Tuesday morning is trash day, and as I went to bring my cans in from the curb, I noticed John sitting on an old chair in his garage. His head was bent so far forward that it nearly rested on his folded arms that laid across his knees. Watching him for what seemed like minutes; he never flinched. John is ninety years old, and sitting in the 100 degree Florida heat inside an open garage, well, I feared the worst, but the fact that he was still in the chair was a positive indicator.
Watching him steadily, I crossed the street at a quick pace on the chance that he might begin to fall, honestly thinking him to be unconscious and not permitting my mind to believe otherwise. I decided I would pull his cans back to his garage on the chance that he simply dozed off and would stir when he heard my approach. Having, many years ago, discovered my mother deceased while sitting on a toilet, it gave me chills to even think of again reliving such a scenario with John, even if he is only a neighbor. Still, if he was breathing, it was indiscernible through distance that separated us.
At the end of his driveway I took hold of his trash can and recycle bin, and began dragging them noisily toward the garage, still no movement or other indication of life. However, as I set the cans inside the garage and walked towards him, I realized he was not wearing his hearing aides and simply may not have heard me.
“Hello John,” I said in a very loud voice, and was much relieved when he attempted to lift his head to see who was talking to him.
Sitting in the position he held for so long, he seemed unable to muster enough strength to straighten himself. Not to mention that doing so most likely meant enduring a good deal of pain due to his deteriorating spine. He finally just twisted his head to the side so that I could see his eyes as I bent low to speak to him.
To lend credence to his superiority through age; although I’m in my late sixties, John considers me to be a youngster by comparison. So, when he speaks to me he addresses me as Jimmy.
“Hey, Jimmy,” he said breathlessly. “Thank you, Jimmy! Thank you!”
His voice sounded even more weak and frail than his body looks, but at least he recognized me. I stood there next to him as he attempted to rise up again, like the phoenix rising from the ashes.
As he gather his strength and pushed through the pain, his head raised slowly and he continued saying,
“I was trying to get up enough energy to go bring those damned things in by myself, but my god damned legs are too weak! I’m jes gettin to damned old, Jimmy! I need a new body!” Moving his arms slowly away from his legs, I could see the deep depression left on his thighs where his elbows pressed into them.
“No worries, buddy,” I said, “I completely understand.” I waited another little while until he could finally straighten his back and bring his head upright. “Is there anything I can do to help you,” I asked him. “Are you alright now?” My voice was so loud I feared I might be disturbing the other neighbors.
His skin is as translucent as wax paper, and despite the garage sweltering as it was, he didn’t have a drop of perspiration on him anywhere. I looked around for any sign of a water bottle or other drink, but there was no indication of anything.
“Hey buddy, I think you need to go inside and drink some water,” I said. “It looks like you’re all dried out! How long have you been sitting out here?”
Instead of answering my question, he stared at me in silence, which I took to mean that he had either not heard, or else, had not understood, but just as I began to ask again, he said,
“Oh yea! I’m okay. I just can’t get used to this heat! I’m usually to damned cold, but a couple minutes our here and then I feel like I can’t breathe anymore. It’s HOT outside!”
Again, more or less shouting at him, I asked,
“Do you need me to help you back inside where it’s cooler?”
Again, a blank look and silence for a minute or two, until he spoke again,
“It’s this goddamned body! It’s too weak,” he shouted back. “I can’t do a goddamned thing for myself anymore! How bout you find me a replacement body,” he says, laughing weakly; “under sixty mind you, and I’ll pay you a finders fee!” He manages to continue a hoarse, but weak laugh at his own oft-told witticism.
“Well, how about I give you my phone number so you can call if you need help with anything,” I responded. “Is that okay?” Again a long stare. “I’m just across the street and I want you to feel free to call me if you need anything, okay?” I say it loudly again, hoping he heard and understood.
He shook his head slightly and continued to stare at me, so I wasn’t sure he actually heard or understood.
“I’ll be right back,” I tell him, and I dash across the street to find something to write my number on. I return in less than a minute with a white business envelope bearing my name and number in large letters, and written in black, indelible ink. “Hang onto this, okay, and call me anytime!”
As I handed him the envelope, he managed finally to stand and take hold of the door to his kitchen.
“The offer stands, twenty four hours a day, okay John,” I say, “If you need my help, just call.”
He examined the envelope as though it held some secret meaning, and after a long moment staring at it, he said, “Okay, thanks Jimmy, thank you for bringing those in,” and he nodded toward the cans.
“Your welcome,” I tell him, as he opened the door to go inside. As I stepped outside the garage, the garage door began to close slowly behind me and glancing beneath I saw his left foot lift off the step as the door to the kitchen closed behind him.
Flashing lights and motors running; it’s late!
