Monday, October 26, 2009

Observations from a Different Field

I should not have sat down. The lack of motion is causing the adrenaline to leave my body, and I can feel it leaking out through my toes. And I still have things to do. I hadn't planned on spending the last two days in a flurry of activity trying to juggle my life and work with Mother's care while she spent a miserable 36 hours in the hospital due to an elevated heart rate. She is back "home" now in her other hospital bed at her nursing home, which she could sporadically remember the name of throughout the day. But, she had to make sure she meted out her dose of grief and aggravation before she got back there, that's for sure. She is a notoriously awful patient in the best of times, and her mind has left those times long behind. The natural combativeness of her senility combines with her long held Bad Patient status to become almost a lethal dose of nastiness. At least it's lethal to me. I don't know how, but the nursing staff that was the victim of her constant haranguing ire, seemed to be able to slough it off like the proverbial water of the back of the proverbial duck. I know they receive training in this sort of thing, but when she actually means it to hurt personally, you wonder how it doesn't sting just a little. Maybe it does, but they never let it show.

I have learned some tips for successfully handling someone like my mother in the hospital. Allow me to share. The first thing she will always, always tell you if you're assigned to her is that she is a nurse, so she understands what is going on. Of course, with one look at her you understand that she has not practiced for a number of years, like maybe since the last Ice Age. The next thing you have to understand is that she wants you to address her, not anyone else in the room. Even if that other person is easier to speak to, both because they can hear you and then understand what they are hearing. That other person in the room is not in control of the decisions. She will make that very clear. If you ignore it, you will do so at your peril, and then later at the peril of the other poor schmuck who is stuck in the room. If you are good, you will look directly at her and address her, but then glance occasionally at the other person to verify what she is saying. Hopefully the person who is accompanying her has not tried to crawl under a chair in humiliation at what she is saying and can gesture, nod, shake the head, hold up fingers or whatever they need to do to paint the true picture. It would be better if you are white and from somewhere other than the south and speak with anything other than a midwestern accent. If you are not white, which, in all likelihood you are not, I pray your skin is very thick. Forget what you are taught about speaking softly so as not to alarm your patient. She can't hear a brass band playing right next to her, so shouting is the order of the day, and you will do better if you are leaning in to her while you do it. Be prepared, despite all that, to repeat yourself often. But, you'll be in good company, she will be repeating herself like a broken record. Or, as she says it, an "unbroken" record. She will tell you with conviction that she hates being in the hospital. You will believe that without any effort because she will make your shift completely miserable just to prove the point. And, finally, if you want her to do anything that resembles cooperation, make sure the companion in the room is not her daughter.

Because I learned something this particular trip, in part thanks to the Steelers. When I was not around, she was pliable. She might fuss and complain, but she would eventually do as she was told. With me present, she dug not only a line in the sand, but the line was a total ravine that absolutely no one could cross. I found that interesting. But, first, since I am sure you are curious, let me explain how the Steelers factor into all of this. Now, if I do that, do not tell Mother. She does not know I skipped out on her for this particular reason. My skipping out on her would not bother her really, but the fact that I got to do something she really wanted to do would.

So, trusting you to keep my secret, here it is. There is a cadence to fall Sunday mornings for Greg and me. Maybe made more important by our loss, maybe it was always inviolate and we just never noticed because it was never tested before this past year, even during Kelsey and Marissa's worst days. Whatever the case, there is a routine to our mornings during the season that is comfortable, expected and not easily trifled with, and the day was just getting under way when I got a call from the nursing home. Mother was having chest pains and her heart rate was elevated. God help me, but the first thing I did was look at the clock. I know a thing or two about surviving an emergency room visit and Rule No. 1 is: don't be in a hurry to do anything else. At about 9:30 AM, I shuddered at what that did to my being set to watch a noontime start. But, no real worries. I had already checked and knew the local Fox station had us on the schedule. I'd just set the game to record. Now I knew the choice to show my game in a central Texas market had raised some eyebrows. The Texans, also playing an NFC team at home, were the default to be shown on Fox and there had been some talk radio chatter about the station planning on airing my game instead during the week. Well, I went to set the DVR, and what do I see? You guessed it. They had capitulated at Fox and were showing the Texans. We have Direct Ticket on satellite for this very crisis, but there is no recording of the games with that option. I stood there dumbfounded for a minute, my ten year plus record of never missing a game was in serious jeopardy. I was busy trying to find out a way to stream the game on my laptop when Greg offered to spell me so I could watch the game. This is not his fight, so I couldn't quite figure out why he would do something so unselfish, but he was seriously sincere in his offer. He would trade out for me at 11:30 so I could make the noon kickoff. I had a little debate with myself, the Good Daughter popped up on my right shoulder and told me that I needed to stay by her side, it was only a game. The Bad Daughter popped up, dressed in Black and Gold and her Terrible Towel, and reminded me that I hadn't missed a game this century, and with the unbeaten Vikings coming to town, this was not the one to start. Besides, Greg should know what he was getting into if he really wanted the responsibility of caring for her if something happens to me. The Good Daughter never stood a chance. With that settled, off I went to meet her in the emergency room. I actually beat her there. She had taken her time and eaten breakfast and been dressed (in Viking purple from head to toe, I might add) and then was brought over across the parking lot by ambulance, complaining the whole way that she had to be back before the game started. She continued that rant over and over, along with two or three other points until I thought I would go mad, but she consistently made it clear she had no intention of staying at the hospital. The ER doctor was still running tests when Greg showed up to take his shift, and the Good Daughter popped back up to try and get me to do the right thing again, but the Bad Daughter waved her Towel and off I went, leaving Greg to call me occasionally to ask me questions about her medical history. We told her I was going back to get her mail (which she had pointedly asked for earlier), and it just happened to take three and a half hours to fetch. In the interim, she allowed herself to be admitted to the hospital. I cannot even count on one hand the number of times I have spent excruciating hours in the emergency room with her over the last year since she was brought to Hearthstone, and every time they had wanted to admit her and every time she had refused. I definitely made note of it, but put it down to how much she adores my husband.

