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Behind Each Face, There's a Story

written by Thu Tran, MD,FACOG
on Saturday, 17th October ,2015

Today, Betsy was placed on hospice care.  Her Alzheimer’s has worsened; often she can no longer swallow or turn her head to gaze at her visitors or the hospital staff.  She was hospitalized for a week with a fever and had a full workup including CT scan confirming again that a part of her brain has degenerated.  Since she was in the same hospital where I deliver my patients, which is next to my office building, I get to come up to her floor to visit her whenever I have some free time.

During the first few days, she replied that she remembered me whenever I asked.  I didn’t test her further by asking her if she remembered my name.  She had lost some weight, and her eyes had that faraway look of somebody who’s lost her way and yearns to come home.  Her lips couldn’t move much when she talked, so it was more like whispering.  I asked if she remembered her children.  I named each of her children and, like a child who just learned how to speak, she repeated the name slowly and softly.  She still had a little smile on her face, as if she enjoyed my company. 

She was such an intelligent woman, well read, cultured, and well lived.  She traveled extensively, and lived her life with such fun.  She used to sing on the SS France cruises crossing the Atlantic as a guest, and spoke French fluently.  Her summers were spent on the beaches of Cape Cod tending to her children and sun bathing.  One by one, each of them grew up and flew away like birds leaving their nest.  They all did well, showing how well she had raised them.  Once the last child left, she continued to live by herself, totally independent from the children who scattered all over the two coasts.

Several weeks ago, some of her children had to take her to Maryland since they couldn’t keep flying or driving to her state whenever an emergency arose.  She left one nursing home to move into another.  Her mind was no longer sharp.  For quite some time, she remembered most parts of her childhood and her children’s childhood, but her dementia had robbed her of the ability to remember things she just did five minutes ago. 

In the nursing home, even recently, her adult children would come for visits.  They played games to keep her mind stimulated or to remember things in the past.  For example, a back and forth fun exchange she and her mom had taught the children when they were toddlers.

Betsy: “Hello Lina”

Child:“Hello Tina”

Betsy:“How you doing?”

Child:“Fine and dandy. How you doing?”

Betsy:“Fine and dandy.  Where you work now?

Child:“Down by Yonson’s.  Where you work now?

Betsy:“Down by Johnson’s.  Who’s your fella?”

Child:“Mr. Yonson.  Who’s your fella?”

Betsy:“Mr. Johnson.  Ummm you like him?”

Child:“Ummm, I like him!  Ummm you like him?”

Betsy:“Ummm, I like him!  Good-bye Lina.”

Child: “Good-bye Tina.”

The game has now turned around with Betsy on the receiving end, to see how much she could recall the simple details of the game.

Around her, other elderly residents were in their own world.  Nobody was talking to anybody.  They watched each other, but nobody knew what they were thinking about each other, or were they thinking at all? 

“Sam, help me, Sam!” a gentleman in a wheelchair in the hall way was calling out to a passerby.  The woman stopped on her tracks, looked perplexed and walked over to him.

“May I help you?” she asked gently. 

He waved his glasses in his hand and motioned to her to come near.

“Can you put my glasses into my pocket, Sam?” He asked, without looking at her. 

She put the glasses into the front pocket of his checker shirt.  He smiled.

“Thank you, Sam, you have always been so kind.”

Who was Sam? Was he a man or a woman? Was he a relative, a friend, an aid?

In the hospital, the physicians and nurses entered and exited Betsy’s room.  Nobody really knew her past.  Nobody knew how lively and colorful her life was.  Nobody could imagine she used to sing on stage on a luxury cruise ship crossing the sea to Europe.  Nobody imagined she read several magazines and newspapers daily and debated about the politics of the time.  Nobody knew how liberal her thoughts were, for someone as old as she was.  Nobody appreciated her wit and sense of humor shown through the New Yorker magazine’s witty cartoons she pasted on her refrigerator door.  

Like a baby, she now was curled up with her arms in front of her, all bruised from the numerous needle sticks, as if she wanted to protect herself from an outside world, one she had very little memory of.  Did she still dream in her sleep? What kind of dreams did she have, of her childhood, of colors, of forests and streams, blue sky and silver moon? 

She looked peaceful.  She looked as if nobody should feel sorry for her.  What’s there to be mourning for, she probably would have asked her children if her mind was still lucid.  She had lived a long fruitful life, turbulent at times, but fruitful nonetheless. After all, who would live a life without turbulence at times? Bad things happened to her as they happened to everyone else, and she bounced back like the brave ones, to continue on the path she chose.

Like the residents in her nursing home who now sat and rocked in their own world, or yelled at the nurses for something they did not comprehend, or wept like babies without their mothers, she showed how the world is in order, like the inside of a cactus flower.  There’s indeed a season for everything, and one season predictably follows the other in a circle.  A time of entering the world without any memory as a baby, a time of vibrant youth, a time of settling as an elder, and a time to prepare to leave the world without any memory.  Life is a circle.  She was spoon fed and wore a bib as a baby, followed by years when she spoon fed each of her children with bibs around their necks.  She now has to be spoon fed with a bigger bib around her neck.  All the world is indeed a stage, as she had entered and now prepares to exit.  Those around her or those who knew her can only wish she had lived a life as fully as she had wished and had achieved most of the tasks she had set out to do.  She has so many stories she can no longer tell.  Behind every face in her nursing home, there’s a story of a lifetime.  

 

Every morning, when we wake up, we have twenty-four brand-new hours to live.  What a precious gift! We have the capacity to live in a way that these twenty-four hours will bring peace, joy, and happiness to ourselves and others.

                                                                                                                       Thich Nhat Hanh

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