Making Rounds with Oscar Page 14

  “By all means,” I said, taking a sip of the coffee.

  “I used to say that I had to make an appointment to eat lunch with her.” Jack smiled. “Even in retirement, Marion led a busy, full life—whether it was with aerobics, her church, or any of the other things she was involved with. She was a woman with a good heart. She found the greatest joy in the simplest things: taking me and the neighborhood kids for ice cream, or starting up the car to chase after a fire engine that had just passed by our house. I mean, how many parents actually do that?”

  He paused for a moment of happy reflection and then added, “She was a great mother, but she didn’t have it easy. My mother was a single parent.”

  “Really?” I said. I realized that there was a lot I didn’t know about Jack or his mother. “Was she widowed or divorced?”

  This is not a question I’d ask a single parent today, but single parents were something of a rarity in the fifties, and I wanted to know more about this glamorous, kindhearted woman who would go out chasing fire trucks with her kids.

  “Neither,” Jack replied. “In 1951 my mom met a man she fell in love with. It was accidental—and instantaneous. He was the one true love of her life. They were together for forty-nine years until his death a few years ago.”

  “I’m confused,” I admitted.

  “My father was married to someone else,” Jack said. “My parents had to keep their relationship a secret. They had an affair that lasted for almost fifty years—though I prefer the word relationship. I was the product of that relationship.”

  Jack paused to gauge my reaction. He looked me over, studying my features for a hint of a reaction. In today’s world, this might not seem so surprising. But 1950s Rhode Island was a different universe altogether and it was clear that Jack’s upbringing had not been conventional.

  “I used to say that I got to know my father from the reflection in the rearview mirror of his car. He would pick us up and we would just drive somewhere—sometimes he would take us for a bite to eat and other times we would go to another town or place where people wouldn’t know us.”

  Jack paused for a moment to sip his coffee.

  “Dr. Dosa, to understand my mother, you have to know that she woke up every day and got dressed impeccably just in case it was a day she could see my father. She never stopped looking over her shoulder for him and that behavior never stopped—even in the midst of her dementia.”

  I thought about the pictures I had seen: Marion with the carefully applied makeup and the beautiful outfits. Suddenly they made a different kind of sense.

  “More than you want to know?” Jack asked.

  “Not at all,” I said. “Not at all.”

  The mysteries of the human heart are not confined to medicine.

  “These days, when I think back about the early stages of my mother’s disease, I realize how naïve I was,” Jack said. “Maybe you just don’t recognize the early stages when it’s your own mother or father. You make excuses for the little things. On one occasion, in the early eighties, I had to drop off my car at the mechanic. We had agreed that my mother was supposed to pick me up. Obviously this was before everyone had cell phones. I remember sitting at the garage waiting for her for over an hour, but she never showed up. When I finally got home, I found that she had gone off on another errand. ‘Was that today?’ she asked me when I caught up with her. ‘I guess I just plain forgot.’ In retrospect, I can see that this was probably the beginning, but I just let it go.”

  Jack rattled off a series of mishaps, equally trivial if taken out of context. “I remember she started to lose her keys. When she couldn’t find them, she’d blame me for hiding them. I would try to reason with her, asking what possible motivation I might have for hiding her keys. It didn’t matter. Each time she lost them she was convinced I had hidden them.”

  Jack shook his head and smiled wryly. “One time she left them at the supermarket on the deli counter. On another occasion, she locked them in the car—with the car still running!”

  He was actually laughing now, though I was quite sure that none of it was funny at the time.

  “You know, Dr. Dosa, you make excuses. I would tell myself she was just tired. I would tell myself she was simply mad at me for suggesting that she sell the house she had lived in for so many years. Eventually, though, I couldn’t bury my head in the sand anymore.

  “For me, I suppose the straw that broke the camel’s back occurred several years after her symptoms began. Now, subconsciously I must have known that my mother was having trouble with her memory because I started secretly placing my business cards in her purse when she wasn’t looking. I don’t know why I did it, but I guess I realized that she might need me one day and not know how to reach me.”

