There is an older woman from India who lives in a senior building in Perth Amboy, NJ. Her name is Razia and she is very organized in how she keeps her surroundings. Razia’s home smells of lemon rinds, cardamom, and freshly baked naan. Not only is Razia’s apartment lovingly kempt, but the entire building within which she lives is stunning. It is a newly constructed edifice with huge windows, tall ceilings, dove grey walls and exquisite architecture.
As a homecare physical therapist, I have been to many senior buildings. Senior buildings are apartments for those aged over 55 years. Many of the ones I have visited have industrial brown carpeting in the hallways, broken elevators (in spite of the fact that many residents cannot climb stairs because they are older and infirm), and in one of them, the inhabitants use stolen supermarket carts to get items to and from their apartments. This makes for a traffic jam of carts between the hours of 10 am and 2 pm, as residents attempt to get belongings on and off the elevators that are actually working!
Razia’s senior building is nothing like this, however. I am glad for my patient, that she has the luxury of living her life in a placid building with sunlight in every corner of her personal and community dwelling. It was on a Wednesday that I came to see Razia and suggested that she climb a stairwell. While Razia lives in a building with two well-functioning elevators, I knew that she wanted to visit the homes of her two daughters and grandchildren, so stair-climbing was important to her future.
Razia and I entered a stairwell which led up to an atrium. There were windows which spanned the sky at the top of the stairs. I instructed her on how to use the railing and her cane and Razia did a splendid job. It was not until we both arrived at the top of the stairs that we witnessed the snow. It had come out of nowhere. Swirls of snow circled about the window. Razia neared the closest window and placed her fingers upon it. She leaned close to the glass and her elated breath fogged the space near her mouth and nose.
Earlier that day on the news, I had heard that a snow squall was on its way. I had no idea what that meant. Until I watched Razia that afternoon, who was spellbound by the rapture unfolding before her. There were blustery winds that we could not hear, every window captured a view of the heavens, it felt as though we were surrounded by snowflakes. They whirled and they encircled us.
“Do you like snow?” I asked Razia, as we stared at this blur of white energy. She shook her head no. She then whispered in reply. “But I do like this…” Razia and I were within a snow globe. This Indian woman who did not like snow was enchanted by the feeling of being in one of those magical glass knickknacks that she had likely never known as a child growing up in India. I had seen many snow globes, but they had never really charmed me, not until now. I had to peel Razia away from her snow gazing and return her to her apartment. “You should not go home yet. It may be dangerous to drive,” she cautioned. I assured her that I had another person to treat in the very same building and scurried downstairs to my next patient.
He was a round man from Puerto Rico. I entered his apartment as this man sat in his wheelchair, strumming his guitar and playing folk music. “You are playing the Musica del Campo!” I exclaimed. (This translates as the Music of the Country). Jose replied, “This is because I am from the Campo! My grandfather sang this song to me!” Behind Jose was another enormous window with snow blinding the view to the outside. I encouraged him to turn his wheelchair around to look at it. “Oh, no!” He shouted. “It is a blizzard! This is going to leave a terrible mess! I have a doctor’s appointment scheduled for tomorrow. How will I ever get to it?”
Alas, Jose was not nearly as overjoyed by the snow as me and Razia. Still, I brought out Jose’s walker as he arose from his wheelchair and stood. Jose could not yet walk after a long hospitalization which rendered him weak, but the standing was still a victory. Together we stood in front of the snowy window, as I helped Jose get up and timed his ability to stand while using his arms on his walker. After four bouts of standing, Jose was able to maintain an upright position for 70 whole seconds. I grinned at him with encouragement. It was at that very moment that the snowfall ceased. It stopped as suddenly as if an angel overhead had hit a light switch into the off position. And when the snow stopped, there was only the faintest of coating of white on the ground and rooftops, as the sun peeked through the clouds.
