by David Dosa
George began to smile.
“My mother was a remarkable lady,” he said.
The lady nodded and then stood up to continue her work.
“You’ll be all right,” she said firmly as she picked up her supplies and left the room.
No sooner had she departed than a night nurse walked in to check on George’s mother. She watched Iris’s breathing and looked at her watch, counting the respirations. Satisfied that her breathing was unlabored, she asked George if he needed anything. He said no, but she left the room and returned momentarily carrying a sandwich. Seeing the food, George realized that he hadn’t eaten anything since lunchtime. He picked up the sandwich and eagerly began to eat.
As he chewed George heard the fast pitter-patter of padded feet on the floor. He looked down to see a black-and-white cat sitting on the floor in front of him. He was not surprised.
“Hello,” George said to the cat. “Are you hungry?”
Oscar simply sat there and they settled into a strange silence, each looking at the other. George offered Oscar some of the meat from his sandwich. The cat sniffed at it disdainfully. He wasn’t there for handouts. Oscar walked over to Iris’s window and leaped onto the sill. There he settled into a crouched position and peered out into the dark night.
Polishing off his sandwich, George got up and turned on the CD player. He put one of his mother’s albums on and selected her favorite song. As the song began to play, Iris briefly stirred. George crossed the room and knelt beside her. His mother’s eyes opened and she looked deep into his.
“I love you,” she said in a moment of stunning clarity.
Her last words spoken, she was silent again, drifting back into a peaceful sleep.
George spent a few more moments at his mother’s bedside. When it was clear that she was no longer awake, he grabbed a blanket from the closet and returned to his seat. Within moments the music carried him away and he was fast asleep, dreaming of a place where his mother was with him, whole, in an unbroken and undamaged state.
GEORGE AWOKE WITH A START. He looked around, momentarily disoriented. Outside it was still dark. Glancing at his watch, he saw it was four in the morning. He had only been sleeping for two hours, yet he felt surprisingly refreshed. Regaining his bearings, George looked over at his mother’s bed. She was breathing rapidly. As he stood to walk toward her bed, the activity roused Oscar from his perched position on the windowsill. The cat watched as he took his mother’s hand and felt her pulse. It was frighteningly fast, crackling like an electrical current.
George rang the call bell and a nurse arrived immediately to reevaluate Iris. She left for only a moment before returning with a dose of liquid morphine. She placed the medicine inside Iris’s mouth and then put her hand on George’s shoulder in a gesture of reassurance. As the medicine began to take hold, Iris’s breathing became more deliberate and her heart rate slowed from its staccato pace. He looked at his mother’s face and studied her features as if to memorize them. He knew that she was leaving him and he began to cry.
A moment later Iris Duncan drew her last breath in this world.
“ABOUT AN HOUR after my mother died, an aide walked into the room,” George said.
We were talking on the telephone late one evening a few months after his mother’s last night at Steere House. We had tried to meet in person, but George had been called away to Florida for business.
“She told me that she was going to bathe my mother. I asked her why. ‘My mother has died,’” I said.
“The aide looked at me and smiled. ‘Your mother has died, but she should be clean,’ she said.”
Somewhere a thousand miles away, I could hear George choking up briefly as he considered the moment. “I have to admit that I was puzzled by her response. I asked her if it was normal to clean a dead body. She told me that she loved my mother and thought she should be clean.”
“I suppose Steere House has many rituals at the end of life,” I said. “For example, the nursing home always has their expired residents go out the same way they came in—through the front door. No one ever goes out the back service elevators.”
“Yes,” said George. “For me, though, of all the things Steere House did for my mother, this is what really took my breath away. A few hours later, the funeral director came for my mother. Oscar stayed for the whole time, watching over her. When the funeral director came, they placed my mother on the gurney and covered her with a white sheet.
