I like living with Freddy. When I was a younger pup, I used to sit in his living room and wait for him to come home. Freddy worked a lot back then. He left me alone each morning, but I kept myself busy. He bought me a black leather sofa and the sun streamed through the windows of the living room. There were little specks of dust in the sunshine and I used to leap up to catch them in my mouth. I can’t jump anymore, because I am twelve years old. But I remember when I could. Freddy had a black box and out of it came vibrations that soothed me while he was gone. He called it “spa music” and he turned it on before leaving each morning. After the sun went down and there were no more specks in the sun to catch, I waited by the door for Freddy to come back. It was that time of day when I knew how much he needed me. He crouched down and kissed my head and told me that I was the best girl ever.
The years flew by. I began to get some pain in my hind legs. Freddy was going to get me surgery on something called my “ACL” but I got so angry in the surgeon’s office that he decided against it. I learned how to keep walking on my back legs, but my left one hurt a lot when it rained or snowed. Freddy brought me to a very kind doctor (a man, thank goodness), who gave me little white pills in a beef flavored snack. This helped my pain and I was still able to climb stairs for a long time. Then, things started to change. I got nervous when Freddy began putting all our things into boxes. He even got rid of my black leather sofa. I became quite angry with him. I turned my butt in his direction while more and more items left our home. But every night I forgot to be angry when Freddy lifted me up on his bed. The woman with the pale hair was also with us. This woman seemed less sad than she used to be. Both Freddy and the woman talked about a place called Florida. Were we going someplace else? Why hadn’t they consulted me? I didn’t want to go to Florida! One day, Freddy lifted me into his truck. I like rides. But this one felt different. Freddy sat in the front of the truck and held a round wheel. The woman with the pale hair sat next to him. I sat in the back seat and felt very confused. This trip was taking a very long time. I began to notice the vibration of the truck. I didn’t like it. My back legs started hurting. I began to gasp from the pain and Freddy stopped the truck and gave me the white pills in the beef flavored snack. He even put on the “spa music” because he knew I liked it.  The trip continued. Freddy pulled the truck over. He knew not to bring me into a motel. I hate motels. The carpets and the sheets smell like strong chemicals. This makes it so I cannot breathe right. We stayed in Freddy’s truck and there were lights overhead. Next to us were other long trucks. The air was hot. Freddy played the “spa music” as we all tried to sleep. But I couldn’t sleep. The woman with the pale hair couldn’t either. She looked back at me every so often. She was worried about something big. Freddy woke up and the vibration of his truck started again. The trip wouldn’t end. It was taking too long. I started to have more pain in my legs and couldn’t breathe. Freddy kept stopping and putting me on the ground but it smelled totally different. There was mold everywhere. There were different plants on the ground. I kept hearing the word Florida and knew that we were here. But if we were here, why did we have to get back in the truck to keep traveling? And what did Freddy and the woman like about Florida? I was feeling worse with each moment. Why couldn’t we all go back to the black leather sofa with the specks inside the sunshine through the window? It was then that I peed all over Freddy’s truck.
My legs no longer hurt me. My body settled into the black leather like the shape my body had made in the sofa from Freddy’s house. I no longer minded the idea of Florida at all! This was a beautiful place…except that Freddy wasn’t part of what was happening now. He wasn’t part of the sunshine and the specks of dust. He couldn’t see that I could jump again.
I didn’t know what to do. I had to make a choice. I’ve always put Freddy first, always taken care of him and have always been his best girl. How could I possibly leave him alone? What would he do without me? I tried to focus on the hurt in my legs and my difficulty breathing, but I knew I couldn’t stay with him. I remembered the smell of my father when I was a pup. I remembered going to Freddy’s house for the first time. And then I knew what to do. I nuzzled my snout against the elbow of the woman with the pale hair. I spoke quietly, so that only she could hear me. “Tell Freddy that I have to go someplace now. I wish I didn’t have to. He isn’t going to do well without me. But you know how to take care of him like I do. I want you to tell him I am worth crying for, and he will cry every day for a really long time. Also, I don’t like girls, but you’ll do in this case.” The woman nodded. She placed her hand on the top of my head and I closed my eyes. I let out a very long sigh. The Florida sky led me right to where I am going to stay forever. I’ll be waiting at Freddy’s door.
