Making Rounds with Oscar

by David Dosa

  Frustrated, she dropped her hands into her lap. I looked at her and racked my brain for something to say that might lessen her sorrow. I had nothing to offer.

  “I really miss him,” Ida said abruptly. “The cat, I mean,” she added. “I miss Patches.”

  I put my hand on her shoulder and we sat together in companionable silence. She acknowledged my touch with a smile, but I couldn’t help thinking that she probably wished I were a cat.

  “Dr. Dosa, animals have this sixth sense and they can communicate with us if we understand their language. I’m telling you that Patches wouldn’t leave my side if I was sick.”

  “You mentioned your other cats. What about them? Were they like Patches?”

  Ida smiled again. “No, Ginger was friendly as can be. She was always at my feet or on my lap, but she really didn’t have that sense of when I needed her. Now Grover, he was—”

  “You named your cat Grover?”

  “I let my niece name him. I probably should have called him Oscar the Grouch, though, because he could be meaner than a rattlesnake.”

  “So you believe all of this about the cat upstairs?”

  Ida looked up at me with a knowing smile.

  “You’re not much of a cat person, are you?”

  “I can’t say that I am, but I’m trying to be.”

  Then Ida openly laughed.

  “I knew it! I could tell you were more of a dog person. You’re too damn nice.”

  Her humor was contagious and I found myself laughing from deep within. I needed that. “Thank you, Ida. I’m not sure you meant it as a compliment but I’ll take it today.”

  “You’re welcome.”

  She studied my expression again.

  “Something’s wrong,” she said finally. “There’s something you’re not telling me.”

  “It’s just been a bad day, Ida.”

  She smiled. “You’ll have a lot more of those in your life. Forget about it. Most of the time it’s not as bad as you think it is. Just go home, kiss your wife and kids, drink a beer, go to bed early, and you’ll feel better in the morning!”

  “Doctor’s orders?” I asked her.

  “Doctor’s orders!”

  RIDING THE ELEVATOR to the third floor, I thought of Ida’s sharp mind and damaged hands and I felt troubled. If I was being truthful—and this did seem to be a day of truths, welcome or not—what bothered me about Ida was a connection we shared. Looking at her sometimes I felt that I was staring at my own future. I glanced down at my own hands and studied my enlarged left thumb. It was ten years since I myself was diagnosed with an inflammatory arthritis very similar to Ida’s. I looked at my swollen right wrist and thought of the swelling in my left knee and ankle. The joints were not as painful as they once were, thanks to my complicated medical regimen of pills and injections. Yet the telltale signs of inflammation were there and I knew that, like Ida, my joints would fail me, my own legs would not carry me into my proverbial golden years, and my own arms might not be able to hold my grandchildren.

  I felt a shiver as I thought about Ida and the curse of not being able to do the things you once liked to do. I allowed the feeling to wash over me, felt the self-pity rise and fall like a fever, and then shrugged it off. Instead, I thought of Kathy and what she had said about the importance of little daily victories in combating chronic illness. I’ve had over a decade to think about chronic illness in my own life and know that she is right. There are more important things in life than careers and grants. There are the day-to-day victories, the gifts of the here and now. Instead of worrying about my old age and my grandchildren, couldn’t I just rejoice in being able to carry my newborn daughter up the stairs and play soccer with my son? I was still able to bend over and tie my own shoes. Tomorrow’s problems would have to wait.

  I exited the elevator onto the third floor, stepping directly into a meeting between several aides and a hospice nurse at the front desk. They were in the midst of an intense conversation, one that I quickly realized revolved around Oscar.

  “So he did it again,” I interjected.

  “Yes, he did,” Lisa, the hospice nurse, replied. “He’s developing quite a unique talent.”

  We were joined at the front desk by Sally, one of the hospice ministers. She had just returned from Mrs. Sanders’s room.

  “How is Kathy doing?” I asked her.

  “She’s upset, but I think she’ll do fine eventually. She’s had a long time to come to grips with today.”

