Category: Anecdotes
Posted by Dr. El - January 22, 2009 - Anecdotes
“I need you to see Eddie,” the social worker told me, “He keeps throwing himself out of bed, and you know how the administration is about falls.” Falls were bad. They get reported to the State. “You hear that moaning down the hall?” she asked. “That’s him. He’s driving all the other residents crazy.” She escorted me to his room, introduced us, and then left me alone with 50-year old Eddie, who could barely move or speak, but had stopped moaning long enough for me try to talk with him. He was lying in his bed, which had been lowered almost to the floor, and blue foam mats were on either side of the bed, presumably to buffer his “falls.”
“It’s going to take me some time to figure out what you’re saying,” I told him, “but I’m going to try really hard, so I hope you’ll give me a chance.”
He stared at me, then muttered something unintelligible.
“I’m sorry. Can you say that again?”
He muttered louder. There was a knock at the door and Dr. Waldren walked in. Eddie’s eyes opened wide and a smile slowly spread across his face. An excellent sign, I thought to myself. He can connect.
Several weeks later, Eddie and I could hold a conversation, though it usually took several repeats for me to understand him. He was remarkably patient. We talked about music, and sometimes sang Smokey Robinson tunes together.
“There was something I’ve been meaning to talk to you about,” I said to him one day. Our eyes met. “What’s with all the moaning you’ve been doing? I could hear you from the third floor as I was coming up the stairwell. Do the nurses come when you moan like that?”
He fixed his eyes on me, and I repeated the question, “Do they?”
“No,” he said sullenly.
“So why do you do it? It seems to me like you’re only teaching them not to pay attention to you. You’d be better off just calling them when you need them.”
Our eyes met again. “Well, think about it,” I suggested.
The elevator doors opened and Eddie’s mother emerged slowly, breathing heavily and leaning on her cane. She was accompanied by Eddie’s teenage nephew, Leon, who wore an oversize army jacket and a forbidding expression. Puffing, she eased her bulk into a chair across from the elevator and gathered her strength for the next leg of the journey. She stopped to rest again at the nursing station, halfway to Eddie’s room. The nurse examined the bags she brought for her son.
“He can’t have this, Mrs. Jones, I told you,” the nurse was saying, holding up a ham and cheese sandwich. “He could choke.”
“I know, but he asked me.” She held her hand to her chest, and sighed. “It’s hard for me to say no.”
“And this soda! He’s diabetic! Can’t you bring diet?”
“He doesn’t like diet soda.” Mrs. Jones stared down at the desk, and Leon glowered and shoved his hands deeper into his pockets.
“Well, I suppose he can have these cheese puffs. As long as he moistens them in his mouth before he swallows them.”
Groaning from the exertion, Mrs. Jones pulled herself up from her seat and made her way toward her son’s room.
“I tell her this every time she comes, which isn’t often,” the nurse said to me, “but she never listens.”
I opened the blinds in Eddie’s room, letting the light flood in and revealing a view of the Manhattan skyline and a bruise on his forehead from his latest fall. “You know, the nurses tell me you throw yourself out of bed. Is that true?”
“No.”
“Really? Because I don’t see how you could actually fall with the side rails up. I’ve been thinking about it, and it seems to me that in order for you to wind up on the floor, you’d have to hurl your leg over the side and let your body follow. That’s quite an accomplishment.”
He laughed.
“So I’m thinking, if you want to get out of bed that much, maybe you can let them get you into the wheelchair you’re keeping in the bathroom, and then I can take you downstairs to the computer room. We can look up Smokey Robinson.”
“Nah.”
“Please? It would be fun.”
“Maybe.”
I spoke to the nurse about twelve weeks after I launched the Get Eddie Out of Bed campaign.
“He finally agreed to get in the wheelchair,” I told her, “so do you think the aide could do it on Thursday? That way I can take him downstairs.”
“He’s not going to get out out of that bed, Dr. Barbera. He’s been in there for over a year.”
“Yeah, I know. But he was moaning for over a year, too, and he hardly does that anymore.”
“Well…”
“Please?”
Months later, Eddie and I sat outside on the patio, drinking Diet Cokes. I held the can up to his mouth, holding the straw steady with my fingers while he took long pulls of the beverage. “Hey, look at this one, Eddie.” I nodded in the direction of a young woman in a red dress, heading our way.
It took him a minute for his gaze to focus, and a grin spread across his bruise-free face.
“I guess she’s your type.” I watched as he visually followed her down the block. “Are you ready to call your mother?”
“Yeah.”
I flipped open my cell phone, scrolled down my contact list to Eddie’s Mother, and held the phone up to his ear.
“Hi, Ma,” he said. “Bring me some shrimp fried rice.”