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It was twelve years ago when I was working in a physical therapy clinic and met a woman named Joan. She was coming for treatment because she had received surgery to her spine for lumbar stenosis. Joan was accompanied by her daughter, Elisa, and this duo of women was extremely entertaining. We laughed so hard during our first few sessions together that after the third session, Joan’s daughter Elisa asked, “Can we be friends?” It was an unusual question posed by one adult to another. Grown-ups speak in the world of nuance. When adults meet like-minded souls, they find ways to keep the connection going via joint activities of their children or following each other on social media. Yet Elisa, the daughter of my patient Joan, had cut right to the chase. Much like children do. She asked me directly if she could be my friend and if I could be hers. I responded to Elisa back then by telling her, “I’m kind of short on friends right now. Yes, we can be friends.” Fast forward many years later to the present. Elisa and I are roommates and best friends. Her mother Joan died several years ago, and I have become so close to the family that I mourned her death just as much as her own daughter did. Elisa was a superb caregiver for her mother and I helped as much as I could to ease the burden for both women. It is hard to watch loved ones lose their memories, their ability to care for themselves. Yet somehow, and with unwavering bravery, Elisa watched her mother’s decline until her heart stopped beating. It wasn’t until the year of 2020 that I needed a caregiver for myself. I was living with terrible low back pain and discovered that I required a lumbar surgery with screws and rods. I didn’t want to hear this news; but it was Elisa, my best friend, who pushed me to pursue it. This surgery was accompanied by a three-month recovery period, where the patient (me), would be unable to bend at the waist, twist the spine, or lift any object greater than 10 pounds. That sounded impossible to me. How many times does anyone bend at the waist to reach for an object during a given day? How often do we twist our spines to reach for cell phone in our purses? Elisa dropped me off for my surgery on a frosty morning in December. I tried not to look at her as I got out of the car, for I knew how concerned she was. I was going to do this alone and I didn’t want to put my fear upon anyone else. Little did I know what I was up against. Anyone who has gone through major surgery knows just how awfully vulnerable it feels to be naked in a hospital gown, awaiting anesthesia and the deep sleep which precedes what is a violent assault to the human body. I spent three nights in the hospital. Elisa came to visit on the second afternoon, bearing chicken shawarma from a local Middle Eastern venue. I didn’t eat the food, because my pain was rising to an astonishing degree. I saw visions of Dante’s Inferno, the fiery depths of hell, as I prayed for relief from what is commonly referred to as “post-surgical pain”. It finally stopped, this hellacious discomfort, and I was able to go home.
For several weeks thereafter, I was unable to dress, turn on the water for a shower or prepare meals for myself. Elisa was the person who adjusted the water temperature so that I wouldn’t have to bend down to get to the faucets in the bathtub. Elisa was the person who made absurd amounts of food for me to eat (though because she is Italian, and she never thought the portions and variety of the food to be absurd), she made sure that the food was always on the top shelf of the refrigerator so that I could reach it, and she placed everything that I needed during the day on a small table with wheels so that I wouldn’t bend or twist my spine. Laverne the dog watched over me like a lioness. I was her cub, I was weak and I needed the care of a child. It was a very strange time. I have been a caregiver for my entire life. And at age 45, I needed to be cared for. It felt demoralizing. I couldn’t don pants or socks by myself, and it was a cold winter. I remember asking Elisa, the human, if she could help me change clothing before she left the house for a few hours. “Do you have time to change me?” I requested. Elisa laughed and replied, “Of course!” She then returned me to the sofa and the dog Laverne nestled her body close to me, though as never to cause pain.  Something strange occurred as time passed and Old Man Winter unfurled his steely presence in the Northeast. About one month after my surgery, my mind began to go down different paths. These were imaginary foothills, remarkable lands that I hadn’t traversed since childhood. I spent hours day dreaming, I stared at the falling snow, the grey skies shape shifted like the fingers of God in soft putty.
