Monday, August 25, 2008

Slippery slope...

A few weeks ago, our youngest son Dónal traveled with friends to Wisconsin, in large part to slip and slide the various water parks that make Wisconsin’s Dells “the Dells.”

I long ago, back around the time I last climbed aboard a roller coaster at Hershey Park in Pennsylvania — and we’re talking some 25 years ago, when Karen and my youngest brother Patrick last convinced me to ignore common sense — started resisting any spur-of-the-moment impulse that might give gravity even more leverage to sooner end my life. Since then, I have reasonably reasoned that the older I get, the more opportunities there are to die without, on my own volition, having to add to the list of possibilities. So, for all my youngest son’s entreaties to the contrary — “oh, c’mon, Dad, it’s fun…can’t wait to do it…it’s only a 50- (or was it 80-) foot vertical drop” — I proverbially begged to differ. After all, he’s sixteen, what does he know about what life can do to him, to me, to his mother, to all those who love him, in that, that one instant of unknowing.

The thing is, that at this, my age of 57, there are not only more — and more frequent — opportunities to die (yes, Karen, I’m showing my Irishness again), but it is truly all too easy to gain admittance into that somewhat less than amusing amusement park that beckons at middle age and broadens beyond. Ignore your high blood pressure, and you’re screwed. Step into the minefield of diabetes, and, guess what, you’re screwed. Crank up on the burgers and fries, and, you know what, you’re screwed. Wait a few more years, and, for whatever good luck you might have had before, the time bomb of genetics goes off, leaving you at the mercy of glaucoma, cancer, stroke, you name it.

It’s a crap shoot…life, that is.

In my former position as a family physician in a small and rural town in Iowa, I would, every Tuesday, every other week, visit a local nursing home. Most of those Tuesdays, I’d see six or eight or ten nursing home residents in the course of a couple of hours. Most were routine visits, mandated, mostly, by Medicare. But some were the kind of encounters, which, I knew, could all too easily lead to that slippery slope, that water slide, which is, young or old, the realm of the possible for all of us, and hardly fun.

If you’re young, let’s face it, time is decidedly on your side.

But get yourself into a nursing home, and all it takes is one infection, one new onset, as those of us of the medical persuasion shorthand it, of A. fib, of an otherwise ordinary UTI, of ARF, and you are, in the vernacular, a get-out-of-my-emergency-room “gomer,” if not an outright goner. And if that shorthand gives you the short end of the stick, consider this: giving you the benefit of a doubt, stretching your diagnosis to atrial fibrillation, to a urinary tract infection, to acute renal failure, changes nothing. It all depends on those immediately around you and how quickly they respond to your more or less pressing problem.

Dare I share a secret?

Every time I entered that nursing home, I smelled death.

I would slip, in an instant, from the car into Iowa sunshine, walk toward the shade of the building, pull open the front door, step into the vestibule beyond, reach for the next door, the shadows beyond, give that last door a yank, and then…

Sometimes it was the smell of the newly dead.

Mostly, however, it was the smell of those about to die.

The infection festered; the heart failure neglected beyond the usual swelling those of us in the know chalk up to everyday lower extremity edema; the pneumonia, treated, too often half-heartedly, and now gone amuck; the emphysema, COPD to those of us in the trade, that makes comfortable company until it decides that today, today, this day is the day you die.

All of us die.

But none of us, not one of us, need be sped off life’s stage.

It is, this doctor is going to say, too easy to die in a nursing home.

You — or your mother, father, sister, brother, does it really matter — are, let’s face it, a bed. Nothing more, not much less. A bed that ups the occupancy rate, ensures reimbursement from this insurance or that, or, if age allows, from Medicare, and, in the end, keeps the nursing home in the black. If you — or your mom or dad or those luckless siblings — die, oh, well. The tail end of the greatest generation and the front end of the baby boom bunch pretty much ensure plenty of replacements. Why get hung up on good-hearted Bob, after all he’d already had 101 good years, or ill-fated Ruth, who, until she started paying rent at the home and then started packing on pounds of water weight, had been in pretty good shape; or luckless Helen, bride, all those decades ago, of Bob and now his widow, whose heel wound, somehow, without anyone noticing, became the feeding ground of maggots; or, for good measure, poor, poor Thelma — ah, c’mon, she’s already 97, who cares if she makes it to 98, and so what if she has a son who himself cares. I mean, she’s 97, what, what at this point is left to enjoy of anything that resembles life?

