Report from Pillville: Nursing Home Ratings Demystified

New Year's Eve 2013

In my daily life of life of caring for my 90-year-old mother, I do not think of nursing homes when things are going well. I have dozens of reasons why it's better for her to live with me rather than in an institution. On bad days though, nursing homes are all I think about. Give me a day with non-stop moaning, a day when I've barely slept because she's scared the crap out of me all night long with her nightmare shouts, or those shaky days and weeks when she's recovering from a fall or an illness, and I'm on the Internet trying to figure out where I can put her. 

My mom had a lobectomy in order to remove a cancerous tumor from one of her lungs in 2009. The day she was supposed to go home, I arrived in her room to find the crisis team preparing to hustle her to ICU. She couldn't breathe. After spending nine days on a respirator, she suffered at least a half dozen other set backs. It seemed that she was dying. During the worst of it, I hoped that she would die. It seemed like the only relief from the suffering. 

After a month she still was not well, but the hospital deemed it was time to release her to a skilled nursing facility. It was my job to find one. It wasn't that I didn't have the time. I'd been living in the hospital guest quarters for a month, writing my thesis, washing my three outfits out in the sink, microwaving weird convenience food in the microwave at three a.m. whenever anxiety kept me from sleeping. Finding a nursing home seemed easier than all that. There were WEBSITES AND RATINGS. I'd get her into some place good.

If you clicked on the link above that takes you to a New York Times article and a video, it's worth noting that I went to the same two websites portrayed in the video: U. S. News and World Report and Medicare.gov. Like the couple in the video, I had only a day or so to pull this off. The five-star place I wanted had a long waiting list, so I went with a four-star place near my brother's house since I lived across the county. I had no car to check out the facility in person, and my brother and his girlfriend had full-time jobs. But hey, U.S. News and World Report, right?

My mom and I arrived at the facility near dusk. The staff was too busy to provide any sort of cordial welcome. Things were chaotic Chez One Flew Over the Cuckoos Nest. The place stank and patients were calling out for various kinds of help. My mom and I had arrived by medical transport, so we were stuck. Later that evening when my brother arrived, we discussed just taking her to his place, but we didn't have prescriptions for her myriad of medications or any oxygen. We sat in her room with her for a while doing what we could to make her comfortable. We rang the call bell for her roommate who was crying uncontrollably. We sat, listening to the clack and hiss of her oxygen machine, going over our options. We tried to talk our not-at-all tech savvy mom into keeping one of our cellphones, but she refused. We sat for a while longer, marveling in horror at the name on her oxygen concentrator. Devil's Bliss, we thought it said. (It actually said Devilbiss, the name of the manufacturer) I couldn't stop wondering why anyone would name a piece of medical equipment Devil's Bliss. It seemed like a bad omen.

The next morning I went back at breakfast. My mother was having chest pains, and I insisted that the staff call 911. She was transported back to the hospital. After some days there, I had to find her another nursing home. Then I went to France on a writing fellowship. Things did not go particularly well at the new skilled nursing facility either. After my mom fell, and was subsequently tied (I'm sure there's a different word medical professionals use) to her bed, and overmedicated, my brother took her to his place. She was well cared for there by him and his girlfriend for three years. It will be three years this August that she's lived with me.

This past May when the man who loved me got sicker and sicker from his lung cancer, and my mom had been ill and had recently come home from the hospital, and I felt that I was not quite set up to care for two frail people at home, I found a nursing home for Dan. This time, I spent a day driving to all of the possible places near my house. I chose one. It seemed good, but it wasn't great. He was weak and disoriented and in grave danger of falling, so due to the fact that his daughter and his friend Linda had come to stay at my house, I slept at the nursing home. The night that I watched him writhe in pain for an hour, waiting for a dose of morphine, I called the hospice nurse at 4:00 in the morning and made arrangements to have him transported to my house. By the next afternoon, he was there. 

I don't blame myself in a guilty sort of way for asking Dan to go the a nursing home for those few days. But I wish I hadn't done it. In my mom's case, well, she was really debilitated, but maybe she would have been better off going right to my brother's place too. Watch that video in the link above. Read the article. Self-reporting????

