A Storied Life

by Leigh Kramer

  I needed to sleep. I took another breath, deeper this time.

  She was depending on me to do this. I could fall apart another day. Another day, when any of this started to make sense.

  Chapter Five

  The traffic gods were not on my side this morning. The cold and rain rivaled my mood. Not even aggressive driving staved off the delay caused by an accident on Route 38. The windshield wipers smacked back and forth as I dared the surrounding cars to mess with me. Twenty minutes past ten, I screeched to a halt in front of Gram's house, one lone and unfamiliar car already parked there.

  At least none of the family attempted to hijack the meeting with hospice. They would already be here if that was the case.

  The effects of late night tears were evident in my bleary eyes. I managed a few hours of sleep before arriving at the gallery at 7 am. Pounding through paperwork and Irish Breakfast tea had kept me awake so far. I hoped I'd sleep well tonight, or at least for a few more hours.

  I ran into the house, any sense of decorum long gone. I hated being late.

  “Gram?” I called out as I stepped through the foyer.

  “In the kitchen, dear,” her clear voice refrained.

  The kitchen. A good sign for the hospice person to be invited into Gram's haven.

  I peeled off my raincoat as I headed back, enveloped by warmth and the aroma of apples and butter. Gram sat in the breakfast nook, along with another woman.

  “Sorry I'm late. I got caught in traffic,” I said with a grimace. I didn't want Gram to notice the dark circles under my eyes so I busied myself with stowing my purse.

  A white woman around my height with salt and pepper hair introduced herself as the Beth with whom I'd spoken yesterday. She looked grandmotherly, though decidedly younger than Gram. I'd been nervous about what to expect from someone who purposely associated with the terminally ill, but she quickly put me at ease.

  “Your grandmother has been singing your praises,” she said.

  I shot Gram a look, still uncertain about her end game. “She's trying to butter me up after what she put me through yesterday.”

  “Yes, I did hear your family has strong opinions about Ella May's decision.”

  Understatement of the year. A harsh laugh escaped me as I turned on the kettle and scooped loose leaf tea into a bag.

  She continued. “They're more than welcome to sit in on a visit, or the hospice team can arrange a meeting with everyone to answer questions. Of course, that depends on whether you and your grandmother would like them to be a part of discussions.”

  Gram and I exchanged glances. That was something we'd need to discuss later.

  I brought my mug with me and joined them at the table. Time to change subjects. “Did I miss anything?”

  “Not really,” Beth replied. “I took Ella May's vitals. That is, I took her blood pressure and heart rate. Everything looks good. She filled me in on yesterday's events and then you walked in.”

  Blood pressure, heart rate. The words settled into my marrow. I visualized future days sprinkled with Gram's health updates and nosy family members. Perhaps I'd been twenty minutes late to protect myself from this new reality. There was no turning back now, though. I had made my choice.

  A folder emblazoned with Sanctuary Hospice's logo rested in no man's land on the table, abandoned over by the napkin holder and salt and pepper dispensers. The detritus of Gram's newspaper and coffee cup almost concealed the folder. Almost.

  Beth followed my line of sight. “The folder is for you to keep. I'll refer to some of the handouts while we talk but it's fine if you want to start looking through it.”

  I looked up, startled. “No, no, that's OK.” I felt like a little kid, pretending I was old enough to be with the grown-ups but aware I wasn't fooling anyone. Play jewelry and a tutu might as well have replaced my favorite red cardigan. Thirty-four is a grown-up age. Life was filled with these moments of realization that I was in fact an adult doing adult things.

  I never pictured life turning out this way. I had envisioned adulthood as carefree, filled with art, passion, and joie de vivre. I'd have lived throughout Europe and loved well by this point. That was the life of a grown-up. Not this, sitting at a kitchen table preparing to discuss Gram's death.

  Beth began asking Gram about her health history. As words like “cancer” and “heart disease” hung in the air, I glanced about the kitchen. I hoped this meeting would not erase my feelings of warmth for this place. How many times had Gram and I sat at this exact table laughing, talking, and crying? This place held most of my secrets and many of Gram's. Her wisdom imbued from one chair to another.

  The rest of the house was updated but this kitchen provided a glimpse into the past. The wallpaper Gram chose in the 1970s, the table passed down from Pop's grandparents, the recipe box filled with tradition. The kitchen reminded me we are all the sum of our parts.

  The oven hummed as it baked an apple-based treat. Crisp the most likely suspect. Delicious, easy to make, and perfect for impressing company. Gram was pulling out all the stops today.

  I cupped my hands around the mug as I sipped tea.

  I may not have felt old enough to participate in this appointment but I could pretend like I did. “Fake it until you make it” had carried me through many a situation. I turned my attention back to the conversation at hand.

  Beth caught my eye. “Why don't I give you an overview of our program and then we'll talk specifically about your grandmother's situation.”

  A way to ease into the difficult. I silently voiced my appreciation for this kindness. Pen and paper readied, I prepared my heart to listen.

