Monday, June 30, 2014

The View from Purgatory

Nearly ten years longing for the sweet release of death, either by means of poor health or a sturdy plastic bang, culminated in one blink when I realized not all the embers had lost their flame.  The realization made for a brief sense of euphoria  before the truth sank back in.  Something can rekindle the happiness of better days, but without a reason for it to stay, happiness is fleeting.  I was still overwhelmed by the burdens of life, but now I had discovered ending it all was not as easy as I had expected.  I was now stuck in a limbo I did not understand.  I did not want to live, but I would not let me die.  In true masochist fashion, I began to beat myself up emotionally because I was condemning myself to live a life not worth living.

If that does not make the slightest lick of sense to you, join the club.  There is no membership fee and the ladies are generally pretty.

My increased depressive state attracted far more attention than ever before.  From December 13th to January 6th, I never l did not leave my room unless a nursing assistant needed me for something.  Such circumstances added up to maybe two hours a week all tolled.  The most significant departure I made was on Christmas Eve when Christy, the mother of  Whitney, one of my favorite nurses at McLeod-Darlington, invited me to come down to the dining hall to celoebrate with the rest of her family.  (Her father is a resident.)  She had bought several nice gifts for me, including a winter coat.  A winter coat was a big missing piece in my much thinner than pre-Oakhaven wardrobe.  I hugged both her and Whitney.  I would not have had any kind of Christmas without them, and told them so.

“My sister appears to have gone off the deep end," I told her.  I left out the part about how I was precariously teetering myself.

 Christy and whitney were not around me long enough to notice any worrisome behavior, but others were.  Caroline increased the frequency of her inquiries.  Josette, a nursing assistant with whom I had some difficulties in getting along, came to my room after her shift was over one night to ask if I had considered assisted living, my personal property Denise would not give up, how hard would it be for me to practice law with my eyesight--anything and everything to get me moving.  I did not say much to either of them.  On her visit the day after Christmas, Eve told me about her holiday, but knew better than to ask about mine. She leaned against the sibk on the other side of my room.

“Jamie, Jamie, Jamie…what are we going to do with you?”

I did not ask what she meant by the question.  She knew I was deeply depressed, but I did not want to get into the matter.  No one knew I had planned to commit suicide.  They certainly did not know I still had the means conveniently within reach should I change my mind.  I wanted those two secrets to remain hidden.   Naturally, it was not to long before it all blew up in my face. 

Permanent residents have a quarterly evaluation to guage the progress of their care plan.  Since I was not considered a perm anent resident until Denise let it be known to both Oakhaven management and me she never wanted to communicate with any of us again, I was not a permanent resident until October.  So my first evaluation came up in early January.  Since Oakhaven does little for me beyond managing my all night tube feeding, the meeting was not much.  Afterwards, I was called into paulette’s office to answer a depression survey.  They are routine.  I had run through four of them since October 2012.  But this was the first one from oak haven, as well as the first one I answered honestly.  When we got to the darkest portion, matters escalated quickly.

 “Do you ever think you would be better off dead?”  Paulette asked.

“I have to answer that one?”  I squirmed in my seat while pausing for a long moment.

"The answer is yes.”

“Daily?”

“Yes.”

Paulette pulled that old therapist trick of offering a tissue to keep someone from crying.  I waved her off.  I had no tears to cry.  Plus, I really hate that trick.  It is so…presumptuous.  Manipulative, too. 

We talked for a few more moments.  She asked with whom I was close to in my previous life.  I had to answer my mother, though she mercifully did not ask me to elaborate on the sheer strangeness the relationship with my mother was.  She asked if I had any friends.  I explained that I had rarely left the house in the last nine years.  Friends had been scarce since law school.  That and college were the last places I enjoyed much of a social life.  Or as much of one as an introvert cares to enjoy.  Paulette wanted to know if I had any kind of support network.  I did not.  Even when living with denise, to be honest. 

I went back to my room once we were done.  I laid down and stared at the ceiling for the next twenty minutes until paulette requested to see me again.  Since I lived on the other side of the building from her office, we ducked into the West wing dining hall.  I knew she would be seeking elaboration about my answers, so I was on my toes.  She started asking about scenarios that might push me over the edge towards suicide without knowing I had already fallen off three weeks prior.  Her key statement was her belief my Christian convictions would stop me from killing myself was now in doubt.

I had told her back in October I wanted to die, but I believed my health issues would finish me off before too long.  I reiterated that now, and added what I knew about psychologist Victor Frankl’s theory that losing the will to live will induce life threatening health even in otherwise healthy people.  Witness spouses who die months apart, for example.  I had been holding on to the theory through bad health issues for nine years.  I would probably do that until the very end.

Paulette was not reassured by any of that, so I thought, the heck with it.  I will just tell her everything that happened over the last few months right on up until December 12th when I backed off suicide rather than go through with it.  It was one of those unwise, on my feet decisions I assume I can clean up later.    But I underestimated the consequences of this particular revelation.  But, as it turned, paulette underestimated exactly how far I took my suicide plan.  So we both had a bad day sizing the other up.

We had to go into her office next.  I plopped back down in the chair I was in earlier.  Paulette announced, because of what I had just told her, she had a mandate to put me one-on-one with a nursing assistant 24/7 and in mandatory counseling.  If you could do more to torture a reclusive introvert, I do not know what it might be.  Nhow I was presented with the problem of whether my suicide kit would be discovered.  I might be able to weather the storm, but if it was discovered, things would probably get worse for me. 

So I gave it up.  I got up from my chair and grabbed the rollator.

 “where are you going?”  Paulette.  She sounded like she was in a near panic.  I assume she thought I would run out the front door rather than put up with a suicide watch and mandatory counseling.  It did sound tempting, but no.

“I am not going anywhere.”  I lifted up the Rollator seat and reached under the sweatshirt covering the suicide kit.   I put it on her desk.  ’I was going to asphyxiate myself just like my mother.”

She looked at the kit.  It was simply a torn, upside cup. 

 “What is this?"  she asked.
   
“Everything I need.  Well, almost everything.  I have to keep the Therabands separate since I have to use them with Lucy.”

Paulette picked up the cup.  Then she could see what looked like a candy wrapper tucked in until she pulled it out.  The thick, plastic bag fell open and the disposable razor fell out.  I actually laughed internally.  It seemed like a good idea to keep a disposable razor in the kit to tie off the bag’s drawstring because one would not be missed.  I was not supposed to have one at all, in fact.  But I was currently amused at how unnecessarily sinister it looked now. 

My amusement vanished as I saw Paulette’s face fall.   I explained everything, even going so far as to slide the cup over my nose to show how it would keep the bag from clinging.  Way too overboard, in hindsight.   My amusement further vanished when she called Dr. Hiatt right on the spot.  This was not going to go well.  

Sunday, June 29, 2014

This Mortal Coil

To sleep: perchance to dream: aye, there's the rub;
For in that sleep of death what dreams may come
When we have shuffled off this mortal coil,
Must give us pause: there's the respect
That makes calamity of so long life;
[...]Soft you now!
The fair Ophelia! Nymph, in thy orisons
Be all my sins remember'd.
--Hamlet, Act III, Scne I

“This Mortal Coil” marks the second time I have swiped a post title from Hamlet’s famous soliloquy.  Unimaginative, perhaps, but it seems so apt, it transcends accusations of lazy writing.  That is what I am telling myself, at least.  You will allow me to hold onto my delusions for yet another time, will you not, kind souls?    I promise to be more creative in the future. 
  
I had a plan to make my exit.  As I had not been sleeping well in a long time, I was generally wide awake around five every morning.  Oakhaven had moved a new roommate in  several days prior to my birthday.  He was in far worse shape than Mr. Cagle.  The staff got him out of bed and took him to the nurses’ desk every morning at around six.  From then until breakfast at about seven-thirty, I was unattended.  This was the time of shift change and tending to residents waking up.  I had my own, independent routine.  I would have plenty of time to do what I needed to do.    So I would go first thing in the morning on December 12th.
  
But I had to get through my birthday first.  I had been at oak haven a shade under five months at that point, so I had seen many residents celebrate birthdays.  Everyone is wished a happy birthday over the intercom during daily announcements every morning.  Families can do whatever they wished for their loved ones.  The more generous ones shared confections with other residents.  I got my fair share since the summer.  Those without families got balloons from the staff to commemorate the day.    I missed out on that one, probably for lack of advertising my complete abandonment by family.  What I did receive were a number of well wishes from staff along with a few residents and their families   It was all nice, but no gesture could penetrate my melancholy.
 
 But I enjoyed--if that is the word--a course correction my birthday evening.  Jackie came to visit.  She was a fulltime nurse at another hospital who filled in one or two nights a week at oak haven.  She was usually in charge of wound care.  I met her back in August when she tended to make various dressings.  She was a sweet, caring person, and we hit it off quickly.  Jackie was one of the few people to whom I felt I could talk freely, so I did.  She was the only person I told I was going to attempt calling Denise at work, knowing full well what I might find out doing so could send me spiraling.  Jackie and I enjoy an unusually strong bond for a nurse/patient relationship.
  
Jackie brought some cake pops and candy canes to celebrate my birthday.  She knew how to tickle my sweet tooth.  It immediately occurred to me the sweets would offer me an opportunity.  I could hand these out the next dayvas a belated birthday celebration.  It would give me a chance to talk to people, give them a last, happy memory of me.  Jackie and I talked for about twenty minutes before she had to leave.  I hugged he and told her I loved her for the first time.  I meant it.
  