 "Two of the three major criteria used to rate facilities — staffing levels and quality measures statistics — were reported by the homes and not audited by the federal government." 

Shit. 

So if you're faced with the need to consider a nursing home, wait, if you can, until Feb. 20.

Little Astronaut at the Bottom of a Crater

The first thing I lost was an emaciated dying man. When my boyfriend breathed his final breath as I lay next to him in the hospital bed in the middle of my living room, I held his ruined body, reveling in its terrible beauty, knowing there was nothing do to but let him go.

I imagined my grief to be an ocean in the days immediately after his death—something that I could swim across eventually if I worked at it diligently. A few days after that, a mountain seemed a better metaphor. I had to keep trekking if I was going to survive. There could be no floating, no riding the waves passively, or treading water. It was claw my way upward or plummet.

Dan died on a Friday. Which meant I didn’t go to the train station to pick him up on Saturday afternoon and that he and I did not go to the local farmer’s market on Sunday. But in those first days, I’m not even sure how specifically I considered where he wasn’t or what we weren’t doing together. Mostly I was just lost in the loss. The lack of him was amorphous and huge.

At some point though, days or weeks later, as I drove to the east side of town, I realized I was not driving to the hospital to see him, nor was I turning onto the street that led to the nursing home where he spent a few days before his hospice care was transferred to my house. I wasn’t overseeing medication, or taking his temperature, or making fresh juice, or trying to imagine what I might concoct that would entice his ravaged taste buds. I wasn’t hunting for sweat pants out of season or debating the merits of medical marijuana. Not only was the dying man gone, the sick man, who was frequently a hell of a good time, was gone too.  

Later still, our ritual of evening phone calls reconstituted itself one night as I sat at the dinner table waiting for my mother to finish. I was feeling physically better. Like going for a walk instead of lolling around on the sofa or simply giving up and going to bed at 8 p.m. But my weeknight walks meant talking to Dan. I went for a stroll anyway and played all of the dozen or so voicemails from him I had saved in my phone. All but one were polluted by opiates or pain or fatigue, and the one that wasn’t sent me careening down into a grief that felt more like a crater than a mountain.

Today, exactly six weeks since he died, the crater seems to getting bigger as grief dances me backwards in time. It’s one thing to mourn the loss of a terminally sick person who deserves relief and release; it’s quite another to remember the vibrant lover flirting with you over email or saying sweet things over the phone. It’s unthinkable to wake expecting kisses when the man so generously doling them out is not, and never will be, on his side of the bed. Little by little, it feels as if the robust man I once knew and loved is being reconstructed, shoving that sick guy into the background, and in the process, the loss grows larger, not smaller.

At night I scroll through Dan’s Facebook timeline with pictures of him when he was healthy. I watch videos of him playing music or doing t’ai chi. A sweater of his, buried at the bottom of my drawer since last winter, surfaces. I walk the stretches of beach we walked together before he grew too weak. A bottle of Siracha on my refrigerator door works its way to the front. I lost all of these things to fevers, anemia, dehydration, pain, and out-of-whack electrolytes. In the last months, I was so busy juggling care for that sick guy along with taking care of my 89-year-old mother, that I’d practically forgotten the man I met five years ago on a Match.com date. The healthy Dan had already been missing for a long time by the time the sick Dan died.

Lately it seems that every tomato, every strawberry, glass of wine, shot of vodka, every train whistle, every moon, all the songs he once sung to me are swirling molecules of memory reconfiguring a man I haven’t seen for months. Each time a scene takes shape, the slope of the crater gives way and I’m back at the bottom again. I don’t mean to argue that my grief is deeper and wider or even different than anyone else’s. I don’t mean to say that losing someone to a debilitating illness or a terminal disease is any more heart rending than a sudden heart attack or a tragic accident. I’m just telling you this grieving thing isn’t going how I thought it would, and maybe grief—our own or anyone else’s—doesn’t ever go as imagined.

