The Genius of Little Things (13 page)

The call buttons lit up constantly. Carmella would be explaining a certain form or procedure to me, then she would break off, mid-sentence, and rush to a resident’s room. By the time I followed her to the destination, she had already solved the problem. Twice I bumped into her as she was coming out of a room. It must have been getting on her nerves, because she sent me to a tiny, windowless room and told me to watch a new trainee DVD. It was nearly three hours long. The content fell into two categories—inspirational, with shots of very old people doing the Hokey Pokey, and informational, including how to fill out the myriad charts, how to feed people, how to roll them over, and how to react to a medical crisis. They were called residents, not patients. The implication was that they were staying at Colonial Gardens until the very end.

Carmella retrieved me for the “dinner rush.” Rush was an inaccurate word because the whole feeding process took up a large part of the second shift. Many of the residents on the D wing needed assistance. Some had forgotten how to use a fork or swallow.

Room D221 housed two women. Milagro Sanchez was emaciated. Edna Brown was enormous, as if she had been stealing Milagro’s flesh. The volume on TV was turned up high. Carmella turned it down.

Edna asked who I was, but not in a curious way. More like a
go away
way.

“Tyler is going to take care of you on the night shift,” Carmella said. “As long as you don’t scare him away.” The corpulent woman grabbed her plate and eyed me suspiciously.

Carmella used baby talk to coax the frail woman, Milagro, to eat. “You don’t want to be stubborn for Tyler. He wants you to eat so you’ll be strong.” Milagro’s gaze was like a searchlight, starting at my knees and ending at my forehead. She opened her mouth. The spoon full of spinach goo went in. Her withered lips surrounded it. All the time she was staring at me.

“There you go,” Carmella cooed. “Let’s see you do that again.” Milagro consumed more than half of her dinner before Carmella had to move on. “She likes you,” Carmella said as we left the room. “Too bad you’re not staying on the second shift. We may have to put her on a feeding tube.”

At 9:30 p.m., Carmella said a resident had made a mess. From watching the DVD, I had a pretty good idea what the mess would be. In room D209, a small, gnome-ish white man was jabbing his finger at his roommate, a large black man who was in bed and staring straight ahead with arms folded. “He does this on purpose,” the gnomish guy said.

The soiled man rolled onto his side, as if he knew the drill well. I lifted the sheet while Carmella cleaned him. I helped Carmella hoist him onto a gurney while we changed his bed. Carmella moved so efficiently that I didn’t have time to think about what we were doing. I just matched her, move for move. She wasn’t grossed out by the stench, so I decided I wouldn’t be, either.

“We’ll see you later,” Carmella told the man after the ordeal was over. “This is Tyler. He’s going to be on the night shift.”

“Pleased to meet you,” I said. Neither man acknowledged me.

On the second evening of shadowing, the button for room D221 lit up as soon as I arrived at my station. Carmella said I should go. It was the room with Milagro Sanchez and her angry, porcine roommate, Edna. I asked both of them how I could help them. Milagro made a
come here
motion with her bony hand. I approached her bedside. “Is the A/C too high?” She said nothing. “
Tu quieres algo
…”

“She don’t talk Spanish,” Edna said. “She don’t talk at all. Works out good for me.”

Milagro gestured to a book on the table next to the bed, the Bible, with a worn leather cover.

“She wants you to pray,” Edna said.

Milagro closed her eyes. This was like nothing I saw in the training DVD. Without knowing what else I could do, I pretend-prayed. I thought of my most immediate concerns, finishing the farking essays on time and being admitted to Caltech.

When I opened my eyes, Milagro Sanchez was smiling. I put the Bible down and told her if she needed anything, she knew where to find me.

Back at the nurses’ station, Carmella offered some advice. “We’re here to make residents happy, but you don’t have to do anything that would violate you.”

Over a week of shadowing, I poured 45 glasses of water, turned down the A/C 63 times, turned up the A/C 32 times, assisted in giving 140 meals, and cleaned up eight accidents. I spent my breaks developing a list of casual conversation topics. Mr. Graciella wanted to talk about sports, which I knew nothing about, so I often just agreed with whatever he said. I informed several residents about the plight of the bees, but I don’t think they appreciated the urgency of the situation.

At the end of the week, Carmella said she would recommend me to begin on the third shift. “The residents really seem to like you,” she said. “Especially Milagro. If you can get her to talk that really would be a miracle.”

There’s something about genuine praise and the promise of steady income that makes a bus ride more pleasant. I had a job. I had money. Money meant freedom and autonomy. I could even list this job in my Caltech application. That should be impressive.

My good mood lasted until three seconds after I entered the front door. Janet stomped in from somewhere and berated me for not cashing the $550 check. She informed me they had opened up a checking account for me and would be depositing the unused cash from the state into it. “It will be your college fund. You won’t be able to touch it.”

I said nothing.

“And I understand you’re leaving us.”

Silence.

“You couldn’t have said something?”

“I thought you knew. My case manager—”

“Of course. The case manager, who can’t even get our names right.” She stood with her arms on her hips in a Superman pose. “So where does this leave us?”

I told her they would need to testify at the emancipation trial. Then I would be on my own, if all went according to plan, by February.

“It’s terrible living here, isn’t it?”

“No, not really.”

“You can’t wait to get away, can you?”

Silence.

She looked like she was about to cry. But I could have been wrong, because the lighting was low.

“All right then,” she said. “Don’t be a stranger.”

I went to my room, closed my door, and settled in for a night of culling and un-culling items from my Box o’ Crap.