  Beth's information could have been dry but the brief history lesson proved interesting. “Hospice first began in England about fifty years ago and came to the US in the 1980s. The hospice of those days is very different from the organizations you'll find today. Sanctuary Hospice started in 1989 thanks to our founder Emily Browning, a nurse who had witnessed pain-filled deaths for her terminally ill patients and decided there had to be a better way. One of the main goals of hospice is to provide comfort care. With comfort care, we're looking at the whole person—physically, mentally, emotionally, and spiritually. We also look at the impact on the family.”

  Her eyes softened as she continued. “We recognize no one wants to have hospice care. In order to be eligible for hospice, a doctor must believe the patient has a prognosis of six months or less. Who wants that?”

  My gaze cut over to Gram with this bit of news. I sagged against the chair. Six months or less? No wonder she refused to say so yesterday. The family would have been in even more of an uproar. Or they would take it literally and begin a countdown.

  Gram caught my eyes and smiled, reaching over to pat my hand. Six months or less until a world without Gram. I felt myself floating, untethered to this room and space.

  “I'm fine, Olivia Jane. I've made my peace.”

  Peace? I could use some of that right now. My eyes began to well with tears until I blinked them back. You’re stronger than this. I wanted to deny the truth of Gram's prognosis and live in a land where Gram would stay on hospice indefinitely, until we all turned old and gray.

  “I'm sure it wasn't easy,” Beth responded. Gram nodded, then shrugged.

  “If this is my time, then it's my time. I'm simply going to make the most of the days I have left.” Gram looked at me again. “And that's why I want hospice involved, because I know they can help me do that.”

  I nodded, struggling to keep my tears at bay. I didn't like crying in front of people I didn't know. Not that I liked crying in front of people I did know either. For Gram's sake, I needed to hold myself together.

  Beth looked at me but I focused on my notebook instead. I blinked my eyes quickly, unwilling to cede to the tears. If anyone spoke to me right now, the defenses would fall. I would kick myself for failing Gram in that way.

  Thankfully, Beth moved on. “Ella May, we will do whatever we can to help you. It's important to t
ell you we will provide our expertise, but you are the one running the show.” I stifled a snort, grateful for the reprieve. Gram loved running the show. “Our services are designed around your goals and wishes. The team will visit and develop a care plan around what you want.”

  She adopted a somewhat sterner tone. “Now, if you want something that goes against what we'd advise, we won't stop you so long as it's not an ethical compromise on our part. If at any time, you feel that hospice is not meeting your expectations, you can opt out. But I think you'll enjoy getting to know your team.”

  Gram perked up at the mention of a team. “Team,” she asked, a coquettish gleam in her eye. “Do tell.”

  I smothered a laugh at Gram's response. After years raising her brood and caring for her husband all while working at the bank, Gram enjoyed having some attention all to herself. No one could blame her.

  Beth smiled. “Primarily, you'll have a nurse case manager, social worker, home health aide, and a chaplain. We also have volunteers, pet therapy, a crew in the office, plus twenty-four-hour phone support and an on-call nursing team.”

  “Our staff covers certain territories so they can be more available to those needing their care. Since you live in Geneva, you'll be with the Blue team, which covers the area west of Route 59. Every week the Blue team meets to discuss the patients. This way concerns can be raised and the team at large stays on the same page. If one of your specific team members is out sick or managing another patient when you have a need, someone else on the Blue team will see you.”

  Hospice turned out to be a bigger deal than I thought. All these people, strangers, coming to the house for Gram and, by proxy, me. I scribbled in my notebook and tried to keep up.

  Beth paused, trying to gauge our understanding. “I realize this can be confusing and overwhelming. Please feel free to ask any questions you might have. There really are no dumb questions and we'd much rather have you ask than be uncertain. Especially when there may be an easy answer. Some of what I discuss this morning might not make sense until you meet your team and see things in action.”

  I checked in on Gram. She appeared her usual cheery self, despite the subject matter.

  “No problem, dear,” Gram replied. “Frasiers never hesitate to make their needs known. Please continue.”

  Beth opened the folder and drew out a postcard-sized paper. I read upside down and saw blanks after each role she'd mentioned. She began writing names in.

  “All right. If you decide to use Sanctuary, this will be your team. Let's start with your nurse, Justin Travers.” Beth glanced up after writing Justin's name down. “Justin has been a part of our organization for a few years and has been a nurse for about fifteen years. A big asset to our group. Plus, he has a wicked sense of humor, which I'm guessing you'll enjoy. Do you have any reservations about a male nurse?”

  A male nurse. That was unexpected. I didn't know if I'd want a male nurse. Luckily, only Gram could decide this one.

  “Is he handsome?” Gram asked slyly. “If you say he's an asset, then we'll have to see how his sense of humor keeps up with mine.”

  Beth laughed. “I'll let you decide how handsome Justin is. We think the world of him. If at some point, you do become uncomfortable then just let us know and another nurse will be assigned. Next on the list is your social worker.”

  “Cassie Santiago is probably around your age, Olivia. She's been working at Sanctuary for about four years.” Beth lowered her voice confidentially. “Now I'm not supposed to say this but truthfully, she's one of my favorite people to work with. She's compassionate, she's funny, and she goes the extra mile for her families.”

  I ventured a question. “What does a social worker do exactly?”