“They wheeled my mother out of the room and down the hall toward the elevator. When we rounded the corner and started down the corridor toward the main elevators, I realized that almost every nurse, aide, and staff member in the building was lined up along the hallway like they were part of a procession for a dignitary. As we passed some of the nurses, I saw that they had tears in their eyes.”
On the other end of the telephone, George began to cry freely.
“That took my breath away,” he said, his voice wavering through the tears. “I realized then that they were like my family.”
CHAPTER TWENTY-TWO
“You can’t own a cat.
The best you can do is be partners.”
SIR HARRY SWANSON
ALL WAS QUIET ON THE THIRD FLOOR. THE RESIDENTS were tucked safely in their rooms and the visitors had gone. The only sound was the gentle hum from the dimmed fluorescent lights. With no one to disturb him, Oscar slept peacefully, sprawled out in full glory on the nursing desk like a big, furry stuffed animal.
From a distance outside came the sound of an ambulance, bringing some untold emergency to the hospital next door. Oscar stirred as the siren grew louder. He lifted his head to investigate. The siren ceased as the ambulance reached its destination and Oscar stretched and yawned. The fluorescent hum returned.
Mary was working the late shift. She was busy doing what she did much of the day, scribbling notes in a chart, content to know that the residents were at rest. Oscar watched her work for a few minutes before announcing with a meow that he was awake and receiving visitors. Mary smiled and reached over to scratch him under his chin. Satisfied that he had been noticed, Oscar dismissed Mary and turned his attention to his hind paws, licking them in slow, deliberate circles.
“Well, are you coming?” Mary asked him, standing up. “It’s ten o’clock, time to pass out our bedtime meds.”
Oscar blinked but did not move. Was he considering her request? He was a cat, after all, and his hard-to-get attitude came naturally to him. After a moment, perhaps after Mary’s request had been recognized and processed, he leaped onto the medicine cart, sat down, and looked back at her as if to say, What’s taking you?
“Okay, Oscar, we’ll start on the west side.”
The squeaky rear wheel cut through the silence, but no one was awake to notice. It was just Mary and Oscar, who peered over the cart, surveying the hallway like the captain of a ship gazing out at a familiar but darkened sea.
The door to room 316 was open and Mary entered, pushing the cart. Louise Chambers was in her bed, snoring peacefully. Oscar was disinterested. Mary paused to look over her medication list and then opened a drawer. She pulled out an anti-seizure medication, popped the pill out of its wrapper, and filled a cup with water. She then leaned over and gently stroked her patient’s hand to wake her. Louise started awake and Mary waited a few moments, allowing her time to get her bearings before helping her to a seated position. Louise swallowed the pill easily and almost immediately fell back to sleep.
Mary stopped for a moment and picked up the silver Tiffany frame on her bedside table. A man in uniform was standing next to a World War II fighter plane. He held his helmet to his thigh with one arm and smiled proudly into the camera. He was tall. Studying his facial features, Mary immediately noticed the familiarity of his tall frame, his wavy brown hair and prominent brown eyes, and his clean-shaven, oval-shaped face.
Mary chuckled and carefully replaced the picture frame.
“At least now I know why you like Dr. D
osa.”
Without a further word to her co-pilot, Mary headed next door, and to the next room, and the next, checking each resident, dispensing medicine where needed. Through each visit Oscar remained on the medicine cart, seemingly uninterested in his surroundings. At last they arrived at the room of Ruth Rubenstein, who appeared to be fast asleep. Here Oscar sat up, tall in the prow of his ship. He looked around and sniffed the air.
Something was not right in room 315.
In one swift motion, Oscar leaped off the cart and onto the bed, carefully avoiding Ruth’s slumbering body. He gazed at his patient and considered the situation. He did not ask for a second opinion but circled—once, twice—carefully preparing a place to curl up next to her. Oscar looked back at Mary, blinking once as if to dismiss her.
“Are you sticking around?”
Oscar put his head on his front paws and pulled his body close to Mrs. Rubenstein. Gently he nuzzled her arm.
