Let me tell you one thing: these know-it-alls who come around hawking computerized this and that to make Shady Rest work like the Holiday Inn have never worked in a nursing home. They’ve probably never even been in one and figure they never will be, which is why they’re so sure they can help us. In the million years I’ve been a nurse here, Mr. Hofstedder, our director, has fallen for gizmos that do everything from medicating to exercising our patients. He even got one to visit our patients: a box that made life-size holographic images of any visitor a patient wanted, however frequently and for however long. A busy loved one would pose for an image and record a set of nurturing phrases that could be updated by telephone as needed. A nurse who’d completed the required in-service would program the box and place a control within the patient’s reach. And like most of these gizmos, it was a perfectly reasonable idea. But Mrs. Wembly dialed up a vision of the welcoming Christ that strolled to the nurses’ station, causing a general tumult on 2-West, and Mr. Johnston managed to dial up a Playboy Bunny.
Then there was the flying vital-signs machine. To save us the trouble of going from patient to patient taking blood-pressures and temperatures, this little wonder zipped around Shady Rest, identifying patients by sonographically determined skull shape until it tried to take a temp on the guy fixing our elevator and he beat it to the floor with a crescent wrench.
But the worst was the Levitron, what Mr. Hofstedder called “an end to all our troubles.” He was beaming the day he called us to the training room and introduced a Ms. Somebody who had a little too much hair, a little too much smile, and clicky little heels that made her satin bosom jiggle when she walked. As if me and the other girls would be impressed. As if we needed to be told that falls were a big problem for our ‘clients’.
“And then there’s you,” she said as if she spent all her free time just worrying about us. She pointed to a machine we would have been looking at and wondering about if we hadn’t seen so many machines of so many shapes and sizes. This one looked something like a Zamboni, the thing they clean ice rinks with only smaller, more the size of a sit-on lawn mower, and she said you could ride it and drive it around but that was just for applications in the field.
“The military designed it to move casualties out of battle. They had no idea it would revolutionize patient care,” she explained. “Think of it,” she kept saying, as if none of us thought until instructed to do so. “You’ve got a patient with vomiting or incontinence, or the patient’s demented and spills all their food. The patient’s a mess and so are you if you have to wrestle him to the shower and into a new set of clothes. But what if you could make the patient float? What if you could push a button and the patient would rise from the bed and stay there until you changed the bed and changed the patient? What if you could float the patient down the hall to the shower, then float them back to bed?” She switched on the machine, pushed a few buttons, and to our collective astonishment, Mr. Hofstedder began to float, an inch, and then a foot, and then several feet. She pushed another button, turned a dial, and he rotated slowly from an upright position to lying on his back, and then his front, and then his back again, and then she steered him around the room, around the cabinets and the light fixtures, before returning him, upright, to his chair.
“How was that?” Ms. Somebody asked.
“Wonderful!” he replied. “Very educational!”
“You can set the Levitron for any height you want,” she continued. “The patient will feel nothing until he or she falls, which they won’t because they can’t. They’ll simply float until you find them and gently push them back again.”
She said the Levitron would be placed at the front desk and anytime one of us wanted to float a patient or to activate the round-the-clock Fall Guard feature, we’d simply come to the desk, input the patient’s name, date of birth, social security number, and, of course, billing information, and everything would be perfect, which for several months it was. Our fall rate went to zero, as did our rate of fall-related hip fractures, scalp lacerations and less important injuries, so we were pleased, and Mr. Hofstedder was pleased, as were those family members who were initially somewhat dubious.
And some benefits were unexpected, like for Mrs. Bergstrom. She was so stiff, her family couldn’t walk her or move her or do anything but sit beside her bed and look at her, but with the Levitron they could float her down the hall to the dining room and enjoy a Sunday meal. Yeah, it looked peculiar: there were her son and daughter-in-law sitting at a table, acting like nothing was wrong, and there was Mrs. Bergstrom, her head at the table and the rest of her sticking out half-way across the next table, but it was the first time she’d eaten in the dining room in over a year. It meant a lot to her, and it meant a lot to her son; it meant a lot to all of us.
