by Tracy Kidder
The four coffee klatchers resume their chat, ignoring Phil. But then Eleanor mentions the Forest View resident who broke her hip a few days ago and has not returned from the hospital. And Phil, still sitting in front of the table, joins their conversation. He says, “That’s the thing. First they have the walker. Then they have one of these.” Phil looks down at the arms of his wheelchair and pats them with his small white hands. “Then they go to the hospital. And that’s the end of that.”
Art turns around in his chair. “Look at you,” he says to Phil. “You fell down the other day and nothing happened to you.”
Phil seems not to hear this. He picks up another magazine, cocking his great, leonine head. “Yeah,” he says. “Leonard Bernstein, he died. Only seventy-one. I used to love to watch him jump around the podium. He was Koussevitzky’s pet.”
“Koussevitzky,” repeats Art, without turning to look at Phil. Art seems deep in thought.
“I was surprised Forbes died so fast,” Phil goes on, musingly, pleasantly. “Another actress died. She was really famous. I can’t remember her name.”
Eleanor now speaks up. “Well I saw Helen Hayes on TV the other day. She looked wonderful.” Eleanor’s voice quivers over the last word.
“She’s somethin’ else,” Phil agrees. Then he adds, “She lost her daughter, lost her husband.”
“Jessica Tandy is ninety,” says Eleanor. “She’s still going strong!”
For a moment no one speaks. Then Phil says, “Sergio Franchi, he’s dead. He was only in his fifties, for cryin’ out loud.”
Eleanor makes a face. Art says over his shoulder to Phil, “He died three or four years ago, didn’t he?” Art’s voice insinuates the question, Why bring that up now?
“Yeah, I was surprised at that,” says Phil, ignoring Art’s tone. “Sergio Franchi. He had some voice. His sister was a singer. Country and western.”
“She was?” Eleanor says, brightening up. “I didn’t know that.”
“Yeah,” Phil says. “Then they got those two girls, a mother and daughter who sing country music. The mother’s s’posed to be dyin’ of cancer.”
“This goes on like Tennyson’s brook,” murmurs Eleanor, but silence descends on the room. Bob, who is Phil’s roommate, has not uttered a word since Phil’s entrance, but has glared at Phil from time to time, making a chewing motion. Now Bob stands up, says, “Bye-bye,” and limps out. Each of the remaining coffee klatchers gazes a separate way. They seem lost in a collective case of the long thoughts, distant memories at hand, and none of them happy. Phil stares at his lap, but he alone does not look sad. “I never saw Al Jolson in person,” he says.
“The nearest I got to him was in the movies,” says Art in a distant voice.
“Yeah, he went overseas in the Second World War and got sick,” says Phil. “And that was the end of that.”
This is not exactly an argument, but more like a contest. Given the subject, Phil is bound to win.
2
It seemed so new a place for people so old. Linda Manor had opened for business only a little more than a year ago. It stood in what had been a hay field, in a suburban-bucolic setting, on Route 9 a few miles west of downtown Northampton, Massachusetts. The developer named Linda Manor after one of his daughters. The building had balconies and balcony railings along its flat roofs and wide frieze boards under its eaves. Out front there was a portico, supported on four Doric columns, and two tall flagpoles, also a little fountain, like a child’s wading pool. And everything, except for the brick walls, was painted white. The building looked not quite finished, like the parts of a giant wedding cake laid side to side.
The obligation of finding a nursing home for a sick, aged person usually falls to a daughter. On any given day in the region, a middle-aged woman would be looking around for an acceptable establishment. There were a few. But there were also places where the stench of urine got in one’s clothes like tobacco smoke, where four, sometimes five, elderly people lay jammed in tiny rooms, where residents sat tied to wheelchairs and strapped to beds, where residents weren’t allowed to bring with them any furniture of their own or to have private phones or to use the public pay phone without nurses listening in. One woman, on a recent tour of a nearby place, had been shown a room with a dead resident in it. Some nursing homes looked fancy and well kept but were all veneer. When Linda Manor’s portico hove into view, it looked like one of those.