  I left them and walked down the hall to Mrs. Sanders’s room. Kathy was holding her mother’s hand, crying quietly, while Oscar sprawled out on the bed, his front and hind legs extended, his spine resting gently against Mrs. Sanders’s leg. Kathy turned to greet me. Beneath her swollen eyes she managed a slight smile and rose to give me a hug.

  “I’m sorry,” I said.

  She began to cry again and I felt her warm tears through my shirt. We held the embrace until it became uncomfortable. Kathy’s eyes were bloodshot and she looked like she hadn’t slept in days. Her blouse was wet from her tears and wrinkled from the vigil she passed in the chair beside her mother’s bed. I tried to think of something to say that might make her loss easier but came up blank again. Thankfully, Kathy broke the silence.

  “Dr. Dosa, I want to thank you for everything you have done for my mother.”

  She wiped her eyes with her sleeves and turned to sit back down in her seat by the bed. She picked up her mother’s hand again and cradled it in her own. The movement stirred Oscar, who looked rather tired himself. He blinked and looked at Kathy.

  “Can you believe this cat?” Kathy said.

  “I heard that he was here when your mother died,” I replied. Through her tears she smiled slightly.

  “Yeah, he and I are buddies now,” she said and reached over to pet Oscar on the head. Oscar accepted the attention and nuzzled Kathy’s hand.

  “The hospice nurse and the minister told me he’s done this before,” she said.

  “For the last year or so, from what I’m told,” I replied.

  “Well, he’s a really special cat.”

  “I suppose…,” I said, and realized that a small part of me was starting to believe it.

  I put my hand on Mrs. Sanders’s hand and said a private good-bye to my patient. Neither Kathy nor I spoke. On the bed next to us, Oscar sat quietly purring. Finally, after several minutes, I asked the question I’d been contemplating since my conversation with Mary.

  “Kathy, were you okay with Oscar being here at the end?”

  She looked at me for a moment and then said, “Dr. Dosa, I think of Oscar as my angel. He was here for my mother, and here for me, too. With Oscar at my side…well, I felt a little less alone. It’s hard to explain, but some animals, well, the sense they give you is that they understand what’s going on. More than that, they just accept. I don’t know, but Oscar gave me a feeling that this is all natural. And it is, isn’t it? If birth is a miracle, isn’t death a miracle too? My mother…well, her struggle is finally over. She’s finally free.”

  Kathy stared at me, waiting for a response, but I gave her no indication of what I was thinking. I guess I really didn’t know.

  “My mother never wanted to live the way she did in the end,” she added. “She was a proud woman. You didn’t know her before, but she had a tremendous sense of pride. She always dressed fashionably and she was quick with a joke.”

  She smiled, perhaps remembering one of her mother’s jokes, one that she did not share with me.

  Looking at Kathy, I realized that she would be fine. The coming days would be hard on her, but she would move on to the next chapter in her life—one that wouldn’t involve daily trips to Steere House.

  I said one last good-bye to Kathy and realized that our association had come to an end.

  “Take care of yourself,” I said.

  Kathy nodded as I left and returned to her thoughts, and to Oscar.

  CHAPTER FOUR

  “Cats
are connoisseurs of comfort.”

  JAMES HERRIOT

  WHEN I RETURNED TO STEERE HOUSE A FEW DAYS LATER I found Mary seated at the nurse’s desk brushing Oscar. Sprawled out in full glory, he looked like a boxer after a major bout—or, given his mane, one of those big-time wrestlers.

  “The last couple of days Oscar’s seemed pretty beat from his vigil,” Mary said.

  “Sure…sitting on a bed sleeping is really hard work.”

  “You laugh, David, but Oscar’s always tired after the fact. It’s like he’s on the clock when someone is dying and then afterward he’s spent.”

  I rolled my eyes, something that annoys Mary as much as it does my wife.

  “Domesticated cats were like dogs, you know,” she said, as she continued her ministrations. “They had to earn their keep on the farm. Maybe this is like Oscar’s job.”