And dear Mr. Claymore. When was the last time we’d heard him laugh or seen him smile? When was the last time his teenage grandsons had looked anything but surly when their parents dragged them in for a visit? But once we explained the Levitron, the boys floated him to the solarium and used him for a game of catch. As horrified as we were, you should have seen Mr. Claymore. He called himself the first talking football. “Claymore has Claymore in the end zone and throws Claymore!” he said, grinning as he spiraled from one grandson to the other.
And the Levitron worked outside the nursing home almost as well as it worked inside. Families could take their previously immobile parents and grandparents out to the front garden or for a walk around the block. The anti-gravitational effect lasted for several miles. With the patients appropriately tethered—and the appropriate permissions signed and witnessed—families could stroll along the waterfront or through our city’s parks, acknowledging the surprise of passersby with a healthy and often long-lost sense of humor. “This is mom,” they’d say looking up the rope to a hovering elder as if they’d won her at a carnival. “She just flew in from Ohio.” Or, “This is Uncle Ethan. He does this when he drinks a lot of soda.”
And we felt lighter too, which in this line of work is the most that anyone can ask. So often we trudge from one mess to another, from one multi-faceted and slow-moving disaster to the next and the next. Sometimes our legs feel like lead, our bodies feel like they’re six times bigger than they’re supposed to be, and all we can do is stand there and gape, and sometimes even that’s a lot to ask. Try showering an eighty-pound woman who kicks and scratches you. Try doing it without breaking her osteoporotic bones. Try doing it without tearing or abrading or even bruising her paper-thin skin. Try changing a bed that’s full of stool again an hour later, and the next hour, and the next because the patient’s not adjusting to the tube feeds that his doctor keeps insisting that he will.
For the first time, our jobs seemed doable, the patients and their families seemed agreeable and appreciative, and Mr. Hofstedder started calling us by name, which was nice even though he usually got them wrong.
“How about that Levitron, girls?” he’d say. “I think we’re really on to something here.”
But just as he was starting to discuss a raise, just as we were starting to feel that we weren’t nurses because we’d made a mistake, or suffered some small but irrevocable accident of fate, there was trouble with the Levitron. First a little, then a lot, and then all of us were remembering just how horrible fate can be.
It started with Mr. Overstreet. He couldn’t sleep, and the aides said he was tossing all night, but he insisted he was bouncing, bobbing like a cork in water, and several other patients said they felt the same, and while some of them liked it, most of them didn’t. They asked if the Fall-Guard was set a few inches too high. We looked and didn’t find anything, and didn’t wonder until the first head injury. After months without an incident at Shady Rest, we were floating Mrs. MontLuis to the shower when she hit her head on the ceiling so badly she needed half a dozen stitches, and the family was upset. They complained about the Levitron, and we explained that as far as we knew, it was working as it had always worked.
But then Mr. Rosselli lost weight, and then Mr. Townsend and Mrs. Torres. All the patients were losing weight, and they weren’t all malnourished, cancerous or hyperthyroid, or harboring another of the bodily wasting diseases. But the weights kept dropping and the patients kept floating in their sleep, and pretty soon they were all getting hurt on the way to the shower or the dining room or church or physical therapy. Still, we tried to fool ourselves. Still, we told the patients and their families that everything was fine: we’d looked at the Levitron, we’d looked at the instruction book,and the Levitron was fine. Everything was fine.
And then it happened.
