The Real ER

Medical TV dramas were always my favorite. I loved the intense pace, hot doctors and compelling life or death situations—with everything wrapped up (most often happily) in an hour. The reality, in case you haven’t been to an emergency room, is nothing like what you see on TV. 

Friday found me waiting in an ER with my dad for over 5 hours, while his bowel impaction was addressed. Most of that time he spent lying back, occasionally dozing, waiting for the next nurse or doctor to come by, while I sat or stood there reading my Kindle.  A few attempts at conversation went by the wayside. Once, asking Gene how he was doing, he shrugged. “Bored,” he said.

Clearly, his situation wasn't critical so the more serious cases were dealt with first. The elderly woman next to us had fallen down “chasing spiders with her grandson,” breaking her wrist and sustaining a nasty cut to her head. Three people down the hall had cardiac issues; an old Chinese man was obviously sick but unable to communicate with anyone. The pace picked up over the afternoon; the staff were all busy, but efficient and organized—no shouting of orders or other disturbances. Now and then a security guard walked through, as did a sweet though persistent volunteer who kept offering refreshments to family members.

My prevailing thought was that all this could have been avoided if either my dad (or Jeannie) had been on top of the situation, which had been building for several days. But she was caught up in a social whirlwind—family members were in town; she was going out to dinner, shopping for clothes with her daughter, enjoying the county fair—and amid all the excitement, my father’s complaints were ignored or minimized.  When I asked him how he felt about the lack of attention, he said, “I resented it.”

About an hour after we got to the hospital, I called Jeannie to give her an update. She launched into a tirade about how Gene “needs to stick to a regime,” repeating that several times, making it out to be entirely his fault, and complaining about his lack of consistency. She rhapsodized about probiotic yogurt and vegetable laxatives; at no point did she ask how he was doing. I found that a little surprising, given that she’d been out socializing when I came to take him to the hospital, and didn’t know until coming home where we were—but on second thought, I wasn’t surprised at all.

Finally—just like in the TV versions—he was released, shaky but better. After a quick stop at the pharmacy to pick up some heavy-duty laxative, we headed back home where he went straight to bed. Jeannie asked me to help open her new box of white zinfandel. I wouldn’t have had any even if she’d offered…but a real drink that night would have been just what the doctor ordered.

All About Me

“But enough about me and my life—what do you think about me and my life?” So goes a joke I read somewhere, and which brings to mind the Way of Jeannie.  I guess I’m as self-absorbed as the next childless only child, but somehow my stepmother (who grew up with a brother and raised two children of her own) has managed to outdo almost everyone I’ve ever met on the “me-me-me” scale.

If she had a formal diagnosis (narcissistic personality disorder, for example) I might understand despite being irritated.  She may in fact have some type of disorder, but would never consider questioning her own motives or consult a therapist, unless it was to figure out why another person in her life was so troublesome.

She regards a question directed at someone else as an insult, and will find a way to answer it no matter how unrelated. (Asking my dad “So how long were you in the army?” prompts Jeannie to deliver a lengthy monologue about her teen years growing up during the war.)

This tendency is not new. Her attitude has always struck me as appallingly self-centered; even those few occasions when she’s expressed regret about something that she did, it’s been defined by her own sense of discomfort or pain, not the hurt she caused others. And most of the time (at least when dealing with me) she simply didn’t care how most people felt.

Once I noticed she’d gone through my closet while I was at school, intent on throwing out “unnecessary” things. One of those things was the treasured overcoat that I’d inherited from my grandfather, made by the workers of his own union in the 1940s—and which I still have today—only because I found it in the garage, packed in a box and ready to donate to Goodwill. When I protested, she was flippant: “That old thing? It’s just a dog, why would you want it?”

Her exasperation at having to “put up with kids” (including her own) was an attitude I’d never encountered before. She seemed to compare being a parent to an 18 year prison sentence, rather than expressing the sheer gratitude I’d come to expect.

I freely acknowledge that I wasn’t the easiest kid to deal with. My sense of entitlement was nurtured by a doting, overly-indulgent father, who along with my grandfather assured me that I was the best and brightest, the most loved member of the family, destined for success.  After being the only child for 14 years, it was inevitable that having to share my father (not to mention living space) with three new people whom I never would have associated with would result in big problems.

Somehow we all survived. I guess that now would be the time to wrap things up philosophically, to affirm how everyone’s become older and wiser—and maybe there’s some truth there, but in so many ways we’re exactly the same as we always were.

How Much More?

This past week found me checking out actuarial tables with mixed hopefulness and trepidation. How much longer will my parents stick around? The correct answer, of course, is that nobody really knows. But according to the life expectancy chart I looked at, my dad can look forward to another four years, while my stepmother has some nine years ahead of her. (For both their sakes, I truly hope it’s less than that, based on their present condition.)