So I altered my plan to accommodate one last tour around Oakhaven.  Now I would wait until after lunch with the cake pops and candy canes at a time when they would be inclined for dessert.  I would chit chat about my birthday, taking whatever well-wishes they had for me.  Then I would wait until supper time when staff is busy feeding the residents who cannot feed themselves.  I would have at least an hour alone.  I might even have up to three or four, if everyone assumed on the West Wing assumed I was walking around or sitting in the lobby on the other side.  Only when my tube feeding was scheduled to be connected would anyone look for me.  Assuming no one tried opening the locked bathroom door at an inconvenient time.  No plan is ever foolproof.
  
I may be a goal oriented guy, but my stonach ties up in knots whenever I approach the culmination of a goal.  These days, I am aware it is a diagnosable case of anxiety.  Back then, I just called it nerves.  My heart may have pounded from the time I popped my eyeballs open until lunch, but I never dithered over my decision.  In fact, there was a touch of bitter irony.  I turned the television on for noise that morning.  It is something I never did.  USA Network was airing one of its umpteen Law & Order; SVU marathons.  The six AM episode happened to be the one in which Marlee Matlin stars as a assisted suicide advocate who helped a woman attempt asphyxiation by a plastic bag over her head.  The plan failed, and the lady who wanted to die concocted a story about an intruder tying the bag over her head.  Matlin’s character had tie d the lady’s hands to keep her from ripping the bag off, but did not use anything to keep the bag off her nostrils.  Not the most pleasant way to go about it.  
  
I was bemused to have caught that particular episode on that particular day.  You may draw your own conclusions about any deeper meaning.
  
It is a shame the apex of a month long narrative has to be anticlimactic, but for the sake of anonymity, it does.  Oakhaven is a small place, and small places have large grapevines.  Gossip that gets out can take on a life of its own.  I have no intentions of Jane doe finding out who she is.  Aside from Dr. Hiatt, who was told under the protection of doctor/patient privilege.  Only two other people know her name.  one was told in professional capacity as evidence Jane Doe needs to remain anonymous.  The other was a trusted confidant who would never say anything to anyone regarding the issue. 
 
 I choose not to take it any further than to say who she was is more important than anything she said, though she did have the right words at the right time.    Had Jackie not given me the sweets to pass out, I might not have even encountered Jane doe that day.  Had I not chosen the day after my birthday as the day to commit suicide, I might not have had the time of past reflection of happier times jane doe inadvertently sparked.  A number of people have said God put her in my way.  I will not argue with that speculation, but the fact is, I blinked for the first time in months.  Maybe even years. 
 
 I obviously did not go through with my plan.  I was even upbeat for a day or two.  But I came back down to earth soon enough.  The urge to get rid of my suicide kit never developed.  It was still handily hidden in my Rollator.  My rollator was never too far away.  But I had a new realization--killing myself was easier to conceptualize than pull off.  But I also lacked the nerve to keep on living.  The joy I had received from Jane Doe was now a bittersweet notion the past is irretrievably gone.  Memories will only take you so far.  So what do you do when you cannot decide whether living or dying is the lesser of two evils?  I fell into an spiritual and emotional tailspin I would not be  able to hide from anyone much longer.  

Saturday, June 28, 2014

The Broken Pieces of Yesterday's Life

 I am a goal oriented person.  I need something to work towards, some kind of finishing line, to work towards.  An end point is necessary even when life is stagnant.  Maybe even more so.  As a fan of irony, setting an end point for the end point was bitterly amusing.  The day after my birthday felt like a good choice.  Either I would enjoy my birthday and go out on a high note, or I would feel as morose as on Thanksgiving, which would reinforce my decision as the right one.  So December 12th it was to be. 
  
The decision left me with fifteen days with which to wrap life up.  It turned out to be a period of reflection.  If I had one regret, it was lacking the ability to write my thoughts down so I could have kept working through them during the time period.  If I had done that, my writer’s instincts, such as they are, might have improved my spirits enough to change my mind.  As it was, memories flooded back of times good ande bad, but who could possibly hold onto all those when the mind if full of thoughts of ending everything? 
  
I thought of my mother.  How she had died, alone in an empty house.  Dead for days before anyone even knew.  I thought of how many times it seemed like it was only the two of us against the world.  The world was going to finally win.  We would both wind up alone, asphyxiated on the floor of what barely counted as home.  I thought of old friends and girlfriends who had long since moved on down the line.  What might have been if I had made stronger bonds as opposed to being my usual reclusive self?    Would anything be different?  Would anything be better?    Probably not.  Whatever will be, will be.  The ebb and flow of happy versus sad caused me to waiver, but never change my mind about my choice.  I was overwhelmed with too many burdens to carry into a rapidly diminishing future.
  
More than ever, I needed to be quietly alone in order to reflect.  I alternated between sitting outside under the carport watching traffic go by when the late fall weather cooperated and sitting in the chair between the two beds in my room.  In both instances, the Rollator with my suicide kit was right there.  Either I was sitting on it outside, or using it as a footstool in my room.  It was my personal in case of emergency, break glass escape route.  I never got too far away from it.
  
Mr. Cagle’s cancer treatments ended successfully at the beginning of December.  He was one of the fortunate few who get to leave nursing homes in order to resume their lives.  I liked him, and I was happy he could leave, but I am human.   It was not jealousy, per se.  Or maybe I am rationalizing.   I just wished I had somewhere to go, too.  But there were no options, and I did not feel in good enough shape to rebuild  my life if there were any.    Not that I did not bitterly joke about the prospect.   The day mr. Cagle was to leave, Ashley, the unit supervisor, came to wish him well.
  
“You ready to get out of here?” she asked him. 

He readily affirmed he was.  Interjected, sitting in my chair with my feet up on the Rollator, protecting my exit plan.
  
“If you can get Reese Witherspoon to marry me, I will leave, too.”
  
“If I could, I would,” Ashley laughed.
  
My darker demeanor attracted attention.  Most conspicuously was Caroline, a nursing assistant who looked after me two or three nights a week.  She would often poke her hwad in the door to ask if I was all right.  I would assure her I was fine, but she was not asking about me physically.  She wanted to know what was eating at me.  I assured her there was nothing, and she would leave me alone.  There were others, but they were wary of attempting to break through the barriers I had long put up to keep people out. 
  
I am not certain whether I was brought were brought to Paulette’s attention, or if she took the initiative herself, but she finally confronted me on December 6th about my obvious depression.  I was guarded during our conversation.  I did not need interference in the home stretch.  But I did allow I was depressed.  Denying such would have compelled Paulette to call in reinforcements.  I need not need the increased attention.    She asked me to consider talking to Michelle, the nurse practitioner, about taking antidepressants. 
  
Oh, dear.
  
I agreed to do so, but I had no intentions of taking them.  I have known people who have.  Foremost in my mind at the time was Neil, a guy I knew in college who suffered from cerebral palsy.  He took antidepressants to deal with the pain of watching everyone else enjoy the college lifestyle.  His situation was not too far removed from mine at the time.  The drugs made him act strangely.  More than mellow.  Almost ambivalent to life around him.  His results reinforced in my mind that antidepressants are more for the comfort of everyone around the user rather than the user himself.  I was not having them even if I was not planning to off myself in less than a week.
 
 I managed to weasel my way out of taking them when I talked to Michelle.  I convinced her I was simply an introvert with strong, but silent coping skills.  She accepted it, offered to help find someway of getting me a computer and even came by the next day with some very nice clothes her son had outgrown.  Denise would have said I was being manipulative, with an emotionally shallow charm bordering on the sociopath.  You may make up your own mind whether she has me pegged.  Regardless,  I avoided further interference in my plans while discovering a few good things remained.  But I cannot say the latter was enough to stop me.

Friday, June 27, 2014

Fragile

My last session with Dr. Hiatt was on November 14th, 2013. Most everyone around me was at least cautiously optimistic I now had a handle on things. The air of unease reminded me much of past experience with my mother. She would often wallow in misery while doing nothing to correct the problem making her miserable while still vaulting those around her into feeling sorry for her. As expected, the number of people around her living under those circumstances eventually dwindled to zero. People simply will not put up with someone who will not help herself. So I was faced with the choice--either shape up, or end it all. It sounds extreme, but the choice sounded logical at the time. I made what I considered a good faith effort. I had ample opportunity to lock the bathroom door and finish myself off anytime I felt like it. Mr. Cagle went home on the weekends now. I had the room to myself with staff rarely coming around considering how highly functioning I was. The temptation was ever present. One little push would have sent me tumbling into the abyss. It was simply a matter of what that push would be. I considered my suicide so inevitable, I never thought about the spiritual consequences. Taking your own life is the ultimate act of rebellion. Yet I was willing to face it in order to escape my suffering. If I feared anything, it was the physical parts of the act. Closing the bathroom door and locking it with the knowledge I will never leave the room alive. Lying on the floor knowing I will never get up again. The bag is was going to use was too thick to rip a hole in. it would also be double-tied. I knew how to stymie my limited dexterity to the point once that bag was on, no air was getting in. Even if I wanted to die, my heart still pounded at the thought. Nevertheless, I knew the end was going to come that way. It only took thirteen days to find the will. Thanksgiving rolled around on the 27th. It had been years since I celebrated the day traditionally with family. All my family was dead. Whoever these folks I was living with were, they were not family. The holidays had depressed me anyway, which probably lead to me celebrating them alone, but “celebrating” Thanksgiving in a nursing home was sinking to lower depths than even my cynical heart ever imagined. Mr. Cagle has gone home to spend thanksgiving with his family. So have a number of other residents, some with health issues one would think would make such a thing impossible. Oakhaven is running on a skeleton crew. Any of the usual hustle and bustle is non-existent with the business staff and therapy crew with their families, too. Here I am eating turkey off a hospital tray while watching a James Bond movie. Alone. You see, it is one thing to be alone. It is something else entirely to recognize you are alone. With my family long since laid to rest in Magnolia Cemetery, the recognition was acute than it had been in years. The realization this would be the way it will be for the rest of my life was terribly acute. I was going to age, alone, while a younger and younger staff enjoyed their lives and families. It would be a constant reminder of all that I missed out on while never being free of the sickness and death surrounding me. Forget merely enduring sad Thanksgiving Days. Life itself was not worth enduring. I had now been presented with the final push. It was time to go.