I walked in one morning and found all the patients on the ceiling. There they were, bouncing along like so many birthday balloons. Many of the patients were frightened or upset, and we had to do something. We called Mr. Hofstedder and got the number for Ms. Jiggly Bosom, but the response was just what you’d expect: for Domestic Sales press one, for International Sales press two, for Service please hold for the first available incompetent. By the time we had him on the phone, he claimed to work for the company but hadn’t heard of the Levitron, and the next guy thought it was a heat pump, and the next guy—a woman actually—said we were calling the wrong division, health care was at a different number, would we like to dial it ourselves or would we like her to connect us? Finally we reached a technician who’d heard of the Levitron and knew what it was and had a screen that told her what to tell us. We told her what was happening, and over and over she said the same thing.
“You’ve got the blue switch up?”
“You’ve got the yellow switch down?”
“And you’ve got the dial turned as far as it can go?”
“Then it really should be working. It shouldn’t be doing what you’re telling me.”
You’re wondering, of course, why we didn’t simply turn the Levitron off, or pull the plug. Picture 78 old people falling from the ceiling to the floor. Picture them landing on linoleum, even if we padded it. So catch them, you say. Pull them down one by one and tie them to their beds until they’re all down, and then turn the machine off. But this state, like every state, has laws against tying or restraining patients in any way, under any circumstances, including this one. Believe me, once word got out, Shady Rest was crawling with inspectors and officials of every type, but they wouldn’t give us the slightest help and they wouldn’t give us a variance, not without a hearing, and that would take thirty days, expedited from the usual ninety days. All they could allow was manual restraint which required enough people to pull each patient down and hold them, or lie on them, or sit on them, or whatever. But in most cases this required three or four people, and the Levitron was so severely hyperactive that several patients needed a half-a-dozen or more people. And you can’t let just anyone touch a patient. It has to be a licensed professional or someone from the family or someone the family has specifically agreed to. We didn’t have the staff and couldn’t hire any on the spot even if we could have afforded it, and both the police and the fire department were called and looked around before saying they couldn’t help us either. It would take the whole force. It would tie them up in one emergency and pose a threat to public safety.
We were left to call the families which we did, and aside from the anger and worry we had to handle, it was hard to get them all in the same place at the same time, particularly since a lot of them were from elsewhere in the country. It was several days before we had it all organized, and by then there’d been the catastrophe we’d been hoping to avoid.
A delivery man brought a load of diapers and left a door open, and the day was hot, and the air-conditioning made a draft from the home to the street that carried out several residents. In a matter of minutes, they were the merest specks, high in the blue, summer sky, and we had to wait until they floated beyond the Levitron’s influence and came to earth, hopefully slowly and safely, which against all odds is pretty much what happened. Mrs. Ventura floated to an adjoining suburb and landed in a garden party meant to commemorate the 35th wedding anniversary of a Mr. and Mrs. Gottlieb who were really very nice about the whole thing. Mr. Sullivan settled at the ball game which was fine except that some of the fans were less than responsible. I was too busy to be watching, but apparently he was batted from one part of the stadium to the next as will sometimes happen with a beach ball. And poor Mr. Alvarez stayed up until after dark and came down on an outdoor rock concert, and the audience thought he was part of the light show. Ironically, the one who fared the worst was the one who landed perfectly. Mr. Dworken floated to his son’s house, and the next morning, when his son was making waffles for his wife and three children, he opened the window to cool the kitchen and in came his father.
There was nothing else to say. They’d said it all already, and a lot of it they’d said at Shady Rest with everybody listening. It was the sort of thing we hear all the time. The son didn’t want his father in a nursing home any more than his father wanted to be in one. But Mr. Dworken had been failing, his mind had been failing, and then his balance, and then he was walking around the neighborhood in his bathrobe. He was getting to be more than his wife could handle unless their son came over everyday and sometimes twice a day, but their son has the three kids, and his wife is involved with the older people in her own family, and I guess she’s got something wrong with her stomach or maybe bowels or maybe she said it was uterine fibroids. Anyway, they’d put Mr. Dworken at Shady Rest but he’d been upset, and his family had felt guilty, and floating in the window that morning was like pulling the scab off a burn. When the son called, we apologized and said we’d be getting the place back to normal as quickly as possible and would readmit his father then. We explained that the spectacle of Mr. Sullivan being swatted around on national television had mobilized the rest of the required family members and authorized volunteers, and the next day was really quite a scene.