  Jack smiled at his deception.

  “Sometimes she’d find the cards and ask me about them. I’d tell her that they were there just in case, and she’d get angry with me. She’d rip them into pieces in front of me or simply throw them out. Luckily, though, she didn’t find them all. I was at my job one rainy day when I got a call from a mailman in another part of town. He asked me if I was Marion’s son and told me to get over to the Eastside as quickly as I could. Not knowing what had happened, I was frantic. I raced out of my office and jumped in my car. I remember very little about the ride over, but I must have been going through worst-case scenarios in my mind.”

  How terrifying this must have been, a call from a stranger on a cold, rainy day. The need to drop everything and just leave, not knowing what you’re going to find. Naturally he assumed the worst.

  Jack glanced off and for a second I felt he might cry. Everyone else I had talked to had. But he composed himself and it occurred to me that maybe he was done with crying.

  “When I found her I remember thinking that this was as bad as you can probably ever imagine. You never ever want to see your mother the way I saw mine that day. She was drenched to the bone and completely confused. It was clear that she had been crying and her mascara had all run down her face, making her look like some tragic clown. I asked her where her car was and she broke down in front of me…she had no idea. She was so completely lost!”

  He paused in his telling. He was reliving every brutal second of that day as if it were yesterday. When he began again, his voice was low and halting.

  “You want to know the funny thing? Even the car event didn’t really bring the disease home for me. I knew my mother had a problem, but I hadn’t put it all together. It didn’t occur to me until a few weeks later when I was at a party. I was telling a friend about the incident and he casually asked me if my mother had Alzheimer’s disease. It hit me like a ton of bricks.”

  Jack shook his head sheepishly.

  “All of these events were happening, and I didn’t realize that my mother had Alzheimer’s until someone uninvolved casually mentioned it at a party! I was in denial.”

  As he uttered the D word, I couldn’t help but think how many people were like Jack. We all make excuses rather than deal with what we don’t want to see—even if it is right in front of our noses.

  “Mom’s just tired today.”

  “Dad’s just got too much on his mind.”

  We minimize symptoms despite a preponderance of evidence. We acquit the victim and avoid the obvious. The mind really does work in mysterious ways.

  “After my mother was diagnosed, I realized I needed to move her closer to me, so I relocated her to an apartment above my own. Thankfully, she let me take over her finances with minimal resistance and I eventually began taking her to the local senior center so I could go to work during the day. At first she complained bitterly, but I was persistent. I had no choice. But if there’s a silver lining with Alzheimer’s it’s that they stop complaining as the disease gets worse. After a few weeks of resistance I think she actually enjoyed the senior center. Regardless, it only worked for a time. She became increasingly difficult for me to care for and I had to hire people to help, to make sure she got dressed
in the morning, took her medications—and to make sure she didn’t disappear out of the apartment while I was at work!

  “Her personality also changed,” Jack recalled. “She would swing from one extreme to the other almost minute to minute. My sweet, loving mother became paranoid and mean—something she never was earlier in life. I would be at work and receive a phone call from an aide who would be in tears over something my mother had done. I would run home and find this docile, sweet woman with no memory of having done anything untoward. Over time, the personality changes became extreme.

  “Finally, the whole caregiver thing became exhausting. After all, they don’t stop being ill to give you a break. Even though my partner understood, our relationship suffered. I didn’t leave town for over four years. I became withdrawn and depressed. My blood pressure went up and I had a very hard time watching my mother disappear. I even started going to therapy to come to grips with everything. The therapy helped me understand that I needed help and that my mother needed to be in a nursing home.”

  “Did it make you feel guilty?” I asked.

  “Initially, but I didn’t feel guilty for long because it had to happen. In the end, though, once I got her into Steere House, I knew it was the right thing. We had a tough transition; my mother had been at another nursing home where things didn’t work out.

