It rained last night, and this morning there’s a heavy mist hanging low over the Blue Ridge Mountains, like a Sunday dress over a grandmother’s sagging breasts. This is the last place I’ll work, the end of the trail, my final stop: Shady Rest Nursing Home. I work full time, day shift, weekdays and every other weekend, supervising the aides, orderlies, and practical nurses. I pass out all the medications on my shift. We have thirty-eight clients — we’re not supposed to call them “patients” anymore; something to do with their rights, and not making them sound more sick than they really are. I’ve been a registered nurse for forty years: hospitals, home health, the county clinic. Shady Rest is a good place for me to finish my stretch.
Sometimes I lie. I’ve lied to families and patients for most of my professional life. Not direct lies, like “You’ll be fine, just fine,” but smiles, pats on the hand. There are a million ways to waltz around the truth. No one suspects a nurse, but most of us lie. It starts when we’re in training. They send you in with a pouch of hot, soapy water to give an old Italian lady an enema. The old woman clutches her rosary and calls you “an angel from God.” Old people can’t hold the fluid. Their muscle tone is gone; their anuses are like satin purses with broken drawstrings. The water comes right back out. She gets wet, gets cold, starts talking in Italian. She begs you to stop. It makes you sorry. You dry her, put her under warm blankets, then chart: “SSE [soapsuds enema] given in left-side lying position; tolerated well. Results: moderate amount of soft brown stool.” You toss the empty enema bag in the trash, and hope that maybe the old lady will have a bowel movement in a few hours, or a few days.
I know my staff here at Shady Rest. I know which ones I can trust. If someone’s out sick, the rest of us carry that person’s load. I work with orderlies who are more caring than most surgeons, and cleaning ladies more sensitive than most nurses. Brier County is a farming community, a river of cornfields over a bed of coal mines. We know everybody. If someone limps or has half an arm, we know how it happened and when and whose fault it was. We all shop at the same grocery store and read the same newspaper. There are five Republicans in our local Masons — we know who they are. Lem Simpson is an agnostic. We pray for him at Easter and Christmas. So far, it’s done no good.
Nursing is serious business. You walk a thin line dispensing pills and shots and advice. My shift starts at 7 A.M., but I’m always early. I’ve missed one day of work in the last ten years: strep throat on a Friday before one of my weekends off. I never get sick — not even the flu. Oh, I’ve got a few aches and pains from arthritis, but I take my pills and keep going. I hate whiners. That’s why I quit Bible study. It was nothing but everybody’s aches and pains over the past week. So life is hard. Look at Dachau. Compared to that, we’ve all had Sunday-school picnics. So just keep going.
Most of our patients are diabetics, amputees, stroke victims, or just plain worn out. We have one woman with multiple sclerosis who’s thirty-eight, Marty. Her husband ditched her the first time she wet the bed. She was an art professor at Pitt. She has silky reddish-brown hair that shines like the mane of a sorrel. We braid it for her. She has a drawer of colored ribbons that we put in it for every holiday, and a hand mirror so she can see herself. Marty can still smile, make some sounds, nod that her hair looks nice. Her mother, who lives in Michigan, makes her floral bed jackets and slippers to match.
Kevin’s our best orderly. He’s premed, the first person in his family to go to college. He’ll make a fine pediatric cardiologist. He’s got the touch of a healer. That’s something they can’t teach you at the university, and it’s what so many of these smartass residents today lack. They’re all books, no heart.
Once you’ve bathed people, brushed their teeth, the way Kevin has, you’re different. You’ve gone farther up the mountain, past the trees. You climb and climb, over rocks, boulders, and cliffs, and discover places tender with moss. You learn to hook your ropes onto whatever’s there. Your palms burn and blister. You learn not to rush. This is not a football game. Not every yard is glorious.
The creases in Kevin’s trousers are sharp. Nobody’s clothes have more starch than his. He irons them himself. He says his mama does enough — he can do his own clothes.