**

October 26. Here’s what I wanted to say to Janet, and I would have if I had time to think about it and prepare:  You’ve done much more for me than I ever thought possible. That scares me a little and I don’t know why. Maybe because it seems like a trick. You are the ones with all the power. You can send me away at any time. If you’re serious about keeping me around, then don’t pretend to be a parent. Because it’s too late for a parent. It’s just too farking late.

TWELVE

I started my first night shift on Halloween. Technically, the shift began at 11 p.m. on the 30th. Half of the staff sported costumes like hasty afterthoughts—a hat here, a nose there. One nurses’ aide painted her face like a lion, which could have been frightening to some residents with more advanced dementia.

I shared a station with Courtney, a blonde and very thin woman with a perma-sneer. She was not in costume, unless her fingernails, which were painted purple and covered with tiny metallic beads, were a nod to the holiday. She wore the standard green-gray scrubs and an expression of constant exasperation. In the first hour she said five words to me;
no, there, don’t, touch,
and
that
. Two nurses’ aides sitting across the corridor, Ruth and Darla, wore matching Raggedy Ann makeup and wigs. Darla was also pretending to be pregnant. The next day it would come as a surprise that Darla’s enormous belly was real and that she was actually six months pregnant.

Overhearing their conversations, I learned about several deviations from normal patient care. One resident on the A wing, a guy named Trent, was having sex with several female nurses’ aides. Darla and Ruth agreed they would “do him” if they had the chance. I was appalled until it became clear that Trent was actually 28 years old. He had been partially paralyzed from a motorcycle accident. The A wing, I remembered, had several young residents on Medicaid. Still, it didn’t seem right to be having sex at work. I made a mental note to avoid doing that.

**

To: all staff

Re: new pet policy

Be advised that Colonial Gardens has revised its policy regarding animals. Effective immediately, live animals will no longer be permitted in the facility. This includes dogs, cats, birds, reptiles and rodents. While this will not affect third shift workers, please know that some residents are quite unhappy about the policy. If questions arise, please reiterate that we are looking out for their safety in the wake of the unfortunate clawing incident last week.

Cecelia Platt

**

Just after midnight, the D wing head nurse, Mrs. Platt, stopped at my station. She was a short, plump woman with a red bulbous nose, and a red greasepaint clown smile. She spoke in a high-pitched pseudo-cartoon voice. I thought she was producing the voice intentionally to go along with her costume. It was a good thing I didn’t laugh. Later that night Ruth told me Mrs. Platt always sounded like that.

“I hope you won’t find the hours too difficult,” Mrs. Platt said. “No, erase that thought, erase.” She waved her hand in the air as if she were trying to erase an imaginary chalkboard.

“I know you will
love
the job despite the hours. No, erase. It’s not a job. It’s a calling. You’ve been
called
, Tyler.”

Mrs. Platt was right about the job being a calling. I was literally called by residents twenty-two times in eight hours. Eighty percent of the time, a call light meant a resident wanted the A/C turned up or down. Sometimes a resident would want it turned up
and
down at the same time. In those cases, pretending to adjust the temperature setting satisfied them. Ten percent of the time they wanted water. Mrs. Platt told us we could only give them a half-cup per night to prevent accidents. Accidents happened, regardless. When changing urine-soaked sheets, Courtney huffed and groaned and sometimes called the resident a baby. I wasn’t aware that these tactics worked in stopping incontinence. I suspected they didn’t. It just seemed mean. In the other ten percent of summons, residents either forgot what they wanted, or they called me close and stroked my hair.

Twice a night we rotated residents to prevent bedsores. Regulations required two aides to do the entire procedure. Courtney viewed her role in our “team,” as standing in the doorway and barking orders. Milagro Sanchez was wide awake for rotations, even though the second shift nurse should have given her two milligrams of Estazolam, a powerful sleep inducer and muscle relaxant.

Around three o’clock, Milagro’s room light came on at my station. Courtney didn’t even notice, so I went to the room with a half-full glass of water. Edna appeared to be asleep. When I set the glass on her nightstand, Milagro gestured to a stack of books.

I held up the Bible. Milagro nodded. It was bookmarked at Genesis. I started reading quietly. I was hoping for some kind of sign that she wanted me to stop, because the Bible was pretty long, and Genesis was at the beginning. I had medicine trays to re-stock.

After I read, “I will not let you go until you bless me,” Milagro held her hand up.

“Should I stop?”

She fluttered her hand as if trying to work out a cramp. Then she closed her eyes. I put the Bible back on the stack. I made a note of insomnia on her chart.

There were two unanticipated drawbacks to the third shift. First, we could only sleep on breaks. Second, we couldn’t do homework. We could browse trashy magazines, as Courtney did, but we couldn’t engage in anything requiring real brainpower during downtime, unless it was related to nursing. I supposed the management feared we would become so engrossed in our business that we would miss call lights or cries for help, although Courtney successfully ignored both.

The problem was not boredom. I was able to keep busy. I pulled each resident’s chart make sure no new orders were missed. I checked the crash cart, checked the temperature in the fridge in the med room’s kitchenette, reconciled orders for discharges, printed W-10 forms for Mrs. Platt, and folded and refolded the laundry.

The problem was, my Caltech deadline was less than 24 hours away, and I had planned to polish the essays during free time.

During the first break, several aides were in the employee lounge, watching a television infomercial about exercise equipment. I took my essay draft and a red pen to the men’s rest room. I sat in a stall, but didn’t close the door. I figured, if there were a sudden rush to use the stalls, I would leave.

A guy in dirty aqua scrubs sauntered over to the urinal. He was of ambiguous Latin/Asian/Caucasian ethnicity, with a faux-hawk hairstyle. His arms were so thoroughly covered with tattoos they looked like ink sleeves.