a more empathetic doctor.
I thought of Mary—my sounding board in this process, my confidante—and what made her so good at her job. I’m sure so much of her caring and compassion is innate; still, I also knew that she’d been through a lot.
This former beauty queen—she had been Miss Cranston, Rhode Island—had married the man of her dreams, only to find herself in an abusive relationship. When she reported him to the police, he killed himself in retaliation.
Having lived through that and singly raised two kids to college age, Mary was a tough customer who relentlessly focused on the positive. She was still full of surprises. Once, after she had pointed out the house where Talking Heads used to play, back in their days as students at the Rhode Island School of Design, she casually announced, “I used to go out with David Byrne.”
As I said: full of surprises.
But the sight of her and the bleak expression on her face tempered any enthusiasm I felt and put my sense of wonder on ice.
“What’s going on?” I asked when I found her frowning in her office.
“Nothing, David. It’s just a bad day.”
Mary stared off into space. I said nothing but didn’t take my eyes off her. Eventually she opened up.
“Well, it turns out that the state of Rhode Island in its infinite wisdom isn’t giving us the same amount of per-patient funding this year as they did last, and the administrator is threatening more cuts.”
Every year, it’s the same thing. The state asks us to do more and more with less and less. In a bleak economy, nursing homes are easy targets for bureaucrats looking to trim the budget anywhere they can. It’s not like our patients line up outside of their legislator’s office to protest.
Mary’s news hit me like a wet blanket and I sat down in my chair with a thud. I knew that she was upset. Jobs were at stake and Mary was a perfectionist. She didn’t like the idea of potentially compromising the care of her residents.
“So, who are you here to see?” Mary asked, attempting to put a smile back on her face.
“I wanted to check on Ruth. How’s she doing?”
“Much better, actually. Her delirium has improved and she’s eating again. I even saw her husband walking down the hallway with her earlier today. They were holding hands and it was really quite cute.”
Mary’s mood seemed to lift but the moment was short-lived. Her expression turned bleak again.
“Have you seen Saul?” she asked. It was almost a whisper.
“Not since shortly after he was admitted to the hospital,” I said. He’d been over there for several weeks now, getting progressively worse.
“His daughter called today. She didn’t sound so good. I guess he’s in the intensive care unit now and not doing well.”
The news wasn’t surprising to me. Saul had been close to death when he left the home and I knew then it was just a matter of time. I looked off down the hallway in the direction of his old room.
“I wish…” I started but didn’t finish my statement. Truthfully, I didn’t know what I wished anymore. Saul had been pretty explicit about his wishes earlier in life—he wanted everything done, he kept saying. Yet his circumstances had definitely changed. Somewhere in the back of our minds, I know that most of us have a vision of how we would like to die. I was quite certain that Saul’s vision didn’t involve his current condition. But it didn’t matter. The die had been cast.
“I know, you wish she’d have left him over here on hospice where Oscar could take care of him.”
“I think it has less to do with the cat and more to do with the care that you and your staff provide up here. But yes, if I were in Saul’s condition, I know I’d rather be here—cat or no cat!”
Invoking Oscar finally brought a smile to Mary’s face. “Speaking of our friend, why don’t you go take a look in Saul’s room?”
I hesitated. I knew he wasn’t there and I had come to see Ruth, and still felt that I hadn’t been of much solace to Mary.
“Go on,” she said.
I walked down the hall toward Saul’s room. On the way I passed Ruth and Frank walking together, hand in hand. I said my hellos. Ruth greeted me with a warm smile.
“You’re looking much better, Mrs. Rubenstein,” I said. Though I sensed some recognition, I didn’t expect her to respond, so I asked her