Histories

The corner of Gail’s eye was swollen and a shadow had formed along her cheekbone.  It was a bruise.  She had a narrow face, distinctive almond eyes, and smooth dark skin with an underglow of orange.  The bruise was a deep brownish-plum.  It looked very subtle to me—my taupey white skin flashed its damage in swirls of bright purple and red.  But I didn’t notice Gail’s bruise until we were sitting at the nurse’s station, doing our charts.  The unfiltered, unrelenting fluorescents over the desk exposed everything.  I snuck a few peeks at the bruise, but it didn’t give any specific indication of what had happened.

When I’d arrived at Liberty Home that afternoon, Gail and Roberta were talking in the front seat of Roberta’s car.  Their windows were open to let the heavy July air pass through, but I couldn’t hear what they were saying.  Although Gail usually sat with the rest of us smoking our final cigarettes before 3 o’clock, that day she stayed outside with Roberta until we all punched in.  I didn’t think it was strange, because even though Roberta was a lot older, they lived in the same African-American neighborhood in Springfield and had known each other for years.

Pat and I were at the nurse’s station reading the card from a small bouquet of flowers when Gail and Roberta finally walked onto Lincoln, the wing of the nursing home where the four of us worked.  The day nurse and evening nurse were in the med closet counting pills for the shift change.

“Hey you guys,” Pat called, waving a plump pale hand.  “Check out the flowers.  Bea’s son sent em to thank us for takin care of his mom.  Nice huh?”  The bouquet was mostly carnations with a couple ferns and some baby’s breath.  “I like when the families do this kinda thing, but you’d think with all his podiatrist money he woulda taken Bea out once in a while.  At least to Denny’s or something.  It was a real shame.”

Gail walked past us to the kitchenette.  “They look nice,” she said.

Roberta stopped and peered into the flowers.  “It is a pretty bouquet.  The shop people picked some nice colors, especially the lavender and yellow.  I like the way those look.”

“Yeah, it’s cool that he thought to do it.”  I jimmied the card back into its plastic fork.  “I was wondering.  Does anybody from Liberty Home ever go to the patients’ funerals?  Because I’d go to Bea’s if anyone . . . if people were going.”

Even though I was only a nurse’s aide for the summer, I’d grown close to Bea.  On quiet nights, I’d made sure to spend some time with her or help her take a short walk around her room.  She’d barely spoken gibberish with a few words of Italian, but she liked to go to her dresser and take out the clothes to refold them.

Stepping behind the desk, Roberta scanned the notes taped to the inside of the countertop.  “I’ve gone to a couple wakes.”

“I only went to one,” Pat said.

“So people don’t really go.”  I was disappointed, but also relieved.  Wakes were full of expectation and sadness and long silences.

“Nah, I don’t think so,” Pat shook her head.  “We know the patients as parta this place.  The funeral is from a whole different life.  I feel bad for the families and everything, but when I’m not here, I got shit to do.  Three kids to take care of.”  Pat stared toward the kitchenette.  Gail still hadn’t come out or said anything.  “I guess we should get started or we won’t finish first rounds on time.  Me and Beth’ll do the south hall,” she said, indicating I should follow her to the linen cart.

“Okay, ladies,” Roberta said.  “We’ll see you back here in a little while.”

“I don’t know what the hell’s goin on with Gail,” Pat mumbled to herself as much as to me.  “But if it’s what I think it is, I’d gut the bastard.  I been through that, it doesn’t get better.”

After first rounds, Gail and Roberta weren’t at the nurse’s station.  “I’m taking Allen for a walk,” Pat said.  She untied his vest restraint from the vinyl chair where he always sat, and I went to read with Milo.  Milo didn’t speak at all, but I wheeled him to his bookcase and read to him from whatever book he picked.  His daughters had moved the walnut bookcase and armoire from Milo’s house, and they also made sure his clothes didn’t get ruined by doing his laundry themselves.

Returning to the station, I found Allen back in his chair and Pat at the desk studying the pictures in a woman’s magazine.

“I took two patients for walks,” Pat announced.

“Yes, bub dee bub.  Oh bub dee bub bub,” Allen added.  “Yes bub dee.”

“I was just with Milo,” I said.  “Maybe I’ll go get another patient and take ‘em outside.”

“Hmm,” Pat nodded without looking at me.

I was about to disappear when the call light beeped.  Pat snagged my arm.  “Wait, come’ere,” she said.  “I gotta show this to someone.”  She glanced around.  “You’ll think this is funny, but you gotta swear not to tell anyone.  You won’t tell, right?”