I noticed Kevin the day he came for an interview. He stopped to pick up a tissue box for Alice Long. Alice has Alzheimer’s. He called her “ma’am,” and she smiled. People respond to respect, even if it’s just a word, just a crumb. I knew then that we should hire him and work around his schedule at school. I’ve seen them all: men and women who help with patients. Most can’t get another job — no education, no luck. A few are just plain weird. Once, when I worked the late-night shift at a hospital, I caught an orderly screwing a young girl in a coma. I belted the bastard with my blood-pressure cuff, cut his head open: twenty stitches. The ER doctor sewed him up. The girl got an extra bath. There was paperwork. Her parents were called. I got a P-22 for striking a co-worker. “Sorry, but I have to give you this,” the supervisor said. “There are rules.” The coma girl got a big belly. There was a lawsuit and an abortion. I had to polish my oxfords, go to court, swear on the Bible, all that. Her folks sat there and cried. I quit the hospital after that.
I watch my staff now, how they touch people, the look in their eyes. You can tell a lot by the eyes. I don’t need to take somebody’s blood pressure or pulse to tell if they’re starting to die. I look at their eyes: the pupil gets bigger, like a pool they’re going to drown in. It’s nothing you learn in school, nothing to do with thready pulses or widening pressures. It’s just people who are tired and ready for a long nap. That’s all.
Patients here don’t get too many visitors. Kindergartners tramp in at Thanksgiving to dance and pretend they’re Pilgrims and Indians. At Christmas, the Pythian Sisters sing carols in their long white dresses. A few nieces and nephews drift by on holidays or birthdays. That’s about it.
We celebrate everybody’s birthday in the main dining room with helium balloons, party hats, the works. One of our practical nurses took a cake-decorating class and can make icing roses that look so real you want to smell them. Ruby, the cleaning lady, plays the piano. Kevin hangs banners. We all sing — not just “Happy Birthday,” either, but anything they can remember, anything Ruby can play. The music fills the place like acres of honeysuckle. The urine smell fades. People don’t slobber.
I just read an article in a medical journal about music therapy for geriatric patients, like it was some big new discovery. In Brier County, we’ve always known music was good for old folks. Most people around here play something — fiddle, guitar, or even just jew’s-harp. Music is like the creek, a vein running through this holler. You can drink from that creek and feel better, feel almost well.
The older kids from 4-H come on Wednesdays and write letters for the patients. They straighten greeting cards, read the newspaper aloud, play Monopoly with anyone who can remember how to roll the dice. One girl wrote a paper about Shady Rest, and it helped her get a scholarship to nursing school. I don’t know if that’s good or bad. She wants to be a nurse like me and wear a white dress and help people. Why should I tell her not to? She could do worse than change bloody dressings and report pressure sores to doctors. There are a thousand jobs worse than being a nurse.
Carl’s hair needs to be cut, and his hearing aids are buzzing again. His shoulders are broad and sturdy-looking for a man who’s been sick for four years. Every day, when I give him his pills, I want to ask about his boy, Roy, but usually I just let him talk. I wonder if Roy’s eyes are blue, like Carl’s. I had a boy, too: Dan. He went to Vietnam and never came home. MIA. That’s all. His name is not on the Wall in D.C. They only put your name there if you’re dead.
I went to see the Wall with Lou Ellen Donley. Her nephew Tom’s name is there. We stayed at a Motel 6 in Maryland and got up early the next day to go into the city. It was a sunny day, and the black stone was shining like a mirror. We both touched Tom’s name, and Lou Ellen made a rubbing on a business envelope for Vonda Taylor. Vonda was engaged to Tom when he died. We saw the rows of crosses at Arlington. We saw Kennedy’s grave, and little Patrick’s, and the flame that Jackie lit so many years ago, still burning. We stood there and felt wobble-kneed and woozy. Maybe it was the heat. We decided not to visit the White House.
Sometimes I wish I hadn’t gone. My boy’s name is not there. And I won’t have a ceremony or set granite until they show me some proof: Dan’s dog tag, his dental records matched, the healed spiral fracture in his left femur — there’s no death without a body. I know what I know.
Carl is just certain his Roy will visit soon. That’s why every day he has us push him to the elevators to wait. He insists on sitting by the elevator door so Roy will see him straight away when it opens. Sometimes he takes his lunch there. It’s against the rules, but we bend. There’s a big green plant in the corner there by the window, so it looks like he’s sitting under a palm tree somewhere tropical: Mark Twain waiting for a macaw.
