written by: Jim Bartlett
Her body shaking with first day jitters, her breath caught somewhere in her throat, Cara took a cautious step up to the door of Marcia Kingsley’s office.
The fact that Marcia was the senior director of Paradise Manor, and had been there since it opened nearly 20 years ago, wasn’t helping much with Cara’s knocking knees. Letting the breath go, she reached for the door’s handle, but to her surprise it opened on its own, Marcia standing just on the other side.
“Hey Cara, welcome aboard! I was just going out for my morning rounds. Come on, I’ll give you the nickel tour.”
Marcia was tall, confident, and wore a smile that stretched across her face as though it had been transplanted off one of those billboard ads.
“Okay, thanks,” Cara replied.
They made their way down the first wing, passing nearly 10 closed doors, before stopping at the nursing station.
“Is Ms. Carson up?” Marcia asked of the nurse.
“She is, indeed.” With the reply she gave her head a shake and her eyes a roll, leaving Cara with the impression this Ms. Carson might be a handful.
Marcia winked, and turned back to the hall. “This way.”
Cara counted off 4 more doors before Marcia veered right, ducking into a bright room with a flowery wallpaper. A window on the far wall featured several potted plants, their flowers kissing the glass as they reached for the sun. To the left, a slender older woman, her gray hair wrapped up in a bun and wearing a summery short-sleeve dress that looked as if it could have been made from the wallpaper, sat on the edge of the bed, a grand smile as they entered.
“Hello, Gracie. This is the new nurse’s aide I was telling you about. Do you remember?”
Ms. Carson continued to smile, her foggy gaze wandering the room as if she was seeking the source of the voice. The Director moved a little closer, but kept her hands at her sides.
“Gracie, it’s me, Marcia. I have someone I’d like you to meet.”
She finally turned, her eyes locking with Cara’s first, before slowly shifting to Marcia’s. “Did I tell you I’m going to see my son today?”
“Janice told me. And that’s wonderful, Gracie. Can you say hello to Cara?”
“Jamaican Janice.” Gracie began a low chuckle, then looked to Cara. “Oh, you’re not Janice.”
“No, this is Cara, Gracie. She’s coming to help here at the manor.”
“Did I ever tell you about my son?”
“No, no you didn’t, Ms. Carson. I’d love to hear all about him.”
Gracie stood and started to take a tenuous step closer to Cara, but a commotion at the door pulled her attention in that direction.
“Hello, hello, Graaa-seeeee!”
Cara turned to see a tiny black woman wearing a colorful Caribbean wrap, her hair in long flowing dreadlocks, and several seashell necklaces dangling around her neck, dancing more than walking as she pushed a metal cart into the room. On it were a number of trays, each with tiny paper cups filled with pills—reds and blues and yellows and whites—next to slightly larger cups half-filled with water.
“Jaaan-neeese,” said Gracie, mocking the woman’s Caribbean accent.
“We have some vanilla pills for yous this here morning,” said Janice. But as she reached to the tray, she noticed Cara for the first time. “Well, well. You, my luv, must be the newbie.” She stuck out a hand, but as to give a high-five rather than a traditional handshake.
“Ye-yes,” said Cara. Though her voice was still not quite settled, she somehow was able to slap Janice’s hand. “I’m Cara Livingston. You must be Jamaican Janice.”
“Indeed I am, my luv.” She beamed a big smile, then turned to Gracie, who’d sat back down on the end of the bed. “One day, maybe not real soon, but one day, I’ll be walking the Jamaican sands once again. Ain’t that right, Gracie?” She leaned down closer, trying to catch Ms. Carson’s eye, but she’d drifted off into an empty stare. Janice took a deep sigh and turned to Cara. “She’s a good woman, Ms. Gracie. This here your first day?”
“Yes, Ms. Kingsley is showing me around.”
Marcia smiled and tapped Cara on the arm. “It’s Marcia. No room for silly formalities here.”
“That’s right, luv, no formalities, but plenty of the silly.” Laughing, Janice rolled the cart so she could get to its side, the front wheel complaining with a loud squeak. The noise seemed to bring Gracie around, and she stood up, looking at Janice as if for the first time.