  “Well, I need to start doing my job,” I said, opening a chart that I had spent the better part of ten minutes looking for. As any nurse or doctor can tell you, the chart you need is invariably the one that is missing. Anyway, I must have made it look awfully inviting because suddenly Oscar left Mary’s side and jumped up onto the counter next to me. Then he twirled around twice before sitting down in a clump of fur on my paperwork.

  “Will you look at that,” I said in anguish.

  “It’s a cat’s world,” said Mary. “We just work in it.”

  I grabbed the chart out from under Oscar, who glared at me.

  “You’re gonna make me sit somewhere else, aren’t you?”

  Mary laughed.

  “David, you never win an argument with a cat. Don’t you know that by now?”

  She got up from her seat and motioned for me to sit down.

  “Here. I’ve gotta go down and see Ruth Rubenstein anyway.”

  “Anything going on with her that I need to know about?”

  “I don’t know yet, but Mr. Rubenstein wants to see me.”

  “Do you need reinforcements?” I inquired, drawing a smile.

  “No, I think I’ll be all right…but you might want to keep your pager handy in case I need you later.”

  As Mary disappeared down the hall, I thought back to the first time I had met the Rubensteins.

  I LOVE MY JOB, even though it’s sometimes less than satisfying. Often I’m the bearer of bad news, the detective with the inconvenient truth. Too often the suspects work in pairs, covering for each other: mother and daughter a lot of the time, or, in the case of the Rubensteins, husband and wife. If they work together to keep me out of their lives—even when they come to me looking for help—it’s because I’m the messenger, the one with the bad news. I’m the one who confirms what they often already know deep inside. There’s simply no easy way to tell someone they have cancer, heart disease, emphysema, or any other horrible disease that takes so much before it results in death. But it’s particularly hard to tell someone they have dementia, even when the person intuitively knows it already.

  That’s what I had to do with the Rubensteins some three years before. I had to look into the eyes of the eighty-year-old woman I had just examined and ruin her life. I knew from experience that her husband would be sitting with her, a deer-in-the-headlights look on his face. I knew this look and it said that I am their judge, jury, and executioner. To a certain extent, he would be right. I thought of the end of the mouse’s tale in Alice in Wonderland: “‘I’ll be judge, I’ll be jury,’ said cunning old Fury: ‘I’ll try the whole cause and condemn you to death.’”

  Earlier on the day that I first met the Rubensteins I’d been with Mr. Earl, a delightful eighty-five-year-old with few medical problems and a mind that ran at full throttle. During his physical exam he told me in great detail about the book he was reading. Then he regaled me with stories of his recent volunteer work with a local nonprofit and his plans to travel to Florida for the winter. When my exam was finished I sat down with him. Even though I was running a little behind, I wanted to let him go on for a few more minutes before I moved toward the door, the indication that our time was over. He took my gesture with good grace and apologized for taking up more of my time than he intended to.

  “Mr. Earl,” I said, waving off his apology, “I hope I am as healthy as you are when I get to be your age.” I knew I wouldn’t be—I already had more health problems in my thirties than he had—but I said it anyway.

  He smiled. “I’m a lucky man, Dr. Dosa. The trick is eight hours of sleep, a healthy diet, and lots of lovin’!”

  Who can argue with that?

  Donna Richards, my office manager, confronted me as soon as I stepped into the hallway. She was looking at her watch and seemed a little frazzled.

  “Are you done yet?” she asked.

  I nodded.

  “You have a new patient in room 3 who is getting restless. Her husband has already been out to ask where the doctor is. I’ve played interference, but you’ve got to speed it up.”

  I told her I was doing the best I could. Of all people, Donna should know how hard it is to appropriately care for older patients and give them the time they deserve. Her own mother was a patient in our clinic.

  I grabbed the next chart and took a moment to look over some paperwork from another local doctor before I knocked on the door. The well-dressed couple I found did not look pleased. The man held up his watch and tapped it several times with his finger.

  “You know, Dr. Dosa, our appointment was for 2:15 pm. You are twenty minutes late.”