Large windows surrounded Linda Manor’s lobby. Thick carpeting covered the floor. A huge brass chandelier had been hung from a coffered ceiling above a baby grand piano with a gleaming, black lacquered finish. Linda Manor’s owner wished that residents were banned from his lobby. That wasn’t an extraordinary practice at nursing homes. But the administrator refused. (She worked for the huge nonprofit medical corporation that leased Linda Manor, and she had full authority over the running of the place.)
What most people take for granted is unusual in nursing homes. Linda Manor had some unusually pleasant qualities. The staff wasn’t the largest per resident in the area, but large by the prevailing standards and far larger than the state required. Every room in the building got natural light. There was a small greenhouse. Residents were allowed to bring their own furnishings and to have their own telephones. Most rooms contained two beds. A few were singles. And none of the residents was tied up. This policy of “no restraints” was rare in the world of nursing homes. The local newspaper carried a long story about it when Linda Manor first opened. The publicity helped to make the policy work. A good reputation meant lots of applications for beds. The management could afford to turn away the very violent and most floridly demented.
Some residents were brought from great distances, from places like Florida and California, to be near their families. Most came from western Massachusetts, and collectively they made up a fairly accurate cross section of the area’s old people. A few were wealthy. About 30 percent paid the high private rate. Medicaid and Medicare paid the room and board for most. Some owned nothing when they arrived. One man did not even own a change of clothes; several of the staff rummaged through their husbands’ closets and outfitted him.
Periodically, wheelchair vans or ambulances or private cars parked in front of the portico and new residents were escorted in, a few on their own feet, others in wheelchairs, some on gurneys. New residents arrived from hospitals mainly, and occasionally from other nursing homes. Some arrived directly from their own or their children’s homes, and for them the transition tended to be hardest. Some newcomers left their relatives’ cars only after coaxing. And, on the other hand, a few residents would say that they felt sad but relieved when they arrived. The eighty-five-year-old woman, for instance, who had lived alone in a two-story house, crawling up and down the stairs, bathing herself with talcum powder for fear of the tub, subsisting mostly on tea and toast.
A few people died within days of arriving—one on her very first day—and it was hard to resist a Victorian explanation, that they died of broken hearts. More often, though, the physical health of new residents stabilized or even improved, in some cases because they had received marginal care and feeding before. Some residents merely stopped here, to rest and receive a few months of therapy, on the way home from the hospital. One well-traveled, well-read woman declared, soon after arriving, that she never played bingo in her life and did not intend to start now. She stayed at Linda Manor for a year, read most of Proust, and then returned home. But hers was an exceptional case.
By this time, December 1990, Linda Manor was running at capacity—121 beds, all full. Most of the residents were over 70 years old. The oldest had reached her 103rd year in remarkably good health. About two thirds were women, a figure in line with national actuarial figures. It went without saying that everyone had an illness. Most had several.
The building was organized, generally, by illness. The upstairs wing, Forest View, was home to the physically healthier residents, so-called Level III’s. Among them were Lou and Joe and the nostal
gic woman who often stood at the western windows and Eleanor and Phil and the other coffee klatchers and a man named Dan. He was only sixty-five, one of the youngest residents, but gaunt and pale. Most hours of the day found Dan lying on his bed upstairs, dressed in street clothes and wearing a thin, blue nose catheter, which was attached to an oxygen concentrator burbling next to his bed. Dan had a huge television set at the foot of his bed and a powerful, programmable speaker phone beside him, a phone fit for a fair-sized office. He had only to lean a little out from his pillow and punch a button, and all by itself his phone would dial up the office of the junior senator from Massachusetts. Lately, Dan had been calling that office regularly, to find out if any action had been taken on his complaint about his breakfast eggs, which the Linda Manor kitchen wouldn’t prepare the way he liked them—runny. The kitchen said they couldn’t oblige him because of the risk of salmonella, but Dan suspected they were just being contrary. The last time he called the senator’s office, a voice over his speaker phone informed him that a letter on the matter of his eggs would soon be in the mail.
