Making Rounds and Oscar (2010) (7 page)

CHAPTER NINE

"A cat is a puzzle for which there is no solution."

HAZEL NICHOLSON

IT WAS AS IF I HAD STUMBLED ON A SCENE FROM THE
Summer of Love. A small group of interested onlookers, residents, and staff had surrounded the front desk of the unit, blocking my view of the spectacle. Like a small child trying to get a better look at a passing parade, I picked my way through the morass of walkers and residents. All eyes were on Oscar and Maya, who appeared to be in the throes of ecstasy. Both cats were charging around the desk at breakneck speed, stopping occasionally to roll around, flailing their limbs in the air. It was like watching a drug-fueled pas de deux, with cats instead of dancers.

I pushed my way to the front, where I found Mary.

"Who put the Benzedrine in Mrs. Murphy's Ovaltine?" I said.

"Catnip," she said.

Watching their whirling-dervish routine, my inner veterinarian took over. "Are they sick?" I asked.

Mary laughed, and then launched into an explanation, almost shouting to be heard over the yowling of the cats and the laughter of the staff and patients.

"Cats love it--it makes them crazy. There's some kind of chemical in the herb that gives them an almost sexual high."

I looked at Oscar, whom I had been thinking of as this wise, Sphinx-like creature with all the answers. He was chasing his tail. "What, do they smoke it?"

"Don't you know anything about cats?" asked an aide who overheard me. I was joking but honestly, I had little idea what catnip was.

"I've never owned a cat," I said to the aide.

She laughed. "Nobody owns a cat, Dr. Dosa. They own you!"

Mary came to my rescue.

"The cats don't smoke it, David," she said. "They just roll in it. You can see the results."

"But they do act like little drug fiends!" said the aide.

As the hilarity died down, the novelty of seeing our two resident cats acting like clowns wore off even before the catnip did. People began to drift off and I stole into Mary's office to check my messages. She followed me in.

"How was your meeting with Donna?" she asked.

"Interesting," I said. "She told me that her mother really hated cats, all animals really, until she met Oscar."

"Isn't that something?" said Mary. "That you could even forget what you once hated."

"An old Irish patient of mine asked me if I knew the definition of Irish Alzheimer's," I said.

Mary cocked an eyebrow, waiting for the joke. "And?"

"He said, 'You forget everything but the grudges.'"

Mary laughed. "Well, I don't think the Irish have a lock on resentment." She looked out the window at the thinning crowd. Oscar and Maya were lolling about on the floor now, a couple of old hopheads coming down off their high.

"But Donna also told me how glad
she
was that Oscar was there at the end," I continued. "It was as if he gave her permission to leave. She said later she figured her mother wasn't going to die with her daughter there, so Oscar did a service for both of them, in a sense."

"Like a bridge between the mother and daughter," Mary said.

"Yeah, like a bridge." I looked through the glass with her at this ordinary house cat, passed out on the carpet. Maybe I was the one who'd been smoking the catnip.

"So, are you going to talk to some more family members?" Mary asked. "Remember those two sisters who lost both their parents here? Oscar was with their mom when she died."

"Rita and Annette," I said. "I thought about them. Though I'm not really sure what I'm trying to discover." I looked at her again.

"You could always go see Jack McCullough...or what about Mrs. Ferretti? Didn't you have a good relationship with her?"

I could sense Mary prodding me on with my journey of discovery. "Did you ever see
Citizen Kane
?" I asked.

"Oh, God, ages ago."

"Maybe I'm like that reporter, you know, the one who goes out to discover the meaning of 'Rosebud.'"

"That's right!" said Mary. "And in the end it turns out to be the name of his sled."

"Yeah, that's what the audience finds out when they show them burning it at the end," I said. "But the reporter never learns anything."

"You never know, though, until you try."

I smiled and changed the subject, "So, who do I need to see today?"

YOU KNOW WHAT THEY SAY
about the weather in New England? "If you don't like it now just wait a few minutes." My day at Steere House turned out to be just as fickle as our climate. Less than an hour after the hilarity of the crazy-cat carousel, no one was laughing. In fact, the atmosphere had become toxic.