Tuesday, June 24, 2014

Descent

 I did not leave the room much over the next two weeks except to sit outside.  The early fall weather was more comfortable than even the late summer, so I often sat outside all day long.  People tended to keep their distance.  Visitors would often ask other residents sitting outside if I was okay.  I seemed so alone.  The residents would tell them that was the way I wanted it.  Considering a visit from a stranger was the catalyst for my current morass, who could blame me?
   
Ellen, Lesley, and Taryn visited one afternoon in the middle of October to invite me out to a buffalo wings restaurant in order to watch one of the World Series games.  It was sweet of them to offer spending one of their weeknights with me after a long workday.  While ellen was a Detroit Tigers fan--they had already been eliminated from the playoffs--Lesley and Taryn could not care less about baseball.  In fact, Taryn had once described watching the sport as less interesting than watching grass grow.  I had not left oak haven since returning from the hospital in august in spite of frequent efforts to get me to join in activities.  But I loved my girls and missed socializing with them since being released from therapy, so I happily agreed.   
   
They made a big effort to make me not feel like a nursing home resident.  We Lezley’s car rather than the activities fan.  I did not even have to take the Rollator oak haven required me to use in order to get around.  We met up with one of the nurses, Jonathan, and his wife at the restaurant.  It was a fun evening, and one I hardly pictured happening.  I never went out with Denise and her family.  My friends from college and law school were all scattered to the wind, so going out with them was impossible.  I lacked the will to go out with the 70, 80, and 90 year olds on activities now.  So life had been small for quite a while with no end in sight, save for that night.
   
Nevertheless, I remained fairly quiet.  I listened to them talk shop while constantly worrying if my general silence was mistaken for me not having a good time rather than a combination of social anxiety and melancholy over nights like this in times past when my friends and I would talk about our shared lives in school or the political trenches.  Those memories seemed like a lifetime ago.  They were inarguably  in another life never to be lived again. 
   
I did have a good time, even if my mind did seem a million miles away.    I did have my mind going in several different directions.  I was enjoying the present company, missing the old company, and trying to hide my irritation that just before we left, I had the best opportunity I had yet to grab a roll of tape sitting near the sign out book,  It would have completed my suicide kit, but ellen was standing over my shoulder, so I could not get it.  This was the first of two times Ellen would stymie me from taking an unattended roll of tape.. 
   
While all this was going on, Paulette was enjoying the ordeal of finding a counselor for me.  Most were wary of working with a 36 year old man living in a nursing home.  Surely someone fitting that description had brain damage from narcotics use or an accident and would be beyond psychiatric help.  In spite of assurances I was mentally fine aside from dealing with the abandonment of my family, the red tape simply could not be cut through.  I finally landed a private practice psychiatrist who specialized in counseling from a Christian perspective.  The arrangement was ultimately for the best. 
   
But not at first, as far as I was concerned.  I was not only on guard, but quite blazen.  I had two therapy sessions with Dr.  Hiatt.  I kept the conversation on family abandonment and future fears issues rather than my suicidal intentions.  I even carried my suicide kit hidden in the Rollator into his office on both occasions.  When Dr. Hiatt asked at the end of the second if these sessions had been helpful, I said yes and took that as a way of cutting off any further meetings. 

 It was no lie dr. Hiatt had been helpful.  He realized quickly what had dawned on me at Buffalo Wild Wings the previous week.  Life with Denise was miserable.  What I really missed was life before my health problems hit back in 2004.  Certainly, I was angry over Denise at her betrayal, but it was much like being cheated in a business deal than a familial split.  I just could not live in her house anymore.  What else had I lost?  Nothing.  Well, other than my personal property, but I will get to that particular knife between the shoulder blades later.  The takeaway for now is, if I continued to be angry at Denise, I would be giving her power over me she did not deserve to have.  I expressed the realization to all parties interested in my counseling.    It got everyone off my back like I wanted.
   
The real issue--my life was destroyed and had been for a long time--was such an insurmountable problem, I kept it to myself to avoid listening to any sort of platitudes, with good intentions though they may have been offered.  I had to solve my own problem.  It still appeared as though making a permanent exit to escape the pain was the best solution.  It was not going to take much more for me to risk discovery or failure in the process of killing myself for me to go ahead and do it.  

Monday, June 23, 2014

Quietly Making Noise

The next morning, I sat in the lobby during the early morning in order to watch the world pass.  Paulette came over to ask if I was all right.  I had declined her offer to find counseling for me the previous evening.  The thought of counseling possessed a stigma my sense of inner strength would not allow.  But when I realized that was only pride talking, I changed my mind.  I had coped with life by myself for too long.  I was not good at it anymore.  She agreed to arrange something, then left.

Shamika sat down after a while.  She had noticed my odd reaction to last night’s special delivery, so I filled her in on everything but the death wish I had confessed to Paulette.   Shamika put her arm around me and told me my sister’s loss was oak haven’s gain.  She was sincere, although I am certain she thought I would consider that the proper thing to say at the time.  She added there are some people who are just impossible to not love.  I was one of them.  Shamika was, without a doubt, sincere with that one.  Even my finely tuned skepticism could not put a dent in her words. 
  
I hit the trifecta that afternoon.  The activities director took me walking outside to talk.  She not to worry.  I would be treated like family at oak haven.  Oh, dear.   I was afraid of that might be the case. 
  
The trifecta is all I could manage that day before my luck did its usual swan dive into a pool with no water.   My roommate, John, had not said ten words to me since I moved into the room.  He laid quietly in his bed all day, only getting up to eat in the dining hall.  This was the way he liked his routine.  It was fine with me, until I discovered absolute silence after dark was another thing he demanded--or else.
  
I had not been a problem before now.  We each had our own television sets.  He never watched his.  I did not watch television much at all, and never at night.  But this happened to be the first night of the baseball playoffs.  The Tampa Bay Rays and the Texas Rangers were playing the American League’s new single game wild card.  I was not even paying the game much attention.  I was laying on the bed moping.  Around nine o’clock, John let me and everyone else in oak haven know how he felt about my television viewing.
   
“Turn that G-d d-mn thing off!” he screamed.
  
I did not even realize it was John at first.  He had been nothing but silent for three weeks.  I assumed another resident had wandered in.  there were a number of dementia sufferers who are frequent offenders of mistakenly going into other residents’ rooms believing it to be theirs, then throwing a fit when a stranger is laying in their bed.  But when I peered around the curtain, I saw no one.  So I had to ask John.
  
“Are you talking to me?”
 
 “H-ll yes, I’m talking to you!”  He was enraged, and becoming moreso as the nurses’ desk cleared and filled up our room.  “I told him to turn that G-d d-mn thing off!  I can’t rest!”
  
The nurses tried to calm him down as I first turned the volume down, then just turned the thing off altogether.  I already had more trouble than I could handle.  Digging my heels in to watch baseball was not worth it.  One of the nurses assured me I could still watch television, then told John I had the right to do so.  That turned out to be a bad move. 
  
“Then get his -ss out of here!  I never liked him no G-d d-mn way!  He makes too much noise!  We ought not even have a TV in here, anyway!” 
  
I had to sit there on my bed while he ranted about how miserable I had made him since the time I walked through the door.  He eventually calmed down, so the nurses left.  A few minutes later, the floor supervisor quietly slipped in to ask if I was okay.  I said yes just to avoid any soothing of ruffled feathers.  She left, then came back a few minutes later with another nurse.  They had decided to move me to another room that night.  So I walked to the opposite wing in my socks and pajamas while dragging the IV pole to which my feeding tube was connected.  I did not classify this as a good night.
 
 I later learned through the grapevine John suffered an aneurism nine years before .  The lingering damage caused him to fly off the handle periodically for the flimsiest of reasons.  He had a string of roommates he had run off.  As of June 2014, he has chased off three more.  No one thought to warn me John would not be a good roommate choice.  The lack of warning is particularly irritating since I moved out of my previous room specifically because my roommate there screamed at people all the time.  I would soon learn making dumb decisions while never taking responsibility when they blow up in everyone’s faces was standard operating procedure at Oakhaven.
 
 One good thing did come out of the whole room switch debacle.  My new roommate was Mr. Cagle, a nice gentlemen who was staying at Oaakhaven while undergoing cancer treatment.  He had all his marbles along with a good sense of humor.  He was good company.  The bad part--depending on your perspective--was my suicide plan had been turned upside down.  I was now in a different wing with a different staff and routine, not to mention a roommate in his right mind.  My new room had a bathroom that locked, but being caught in the act of taking my own life was again a strong possibility until I could figure out the general routine of everyone around me.  Itf it was not one thing, it was another.