“I’ll be seeing my son today,” she said, her eyes a little misty. “I think he’s going to be waiting on a beautiful Jamaican beach.”
“The finest beaches in the world, Ms. Gracie. The ab-so-lute finest.”
Janice picked out a cup, handed it to Gracie, and followed it with some water. Gracie took both cups, turning to sit back on the edge of her bed. For a moment her eyes seemed to glaze over, her focus once again lost as she stared into an unseen world. Then, slowly, she put the pill cup to her mouth. A moment later she tipped back the cup of water, making a big production out of her swallow.
She suddenly stood, pulling on the side of her dress. “Do you think I should change before I see my son?”
“Of course not. You’re as beautiful as ever,” said Marcia. “We’re going to go now. I need to introduce Cara to some of your friends.”
Gracie said nothing, instead falling back into her absent gaze. With a wave goodbye, and humming as she went, Janice pushed her cart out the door. Marcia stood for a moment longer, as if there was something she forgot to say, before shaking it off and following behind. But as Cara turned for the doorway, the old woman touched her arm, causing her to spin back around.
“I’m going to see my son,” she said.
“That’s wonderful,” said Cara.
It was then the old woman leaned closer, and for a moment Cara thought she saw a twinkle rather than the dull curtains in her eyes. She opened her right hand, exposing 2 white pills. With a wink, she reached across to the left sleeve of her flowered dress and tucked them into the cuff, a spot where Cara could see a couple of the hemming stitches had been pulled.
“Oh, my,” Cara said. She started to call out, but Marcia and Janice had long since disappeared into the hall.
“I’ll be back,” said Cara, dashing through the opening.
“I won’t,” replied Gracie.
Cara caught up with the other two women just as they were moving into the next wing.
“You look like you’ve seen a ghost, dear. What’sup?” asked Janice.
“Gracie,” she replied, her breath in gasps from running. “She didn’t take her pills.”
Both Janice and Marcia smiled.
“Palmed them again,” said Janice. “She’s done got pretty good at that. I didn’t even notice this time.”
“Don’t feel bad, neither did I,” said Marcia.
“Wait, so you know about this?” Cara stood with her eyes wide.
“Yeah, she...and some of the others, for that matter...try to be sneaky now and again doing this faked-you-out thing, pretending to take their meds. We usually catch ‘um, but it’s still a pretty sticky situation. It’s not like you can have them take make-ups the next day; some of them are on heavy prescriptions and you run the risk of an overdose.” Marcia shook her head and then pulled out her phone, typing in a quick note. She then pointed to the next corridor. “This is the ‘B’ ward. Sort of middle of the road. Our residents here aren’t yet experiencing the more advanced symptoms such as Gracie back in ‘C’.”
“How long has Gracie been here?”
Marcia let go a long sigh. “Just over 5 years.”
“I don’t understand. How is it she’ll be able to visit her son?”
Janice stopped, turning to face Cara. “Hon, that dear boy of hers was killed forty-some years ago in Vietnam. Right toward the end of the war. Like ’74 or something.”
Marcia nodded. “When she first came we had her in the ‘B’ ward. But she went downhill pretty quickly, leaving us no choice but to shift her over to ‘C’ about 3 years ago. And, over the course of the last few months, the dementia has begun to tighten its tentacles around her even more. It’s really sort of ironic, because she’s been talking more these last months than the previous 4 years combined.”
Cara felt her shoulders drop. Her heart becoming heavy. “Does she have a husband? Sister or brother?”
“No one, child. She was a single mom and that boy of hers was her whole world.” Janice looked down, then began humming another tune, slowly rolling her cart up the hall. “Got my rounds to do. Nice to meet ya, Cara.”
“And you, Jamaican Janice.”
“We’d better go, Cara. Lots to cover and time is short.” Marcia pointed to the next open door. “Let’s meet Mr. Hugo. He should cheer you up.”
For the next two hours Cara followed Marcia from room to room, stepping out of the last door just as lunch was being served in the dining commons.