“How did that just happen?” Jose asked me, his eyes large and astonished. I had never seen anything like it myself. Apparently, this was not a celestial happening. It was merely a snow squall, a common weather event. However, I had been with two other people who had never seen one either; and we three happened to be safely cocooned in the perfect location when it happened. We were together in a snow globe. Safe, contented, warm and able to observe the beauty of this quirk of Mother Nature as children do.
As I left the senior building, I hurried home to take my dog Ruben to the veterinarian, located near my house in Sayreville. I had chosen a new vet because my dog was having trouble walking. His hind legs were not keeping up with him, even when I bought little traction booties to help to stabilize him (for the low, low cost of $25). Ruben’s previous vet had been fine. I just wanted a second opinion on why he had stopped walking. Was it arthritis? Did he need glucosamine for his joints? But the bigger problem I was grappling with was my own guilt; I no longer walked Ruben on a leash and simply let him outside in the fenced-in yard. Had I created laziness in my own dog? In my line of work, I tell people that they have to get up and out of bed or they will wither and die. If I allowed that for my pet, then I deserved the humiliation that I was experiencing.
The temperature was rapidly dropping. I pulled up outside this vet’s office and noticed that the walkway was covered in coral-colored salt crystals. The pattern the crystals made was winding and led up to the well-lit front door of the establishment. I picked Ruben up and carried him inside; he looked upset with me. Why had I taken him out on this night of bitter cold, his eyes asked?
I was brought into a private treatment room to wait for the new vet. He was kind of famous in town. All of my homecare patients used him for their pets. “Go to Dr. Spin,” they said. “He is the best.” After a few short minutes, Dr. Joseph Spinazzola entered the room. He had that presence of someone completely comfortable with people and animals. He reached to touch Ruben’s head and the dog bowed his head accordingly. It was in that simple exchange that I was certain that everything was going to be okay.
Throughout the process of Dr. Spin’s examination, he spoke and asked questions with the utmost of concern. He bravely opened Ruben’s mouth and placed his fingers inside to examine the teeth and gums. He listened to Ruben’s heartbeat as my dog began to wag his tail. Dr. Spin stretched Ruben’s back legs behind him individually. “If your dog had arthritis, this would hurt him. I do not think that is why Ruben stopped walking,” Dr. Spin told me.
He then waved me closer to the treatment table. “Check this out. You are a physical therapist, so this will interest you.” Dr. Spin took Ruben’s right hind paw and flipped it over, so that the upper side of the paw was now bearing weight against the table. Ruben quickly corrected the position of his paw. Yet when Dr. Spin tried this on the left, Ruben did not realize his paw was in the wrong position and it remained there.
“Your dog does not have arthritis at all,” Dr. Spin calmly informed me. “There is nerve damage on the left side. It is likely coming from a problem in Ruben’s spine. And as you know, nerve damage is irreversible.” My face fell. Dr. Spin shook his head. “Did you hear what I just said? This is not your fault. Taking him on walks would not have prevented this. Your dog is thirteen years old! The fact that he looks this good is remarkable. I just want to double check the heart medications that were prescribed by your last vet one year ago.”
Dr. Spin picked up the file that had been faxed from the previous vet. He had a perplexed look on his face as his eyes scanned the paperwork. This was followed by a sudden smile. Then, Dr. Spin calculated the dog’s weight versus how many milligrams of diuretics he should be taking. He did this all out loud! I tried to follow along with what he was saying, but it was impossible. I could, however, see small mechanical gears turning in the doctor’s head; his mind was a series of well-oiled cogwheels, it was as flawlessly smooth and orderly as that child’s toy Mouse Trap when perfectly assembled.
Dr. Spin quickly rubbed his palms together. “We are changing the dosage on your dog’s heart medications. And lucky for you, I have these same medications in the back room. I know they are not cheap. These meds were donated from the owners of previously deceased dogs, so I will not charge you for them.”
