Thursday, December 18, 2008

Nursing home

Much of this blog is a reflection on many events I wish I had written down as they were happening. Those days in medical school, residency and private practice that are so clear in my memory that I can picture them as if they were yesterday.

In my second post on this blog, Choosing medicine, I mentioned the summer job that I had working as a nurse's aide in a retirement center. In 1976 these facilities were called nursing homes and the one I worked in cared for clients that spanned the economic spectrum. I have many fond memories of the people there and it was also a taste of just how cruel life can be.

Roberto H was a man that I still think about. The youngest resident of the facility, Roberto was in his mid fifties. He was not an American citizen. Twenty seven years before he was legally in the United States working when a terrible car wreck left him paralysed from the neck down. He had limited use of his left hand. To this day I cannot help but think about the barriers that prevented his rehabilitation. I am sure they were economic and cultural and his plight was not helped by the fact that he had no family in the United States. He was one of the people that I wrote to for several years after I left that summer job and returned to school. Though Roberto I learned how patentedly unfair life can be and how gracefully some deal with this fact.

Two other residents that I think about these many years later are Tammy and Opal. They were roomates on the women's hall for patients who could no longer walk. Both woman were over one hundred years old. Neither could see and while they could carry on a conversation with you or with each other, neither would remember what she had said thirty seconds later.

I met these two ladies on my second day at work. The other aides, most of whom were middle aged, had not yet decided what to make of me. I was twenty years old, fairly naive, and eager to please. The women's hall A hall was the most difficult. Some of the aides would skip several of the reguired duties since the work of bathing these women and changing their bed linens was so physically taxing.

Jo, who in the end would be my favorite coworker, had decided to play a little trick on me. She ask me to go "feed the two women in room A-3. I went to the kitchen and got the two trays, noticing the card on both trays said "mechanical soft." This meant that all the food was like mush. Everything both these women would eat had to be such since neither had any teeth.

When I knocked on the door and wheeled the cart with the trays in the room I was greeted by two thin, old women with opaque eyes who both turned their heads in my direction following the sound of my voice. Opal was Caucasion. Tammy was Africian American. They both had thick, white hair cut short for easy care.

"Come in Honey!" Opal called.

"Yes, yes, yyyyesss!" Tammy chimbed. "It is lunch time and I smell that food." Both seemed enthusiastic and ready to eat. How difficult could it be to feed two ancient women.

I kept them talking, set up the trays and gave first one and then the other a bite of food alternating spoons and entering into the conversation that they carried on with each other. They seemed to enjoy each others company and as with most people who are blind, their hearing was remarkable.

Suddenly Tammy stopped eating. "I'm hurting, Honey! Hurting, hurting, hurting!" she repeated with her voice reaching a cresendo.

"I'm sorry, Tammy" I exclaimed moving closer to her, looking to she what could possibly be causing this her pain.

"Oh hurting, hurting, hurting!" Tammy kept repeating shaking her head.

"Tammy, I am sorry! What is huring? How can I help?"

"Hurting, hurting, hurting!" Tammy kept repeating.

"I am sorry, Tammy," I stated again becoming a little frustrated that she would not tell me why she was hurting.

Then it came, in a clear, serious voice, "You're not kidding your are sorry! Your are as sorry as the devil!"

With that Opal, Tammy and to my crigrin, Jo and two other nurses aides standing just outside the door burst into laughter.

"You're not kidding. Your are as sorry as the devil." And then that 'I got you' laughter. I think about it every time I say I am sorry but am afraid I am not serious enough for the situation. I think about it every time I know I am about to learn a lesson that is bigger than the one I bargined for in a particular situation.

I learned a great deal in that nursing home about myself, about life, about living and about dying. I am not sorry that I spent a summer working there. It was a turning point in my life.
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