Years ago on a family vacation to Meteor Crater in northern Arizona, I was stunned to be standing or the rim of a hole in the ground that was a mile across and deep enough to hold a 50-story building. It wasn’t what I had expected at all. It might be that a crater is the perfect metaphor for grief. It might be that grief digs deeper and deeper inside of us and that each new revelation of the loss is a subsequent impact, adding depth to the initial event. Yet somehow we go on, survivors who’ve lost lovers and parents and children and friends. We stand at the bottom of our grief, feet solidly on the ground like the barely visible life-sized model of the astronaut at the bottom of Meteor Crater. There we are, waving a seemingly tiny flag, providing scale to the immensity of our loss, which in the end is really about the immensity of love. So much bigger, so much deeper and wider than we ever imagined.

Meteor Crater, Arizona/Summer 2001

June 6/Afternoon

Blood pressure dropping. Blood pressure drops some more. The nurse delivers her tidings every hour. We murmur. We watch. We wait. Lunch. Snacks. Coffee. Conversation. Silent sitting. Phone calls.

Dan's friend Will drives down from Berkeley for the second visit in 4 (or is it 3?) days. Dan's friend Russ arrives, and Will and Russ begin to make music, sitting next to Dan's bed.

Do you want to climb in with him? the nurse asks, nodding toward the bed. Of course, I do, I say, but I can't figure out how I'm going to fit myself in with the five pillows propping him up. And there's the oxygen line, the tube from the catheter. It looks impossible. Instead, I help the nurse with the cool washcloths we are placing on Dan to relieve his fever. Let me know when you think I should crawl in with him, I say. How about now? she asks. I'm still doubtful. I'll help you, she says, lowering the bedrail and then pulling it back up again to support my back.

The songs Russ and Will are playing are Dan's favorites. Wow, I tell them, I never thought I'd find myself in bed with my boyfriend with live music in the room. Best girlfriend ever, Dusty says.

I begin whispering my "litany of bests" in Dan's ear. I've told him some of these things already, but I begin again, telling him everything I can think of. Best first date, best kisser, best friend, best guy in the kitchen, best massager.... Dan's breaths are shallow, as they have been for days. I watch the rise and fall of his chest. And then there is no rise. I call out for Dusty who is just a few feet away on the couch, and she sets her fingers against his neck where there is still a pulse. The rest of the family is at  the bedside now and everyone lays their hands on him. The pulse stops too. He sighs a final sigh, and he's gone.

The nurse pronounces him dead. It's 4:04 p.m.

Today/1:38 p.m.

June gloom. Slight breeze. We sit, but not for long. It's slow motion musical chairs--without the music for right now. We have cake. We have bagels. Lox. Chips of every variety. We have sandwich stuff and leftover chili. We are running out of pillows because we have Dan propped up every which way to make him comfortable. The phone calls, the Facebook messages and the emails keep coming. People keep arriving. I had this idea that it would be just the immediate family and me when Dan breathes his last--whenever that may be. But I've given way to the tide of love washing over the man who loves me. I think he would like it. So the friends, and old girlfriends, and roommates, the t'ai chi students, and the band mates come. They tell us things we don't know. We listen.

And here is a story for them. A blog post from about 3 years ago called I Could Drink A Case of You:


Saturday night after the super moon refused to show its face, there was more darkness. I pulled the mail out of my mailbox to find a "letter" from my attorney which wasn't a letter at all. What is was was a photocopy of the judge's ruling on my motion to recover attorney fees. Denied, it said.

 I'd been waiting since our day in court on March 2nd for the news. I'd emailed my attorneys asking for an update a week after the court appearance. The judge was out of town, they said. So I waited some more thinking I would email the attorneys again after the weekend. Maybe the beginning of Spring would bring good news.