  “Ultimately, I was so happy to get my mother into Steere House. Aunt Barbara had also come down with dementia and was already living there. I was able to get my mother into the same room as her on the third floor. You know, my mother and Barbara lived together for sixty-eight years. They were apart for about ten years, but when they got back together at the nursing home, it was like they had never been apart.”

  Jack laughed. “The two of them loved their animals,” he said. “I’m sure they thought that they owned those two cats. I’d come into the nursing home and find my mother in her room, but Barbara was always missing. I’d go hunting for her and find her sitting in some random room with one of the cats curled up in her lap. She’d light up and tell me that her kitty was here.”

  “What about your mother?”

  “Oh, she was the same. There were times when I thought that my mother no longer recognized me, but she would always light up when one of the cats was in the room. Both of them. I would put one of the cats on their beds and they would just smile.

  “The strangest thing is that my mother and aunt eventually forgot almost everything. They couldn’t remember my name, where they were, or who they were. Yet those feelings—well, they remained. It was the same if there was a baby on the floor or if a certain tune was playing on the radio. Even in the end, they would simply light up.”

  “So, was Oscar there at the end?” I asked.

  “The nurses tell me that Oscar was at Barbara’s death. He came in a few hours beforehand and she died shortly thereafter. I wasn’t there when my aunt died, but I can tell you what happened to my mother with Oscar.”

  Jack grinned.

  “When Oscar was just a kitten, I used to bring him into my mother’s room and put him on the bed. He would stay there for a minute or two, and then he would leave. You know what kittens are like.”

  Actually, I didn’t.

  “It was great for my mother, but he never stayed long. During the last week, when my mother was unconscious, Oscar would come into the room, look around or jump onto the bed for a moment, and then leave. On the night my mother died, the night nurse called me in to see my mother. She told me my mother wasn’t doing well and that I should be there. When I got to the room, the lights were dim and they had started doing aroma therapy. I went to the bedside and was stunned to see Oscar lying there on the bed, curled up next to my mother. When I sat on the bed, he didn’t budge; he just sat there purring.”

  Jack now wore a look of befuddled amazement.

  “Seeing Oscar there at the bedside, I looked at my partner of eleven years, who was always there for me and my mother, and told him we were not leaving. As I said, my mother had this unique connection with cats and I knew this was the way she was going to die, with a cat at her side. Two hours later, my mother took her last breath. Oscar never moved until she died. Then he got up casually, like nothing had happened, and left the room.”

  We sat in silence. I was picturing Oscar. I bet Jack was too.

  “I suppose my mother would have been happy to know that she died with one of the critters she loved the most. But to tell you the truth, all I felt was relief. I’d like to tell you that I felt horrible when my mother died, but I didn’t. I think Ronald Reagan’s daughter said it best for all of us when she called her memoir of her father’s Alzheimer’s The Long Goodbye. Every day I miss the mother I had sixteen years ago, but not the person she became. It was like watching a kid, but having them unlearn everything they knew.”

  I thought back on my conversation with the Scheers, who had voiced the same complaint. It must be like watching a film of a person’s life run backward, I thought, except the person doesn’t get any younger.

  I asked Jack if he had any last thoughts about his experiences. He considered for a while before responding.

  “You have to learn to love the person they become and find moments of happiness in the little things,” he said. “That’s why those animals at Steere House are so important. Dementia is all about comfort and distraction. I always felt okay about leaving my mother and Barbara because they had excellent care, each other, and they had their cats.”

  Standing at the doorway as I took my leave, I shook Jack’s hand. Before I could go he offered one last thought.

  “You know, Oscar the cat was not just a distraction for my mother,” he said. “He was my distraction as well.”

  CHAPTER EIGHTEEN

  “It always gives me a shiver when I see a cat seeing what I can’t see.”

  ELEANOR FARJEON

  ONCE AGAIN, I HAD GONE OFF IN SEARCH OF ANSWERS and had come back with only more questions. Regardless, my visits were providing me with fresh insights into the disease that was afflicting so many of my patients and their family members. In a way, they were making me 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?”