“No, I won’t tell.”  I couldn’t imagine any reason to be concerned.

I walked with her to Edna’s room, where the white light blinked over the door.  Although Edna couldn’t speak because of a massive stroke, she was able to use her left hand for the call button.

“Hello Edna,” Pat said and stopped by the wheelchair.

Edna jabbed a lumpy finger toward her two slippers on the floor.  They’d fallen between the footrests, exposing her normal left foot and the bent, contorted right one.

“You get the call bell,” Pat said.

As soon as I turned it off, Pat checked the door.  She returned to Edna’s wheelchair, and I stood by the bed and watched as she pushed it back a couple feet, stepped in front of it with her butt toward Edna, bent to pick up the slippers—and farted.

Despite my physical effort and a voice telling me the joke was cruel and childish, I giggled.  To counteract the laughter, I spoke seriously.  “Now, here.  Let me get the other slipper.”

“No, I got it,” Pat said with a mischievous smirk.  She reached down and farted again.

I had to get away so I wouldn’t laugh in front of Edna, but I didn’t want to attract any attention or betray Pat.  The hollow unused bathroom in Edna’s room pounded with the echoes of my laughter.  I couldn’t stop.  The laughing felt almost feverish, rough and sweet, as it took over my body.

By the time I came out, Edna had her slippers on and Pat was returning the wheelchair to its position in front of Edna’s tv.  As we left, Pat had confetti in her eyes.  But from the corner of mine, I saw Edna’s slumped body, her withered leg that crooked underneath her chair, and the slack droopy face.  I felt giddy yet sick to my stomach.

“That snotty old bat deserves it,” Pat whispered in the hall.  “You didn’t know her before the stroke, but she used to pick on the other patients, and she liked to order us around like we were her servants.  She’s probably half out-of-it now anyway.”

“That’s really bad though,” I answered.  “I mean, if she has any idea what’s goin’ on.”  I felt the scratch in the back of my mind, the awareness that I should say more.  Even though I had laughed, I wanted Pat to stop.  But she was a regular aide, and I needed to get through four more weeks before returning to college.  “Ya never know, any one of us could end up like that.”  I half-smiled and shrugged to remove the heaviest accusation from my words.

“Hey, listen.  No one should get stuck-up like she was,” Pat said as she got her pocketbook from the kitchenette and zipped it open.  “We’re human beings and paid professionals, not dog shit.”  She pulled out a stack of photographs bound by a yellow rubber band.  “Liberty Home makes us do their stupid in-service trainings, and we all have to get certified from now on.  Take that state test.  Edna isn’t better than anybody else.  Like here, look at this.  Who’s that?”  She held out a photograph that she’d pulled from the stack.

A short woman holding a can of Miller Light looked directly at the camera.  Her well-placed voluptuous rounds of flesh pressed against a black Indian-Motorcycle tank top and frayed jean cut-offs.  I didn’t recognize the oval face with the full lips and high cheekbones until I caught the eyes.  They were wide and circled with eyeshadow, black eyeliner, and thick mascara—just like Pat’s.  Her hair hung longer without a tight perm, but she still had the crisp feathered bangs.

“That’s you!  Oh my god, I didn’t recognize you.  No offense, I mean . . .”  My face flushed.  I reasoned that she had to see the difference.  She was at least 250 pounds now.  I dragged my jaw back into place, closed my mouth.

“Don’t worry, I’m not pissed.  That was me nine years ago and a hundred pounds lighter.  When my last kid, my son Steven, went into kindagarden, I went on a huge diet.  Man, I lost so much weight.”  Pat rested her arms on the counter and stared at the med closet door.  “But I’d been heavy all my life, so as I got skinny, I got all this attention like I’d never had before.  From other men besides Bud especially.  They’d whistle and buy me drinks and smile.  The women changed too.  They looked me up’n down but tried to hide it.  Like I didn’t notice!

“But then my friends started telling me that I was actin snotty and I wasn’t any fun.  I wouldn’t go out to eat, or else I’d order a salad and measure the oil’n vinegar right at the table.”  Gordon, a patient who wandered safely around Lincoln, came and stood next to Pat.  He smiled and nodded with her voice.  “They got sicka hearin me talk about my new clothes and how I was wearin a size eight and how I wanted to go to the bars where I’d get hit on.  Then Bud got nervous too.  He’d ask where I was goin, call my friends to check up on me.  We didn’t have sex as much either, he was always complaining that there was nothin for him to hold onto.”