Posted by Dr. El - January 19, 2009 - Anecdotes, Business Strategies, Communication, Customer service
I once dated a man who didn’t speak nicely to me. I don’t know when his endearments changed into negative comments, because, frankly, I didn’t notice them until I returned from a solo weekend vacation. “Hmmn,” I thought to myself after he threw a verbal barb at me upon my return, “they didn’t talk that way to me at the spa!” I recalled the pleasant demeanor of the staff and their courteous anticipation of my needs. We ended our relationship shortly after that.
I thought about this as I watched the scene unfold in front of the Nursing Station the other day.
“Did you hear what Carlos just said to me?!” his aide asked the staff members standing near the desk. The residents sitting in a row nearby looked up with curiosity. “He said he wanted to marry me and move to my house!”
The staff members laughed. “Carlos,” the nurse behind the desk called out, “I thought you were going to marry me?!”
Carlos glanced up at her, knowing he was being discussed, but not quite comprehending the subject. Smiling, the workers went back to their tasks.
I studied the faces of the residents across from the nursing station. None of them were smiling. What could be seen as good-natured teasing by the staff might easily be perceived as disrespect and mockery by the residents. No one would talk to them like that at a spa!
If we could marry the skills and expertise of the hospital model with the respect and philosophy of the hospitality industry, then maybe a nursing home might be a place I’d want to live.
Posted by Dr. El - January 10, 2009 - Anecdotes, Role of psychologists
Louise was a petite 79-year old woman who spent her days watching TV and working her needlepoint, anchoring the tapestry frame against her chest with one arm while she slowly pushed the needle through with her good hand. I first met her casually because she was the roommate of another resident I was seeing. I’d say hello and excuse myself as I pulled the curtain for “privacy” while I spoke to her roommate, Cynthia, who was dying of cancer. I wasn’t too sure how much Louise could understand, since her speech was garbled and unintelligible, but we always acknowledged each other when I arrived for my weekly sessions with her roommate. When Cynthia died, I made a point of stopping by to offer my condolences. To my surprise, Louise burst into tears and held up her good hand for me to wait, while she labored over a note she wrote on the back of the recreation calendar. She pushed the paper toward me. I read it out loud. I was in the room when she died. I was in the room when my father died. She began to wail, and I murmured reassurances and stayed with her until she became calm.
Louise wasn’t referred to me for treatment, however, until she threw a cup of water at her aide several weeks later. (I’m not allowed to refer patients to myself.)
Louise told me about her life via handwritten notes and the occasional using of the talking computer that verbalized what she painstakingly typed out.
I’ve been a cripple ever since I got polio as a girl. I never had a job.
“Yet you write so well,” I commented, “and your spelling is perfect.”
My mother home-schooled me. My parents insisted on an education.
She told me about her twin sisters, Lina and Lana, now 81 years old.
They doted on me, just like my parents did. She laughed, and took back the scrap of paper to add, They still do.
Once Lana came to the nursing home for rehab and I pushed Louise in her wheelchair to visit with her. The kissing and hugging that ensued caused me to turn away with embarrassment. I felt like I was interrupting a pair of lovers. When I said this to Louise, she giggled.
I took Louise out to sit on the patio, and I introduced her to some of the other residents, but still she sat in her room day after day.
I can’t talk to them. No one understands what I’m saying.
“Why don’t you try using your computer?” I suggested. I set her up in the hallway and explained to some of her neighbors how the computer worked. She tried this a couple of times, but soon retreated to her television and needlepoint.
“You know, Louise,” I finally said, “you might have been disabled and different from others all your life, but now you’re just like everyone else here. Almost everyone is in a wheelchair. When I first met you, I didn’t know you’d had polio. You looked like you could have had a stroke like Ms. Lopez or Mr. Wilson down the hall. It’s hard to understand them too, and they’re still out there, attending activities.”
She didn’t say much about this, but the next week I found her at a concert in the dining room with the other residents. Soon after, she became a regular at all the recreational activities and her childish rages with staff diminished. She stopped me in the hall one December day after we’d concluded treatment to ask me if I could come by to see her perform as Mary in the 3rd floor’s Nativity play. I managed to stop in the doorway for a while to watch the performance. She caught my eye and beamed a smile.
