May 29
This day felt very busy and businesslike. I felt like there was never enough time to do something at a leisurely pace, before I was being interrupted and urged to turn my attention to something else. This is why I’m writing my entry a day late – by the time I had time to write, I simply had no motivation to do anything but relax and read magazines.
I was woken at 7:30, to the distinct feeling that I was rising a bit late for the norm, even though I’m not used to considering 7:30 “late morning”. The morning CNA, a middle aged woman I’d not dealt with before, had just finished getting my roommate ready to go, and woke me by announcing that the bathroom was free if I wanted to wash. I felt my face, and realized I’d need a shave. I’d brought a 69-cent single blade Bic razor with me, but no shaving cream. Using the apricot scented all-purpose shower goop that flows like synthetic milk and honey at any nursing home, I proceeded to swiftly scrape my face. Ouch! I’m used to using an electric razor, which I did not bring for the sake of traveling light.
Shaving male residents is one of those tasks that’s high-risk-low-return for caregivers. I’d done it many times as a CNA, and was happy to do it, especially because it quickly became conspicuous when I’d neglected to do it. Leaving male residents unshaven reflects poorly on a CNA’s caregiving skills, even though when you think about it, it’s entirely cosmetic. Breaking the skin is a real risk, since the caregiver can’t feel the pain in the skin he or she is shaving, and this presents a serious problem for diabetics and people with blood clotting problems, that can be anything but cosmetic. Therefore, it came as no surprise that no CNA ever asked me about shaving assistance during this stay, even though I was listed as someone who needed setup help with toiletries. Time just didn’t allow for it. If I were a long term resident who was neither nimble nor thick skinned, I would make sure I bought myself a good quality electric razor.
When I emerged, the CNA was there to hustle me to the dining room to eat, for the first time. No more eating in isolation in my room. As I had feared, I was running late from the very start. Breakfast was served at 7:30, and the CNA had failed to rouse me at 7:00, when she entered our room and announced her presence. This annoyed me. If I had known I was expected in the dining room at 7:30, I would have put off shaving, and might have considered setting an alarm. Although I have gone through phases of my life where I was definitely a morning person, now does not seem to be one of them. One feeling I’ve always subtly resented was being the last one to get up and get going wherever I am, and rising to find everyone else already up and ready to face the day, nonchalantly unsympathetic to my frustrated craving for more sleep. It was my own fault anyway. I knew today way my glorious debut in the dining hall, and could have easily inquired about what time breakfast was. I just wasn’t used to it, and never thought to do this.
The dining room staff were understanding. They all knew my name, even though I didn’t know any of theirs – I am definitely a celebrity around here. I was offered a thick terrycloth “clothing protector”, a phrase that I can’t say without rolling my eyes. I never thought I’d hear that expression again after I left my first nursing home job, and their lengthy lexicon of dignity-promoting doublespeak; the second nursing home I worked at, in big bad New York City, didn’t mince words and called a bib a bib. Apparently here, as on my first job, a diaper is called an “adult incontinence product” or a “brief”. (I don’t mind the latter, since it is, well, brief.) I’m starting to get the idea that practices at my first job were up to date with industry standards, and that the cutthroat and expensive nature of New York City, somewhat counterintuitively, favored a resistance to change from an earlier era. I still remember finding it odd and dated to be paged by my surname while working there.
I was seated at a table with three older gentlemen, who all turned out to be highly interesting people to talk to. I’ve enjoyed good food and good conversation with this same group every meal since. There was “Rex”, a former security guard from Acton, Massachusetts. He wore the thickest glasses I’d ever seen, was confined to a wheelchair, and definitely in the worst shape of the three. He didn’t say much, but was still mostly lucid, and easy to talk to. There was “Jack”, a retired elementary school teacher from Waltham. I could tell from the twinkle in his eye he had a way with kids, and was quite intelligent. He had a lot to say about education in America, and lamented the widespread decline of the community public school that was within walking distance of students, and served as a social hub for parents. He rolled his eyes when telling us that the school he taught at for 45 years had been sold to a developer for condominiums. Then there was “Mark”, a proud Armenian man with a thick white moustache and the demeanor of a scholarly gentleman. He had worked as a journalist, and had traveled a lot. He enjoyed telling me about the history of his people, both in the old country and in Massachusetts. When the conversation inevitably turned to politics and public policy, I found myself in very thoughtful and sensible company. All three were WWII veterans, with nothing glamorous to say about war. These men were a far cry from the stereotype of the old curmudgeon who clings stubbornly and without thinking to the ways of the past.