Or not. But it wasn't the bad news about the money that was the worst thing. Instead of days of waiting, I could have used a prompt email last Tuesday when the ruling came down. Or a phone call. I could have used a tiny slice of personal communication--something like, "Dear Denise, We're sorry to be the bearers of bad news, but don't be discouraged, and here's what we'll do next..." I could have used a scrawled post-it note stuck to the corner of the blurry photocopy with some kind missive like "hang in there"--or even a crude little drawing of a frowny face. Nope.

I admit to dark thoughts. I have them. I'd been having them less. But Saturday night the dark thoughts had a party. They wore black and carried knives. They looped ropes over beams. They made tea and reminded me that the deranged husband in Tim O'Brien's excellent novel  In the Lake of the Woods killed his wife with boiling water while she slept. I didn't sleep Saturday night. I sat in my bed frozen with dread. I emailed Mr. Ex. I texted him. Then the sun sort of rose--or did what the moon did the night before--lurked somewhere behind the clouds while doing its job in a less than satisfactory way. And that's what I did Sunday. I skipped a good friend's fabulous First Day of Spring party and drank mimosas in my pajamas with M. while we watched basketball. Then I crawled to bed and slept the day away.

When I woke I felt stupid and lazy and realized I had a house full of people whom I love. I cobbled together dinner, took a shower while the chicken was in the oven, then lit the candles and sat at the dining room table like a human being. And somewhere in there I'd talked on the phone with the man who loves me. He was wrestling with his own First Day of Spring demons. "You'll know what to do," he said. "You always do." Or somethin' like that.  Maybe not, I thought. And maybe this thing between us could be going a little better.

I was putting the last of the dishes into the dishwasher when the brass door knocker that nobody ever  uses announced that someone was at the door. Yup. "Someone's at the door," the daughters said without moving as if they knew it was for me. There he was, the man who loves me standing in the rain with a little cluster of daffodils in one hand and a case of wine hoisted onto one shoulder. You read that right. Not a bottle. A case.

I'm still on my feet.

This Evening (again)

one of my favorites of the many photos of Dan that his friends have been posting on his Facebook page

Rise and fall. Rise and fall. We sit in the living room watching the rise and fall of Dan's chest. We look up from our books or magazines, our laptops or our phones. We all have something we are doing as we wait, yet we all see the changes and ask one another, is the breath more shallow? Is he breathing faster now? Was that a pause?

Hum of the fan. Hiss and sigh of the oxygen machine.

A little later we set up a bed in the front hallway for Dan's oldest sister. Ready another bed in the garage for a dear friend from the Bay Area who has decided to come back down. I pull out blankets for the other sister and her husband who will camp out on the couch. My mother, thank god, has gone to bed. Every time she tells me I have to be strong or hold it together, I say, no I don't. That I'm just going to go ahead and be sad. 

Hum. Hiss and sigh. Breathe in. Breathe out. Dan's breath now seems more like...like what?

At least we are well fed. When my friend E called and asked if she could come, I told her yes. Yes, please, tell me what we should eat, I said, and help me with my mother. She brought the fixings for chili, and sat in my mom's room with her for quite a while. She sat with her at dinner, and stood over the iPad with her afterwards reading and taking about something.

Now the rest of us sit, transfixed--and then not as we go back to reading or scrolling or typing. We sit breathing, waiting for Dan's last breath. So many "lasts" have already occurred. They stole by us, unannounced. No fingers on the strings of his bass. No more walking. No "Hi baby." No singing. No kisses. Better not to know, perhaps, when the last of these things occurs in anyone's life. How would we bear it?

This Morning (again)

Calm and gray. The mirror of water outside the window just beginning to ripple. We sit on the couch (Dan's daughter, his sister and I) asking ourselves why he is hanging on. There has been no change in Dan's condition in the last 24 hours. The nurse asks us if we have had "the talk" with him. We have. Go, we've said. Separately, we've said it. And together. His daughter and I stood on either side of him  yesterday afternoon and told him we love loved each other. I will take care of Dusty, I said. I will take care of Denise, she said.We've delivered messages from others. Held the phone to his ear for a number of one-sided conversations. Read him the emails that keep filtering in from long-ago school friends. Filled the room with music from his own iPod.

