I was good with patients, I could put them at ease, likely because I was only interested in putting them at ease. So I’d introduce myself, sit back, and start a conversation. I’d open my eyes —not just the lids themselves, but the meaning, the world behind them, to open myself —an invitation to engage in an attempt to better understand one another.
So I opened my eyes. I’d always keep a slight smile on my face, just the corner of my mouth on the left side slightly upturned —not enough for my one dimple to really come in but enough to make you guess at it if you hadn’t seen it. A smile that I’d hope would convey willingness to hear, but not presumption, not my own world but a request to enter theirs for a while. Hands clasped right now, but undoubtedly will be waving around when I speak.
I’d sit in a chair, or on the edge of the bed, look around at a uniform little compartment,
decorated here and there with bits and pieces of their life —a picture of them at another time, an award, a diploma, a small bag of chocolates, a phone charger, a card, flowers, or in some cases, an absence of all of those, replaced only by a frown and what I can only describe as the truest facial expression of melancholy, heartbreak, emptiness. It emanated from their eyes, like the light out of a flashlight, except black, like the world behind it has long fallen away, eroded.
I’d feel around for something that would bring the light into their eyes, that would awaken the world behind them, like bringing back the power after a blackout, the wave of brightness, vigour rolling through them, rejuvenating—because unfortunately some of them seemed to have blacked out their belief in having that again. And we’d dance. The first steps of conversation cautious and guarded, a rally, step for step until our moves, our responses would become more fluid, more natural, more spontaneous, more in tune and we’d be laughing, joking, shocked at some things, completely not so at others —a warmer smile on my face, my dimple is showing, but that’s okay. I am satisfied at hearing their
happiness, or at least what I perceive to be happiness, to hear their own personal investment into the dialogue, for that to affirm that they were indeed willing, no longer cautious, no longer guarded. What a contrast, such light in an environment that was rather desolate, plain, whitewashed walls and curtains with meaningless print on them, placed there —it seemed— just to remove the regularity, to add some rhythm, however mundane.
I fell into a rhythm of meeting my patients, my friends. I was able to befriend a stroke patient who refused to talk or interact with anyone, including their speech pathologist and so I was asked to see another patient. No problem. I’ve done this a million times.! !
I’m walking into the room, there is a man in a wheelchair, staring at the wall as if it were a puzzle he couldn’t figure out. A few things on the desk behind him, nothing memorable. He was tall, gaunt, legs sticking out relaxedly from his chair, dressed in blue sweatpants that were comfortably worn, enough that the little grey lint balls were visible, a few food-coloured stains sprinkled here and there. A white shirt loosely fitted on the thin man. His face showing the lines of old age, his mouth a flat line, liver spots speckling the sides of his head and a few white hairs poking out of his ears, the only ones on his face. His eyes though, were infused with a restless fire, still trying to figure out the puzzle.
I’m seeing all of this. I’m walking —still— into the room, past the empty other bed in the room, the 3 and a half meters and the 7 seconds it takes to cross them.
Then I see the other person. I see a woman, older too, a ring on her finger —his wife? He has a ring too. Maybe his wife. Maybe not, do not presume. Someone in such a vulnerable state, already being told what they are, who they are, who they will be —never presume.! !
She wears a baby blue sweater-t-shirt thing, loose too, black loose pants billowing around her slight frame. She has a warm, old, oval face, short hair, her smiling eyes squinting, her inviting smile welcoming me into the room. She sits in the chair, I walk towards the pair of them. She greets me “Hello”, a kind voice, but a faint one, I can almost hear it falter, on the cusp of it. He says nothing, she greets me on his behalf. We exchange names and converse. I am an experienced dancer, even with two partners, this will be fine. I am excited to learn about them, to give them someone to talk to, and make them smile.
We speak, same moves, same caution, same guards. I try to converse with both of them. She speaks for him. Moving through the dialogue is like navigating shifting streets, the focus is dynamic, the speakers are dynamic. You move and things move, you move again. I want to show him that he is not an object to be spoken of, but it is difficult as making such moves would be grossly inappropriate for my state of rapport with them.
We’re communicating, making progress but the majority of the discussion is with her, albeit about him too. I learn he has dementia, I learn he hallucinates, I learn that he is most often not being in the same reality as his wife and myself —then again, few of us are all in the same reality, yet his seemed far more distant, somewhere in the puzzle on the wall.
This happens a few times. I wonder how strong this woman is to stay by his side —he is far off, to stay hopeful. I wonder how much of a fortress this woman is. I cannot help but think her hope is largely in vain.
She breaks. She starts to open. She is shaking, folding inwards. Her smiling squint becomes a grimace, her mouth turns downward. She is gasping, sobbing, her breaths and cries meshed together in a wailing, moaning and intermittently breathing stew. Her hands are folded inward, held close, her legs tucked under the seat. It’s almost as if she’s trying to fade out of the world. She is withering, unravelling, like a flower falling apart in a time lapse. The fortress she was, built on pillars of sand and salt, escaping with her tears, as she breaks down and collapses, “It’s so hard. It’s so hard.”
The air is thick with lament, with an inescapable sadness, in the truest sense of the word, simply an unwavering and paroxysmal loss of hope, as clear, present and yet untouchable as the light from the sun. It envelopes the room.
I wonder how the chair can support this woman’s heavy mind.
All the while, her husband looks on. Honestly, I am paying less attention to him, it appears that he is still entranced by the wall.
My eyes have opened wide, I’m staring. I’m trying to console her. The moment is a blur. She gathers herself and we continue somewhat. I leave the room. It is the last time I see her.
— Author’s note: This piece was written years ago about a volunteer experience on the restorative ward at St. Peter’s. —