Relations who hadn’t seen each other or spoken to each other for years were suddenly having to share ladders, climb on chairs and sometimes each other to reach the patients who, often enough, they also hadn’t seen. Predictably there was a lot of complaining and several sprained backs and twisted ankles and knees but also some surprises, particularly when the time came for the head nurse on each floor to give the all-clear and Mr. Hofstedder finally turned the machine off.
It was like when a patient died. A family might have been complaining about the food, about the laundry, about the sweater or the slippers or the dentures they were sure we’d lost, which we should find or pay for. Sometimes a family would get so difficult, we’d start to feel resentful, even threatened. And then the patient would die, and we’d expect even worse, but it was almost always the opposite. No longer tortured, the family no longer snapped but instead brought us cards and flowers and chocolates and food they’d prepared. I’d seen this about-face in any number of families, but I’d never seen it or imagined it in all the families, all at the same time.
Once the Levitron was off, once the patients were back to being patients and the families were back to being families and we were back to being the nurses they were always complaining about but not yet—not for at least ten or twenty minutes—there was a wonderful and precious human moment. There were handshakes, hugs, thank-yous, fond stories, and apologies. There was some recognition, however brief, that whoever and wherever we are, we all live and we all die, although in between things can sometimes get discouraging.
But as soon as he was back in bed, Mr. Tomaczek turned on his television, and Mr. Halpner said it was too loud and turned his own television even louder, and Mr. Levin pinched Mrs. Hanratty, and Mrs. Hamamoto threw her lunch on the floor. The next day, Mr. Sherman punched one of the other nurses in the face and the family refused to believe it. She must have been provoking him, they said. What’s the matter with you nurses? Don’t they train you? Our father’s not the kind who punches people for no reason so whoever he punched probably had it coming.
Within a few days, life at Shady Rest was back to what it always was, but after what had happened we weren’t about to complain. We didn’t complain when the inspectors came through with the variance we no longer needed. We didn’t complain when a number of families took their loved ones to other facilities and then demanded emergency readmission when they learned about nursing homes being nursing homes and pretty much the same everywhere. We didn’t even complain when Mr. Hofstedder said that he’d gotten through to Ms. Jiggly Bosom, and she didn’t know about the Levitron, that she’d been reassigned to another product—Once-A-Year-Feeding—and she hoped we’d consider a presentation. “We’ll hold it in the training room,” said Mr. Hofstedder. “I think we’re really on to something here. How about it, girls?”
And when you think of all the damage there could have been, when you think of all the patients who could have been injured either at the home or out floating around the city, there was really only one person who ended up any worse than he had been, Mr. Dworken. Last I heard he was still at his son’s house causing problems. Several times, his son has tried to bring him back. He’s loaded the old troublemaker into his car, strapped him in, and gotten as far as our parking lot, but he can’t get his father to leave the car, can’t carry him by himself, and under the circumstances, we don’t feel comfortable helping him. Oh, we’re willing to come out and tap on the windshield. We’re willing to smile and say, “Hi, Mr. Dworken. It’s wonderful to see you, sweetheart. Why don’t you come in and play some bingo? Why don’t you come in and let us make some hot chocolate?” One time, the son asked if we could use the Levitron to get his father from the car. We told him we no longer had it, we’d returned it, we were sorry but the two of them were on their own which was a hard thing to say and, I’m sure, a hard thing to hear. Not surprisingly, the son said what so many of our families say: you’d help us if you cared.
As if we don’t care. As if we don’t help. As if the Levitron would have helped. Believe me, we do what we can here at Shady Rest, but things are what they are, are what they always have been and always will be. As much as we might want to change them—as much as we nurses might wish a lot of things were different in the first place—bad enough like good enough, we’ve learned to leave alone.