Tuesday, June 17, 2014

The Shape of Things to Come

Shamika, one of my favorite nursing assistants, helped unpack the box of toiletry items.  It was incredibly large, holding enough supplies for months on end.  As of June 2014, I still have some items left to use.  Denise had definitely planned for the long haul.  I did not let on to Shamika the significance of receiving the package, but I did want Paulette to know.  I took the invoice and headed for her office. Her door was open, so I knocked on the door frame. 
 
“I have got to show you this, because you would not believe it if I just told you.” 

 I handed her the invoice.  She already suspected what it was before even looking at it.  She had seen the Federal Express truck, too, and feared the same as I did.  She looked  at the invoice anyway with bemusement.
 
“Well, if you wondered whether yesterday was a kiss off, here is undeniable proof.”  she laid the invoice on her desk and studied it for a long minute.  I assume she was buying time to figure out what to gently say to me.  She tapped the invoice with a pen she had been holding.  “This is dysfunction at its worst.” 
 
“She lied to me.  She said Tony was going to bring this stuff.  She never intended for that.  She got off the phone, went online, and ordered it instead.”
 
“She paid for overnight shipping for what would have ben a fifteen minute car trip,”  Paulette said.
 
“Maybe he refused to come.  More likely she did not say anything to him at all.  She probably does not want him to know she talked to me.”
 
“You think that’s true?”
 
He refused to allow the social worker at McLeod-Darlington to speak to her.  He told her she could deal with him.  I figured I was done for at that point.  He finally got his wish.  He had suggested assisted living for me as early as 2005 until he realized that had to be paid for out of pocket.  What is the next best thing/”
 
“This,"  Paulette said.  I nodded affirmatively.
    
“What do you think?”  I asked.
 
“Judging by my experience with this sort of thing in the past, I would think Denise is driven by guilt.  Tony seems very controlling.  What motivates control is usually fear.  My best guess would be tony resents the time Denise spent on you.” 
 
We resented each other period.  Personality clash is a kind way of describing our often passive-aggressive dealings with one another.  Although I tolerated him a heck of a lot better than he tolerated me.  I did not feel like discussing this issue further with Paulette, so I asked the question foremost on my mind.
 
“If I came in here and said I wanted to leave, can I pack my bags and go?”
 
“Yes, you signed yourself in,” Paulette said cautiously.  “But where would you go?”
 
“I am not planning to leave yet.  I just do not chase rainbows.  If denise can do anything to stop me, there is no point in me even thinking about it.”
 
“She has no control over you.  You’d have to sign a document saying you are leaving against medical advice, but that is not a big deal.”
 
I sat quietly for a moment to let it all sink in.  I immediate started to brainstorm where I could go.  I could not come up with much.  It all seemed like too much of a struggle to bother doing.  But the thought of spending the rest of my life in a nursing home was not any more pleasant.  There were no good options except one that I could see, so I blurted it out for the first time to anyone other than Denise.

 “I would really just like to die.” 
 
I do not think I could have been more blunt about the matter.  I had been thinking about it for nine years at that point.  I could not muster much emotion about it.  It was a moment of weakness that immediately caused me to go into damage control mode.  I did not want anyone interfering  with any suicide plans.   Paulette used that therapist trick of handing a tissue to keep a person from crying.  I knew how that worked, and waved her off.  I was not going to cry, anyway.
 
“You don’t have anything to look forward to?” she asked.

 “Like what?” 
 
She did not answer.  I explained to her how I had experimented with suicide methods back in 2004.  Denise had even caught me once.  I backed off because I thought my health issues would finish me off before long.  They still might.  But my patience is wearing thin.”
 
“Are you thinking about harming yourself?” 
 
“I have religious convictions against killing myself.” 
 
That was not really a lie, I rationalized.  I did have religious convictions against suicide.  Killing yourself is never an option for a Christian.  I just did not mention I was willing to ignore my conviction and off myself regardless.  The conversation was taking an uncomfortable turn.  I did not want to risk any elaboration that might lead to discovery of my intentions, so I cut things short with the declaration I needed to go somewhere and be alone for a while.

Which was not actually true.  I left paulette’s office and headed for the therapy room.  I had been released from physical and occupational therapy for three weeks at that point.  I was too physically ‘advanced” to continue.  I loved my girls Ellen, Lesley, and Taryn.  I expressed hope they would still be sociable even though they were busy all day.  Ellen had invited me to visit the therapy room anytime I wanted.  I am always apprehensive about whether people who make offers like that are being earnest in their desire or simply polite and hope I never take them up on it.   It was time to test the waters on this one. 

 It was late afternoon when I walked in, so things were slow.  The three of them happily greeted me.  I told them I needed to see a friendly face.  Lesley struck a ‘at da” pose with a huge grin.  I had to laugh.  For the first time in a while, I might add.  I went over to Ellen sitting at the desk in the corner doing paperwork.  She had been a reliable confidant in the past.  Young, but mature.   I told her the details of the last few days.

 “Denise is not coming back for me,”  I punctuated the story.

 “We are glad to have you,”  Ellen said.  She was sincere, but I was not ready to embrace Oakhaven.

Monday, June 16, 2014

Over the Edge

I can literally grieve myself sick these days with my digestive system in the shape it is in, and did so the Friday night I discovered my grandmother had died months ago with me knowing it.  The night nurse debated calling my physician for an sedative order.  I declined, but nausea medication was beyond debate.  I skipped the all night tube feeding for the first time since late may.  I mercifully fell asleep quickly.  Such a thing is highly unusual when something brutal is gnawing at me.
  
Which is how it was all day Saturday.  I laid in bed all day, drifting in and out of sleep.  I do not recall any of the dreams, but I remember waking up agitated a couple times.  It appeared both my conscious and subconscious minds were in agreement over how dire my situation truly was.  I still did not feel like getting up in ordeer to make any kind of contact with Denise, but I knew I would have to find the spark to do so to find any sense of peace.  I ate for the first time in 24 hours at supper--the diced fruit offered as dessert.
  
 I hopped out of bed the moment my tube feeding was disconnected at six am Sunday morning.  Anger probably gave me the boost I needed.  Because I did not take my cell phone with me to the emergency room back in may, I had to use the community phone in a tiny room across from the restroom I had previously chosen as my place of suicide.  That fact was not on my mind at the time.  Oakhaven is pretty much a ghost town until about seven am when the staff start getting residents up and ready for breakfast.  I had walked around this early many times before to enjoy the rare quiet.  Usually, there was no sound other than my footfalls.  But this morning, I could hear my heart pounding. 
  
 I went in the telephone room to dial Denise for the first time since my hospitalization in August.   We did not have a landline at home.  Everyone, save for six year old Jackson, had a cell phone.  I am not much of a chatter, but everyone else lived on theirs.  The rest of them will all be in the same cancer ward with brain tumors one day.  Denise being apart from her cell phone long is unthinkable.  My early attempts to call her, only to go to voice mail, had the benefit of plausible deniability.  She was recovering from surgery and was not talking to anyone.  When no one else from McLeod-Darlington or Oakhaven could do so, I became wary of trying myself.  Never had I left an actual voice mail message.  Until today.
   
I left a short, but angry message about how I need my clothes and toiletry items, that I had heard through a stranger my grandmother had died months ago, and there had to be some line of communication established because the current situation was absolutely insane.  I hung up abruptly and walked out, shaking like a life.  I do that a lot, particularly after I have gone on the offensive.  It is more a sense of anticipation of a battle I am eager to fight than fear of it.  There was obviously no way for Denise to contact me without my cell phone.  I certainly did not anticipate her showing up in response to my call.  She had not talked to anyone, anywhere in regards to me, so I figured she was not going to start now regardless of the issue at hand.  I had to bring the battle to her front door.
   
I gave her one last chance before doing anything particularly aggressive.  I called her cell phone one more time Monday morning to see if she was on the look out for me.  She was not.  So I decided to call her at work.  Why had I not done this before?  I do not know.  Fear of finding out she had returned to work from sick leave long ago and so really had abandoned me?  Probably.  Even cynics like me can cling to silly ideas in order to keep the deeply wounded idealism alive.  Unfortunately, I am in another town now.  The phone book was useless for finding the lawyer for whom Denise worked even though I was living only .  Paulette was out of her office, so I finally had to ask Brock, the administrator, if we had a phone book covering my hometown.  She found the number, but it turned out to be old.  Obstacles upon obstacles!  Finally, I just called information.  I do not know why I did not just do that in the first place.  It would have been too easy, I guess.  The phone rang twice before the secretary picked up.
  
 “Is Denise [last name] back at work yet?”  I asked.
  
 “I’ll check,“ she answered.  “Who shall I say is calling?”
   
I am not sure how long I sat there in silence processing the situation.  It probably was not anywhere near as long as it seemed.  I was asking if Denise was back from sick leave.  The secretary acted as though I was asking if Denise was back from lunch yet.  This was not going to be a good encounter.
   
“Her brother,"  I said with much irritation.
  
 Time expanded again while she was gone off to look for Denise.  She was there!  She was recovered from surgery!  She had been for who knows how long!  She had abandoned me?  What was she going to say to me?  What was I going to say to her?  None of this mattered when the secretary returned.
   