“Normally we wander through, helping the staff keep an eye, then have our lunch in the faculty room,” explained Marcia as they cut across the wide high-ceilinged area. “But of course if we’re short-handed, we try to help out when we can.”
Cara nodded and smiled, for a moment thinking it sounded more like they were teachers at an elementary school than caregivers at an Alzheimer’s treatment center. She let her gaze wander from resident to resident as they slowly gravitated to their favorite tables, gathering in groups large and small. Overhead, a large skylight lit the center of the plaza, where lush ferns and other tropical plants filled planters situated around a dancing fountain. Light soothing music, strings, maybe some piano, played in the background, and Cara started to feel, for the first time, that her career choice and her choice of places to utilize her training, had been a good one. She was going to like it here.
Just as they reached the far side of the pavilion, an alarm sounded, followed by a set of flashing red lights mounted on each of the support pillars.
“Code Blue, Room C-10. Code Blue, Room C-10” it repeated over and over.
“Follow me. Quick,” said Marcia.
Cara chased behind her into the hall, where they broke into a run. When they rounded the next corner, Cara could see two nurses rushing the crash cart through an open door, several other caretakers following right behind. As they came closer, Cara recognized the room as Gracie Carson’s, and she felt her knees go weak.
Marcia forced her way through the group, nudging up next to the crash cart. Cara, meanwhile, slipped to the back of the room where she could see the team at work. The top to Gracie’s beautiful flowered dress had been ripped open and she lay motionless on the bed. Janice was administering CPR while one of the nurses finished up with the ECG leads and defibrillator pads, attaching the cables to the monitor.
With the final connection, a tiny flat line appeared on the screen, and the nurse called out, “Asystole!” She worked something on the defibrillator, and spun around, raising her hands. “CLEAR,” she shouted out, causing everyone to move away from the bed.
But Marcia stuck out a hand. “Wait.”
The room, just breaths before in utter chaos, dropped into silence.
Marcia stared down at Gracie, her body helpless, her face at peace. Finally she nodded. “Go ahead.”
Cara watched Marcia turn away, giving her head a slight shake. The nurse repeated, “CLEAR,” and Gracie’s lifeless body jolted up in an arch, then settled back down onto the bed. For a moment no one moved, all eyes on the monitor. But the flat line stayed and everyone jumped back into action.
Cara slid over to Janice’s side. She watched her mouth off the count as she continued the compressions, all the while tears streaming down her cheeks. Her heart aching, she looked away, Gracie’s left arm hanging off the side of the bed catching her eye.
The rest of the cuff’s hem had been ripped open. The pills were gone.
“CLEAR,” called the nurse.
Janice stepped back.
Another jolt lifted Gracie’s body, but the flat line remained and Janice reached in to resume, but Marcia again stuck out her hand.
“That’s enough, folks. That’s enough.” Marcia bowed her head, choking back her emotions. It took her a long moment to gather her breath before she finally looked up and around at everyone who had raced here hoping to bring Gracie back. A single tear broke free and ran down her cheek as she struggled trying to find words. When they finally came, they were slow and shaky. “Gra...Gracie had a DNR. She had it made up long before she joined us here at Paradise Manor, when she was sharp enough to know that this terrible disease keeps you prisoner for only so long. I think she finally tired of waiting to be released from those chains. Like you, she is dear to my heart, and I thought maybe, just maybe, we might be able to bring her back. But that’s not to be. And that’s not what she wanted. And so we need to comply with her wishes.”
Somewhere off in the distance, breaking the quiet that now stole the room, a solitary siren closed in on the building. Cara started to turn for the window, but instead moved to the corner by the nightstand. On its top, next to the lamp, a gold frame lay face down, almost as if purposely set that way. On impulse she tipped it back up, revealing both a faded picture of a young man in fatigues hanging from the side opening of a military helicopter and a single sheet of yellow paper. She stared for a moment at the photo--she could see Gracie in her son’s eyes and chin--then picked up the paper. Beautiful flowing cursive filled the top of the page.
I’ve gone to see my son. He’s waiting for me on the Jamaican Sands.