I had barely returned from breakfast, when a trio from Corporate Headquarters showed up at my door. In contrast to the last three people I’d interacted with, these two men and one woman were walking stereotypes, who would have fit in very well on the TV show The Office. Their interest in me had a lot to do with the good publicity I was capable of generating for their chain of nursing homes. Little they told or asked me stuck in memory a day later, but I do remember they smiled at all the right moments, and seemed eager to please, in a very slick, “make a good impression on our client” sort of way. This became crystal clear to me when the older man volunteered to personally remove the nutritional shake I was served unsolicited, and which I’d mentioned offhand I had no interest in. They even flattered my spiel about myself and my mission at the nursing home with a vague interest in hiring me after I was done with medical school, odd for not even really knowing me. The woman urged me, “out of our own selfish interest” (her exact words), to be a bit more demanding of the staff, so that I could help them identify any problems or weaknesses in the quality and delivery of care. As I expected they would, they strongly encouraged me to call them at headquarters right away if there were any difficulties, or anything I needed.
I reciprocated the plastic smile, and took them up on their offer to fix any problems, by treating them to a mildly impassioned rant about my frustration with their web filter. I told them I understood why they’d have an interest in preventing employee loafing by blocking Hotmail, as well as any websites that were not, well, G-rated. They diplomatically tried to frame the latter as a protected health information security issue (unconvincingly). I told them I was not only not an employee and not a hacker, but also an adult, capable of making his own decisions about what content was appropriate to view online. I let them know that Hotmail was my main e-mail source, and that I also would like to be able to listen to streaming audio, also blocked. True to their word, I later received several calls from IT. Yes to Hotmail, no to streaming audio sites – this hogs bandwidth and slows down the system. Quid pro quo, sort of: I’ll say good things about their facility to the press, within limits, if they’ll lay off the Internet censorship, within limits.
My next visitor was a student nurse, here to repeat the same neurological exam that her classmates did to me the day before. She had a flirtatious vibe about her, and seemed to want to prolong her time spent with me. I wondered if her mentor had wanted her to learn the neuro exam from me, knowing I was a medical student.
After lunch with the guys, remembering my promise to involve myself in more activities and get out of my room, I stayed in the dining room to attend a concert by a popular local folk singer. It was just a guy with a guitar and a harmonica, who sounded like I imagine Bob Dylan would sound if he could sing. He played a lot of old standards and his own arrangements of showtunes, and the residents really enjoyed him. I observed a faint pitter-pat throughout the room, and a slight squeaky rocking of wheelchairs, as residents tapped their toes, and there was a warm, almost churchlike drone as residents gently crooned along to songs any American knows. Music is truly as powerful and soothing to the mind as any drug, and I felt the residents were lucky to be regularly treated to such talent.
Not content to do the bare minimum in terms of activities, I also attended bingo. The caller was a young upstart, just recently graduated from high school, whom I later learned was the CEO’s son. He had powerful voice and a desire to major in philosophy, and he knew the typical bingo crowd and each of their idiosyncrasies quite well. He had an eloquent and subtly world-weary sense of humor that reminded me of a young George Carlin, as he reacted to the same tired puns and moments of resident confusion he’s undoubtedly treated to every time he calls bingo. I had been told the bingo crowd was quite a clique, and though they are undoubtedly loyal fans of the game, I found them at the same time welcoming to me as a newcomer. Their aptitude at keeping up with the game varied. There was the trickster who took chips off her neighbor’s board when she was not paying attention, the dotty old lady who could never keep track of what numbers had been called, and the sharp-tongued, loudmouthed Italian grandmother, among others. All told there were about ten players seated around the big table, with two cards each, all vying for worthless plastic tokens. I didn’t win any rounds, but I didn’t care – observing the seasoned social dynamic of a dedicated group of aging gamers was plenty fun enough. The game had the thinnest veneer of competitiveness, but it was clear that companionship amongst people who might not otherwise have anything else in common to bond over, was definitely the real prize to be won.
Other little things not particularly relevant to my immersion experience rounded out my day, such as some calls to friends, and a visit from the head of nursing, a very helpful and practical woman who’d heard from the nurses that I had some unexplained skin lesions. She invited me to her office, because her nursing specialty was dermatology, and diagnosed by lesions as psoriasis. It was also my shower day, and not needing a CNA to accompany me to the shower chair anymore, I felt like a Scottish rebel for wearing no swimsuit under my hospital gown.
