by David Dosa
I didn’t feel frustrated, though. While I didn’t feel enlightened necessarily, I did feel oddly elated. The image I was left with was that of Oscar walking Cyndy Viveiros down the hall and sitting with her in the darkened dining area—as he had sat with her mother in her final days. Maybe that’s all he was: a companion, a sentient being who might accompany one person on their journey to the next world, or another through the grief of losing one they loved—a kind of underworld of its own. Wasn’t that enough?
Did it matter if he had some extrasensory power of perception, if he could pick up on impending mortality before the best minds of medicine could? Maybe he was just a master of empathy. Maybe caring was his superpower.
I needed to talk to Mary.
“I’ve been thinking about what you said, that Oscar has forty-one family members and when one of them is in trouble, he goes and stays with them.”
It was a little before three in the afternoon and Mary and I were sitting in her office. She had asked the staff to assemble at the nurse’s desk at three, and I had arrived in time to get a few words in with her before the changing of the guard. The worries of our last encounter—the latest funding crisis, the Sisyphusean task of running the floor of this nursing home—seemed to have vanished, and she was looking calm and collected. She was also being quite modest.
“Oh, David, that’s just my theory,” she said. “What do I know? You have to remember, I’m a dyed-in-the-wool animal lover. It’s not like I’m objective.”
“Objectivity has its limits,” I said. “Remember, I started out not believing in Oscar. To be honest, I thought you guys were all a little crazy.”
“You know what the sign says,” said Mary with a smile. “you don’t have to be crazy to work here—but it helps!”
“But now I think that Oscar has some purpose,” I continued. “Maybe he’s meant to help the residents—the family members, as you put it. But also their family; they may be the ones who suffer the most.”
“Don’t forget the staff,” said Mary. She was fully engaged now, playing Watson to my Holmes. “You can’t work up here and not become involved in the lives of your patients. We come to love these people, David. Their loss grieves us, too. In the end, we often become as close spiritually and emotionally to these patients as their own family members.”
“Does it help to have seen so many die with Alzheimer’s?” I asked. “Doesn’t it make it any easier?”
She thought for a minute before answering. “It makes it easier to understand what’s happening,” she said finally, “but not why. Why would anyone be afflicted like this? Why would God allow this to happen?”
Though we seldom touched on the subject of religion, I took a chance and asked her, “Do you pray, Mary? I mean, have you asked God why?”
She smiled without directly answering the question. “I don’t think He’d answer right away,” she said.
No, I thought. He’ll take a message and get back to you.
“As I’ve said before, the thing you have to remember about domesticated animals,” Mary said, as if she’d been reading my mind, “is that people started to keep them because they had a purpose. They worked. If you were a dog, you were herding sheep or something. Any cat that wasn’t doing some serious mouse hunting around the farm wasn’t going to be there for long. They had to earn their keep.”
“So you think that’s Oscar’s job,” I said, “to take care of people?”
Mary shrugged. “Why not? Maybe he’s just more highly evolved than the other cats. Maybe it’s his way of paying the rent.” She checked her watch and smiled at me. “We’re all just guests here, you know.”
At that, the door to the unit opened and a parade of evening staff shuffled through.
Mary got up from her chair. “I’ve got to get the troops together so we can run our list. Are you sticking around?”
I shrugged.
“Please do. There’s one more patient I’d like you to see before you go. Our sign-out should just take a minute.”
A few moments later Mary was standing with her back to the door, addressing the afternoon charge nurse and four aides about the day’s events. This was her daily change-of-shift meeting, when she would advise the incoming staff on what to look out for and which residents might need special attention. I took my place by one of the aides and tried to be unobtrusive as I listened in on the conversation.
“Over on the west side,” Mary said, “there are a few things going on. In 312, Mrs. Carey seems to be—”
As Mary continued with her report, I began to daydream. Farther down the hall a handful of residents sat watching TV. This time of day it was probably one of the soap operas they seemed to enjoy. All that drama and nothing ever seemed to change. Behind them, I noticed the silhouette of a cat perched on the windowsill staring intently at the world outside. It appeared that Oscar was off the clock and had found a favorable place to while away the day. It seemed like there would be no deaths on the third floor today.
Mary’s voice brought me out of my reverie.
“Dr. Dosa, you might want to hear about Mr. Grant. He’s the resident I want you to see.”
I turned my attention back to the group and Mary continued her report. “Mr. Grant has a pressure sore developing again. We’re changing the dressings twice a day and it looks fairly clean. Just make sure that we turn him often. He’s completely bedbound now so we really need to be careful that the ulcer doesn’t get worse.”
To me she added, “I need to change the dressing before I leave. Why don’t you take a look with me in case there is something else you’d like us to do?”
I nodded as Mary wrapped things up. “Finally, there’s Ruth Rubenstein. She’s really rebounded over the last few weeks. She’s walking again and her weight is back up. As you know, her confusion is finally gone and physical therapy has been working with her. By the way, Frank just got here and he’s requested some privacy. Please keep her roommate in the dining area, out of respect. I think today is their anniversary or something and he wants to be alone with her.”
