When we lived in the Chicago suburbs, I worked as an aide in a retirement home, on the fourth floor health care unit. I led activities, simple ones because all the patients had some degree of dementia. At the end of the day I was required to fill out a form for the state, reporting each patient's participation. The rows were labeled Music, Crafts, Reading, Nature, etc.
The most ambiguous item was Socialization. There were just two options: a check for “yes,” a dash for “no.” I was required to mark it and encouraged to be very liberal: check yes if the patient is breathing. I was told that you never knew, that the person might be socializing with him or herself. Or with someone in a dream. Or you simply may have missed a meaningful movement of their eyes.
The most difficult patient to judge was Dorothy. Her dementia was among the worst, and her behavior was unpredictable. The head nurse told me, “Don't stand too near her; she sometimes hits people.” This made Dorothy a liability on the ward. They kept her wheelchair next to the nurses' station all day. She had lost the ability to speak, and did not move her head, which made her look very sullen.
The genuinely sociable patients spent the day in the dining room seated at tables of four. Some of them could stand and poke around the room with their walkers, but most sat all day. They especially liked Bunco and could still toss the dice from their bent fingers. The ladies loved getting their nails painted, choosing colors like Fire Engine Red and Passion Pink.
These residents were mostly from Cicero, and a few had seen Al Capone himself. Nearly all had heard Benny Goodman live. They remembered Marshall Fields at its most magical, and were ardent White Sox fans. But the topic that animated them most was Friday nights at the Aragon ballroom. They really did use the phrase “the good old days” for it. One woman, who could barely put together a sentence otherwise, told me she had met her husband on the dance floor. “He was woo-hoo,” she said, with a breathy treble on that last syllable. I regularly played big band records and took these ladies by the hands for a dance. They couldn't leave their chairs, but they could bob their shoulders and swing their arms for a little fun. On those days, everyone within earshot got a check mark for Music.
Despite the cheery moments, decay loomed on the fourth floor like the wet ends of cut flowers. There was a fecal smell from poor bathing; an odor like horses from old teeth. There were smiles, but also complaints, some irrational, some fair enough. I was once chided for lifting the blinds to let in the morning sun. I thought it would cheer them, but they told me it hurt their eyes.
Parked at the nurses' station, Dorothy couldn't hear the music. She couldn't tell what she remembered, and had no amusing qualities or ability to exchange basic pleasantries. She had a folkloric face, large and square with a sharp nose, long hairs on her cheeks, a chin that angled outward rather than curving nicely from her bottom lip. Her forehead never relaxed. Her shoulders hunched to the level of her ears so that she could not look up into faces. Even so, you could tell she'd been a tall woman. Her hands were mannishly large. Her feet were unattractively long. She looked, in fact, a bit sinister, an impression that was reinforced when she exasperated the staff by suddenly swiping her hand and spilling juice, with a scowl that made it seem on purpose.
One day a fellow aide told me that Dorothy had, for decades, been a very active member of the Salvation Army. The image came to my mind (granted, more Victorian than post-Depression) of a severe woman in a cape swinging a schoolmarm's bell. I saw black-booted feet planted on a cold walkway of snow. I saw her staring down people who averted their eyes and walked on. This was all I could tell of the soul of Dorothy.
The day finally came, the inevitable pronouncement on ninety-three years: Dorothy was put on hospice. It had been delayed by a strong heart and a daily dose of large pills. Now the nurse brought them to her bedside in a paper cup the size of a communion glass. The juice was poured directly into her mouth, and the droplets that hovered on her lips were dabbed away. Witnessing this, I checked 'yes' for socialization.
Her slippers were empty on the floor, permanently stretched in the shape of her feet. The hospital blanket stayed molded over her long form. Her hands, streaked with veins like swollen rivers, stayed still. Had she even wanted to, she couldn't turn her head to see the bits of sunlight that slipped through the edges of the closed shades, or the gifts that had accumulated on the windowsill: a potted plant, stuffed animals, thinking-of-you cards.
One day I tested what was in her line of vision. With my face next to hers, the only thing I saw was the clock on the wall. I considered taping up her cards or digging an old poster out of the activities closet. I wondered what Dorothy would like to see. The question, I realized, was ultimately, Who was she? What would speak to this unyielding captain at her watch?
People active in the Salvation Army know all the best Bible verses, so I decided to write one on a card for her. In the office I found cardstock and a marker, and wrote out a portion of Psalm 23:
The Lord is my shepherd, I shall not want;
He maketh me lie down in green pastures,
He leadeth me beside still waters,
He restoreth my soul.
I put the over-bed table across her straight body and made sure it was at eye level. I folded the cardstock into an inverted V so that it stood up. I took off her eyeglasses and cleaned them; she blinked her blue-gray eyes and did not flinch. The glass was badly smudged from neglect, which in retrospect explains a lot.
Dorothy's eyes slowly scanned the words. Or did I imagine it? Was it pretense on my part, taking credit for a good deed? Maybe, like all those check marks, I was falsifying what I saw. But no, there it was again; I was sure of it: her forehead relaxed a little, and she really seemed to be reading.
A few days later I arrived at work and saw two men pushing a trolley out of Dorothy's room. On it was a canvas bag the length and girth of a body. They wheeled it toward the elevator. Nurses stood aside. The door slid shut.
It's a strange thing to walk into a room and see a bed that has just been stripped. It's strange to gather up hand creams, a hairbrush, stale candies. To open a closet and see blouses hanging there and a pair of dress shoes on the floor. To stand in a room that is large with absence and consider that a life was there, a person incapacitated but able to see a promise, even in dim light, and perhaps discover that, on no strength of her own, she could still draw near to someone who had dared draw near to her.