University of Virginia Library

Growing Older With The Dying

Young Gal's BluesLangston Hughes

By Steve Grimwood
Cavalier Daily Staff Writer

First impressions: You step
off the elevator and are nearly
overpowered by the smell of
urine. Stale, fresh, and drying,
it all coalesces to form a fetid
atmosphere that assails the
nostrils. The hallway walls are
appropriately papered in pale
yellow. Unlike the other floors,
there is a waist high gate
running from the nurses',
station to the wall, effectively
blocking access to the
elevators. Several very old
people are wandering aimlessly
on the other side of the gate.
Others sit slumped in
wheelchairs gathered in a rough
semi-circle around the nurses
station. Only two or three
vaguely acknowledge your
appearance, but only with a
vacant gaze. There are no
fellow workers in sight.

You stand for a moment,
searching the dim halls for a
sign of life. Finally a nice
looking (thank God) young girl
in a white uniform appears
from around the corner. "Hi,
Welcome to Mezz. You're
really going to like it here."
She smiles.

The nursing home rests well
off a main highway in
suburban Washington, guarded
from the prying eyes of passing
motorists by a bushy parking
lot. The building itself is fairly
new. The offices are carpeted,
as is the floor of the chapel.
Small fish flit about in the
solarium aquarium, while a
canary attempts to sing over
the voices of the color TV in
the lounge.

The home is built into the
side of a hill. You enter on
first. Below is Mezzanine and
Terrace, above is the second
floor. Each level has essentially
the same layout. Two halls
form a right angle, with the
nurses station at the corner,
there is a dining room and a
solarium on each floor. In
addition to these, floor one has
a large lounge and hobby
room. There is a small beauty
parlor on the second floor.

An orderly is paid $2 an
hour. Working the standard
forty-eight hour week, you
take home about $160 twice a
month. I worked the three to
eleven shift, rarely seeing any
of my friends working more
conventional hours. Life
quickly centered around the
ancient and infirm.

The four floors differ in
color and temperament.
Ambulatory "sane" patients
generally lived on the second
floor. Floor one contained
"show" patients (meaning they
rarely urinated on the floor.)
On Terrace, very few people
ever left their beds.

I spent nearly all of my
working hours on Mezzanine.
This is the floor they
conveniently skip over when
giving the tour. The majority
of our patients (or residents, as
the brochure calls them) were
sufferers of "chronic brain
syndrome." This is a polite
medical term for senility.

You walk into a job like this
with a lot of preconceived notions.
Consequently the first few days are
pure hell. You attempt to do
everything that everybody asks
you. You take everything that
everybody says at face value. You
leave at eleven o'clock dead tired
and terribly confused.

The first few changes come after
a week. Several conclusions are
reached. One: It is physically
impossible to answer all the
patients' requests. Two: The great
majority of these people are nuts,
so don't believe anything that any
of them tell you.

The duties of an orderly are
numerous. Generally, he is in
charge of the care of any male
patients on his floor. There were
usually fourteen men on
Mezzanine, though it varied from
week to week. Care consisted of
keeping them shaved, well-fed,
clean, and out of trouble. But this
is an oversimplification. The
"unexpected" parts of the job took
up much more time than the
routine

Chasing down old ladies who
had managed to open the gate and
had wandered off, coercing a
reluctant one-eyed man to take his
medicine, administering enemas,
wrestling with an old, but powerful,
schizophrenic black man when he
bothered the other patients,
administering oxygen to
emphysema patients, lighting
cigarettes for an emphysema
patient, tricking a noisy old lady
into drinking a librium-laced coke,
putting out minor fires, taking
"walkies" for a stroll outside,
dislodging food from the throat of
a patient who had forgotten to
chew, getting kicked in the stomach
and putted by the hair, being
urinated upon, finding the back of
your shirt covered with excrement:
it was all part of the job.

Even with this to contend with,
a routine of a sorts had been
established. I would arrive at three,
and until five would wander about
checking things over, occasionally
shaving faces or trimming nails,
more often cleaning people up.

At five, we would wheel
everyone in for dinner. Only about
half took their meals in the dining
room, the rest eating in bed. About
a dozen were 'feeders." Everyone
had their favorites so a select few
patients always ate last. I had a
half-hour dinner break after
gathering up the trays.