Just an hour or so before everyone had been laughing as if they were at the circus. Now it seemed I had stepped right into the midst of a heated battle between Mary and a well-dressed, middle-aged woman I recognized to be Saul Strahan's daughter, Barbara. Two nursing aides were standing silently beside the desk, watching the two of them go at it, apparently over a pair of slippers.

Mary was trying to placate Barbara Strahan. "I appreciate this may be upsetting, but if we can keep this in perspective..."

"Don't you tell me about perspective! I don't need--" and before I could slip past she recognized me as her father's doctor.

"Can't you do anything about your staff up here?" she said to me. "This is the third pair of slippers that they've lost in the last two years."

Finding myself in the middle of a conflict I knew nothing about, I said nothing. Barbara threw up her hands, then turned her fury back to Mary and the aides.

"Is it too much to ask that you keep track of my father's stuff?"

Mary offered a cautious explanation.

"I'm sure that your father's slippers will show up soon. One of the other residents probably just took them from his closet. We'll find them eventually. We almost always do."

"Why can't you keep the other patients out of my father's room?"

"We try, Barbara, it's just that it's very hard to control what they get into when we're not watching."

"Well, try harder!"

As if to emphasize her point, Barbara made eye contact with each of us one by one, and then stormed off. But before she did, she took one last look at Lydia, a Spanish-speaking aide.

"You guys need to get better help around here," she said. "Or at least someone who speaks better English!"

With that parting shot, she stormed off down the hallway toward her father's room.

I looked over at Lydia. A tear had come to her eye, one that she quickly wiped off with the back of her hand.

Mary put her hand on Lydia's shoulder.

"She doesn't mean it," she said. "She's just upset."

Lydia nodded and attempted a smile, but the insult had stung deep and I could tell that it would take some time for her to recover. She turned and walked away. The rest of us remained in awkward silence. Mary shook her head and then turned to an aide.

"See if you can find those slippers," she said quietly.

"Well, as always, I timed my arrival perfectly," I said as the young woman left. "What was that all about?"

"
That
was Saul Strahan's daughter. I thought you two had met."

"Only once, when her father was admitted. Mostly we just talk on the phone. We've been talking a lot lately."

I sat down at the desk and looked directly at Mary. A perfectionist in her work, she was probably seething inside. Aside from her own pride, injured by the accusation that she didn't run a tight ship, I knew that she felt even worse for the aides.

"I need to go outside for a cigarette," Mary said. She walked back into the nurse's office and spent several minutes searching for her pack. When she emerged without her coat, I could tell that she had already calmed down.

"Seriously, Mary, doesn't that get on your nerves?"

She sighed. "It's hard to believe sometimes, but I've worked here for almost ten years, and at a lot of other nursing homes before that. At this point in my career, I can pretty much put every family member I meet into one of four categories: those who are angry, those who feel guilty, those who are afraid, and those who are all three. We try to work with everyone to eventually accept
this
," she said, holding up her hands to encompass the ward, the residents, and the finality of it all. "In time, most of them do. Sometimes we just can't get them to accept this reality quickly enough."

"So, what is Barbara Strahan?" I asked. "Which category does she fall into?"

"She probably just feels guilty."

Mary paused to consider what to say.

"You know, David, Saul probably hasn't worn those slippers in the last half year anyway. But if I don't find them immediately, she'll be speaking with my boss."

"Have you tried talking with her?"

"In one ear, out the other."

"Sometimes, I don't know how you do it," I said. "At least, as physicians, we get to come and go."

"Actually, the ones who feel guilty, like Barbara, are easier to deal with than some of the others. You just have to develop a thick skin. They usually just yell at us about silly things and most of them calm down eventually. Barbara will probably even come down here and apologize for her behavior before she leaves. Some of the other family members can be worse."

"Worse?"