“No, she is not back yet.  Is there a number you have so she can contact you?”  the secretary asked.  I knew she was lying.  I could tell in her voice she did not want to do so.  Denise, in a panic, was forcing her. 
   
“No, I do not have my own phone.  I am in a nursing home.  How come you did not know she was back?”
   
She hung up on me. 
   
I walked out of the telephone room slowly as I absorbed it all.  I had been abandoned.  I had been abandoned for months.  I just did not want to see it.  What to do next was a mystery.  I wanted either Brock or Paulette to try calling Denise at work.  Brock stopped me on the way back to my room to ask how it went.  After I told her, she said they would send Denise a certified letter, then went back to her business.  Maybe I would have better luck with Paulette.
   
She was out to lunch at that time, so I went back to my room to brood.  I could not eat my own lunch.  I left three times to see if paulette’s door was open.  The third time was the charm, but she was not there.  It was not proper procedure, but I went in and sank in a chair to wait.  When she came in, I explained what had happened and asked if she would try calling.  She agreed.  The law firm apparently had caller ID because her call went straight to voice mail.  She left a message for Denise to call her back and hung up.
   
“What do you think?”  I sheepishly asked.  She took a deep breath.
   
“I will fight as hard as I can to preserve your relationship with your sister, but this does not look good.  She’s there.  She is deliberately avoiding us.”
   
I do not recall many specifics about the ensuing conversation.  I know we discussed the prospect of my being abandoned.  I suggested, because it sounded plausible at the time, Tony had taken the opportunity to get rid of me while Denise was recuperating from surgery.  She would have no choice but to go along with it.  He was a domineering, controlling man like that.  We talked for about ten or fifteen minutes before the phone rang.  Paulette answered, then indicated by shaking her free hand at me that it was Denise.  She asked if Denise wanted to speak to me.  She agreed.  Paulette left to give me privacy.
  
 I was not ready to fight any longer when I took the receiver.   This was the first time in months I would have an audience.  I had to make it count.  More flies with honey than vinegar.  It did not help any that Denise had actually had two surgeries.  In the second, the intubation had damaged her vocal chords.   She could barely whisper.  I may have been angry, but I was still her sympathetic brother.  Or a sucker.  You may make up your own mind.  Discuss amongst yourselves if you wish, but I would rather not know the verdict.
   
In hindsight, Denise used her favorite weapon--guilt--to get me to back off.  She explained her health issues, she explained that Kirsten had returned in July to retreive her belongings, then left for good, and that this was all extremely hard on Tony.  She claimed Tony had taken her cell phone so she could recover in peace.  He still had it, according to her.  According to Paulette’s caller ID, he did not.  I did not call her on the lie.  Maybe I should have.   When the subject turned to my grandmother’s death, she told me she knew about it, but showed no interest in how the news affected me.  It did not bother her I had heard by happenstance from a stranger.
   
 Denise never asked anything about my health.  Not about the fissure. Not about the incision.   She did not even ask who much I weighed.   When I asked when I could go home, she told me I needed healthcare, but evaded any suggestions I was better than I had been in over a year.   She did, however, reiterate that times were tough on Tony.  I got the impression she was trying to shift any blame I wanted to give off her and onto him.   She wanted to cut the conversation short, so she said Tony would bring the toiletry items by within the next day or so, that she had ordered some new clothes, and then told me if I had anything else to tell her, to leave a voice mail.  The phone call ended.
   
I could not  decipher the contradiction in that last bit.  Telling me anything I have to say will go to voice mail is saying she does not want to talk to me again.  Especially do not call her office again.  But then she said Tony would bring supplies for me, so there would be physical contact.  But she was also evasive about me going home.  It was all so overwhelming, I cried.  Paulette4 hugged me for a while before I needed to go off to be alone.
   
The next day, I was sitting outside in the late afternoon when a Federal Express truck pulled up with a large package.  I laughed to myself.  Surely that is not the stuff Denise promised Tony would bring.  But it was.  She lied to me.  She had no interest in dealing with me again on any level.  Even the biggest optimist could not deny my situation now.  I had been squarely abandoned.      

Sunday, June 15, 2014

Unfortunate Crutches and Revelations

When asked in the McLeod emergency room if there was someone who should be contacted, I gave the nurse Denise’s cell phone number.  I warned her she would probably get voice mail, but did not add that Denise had cut me and everyone taking care of me off completely for nearly three months now.  I figured if she was ever going to make contact, it would be because of an emergency hospital visit.  No such luck.  McLeod staff tried calling her for two days to no avail.  So I left McLeod with the workably final piece of my suicide puzzle and a renewed sense of my abandonment.  The combination hit me squarely between the eyes as I stood at the tenth floor window of my hospital room, surveyed the city of Florence, and realized I was waiting for an ambulance to transport me back to Oakhaven. 
   
I could have gone with everything I had with which to asphyxiate myself, but I would have more confidence using tape instead of a Theraband to seal off the bag.  So I decided to look for a chance to grab one.  In the interim, I needed to hide what I already had.  The walker I was using had a seat which lifted up to reveal a bag.  It was perfect.  I  folded up the bag and stuffed it in the cup along with the razor.  I placed them in the walker’s bag and covered it with a long sleeve shirt.  I had to keep the Therabands separately because I used them conspicuously, but otherwise, I had a handy “in case of emergency, break glass” escape route all ready to go.
   
The weekend after my hospitalization was the Labor Day holiday.   The therapy crew skipped Friday, so oak haven had a fill in come on Saturday.  I was happy to see the fill in was Tiffany.  Even though she had only been my therapist for two weeks a month prior, we had bonded.  I had explained to her my fears of abandonment back then.  Now I told her that Denise had completely ignored my hospital stay, so it was certain I had now been abandoned.    As she had been a month ago, she was very comforting, but there really was not anything she could say.  At this point, I was carrying around the means of suicide right under everyone’s noses.  I was not going to listen to anyone else.  I was going to do what I wanted in my own time without anyone interfering.
   
Something interesting happened.  Being in possession of a convenient means of killing myself gave some strength to carry on.  Surely it was an unhealthy crutch, but it kept that final push over the edge from happening.  The “comfort” it offered hid my mindset well.  No one at Oakhaven suspected a thing.  Everyone who saw me out and about thought I was adjusting well to be a nursing home resident.  I even started walking outside with a couple nursing staff members during their smoke breaks.  I still did not talk to many, but it was assumed I was slowly, but surely coming out of my shell.   
   
As summer slowly turned to fall, I began to sit outside for the first time.  Only about a third of oak haven residents are allowed outside unattended, so it was often a solitary place where I could forget that I was trapped in a nursing home with seemingly no way to leave while still alive.    I would spend the whole day out there sitting on the walker’s seat.  My escape kit was always under me.  The combination put me at much ease. 
   
I was enough at ease to dig in for the long haul.  My roommate escalated his hollering at other screaming dementia residents to the poin the got out of bed, climbed in his wheelchair, and headed to the area across from the nurses’ desk where said residents sat in order to physically threaten one of them.  The incident was the last straw for me.  I went to Paulette in order to request a room change.  I was in a new place with a new roommate that afternoon.  His name was John.  He wanted a quiet roommate just like I did.  After that first evening, he rarely ever spoke and never initiated a conversation with anyone.  It was difficult to tell he was ever in the room.  That was fine with me.  I now had the bed further from the door.  A curtain kept anyone from seeing what I was doing.  John and I were both highly functioning, so the nursing staff rarely came around.  Even better, there was a large bathroom with a locking door.  Forget that public bathroom I had chosen as the place to commit suicide.  I would never have to leave me room when the time came.
  
 I could never have predicted what happened next.  It was the first day of October.  I was sitting outside in the late afternoon when a family member of another resident recognized me.  She was the daughter of the lady who kept our church’s nursery when I was at the age to be there.  We are talking about thirty-two or thirty-three years since I had seen her.  Her daughter was my age, so there was no way I could have recognized her.  How she knew it was me is a wonder.
   
We exchanged pleasantries.  She asked what was going on with my health, so I told her.  I asked that she not tell anyone she saw me here.  She agreed to respect my wishes, but added there was no one left to tell, anyway.  I asked if that meant my estranged father was dead.  No, he was still alive.  I cautiously asked about my paternal grandmother.  She had died on June 13th.  I had been   in McLeod-Darlington at the time of her death.    I do not know if it was reasonable, but in my grief, I became enraged at Denise.   Everyone in my hometown knew my grandmother.  She had been the head teller at the largest bank in town for decades.  Everyone knew she had died.  Denise definitely knew, but I had to learn the news from a stranger.  It was the last straw.  I needed to contact Denise whether she wanted to talk to me or not.

Saturday, June 14, 2014

Silent Running

So now I had the place to do the deed, but now I needed the means to commit suicide.  My preferred method had been asphyxiation since seeing in done in the film House of Sand and Fog nine years prior.  Online research confirmed it had been accurately depicted as relatively quick at seven minutes to death and relatively painless. There were a couple problems aside from the big one of discovery before the seven minutes were up.  One was keeping the bag off the nostrils while there was still air.  A clinging bag could cause even a determined soul to panic.  The other was the automatic urge to rip off the bag when the brain realizes there is no oxygen. 
   
