"I walk back to her bedside and take her hand. I kiss her gently, hoping it won’t be the last. 'I’ll be back soon. You know I will always find you,'” writes the author in a personal account of life with her aging mother.
Dr Tully is Clinical Associate Professor, in the Department of Psychiatry and Neuroscience at the University of California, Riverside, School of Medicine.
Editor’s note: The patient described here is the author’s mother, who has signed a consent form to appear in this piece.
First, I have to find The Poet. Past the pots of spring flowers outside and the lobby of the skilled nursing facility by the beach, I look for her in her wheelchair. She might be eating lunch in the dining room, sitting near the nurses’ station, or in her small bedroom in the back. The nurses glance as I hurry by and say, “Hello, Doctor.” I am not one of the facility’s physicians, so my arrival is greeted without fanfare or demands.
When I stand in front of her, she peers at me and a knowing smile spreads across her thin, lined face. She listens happily to my greeting, reaching her bony arms up to mine. She still recognizes me. Finally, she has a new pair of glasses after the old pair broke and I made call after call to the facility’s primary care doctor to re-order them. I lean in, and she slowly grasps my long necklace with one hooked, nearly translucent, finger. “How much?” she asks. I tell her I got it at a thrift store for $3.95 and she gasps, “Very good! It is lovely. . . luminous.”
The Poet was born before World War II in 1930s Europe and evacuated at age 8, with her 4-year-old sister in her charge, to the Welsh countryside during the German bombing. Before the onset of dementia, she was an avid reader, earned a Master’s degree in English, and won awards for her short stories and poetry. In later years, she made the journey back to Wales with her sister and found the home where they had lived with the kind woman who took the evacuees in. In the May 1941 Blitz of Liverpool, those little girls were safe. They survived.
Today, we are going to look at the videos of her great grandson, Flynn, aged 6 months. I tap on the video of the baby being fed his first solid food, and she stares incredulously at the device. “Who is this . . . gorgeous baby?” she asks. Her delight is mixed with confusion.
“Flynn. His name is Flynn. Your granddaughter’s firstborn.”
“Flynn, yes . . . Flynn. A good name, Irish. A great bonnie baby. Look at . . . those hands! He’ll stand up to them!”
“How are your girls?” she suddenly asks me, although I know she usually doesn’t remember her grandchildren’s names.
“Growing like weeds.”
“No,” she chides me, “Growing like sunflowers!”
“Yes, growing like sunflowers. Growing up beautiful and brilliant like their wonderful grandmother, the poet and writer!” She smiles again, content, but her eyes are reddening.
She clenches the device in her hands, and after several viewings, I have to pry it gently from her fingers when the screen goes dark. A nursing assistant walks in with her lunch tray and places it near her bed. He is mildly exasperated. “Miss Evelyn won’t eat, Doctor. She pushes food away. Nothing!” He waves his hand in the air and waits to see my reaction. “I’ll try,” I tell him. I manage to get several spoonfuls in while she obediently opens her mouth and swallows. She urges me to eat the food instead, but bit by bit she finishes all of it. I feel victorious.
I suggest that we watch the video again of Seamus Heaney, reciting his poem Digging, but she says no, not now. She is preoccupied, quiet. She picks up a novel I put on her lunch tray and strokes it with tremulous fingers, turning it over in her hands but not opening it.
I go in search of the nurses. How is she doing? What is the last weight? Blood count? Is she sleeping? Medication changes? Is anyone getting her up to stand in the morning, not sitting all day? “She’s okay, Doctor, doing okay,” they say and turn back to their charting.
The Poet is gazing at the window when I return, silent. I hand her a souvenir tea towel showing a brightly colored map of Wales. I point out Llandrindod Wells in the middle of the map. “You were such a brave girl, separated from your parents during the war. Do you remember how you and Aunt Joan found Grove Lodge? Do you remember Lady Llewellyn and her housekeeper, Mabel? Do you remember all those great stories you told us?”
The Poet nods and smooths out the linen with her hand. “Of course I remember,” she says.
She is stable for now, but I remember that terrible night her nurses called to inform me that there was a change in her condition and they were calling an ambulance. I flew down the freeway along the ocean to the hospital emergency department (ED). The waves were a long flat line of white foam on the sand in the pitch darkness. We put our heads together around the gurney, the young ED doctor and the nurses. I told the story, reciting lab values and the medication list, as somehow no records had arrived with her. She suddenly woke up and smiled when I called her name. “I thought this was going to be full basic lifesaving,” said the nurse, relieved, pulling machines out of the room.
There was a time when I never set foot in a skilled nursing facility, before I was also her caregiver and probate conservator. Now I am a daughter on different terrain, without the luxury of ignorance.
Another nursing assistant is clearing her meal tray in her room and unfastening her bib when I walk back in. The Poet asks her, “Did I introduce you to my daughter? The doctor?” “Yes,” nods the assistant. “Oh yes, you have, thank you.”
Then it is time to go. The Poet has raised six children, and I know she is used to comings and goings in a busy household. “Drive safely. Be careful. Get some rest,” she says. She is saying something indistinct, picking at the sheets, so I walk back to her bedside and take her hand. I kiss her gently, hoping it won’t be the last kiss. “I’ll be back soon. You know I will always find you.” She looks up at me and says firmly, “You’re my daughter. I know what you can do.”
This article was originally published on 8/15/18 and has since been updated.