Seven thirty, time for bed.
Wheel them in, set them on the
toilet, clean them up, spread Chux
over the clean sheets, pick them up
and drop them in the bed. Fourteen
men and their idiosyncrasies took
about an hour and a half. This was
of course variable, ranging from
thirty minutes to three hours or
more. Twenty-eight and a half was
my record time.

Bed check is run at ten. If you
had been careful earlier, this usually
involved little work. The remainder
of the evening was spent cleaning
up, sorting laundry, or screwing
around. Entertainment ran from
television to wheelchair races.

Second impressions: The odor
of urine has disappeared. Your
olfactory nerves have finally given
up and no longer report the
message to your brain. Excrement
is still somewhat bothersome to the
nose, but not intolerable as it was
the first few weeks.

Your humanitarian instincts are
still operating, but practical
limitations have dampened them.
You attempt to carry out little
rehabilitation projects on your
own, occasionally having minor
successes. But the incentive for this
gradually dies as failures become
more numerous.

Conversations with the patients
decrease gradually. At first, you
talk with them all the time, trying
to learn from the aged. Many of
them had entertaining tales to tell,
but only for a while. Blood had
ceased to flow through half their
brain, memories had faded along
with intelligence and vitality.

Incidents and actions that were
previously perplexing and troubling
now had taken on a humorous
taint. Mr. S. answering the pay
phone when it wasn't ringing, Mrs.
B. using the linen closet as a
bathroom, Mr. D. eating ice cream
with his fingers; humor abounded
and young laughter rocked
halls.

Two months pass. The job has
finally become just that. All
thoughts of rehabilitation are gone.
You finally agree with the doctor's
prognosis: chronic brain syndrome.
It can never get any better.

My conversations with patients
have practically ceased. They have
nothing more to offer me and I
have nothing to offer them.
Everything becomes routine.
Nothing is funny anymore because
it almost always involves more
work on my part. Only a shred of
humanitarian instinct remains, my
human kindness has been milked
dry. I no longer want to spend
forty-eight hours a week living the
lives of fifty old people. The
summer ends, but the memories
remain.

Wiping someone else's ass is a
humbling experience, even though
it became only a "job" after the
fiftieth shit-smeared bottom. I left
the home with broadened sense
"delicacy," meaning that I don't
particularly like to wipe asses, but if
the need arises I won't be totally
incapable as many people would be.
A small thing in practice perhaps,
but try it sometime.

Watching a man slowly die also
leaves something with you, though
I am reluctant to admit to
myself what. One of my male
patients had cancer of the bladder.
Five minutes after I arrived one
afternoon he began bleeding from
his penis. There was nothing to do
but replace one bloody Chux with a
clean one every half-hour. He
literally pissed his-life away for my
entire shift and was still bleeding
heavily when I left at eleven.

When I arrived the next day,
there was an empty bed. I checked
his chart. "patient very
agitated-given Librium. 1 a.m."
"respiration ceased approximately
4:30 a.m." He had died doped up
and alone. I briefly wondered why
no one had been with him.

The idea of death became like
shit. You saw so much of it that it
didn't bother you anymore, you
reacted to nothing. It was all part
of the job.

Ralph Nader recently turned
loose some of his "raiders" on
nursing homes. One of them
worked with me on Mezzanine for
two nights, a recent graduate of
Mrs. Porter's School for (rich)Girls.
I didn't know who she was at the
time, but saw her picture in the
paper about a week later.

During her short stay she found
"blocked exits, filthy floors, tied
up patients, and inadequate
staffing." She of course gave no
notice that she was not returning,
so we were short of help the next
two nights.

Nader is a well intentioned
fellow, but attacking homes in this
manner will ultimately prove
fruitless. Every home is going to
have partially blocked exits if its
patients wander about. Every home
is going to have fifthly floors as long
as addled-brained old people
urinate and defecate where they
please.

Every home is going to have
inadequate staff until the values of
this society once again swing back
to a reverence for age, and nursing
homes disappear for lack of use. I
met very few people at the home
who had been there for any length
of time, because very few people
can handle that sort of situation for
long.

I couldn't. I left a week earlier
than planned for fear of losing what
little sympathy I had reattained. The
job drained me of emotion and
hardened what little remained. I
can only imagine what would have
happened next, but that
is something that I would rather not
know.

Find those few people and
you'll have good nursing homes.
They do exist. There is perhaps one
for every thousand residents.

Question: What are you going to
do with your mother?