Let’s say, though, it was me. Or, maybe, you.

Are you ready to be admitted to the home, welcomed, more or less patronizingly, encouraged to mix with those who, knowingly or not, signed on before you, survived so far, and who are, like it or not, your new neighbors and roommates? Are you willing to give up those extra years, whether in your 80s, 90s or beyond, to the unintentioned ignorance or ill-intentioned malfeasance of those hired to care for you? Are you, at 97, ready to hear, in action even more than words, why bother imagining a future when your life, your precious life, is all about the past?

If you’re lucky, you’ll fit in, stay healthy, avoid the ever-swirling infections, the stumble in the hallway, the all-at-once illness that means a trip to the emergency room and, perhaps, a longer stay in the hospital, and the risk, simply by the company you’re keeping, that you’ll buy the infection that will buy you the farm. If you’re even luckier, you’ll look forward to bingo, enough so that, even when called out for your every-other-month checkup, you won’t, as did my patient Jean, who threatened me with a “kick in the pants,” mind the intrusion. Luckier still, and lunch — which, like breakfast and dinner in a nursing home, is but a stepping-stone in the slow, ineluctable journey that marks life’s end, and which, on any day, guarantees a traffic jam of wheelchairs and walkers at the chalk line of the cafeteria — will be nothing more than a speed bump in your day, and you’ll soon be in and beyond to the momentary nirvana of gelled this and gravied that. Another meal, another day, in lives all too achingly short of days.

And if you’re not as lucky, if death sniffs around and decides you are the one, that today is your day, that no number of prayers, no amount of hope can stiff-arm its approach?

Oh, well.

Life, if not for you, goes on. Your bed is serendipitously open. There is, like it or not, insurance money to be had. Those left behind — spouse, siblings, children — will get over it, won’t they?

© 2008 by Dónal Kevin Gordon

Sunday, August 10, 2008

Her beautiful life...

Karen and I first met Joan in 1988, twenty years ago now, at a farmers’ market in Middlebury, Vermont. She was selling apples from her orchard in nearby New Haven, and Karen and I were among the day’s browsers and buyers.

It is distant enough now in memory that I cannot recall exactly where in Middlebury the market was located. Nevertheless, at some point in that morning’s wanderings, Karen and I had chanced upon Joan’s booth. Again, time has smudged the details, but without question we exchanged the appropriate niceties of the moment, in the course of which Joan at some point spotted the Claddagh rings that both Karen and I wore, and we, for our part, took note of Joan’s accent.

“Where in Ireland are you from?” I asked, my eyes drunk in an instant on Joan’s own eyes, her blonde hair, her cheeks at once appled and summer-blushed, a smile dialing up the glow.

“Dublin,” came the answer, the geography confirmed in a breath by the brogue.

Joan, as we soon learned, had left Ireland for the States as a lass of twenty-something and had, at some point not long after, met an American lad from Massachusetts named Frank. That meeting had led to marriage, which, in turn, had led to children, three begotten, one adopted, and to the usual vagaries to which time and circumstances make us all victim.

For Frank and Joan, that road forward had led eventually to New Hampshire, to a farm in rural Francestown, the house and land heartbreaking in their beauty, and, years later, to that apple orchard in New Haven, culmination of Frank’s dream to live in Vermont.

Résumés, if you had them, would tell you that Frank had done time as a high school guidance counselor, while Joan had earned her stripes as a small-town librarian. Along the way, too, there had been a detour to some sun-soaked island in the Caribbean, Frank and Joan’s would-be ticket to a better and different life, that had led, as unhappy circumstances would have it, only to a ticket home to New Hampshire.

For our part, Karen and I had only five years before lived in Ireland. We had sold almost everything back in 1983, cast fortune to the proverbial wind and crossed the pond with the intention of never returning to the States, only to return to the States, partly because Karen missed her family and partly because my youngest brother, Patrick, whom we were then raising, missed mine. We had lasted six months, more or less, and we have ever since, especially in these the years of Bush redux, regretted leaving.