My husband, for his part, was more than glad to switch back and go home to watch his game, and then the fun really began. They wheeled her down for an MRI and something happened down there, because she was riled up but good when she came back. They had not been able to do the test because she had insisted they stop, but she had laid flat long enough that her back was hurting her severely. She refused the pain pill I asked for her, and she refused to eat. She began the litany of racist invectives and insisted that she be allowed to check herself out. In case you are wondering, I do not have Medical Power of Attorney, but even if I had, the patient, no matter how senile they may be, has the final say in their care as long as they are able to communicate, no matter how scrambled that may be. I was, in short, relatively powerless to stop her if she was indeed set to leave. On the other hand, if you check out of a hospital against medical advice, you get to find your own way home. In this case, that means me. Finally, at about 9:00 that night, I had taken just about enough of it and reminded her I had buried a daughter earlier this year, and I had all I could take of her games. Then I walked out. That broke her. She agreed to stay. I walked back in, and the nurses got her settled for the night. I was rattled by having to dredge up the memory of my poor lost daughter to shame her into doing what was in her own best interest and determined right then and there that I would not do it again.

Sleep was elusive that night, so I was ragged and tired the next morning as I arrived to a new day of her insisting she would participate in no further tests and insisted that she be taken home. She again refused a meal, meaning that she had not eaten in over 24 hours. The charge nurse worked on breaking her down for a while, using the same therapy inspired speech I'd paid thousands to learn. Nope. Then a female doctor came in, and I thought we were lost for certain. Not only was she Indian, but she was a she. Not a good thing for a doctor to be in Mother's eyes. She said the same things the nurse had said, and in the same good manner, knowing when to let something Mother said that was clearly untrue drop and repeating herself endlessly, while not becoming irritated that she was having the same cyclic conversation over and over and over again. Finally, she got Mother to agree to a stress test, but that was all. The test was scheduled for 1:00, so I gladly went to work for a few hours, admittedly staying there longer than I had originally intended. By the time I got back I found Mother not only happily eating more than I've seen her devour in a single sitting for more than a year, but also having allowed herself to endure not just the stress test, but three others with one more to go! She was flattering her nurse and just pleased as punch with all the attention. Now I knew it wasn't just Greg's charms that had worked on her. It was my absence!

Why, oh why, I asked myself, did she feel the need to be so abusive and stubborn when I was around, only to become pliant when I wasn't? The only answer that sprang to mind is that she feels compelled to show me how independent she still is, and make sure I know she's in charge of her own body. Maybe it's that simple, maybe it's something completely different, but one thing is for certain; we are still, at the end of the day, stuck with one another. There is no one else I can call in to reason with her. Greg went above and beyond, but he has less decision making authority than even I do, and it's not his task. This is a conundrum I have yet to ponder fully, I am way too tired still, but for now, she's back in her own room, safe enough, with three new medications added to the long roster. I have a bye week just in case something else comes up soon, but I'll need all my patience if it does, so I will ponder later and sleep now.


  1. OMG! I loved the "Tips" for dealing with mother, it hits SOOOO close to home. Glad to hear she is
    out of the hospital (I think)

  2. Maybe you could go down to the cafeteria when you take her in. Tell her you are leaving and pass a note to the doctor with your cell phone number! She'll think you are not there, the doctor can ask you whatever she/he needs to. Heck, you wouldn't even have to go to the cafeteria, just go outside the room, where she can't see you - you and the doc could text. Ah, the wonders of technology.