In my experience, the nurse says, it's the women who hang on. Men, when they can't use power tools, are done, she says. The women want those grand babies.

We don't know what Dan wants. To say something, Dusty says. He would say the most perfect wonderful thing, we are certain, if he could talk.

I am done with questioning. Instead, I sit at the foot of his bed. I'm watching. I'm waiting. With every email, phone call, Facebook message, every old photo, every family story, the heart of this man I love grows larger even as the shell of his body grows smaller. My house hums with the fan that blows across his fevered body, the sound of his oxygen machine merging with the sound of my mother's oxygen machine, the rustle of newspaper pages being turned, the click of laptop keys. My house hums with life.

The trick is in knowing when to let it all go
hanging on til you're sick to your soul
saying yes and forever and never and no 
They're just spots on the dice as they roll

---lyrics from the chorus of a song Dan wrote long before I knew him.

This Evening

We've eaten the candy. (Okay, I've eaten the candy), half of the cookies, most of the berries. It's three nurses later. There's been a sandwich run. Wine has been poured. Hugs have been exchanged and stories told. Tears wept and wiped and wept again. Hands have been held. Hands have been massaged. Hands have been placed on Dan's forehead, slipped into his hands, and hands have stroked his arms and his improbably hollow cheeks.

Wishes have been whispered. Blessing proffered. Permissions given. Predictions made. Love given, received, multiplied and returned.

Meanwhile, my mother is standing in the kitchen in her purple plaid pajamas finishing her millionth  martini.

And I'm just wondering. Anybody else out there have two Do Not Resuscitate forms posted inside their door? Just asking. Just asking. Just asking.

This Morning

It's morning. I come downstairs and do what I always do. Coffee. Pull up the window shades. And this particular morning I talk with my friend L who is flying back to Hawaii. How long have you two known each other, the nurse asks. L and I laugh. Three days, she says. But she's known Dan for 50 years, I say.

I tell Dan I'm taking L down the street to catch a shuttle that will take her to LAX. Tell him I'll be right back. Kiss his head. There's activity under his eyelids, and he tries to say something.

When I return I sweep the floor, stopping by his bed, which is in my living room, to kiss him or lay my hand on his head. I tell him I'm back. That his daughter is upstairs. That his family will be here soon. Friends too, maybe, I say.  I unload the dishwasher as quietly as I can. Drink coffee. Take out the trash. Throw in a load of laundry. These are the things that need doing even when there's someone you love lying in your living room actively dying. A hospice phrase. Actively dying. Right now, it seems like Dan and I are dividing that phrase in two.

I talk to him. Read him some of Jack Gilbert's poems. Then I turn my attention to the piles of things on my kitchen island. I take cookies out of their bags and arrange them onto plates. The candy that L brought from Hawaii into bowls. The strawberries that K brought into a bigger bowl. Bright red into green. Beautiful opposites. I peel all the stickers off the bananas so they look prettier. Are these the things a person should do when someone you love is actively dying just across the room? The nurse suggests a basket so all of the morphines and other medicines can be tucked inside instead of strewn across the counter. I pull one out. Perfect, she says. Thank you, I tell her.

Then I settle onto the couch. Open my laptop. I am actively living.

Escape to the Sea

I had a dream last night as I slept in two chairs pushed together in the room at the care center where the man who loves me now resides. I dreamed I sewed a special backpack out of sturdy leaf-green canvas. I put him in it and carried him to the ocean.

He was wide awake this morning after it took 25 minutes to get him his morphine, so I told him the dream. Haha, he said. Later as the morphine trickled down his throat, he said the word dream as if he wanted me to tell him the dream again. I did, and he said let's go. He flung his legs over the side of the bed, but couldn't get up. What is going on with my legs, he asked.

I didn't tell him the 2nd half of the dream where I hung him in his back pack on a tall iron fence and went to see a my friend J in her cottage next door. When I came back, he was gone.