Elisa continued to care for me, with unerring grace and hilarity. She never missed a beat. Even when I was ornery and obnoxious, she made chicken seared in oil with garlic and hot sauce, she laundered my clothing and cleaned the house to spotlessness, and she made certain that I would not bend down to set the water temperature in the shower. (Even when I wanted to and told her that I was bending down correctly, that I am a physical therapist who knows what she is doing and that I do not need help from her anymore!). What I realized through the time of being on the flip side of caregiving is that it is really quite illuminating. It can return the patient to feeling like a child, in all of the wonderful ways that we associate with childhood. A child does not have to plan meals, or shop for the ingredients of food. The child is simply fed lunch. Whether it is delicious or not (mine always is), the lunch is the lunch. The adult must plan accordingly to make this happen. The child simply eats the food. When the snow falls outside, the adult must shovel, buy salt for the steps and ensure that everything is in the house in case of a blizzard. The child has none of these concerns. The child sees only the magic of snowfall, the anticipation of a day off of school and the potential for igloo or snowperson building. In some ways, it is really nice to be a child. It is even nicer to experience this as a 45-year-old adult. I was afforded this because of my caregivers. Elisa provided a safe haven for my recovery in terms of doing basic life tasks for me. The dog Laverne sensed my weakness and gave to me what makes dogs famous, their ability to look within humans and say, in no uncertain terms, “I love you. I will not allow anything to harm you. I will do anything to help you feel better.” In all of my years of caring for others, it has taken this surgery to show me what caring for others really means. To be a caregiver means that you will buy groceries when you are tired and have worked all day, you will prepare food for someone when they are not always appreciative, you will put pants on someone when they are moaning in pain, you will shovel snow in biting cold while the person you are caring for is marveling at the wonder of snow, and you will have to plan your entire day around that person’s shower. And that is impossibly annoying! Yet as a caregiver, you are also doing something amazing. You are allowing the person whom you are caring for to return to childhood. I am now able to dress and bathe myself, though I still don’t like grocery shopping or cooking. Elisa the human still does an excellent job taking care of the household and I can pull my weight. Laverne the dog knows that I am stronger, though she still glances at me with concern when I overdo things. I have very little pain after my surgery. What has remained is a sense of childhood wonder and excitement. Witnessing the changing of the seasons is nothing short of miraculous. A well-prepared hot meal is delightful. Spending time with animals is enchanting. As is the thrill of asking another person what Elisa asked me years ago: “Can we be friends?” Meet Mary. She is an 88-year-old woman who lives in New Jersey. I met Mary several months ago, when she had just returned from the hospital and needed homecare physical therapy. Her legs were quite weak and upon our first meeting, Mary could not get out of bed by herself. Yet there was nothing weakened about Mary’s will nor her humorous personality.
Mary has three grown children and lives with her one daughter, Denise. Denise is a retired flight attendant and it is obvious how good she must have been in that professional role. Denise never sits still, she flits around the house, changing bed linens, organizing food in the pantry, hanging new drapes to allow the sunlight to filter through windows in just the right way, and lighting candles for ambiance and aromatherapy. Denise is a superb caregiver who takes her responsibility of surrounding her loved ones with beauty to an entirely new level. Mary often gets annoyed with her daughter Denise, however. And despite their brief tangles which often end up in teasing a few minutes later, they have coined an expression as to why their life situation is very so common. “My Mama needs to understand that she is now at the time in her life for ‘the changing of the guard’, as I like to say,” Denise explains. “She used to take care of me when I was a toddler or did stupid things as a teenager. Now, it is time for me to take care of her. My Mama doesn’t like this shift, but she has no choice in the matter.” Mary responds to this while shaking her head. “It’s true,” Mary concedes. “I have to put up with the ‘changing of the guard’ and it truly is difficult having a person who you once put diapers on telling you what to do!” Mary copes with this transition by being a person of great faith. She reads the Bible and is part of an enormous prayer group who speaks daily to each other on the phone. Mary makes long lists of people in need of prayer. “I have some pull with God,” she assures me. “My prayer group gets results!” Mary was progressing quite well during her treatment in physical therapy. Yet she was still unable to walk to the bathroom so that she could get into the bathtub. And this was no ordinary bathtub! Mary’s daughter Denise has been known to be very extravagant with her mother. Denise bought Mary a black shining Audi a few years ago. Even though Mary can no longer drive, that black Audi sits in the driveway, waxed and gleaming, as a reminder of her daughter’s generosity. And the bathtub? It is one of those walk-in versions with the upright seat and a door that closes so that the person inside can have the experience of being immersed in water without having to lie down in a traditional tub (which many older people cannot do). Mary had a lot of trepidation, not just regarding walking to the bathroom and negotiating the different thresholds on the floor, from hardwood to tile, but she was especially fearful about getting in and out of this fancy bathtub. She refused to attempt this activity with her daughter Denise, knowing that it would wind up in a skirmish between patient and caregiver. So, Mary and I walked together to the bathroom and she got into the tub. She admitted later that it was easier than she thought it would be. Denise then came into the bathroom to turn on the faucets and fill the tub with water for her mother. The retired flight attendant added bubbles and bath oil to the water and turned on the jets to circulate it. Multicolored lights illuminated the base of the tub. There was even a music feature