Now, you probably think that’s real sad. But think of all the things other people wish for: a winning lottery ticket, a new car, a trip to Disney World. See, it’s not so sad. Carl has had a stroke. His right side’s gone, but he has speech, and his mind is clear. If he wants to wait by the elevator, it’s fine with me. He’s got rights; he’s a client. And we’re friends. I don’t tell my friends what’s wrong or what’s right.
“Hi, Carl,” I say when I take him his medication. “Wait until you see Mary Lou’s new sweater. It has purple and yellow and lime green stripes. She looks like a circus tent. Her daughter in Florida must have been knitting for two years.” I give Carl his insulin in his belly. His skin’s like beige crepe paper.
“That Mary Lou’s a big woman,” Carl says. “My wife, Merle, was a big woman. I like my women big. Like you, Hattie. I like your hips. A man can hold on to hips like those in bed.” Carl’s eyes twinkle, then he chokes on his water. He’s had trouble swallowing since his stroke. The thinner the liquid, the more he chokes.
I wait for him to settle. “Ready to go to the dining room now? Ralph should almost be there. Kevin started on the west wing a half-hour ago.” Ralph is another patient, Carl’s best friend.
Carl nods, wipes his chin on his sleeve. His lips are dusky, like field violets. He catches his breath, and we head for breakfast.
The dining room is painted ivory, and on the back wall is a mural of a Southern plantation: white columns, fuchsia geraniums, brick walks — like nothing in Brier County. Some interior decorator did it. The VFW donated the flag in the corner and the pole with the gold eagle on top. Everybody here still says the Pledge of Allegiance, gets all the words right — even Alice Long, with her Alzheimer’s. Show her the flag and she starts the pledge. On windy days, she sings “Chicago.” She used to be in vaudeville.
I push Carl to a table. He lifts his dead arm up and lays it beside his tray, stroking it like a kitten. I butter his toast, open his milk carton. He waves me away after that. Ralph’s coming. Kevin pushes Ralph’s wheelchair through the door.
Ralph looks like Lyndon Johnson with curly hair. His stroke was on the left side. He has no speech. Still, he and Carl are best friends. They hunted squirrel in these hills together when they were boys, worked in the coal mines for thirty-some years, and lost their wives two years apart. These men didn’t want to move to Atlanta or Miami or California. They wanted to stay put. One day they will become part of the fog rolling across the mountain’s back. They shake hands every morning, right hand to left, the wrong way, the only way they can. Carl asks for extra sugar for Ralph, every day. We know Ralph likes two sugars in his coffee, but we wait for Carl to ask. Ralph thanks him by nodding and smiling. Every morning they sit in their cardigan sweaters and eat Egg Beaters and gray oats while the sun pours through the windowpane.
Because he’s a diabetic, Carl’s prone to vascular disease. They taught me that in nurse’s training. I also learned that medicine is a cold steel cabinet with drawers and labels. Ralph didn’t know he had blood-pressure trouble; he never got headaches or nosebleeds, and everybody knows those are the symptoms. Doc Mason had them, and he died from blood-pressure trouble. We had to drive much farther for a doctor after that. We had to lose him to learn how spoiled we’d been.
Today is the second Tuesday of the month, the day Summar — with an a — comes to give a poetry workshop for anybody who wants to write. Summar taught at Pitt with Marty before Marty was diagnosed with MS. We cannot pay her. She wouldn’t take it if we could. She starts by reading poetry in the dining room. The words come through her like she’s a harp, something delicate being touched by language. Everyone is quiet when she recites. Nobody moans. Ruby stops the washers and dryers. The women in the kitchen have baked ginger cake and sprinkled it with powdered sugar for Summar’s visit. Poetry’s different than preaching. We have preaching on Sundays. Poetry is the flower you stumble across growing near the barn, a purple bloom that nobody planted.
Summar takes off her pink sweater and gives Marty a hug. Marty’s eyes smile, like she’s saying, “Thanks for coming; thanks for not forgetting me.” Marty’s paintings hang in all the corridors: a lighthouse by the ocean, a cottage at the edge of a forest, a woman holding a baby on her lap. She has one sculpture, of a woman hugging herself. I always have to explain that one to the new staff members — why the woman is holding on to herself.