“You gained back the weight because Bud was insecure and your friends said you were fulla yourself?”  I couldn’t take my eyes off the photo.

Gordon reached a shaky hand toward it, but I moved away.  “What’s for supper?” he asked.  I was too intent on the picture to deal with his question—he was standing with us, but he wasn’t really part of what was going on.

“We don’t know, Gordon,” Pat answered and pointed toward the dining-room door.  “Go look at the calendar.  You ask the same question every day.”

“Couldn’t you’ve waited to see if, like, once the excitement wore off, you mellowed out?” I asked her.  “I mean, didn’t you feel better?”

“I didn’t just feel better though, Beth.  I began to feel like I was better than everybody else.”  Pat shook her head.  “My sister hated hearin my lectures about her weight, so we stopped hangin out.  I never had any fun—I only thought about food servings, exercise, and people lookin at me.  You don’t really know yourself til you’re put in a spot like that.”  Pat raised and lowered her shoulders as she pointed at me.  “I stopped the diet after me and Bud got in this huge fight cuz I came home late one night.  I had to keep my family together, ya know?  So I went back to eating what I wanted, what I cooked for dinner, not a separate salad or nothin.  And if I didn’t get to take my walk round the block cuz there was somethin I had to do, that was okay.  My body went back to normal and I felt like me again.”  She looked at the photo and twisted an earring.  “Course, I wish I hadn’t gained so mucha the weight back.  I wanted to stop around 180.  But this picture reminds me what I was like then.  Stuck-up.”

My eyes locked onto the picture, onto every physical detail.  The fingers around the beer can projected knuckle bone from flesh.  Her boobs were like cantaloupes not watermelons, and her chin jutted out, casting a shadow along her neck.

Why did she turn around and put all that weight back on, I wondered.  Part of me understood what she’d said about feeling different with the attention.  During high school, nobody had shown any interest in me as a girlfriend.  I was too hard, too intense, too skinny.  But freshman year at Brown University had changed that.  The setting had changed it.  Some guys flirted with me, even wanted to hook up.  The new reactions had weirded me out at first.  I could tell that I’d acquired some power, and that it came at the price of my easy independence.

But for Pat to gain all the weight again, I thought, that was crazy.  I would not have gone back to the way it was.

“Pretty strange, huh?” she took the photo and slid it under the rubber band.  “Anyway, something to think about.  Right.” 

Pat’s final words cut short my curiosity about her weight.  They were a message to me.  A warning about me being conceited or in college or not interested in nursing or all of it.  I wasn’t sure.  I’d tried so hard at Liberty Home to be normal that Pat surprised me.  I was sick of trying and still being seen as the stuck-up college girl—especially since I was the only one in my family who’d ever gone to college.

The photograph and Pat’s warning made me forget all about Edna until I had to get her ready for bedtime.  She was still curled in her wheelchair in front of the television, but one of her slippers was on the floor again.  It seemed like a wretched surrender.  “Hello,” I called into the room.  “Wanna get ready for bed?”

Edna slanted her face in my direction and slowly blinked her eyes.  She raised her gnarled right arm, but I didn’t know what she meant.

“Let’s get this sweater off and get you into a johnny for the night.”

I wanted to make up for what Pat had done, so I took my time, pulling the back of the sweater to Edna’s shoulders and slipping the knobby white sleeve from her good arm first.  When I slid the other sleeve over her crimped hand, Edna flung her head to the side and winced.  “Sorry, I was trying to be careful.  It’s hard for me to tell sometimes.  Sorry.”

The white tank top underneath her sweater came off easily, but I realized too late that she was stuck there topless.  Edna moaned.  Her skin hung tight against her collarbone, pulled by the weight of her breasts which lay flat on her belly.

I glanced up from shaking open the johnny.  “I’m sorry, I know.  Just one second here and we’ll have ya covered up.”  I got the johnny unfolded as fast as I could.

Edna shook her head and moaned louder, pointing toward the dresser with her good hand.

“Do you want a different johnny?”

She jerked her head back and forth.

“I don’t know what you want.  I’m sorry.  Here, just let me get this on and then I can figure it out.”

Edna dropped her head to her chest and her shoulder went limp.  I had to lift her good arm to put the johnny on, and then tie the strings loose because she refused to raise her chin.