I knew from experimenting the first problem was a big one.  There was no point in even finding a bag to use if I could not cover my nose.  But options other than asphyxiation were limited, so I had no choice but to go with whatever I could Whenever we were given diced fruit or pudding for desert, in came in a small, clear plastic bowl with a disposable lid.    It was not deep enough to fit well over the nose, but it could balance decently enough.  When we were given drinks other than during meals, they were in plastic cups.  One of those would have worked better, but I did not have the dexterity to tear them carefully enough.   I had no scissors, either.  I was going to go w8ith the lid up until one afternoon when a nursing assistant brought me a cola in a Styrofoam cup.  Now we were talking.  I took my newfound  treasure into the bathroom.  After washing it out, I carefully tore off one side in a U-shape from the lip to halfway down.   I turn the cup upside down and slid it over my nose.  I had make a few more tears, but I eventually got it to both stay in place and cover my mouth, too.
  
The bag was more complicated than I thought.  McLeod-Darlington had placed all my belongings in a thick plastic bag with a long drawstring.  It was sitting at the top of my closet loaded with knick knacks.  I emptied it out and took it into the bathroom to blow up so I could find any holes.  Naturally, there was one.  There was a tiny tear towards the bottom.  Asphyxiation did not require complete lack of oxygen to work, I did not want to take any chances.  I looked towards the trash bags as an alternative, but they were too thin.  No matter how many I layered together, they could still be torn.  It was the McLeod-Darlington bag or nothing.
   
I needed a roll of tape to cover the hole.  I wanted one anyway in order to seal the bag off period.  I had two Therabands, which are long, stretchy bands used for exercise, given to me by the occupational therapist at McLeod-Darlington.  They were like large tourniquet’s.  If tied tight enough, one of them would cut off the air flow nicely.  But I hate being squeezed.  For me, the tourniquet is worse than the needle.  I am not even fond of having my blood pressure taken with the way the cuff squeezes.  Tape sounded like a much better idea.  So in the time I was searching around for something better to cover my nose, I was looking for a roll of tape, as well.
   
It is funny how certain things you ought not have fall into your lap at the oddest times.  During the last weekend of August, the fissure began draining.  This time, my surgical incision was fully healed, so it had nowhere to go.  An abscess the size of a golf bag sprung up on my abdomen.  That may not sound so bad, but I promise you it hurt like the Dickens.  I could not even stand up straight.  Knowing the treament would involve a surgeon, I opted to not go to my hometown hospital so I could avoid the surgeons who had been treating me prior to my “exile.”  I really did not want to mess with them.
  
 I spent five days hospitalized.  The first day was spent completely in the emergency room.   The abscess swelled to the point it split the incision back open.  It made a huge mess, but the tear allowed me to avoid a surgeon cutting the abscess open under a local anesthetic.  I was back to square one with the incision, though.  Fortunately, I was put on a better medication that kept the fissure from leaking, open incision or no.  I need four days of IV antibiotics with an additional twenty by mouth after discharge.   The relevant part to all this is that I got a new patient’s belongings bag.  This one did not have a hole in it.
   
All things considered, my hospital stay was a vacation from screaming residents and the stigma of living in a nursing home.  It reminded me of mcLeod-Darlington, which I much preferred to Oakhaven.  I did everything but prostrate myself to anyone and everyone who had the power to send me back there, but to no avail.  The general thought was a nursing home was as good a place as any, so why bother moving me?  Gee, thanks.
   
You can imagine how happy I was to return to oak haven.  Only the therapy crew could drag me out.  But now all the stuff was together.  I had a bag, a cup, a theraband, and even a disposable razor--something small that would not be missed--to tie off the bag’s drawstring for reinforcement.  I still wanted a roll of tape instead.  Now that I had a new bandage on my abdomen that needed regular changing, I was certain a nurse would make a mistake so I could get one.  So I waited.

Friday, June 13, 2014

Schemes and Explorations

 Other than going for physical and occupational therapy for about an hour and a half a day, I never left my room.  I did not want to be reminded of where I was period, much less think I might be condemned to remain here forever.  It did not help much that I was required to select a funeral home to use “just in case” during my admissions interview.  From the interview, which was conducted by the social worker, Paulette, until confirmation in early October, everyone knew there was something peculiar about the relationship with my sister.  Why did she never contact me, even when I was moved from McLeod-Darlington to Oakhaven?  Why did all our calls to her go to voicemail?  Why did she leave him with so few items with which to stay here?  No one had the nerve to actually ask, thankfully.  I was still quiet as a mouse.

Oakhaven, however, was not.  My room was close enough to the East Wing nurses’ desk the angry shouts and frightened screams of the extremely far gone dementia patients across from the desk could be heard in stereo well into the night.  My roommate suffered from dementia as well.  He would often bellow and threaten anyone who interrupted his sleep by screaming.  I was in the bed closer to the door, so he had to shout at them over me.  It made sleeping consistently through the night impossible.  He always had the heat on because of his blood pressure medication.  Add to this misery my feeding tube now being connected to an IV drip and you can guess why I was teetering closer to the edge by the day.
  
My thoughts began again to turn towards suicide.  I had not seriously considered the hands on approach in a very long time.  I had been content to allow my poor health to finish me off.  The burst diverticula the previous October seemed like a decent prospect that kept on cruelly teasing me as I languished for months withering away from weight loss.  I even thought the fissure might do it, but three months on, it was only causing a few bumps in the road.  While I would still have preferred to go home--I even tried to be sent back to McLeod-Darlington--reality was quickly sinking in.  As usual, I can only depend on myself when something needs to be done right.  For a long time, it was my mother and me against a harsh, uncaring world.  Not it was me alone. 
     
 My first obstacle was finding a place to do the deed.  I could not do anything with a private place to work.  My room was out of the question.  My bed was closest to the door, so I definitely could not lay there and do anything without someone seeing.  While my roommate slep sixteen hours a day, he was up at unpredictable times.  His mind was still good enough  he could probably recognize I was doing and call for help.  Nursing staff came in to tend to him every two hours all day and night regardless.  The bathroom was out, too.  It was little more than a cubicle with door that would not lock.  I was desperate, but undaunted.  I would simply look around for a usable option. 
  
So I started venturing out the room beyond the path to the therapy room.  Ironically, the staff was happy to see me finally getting out.  I guess they thought I was finally acclimating to nursing home life.  I confess to a certain thrill at sneaking around while quietly planning my exit.  Oakhaven was boring enough that a resident much manufacture his own fun.  Well, the 90% who did nothing but eat and sleep never worried about such frivolity, but I did.   I started sitting in the lobby a while to see how staff scurries about.  I had always eaten in my room, so the dining hall was completely unknown to me.  Finally, I began taking laps around the residents’ halls so I could check out the whole building.  It was tough going.
  
The staff covered the place pretty well at all times.  There were four showers, one on each hall, but if a nurse did not see me enter, a surveillance camera would.  I was not clear whether someone constantly watched those or viewed them after an incident, so I was not going to risk it.  Asking for clarification on the matter might have aroused suspicions.  I was aware residents had pulled shenanigans in the past, so staff was on guard for anyone who might be up to something.  I did not think anyone suspected anything about me yet.
  
The same went for the public restrooms along the hallway to the therapy room and some administrative offices.  The doors were too narrow for wheelchairs to fit in order to ensure only staff and visitors used them.  One day during physical therapy, I asked my therapist, Taryn, if I could use that men’s room during a break.  Yes, that was fine.  The walker Oakhaven made me use would not fit through the door, so I had to leave it outside.  Once inside, I noted the restroom was very large.  It also had a door that locked.  It looked like my only option.
  
Weekdays were not an option, however.  Too many staff walked by the restroom.  They would have seen the walker and knocked on the door to see if I needed help.  A locked door for a resident is highly discouraged.  Weekends were better.  The therapt room and offices were closed.  Hardly anyone walked by the door.  I even used that bathroom several times a day over a couple weekends so anyone who happened by would not think seeing my walker there was unusual.   

 The first step was out of the way.  I had the place.  Now I needed the means. 

Thursday, June 12, 2014

Six Months Ago

I took a course called Themes in American Literature during my sophomore year of college.  The chosen theme was not revealed to students until they ordered textbooks for the class weeks after registering.  It wound up being E Pluribus Unum.  It is the motto on the Seal of the United States translated to “Out of Many, One.”  so the theme was writing from the melting pot of America.  As it turned out, most of what we read could best be identified as grievance narratives.  The term sounds insulting, but the reality about grievance narratives is they sometimes how little literary merit beyond the race, ethnicity, religion, or sexual orientation of the author.    
   
Grievance narratives are just that--an author complaining about hardship while offering no explanations of how or even if the author overcame the obstacles or even hints of solutions for others facing the same issues.  They appear to largely be an exercise in self-pity and guilt trip inflicting on whoever may be causing one of these obstacles by whatever means.  Yes, they were about the worst form of political correctness I have ever encountered.  I have avoided them as desperately as paperback novels with Fabio on the cover.
 
All that said, I have been mindful of not falling into the trap of turning my personal blogging into a grievance narrative itself.  It may seem as thought I am wallowing in self-pity by the posts I have been making throughout June thus far, but the reality is that I am trying to get my issues all out there so taking about my spiritual and emotional growth will make sense without rehashing months worth of events in order for it to make sense.  I was suffering an existential crisis.  Resolving those requires many intangibles that teeter on the edge of becoming naval gazing.  Who in the world wants to read that?  Cogito Ergo Doleo is already a shameful exercise in ego I am surprised anyone cares to read.
 