"Well, as I said, there are families who are afraid of the disease and what it does. I get it. But they're usually the ones who are the most in denial. They'll come in here and question everything. If we change a resident's diet, they'll ask a million questions about why. Those cases end up being harder because you feel so sorry for the family. When they finally get it, what's actually happening to their mother or father, they look like they've been beaten with a two-by-four."

Mary sighed again.

"I'm sorry that you can't smoke in here," I said.

"No, you're not," she said, and smiled. "Finally, there are the angry ones who blame us for everything. Just last week, I had a daughter ask me why her mother was in one of those walkers. When I told her it was because she had fallen down a couple of times, she said that I didn't want her mother to get better! 'You probably want her out of here so you can have her bed,' she said."

"You're kidding!"

"I wish."

I understand how hard it is to see a loved one fail the way so many of these patients do. Quite frankly, I have no idea how I'd handle taking care of a parent or spouse with dementia. Maybe I'd be the same, casting about and blaming everyone, but from the outside looking in, I'm always perplexed at how some people accuse those who are merely trying to help. Our conversation was interrupted as Louise came wandering toward the front desk pushing her own walker. Mary noticed her first. "Your fan club has arrived," she said.

I got up from the desk and walked around to greet Louise. A hearty smile came to her face before she spoke.

"She says, 'You're so tall,'" Mary translated behind me.

I gave Louise a quick hug and she giggled. Then she wandered back down the hallway.

"She gets around pretty well," I said as she left.

"Mobility is not
her
problem," Mary replied. "She's always visiting the other patients, whether they know it or not."

Suddenly, Mary jumped up and raced down the hallway. She caught Louise a few doors down and rifled through the basket on the front of her walker. A few moments later, Mary returned to the desk carrying an assortment of articles.

She presented me with a beige sweater, a doctor's stethoscope--and a pair of men's slippers.

"Mrs. Chambers," she said, "our resident kleptomaniac."

She placed the stethoscope and sweater on the desk.

"This stethoscope belongs to a medical student who was up here working last week. I bet he's been looking everywhere for it."

She put it in her office for safekeeping and was about to take the slippers to Saul's room.

"Hold on," I said, before she could get past me. "Do you mind if I do the honors? I want to find out where her head is at."

Mary shrugged and handed me the pair of slippers. "Be my guest."

What I really wanted to do was give Saul's daughter a piece of my mind. It's not that I don't understand how hard it is to watch all of this happen to a loved one, but there are boundaries and Barbara had crossed several.

I found her lying on the bed, her head resting in her father's lap as my son's does sometimes when he's watching television. "I have the slippers," I said. Barbara lifted her head up and turned to face me. Her eyes were red, her mascara smeared. As she sat up, she wiped her eyes with the sleeve of her blouse.

I walked over and put the slippers on the bedside table. "You know," I said, "you were pretty hard on the staff out there."

She started to cry. Not a slow trickle of tears, but a soul-cleansing deluge.

Now I felt terrible for setting her off. As her tears slowed I grabbed a box of tissues off the table next to me and offered her one.

"Doctor, I'm so sorry for my behavior," she said as she dabbed at her eyes. "Can you tell Lydia that I'm sorry? I don't know what got into me. I feel like such a fool."

"You should probably tell her yourself. By the way, Lydia's one of our best aides. She goes to night school five times a week so she can improve her English."

She nodded. "It's just that I come in here and I don't know what to do," she said, pointing toward her father. "I can't even tell if he knows I'm here."

"You're doing everything you can for your father right now by just being here with him."

She nodded.

"My mind gets that," she said. "My heart doesn't."

It's a phrase I've heard a hundred times.

Intellectually, Barbara understood what had happened to her father, but when she looked at him, she could still only see the man who raised her.

"I mean, look at him. He just sits there with this stupid, vacant expression on his face."

I know she didn't mean it but her despair was driving the bus now.

"My father doesn't know who I am anymore," she continues. "This handsome man, who was everything to me growing up. He would walk me to school every day when I was little, and when I was older I could call him and talk about my problems at work, even boy trouble. Who am I to him now?"