About half of Forest View’s residents were able-minded. The management had mingled among them most of the residents who were demented but mobile and restless. Living upstairs made it harder for those people to find their way outside, where they might vanish in the woods or get hit by cars. There was a former inner-city schoolteacher who would sometimes rush down the corridors of Forest View, muttering threats to call the police if the children wouldn’t behave, and a woman whom Phil had nicknamed Lady Godiva, because one night she ran nude and screeching through the halls, fleeing the aide who was trying to bathe her. That woman usually didn’t run, but walked very gingerly upon the colorful, elaborately patterned carpet. In a place of damaged minds, a carpet full of complex shapes was a mistake. She balanced on the rectangular borders as if on the narrow ledges of a skyscraper under construction. Evidently, she saw an abyss in the carpet’s deep blue background.
When the demented roamed the halls, Forest View could seem like an underworld of myth. There was Fleur, a tiny, spry ninety-two-year-old, her face quilted with wrinkles, who a dozen times a day would stand at the nurses’ station counter and ask if someone wouldn’t please call her mother. Clutching her pocketbook, Fleur would say that even though she liked this resort and her family had been coming here for years, it was time for her to go home now. There was Norman, who walked the hallways slowly, sometimes looking for an exit, sometimes looking for his wife. (When he mistook certain fellow residents for her, they got upset and yelled at him.) Zita was always out in the halls. Unperturbed by any of the sights and voices around her, moving at a steady pace, sometimes holding her hands cupped before her as if to receive a communion wafer, leaning slightly forward, her short gray hair swept back, her eyes half hooded, Zita paced the halls of Forest View from the time she arose until she went to bed. Sometimes she paused and, bending down, scratched at the flowers depicted in the carpet, trying to pick one.
Two thirds of Linda Manor’s residents lived downstairs, on the nursing units called Meadowview and Sunrise. These units were, by and large, reserved for the very ill and the immobile, the so-called Level II’s. Some never left their beds, and many didn’t mix much, but some were gregarious, and none more than Winifred. She lived in a room just past the open fire doors of Sunrise. She endured great discomfort daily for the sake of sociability. In the morning she would lie in bed and stare unhappily toward her door as the Hoyer Lift, a contraption that looked like a miniature gallows on wheels, rolled toward her across the room, a nurse’s aide pushing, another following.
Winifred wasn’t tall, only five foot four the last time she was vertical. But she was big. She weighed over 200 pounds. Winifred was in her eighties. In her youth she had been one of the prettiest girls in Florence, Massachusetts.
The aides would truss her up in a black mesh sling and crank her out of bed. As she rose on the Hoyer Lift, Winifred groaned. She sobbed. “Oh, it bends and it breaks and it pinches.” She wore a shocked and fearful look as she was rolled, dangling in midair, toward the bathroom. Eventually, the aides lowered her into her recliner. She’d sit there until it was time for her to be Hoyered into her wheelchair, so that she could sally forth to church services or resident meetings or any other local event—she went to all. After the aides wheeled the Hoyer out, Winifred sat weeping into her hands.
An epidemic of injured backs threatened to decimate Linda Manor’s staff. A while ago, to prevent more injuries, the administration had ordered that Winifred and several others be lifted mechanically. It took its toll on her. Winifred had grown increasingly volatile, cheerful at one moment, weepy the next. Sometimes lately she shrieked at the nursing staff for small and imagined offenses. Behind all that lay her conviction that they had wronged her with the Hoyer Lift. To her, the hoisting signified defeat. She surmounted polio as a child and later a terrible car wreck, and she would not let herself think that she wouldn’t walk again. But how could she, she’d cry, if they used the Hoyer? If they went on using it, she sobbed, her feet might never touch the ground again.