Much like his mind, Dr. Spin moved very quickly. He ran into the back of his office to secure the medications and rushed them up front so that a vet tech could measure and label them for Ruben. Dr. Spin had spent close to one hour with me and my dog. He charged only $150 and the value of the donated heart medications equaled over $200. (This vet had also shaved and cleaned out Ruben’s ears. This was an incredibly good price). But money was not my primary concern for this particular appointment.
Over two weeks have passed since the snow squall. I look at Ruben as he tries to walk on the floor. Somehow, it seems easier for him. I am finished treating Razia, as she has improved to the point where she no longer needs me. I still see Jose, and he sings the Musica del Campo. A different song each day. Some songs are about broken hearts and suffering, some are about the beautiful sunshine of the land of Puerto Rico, and none of them are about snow.
Yet Jose still talks about the snow squall. Even as a guy who is not a fan of Northeast winters, he acknowledges that there was something surreal about it. I think of that afternoon in the snow globe that we shared. I will always remember the look on Razia’s face. She had seemed so much younger during the squall. Perhaps we all had. I recall the coral salt crystals arranged in a winding path that led me to help from just the right person. Dr. Spin had been part of that glorious day. Since then, Ruben seems younger. Perhaps it is because he sensed the protection of being around someone who allowed him to feel like a puppy. Much like my experience in the snow globe of a senior building, we had all journeyed back in our lives, with the wonderment of children. All because of a sudden tornado of snow that enveloped us in deep happiness.
I have since opened the door to the main office at the entry of this senior building. I inquired about the requirements of residency there. It would be a great place to live, I figured. I would have very cool singing neighbors from Puerto Rico. But the cheerful young woman in the office informed me that I would have to be at least 55 years of age to move in, and I am too young. Now that I ponder this, it seems fair. Beautiful buildings that resemble snow globes should not be reserved for the young. Razia, Jose and Ruben the dog have earned their right to be cherished, nurtured and surrounded by brightness because of their age. We as younger caregivers have the responsibility to allow them to feel this way. It is just as Dr. Spin said: “Anything can happen. Just take Ruben home and love him.” It is reassurance that keeps those alive who can no longer walk, it keeps them singing during the storms of life and it widens their eyes to watch the snow fall, while in their eighties, as if for the very first time.
As the world prepares for the lighting of the first Hanukkah candle, I am reminded of one of my fondest relationships. I once had a Jewish husband. We were married for roughly three years. His name was Benny and he was very old. I met Benny when he was 92. At that time, I was in my late thirties.
Benny had panache. At age 92, he made advances towards every single woman in the nursing home. Most of them turned away from him in disgust. But there was something about this man that appealed to me. He was undaunted by rejection. His flair in speaking and hand gesticulations were evidence of a man who had really been somebody before dementia had set in. “Darling, you are so beautiful,” Benny declared to every woman who crossed his path. “Do you want to marry me?"
Each morning, Benny sat in the foyer of the nursing home, right at the entry. When our relationship first heated up, this guy read The New York Times. By the end, he could not read or follow what was happening on the news. That never really mattered to me. What mattered was Benny’s interest in people. He loved socializing, he loved politics. I wondered how he had come to be this ebullient person.
I learned about Benny’s past by talking to his children and other residents of the nursing home. Benny was conceived in Siberia, in the year 1919. His mother’s name was Rachel. This pregnancy of Rachel’s fell at the same time in Russia when Jewish people were being murdered by the Bolsheviks in pograms. Rachel discovered that she was pregnant with her first child and fled across the continent. She gave birth to Benny in a snowy field, and a local farmgirl came to assist her in the delivery.
Through a series of miraculous events, Rachel, her husband and their son Benny traveled through Eastern Europe and wound up on a boat headed to the Lower East Side of Manhattan. Benny had no more than a sixth-grade education. While I never knew Benny’s father’s name, I learned that he had a respiratory disorder. So, what did Benny do, as a Russian 12-year old immigrant child? He worked in a factory to support his parents and his younger siblings.