“What didja want?  Something in here?”  The top two dresser drawers were full of socks, tank tops, and sweat pants.  The bottom two were empty.  “I don’t know, I guess I can’t help you with that.  But I’ll get you into bed now.  That’ll feel nice, right?  Get outta that chair, get the weight off your butt.”  There was a dried orange spill on Edna’s skirt.  “We’ll have to put this in the laundry, huh?  Got some juice or somethin’ on there.”  I felt badly that I wasn’t able to get her what she wanted, but I couldn’t stop every time I didn’t understand a patient or felt inadequate about something in Liberty Home.

I reached around her waist and unsnapped the top of her skirt, which was made with a slit in the back for incontinence.  When patients like Edna wore specialty clothes, I assumed their family was involved somehow, even if I never saw them.  Most families who visited came during the day shift, so we didn’t meet them on 3-to-11.  The patients with new clothes at least seemed better off, especially compared to the patients who only got hand-me-downs from the ones who’d died.

I set Edna’s wheelchair next to the bed.  “Okay, let me see if I can get some help.”

Pat was leaning over the counter at the nurse’s station when I stepped into the hall.  She was writing something, but I couldn’t see the paper.  I stopped because I didn’t want to ask her for a lift with Edna, I wanted to save Edna from that.  But I didn’t want Pat to know I was avoiding her either.

“Well, looks like it’s just you’n me,” I said to Edna.  “We can do this, right?”

I slid my arms into Edna’s armpits, locked my elbows, and lifted.  Her pinched leg swung against my inner thigh as I pulled her toward my chest, and her wet diaper fell from the seat of the wheelchair.  With a quick suck of breath, I jammed my shoulders high, thrust my pelvis forward against Edna, and lowered her as far onto the mattress as I could.  It wasn’t the best lift, but it was sufficient.  And I’d grown used to that at Liberty Home.

I’d even grown to like working there, despite such limitations.  There weren’t many people who could do what we did.  We faced the reality of those old people—they were dying in miserable ways.  The work was often mundane, not benevolent or heroic like I thought it might be when I’d signed up for CNA training in May.  Yet it still felt crucial and meaningful.  Definitely more than a summer job at the mall.  I was part of something bigger than my own simple life.  It would’ve been better if there weren’t people going through those things.  But they were, and I could touch them and clean them and feel their worn delicate skin and chat about the day, and I didn’t cringe or pretend.  I had come to know Liberty Home, to succeed in it.

 “Alright, Edna,” I said.  “We’re all set except for washing you up.”

When I was filling in the tiny columns of Edna’s chart after bedtime—intakes, outputs, skin changes, exercise—Gail sat next to me doing a chart from her list.  The bruise looked painful, but I decided not to say anything.  She and Roberta were clearly trying to keep quiet about it.

The hum of the fluorescent lights suddenly overwhelmed the space around us.  Gail continued to write little checkmarks and numbers in her chart.

“Ya know,” I said.  “I sometimes try to imagine what the patients’ lives were like before they got here.  What they did and stuff.  It’s kinda weird to not know anything.”

Gail pointed toward the rack of charts with her pen.  “They all got histories in there.  You gotta look in one-a the back sections, after the incident reports.”

I’d never taken the time to page through the patients’ charts, which were kept in three-ring binders on a librarian rack next to the desk.  Patients who’d been at Liberty Home for years had thick collections of physician reports, nurse’s notes, equipment orders, insurance changes, Medicare memos, and hospital forms.  Nurse’s aides only dealt with the daily log, the two pages at the front of the binder.  I flipped to the end of Edna’s chart, through the copied and carbon pages, until I found what I wanted.

Her story was written on a single sheet of paper titled Patient History and stamped with Page ___ of ___.  It was barely official, a series of black lines inside a border.  Someone had written 1 and 1, which made me curious if the person had decided Edna’s story was only one page before or after writing it.

The handwriting was cursive and elongated.  A woman had written it, but there was no mention of whether she was a daughter or a sister or a niece.  Edna was born in New Britain, Conn., and had three brothers and two sisters.  Her husband Ned worked as a cleaning and janitor supply salesman, and they had three children.  But their only son died while serving his country in Vietnam.  She liked to knit and crochet.  After moving to Springfield, Mass. when Ned’s sales district changed in the 1960s, they got involved with the local Democratic Party.  He passed away in 1979 from liver disease but Edna stayed in their house until she fell and broke both her hip and wrist in 1988.

That was it.  One page.

I returned to the front of the chart and continued to document Edna’s evening in the thin beige and white columns.  Before I finished the sheet, I flipped to her admission form.  She was born November 4, 1909.  Eighty years.  Eight decades reduced to one page and a daily record of how often she took a bm.  It made Pat’s behavior much more brutal, another insult to the end of Edna’s life.