Soon, however, Winifred would cheer up, laid out in her recliner, her swollen feet elevated. “All my parts have been broken or bent.” She’d laugh a high, cackling giggle. “Don’t you think there ought to be some dump somewhere, like there are for used cars?” In a moment, she would turn to business. She was the preeminent fundraiser here. She intended to raise the money to buy Linda Manor a chairlift van, and she felt sure she would succeed. She had only to put her full mind to it.
In one of her many poems, Winifred had written:
Youth fled, agility failed,
With hoisted sails, high hopes afloat,
I brace channels of stormy, ever-changing tide…
Beauty not duty I left behind
Back in the time when.
***
Linda Manor’s grounds were often empty. Their stillness lent a secretive quality to the sprawling, low-roofed building—set back from busy Route 9, surrounded by wintry woods and dormant grass, adorned with Greco-Roman columns, balconies and parapets, all as white as a nurse’s starched uniform. As one stared at it, the place grew odder in the mind. The building looked so provisional. So new and yet containing so much of the past. Many residents remembered World War I as if it had ended yesterday. Some remembered firsthand accounts of the Civil War. They were like immigrants arriving in a new land with long lives behind them, obliged to inhabit a place that was bound to seem less real than the places they recalled. For most of those long-lived, ailing people, Linda Manor represented all the permanence that life still had to offer. It was their home for the duration, their last place on earth.
3
Lou and Joe had been placed together in the room upstairs beside the elevators ten months ago. People entering nursing homes have, for the most part, already lost control over their lives. Once inside, they usually don’t even get to choose their roommates.
Lou had come to Linda Manor with his ailing wife, Jennie. They had been married for almost seventy years when Jennie died, in early March of 1990. In the weeks afterward, Lou walked the familiar corridors of Linda Manor on his cane. For hours at a time, he sat alone in the room he’d shared with Jennie on the Sunrise nursing unit. In the room, the two beds, which Lou had kept shoved together, stood apart.
Lou’s daughter, Ruth, asked him to leave and live with her. But he said, “I couldn’t do that to you, Ruth.” If he lived at her house, he’d feel he was a burden, and he didn’t want to feel that way. Besides, at her house, he’d inevitably spend a lot of time staring into space. So Lou thanked his daughter, but said he’d just as soon stay on at Linda Manor.
Jewish ritual prescribes a period of mourning that lasts for thirty days of outward abstinence from joy. This was easy for Lou to accomplish. He faced a new life, which consisted mainly of absences. He had thought of himself as his wife’s main nurse and protector. Now he lacked his life’s companion, and he lacked employme
nt for the first time in eighty years. His daughter was very worried. She thought that Lou might find that there was nothing more for him to do in life except to await an end. And an end wasn’t clearly in sight. Lou was ninety, but bodies keep their own time. Except for his eyes and occasional angina, Lou remained quite healthy.
***
Joe had left home for good in his early seventies, after a siege of operations. He had been disabled for many years, during which his wife had managed his care and feeding. His operations left him more disabled, his wife’s own health was failing, and finally she could no longer take care of him at home. Joe lived as a convalescent patient for about four months at the veterans’ hospital in Northampton, and then was moved to Linda Manor. When he arrived he was deemed a Level II and was placed on the Sunrise unit. When Joe began to walk again, he became a Level III, and was moved upstairs to Forest View. Joe had been the chief probation officer for the district court in Pittsfield, Massachusetts. He was a big man in his town. For thirty years he sat on the right hand of powerful judges, dispensing justice for a county. Now he lived in the care of strangers, exiled by illness from his family and his home. For hours at a time, shunning all scheduled activities, Joe lay alone in the room beside the Forest View elevators and watched TV, which he used to hate.
Both Lou and Joe became administrative problems. Joe had no savings, and nursing home bills had long since exhausted Lou’s. The VA paid Joe’s room and board, and Medicaid paid for Lou. Each man was occupying a two-person room, and the nursing home wasn’t being paid to keep them in rooms of their own. Moreover, Lou did not belong on Sunrise—he was too healthy. Both men were wrongly situated. It was a truth, as Jane Austen might have said, that a single nursing home resident without the money for a private room must be in want of a roommate.