Posted by Dr. El - January 1, 2009 - Anecdotes
I’ve been treating two women who have suffered and survived with Bipolar Disorder all their lives. Sara, in her mid-seventies, has been struggling with deep depression, trying to find her way out of a depressive swing. She sits very still these days, watching the people in the hallway. From a closet full of colorful matched sets of tops and bottoms, she has chosen a wrinkled beige blouse and maroon sweatpants. Her knee-high hosiery is bunched at her ankles. I miss seeing her with her purse tucked under her arm, reading her latest book by the building entrance downstairs, where she kept an eye on the comings and goings of residents, visitors, and staff. She used to smoke voraciously, the smell of cigarettes emanating from her like Pig Pen’s perpetual cloud of dirt, but she no longer has the energy to make it downstairs to the smoke room. Now she is sitting in the dining room on her floor, half-watching the TV in the far corner of the room, with one eye toward the doorway, where she has a glimpse of the nurses’ station.
I am looking for Sara’s roommate, Kathleen, who is a tiny, but vigorous, 97-year old. When she was 86, she got a poodle to keep her company at home. She keeps a picture of Goldie on the wall in her room, and speaks fondly of the nine years they were able to spend together before she had to go to the nursing home. I hope I have that much faith and enthusiasm for the future when I’m 86.
Kathleen recently lost her 70ish son, her only child, to cancer. She is in mourning, but her natural tendency toward mania keeps her going. On this day I had already spent time with Sara, and when I came over to see Kathleen, the two of them were sitting together in the dining room.
“Hello, Dear,” Kathleen said, grabbing my hand in her iron grip and not letting go for the length of the conversation, “That’s right, it’s Thursday, I’m so glad to see you, Darling.” Kathleen speaks in a singsong voice, calling everyone by endearments. It’s possible it’s a cover-up for not remembering anyone’s name, but it is a charming cover-up. She refers to family members as “my darling cousin Louise” or “my dear Uncle John, I’ll never forget him, what a wonderful man he was.”
Normally I would take Kathleen into her room for a private conversation, but I didn’t do that today. Instead, I began to chat with the two of them, as if we were just regular people, moving the conversation toward their shared fight with depression.
“The trouble with depression,” I said, “is that when you’re in it, it makes you think you’ll never get out of it.”
They nodded with recognition.
Kathleen began talking about the loss of her son James. “I was hoping I’d be the one to go first,” she lamented, “then I wouldn’t have had to deal with the pain of his death.” She sighed, and Sara, who has only one son herself, sighed with her. “But,” Kathleen brightened, the mania allowing for just a moment of sadness, “you have to go on and appreciate the things you do have. It could be worse,” she added, “I could be like one of them.” She nodded in the direction of the row of white-haired women in wheelchairs who had been set up in the dining room and who were clearly oblivious to the world around them. Sara agreed. As depressed as she was feeling, it was better to know what was going on.
I pointed out to Sara that though she was in her mid-seventies, she was like a kid to Kathleen, who was twenty years her senior.
“That’s right, Dear,” said Kathleen, giggling, “you’re like my kid roommate.”
Sara laughed, a rarity these days, and I could sense the good feeling flowing between them.
Sara started commenting on my youth and good looks.
“That’s what I like about working in a nursing home,” I joked, “no matter how old I get, I’m always so young.”
“But,” Sara insisted, “you really do look good.”
“Well,” I said, “I do the best I can with what I’ve got. That’s all we can do.”
“But what if you don’t have anything to work with?,” Sara countered, her depression speaking clearly.
“You just do the best you can with what you’ve got,” I replied steadfastly.
Kathleen said to me, “You know, Dear, that’s very good advice.” She turned to Sara. “She’s very wise. That really is all you can do, Darling.”
The three of us sat and pondered that for a while.
“Kathleen,” I announced, “when I get to be your age, I’ve decided that I’m going to call everyone Darling and Dear just like you. It’s such a friendly way to relate to people.”
Kathleen flushed with pleasure.
I went on, “It’s true. Everyone warms right up to you when you do that.”
Sara concurred.
“But I can’t start doing that now,” I continued, “I’m too young. I have to wait a while.”
Thinking a moment, Sara agreed, “No, you have to be an older person.”
“People would take it the wrong way if I started to do it now,” I added.
“Yes, that’s true,” Kathleen said, “You have to be an old lady in order to do it.”
We sat in silence for a while, contemplating this unique benefit of age.
Posted by Dr. El - December 4, 2008 - Anecdotes, Communication, Tips for gifts, visits
Over the years I’ve worked in nursing homes, my sister has come into the building exactly once. That experienced so disturbed her that she subsequently waited outside in her car, phoning on her cell when she’d arrived to meet me.
My sister isn’t unique in her reaction. Nursing homes are places we like to avoid, unless we are called to work in one. Which is one of the reasons why visitors are sometimes sporadic, with some family members afraid to come at all.
When it’s my turn to be in a nursing home, throw me a big room-warming party. Make it an open house all day long. Hang up balloons, serve coffee, seltzer, and finger foods, and put on a little Barry White. Invite my relatives, neighbors, and friends, and show them how to visit me in my new digs.