I didn’t understand what made a good aide do something like that.  Pat took patients on walks, chatted with them, straightened out their clothes when they looked rumpled, changed a sheet if even the smallest drop of urine touched it.  But I didn’t know if it was the nursing home either.  It was a terrible place.  There were shocking moments of isolation with the patients when I realized the only person who cared about the next thing I did was me.  I knew most of the families didn’t really care, not the way people liked to pretend they did.

Despite the seclusion and sterility and workload and routine, I couldn’t believe every aide eventually gave in to her worst impulses.  It didn’t seem possible.

Gail walked around my chair to return the chart she’d finished and grab another.  The brown plastic binders were identical except for the patients’ names written in different styles or colors on removable manila cards.  But the charts were organized by room number rather than by name.  Those numbers were computer-printed on permanent white labels, with the letter A or B to indicate the bed.  I returned Edna’s binder and looked for Bea’s.  She’d only been dead for a day, but someone had already removed her manila name card from the plastic sheath.  The binder had been emptied of her chart and papers too.  I didn’t know where they were taken.

I stuck my index finger into the top of Milo’s binder.  His patient history was much more detailed.  Someone had written three full pages in carefully printed letters that reminded me of my grandfather’s measured penmanship.  Milo was born and raised on a sheep farm in Cummington, Mass., with two older brothers.  The middle brother George had polio and walked with braces.  When Milo was growing up, he learned everything about taking care of sheep, but he was the youngest.  The eldest brother Lukas wanted the farm, so Milo decided to be a pharmacist.  He won a chemistry prize his senior year and received a scholarship from a pharmacy school in Boston.  In 1929 Milo met Ada, a young woman from Plainfield, when he returned to Cummington for the summer fair.  He courted her for less than a year before asking her to marry him.  Her father didn’t accept Milo at first because he had not yet—

The console beeped and I jumped, slamming Milo’s binder shut like I’d been caught snooping.  The beep sounded at a furious rate, meaning a patient had either pulled the cord out of the wall or yanked the chain in the bathroom, both of which sent an emergency signal.

Gail stood and the chart she was doing clattered to the desk.  “I’ll get it.”

“Oh, okay,” I said.  “Thanks.”

While Gail was taking care of the call light, I returned Milo’s chart to the rack and grabbed one that I needed to complete.  Roberta emerged from the rinse room and sank into a vinyl chair along the wall.  “I am having one of those nights,” she sighed.

The phone rang with a quick double ring, which meant a call from inside Liberty Home.  I reached to answer it, but Roberta leapt from her seat.  “Hang on a second.  I’ll get that, Beth.  You keep doing your charts.  Hello, this is Lincoln.”  She paused.  “Okay, that’s good.  That’s good.  Do you have your mother’s car tonight or do you want me to give you and Gail both a ride to your place?  Okay then, she can go with you.  Alright, Kiki.  God bless you, girl.”  Roberta hung up and sighed again.  Kiki was a regular aide on Roosevelt, one of the wings on the second floor.  “Do you know where Gail went?  Oh there she is, down by Allen’s room.”

When I punched out at 11:02, Gail and Kiki were lingering in the breakroom.  I couldn’t hear their full conversation, but a few words—couch, clothes, tomorrow—escaped from their hushed tones.  Kiki hugged Gail, rocking her back and forth, before the two of them came into the service hall.  I watched Gail and waited for the timeclock to return my card.  She’d been crying, which made her eye look worse.  She gave a weak smile, waved her hand once, and walked past.

 “You starin at something white girl?” Kiki asked.  “Far as I see, ain’t nothin that’s your business, so why don’t you just keep to what you’re doin.”

Her intensity and aggressive shielding of Gail surprised me.  I felt stupid but defensive.  I hadn’t meant to be gawking.  I was just thinking about the fact that we all carried some secrets and unknown parts.  Which made me think that maybe what we had most in common was the inability to ever really know each other.  But that people kept trying anyway, for whatever reasons.

Kiki pushed the handle of the glass door, letting a burst of humid air into the service hall.  “I don’t know why you’re nice to that girl,” Kiki said to Gail.  “She ain’t done nothin for you, and she just summer help before goin back to college.  We don’t need that kind.  Miss Thang walks around here like . . .”

I stood in the hall, under the drone of the fluorescent lights, and pretended to burrow through my canvas bag for my keys.  Finally, a set of car lights went on outside and they drove away.