I hope that you’ll be old enough then to know what dying is, and not fight it. Maybe you’ll even be waiting for it, like me and my friends at Sunset Grove. Even if you put pacemakers in all of us, you won’t change our everyday lives one bit. So I thank you, from the bottom of my heart. I need your report and I’m grateful that you’re writing it. May I have two copies of that paper? That’s all I need from you, and I hope that you’ll take care of young people who are too tired to work any more. The nurses at Sunset Grove are so overworked that we’re practically left alone there.’
The doctor looked distressed. He tugged his hands forcefully out of Siiri’s well-intentioned grip, rushed to the sink, disinfected them, tightened his tie, straightened his doctor’s coat, and sat back down in his chair to stare at the computer screen as if the machine actually knew something and would give him the solution to this dilemma. Then he straightened up, picked up his Dictaphone, and started to murmur into it, glancing now and then at Siiri.
‘. . . otherwise healthy for her age comma memory functional and the patient is alert full stop refuses pacemaker however full stop in respect for patient’s wishes taking into account her advanced age full stop.’ The doctor turned off the Dictaphone and asked her if she wanted some anti-depression medication in addition to the heart medicine.
‘What for?’ Siiri asked, sincerely surprised.
‘They can help your . . . condition. You might regain your zest for life.’
Siiri got up. She had a mind to put the silly man straight about the hard facts of life and death, but she remembered her heart and its raggedy impulse pathways and took a deep breath before replying that she didn’t need any of his peppity-pills. She didn’t need them now and she hadn’t needed them back when her husband died either. The doctor was persistent.
‘Some sleep medication might be helpful. You said that you weren’t sleeping at night, and there’s no reason for that.’ Siiri started to have the desperate feeling that she would never get out of there without a stack of prescriptions. There had been something in the papers about responsibility for outcomes, how it was becoming a problem for public-sector employees. Outcomes were measured in numbers, so child-protection services were considered more effective when more children were reported to state custody officials, and doctors apparently were only earning their salaries if they sent patients for surgery and wrote them a certain number of prescriptions. ‘I’m just trying to help you and do my job as well as I possibly can,’ the doctor said wearily.
Siiri realized she ‘d behaved badly. The doctor surely had enough work to do without her making more work for him. He had studied hard to be able to prescribe sleeping pills to old people, and what would happen if all his patients refused his pills and pacemakers? He had no need, at his age, to know what a ninety-year-old’s life was like. It wasn’t his fault that Siiri had lived to be too old. She thanked him for a job well done, left the hospital, and headed for the tram stop. It was such a beautiful early winter day that she decided to walk one stop further towards town just so that she could look at the imposing Aura Building, designed by Erkko Virkkunen. It was still handsome even though they had ruined the window frames a long time ago when they renovated it.
Chapter 16
Irma and Siiri decided to tell Anna-Liisa about Mika Korhonen, the taxi driver. They thought it was peculiar that Mika had been so friendly, even promised to visit, and then they hadn’t heard anything from him. Anna-Liisa’s logic
al way of thinking was bound to be a help in such a situation. But when they went to the card table in the common room Anna-Liisa was playing double solitaire with the Ambassador and it was a long time before the Ambassador got the hint that he should leave. The poor man was terribly starved for company now that Reino was shut up in the closed unit. Only one of the Ambassador’s children was still alive, and he lived in another country. Irma thought it was as clear as day that because he had dragged his family all over the world his children hadn’t put down any roots in Finland and that was why they had ended up living abroad. The three women promised to play cards with the Ambassador another time if he went to the auditorium to listen to a presentation on ‘Loneliness in the Everyday Life of the Aged’.
‘He has homophobia,’ Anna-Liisa said when Siiri and Irma had told her about Mika Korhonen.
‘He looked healthy enough,’ Irma said.
‘I think the word he used was mafia, not phobia,’ Siiri said. She was trying to keep the conversation focused. They’d got so excited that they’d been talking and stumbling over each other’s words and forgetting the essentials, making the whole story even more confused.
Anna-Liisa used this opportunity to exercise her lecturer’s skills with a brief overview of changes in the meanings of foreign words borrowed into Finnish, of which mafia was, in her opinion, an excellent example, since Mika Korhonen hardly meant to claim that there was actual organized crime at Sunset Grove.
‘I think that’s exactly what he was saying,’ Siiri said emphatically, having got her thoughts back on track. But Irma was muddle-headed.
‘My daughter’s son is gay and he’s a terribly pleasant chap, and so is his boyfriend. They always bring me cake when they come to visit, and they actually come quite often. And they have a little brown dog they’ve adopted.’
‘You don’t adopt dogs,’ Anna-Liisa said, shooting down Irma’s flight of fancy.
The Lavender Ladies Detective Agency: Death in Sunset Grove Page 9