John lives totally alone, with the exception of his cat, Jemjem, and according to another ninety-something neighbor who lives next door to us; she says that John has no one, no family, no cousins; literally alone in the world with the exception of friends like her and a few others who have known John since he arrived here in the community about twenty years ago.
She, her name is Bessie, a real sweetheart, also told us of John’s frequent falls and calls for help. For the past several weeks we have, from time to time, seen the paramedics at his house. So there was no irony in the fact that this same evening, of the same day that John and I spoke in his garage; I heard the sound of engines on the street and looking out the window saw that, once again, a fire truck and an ambulance were out there. He’d evidently fallen again.
The next morning, which was Saturday morning; there were two cars parked in his driveway, and so I went across to offer help and see if he was okay. Since everyone knows that he cannot come to the door, I knocked and then let myself inside where I was met by Barbara, and Bonnie; two of the other neighbors whom I mentioned, who, along with Bessie, have known John so for so many years. All three began looking in on him daily since he began taking these falls. Introducing myself, I explained how John and I became acquainted the day before, and that I saw the rescue team again last evening and was hoping that he was alright.
From the front door I could see into the bedroom where John was tucked into bed, his reading glasses resting on the tip of his nose and a book lying across his belly. He was looking at me, so I waved, and he waved back. Next to him lay his old cat, Jemjem, and when I went to his bedside to say hello, I notice the bed was littered with papers, books, an unused pee bottle, a sandwich in a plastic bag, and several document folders stuffed with papers. He appeared to be keeping himself busy and was far more lucid now than he was in his garage the day prior.
The cat, Jemjem, I learned, got his name from John’s initials, J.E.M., because John would name the cat and then forget what he named it. So, he used his own initials to ensure he would remember its name consistently. Of course Jemjem didn’t seem to mind one way or the other, and it was obvious that he and John were good companions for one another. Unfortunately, or so it appears, a companion was no longer going to suffice. What John truly needs now is a live-in care provider.
In the ensuing conversation about John and his health issues, I made the ladies aware of the trash can incident on Friday, and how it worried me that John is so weak and possibly dehydrated. Then, after hearing of the many falls he’d taken, I had to ask,
“Should he be here alone?” Of course, the ladies had the same questions and concerns, but what to do about it was not easy to answer. With each fall, John refused to go to the hospital, and we all felt certain that his reasons for not going was his concern were for Jemjem and his home; who would take care of either of them.
Speaking to John as he lay there in his bed, I told him again,
“Don’t hesitate to call if you need me, okay!”
He had my number next to his bed on the nightstand and promised he would let me know if he needed anything. Although the ladies assured me that he would be fine, when I returned home, I told my wife that I was uneasy about leaving him alone as there was no way for him to get to and from the bathroom or to get food or water, or anything else on his own. It left me feeling very uneasy about his situation.
That same evening, as my wife and I sat in the kitchen playing a board game with our son and his family; the phone rang. It was a 386-number that I didn’t recognize, so I assumed it to be John’s number and I answered. John’s panicked voice came through in such a fearful tone that I knew he was in definite trouble.
“Jimmy! I need help Jimmy, can you help me please!”
My son and I immediately rushed across the street and found John wedged between the edge of his bed and the wall next to it. His shoulders were partially on the mattress and his feet were twisted and jammed against the baseboard. His right hand clutched the headboard and his face was an expression of fear and distress that was so painful to witness because he was crying and hopeless in his condition.
We lifted him as gently as we could up onto the bed amid loud cries of pain that truly made me wonder if he hadn’t actually broken something during one of his many falls, but did not realize it.
“What happened, John,” I asked. “Did you fall out of bed?”
Instead of answering, all that he could do was apologize.
“I’m sorry Jimmy, I’m sorry. I shouldn’t be such a burden to everyone, I’m sorry!” It took him several minutes to calm himself as we stood next to him and waited for the pain to subside and for him to catch his breath.
Once he was relaxed he explained that he’d made it to the bathroom and back, but when he attempted to lay down again, he was unable to lift himself onto the bed. Instead, he slipped off the edge and into the position in which we found him. Fortunately, the telephone laid next to him or, otherwise he could have been there until, well…we don’t know what could have happened or how long before someone found him.
Finally calm and appearing settled, he assured us that he would be fine for the remainder of the night as it was already after eleven o’clock. Making certain the the phone and my number was within reach, my son and I crossed the street again and finished our board game, which ended just after midnight.
Around 1:00 am, about thirty minutes after we all went to bed; I lay in bed reading and once again heard the sound of truck engines in the street and the hints of emergency lights flashing against the blinds. I peeked out and saw the ambulance in front of John’s house. Had I fallen asleep, I most likely would have slept through it, making it an even more horrific night for John to live through on his own.