Mary stopped what she was doing and approached the bed. She assessed the patient, who was resting comfortably. Medically, there was nothing to do there, so she sat down on the bed next to Oscar and considered the family situation. Ruth had received no visitors since Frank died of a heart attack a few months back. She had outlived her immediate family, she had no children, and her lawyer was the closest thing she had to next of kin. There was no one left to call.
Mary reached over and lovingly stroked Ruth’s hair. She looked over at the empty armchair across the room. A knit blanket was draped over the back; it had sat there unused for months. Mary was sad for a moment as she thought about how often she’d found Frank asleep there, long after every other visitor had left for the evening. Sometimes she would have to send him home. Grudgingly, he would collect his things, kiss his wife good night, and trudge off to his car only to return early the following morning. But Frank had never returned to the floor after the day of their last anniversary. He continued his daily phone calls but no longer visited. One day there was no call. A friend found Frank a few days later, laying peacefully in his bed.
Looking down at her patient, Mary perceived the faintest hint of a smile across Ruth’s face. Maybe she was dreaming about her husband. Maybe she knew they would be together soon. Mary thought of the Rubensteins’ half century–long relationship and Frank’s stubborn dedication to his wife in the face of everything she had lost to dementia.
“God, Oscar,” Mary said, “he really loved her. We should all be so lucky.”
Mary leaned over and kissed Ruth’s cheek while Oscar quietly purred. A few minutes passed as the two sat in quiet vigil. Then came a faint coughing from the room next door. Mary got up and said one last good-bye.
“Good luck, Ruth. I hope he’s waiting for you somewhere.”
She turned to face the black-and white-tabby cat.
“I don’t suppose you’re coming with me?”
His only response was a purr.
“No, I guess not. Well, I need to check up on the rest of our family.”
Mary made a mental note to check back on Ruth when she was finished with her rounds. As she exited the room, she looked over at Oscar. The woman and cat locked eyes momentarily.
“Thank you, Oscar,” she whispered, then dimmed the lights.
CHAPTER TWENTY-THREE
“A cat makes all the difference between coming home to an empty house and coming home.”
UNKNOWN
ONE AFTERNOON A FEW DAYS AFTER RUTH’S DEATH, I was seated at the nurse’s desk on the dementia unit, scribbling a note on one of my new patients, when I was interrupted by a commotion. Looking down the hallway, I noticed Maya chasing Oscar at full speed the way cats do when they are bored. Suddenly intrigued, I stood up and watched as they sped down the hallway past Louise Chambers, asleep in her chair. Then they were gone.
The scene of cat chasing cat in innocent play made me smile. As Mary said, this third floor really was their home. I looked past Louise in the direction of the departed cats. The afternoon sun had just started to make its impression, setting the walls aglow. Soon it would illuminate much of the hallway, then fade. It wasn’t a lasting impression after all. I found myself thinking about Ruth Rubenstein; her death was still fresh in my mind. An hour earlier I had stopped by her room. I lingered there alone. I studied the unoccupied bed, neatly made, and the barren walls. Gone were the pictures of her youth, her husband, her past. The room was no longer hers, save for the faint reminder of her perfume. That too would disappear in time.
The main doors to the unit clicked open, interrupting my thoughts. I turned toward the door and saw Mimi, the admissions coordinator, escorting an elderly gentleman and two younger women onto the unit. They looked like sisters. They were on a tour of the facility and Mimi was in the midst of describing the unit.
“This is our advanced dementia unit. It is forty-one beds and staffed by nurses twenty-four hours a day…”
Suddenly the door closed behind the family with a thud, locking them in with the residents. I could sense their discomfort, even from a distance. They listened politely to Mimi as she carried on with her explanation, but I could well imagine what they were really thinking: How in the hell do we put our mother in this place? The doors lock behind you! What did she do to deserve this? I’ve seen this before: the deer-in-the-headlights look of a new family.