So in order to throw a redemptive bone in at a good time, it was six months ago today that I planned to exit this mortal coil, but backed off after a chance encounter.  Anyone who has been reading the blog already knows this and I will still add more details as I lay out the story the rest of the month--other than the identity of Jane Doe, that is--but it should be noted said encounter was the first positive step in what was likely years to make me reconsider whether life’s struggle is worth it. 
 
Granted, that was not the corner turning event.  Truth be told, I do not know what was or--bare with me--there even was an identifiable one.  The search for it is a large part of what this blog is all about.  But at least I am exploring now for solutions rather than planning the end.  With that, I have avoided--and this is the least I have avoided, of course--turning my life into a grievance narrative.  Take that for what it is worth while I continue to bring out the turmoil for a little while longer.     

Precipice

McLeod-Darlington booted me out in a hurry.  Such an event was getting to be a frequent habit that was about to come to a dead halt.  I was extremely angry for the few minutes I was left alone while the discharge paperwork was done up and again on the van ride to Oakhaven.  I tried not to show up.  There is constant disagreement whether I wear my emotions on my sleeve.  It depends on how deliberate I am in presenting myself a certain way.  So I tried to snap out of it by the time we reached oak haven’s carport. 
  
The van driver told me to wait while he went inside to see what I was supposed to do next.  That was the time to compose myself.  He came back out a few minutes later and opened the side door. 
  
“It’s quite a hike to your room.  Someone’s bringing a wheelchair out for you.” he said.
  
“All right,” I said.  Great.  Another place that is going to stick me in a wheelchair.
  
“This does not look like a nice place,” he blurted out while wiping the summer sweat off his brow with his left arm. I blinked. 
  
“Did you say it does or does not?”
  
“Does not,” he enunciated.
 
 “Well, I am probably about to get my comeuppance.”
  
We kept quiet for a few moments until my wheelchair arrived.  It was brought out by Ellen, a tall blonde who introduced herself as the occupational therapist.  The van only had a small step between the ground and me, so the driver and Ellen had to help me down.  For whatever reason, the driver let me go before I was on the ground.  I wound up nearly putting ellen in a bear hug.  Maybe that is why she scurried off to let the driver carry me in.  Winning friends and influencing people.  That is the name of my game.
  
Oakhaven was, at first glance, everything I feared it would be.  There was a resident near the East Wing nurses’ desk screaming in terror.  We rolled passed an emaciated lady slumped over in a recliner-like rolling chair.  We had to stop so another very thin lady holding a doll and loudly talking nonsense to herself could pass.  Then the fellow handed me off to a nursing assistant and quickly left.  Suddenly, I was being driven onto a scale three separate times to make sure my weight reading was accurate.  Eighty-one pounds.  Up seven in six weeks at McLeod-Darlington. 
  
I finally got to my room and met my 79 year old roommate.  I actually had to introduce myself three times that day.  He had a short term memory of about ten minutes.  His fuse was even shorter than that.  He also had blood pressure problems, so the room always felt like a sauna.  Yes, this was not going well at all, but it was still everything I had expected.    The room became a sanctuary anyway once all the nurses, nursing assistants, and various other curiosity seekers departed.  Who could blame them for being curious?  They had heard I was 36, disabled, visually impaired, and fashioned with a colostomy and feeding tube.  They must have thought I was an invalid, but I clearly was not at first sight.  So what was my deal?
 
I could not answer that one myself.  Not that I offered up any answers  I barely talked at all and never left the room unless dragged out by the therapy crew.  Those two points collided when I met Tiffany, a fill in for who was to be my occupational therapist, Lesley.  Tiffany and I were roughly the same age and had much in common.  She was the only person with whom I bonded for a long time.  She is the only person I expressed the explicit fear I had been abandoned.  I was still in denial for the sake of my sanity.  Spending the rest of my life in a nursing home was too horrible a fate to contemplate.   When Tiffany left after two weeks, I said little to nothing about what I suspected, mostly because I was already planning suicide.  I believed I had the will, but I needed the place and the means.  Very little I experienced in those first few weeks discouraged these thoughts. 

Wednesday, June 11, 2014

"Good Riddance" is the Loudest Sound I Never Heard

I remained in the hospital another six days after that phone conversation with Denise.   Blood transfusions had given me a minor boost and antibiotics had cleared up the sepsis infection by the time the slow wheels had turned on my admission to a sister hospital.  Ironic, I know.  I will give the social worker much credit for attempting to appease me.  McLeod-Darlington was an intermediate facility rather than one for long term care.  Patients were there on rehab assignments for reasons like a broken leg with no one to take care of them at home.  I was going there to receive all night tube feedings.  It was like an IV drip, but it went in the feeding tube rather than a needle in one of my veins.  I was also going to receive physical and occupational therapy.
  
I was transferred from McLeod to McLeod-Datlington by ambulance on June 3rd, 2013.  I most certainly did not want to spend five or six weeks there, but I had crossed the Rubicon on the matter.  I received two unpleasant surprises.  One, I had a roommate.  I had not had a roommate in such close quarters since my 1997-’98 junior year at college.  The second unpleasant surprise was that he suffered from dementia and went into a near sc4eaming fit because he believed I was there to murder him.  He was relatively fine while the nurse was in the room.  So was I.  She was a cute little thing named Chappel.   She checked my heart rate and said it was elevated.  I told her it was because she was here.  We became fast buddies, especially after she moved me to a room with a more suitable roommate.
  
Denise’s surgery was the next day, so once I was settled in, I called to wish her well.  Chappel was out checking for a better roommate arrangement at the time, so denise could hear the cries of, ’Why do you want to kill me?” coming from the other side of the room.

 “Who is that?” she asked.
  
“My roommate.  His mind is bad.  He think I am going to kill him,”  I answered.

“You have a roommate?”
  
“Yep.  You owe me big time.” 
  
There was an awkward silence there for a moment.  At the time, I assumed she was trying to figure out if I was being funny or meant it.  Today, it is obvious she was actually trying to figure out how to respond considering she had no intentions of ever dealing with me again.  She solved that problem by sending all my phonecalls to voicemail.  I would guess thirteen months later, they still do.  She escalated her off the grid status by eventually ignoring any and all parties associated with my medical care.
  
Denise’s surgery was on a Wednesday.  By then, I had been moved into a private room.  Chappel was awesome, folks.  My brother-in-law, Tony, dropped by unexpectedly to bring another duffle bag full of clothes.  It was awkward, because we really do not like each other and never have.    I am certain I will elaborate on that a whole lot before all is said and done.  I treaded carefully.  I figured he was upset about Denise and Kirsten.  I also assumed he had a certain glee I would not be around for the next five or six weeks.  Or ever again, in actuality.  He never left the doorway as he tossed the duffle bag on a chair beside my bed.  He asked if I was all right.  I asked about Denise.  He said she was in pain, but otherwise okay.  He left after that.  I have not seen or heard from him, either.  At least one thing came out of all this mess.

 I would like to tell you many interesting anecdotes, but there are none to tell.  I bonded with several members of the nursing staff.  Vicki had health problems that kept her from becoming a nurse long after she earned the degree.  Whitney and her mother drop by the nursing home still and see me when visited her grandfather.  Becky threatened to get in her car and drive to the main hospital to get my lunch tray when they forgot it one day.  Everyone wanted to put weight on me, but especially her.    But I did not talk much.  I just stayed in my room, staring at the ceiling.  Staff again inquired as to why I would not watch television, but no one hassled me about it or asked if I was depressed.
  
They knew it, though.  McLeod-Darlington forced me to use a wheelchair instead of a walker to get around, so I just did not go out.  On slow days, Chappel would take me walking outside so I did not have to use a wheelchair.  They asked once if I would like to sit at the nurses’ station.  I politely decline.  Once, the physical therapist we walk outside.  I got ambushed with an activity involving potted plants that I could not refuse to participate in.  The activities director left audio books running in my room on two separate occasions.  I fell asleep both times.
  
The fourth week of June rolled around with what I thought was good news.  My insurance was not going to pay for any further rehab assignment.  I assumed this would force me to go back home.  But here is where reality sank in.  Denise would not answer her cell phone.   My cell phone was at home--or so I believed.  A landfill is more likely--with every other number on speed dial.  The social worker could not reach Denise, either, so she sent a certified letter which Tony handled.  When he called her, he said Denise was still recuperating, so I could not go home.  He suggested the original plan of a nursing home.  The social worker asked to speak to Denise, but refused, citing her convalescence.  He told her she would have to deal exclusively with him.
       
I have already mentioned Tony and I do not like each other.  He had suggested as far back as 2005 that I be placed in some sort of managed care facility rather than his house.  Denise stood in the way at the time.  His passive-aggressive contempt for me flared up often in the ensuing years.  I figured he was taking advantage of Denise being down to get rid of me.  If so, there was a faint hope Denise might stand up to him.  But I really had no idea what was going on.  All I knew is that taking up permanent residence in a nursing home was something I would have preferred to die than do.  That thought never left me.

    Neither Denise, nor tony ever contacted me.  My attempts to contact denise were futile.  They left no messages with anyone at McLeod-Darlington.  On July 19th, roughly six weeks after I arrived, I was notified by Chappel--of all people, why did it have to be her?--that I was to be transported at noon to Oakhaven Nursing Center.
  
“No one told me anything!”  I said.

 “Brenda [the social worker] didn’t tell you?”
  
“No.  No one did!”
  