  “Great question. Cassie will probably address this better when she visits. In a nutshell, social workers are there to provide emotional support and assist with resources, which could include caregiving, financial limitations, and so on. There's much more to it, of course. Many of our families feel they could not make it through this without the support and guidance of their social worker. Our social workers help normalize a very difficult time in people's lives.”

  I wanted to tell Beth to stop right there. If I'd been given grief for seeing a counselor, there was no way the family would want a social worker around. Gram never weighed in on my decision to seek counseling, other than to tell me I should do whatever I needed to do.

  Gram surprised me.

  “That is marvelous,” she declared. “I saw a counselor after my husband died and I can't speak highly enough about that experience.”

  “You did what, Gram?” My jaw dropped. She'd never breathed a word about this before. A pinprick of hurt welled up inside.

  “I saw a counselor. No one in the family knows, Frasier Way and all that. But I did what I needed to do at the time.”

  Her past words came rushing back to me. I couldn't understand why the matriarch wouldn't put her children in their place when it came to her mental health. I puzzled over why she never put them in their place when it came to my mental health either. Or why she hadn’t shared her experience when I started seeing my own counselor.

  Gram turned her attention back to the admission nurse. “Beth, I don't believe the family at large will be amenable to Cassie's services but Olivia Jane and I will surely take her up on it.”

  “Sometimes people don't know what they need until they give it a try. We respect everyone's right to decline certain services but we do ask that each team member come out to visit at least once.”

  “That seems fair,” Gram replied. “I haven't decided how often family will be around when y'all visit. Other than Olivia Jane, of course.”

  That was a relief, at least.

  Beth began discussing the next role on the list. “The home health aide, or nurse's aide, or CNA—it's all the same, really—likely won't visit right away. From what I understand, you're not having any difficulty with bathing, toileting, getting dressed...” Her voice trailed off, as she let Gram respond.

  “No, thank goodness.”

  “A time may come when you will need more assistance. Certainly your family can help with these matters but a CNA is trained to help with what we call ADLs, or Activities of Daily Living. Justin, your nurse, will check in each visit on how you're doing and assess whether more help is warranted. At that point, he'll suggest that the aide come out to help or to teach your family easier ways of helping you.”

  It was crazy but until that moment, I hadn't equated Gram's death sentence with her inevitable decline. Pop died in a hospital. I'd never watched the process of dying before. The road ahead appeared darker and more challenging with each word Beth spoke.

  That Gram would need help taking a shower? That she would need help getting dressed? These thoughts hadn't entered the realm of possibility prior to this morning.

  The room felt hot. I shoved my sleeves up to my elbows, a welcome reprieve. I briefly closed my eyes, face down so I appeared to be studying my frantic notes. I breathed in, then out. Focus, Olivia, focus.

  Beth moved on to the last team member, the chaplain.

  “Norma Chambers is an absolute treat. Now I know some people hear chaplain and they're not sure what to expect or feel they receive enough support from their church. Just like the social worker, we ask that you allow the chaplain to come out once and explain their role to you. Chaplains are familiar with the feelings and doubts you might experience during this time, in a way that some pastors and churches are not. Chaplains also work closely with churches and are able to coordinate with your pastor.”

  Gram nodded. “That sounds fine. Faith has always been important to me. I don't mind meeting her.”

  Another schedule to coordinate. Three, eventually four, people who would visit Gram. The needs of the gallery began to compete with the needs of the house on Beech Street.

  Gram turned to me. “I can tell you're worrying about that gallery of yours. I don't expect you to be here all the time. I'm still too feisty
for that. I do want you to meet these people at least the first time they visit.”

  I nodded slowly, still unsure how I could juggle these demands without breaking myself in the process.

  “I'll figure it out, Gram.” I smiled with false confidence. I asked Beth how often the hospice team visited. I needed a sense of the time commitment ahead.

  “Since I'm here today, I'll count this as the first nursing visit. Your grandmother hasn't mentioned any concerns so far and her pain appears to be managed well, which is how we'd like to keep it. Normally, your nurse will contact you within a day or two to set up the first visit so long as there aren't any problems. If something comes up in the meantime, you'll call us and he'll come out sooner.”

  That sounded doable. My heart eased that we would not be inundated with visits. At least not yet.

  “The social worker and chaplain will contact you in the next couple of days as well. Let them know what works best for you. You'll find that our team is fairly flexible.” Beth's voice reassured me as she talked through logistics, insurance coverage, whether medical equipment was needed, and the rest of the services available to Gram.

  I wrote down as much as I could, knowing the family would call with questions. There was too much to remember.

  Whatever baked in the oven smelled about done and I needed a break, even if only for a moment. I retrieved oven mitts and pulled out the aromatic concoction. Apple crisp, I'd been right. I set the pan down to cool and turned the oven off.

  As I returned to the table, Beth rifled through the folder and pulled out several forms.

  “Do you have any other questions?”

  Gram and I looked at each other before shaking our heads no.

  “You'll find the questions come at the oddest times so feel free to keep a notebook for writing them down. That way, you can refer to that when anyone from the team visits. It's better than trying to remember everything,” Beth advised.