But again, how did I come to be wed to this old man, you may be wondering? Benny liked that I had a Jewish name. He began writing love letters on paper towels and left them near my computer desk. He started to tell all the staff and residents that I was going to become his wife. My coworkers rolled their eyes. His fellow residents scoffed at him. The more the others found our companionship to be ridiculous, the more I returned Benny’s affections. I took to greeting him with relish and never denied his marriage proposals. A few months later, Benny sat with The New York Timeswrapped on his lap in his wheelchair in the foyer of the nursing home. He asked why his wife was late for work (even in his confusion he had figured out that I am a late sleeper), and the staff began to play along with the delusion of our marriage. The cooking staff asked me to watch my husband eat, to ensure he was getting enough nutrition. The nurse’s aides asked me if I could help to pick out Benny’s clothes, because he refused to wear anything without his wife’s approval. The hairdresser implored, “Can you please bring your husband to the beauty salon today? He needs a haircut and will not listen to me.”
Through the three years of this delusional relationship, I tried to uncover all that I could about Benny. I spoke with his son Jeffrey, a broad-shouldered and bearded ex-hippie. Jeffrey visited the nursing home quite a bit. He was the person who explained Benny’s Jewish faith. “My Dad was involved in the Massah and Aliyah movements in the late 1940’s. These were the revolutionary groups who helped to found Zionism. My father stood on the corners of Greenwich Village and shouted to anyone who would listen about the necessity of the State of Israel for the Jews after World War II. He was a fiercely political man.”
I was spellbound. Jeffrey showed me pictures of his father Benny and his mother Sylvia meeting dignitaries by the Dead Sea in the late 1960’s. They had been tucked away in Benny’s sock drawer. “My father always wanted to move to Israel, but my mother forbade it,” Jeffrey told me. “I think that always tore at my Dad. His soul was living in Jerusalem, but the rest of his body was forced to live in Brooklyn, New York.”
As Jeffrey and I spoke of these things, Benny ate egg drop soup (his favorite), and gazed at the two of us adoringly. My husband would stop and ask his son, “Do you think I should marry Rebecca?” Jeffrey always replied, “Yes, Dad. I think Mom would approve of this girl for you.”
I guess you could say that our marriage was ephemeral. It felt like a dream. An odd dream, as Benny would show up at the rehab gym each morning and ask where his wife was. My coworkers would tell him that his wife began working at 10:30 and that I would show up later. Benny became an everyday presence in my working life, and I knelt to hug and kiss him in his wheelchair each morning. Much as one would a spouse.
Benny’s son Jeffrey had a daughter who was getting married. It was important to Jeffrey that Benny attended his grand-daughter’s wedding. But Jeffrey also knew that Benny did little without me. I was invited to a large and beautiful event in August with Benny as my date. I had gotten a spray-tan and a fancy updo so that I looked as elegant as Benny in his suit. As we entered the venue, and I pushed him in his wheelchair, I was not blind to all the snickering and nudging of the other wedding attendants. While I cut up Benny’s steak that evening, it was clear what everybody was thinking. They believed I was some sort of Anna Nicole Smith, who was after Benny’s money. The truth was that Benny had no money. Jeffrey had filed a Medicaid application for his father years ago. Benny had a great time that night, however. He danced in his wheelchair to the Hava Nagila. He became confused at times and asked where we were. I simply reached for his hand and he resumed smiling and laughing.
There were afternoons when he would be sitting in the Day Room and suddenly place his forehead on the table in front of him. Benny could be heard shouting: “I am dying! Someone please help me! I cannot even pick my head up off this table! Please help me!” Ten minutes later, Benny would promptly sit up and wheel himself back to his bedroom. (These were the moments when I giggled uncontrollably; I wept with laughter and tears of mirth fell down my cheeks. Benny’s theatrical flair and determination to get the attention he deserved were what I loved most about him. Yet all the while, I knew what was coming. Benny would leave us soon).