Mimi led the tour down the hall toward Ruth’s room. She pointed out key locations on the unit—the kitchen area, the dining room, and the nurse’s offices. As they passed Louise, asleep in her chair, one of the daughters stopped briefly to consider her.
I could almost hear the questions in her head as she studied Louise: Is she clean? Is she happy? Do they take care of her?
She was looking for reassurances that they were making the right decision, that they were in the right place.
I didn’t envy them.
The lady moved over and studied the pictures on the corkboard next to Louise’s door. For the first time since she arrived on the unit, she smiled. Then she disappeared down the hallway, chasing after the rest of her family.
I returned to the note I was writing. Something brushed against my feet. I looked down.
“Hello, Oscar.”
He had finished his playtime with his sister cat and was looking up at me.
“I heard you were with Ruth when she died.”
Much to my surprise, he sprang up onto the desk and sat down, staring at me as if to say hello.
Our eyes met and he started to purr.
“What’s up, Oscar?” I asked, nervously reaching out my hand. “What’s going on?” What if he was like Lassie, as I joked with Mary all those months ago, trying to say someone had fallen down the well? What if Oscar was trying to tell me something?
He considered my hand and then moved his face in toward it as if to say, Scratch, stupid!
I relaxed and began to scratch under his chin. I pulled him closer and he continued to purr more loudly. We sat together, sharing a moment, before we were interrupted.
“Hello, Dr. Dosa. I want to introduce you to the Carey family.”
I looked up to see Mimi returning with the family. Oscar saw them too and began to take his leave. He leaped out of my grasp onto the floor before sprinting down the hallway.
“Cats,” I said, by way of introduction, and leaned over to offer my hand.
Both daughters smiled.
“Do you have any questions about the unit?” I asked, trying to be helpful.
“Do you always have cats here?” one of the daughters asked incredulously.
“Absolutely. We have two cats on this floor and four more downstairs, along with a rabbit and several birds,” Mimi answered.
“That’s so nice,” her sister responded. She was the one who had been studying Louise earlier. She turned to the father.
“Dad, Mom really loved cats.”
Past tense.
“You mean, your mother loves cats,” I said.
She gave me an odd look, perhaps slightly embarras
sed. I realized how many of the families I worked with spoke of their loved ones with dementia as if they were already gone.
“Actually,” I said, letting the poor woman off the hook, “we’ve found that the presence of animals really helps residents in the latter stages of dementia. Your mother will know that they’re here.”
“Really?” the woman asked.
“Yes, I didn’t really think so myself at first, but I’ve spent enough time up here to realize that the animals really do make a difference for the residents and the families.”
The woman gave me a questioning glance that I immediately recognized. It was probably the same look I had given Mary the first time she had shared her musings about Oscar.
“I suppose there is just something about animals that still gets through.” I paused for a second. “I’d like to think they have something to teach us, too.”
The woman nodded and looked around, “So, what do you think, Dad?”
“I think this is the place.” He attempted a smile—an effort, given the circumstances and turned to Mimi. “If it’s still available and you’re willing to take care of my Lucy, we’ll take the bed.”
Mimi nodded and escorted the family out of the unit, deep in conversation about the various forms and paperwork that would need to be filled out.
As they left, Mary appeared from down the opposite hallway, pushing a resident in a wheelchair. She parked the patient by the desk and then reached over to give the woman a hug.
The woman smiled and returned the embrace.
“What was that all about?” she asked me as she rounded the desk to sit down.
“Mimi was here with a family. It looks like we’ll have a new resident in Ruth’s bed.”
“We always do, David. They never stay empty for long.”
The afternoon sun had faded now, like words written in water. Halfway down the hall I saw Oscar appear out of one of the rooms where he had taken refuge from the visitors. He looked at both of us and paused for a moment. Then he turned and trotted purposefully down the hall in the opposite direction. When he came to the last room on the right he stopped and appeared to sniff the air. Then with a flicker of his tail, he disappeared into the room. I looked at Mary with the hint of a smile. Was Oscar trying to tell us something?