The Claddagh rings were a testament to those Irish leanings, both genetic and otherwise, even as the lilt of Joan’s accent had, in an instant, again brought us home. I don’t have to tell you, but will, that the fact that she and Frank and Karen and I were spirits both kindred and free ensured nothing less than camaraderie right from the start. Indeed, not long after we had met Joan, on a fall day lit less by sunlight than by leaves crimsoned and gilded, Karen and I and three kids shoveled five pairs of feet through windrows of leaves to the roadside shed from which Frank and Joan sold apples. There we found, as I remember, apples by the bag and apples by the bushel, and, somewhere on a table, a basket for collection by the honor system, but no Frank.

Later, I’d come to understand that that same honor system, by happy design, put the buffer of the basket between Frank and his market, something, which, in Joan’s Ireland, would have been beyond all reason, but, which, to consummate New Englander Frank, was reasonable enough. But on that day, the day on which we first met Frank and the first of many get-togethers over the decades and all the many miles since, I also learned that Frank’s New England veneer was easily scratched, exposing the heartwood that was so obviously the common ground between Frank and his Irish bride.

Not much deeper into that first fall of our acquaintance, six-year-old Declan, his four-year-old brother, Brendan, and I killed any idle hour, rare as they were, in those, the years of my freelance writing, picking up drops — apples fallen by wind or whim — the better to help our new friend, Frank, who would otherwise have had to cull all 200-plus acres himself. We’d later feed these drops to the neighbor’s cows, whose involuntary swish and sway, laughable to see at the time, spoke to their fermentation-induced happiness.

God, I loved those days. Lord, how I remember them.

They were so different from what I did for a living every day. No writing. No solitary me in an otherwise empty room. No pleasing this or that client — only apples, bruised and ripe for the rotting, awaiting the salvation of our hands and a last chance to become fodder for heifers. And, in those, my own wistful and halcyon days, there I was, along with my sons and my good friend Frank, raking apples by the fistful, in an orchard which in that time, for me, of relative youth, and, for Frank, of middle age, stretched forever, even if our shared sun was then, without us even noticing, dipping ever lower that fall and every fall since.

That autumn, and those memories, give glow today to the mind’s hearth, and are all the dearer now that lovely Joan did herself slip away this past year and a summer ago. Indeed, Frank’s visit today is the first since Joan’s death, and her absence was beyond heartfelt.

To be sure, there had been times in the past, when Frank had visited us alone in Vermont, mostly because Joan, her feelings toward Vermont tempered by what she came to see as an unhappy experience in New Haven and a foreordained return to Francestown, would do anything to avoid crossing the border from New Hampshire. And always, always, we knew that Frank’s Vermont was not Joan’s, no less than my Ireland and my own Vermont was like the Ireland or Vermont of those I love. Moreover, like my own meanderings, Frank’s had come at cost to those he loved, something he knew and felt, as do I about the price of my own wanderings.

Yet here we all were, on this, the second day of August, Frank, Karen, me — all of us, of course, except our missed Joan. Around us, too, were three of our five grown and almost-grown children, all of whom Joan had known, and who, in the years since, had grown from tots and toddlers to four young men and a woman.

For two hours, Frank and Karen and me and the gathered children talked and laughed, even as we stopped short of speaking of Joan, the better, I knew, then and later, to stop short of sobbing. There were memories, memories of bread pudding, absolutely perfect bread pudding, baked once, only to have Joan change the recipe forever; of other dishes when Joan, not finding a needed ingredient, substituted whatever was handy, regardless of its relationship to the required ingredient; of the Scottish Highland cattle Frank once raised, which, on one afternoon, were driven to dancing — no exaggeration, as we’ve the photos to prove it — by our son Brendan’s bagpiping.

Those things never mentioned last Saturday count for more: Frank’s “Go Away” welcome mat at the farmhouse in New Haven; Tiernán’s christening all those years ago, with Frank and Joan enlivening the celebration; so many weekend dinners together at our home in Cornwall, Vermont, or theirs in nearby New Haven; the visits, time and again, after we had moved to Peacham, to Francestown, to Frank and Joan in their book-lined family room, in the kitchen of changed recipes, and, just beyond, in the field of the Highland cattle. Or the time Frank helped me haul a washing machine up the outside stairs of our Vermont home in Peacham, in the course of which the washer, easily given to tumbling in its day’s work, tumbled less willfully from the handtruck and down the steps, although, to Sears’s credit, it took a dinging and kept on wringing. Or, in the year or two after returning to Francestown from New Haven, when Joan, by her own admission never more than an Irish cook of her time, welcomed the good excuse that the oven of her rented house lacked a door, rendering any temperature, and any result, beyond her control.