Wearing only a pair of shorts and sandals, I quickly crossed the street and followed the paramedics into the house where we found John laying in a heap on the floor, only this time he’d fallen on top of a utility table that shattered beneath him. His right arm was folded beneath his body and his left arm was extended outward as he appeared to be attempting to grip the carpet and pull himself off the broken table. Once gain, however, his body is too weak to aide himself.
For some time, the paramedics just stood there talking to one another in such low tones that I was unable to hear what they were saying. Finally, one of them knelt next to John and asked what happened. There was no explanation as he was crying and obviously in severe pain, and most likely could not hear what they were asking anyway, not without his hearing aides.
After some minutes of waiting, two of the six medics began to extricate him from the tangled mess.
“We’re going to get you up into the chair,” one of the medics said to him loudly. As they attempted to move him he screamed in pain again, as he had when my son and I moved him earlier, and he again began apologizing profusely for having done so.
“No need to apologize,” one of the paramedics answered, “we know it hurts but we have to get you up.”
It shocked me that there was no back board, no checking for broken bones or neck injury; they simply flipped him and lifted him into an arm chair that was padded with one of the cushions that belonged on the sofa.
Trying to piece together what may have happened, they merely theorized that John had attempted to sit himself on the padded armchair and missed. Either that, or the over-sized cushion was too high for him to slide onto, causing him miss the edge and fall onto the table. In either case, he ended up on the floor and unable to recover himself.
In the meantime, John sat in the chair wearing nothing but undershorts. He chills easily at his age and sat there shivering and shaking from head to foot, and still moaning in pain. After several minutes of discussion, one of the male attendants asked loudly,
“Do you want us to take you to the hospital?”
He either didn’t hear or understand the question at first, so one of the female attendants repeated to him,
“Do you want us to take you to the hospital?”
“I don’t want to go to no hospital,” John shot back; his voice shaking and barely audible.
“Okay then, if you fall again, just give us a call,” she said, as the others began preparing to leave.
My jaw had to be hanging open as I watched this.
“Are you just going to let him sit there? Shouldn’t he be in bed?” I asked. The older medic then turned back to John and said,
“Do you want us to help you into bed?”
“No!” John shot back at them. “Just let me sit here for awhile.”
Unable to justify the scene mentally; no exam, leaving him alone, etc., I said to the group, “He’s not going to be able to get back into bed himself.” And then asked, “How is he going to take care of himself when he can barely even walk?”
One of the female medics turned and asked if I was a relative.
“No,” I said, “Just a neighbor. I live across the street.” and then went into the explanation of how my son and I had rescued John from an earlier fall that same evening, and that he has nobody to care for him, and that there is no way he can take care of himself.
Without any acknowledgement of what I told her, she turned toward the door and shouted,”Okay, well, give us a call if you need us again.” She fired the comment over her shoulder and across the room toward John like a mortar shell that he never heard explode. The others were already outside as John sat there, shivering, uncovered, and with no one to care for him but me.
Although he objected weakly to my remaining with him, I could tell that he was grateful for the company, so I ran home and dressed and returned with a pillow and a book to read. The sofa was missing cushions and piled with paraphernalia so I took up my station on a small love seat near the back windows and, more or less, directly in front of John just in case he tipped over while dozing. As much as I tried to talk him into resting in bed, John refused. He said he did not want the pain of getting into and out of the bed to go to the bathroom, and I soon discovered why he said this.
As it turned out, he had taken a laxative earlier, so we spent the remainder of the night with repeated trips every hour to and from the bathroom. Had I not remained, I’m certain he would have hurt himself again, among other nasty things that might have happened. There was no way for him to maneuver without assistance and his bathroom visits were frequent. Had I not been there to lift him in and out of the chair, on and off the toilet, and assist him across the room, he would surely have fallen again, or worse.
In between bathroom trips we sat and talked (he talked, I shouted). After the paramedics left I’d covered him with warm blankets and watched closely that he did not slump or tip forward as he periodically dozed off for a few minutes at a time. So we just sat there together the remainder of the night. Just as the sky began to lighten with the break of day, and despite his awkward sitting position, John appeared, finally, to be in a sound sleep.
Laying back into the love seat with my legs dangling out into the room, I had just begun to doze a little, opening an occasional eye to see that John was still upright (it was just about 7:30 am) when the front door popped open and in came Barbara.
Seeing me laying there across the small sofa obviously surprised her as she let out a little yelp that was not quite loud enough for John to hear. His chin resting on his chest, he was sleeping soundly now and taking breaths so shallow that it was difficult to detect them.
“What on earth happened!” Barbara asked, obviously startled by our appearance there together and poor John sitting in the chair instead of laying in bed.