Sublingual

This comes from Anne Lamott’s book, Traveling Mercies:

All those years I fell for the great palace lie that grief should be gotten over as quickly as possible and as privately. But what I’ve discovered since is that the lifelong fear of grief keeps us in a barren, isolated place and that only grieving can heal grief; the passage of time will lessen the acuteness, but time alone, without the direct experience of grief, will not heal it.

I am already grieving although the man who loves me is still among us. Today he ate half-dozen bites of watermelon, a strawberry, two or three walnut halves, the tips of fork tines coated with almond butter, and a thimble of latté. Oh, and two bites of chocolate ice cream. He told me a dream, and I tried to hang onto to it, but lost it. Or most of it. He was involved in a project, he said. In the first try at the project he was disconnected from everyone, and then in a different dream (or was it the same dream and just a different project?) everyone was working together......on something. It's hard to focus on words. There's the hum and hiss of the oxygen machine. And the place has its resident screamer. I don't think he hears her. But maybe he does. He and I have other things to talk about. The taste of morphine under the tongue. Sublingual. We talk about his dreams. His drugs. While I hear the  woman screaming down the hall, a woman we don't talk about. But a woman screaming down the hall Is a woman screaming down the hall. I hear the staff interacting with her.They're doing okay. She still screams. My only hope is that she's not in pain.

"You have to buckle up," my mother said to me tonight as I sat on the couch weeping. Buck up, I suppose, is the phrase she was after. A swing and a miss. Like so much of my communication with her these days. I was speaking to the man's sister on the phone. Is there anything I want from his apartment? Everything. Nothing. Him. Us. My mother told me and the man's daughter, who was sitting beside me on the couch, how her husband (my father) died standing up. Just like that he was dead. He only fell to the floor when she tried to move him. It was terrible, she said. It was.

"Are you going to the nursing home tonight?" she asked as she shook the last drops of martini into her glass. A swing and a miss. "Sure," the spiteful horrible grieving me wanted to say, "I'll leave you here stumbling and shuffling and go lie next to him." But I left those words under my tongue where they belong. Sublingual.

Report from Pillville: The Other Side of the Story

While things are going well with my mom (the CT scans did NOT show any cancer or tumors as cause for her weight loss,) things are going less well for the man who loves me. Still in the hospital, he's not really feeling great. However, his appetite might be making a comeback. I will take good news where I find it.

I took an early morning walk on the beach before I went to visit him and photographed from a  different point of view. You've seen dozens of pictures of the water, the waves, the islands on this blog, so how about this for a change?

view of the sand and the sky taken standing in the ocean

Years ago when I was acting, a sage director once told me it was absolutely essential to step out of the character's skin before leaving the theatre, especially when playing someone sick or dying. I frequently wonder what it's like to have the ancient body my mom possesses. My knees are 61. What do almost 90-year-old knees feel like? I wonder what it's like to "pull for breath" as my boyfriend so often says he does. I wonder about so many of the things that he and my mother are going through. I put myself in their shoes, but only for a brief moment. Then I step out again.

Tuesday Afternoon Weather Report

The clouds pile up against the mountains until they become mountains themselves. The blue sky comforts me on this May afternoon. But the wind, which today is cold, not hot, I find unforgiving. I foist words onto natural phenomena, practicing anthropormorphism with abandon. Trees scratch at my windows as if they want in. The neighbor's wind chimes call me toward something, but what? I ignore, but they keep calling.

Comfort. Forgiveness. Wanting. These are words for the day you tell your boyfriend you can no longer care for him at your house. You explain that you cannot be the day nurse and the night nurse. That you never wanted to be a nurse at all. That you know nothing of what you need to know. That crisis hovers in the corner by the bed where he sleeps and that you see its hungry eye on him.

You know love. You know fresh green juice. You know the numbers 9-1-1. You know that clouds are not mountains and that sky and the wind care nothing for anyone.

Weekend Recap

In chronological order, beginning with Friday afternoon:

My mother weighed in during her doctor's visit at 99 pounds.

On Saturday Piper, our beloved and ancient cat, died.

Later that evening, the man who loves me was taken by ambulance back to the hospital.