Summar reads a poem about being afraid. She passes out paper and pencils to her pupils and asks them to write down things that scare them. “Don’t worry about titles or spelling or commas,” she says. “Just write. Just get the things that scare you down on the page. Then we’ll read what you wrote.” Mary Lou and Alice start writing like there will be extra doughnuts for the most words.
I leave to pass out the ten-o’clock meds. When I’m done, I stop by the dining room again to listen. Mary Lou is reading from her paper:
“I am afraid to go to sleep at night. I am afraid I will die and not wake up. I am afraid of fire. I am afraid they will not get me into my chair and get me out if there’s a fire. I am afraid of going blind. I am afraid —”
Alice slaps Mary Lou’s hand. “You looked on my paper!” she snaps.
“I did not!” Mary Lou shouts back, then looks to Summar for help.
“Maybe you’re both afraid of the same things,” Summar says. “I’m afraid of fire and dying, too.”
Alice shrugs and folds her poem into an airplane.
“Does anyone else want to read?” Summar asks.
The room is quiet.
“OK, that’s fine. I’ll read some more. I’ll read you one of Louise McNeil’s poems. She was poet laureate of West Virginia. We should all know her poetry.” Summar lifts a thick green book and starts reading a poem about horsemen and the cutting of virgin timber from our mountains. Most of the patients understand. Alice twists her hair and looks out the windows at the evergreens.
I order red tulips for Carl. I tell the florist to sign the card, “Miss you, Dad. Love, Roy.” I told you I lied. I send Carl flowers about every six months. I’ve never told anybody. It’s not the kind of thing you can bring up at coffee break or Bible study: “I send flowers to a guy named Carl in the nursing home and sign them from his son.”
Other people lie about smaller things. I read an article that said all the clerks in the driver’s-license bureau automatically add ten pounds to every woman’s weight on her driver’s license. And Jack Benny was thirty-nine for a hundred years. At least the flowers do someone some good: they make Carl smile. I don’t know where Roy is, or else I’d make him visit his father. I mean it.
Each day, I sort the mail at Shady Rest: letters, cards, bills. Mail can be dangerous. Consider bills, how many fights they cause married folks. What you pull from the mailbox can explode in your face. It can be as shattering as a captain in his dress blues knocking at your door when you’re bent over the sink washing your hair.
My sister Grace found our Grandma Haney’s letters in a shirt box. They were nearly eighty years old. Grandma Haney wrote of loneliness on the farms, bitter winters, not being able to make it to church in the wagons. Most of the letters were written in pencil, and every inch of paper was filled. She apologized because the paper wasn’t finer, but it was all they had. Every letter was full of talk about spring and gardening and longing to visit each other.
I used to get letters from my Dan. The Vietnamese stamps were red and white with the face of a dragon on them. All his letters are tied together with yellow ribbon and locked in a box with my deed, my will, my insurance papers, and two tickets to Arizona. The box is fireproof. I bought it from the 4-H kids. It has a lifetime guarantee.
I still write to Dan. Every Saturday I sit at my kitchen table, work the crossword puzzle in the Gazette, have a cup of coffee, and start my letter. I tell him everything: who’s living on the Donovan farm, who’s playing the organ at church, how many basketball games we’ve won this season, and that I’ve got airline tickets for Arizona. I have enough money saved for two weeks’ vacation.
The Grand Canyon must surely be something. Dan saw pictures of it in his geography book and never got over it. He cut out every picture in Life magazine, knew the names of the ancient tribes, and pasted everything in a scrapbook. I bought him a book from National Geographic full of color photographs for his fourteenth birthday. But that’s not really standing on the edge, looking down, and feeling the canyon’s hot breath against your face.
I mail every single letter to Vietnam. I have a list of cities, and I correspond with a mothers-of-MIAs group that provides the names of hospitals and clinics — things the government won’t give you. I try them all. I always spell the name right, get the mailing code correct.
In nurse’s training, I did a research paper on people in comas. One woman in Finland woke up after twenty years — just like that. Her eyelids went up like scalloped shades hanging in a parlor, and boom! she stepped out of her coma and back into this world. It was documented by scientists, physicians, scholars. Imagine.