(HOST) Commentator Bill Schubart is also a writer with a sharp eye for the details of country life. In the following story he explores the difference between "health care" and "caring for people", as a veteran nurse tends to elderly ladies at a small-town hospital during the holidays.
(SCHUBART) It’s deep into December and Anne Stone braces for Christmas. Anne’s been a nurse for 48 of her 69 years. Most of the time, Anne loves her work. Oh, she has opinions about many of the "advances" in health care, but she keeps them to herself. Anne’s life as a nurse is made harder because she knows many of her patients and their life stories. She’s been nursing for half a century and can often predict a neighbor’s admission to the week, if not the day. If you know the person and their story, you can usually predict their arrival at the hospital door. Weather, daylight, and economics all play parts in the ebb and flow of hospital admissions and she can predict admissions by the time of year and the surge of gossip that may engulf someone in the community.
"That bunch on Tiny’s neck’s gettin’ bigger."
"Did you hear? Peavine’s back on the sauce."
Anne can tell you within a week or two when he’ll show up at the front desk. Peavine reels in, always during the day, and collapses on the floor. He’s then rushed to emergency where he’s diagnosed with acute alcoholism, "weaned and cleaned," rehydrated, put to bed for a night, and then discharged to his 93-year old mother who again commits him to a life of sobriety. Whereupon they disappear in a taxi together with Peavine staring at his shoes and his mother staring straight ahead.
There’s Glenna Farr, a distant cousin. For 14 years, Glenna’s had "the sugar." She manages it, more or less, with diet and insulin. Exercise was never an option. Glenna grew up on a farm where one’s cunning was applied to find easier ways to accomplish hard work, not harder ways or ways to extend the work. Exercise was and remained counterintuitive, but then again so did eating foods like green vegetables, whole wheat toast without butter, and sugarless cereals with skimmed milk.
For years, Glenna’s taken her annual turn hosting the ladies of the "Uplift Club" for their monthly meeting. Although the meeting has a set agenda in which members share ways to enhance their economic position in the community by learning crafts and skills such as crocheting, raising hens and selling eggs, or crafting such things as tongue depressor lamp shades or milk-filter doll gowns, a meeting’s true success was adjudged by the quality and nature of the goodies served during the "fellowship hour" that followed. These became the principle topic of conversation and certainly held sway in later gossip about how the meeting went. Most recipes for things that tasted good involved large quantities of sugar, flour, eggs and butter, all ingredients that were denied her. As she combined the forbidden ingredients, slid them into the oven, and then inhaled the beguiling aroma, she firmly resolved to abstain for the sake of her health. But all the anxiety eventually conspired against her and she’d tuck into those lemon meringues that held their teardrop shapes so well and the exotic macaroons which proved to be a big hit.
The next day, Glenna’d be admitted to the emergency room in a diabetic relapse. Anne would have advised ER staff of her impending admission and procedures would be followed such that Glenna could leave the following day after a night of close monitoring of her blood sugar.
Christmas was the most difficult time of year at the hospital. It seemed to staff as if half the town’s personal stories came to some sort of head and the stoicism of small town life somehow unraveled. The arrival of bitter cold days with little or no sunlight, forced holiday largess that only those with a decent job could afford, and the often painful intimacy of jovial relatives descending on them all pushed some folks over their limits.
There would be a bloom of dormant alcoholics who usually managed to keep their lives under some degree of control, but in the waning light of December would toss caution to the wind and imbibe until either a vehicle, a relative, or their pastor intervened and they would end up in the hospital, as the nearest jail was 22 miles away.
Those townspeople and farmers who had never managed to maintain their place in the town’s fragile economy might have accidents. A broken leg or arm, a sprain or dislocation was a swift ticket to a bed and gentle care, surcease for a few days from the hardscrabble monotony of trying to survive.
Anne’s favorites, however, were her "biddies," elderly, frail women, many of whom lived alone or in back rooms where their families tried to care for them – grandmothers, widowed aunts or mothers patiently counting out their days. Few men in town seemed to endure deep into old age. Especially poignant for Anne was the number of "children" in their seventies living on assistance and caring for ailing mothers or aunts in their nineties. Anne saw the exhaustion in the aged, craggy faces of these children and knew the harsh toll it took on them to be caring for an even older mother, at an age when they themselves might expect to be cared for.
Her biddies begin arriving after Thanksgiving. It was the only time of year when Anne played her respected hand with the hospital administration.
In an unspoken détente, Anne would be given almost total control over available beds during Christmas. Her long experience enabled her to parse out beds to her biddies while ensuring adequate capacity for the few real crises like ski and car accidents or coronaries.
Among all the fragile holiday visitors, Anne’s favorite is Elise Desrochers who every year arrives just a day or two before Christmas and usually leaves on Christmas afternoon. She shuffles in slowly on the arm of her daughter who worked for 34 years at Gillen’s Department Store as a clerk in the fabric department before they closed down. Over the eight years she’s been coming, Mme. Desrochers’s complaints have ranged from "hip pains" to "female troubles." She’s 96 and, although great attention is paid to her symptoms, they are nondescript enough to require only "observation and a few days of bed rest." Installed in her hospital bed with her lace nightcap framing an angelic smile, she looks to Anne wraithlike, weightless. She hardly makes a bump under the fresh-pressed hospital sheets.
Ginnie Bettis always arrives in a wheelchair with her red holiday nightie and a stained cotton coat. She is pushed by her 74-year old son Arthur who’s cared for her since he was 34 when she became disabled with a mild form of muscular dystrophy. Ginnie always arrives triumphantly, usually on the 21st, and is greeted warmly by the nursing staff. This year she brings peanut butter chocolate balls for the staff.
Yvette Courchaine is an altogether different quantity, and generally means trouble. A large imperious woman of French and Indian descent, she is usually wheeled in in her rolling throne by a hard-drinking neighbor, Ti-Jean Ferland. Ti-Jean is only a few years younger and inhabits a badly tilted trailer next to Yvette’s. A few years back when asked by the Overseer of the Poor if he wanted his rented trailer leveled, he answered only that "he purfurs it how it be." Ti-Jean looks after Yvette when it doesn’t interfere with his drinking and brings her into the hospital each year for her "tune up."
Each year one or two don’t show up and others arrive to take their place, but Anne knows why and who beforehand. No one counts the days or initiates "discharge planning," since the people who bring them in will show up after Christmas to fetch them home.
Anne knows these women and their lives well. She knows it’s her privilege to make room for them in December in her hospital.
At Christmas women who have lived this long should sleep in warm beds with clean sheets, have young attendants ask if they’re comfortable, serve them hot meals, or help them to the bathroom if need be. It’s a time for ladies who have reached this age to peruse a Ladies Home Journal or just lie back and revel in the smell of freshly laundered sheets and daydream of what might have been.
(TAG) You can find this story and more from Bill Schubart on-line at VPR.net