  “Mr. and Mrs. Rubenstein, I’m so sorry to keep you. Please accept my apology.”

  Going to the doctor is not like getting your shoes shined and, unfortunately, there are times when other patients need my attention for longer than I anticipated. But I’ve learned over the years that explanations only make things worse. Simple apologies work better. Not in this case, though.

  Frank Rubenstein was insulted, not on his behalf, I soon realized, but on his wife’s. He was a gentleman of the old school, and rather old world, at that. I recognized his Eastern European accent as being not so distant from that of my own parents, and I thought I recognized the attitude too.

  Concern takes many forms, I’ve come to learn as a doctor, and it’s easier to recognize when it comes as a purr than a growl. Frank was like a papa lion protecting his lioness from predators, real or imagined. I posed no threat to his wife—I was simply there in front of them at the wrong time. What was really stalking her came from within.

  Ruth Rubenstein, who was sitting across from him, seemed mildly embarrassed.

  “Oh, Doctor, I’m so sorry for my husband’s brutish behavior. I’m sure you have lots of other patients to attend to. Frank just doesn’t like coming to the doctor’s office.”

  She flashed me a disarming smile and then turned quickly to glare at her husband. He got the message; they’d been together long enough. As Ruth stared down her husband, I took a moment to look her over. She was neatly dressed in a long skirt and white blouse. She was strikingly attractive with blue-green eyes that radiated warmth. Her long silver hair was arresting, pulled back behind her ears with what looked to be an expensive pearl hairpin. Her skin still had a youthful vigor, and my first thought was that this woman still had it together.

  I offered her my hand. She grasped it firmly and I was overpowered by her perfume.

  My heart sank.

  I moved in closer and confirmed my initial suspicion. Beneath the scent of her cologne I recognized the unmistakable musty odor of urine, a sign of incontinence.

  I introduced myself again and asked how I could help them. Mr. Rubenstein launched into an explanation.

  “Doctor, as you’ve probably figured, neither of us particularly want to be here, but I’m concerned about my wife’s health.”

  He looked down at the floor, collecting his thoughts.

  “I’m concerned…” His voice trailed off as if he was searching for a delicate way of telling me about his wife’s problem.

  “Go on,” I said, nodding
. He looked back at me, having found his voice.

  “My wife has started to do some strange things. She loses things. The other day, she couldn’t find her keys. She blamed me. Eventually I found them in the refrigerator with the groceries she had just brought home. She’s also gotten lost a couple of times coming back from the grocery store. One time she called me and she was halfway across town.”

  He looked over at Mrs. Rubenstein, who acted as if we were talking about someone else. She just stared at the cover of the magazine in her lap.

  Frank continued. He was likely the same age as his wife, although he appeared significantly older. He was dressed in a vintage suit, circa 1970. No doubt he was the original owner. His hairline had receded and whatever hair remained was uncombed. As he told me more stories about Ruth’s memory lapses—the day she forgot to meet him for coffee or the morning she put the milk in the cupboard—I looked back over at Ruth. Now she was attending to his words, and if looks could kill, he was the one who would have needed medical attention.

  When Frank finished speaking, I asked Ruth conversational questions geared at assessing her memory. She skillfully deflected many of them, often deferring to her husband. There’s an almost symbiotic relationship between couples that have been married a long time; the Rubensteins were no different. When I asked Ruth to tell me about her favorite restaurant she responded by playfully asking her husband to answer the question.

  “Darling, what was the name of that restaurant we ate at the other night?”

  “The Golden Palace, Ruth.”

  “Yes, Doctor, have you eaten there?” she asked.

  I shook my head no.

  “You really must try it. We really love that restaurant. They have the best meals.”

  “What do you like to eat there?” I asked her, doing my Columbo routine.

  “Oh, I like everything.”

  “What did you eat last time you were there?”

  Ruth stared at me blankly. I imagined her flipping through her mental calendar and finding every page blank. Eventually she looked to her husband for assistance.