Four years. It sounds like so little. Even my own number (29.5 years left) seems pitifully small compared to what I’ve enjoyed so far.  Our lives are simultaneously blighted and blessed by the full (if often repressed) awareness that we are here only for a brief moment in time. Not long ago, I asked my father if he ever expected to live as long as he has. “I just never thought about it,” he said. I can’t imagine that’s true; unless I’m the only one obsessed with these things, I’d guess most people wonder from time to time how much time they have—and then hope for more. 

I read somewhere that “old” means anyone who’s 15 years older than we are.  But how does that apply to someone in their late 80s with serious health problems?  My attitude, as anyone reading this may pick up, is that truly old people are sticking around too long, although not always by choice. Thanks mostly to medical advances and healthier lifestyles, 70 really is the new 50; the formula works well as long as people stay healthy and active, though at a certain point the inevitable problems start creeping up.  Medical intervention might prop us up for a while, but….

When humans are warehoused in nursing homes, staring blankly at a TV screen, or at nothing, what have we accomplished? They may be technically alive, though it’s not a life most people would want.  Yet there they are, in ever-increasing numbers, but nobody in the political sphere would dare suggest that we “do something” that would help nature run its course a little faster. 

At least for the moment, the humane option of setting people free from a miserable, pointless existence is not available here—but let’s hope that changes before “we” get there.

Not Over Yet...

“Over 90 and Loving It” sounded like it would be an inspiring program to watch, so I watched it. As expected, this PBS special showcased people in their 90s who remain active and involved—a 94 year old taxi driver, a 98 year old woman who completed her master’s degree, Pete Seeger at 90, chopping wood behind his cabin. Bandleaders leading bands, politicians running for office. You get the drift.

So was I inspired? Ultimately, no. If anything, the program was exhausting and a little pathetic. My parents watched it too, and felt similarly—in fact, Jeannie commented, “They must have really spent a lot of time finding those people—that’s not how it is for most of us.”

And so it isn’t. While it may be helpful to counter the negative stereotypes of old people so prevalent in our culture and media, a program like this does not convey an accurate picture of what most elders should expect. To give seniors (or their families) the impression that aging well is more a matter of attitude than anything else is frankly cruel.

Of course, attitude is important.  It’s important to stay connected with others, with the world. People shouldn’t give up too soon, and are better off if they push themselves a little farther than they want to. Just adopting some kind of regular physical activity makes a positive difference.

But we know the best laid plans sometimes go awry. As my mother used to say, “Life is what happens while you’re busy making plans.” The combination most aging people face is one that simultaneously adds and subtracts—a devilish formula of new illnesses and pains, countered by diminishing strength, senses and (often) mental or creative ability.

The prospect of an intact mind trapped inside a diseased body is no more appealing than that of a fit body housing a debilitated mind.Yet most elders end up taking one of those two routes, however unwillingly. An unlucky percentage suffers through both—while only the very fortunate few manage to escape chronic physical and mental infirmity until the end.

That reality, the hard facts of aging are what make me uncomfortable with programs like “Over 90.” Having good genes is not a choice we get to make, at least not yet. The environment we live in exacts its toll on almost everyone. Avoiding toxins only goes so far: I know one man, a healthy vegan who never smoked in his life, who was diagnosed with lung cancer in his early 70s (fortunately, he survived.)

So for those who truly want to believe that aging is a subject of “mind over matter,” I say good luck and bon voyage. Just don’t be surprised when a hurricane hits.

No Shit

Chronic constipation is one of the few things my parents have in common. They both down a variety of laxatives and stool softeners which sometimes do the job—but a couple of days later they’re heading back to the medicine cabinet. On average, they go through milk of magnesia at a rate of two 12-oz bottles per month, supplemented by “softening” caplets, and when all else fails, they bring in the big guns: magnesium citrate and Fleet enemas.

It’s an unpleasant reality for many elderly folk, and yet once again I find myself sighing in exasperation when, at the store, they head down the digestive aid aisle to replenish their supply. There are so many things they should be doing (or not) that could wean them from their laxative dependency, or at least reduce it.

Start with an attitude adjustment: a BM every day is not strictly necessary. For an older person, 2-3 times a week may be sufficient, but many seniors are fixated on the idea of daily evacuation. Other than that, simply increasing fiber and water intake along with more physical activity would help everything along.

Ah, but that’s where things get sticky. My dad, anyway, drinks nowhere near enough fluid, and shies away from fiber.  (He’s the only person I’ve ever met who, before eating raisins, carefully inspects them one at a time, removing any vestige of stem.) As for staying active, he goes from the bed to the sofa to the bathroom and back again…only rarely venturing outside for a walk. Jeannie ranks slightly higher on the activity scale and drinks more liquid—even if that means white zinfandel and Diet 7-UP—but she’s been chugging laxatives since she was in her late 30s so is pretty much addicted. 