When Mary mentioned the request for privacy, a few of the aides exchanged knowing looks. Requests for privacy between patients and spouses are not uncommon; still, sometimes the people who work here can act like schoolkids. Mary cast a cold eye on the smirkers and order was restored.
As the group broke up I followed Mary back to her office. “Now, why is the idea of the Rubensteins wanting privacy so funny to them?” she asked. “They’re a married couple. Just because she lives here doesn’t mean that they don’t have needs.”
Mary raised her head. “You know, one of the other male residents has been spending a lot of time in the room with Ruth lately. The thing is, she doesn’t seem to mind his attention.”
“Frank won’t be happy,” I said in a hushed voice.
“I suppose we’ll have to tell him eventually.”
“Please make sure I’m on vacation when you do,” I said. I’m not sure I was joking.
Mary shrugged. “I’ve got to get out of here, so let’s take a look at that pressure ulcer.”
We left her office and headed down the hall toward Mr. Grant’s room. Suddenly there was a scream and Ruth Rubenstein charged out of her room. The look on her face was one of pure terror and she ran past us without stopping.
A moment later Frank followed her out. He stopped when he saw Mary and me.
“Dr. Dosa, I need to speak with you,” he said breathlessly. His face was a study in anguish.
I directed him down the hall in the direction of their room while Mary went in search of Ruth. We entered her room and sat down next to each other on Ruth’s bed. Frank looked at me through eyes heavy with tears.
“Dr. Dosa, I need to tell you what happened today, but I need you to understand a little bit more about us first.”
“All right,” I said.
“Ruth and I were married shortly after the war. I don’t know if you are aware of this, but we met at a concentration camp.�
� He looked at me to gauge my response.
“I didn’t know that,” I said.
“Dear God, I still remember it to this day. It was late October 1943. I had already been at the camp for a few months.” Mr. Rubenstein paused for a moment and became lost in his memories. A minute passed before he began again. This time his voice was low and uneven.
“They say when you get older that you forget. It’s not true. I remember the past more vividly every day. In some ways, I envy my wife—she doesn’t remember any of this anymore but I live with the memories every day. At night I dream about it: the humiliation, the suffering…” Frank paused briefly and looked at the floor before continuing.
“I remember the first moment I saw Ruth like it was yesterday,” he said. As he spoke his accent seemed to become more pronounced, the Eastern European inflections and inverted sentences bubbled up through time to the surface. “She must have just arrived at the camp. She was dressed in a brown dress, torn. Her overcoat…it was still new, but stained now from travel. This heavy suitcase through the mud she was pulling. I still remember her long dark hair: tangled and dirty but oh! it was beautiful. For some reason—maybe it was fate—our eyes met. Doctor, she had the most magnificent eyes I’d ever seen. Most important, there was no fear in her eyes. She was in this horrible new place but all she looked was determined: She was going to live!
“So like that I fell in love with her. I had to know her. I walked over and offered to carry her bag.”
Frank looked over at me, the hint of a smile coming to his face.
“She turned me down, but never once did I stop thinking of her. It was weeks before we met again. This may sound crazy, given our surroundings, but, Doctor, it was the happiest day of my life. From that day we were inseparable. For nine months we were together. Then suddenly, we were sent to different camps. Before we were separated we agreed that if we survived we would look for each other after the war. We chose a place to meet—a church in my hometown. Neither of us knew whether the other person survived.”
“Mr. Rubenstein,” I interrupted, “I can’t even imagine what you went through.”
He put his hand up to stop me from talking.
“Dr. Dosa, it was sixty-three years ago today that we met in the courtyard.” He paused to allow the news to sink in. “For the first time since that day, Ruth does not know who I am.”
As he spoke his tears poured down his cheeks. I looked at him in silence, unsure of what, if anything, I should say.
“When we came to the United States, we didn’t have a lot of money. All we had was each other. We couldn’t speak the language. Ruth cleaned rooms at the hospital and I went to school during the day to learn English. At nights, we would walk around New York City, looking in the store windows. Then we would go back to our little apartment and lay down together. That we could afford!
“Things got better. My English became not so bad and I got a job as a laboratory assistant. Ruth took a job as a nanny for a rich New York couple. She loved that job and those kids. Maybe because we couldn’t have kids ourselves.”
Frank began to tear up again.
“I’m sorry,” I said.
He acknowledged my response with a quick nod before continuing. “We never had it easy but we made do. Our lives got better. I went back to school and finished my Ph.D. For my first real job we came here to New England.”
I looked at Frank for a clue as to where this was going. Perhaps he realized that he was rambling. He stopped himself and looked at me.
“Today, for our anniversary, I brought her a dozen red roses and a piece of her favorite pear tart from that excellent bakery downtown on Federal Hill.”
I glanced over and saw the unopened pastry box on the bedside table along with the vase full of roses.
“I walked into her room and said, ‘Happy anniversary,’ like so many times before. I sat on the bed and bent over to give her a kiss on the forehead.”
