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Laura, Toucan Editrice

Wednesday, December 1, 2010

Circling-Cavenaugh Kelly

The waiting home health nurses shivered under the dagger of a frozen gutter, blowing rings of cigarette smoke. Others searched the morning obituaries for a hospice nurse’s greatest compliment, being mentioned, or discussed problem patients, lazy husbands, Christmas debt, the expected “murderous mess” of a coming ice storm, and yet another day “in the old sick factory.”

Donna, the area manager, with burgundy hair, gray eyes, and a gap in her front teeth, laughed and smoked with the nurses outside, sipped coffee over the obituaries with the others, and finally, told everyone it was time for the meeting. She wanted her nurses on the road seeing patients before the storm hit and no one driving after dark unless it was an emergency.

Sagging red and silver garland hung from the walls of the conference room. A few Christmas cards and a fake wrapped present stood beside a percolating coffee pot on a far table. Donna opened the boxes of donuts, pastries and green Christmas cookies she’d purchased on her way to work. As the nurses arrived, Donna offered them food and passed it down, while Elaine, a bone-thin nurse with a smoker’s voice, took requests for juice, soda, and coffee. The talk and laughter grew loud until Donna interrupted with the first patient on her list. His name was John Reynolds, a seventy-five-year old with a spinal cord injury and chronic bladder infections.

“He’s shaped like a I don’t know what,” Elaine said.

“A Buddha,” Mary, a small nurse with frizzy bleached hair and a big voice, said.

“Exactly,” Elaine said, reaching for a donut. “A Buddha. With ears like Yoda.”

“I prefer rotund,” Donna said. “And let’s stay away from his ears. They aren’t clinically relevant.”

“I’ll have to remember that,” Mary said. “Not fat, or clinically obese, but rotund. I’m sorry honey, but we can’t do it tonight because you’re too rotund.”

“Whether he’s a Buddha, or rotund, he can’t use the urinal at night because he has a hard time finding it,” Elaine said. “And since he can’t get to the commode, he sleeps in a wet diaper all night, and he keeps getting infections.”

“Don’t the aides clean it thoroughly?” Donna asked.

Kathy, an aide with gray hair and missing teeth, shook her head. “It’s too small and there’s too much fat.”

“Just give it a pull, Kath, and it’ll make an appearance,” Mary said with a grin.

“I’m not gonna give it a pull,” Kathy said, scowling.

“Focus people, focus,” Donna said, tapping the table. “We need to move on. Don’t think there’s much we can do about the man’s…shape. And the fact that it’s hard to find. We just need to clean his peri area best we can and continue with the antibiotics per doctor’s order.”

Jen, the office manager, poked her head in the door. “Elaine, you have a call.”

“Who is it?” Elaine asked.

“It’s Haley’s mom.”

“Oh God,” she said, rubbing her forehead, and left the room.

Donna ran her finger down the list, wanting to keep the meeting moving.

“Isabelle Hanson,” Donna said, “is an eighty-four-year old with a stage two pressure ulcer on her coccyx. She’s been on the program for six months and it’s still not healed. Medicare will not pay for maintenance care.”

Elaine came back white faced. She pulled on her fur-lined jacket and stuffed a pack of Marlboro Lights into her pocket. “My little girl is starting to circle.”

“Oh, Elaine,” Donna said, touching Elaine’s arm. “I’m so sorry.”

Kathy leaned over and hugged Elaine.

“I need to leave before I lose it,” Elaine said. She grabbed her nursing bag and left.

Everyone reached for tissues and dabbed and blew.

Donna put aside her list. It was no longer important.

“I’ll never forget my first hospice patient,” Mary said. “Started circling the drain Christmas Eve. He was forty-six and had three kids. A wonderful man. Taught English at the high school. Had two hospice goals. See his boy play one more basketball game and survive until Christmas. Did both. Then he died.”

“My brother died the week before Christmas,” Kathy said. “And not a holiday goes by when we don’t think of him.”

“It should be a law. No deaths between November and January,” Mary said.

“And no deaths for anyone under ten,” Kathy said.

Donna took a long drink of tea. The clock on the wall ticked and a brewing second pot of coffee gurgled.

“Grandmother was my first,” Donna said. “A strict Presbyterian. Always made sure every Sunday was quiet. No TV, no games, and no fun. Everyone just sitting around reading our Bibles.”

The nurses closed their notebooks, capped pens, and reached for more coffee and pastries.

“She was sick forever,” Donna said. “Going in and out of the hospital, recovering from this and getting that. Then one morning, she simply said she was ready. Mother believed her right off, and said we all had to go in  and say good bye. I was the last grandchild to see her. She was in what everybody called the birthing and dying room. The house was over two hundred years old, and in that room they delivered babies and lay bodies at rest for the viewing. My brother used to tease me about the ghosts from all the dead people and for the longest time I believed him.”

“My great grammy had a room like that,” Kathy said. “Only I think they called it the bucket-kicking room.”

“Great. I can see it all now,” Mary said. “Looking a little weathered there, Nanna. Time to send you off to the bucket-kicking room.”

“I was just kidding about the bucket part,” Kathy said. “They also called it the dying room. And it was only for viewings after they died.”

“Do you wanna hear the rest of my story before the storm hits?” Donna asked.

“I promise, no more interruptions,” Kathy said.

Donna smiled and continued. “When I went into what we called the dying room, Grandmother was propped up with pillows in the big brass bed. Her gray hair flowed down to her knitted patch quilt, her face looked all powdered, and she was wearing her wedding dress. I thought this was all very strange, and I only wanted to turn around and run, but it wasn’t like I had a choice.

“‘I’m going to die tonight, Donna,’ Grandmother said. ‘And I have some things I have to say to you.’

“‘You’re not going to die tonight, Grandmother,’ I said.

“‘I’m ninety one, and I’m not going to live forever. So please come in and sit.’

“I did as I was told and sat beside the bed and folded my hands. Sitting there I couldn’t help but stare at her dress. For years I’d sneaked peaks at it in her closet, and I can still remember its intricate lace and little white buttons and ribbons. But it didn’t exactly look dreamy on Grandmother that day. To be honest, it kind of sagged off her, and it was more of a faded yellow than creamy white, with lots of wrinkles and folds, like it needed a good pressing and white-washing.

“‘Number one,’ Grandmother said, waving her finger at me, ‘study hard. Number two, obey your parents. And number three, stay a virgin ‘til you’re married.’

“I was thirteen and I thought, there’s no way I’m gonna do that,” Donna said. “But I didn’t say it of course.

“‘Number four,’ Grandmother said, now smiling. ‘Become a nurse. Don’t let any man stop you.’

“I’ve wanted to be a nurse since I was three,” Donna said.

“‘Number five,’ Grandmother said, once more serious, ‘Raise your children Presbyterian.’

“Didn’t do too good on that one either.

“‘You can leave now,’ Grandmother said, waving me off. ‘Give me a kiss, and send in your mother.’

“‘But Grandmother,’ I said. ‘Why are you wearing your wedding dress and why do you think you’re going to die tonight?’

“‘Please go, Donna.’

“I kissed her powdered forehead like she wanted and left. That night she went to sleep like always and I stayed up all night staring at the ceiling, wanting to run in there and see if she was all right. In the morning I ran in first thing and there she was asleep in her rumpled dress, eyes closed. I walked up to the big bed and nudged her shoulder gently. One eye opened, she said, ‘Oh shit,’ and closed it. And that was that. She never opened her eyes again, lost consciousness, and passed that afternoon.”

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