As she and I talked about the events of the evening, John finally stirred again and joined the conversation. She told him that she was going to call a nurse to come visit him, and I, again, expressed my concern to her about the lack of care the paramedics showed, and concerns about John’s possibly having broken bones or other injuries of which he himself may not even be aware. Barbara stated that she would tell the nurse and have him examined.
Saying my goodbye’s, I took my leave, again telling John to call if he needed me, and I returned home to try to enjoy a very groggy Sunday with my family.
What are neighbors for; ambulance service notwithstanding!
The next day; Monday afternoon, Barbara called and asked if I could assist her and Bonnie in taking John to the emergency room. They explained that the nurse did come to evaluate him and then spoke with his primary care physician, and that the doctor asked that John be taken to the ER as soon as possible.
The ladies dressed him in some clothing that appeared to have been worn for some many months; i.e. filthy blue jeans and a stained and graying t-shirt. It was difficult and very painful for John as we moved him to the car. Barely able to support his own weight, I dead-lifted, and stood him behind his walker and we held him upright to get him out of the house and safely into and out of the car, and with as little pain as possible. We did manage to get him into the Emergency room where, fortunately, the wait was not long and John finally received his much needed examination.
Although he was now, finally, getting some medical attention, we were not certain that his troubles were over. We were told by the nursing staff that, if they did not find a reason to admit him, he would have to return home. We explained the situation to his attending E.R. doctor, i.e. that he had no one to care for him, and that after his many falls, he could, in no way, care for himself. The doctor then assured us that a social worker would be called in to assist.
Leaving him in their care, I returned home and waited several hours before following up. When I called the E.R, about 9:00 pm, his attending nurse said he was doing fine, that so far no injuries or major issues were found, meaning that they found no reason for him to be admitted. This was cause for great concern, and I informed her again of his situation and asked if she would please call me when he was discharged. I then told my wife that I would be spending another night with John.
When bedtime rolled around, about 11:30 pm, there was still no word from the hospital and I peeked out at his house, which lay dark and still. He obviously did not come home and since no call came, I went to bed assuming they were keeping him.
When I awakened, I immediately called and learned that, thankfully, they had admitted him because he was unable to walk. When we went to visit him later that morning, the charge nurse we spoke to informed us that there was no possible way that he would be discharged in his condition, but would likely be moved to a rehab center. Doctors were ordering an MRI and other tests, and social workers were finding a bed for him at a local center.
What will happen during and/or after therapy is still up in the air. The neurosurgeon plainly pointed out to him that, at his age, surgery is out of the question. The best that can be done is to move him to a rehab facility where they will attempt to strengthen him, however; his spine is in such a deteriorated condition there is not much optimism about his ever walking again, or taking care of himself.
Sadly, during our last visit, John was exclaiming his views on self-euthanasia, and my wife and I did our best to encourage him to not give up. Fortunately, the conversation was interrupted by a visit from the surgeon. John curses his body for failing him and wells up with tears, recalling how things used to be. Falling into long periods of quiet thought, he will suddenly erupt with a mental list of things that need to be done with his possessions, and particularly with Jemjem, his cat, which he says that Barbara will inherit. “She really good with cats!” he repeats with a smile.
As he lays there in his hospital bed, I watch as he looks at the back of his hands as if contemplating his age, and eventually he says to me,
“Jimmy, I doubt that I’m ever going to see my house again, you know. I really have my doubts about it.”
He eyes remain downcast as one hand touches the other and then I say to him,
“Well, John, there’s just no way of knowing until you see what rehab will do, but we will be with you whichever way it works out, you know! Your friends will still be here with you!”
As I age, there are constant reminders of what lays ahead: My brother-in-law died just last week of cancer, and my sister (his wife) not many weeks before, of a stroke. My oldest living brother is eighty one with several physical maladies and he and I have both been treated for prostate cancer. The other four of our older siblings are already gone, as are our parents who died ages ago. Even the thought of my grandson’s dog, who was a newborn puppy that his mother purchased from him when he was only two or three years old; is now thirteen years old approaching the limits of his life.
So as I lay my head on my pillow at night, my mind is full of questions that I cannot even begin to put into words. It has always been my view that there are many things in life that are far worse than death; one of them being, simply waiting for it to arrive, as it is in John’s case, and so many others who live around us in our current community that have passed the octogenarian stages. There will be no warden to walk us to the chamber, and we will probably never know when or what our last meal will be until after we’ve eaten it, but we will all have one, sooner or later.
Like being nose deep in water, barely able to tip our head back far enough to take another clean breath, one has to consider, ‘Is another breath worth it, or would it not just be simpler and more justifiable to simply allow ourselves to submerge and enter that quiet sleep where all these troubles cease to exist.’ Like the Shakespearean writer opined: “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.” (Hamlet, Act 3, Scene 1)