When the last few weeks of his death were approaching, Benny no longer wheeled himself around. He no longer looked for his wife. Instead, I sat next to him and held his hand. For a short man, he had enormous hands. He looked up at me and said, “I love you, Rebecca-la. I am so glad we got married.”
Benny kept lingering. His family began to take vigil in Benny’s room and I was reluctant to go inside. While his family was grateful for the succor I had given their father and grandfather in his later years, it was most embarrassing when Benny’s eyes flew open when I entered the room and he stated, “Here she is! I love her!” I stayed away from that entire hallway of the nursing home during those days.
Each night I went home and wondered why Benny was still alive. What was he hanging on for, exactly? But he kept on living, and his children and grandchildren sat around him in a watchful throng.
It was not until February 29th, leap year day, the day that only happens every four years, when Benny drew his last breath. It was true that everything about Benny’s life was remarkable. He had been born under great peril in a snowy field in Siberia. He had fought without tiring for the establishment of Israel as a haven for Jewish people after the war. Benny was a man who had controlled his environment as best as he could. Despite the many obstacles in his path, Benny had great willpower. He had worked since the sixth grade to support his family of origin, he had opened a dry-cleaning business in adulthood to ensure the well-being of his wife and kids, and he had traveled to Israel several times to see the land he had helped to secure for his fellow Jewish people. In his last years, Benny wed a much younger woman. While most people dwindle and weaken like brown flowers without water in a nursing home, Benny had thrived.
I went to Benny’s funeral. I heard his son Jeffrey speak about Benny’s views on religion: “Man created God, not the other way around.” Benny had not been a believer in the spiritual aspect of Judaism, even though he went to Temple and celebrated all the Jewish holidays. No, Benny was a believer in fighting for his heritage. He fought for his roots in Russia, when Bolsheviks were attempting to kill his people. He fought for Israel, for Zionism. There were many days when I drove home from working in that nursing home and I felt more secure about the world. This was because of Benny. Benny did not espouse the idea of miracles or God’s direction for our lives. Rather, he believed in the individual’s ability to alter the world through his or her own will, intellect, politics, actions and fighting for the good. It seemed to be no mistake that Benny willed his own death on the most remarkable day on the calendar, February 29th.
I know that Benny decided on the moment of his own death. His son Jeffrey knew it also. I was thrilled to see Jeffrey a few weeks after Benny’s death, when he dropped off sandwiches for the staff in thanks for all they had done. “Just so you know, everyone knows it was you who kept my father alive for the last three years. You did a great job as his wife. You also made one hell of a step-mother…"
I believe that I was a good wife to Benny, in our bizarre and complicated romance. But I do not think that I kept Benny alive for as long as he lived. If anything, I believe the opposite to be true. I was working in one of the hardest environments possible. I wept frequently, could not sleep many nights and felt purposeless in performing my job duties at the nursing home. It had been this short Jewish guy who greeted me at the sliding glass doors each morning who helped me to keep living. He showed me that we cannot always look for miracles; we must look for ways where we can summon the strength in our souls to create a world that we want to see, for ourselves and those that we love.
I will light a candle for Hanukkah this year. I will light it for my Jewish husband, even though he would find that unnecessary. Maybe I should get one of those old-fashioned matchboxes, the kind with the very sturdy sticks. Yes, I will quickly strike the colored tip of the wooden match along the phosphorus surface of the box and watch the flame suddenly come to life. I will listen for the electrical crackle that happens in that instant. I won’t await a miracle. Instead, I will act and fight and choose my life and my (hopefully distant) death as well as I possibly can. Just as my Jewish husband did.
Some things in life are easy to describe. I have a friend named Jessie. We have worked together for years. At first, it was at a physical therapy clinic in New Jersey. Jessie ran the front desk and made sure that the scheduling and insurance authorization ran smoothly. I later convinced Jessie to apply for a job in the nursing home wherein I worked. The nursing home was a slipshod organization; I was not sure if Jessie wanted this job, but I felt that I needed her. The nursing home needed her more. When Jessie accepted this position, everything changed in that place.