Life, in those days of our shared Vermont and, later, shared border, seemed, in the naiveté of those years, without limit. None of us could imagine at the outset of our friendship that my family would twice leave Vermont, once for graduate school at Notre Dame and later for med school in Iowa, stretching but never breaking our ties to Frank and Joan. That visits since would be so few, so far between. That that last visit, four years ago, when we were returning from Maine to Iowa, would be the last for all of us.

And, yet, Joan is now dead, and Frank is stiffer of limb since we last saw him four years ago. He is, nevertheless, still Frank, his references to the “fahm” a testament to those New England roots, with enough granite, and only just enough, in his constitution to firm the foundation. Everything above ground, however, reflects Joan: that easy laughter, the easy laughter of an Irishman by marriage; that shared memory; his own unbearable lightness of being, which, without Joan, might otherwise, given that New England upbringing, have become rock.

But it is Joan, now, who is missing, missing for Frank, missing for their children, missing for Karen, for me, for our children, for all of us lucky enough to have ever touched — and been touched — by her beautiful life.

Frank, true to the spirit that first led him to Joan and to all he and Joan later lived together, is moving on. He is San Francisco-bound this time, the promise of a new, if later, life luring him west. If it doesn’t work out, he says, he’ll go back to New Hampshire. And that, with nothing more than a shrug, was spoken like Frank.

I have written here of friendship. I have implied, and surely do intend, love.

Karen and I loved Joan. Karen and I love Frank. And neither time nor loss has dimmed our love for either, nor could it ever.

Shortly after we all met, Frank and Joan joined us for the christening of our fourth child, Tiernán, baptized maybe six months after our meeting. Since then, that child has grown to a man of almost twenty. And yet, can I again write the words, Joan is now gone. Since then, Karen and I and the kids have wandered elsewhere in Vermont, then to Indiana for graduate school, and later still back to Vermont, only to leave again for Iowa and medical school and for all that has happened since. Still, still, Joan is gone. Tiernán has turned another decade, Siobhán has become a woman of almost 22, Dónal a lad of 16, and two more, Declan and Brendan, have grown and gone from the fold. All of them knew Joan, and, if I’m allowed to speak for them, all of them, every one, every last one, loved her.

We are told that hundreds from Francestown and thereabouts attended Joan’s funeral. Should it surprise me that so many found in Joan what I did and what friends from Scotland took note of in an online memorial: a heart, both wonderful and big. A fund, established since Joan’s death, has bankrolled an ongoing lecture series in Francestown, ensuring that a sliver of what Joan was will live on in the New Hampshire town, which despite those sojourns in Vermont and the Indies, she called home and which, from somewhere beyond, she still loves.

I can, if I want, walk right now into our kitchen and pause for a moment before a simple hutch against the back wall. Two of four shelves are lined with Nicholas Mosse pottery, crafted in Ireland, but sold in New Hampshire, and showcased in her barn, by local rep Joan. I bought some pieces as gifts for Karen, and Joan gave us others as gifts from her and Frank. Each cup, saucer, pitcher is made of Irish clay, shaped by Irish hands, embellished with Irish designs. Each piece is of and from Ireland. But each cup, saucer, pitcher, speaks only to me of Joan. So, too, does our recipe file, however softly, of that changed bread pudding, as does the apple pancake, which Joan, on one occasion, memorable to our daughter Siobhán, hurried to check on lest it explode. Nor can any mention of Joan fail to include the coziness of her home and, again, to daughter Siobhán, the embrace of that favorite armchair in the family room.

Truth is, our lives are our lives because Joan, then and now, brushed against ours, once, then and forever. We have lost Joan. We still have Frank. And onward, for all that loss, we go, Frank and his children, Karen and me and our children, all of us the better for having loved Joan.


© 2008 by Dónal Kevin Gordon