He paused. “In her eyes all I could see was terror. Dr. Dosa, I was a stranger to her. She just started screaming….”
It was as if all the air had left the room.
“I didn’t know what to do,” he continued. “I tried to kiss her and she just kept screaming. I put my hand up to comfort her and she slapped me in the face. Then she got up and ran out of the room.”
I could see the red mark on his left cheek. We settled into an uneasy silence. Finally Frank spoke.
“Doctor, I don’t want my wife to live in fear like this.”
I looked at Frank. He had stopped crying. His expression was fierce, as determined as hers must have been back in the camps. I understood now why he had wanted to tell me the story of his marriage.
“Will you help me, Doctor?”
Deep in my soul, I knew where he was coming from—and I knew where he was going. His heart was broken; there was nothing left. They had survived; they had come this far and now he was alone. I put myself in his shoes and for a moment, I thought of how easy it would be to break a cardinal medical oath and do what he was asking.
“No,” I finally said. “I can’t help you with that.”
There was another awkward silence that I finally broke. “Mr. Rubenstein, your wife is terminally ill. Physically, she’s been doing better lately, but when her time comes, we can put her on hospice and just make her comfortable.”
“How long does she have?” he asked me.
“Mr. Rubenstein, only God knows that.”
He allowed my answer to sink in. I wondered what he thought of God. Maybe God no longer existed for someone who had experienced so much horror. “Doctor, in my mind my wife died today.”
He gathered his things from the bed. “Please just make whatever is left of her comfortable and don’t let her suffer anymore.”
“You have my word, Mr. Rubenstein.”
Frank gave me a halfhearted smile and stood up. He crossed the room quickly and then went out into the hallway. I followed him as he passed his wife seated at the nurse’s table at the front of the unit. He didn’t give her a second glance and she did not see him. Maybe she was fixated on the black-and-white tabby cat that had left his perch at the window and had come to the front desk to inspect all of the commotion.
When he got to the front door I buzzed Mr. Rubenstein out of the unit with my ID card. As he left he turned quickly and grabbed my wrist. He looked me in the eye.
“Thank you for all of your help over the years,” he said. “I know I haven’t always…”
His speech trailed off and tears sprung to his eyes again. “Please just make her comfortable, Doctor.”
I nodded and he smiled grimly through his tears. Then he was gone.
CHAPTER TWENTY-ONE
“The smallest feline is a masterpiece.”
LEONARDO DA VINCI
GEORGE DUNCAN LOOKED AT HIS MOTHER THROUGH tired eyes. Only a few hours before, he had been 300 miles away on the job in southern New Jersey; his work as a bankruptcy liquidator frequently took him away from home. His day had started uneventfully. Then at four o’clock he had received the call he had always dreaded.
“George, your mother is not well,” Mary had told him. Usually he was the one to call her—so much so that when he saw the Steere House number on his cell phone he knew it wasn’t good. “I think you’d better come up here as soon as you possibly can.”
Instantly, he regretted having left his mother. He had spent almost every minute of the previous weekend’s Thanksgiving holiday in her room. It was clear to him then that her health was in steep decline. But Monday had come calling, and with it his work responsibilities. His mother’s chronic illness and frequent hospitalizations had already caused problems for him on the job. As he hung up the phone, he had felt the guilt ravage his mind and body.
“I’m sorry,” he had told his surprised colleague. “It’s my mother.”
When he arrived at the nursing home shortly before midnight, George was pleased to see a family friend seated at the doorway, as if she we
re guarding it.
“I didn’t let him in,” she had told George, pointing to the black-and-white cat down the hall. “I didn’t want him in here until you arrived.”
For hours she had fended off Oscar’s advances into the room. Eventually Oscar had grown frustrated and had walked away. But she knew he hadn’t gone far.
George hugged her and then crossed the room to sit with his mother. She stirred briefly as if she recognized his arrival but then quickly returned to a peaceful slumber. He watched her breathing. It was rapid and rhythmical but did not have the violence that marked her many earlier episodes of aspiration pneumonia.
George took his mother’s right hand from where it lay by her side. He grasped it vigorously with both of his hands and then cradled it softly to his chest. He began to cry again. He knew he was losing her.
He sat there like that for a while, unaware of the passage of time. Then came a knock on the door. A cleaning lady quietly entered the room and disappeared into the bathroom. She returned, carrying several bags of trash. George looked at her through his tears and she smiled warmly at him. He bowed his head.
Then George felt a hand on his shoulder. He looked up to find the cleaning lady’s concerned eyes looking into his. She put her cleaning supplies on the floor and sat down next to him on the bed. George let go of his mother’s hand.
“Don’t cry,” the cleaning lady said and handed him a tissue from a box on the bedside counter. “Remember, you will see your mother again. We have an earthly hope and you will see her again.”
George stared at her in amazement. He wondered whether she attended the same Kingdom Hall he and his mother had.
“Do I know you?” he asked. The lady smiled warmly.
“Not really, but I know your mother. I have been working here for eight years. In the early days, when your mother was still able, she was my teacher. She was the one who taught me about the Bible.”