I came home from the E.R. in the wee hours of Sunday morning to find I'd forgotten to take my house keys with me and was locked out, thus having to awaken M, who due to Piper's final hours the night before, had barely slept.

Today I turned off my phone and, after briefly checking in with my mom to say good morning around 8:00 a.m., went back to bed and slept until 3:00.

I might be coming down with a cold. But as I sit here with my cup of tea, I am aware that the figurative cup overflows. Many loving condolences re the cat; daughter C's offer to come to my side; friends who've left messages saying that no distance is too far, if I need them; a friend who proofread the galleys for my book while my brain went out of writer mode and into survival mode, another friend who came today and allowed me to do some hard thinking out loud, helped with chores around my house, and brought us strawberries; my mom, who in her frail state is still more than willing to pitch in and help in any way she can; M doling out love to Piper, me, and my mom and offering to drive me to the hospital.

I sit here in the dark, replaying it all. Re-evaluating, re-grouping, readying myself for tomorrow.

Thank you. All of you.

And now a poem.

copied from the poets.org website  The Fire   Katie Ford

When a human is asked about a particular fire, she comes close: then it is too hot, so she turns her face— and that’s when the forest of her bearable life appears, always on the other side of the fire. The fire she’s been asked to tell the story of, she has to turn from it, so the story you hear is that of pines and twitching leaves and how her body is like neither— all the while there is a fire at her back which she feels in fine detail, as if the flame were a dremel and her back its etching glass. You will not know all about the fire simply because you asked. When she speaks of the forest this is what she is teaching you, you who thought you were her master. There was a quickly knocked down fire last week.   It's impossible not to think of fire in southern California when it's hot and dry and windy like it is today. It's impossible not to think of the phrase trial by fire. Or the word  crucible. Or hell.  Or chemotherapy. Or radiation. Or the image of walking across hot coals as a test of one's fortitude or belief in not being burned.

Anything is Possible.

I accomplished many things today. Things that would not impress anyone, really, but I feel like I have superhuman powers due to said innumerable trivial accomplishments. I could go to sleep or I could stay awake FOREVER. DOING MORE TRIVIAL THINGS.

Perhaps I should mention that I've been sleeping a lot prior to the combustible energy I experienced today.

And perhaps I should mention, that tomorrow, the man who loves me might sit in the chair pictured above--at the makeshift desk in my room. It'll be rather remarkable if he sits anywhere since he has been mostly asleep since Thursday night when I took him to the ER. But he's been infused with blood and antibiotics and fluids, so who knows, anything is possible. Anything.

State of the State of the Margaritaville

It not yet 8:00 p.m. here in Margaritaville, and I am in bed, wearing my warmest pajamas while the wind tosses patio cushions askew and makes my house feel about as airtight as tent fashioned from a fishnet. In bed with me is my heating pad, a sorry substitute for the man who loves me. The man is tucked into a hospital bed (where he's been since Thursday night,) and if the energy level he exhibited when I left him around 4:30 remains the same, I'd say he is fast asleep. Once again he's been laid low with a soaring white cell count, and this time he had a racing heart and a fever to go with it.

"You knock me out," he murmured when I kissed him good-bye. He looked at me the way he looks at me. Go ahead, imagine it--because I don't have the words for it. Maybe it's the way you'd look at a woman made of water if you were dying of thirst. The way you'd look at a woman breathing out sunbeams if you were freezing to death. Yeah, something like that.

I came home from the hospital and made my favorite no-brainer of a dinner. Salmon poached in a little vermouth, sweet potatoes, green beens, and sliced tomatoes and avocados. I loaded the dishwasher and left my 89-year-old mother to wash the pots and pans.

And in other news, before going to the hospital, I drove to 65 miles to a divorce mediation first thing this morning. Long time readers of this blog, those of you might recall its original name, which I am prohibited by order of the court to render into  print here, sit yourselves down. The mediation went well. Yes, indeed, two months short of seven years since the uttering of the sentence with the trifecta of bad news (our marriage is over, I'm marrying someone else, and we want the house so we can raise our new family here,) the mediation went well. 