Chappel tilted her head down rather than look me in the eye.  She spoke unusually softly because she knew what she was about to say was not true.  

“Hopefully, your sister will heal up fast so you can go home.”

No chance of that.

Tuesday, June 10, 2014

Fissures Both Great and Small

It felt like a short night in the ICU.  The moment I was settled into bed, I began sawing some serious logs.  The day’s events had wiped me out.  It was a Sunday morning.  Even the ICU is slow on a Sunday morning.  I was now on medication to control leakage through the fissure while being pumped full of blood, fluids, and antibiotics.  Denise came to visit in the early afternoon.  She brought a duffel bag with two changes of clothes/  Out of the blue, she said that Kirsten had packed up and left last night.  She told me with an unsettling matter of fact attitude. 
  
I asked what had happened.  Denise said Kirsten had a fight with her father and her sister.  The fight with her father I knew about.  It had happened a couple weeks prior.  Kirsten nearly took the front door off the hinges when she came home from wherever she had been with him and bawled for a solid thirty minutes.  I do not know what the argument was about, but I have heard her father scream brutal obscenities and threaten violence with her numerous times before when her bedroom was next to mine.  I have been on the receiving end of his bellowing histrionics myself and I--thank God--am not even one of his kids.  For the record, Kirsten makes three of his four children who now have nothing to do with him.  Take that for what it’s worth in judging how justified Kirsten was in leaving...  I have no desire to waste anymore time on my brother-in-law now that I no longer have to tolerate him.  Leave him for Divine justice.
  
But the argument with her older sister, Erica, I do not know.  Sometime while I was in the emergency room the previous day, Denise called Erica to come from Columbia to pick up Kirsten and her little brother and take them home.   Erica must have spent the night, because she had to be babysitting her brother while Denise was visiting me.  Their father, a state trooper, was in Myrtle Beach directing Memorial day weekend traffic.  Did the fight occur last night?  Was it the direct catalyst for Kirsten leaving?  Did the fight occur sometime prior?  If the latter, then perhaps Kirsten simply took advantage of the opportunity to leave while her parents were otherwise occupied.  Whichever the case, I thought back to the conversation Denise and I had five months before on the ri8de home from HealthSouth.  She had expressed concern then Kirsten’s father and sister would not be sympathetic to her fragile state.  Indeed, they were not.  Kirsten clearly regressed over those five months, buckling under the stress of living in that house   I was stronger, but then I believed I was going to kick the bucket sooner rather than later.  I guess we both held out for our own exits. 
  
There is no point in pondering these questions.  After dropping off some clothes and telling me about Kirsten’s departure, Denise left herself.  I have not seen her since.  I likely never will again.    I know now via Kirsten, who returned home to retrieve the rest of her belongings the following July, Denise cleaned out both our rooms in between May 26th, the last day I saw her,  and June 3rd, the day before her surgery.  Kirsten’s room was given to her brother.  Mine became storage space.  I have never been able to retreive my personal belongings because they no longer exist.
    
But I was unaware of my abandonment period, much less all the trappings, when I was moved into a regular room  on Monday.  Things were peaceful until Tuesday when Denise’s old tactic of lying to someone in a position to force me to do something in order to not get her hands dirty.  I cooperated reluctantly when she had done that with my occupational therapist months prior, but I balked when the social worker wanted me to go into a nursing home while she recuperated from surgery.  I said that was completely unnecessary and declined to cooperate.  To her credit, the social worker backed off and informed Denise of my refusal.
  
I paid dearly for that one.  I called her later that afternoon to ask why she had exaggerated my abilities to live independently yet again.  The last time, she let my objection slide.  This time, she did not.  Denise chewed me out over the burden I have been, how she had lied about my death wish, and the general irritation of dealing with my medical issues.  Nowhere among the histrionics was an acknowledgement that I lived independently, which was the social worker’s express concern. 
  
Guilt is a great weapon.  You do not even have to wield it like a master swordsman for it to work, although Denise does.  I had no desire to live in a nursing home, even for five or six weeks, but I had no choice.  I assumed Denise was under the stress of her impending surgery exacerbated by Kirsten leaving.  She was asking me a huge favor, but I agreed to do it.  I had no idea Denise was actually upset because she had already thrown all my belongings out/planned to do so and I was gumming up the works   I was na├»ve enough at the time to still trust Denise.  Not that I had any choice.  

Monday, June 9, 2014

The Distinct Sound of the Other Shoe Dropping

They say when it rains, it pours.  In my case monsoon season usually comes early and stays for a nightcap.   I had been cruising along for over two months health-wise after my tense encounter with Denise in early March.  I was still perilously thin, but not dropping weight like I had been.  I had little energy to go out and about, but I was not leaning on the walker any longer.  My progress was enough to avoid any hassle as the summer drew near.
  
But then I woke up on the morning of May 10th, 2013 to find an abscess to the left of my surgical incision.  I could barely stand up straight with the pain.  The abscess was similar to the bleeding under the skin I often suffer when bruised.  I could not imagine how one of those could blow up on the abdomen.  It must have been something else.  The abscess merited a trip to the emergency room.  The emergency room visit marked the first time since I took over the tube feedings that Denise took a more than marginal role in my healthcare.   She did not appear frustrated about the matter.  Her earlier attitude was still fresh in my mind, however.
  
The surgeon who had performed my operation in June came down to the emergency room to drain the abscess himself.  Before he could get there, the problem took care of itself.  The abscess swelled to the point it split the bottom part of my incision back open.  The abscess drained everywhere.  Yes, it was gross.  I ended up with heavy-duty antibiotics after a painful cleaning of the newly open wound.  I thought it peculiar for something like this abscess to suddenly develop, but the surgeon acted as though this sort of thing happened all the time.    His assurance was enough to convince Denise and I that we were not back at square one.  Okay.  Taking care of this newly open incision is not going to be a burden. 
 
 Every care was taken to the letter for two weeks.  I was forced to move about even more gingerly than before the abscess appeared, but other than the discomfort, nothing seemed amiss.  Not that I noticed, at any rate.  Seven months after surgery, I was still dragging.  Resignation set in that was how it was going to be.  But, hey--I still held onto the idea I would not be a whole lot longer myself.  On the morning of May 25th, it looked like I might get my wish.
 
 I woke up with my colostomy bag seeming to have leaked on the incision dressing.  It was not loose anywhere, but what else could have happened/  That is definitely not a good thing.  Neither was the fact I felt unusually cold.  I could not stop shivering as I took off the bandage and got in the shower.  I could not get the water hot enough to suit me, either.  When I got out of the shower, denise wanted to bandage the incision herself.  I obliged.  She took the opportunity to tell me a few thingts I needed to do while she would be down for her own surgery.  One was to keep my laundry separate because I was contagious.  The takeaway here is there was no plan to get rid of me on May 25th. 
  
I tried desperately not to shake while Denise redressed the incision.  I am cold natured, so neither one of us thought it was a big issue.  But then I settled down for a while.  All the sudden, a bowel movement happened again.  It was all over the bandage.  Once again, the colostomy bag was on tight.  I did not like the idea of pointing out the problem to Denise, but I had no choice.  She looked at  both the colostomy and the bandage for a long moment, then declared the bowel movement was coming from the incision itself.  The only way that is possible is if there is a hole in the colon.  Ah, so October was merely a dress rehearsal, I thought to myself.
  
Denise called the surgeon who performed both the October surgery and treated the abscess for advice.  He was the surgeon on call, but advised taking me to the next nearest hospital rather than my hometown hospital.  It sounded peculiar, but okay.  There was no one to watch my six year old nephew, so Denise had to take him and Kirsten along for the ride.  It was a darling sight, with the four of us on a thirty-five minute trip with me holding a towel across my belly to catch any accidents while the kids acted about as casually as could be.
  
When I got to the emergency room, I was immediately prepped for a CT scan.  A half dozen nurses tried to unsuccessfully draw blood.  There was even the possibility of going through the jugular before they actually got enough to run tests.   I laid there a gtood two hours shivering.  I had a bowel movement out the incision in the middle of it all.  I was curious why I was neither in pain, nor nauseous like I should be with a rupture, but was told that was because the contents of my colon had a place to go rather than remaining inside to poison me.  Ah, so I get to go peacefully.  It is about time that was a possibility.
  
The on call surgeon came in after viewing the CT scan.  He told me there was no rupture, but he would not operate on me even if there was.  I had a fissure in my colon, which is a crack caused by poor nutrition.  The contents of my colon was leaking through the fissure and out the incision.  This was also the case with the abscess, although no one looked any deeper at the time to find the root cause of that problem.  He looked at me and declared I was malnourished.  The blood tests showed I was also severely anemic--hence the shivering--    and suffering from a sepsis infection.  He wanted to know why I was not being treated by anyone for these problems before now.  Worse yet, when he called to consult my surgeon, he lied and denied sending to this hospital.  Presumably, he knew from the description  I had a serious problem and handed me off to someone else rather than deal with it himself.
  
Being dumped onto a surgeon unfamiliar with my case in the middle of a serious matter was unnecessary drama considering everything else that was going on.  I did not know what to say about the shape I was in.  I feared another confrontation with claims I was trying to comitt suicide.  I could not get another feeding tube this time to get everyone off my back.  Denise did not have anything to say, either.  I was due for some serious medical treatment.  I was even placed in the ICU after leaving the emergency room.  The next day is when things went completely off the rails.