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.