It's been a mixed day. And while I would not have ever thought it possible seven years ago to imagine   being more sad than happy on a day when the divorce mediation went well, that is how it is here on this particular evening in Margaritaville.

A Story in Pictures

LAST NIGHT'S MIDNIGHT SUPPER

THIS AFTERNOON'S PAJAMA PARTY

THIS EVENING'S VISIT

Red

heron with rocks and bougainvillea to take your mind off this post

8:30 a.m.

I am 61 years old, and I am wearing red pants. This is mitigated somewhat by the fact that my red pants and I are in a yoga class. But after this hour of serenity, I will drive to the seedy side of Hollywood, check my boyfriend out of a nursing home, and take him back to my house where he will take a break from the chemo and radiation that have been rendering him weaker and weaker. If chemo and radiation were assigned a color, in my mind, it would be red. So the red pants might be appropriate after all.

I do not like to buy clothes. Visiting the mall always propels me toward anxiety. I feel like a greedy consumer when I buy new things and much prefer a thrift store, but mostly, I don't shop anywhere; I just wear what I already have. I bought the red pants for daughter M to take on her 8th grade class trip. She has a master's degree now. When she abandoned the red pants early in her undergraduate days, I claimed them. They still look new, but usually I wear them only when my other two pairs of yoga pants, sedately hued in brown and gray and more than a decade old, are in the laundry. Today the gray pants were folded neatly in my drawer, but I chose the red pants anyway. I don't know why, but it seems important.

1:30 p.m.

We're home. I make fresh juice. Two kinds of kale, celery, carrots, grapefruit, lemon, blood orange. M and the boyfriend and I agree that it's tasty--though I briefly consider dumping some gin into mine. For the rest of the afternoon, it's managed chaos. There are meds to organize and discharge instructions to digest. We need a glucose meter and test trips, so M goes to Rite-Aid. I discover there's stuff, "an appurtenance," the boyfriend calls it, attached to the chemo port and taped to the outside of his chest. Tubes with dried red blood in them, a white clip and a yellow clip. He thinks a nurse in the hospital put it there on Tuesday. He has no idea if this thing needs maintaining. I make him promise he will not try to uninstall it, and I call the nursing home and then the hospital where he spent some time at last week. I call the chemo center and talk to the doctor on call. No one has anything relevant to say, so I Facebook my ex-sister-in-law who's a nurse, and then  I cook dinner. Rib-eyes on the grill, more greens with radishes and onions. Sweet potatoes.

10:00 p.m.

 I'm on the couch with M watching the watching the Clipper game. The boyfriend is in my bed, asleep. The blood in the tubes needs to be flushed, the sister-in-law nurse writes back. I fill my wine class, watch the Clippers win, all the while thinking of blood. Of red wine. My red pants. I might obsess all night over the blood in the tubes taped to boyfriend's chest. I might sleep, oblivious to all this terror, relieved that after two months away, he is finally lying next to me.

What I Cooked

At the end of a week during which my mom seemed especially tired, and a week during which every conversation with the man who loves me contained the words cancer, or chemo, or radiation, this is what I cooked:

Artichokes. Pasta with pistachio/spinach/basil pesto. Heirloom tomatoes with basil and fresh mozzarella.

My friend Paula arrived with a lots of wine and chocolate.

And she brought her dog.

Now, if you'll excuse me, I think I'll go eat some more chocolate.

Context is Everything

If context is everything, then this was a delicious meal.

And if context is everything and you live in Los Angeles, then this is a river.

And, in the context of his situation, the man who loves me is where he needs to be. Weakened by cancer, chemo, and radiation, he's in a facility where he is being cared for to an extent that I cannot provide chez moi. As he put it, the place is not burdened by pretensions of elegance, but if you sit on the patio (as he and I did today)  and look up, the view is all right.

There are many reasons to be hopeful. He is better than he was a week ago. We may again get back to this:

And in the meanwhile, I am filled with gratitude for the love and support of family and friends.
Thank you.