on this bathtub! Yes, smooth jazz filled the air and Denise lit candles and placed them on the sink, before exiting the room and leaving her mother to bathe. I remained in that bathroom with Mary; it wasn’t long before her face relaxed into great joy and she inhaled deeply and washed herself with a face cloth. “I haven’t had an actual bath in seven months! This feels glorious. God is washing me clean and I thank Him for his blessings upon me right now.” There was something transformative about that bath for Mary. After drying herself off and donning a freshly laundered housecoat, she returned to the recliner in her bedroom. Mary called for her daughter Denise. Denise entered the room of her mother. “I am going to need you to bring me the letters that I have been working on for my prisoners,” Mary declared. I knew that Mary was fond of writing to people in the prison system to help them understand the word of God. But she hadn’t done this in a while, perhaps because she had been feeling so low about her inability to care for herself. Denise was in a hurry, as usual, and told her Mama that the writing would have to wait, because Denise would have to look through the closet for the letters and she simply didn’t have the time in that moment. Mary pulled a small table close to her, picked up a pen and put on her reading glasses. And with that small series of acts, Denise dropped her dusting rag, brought out a step stool, got into the closet and found the letters to the prisoners. Something strange was occurring. In the silence of that room, the ‘changing of the guard’ had been reversed. Mary was once again the mother, the matriarch, the queen of her castle. And Denise had returned to being a daughter, to listening and obeying her mother, much like a young supplicant child would. Was it the bath that had changed the dynamic? My suspicion on this is that Mary was finally able to conquer her fear of getting into the tub, but the power of cleanliness cannot be discounted either. The occasion of the transformative bath was three months ago. I now consider Mary and Denise to be family. Family that I really came to need because of something that was happening in my own life. Through the course of working as a physical therapist for over two decades, I began to notice low back pain. It used to be transient, but during the past summer and fall, the pain became constant. I tried to ignore it, but my Primary Care Physician insisted that I get an MRI of the spine. I thought little of this and kept working through the pain. Yet when the radiologist emailed me the MRI results, I was shocked to discover the damage revealed on the imaging. I recall my fingers trembling as I held my phone while reading these words. I told Mary about the MRI. She often witnessed me wince in pain as I bent over to put on her socks during her physical therapy treatment. Mary’s motherly role was now turned in my direction. “You need to follow up with a specialist and see what can be done. You are too young to live this way. And stop putting on my damn socks! I can have Denise or my grandchildren do it.” Through much searching, I found a spine specialist in Manhattan. He is something of a genius, though he is Asian and very modest, so he doesn’t acknowledge this about himself. This surgeon wants to perform a spinal fusion on my lowest lumbar vertebrae. He will implant two screws on either side and within three months, bone will grow around the screws and stabilize this unsteady segment of my spine, which had been causing all the pain. He told me that there is no alternative to surgery; that my spine would simply get worse if I continued to ignore this problem. Through the fear of this news and the upcoming surgery, I have had Mother Mary to counsel me. “You will finally be on the flip side of the coin of caregiving,” she says. “I was a nurse, so I am a very bad patient. Most people in the healthcare setting are because they think they know better. I believe the same will be true for you.” Yes, this was something I was ALL too familiar with! I used to visit my Primary Care Physician with my list of symptoms, develop my own diagnosis and suggest the proper plan of care and medication for treatment. It was very humbling to be told by her that “this isn’t the way the practice of medicine works, my dear. I am the physician and I will decide what you need.”
I must admit that despite my great confidence in the Asian surgeon and the research I have seen which correlates very positive long-term outcomes associated with the procedure I will be undergoing, I am quite scared about the prospect of lumbar surgery. I feel guilty about having lifted so many people out of bed during my career, without ever asking for help or realizing my body’s limitations. But then I stop and remind myself that this could have happened if I were a farmer’s wife in the 1800’s, from gardening, chopping wood, and working the land. This can happen to anyone with a job in manual labor.
I am relieved that I am lucky enough to have found this great surgeon and that I have Mary to assist me in the ‘changing of the guard’. She tells me, “Luck ain’t got nothing to do with it. It was God that made this happen. I will be praying for you. I am going to need your surgeon’s full name, so I can pray for him and his scalpel. I will pray for a sanitized Operating Room, so there will be no risk of infection. My entire prayer group has got you. And as you might remember, we have a lot of pull with God.” As I anticipate this next season of my life and what it will resemble, I hold onto the image of Mary taking her bath. The colored lights and the rising bubbles of the water from the jets. The smooth jazz music. The lit candles that smelled of peaches and cream. Mostly, I will recall the look on Mary’s face during that bath. The bath that changed her and gave her back her freedom. The moment when Denise searched for the letters to the prisoners after Mary was fresh and clean and ready to face the world once more. I know I will one day return to my previous health and strength. How could I not? I have the backing of Mother Mary and her entire prayer group. The ‘changing of the guard’ will happen and I will get through it. But what makes Mary’s prayers even more remarkable is that she will call upon God to help the people who will be taking care of me. There will be many of them and they will be dealing with a very bull-headed physical therapist who will be itching to have things done her own way. “Oh, my baby,” Mary exclaims. “Those people need my prayers most of all. Your caregivers will have their work cut out for them!” Indeed, they will. |