I don’t pretend to understand their diet, but know it only makes the situation worse. Focusing heavily on dairy products (ice cream and nonfat cottage cheese by the quart each week along with a daily “light” yogurt), they eat about half the recommended daily amount of vegetables and virtually no legumes or whole grains other than occasional whole wheat bread. Usually, they opt for English muffins or sourdough. Meat every day is a given, followed by sugar free jello, or a bowl of ice cream for my dad; then Jeannie devotes her evenings to sugarless gum. How she goes through 4 packs of gum per week—each pack containing 15 sticks—is a mystery for someone to solve, if anyone actually cares to figure it out.

But it is what it is. No amount of gentle persuasion will change their habits at this point, and like most problems my parents have brought on themselves, this one is not worth arguing about.  You could say I really don’t give a shit…

Kiss & Make Up

The most tedious argument has a longer shelf life than the ideal reconciliation. We forgive, but we don’t forget; raw feelings can easily be reignited, while the memory of sheepish—even sincere—words of apology stokes anew the fire of resentment.

But being good citizens and realizing that we need to get along, Jeannie and I followed up our recent outburst with a rational discussion, each acknowledging the other’s feelings and apologizing (more or less) for the harsh words. We even agreed on the point that my father and I deserve some “father/son” time together, doing whatever we choose. 

Happy times

To top it off, she even said she’d like to treat us to lunch one of these days, an idea I gratefully acknowledged while trying not to think that my accusation of her selfishness is likely what prompted the offer.

Again, as we negotiated the usual, tedious shopping trip I noticed Jeannie’s increasing frailty, her failing body and mind. Simultaneously sympathetic and annoyed, I realized it will only be another year or so before even these basic errands will be past her ability.

I also question my own abilities: will I be able to stand this until my care-giving services are no longer required? How much more patience and understanding will I have to cultivate?

Happy 4^th to everyone—and may we all appreciate our independence as long as we have it.

Fight! Fight!

Nothing clears the air like a good argument.  A sudden, therapeutic release of negative energy and everyone feels better.  That’s how it’s supposed to work, right?

Jeannie and I finally had it out; months of resentment and occasional snide remarks gave way to a full-on brawl, minus the physical contact. Unfortunately for all of us, it started on Father’s Day and culminated on my dad’s birthday, shedding new light on the concept of "special occasion.”

I’d mentioned beforehand that I planned to pick up my dad on the morning of his birthday for an appointment at the DMV (to replace his expired license with an ID card), followed by brunch. She heard me, but automatically assumed that she would be going as well. When I informed her on Father’s Day that I was planning to take him alone, things got ugly. “Don’t exclude me, don’t EXCLUDE me!” she cried. Besides, she added, there were a couple of errands she needed me to do, like going to the bank and the post office.

Nothing doing, I said. She hadn’t mentioned those errands earlier, so I told her she’d have to make other arrangements. And I wanted to spend some quality time alone with dad on his birthday. I imagined that would be the end of it (I have a lively imagination).

When I arrived to pick him up, they were both waiting at the door; I could see the anxiety on his face, while she was darting back and forth like a boxer preparing to lunge. Before I was halfway up the stairs, and faster than someone can say, “Happy Birthday,” the yelling started.

“I want you to know how UPSET I am at what you’re doing!” she shouted.  “This is so inconsiderate and thoughtless, and I want you to know how I feel!” I waved away an imaginary cloud of mosquitoes and said, “Let’s not discuss it now, this can wait.”

“NO IT CAN’T! I want you to know how I feel, and Gene has some things to say to you too. He’s going to talk to you about how upset you’ve made me. You’re being very selfish.” 

At this point, I decided to hit back. “Selfish? Look who’s talking! We’re at your beck and call, doing your errands every week and you don’t even think about our time and energy. And I hope you enjoyed the Father’s Day lunch we treated you too—you never even said thank you.”

More shouting ensued. I accused her of ruining my dad’s birthday; at one point I bowed deeply, saying, “Of course, your majesty, your needs are the only ones that matter,” and finally my dad and I left. My mouth was parched and I was shaking.

At that moment, my concern was for him. He slumped in the front seat of the car, and when I asked him how he was, he shrugged. “Oh, we’ve been yelling at each other for the last couple of days.” I apologized for causing the upset; I didn’t want him to be the recipient of her rage and assured him it was between her and me. But of course, it wasn’t.

Our visit turned out well. We finished early at the DMV, and I took him to the office to meet my co-workers. He perked up at the friendly attention. At brunch, I asked him if he had anything he wanted to say (or had been directed to say); but he said no, nothing. I also mentioned that he might get her to shut up by threatening to leave her, and that he could stay with us for a while. “That occurred to me,” he said. “But I wouldn’t want to do that to you.” Still, I could see how easy it would be to persuade him to leave, once and for all, at the tender age of 87.

Truce

But no. It would not be easy and we all know it. In the end, I took him back home to find that tempers had cooled considerably. We were all cordial—and the next time I called to discuss the weekend grocery list with Jeannie, the conversation was friendly, as if nothing had happened.  But it did happen, and will probably happen again unless we manage to decide calmly on an unsupervised visitation plan.