Jessie’s job description was to coordinate the care of the elderly for their rehabilitation needs. Not only did Jessie perform these requisite duties, she also adored the residents of the nursing home. When dropping off printed information to each of the four nursing stations at this place, she was found helping residents getting dressed, she lifted them on and off toilets, and she pushed patients in their wheelchairs to her desk and talked to them while she did her computer work. These qualities in a person like Jessie are easy to write about.
This day was somewhat different from the other days that we worked at the nursing home. This day is harder to describe. The patients had awakened earlier, even the ones with dementia. It was as though they knew that something unusual was happening. The nurses were taking extra time with dressing and grooming the residents. By 9 am that morning, the residents had a look of thrilled anticipation, as they sat in circles in their wheelchairs.
It was around that time, in late morning, that droves of families entered the building. Jessie and I had never witnessed this before. People pulled up in SUV’s and carried trays of turkey, mashed potatoes, pumpkin pies, yam casseroles and they set up their Thanksgiving meals in the Dining Hall of the nursing home. As a staff, we had never before seen such attention paid to the residents.
Jessie is an avid football fan, but primarily of the New York Giants. She rushed around to each of the four wings of the nursing home and ensured that football was on every television. We brought the patients to the rehab gym and blasted Chubby Checker, while they walked and exercised and their families watched in awe. Jessie and I ate a Thanksgiving meal made by the cooking staff, after we were finished taking care of everyone.
That was year one of our Thanksgiving tradition. Jessie and I worked together on this day for the next two years. We grew to look forward to it. There were great-grandmothers who held infant relatives for the first time. Toddlers wandered down hallways and banged into wheelchairs, they were picked up and consoled. Middle-aged men shouted against referee calls in football. The cooking staff of the nursing home took great pride in their green bean casserole recipe. Families offered their food to other residents and brought the food to their tables (for residents who had no family at all to visit).
This next part of this story is even more difficult to describe. It was after our third Thanksgiving together that Jessie was involved in a motor vehicle accident. One of the vertebrae in her neck was shattered. Thereafter, everyone in the nursing home asked how she was doing. I never answered them, because I did not know how she was doing. Nobody knew. Not even the doctors.
Jessie had become paralyzed and could no longer walk. She needs a wheelchair to get around now. Jessie also needs a caregiver to address her physical needs. This came as a shock, as this is the same woman who helped others to address theirs. Jessie used to help diaper people. This was never her job. But she did it anyway, because she has a fiery heart and refuses to allow others to ask for help. She just gives it, without question.
Jessie lives a few hours away in Pennsylvania. I think about the losses that we have sustained. We have lost most of the elderly patients we cared for. Jessie has lost her ability to walk. It seems all too easy to fixate on these very hard realities. And these things are quite real; they cannot be reversed. Just as the old people in nursing homes without families cannot be soothed by some green bean casserole made by the staff.
But here is the thing that sustains the holiday of Thanksgiving: there are families who welcome the ones without families to their tables. The clamor of the preparation and dressing of the elderly in their finest clothing for this holiday is important. When Jessie changed the channel of the televisions so that our patients could watch football, she changed everything. Jessie created a holiday, in a place known for a lack of celebration. I will be with my family this Thanksgiving, and Jessie will be with hers.
I miss my nursing home Thanksgivings with Jessie. I miss the woman who made a festival out of nothing at all. When I smell turkey, I remember Jessie hurrying around to push patients in their wheelchairs, so that they could find a piece of joy. Jessie made everyone feel like family. While the New York Giants may not be doing their best lately, I thank the Master of the Universe for football, for crying toddlers who crash into wheelchairs, for the very old people who teach us everything we need to know, and for the Jessies of the world.