ENCOMIUM – PART 2

My last post detailed a typical visit to a patient named Ted, an eighty-four year old man I saw twice a day for over a year. Ted lived alone in a run-down unit, due for demolition, and had such severe short-term memory loss that within the course of a visit he could tell the same story multiple times. Luckily Ted retained his long-term memories, and, even luckier for me, the stories he told were so interesting it was no burden to hear them repeated.

As nurses we assisted Ted by administering his medications, ensuring he was having something to eat, moisturising his legs, and occasionally dressing any wounds he developed. We also gave the solitary man company, and, uniquely, Ted gave back. Some days it was hard to tell who was accompanying whom.

Ted was a joy. Normally seeing a client this often, particularly one who offers up the same conversation like a meal repeated until you’re sick of the sight of it, would become wearisome, but Ted was so genuinely happy, and so sharing in his happiness, that visiting him felt like recharging. Each rendition he gave of his stories was animated and energetic. His jokes, which after a few months I could mouth along with him, were always delivered with such sincere amusement and enjoyment that it was impossible not to laugh with him.

I was moved from the area where Ted lived and began nursing further north, and my visits with Ted were cut off. It was a different nurse who got to hear about the time his car broke down on a set of train tracks and was hit, with Ted still in the car, by a train. Ted walked away from the accident, went to get a beer at a nearby pub to steady his nerves, and decided the car was probably a wreck, and so hitchhiked his way home. True story. I heard it at least seventy-eight times.

A few months ago I found out Ted was no longer on our books. Ted has chronic obstructive pulmonary disease, which is a fancy way of saying his lungs are shot. He spent his early adulthood chewing on cigars, sucking on cigarettes, and even having the odd puff of a pipe. His later adulthood was spent working in a pottery factory at a time when OH & S didn’t include face masks, and so, even though he had quit smoking, the deterioration of his respiratory system continued with lungful after lungful of ceramic dust. Because of his COPD, Ted was particularly prone to chest infections, which made him particularly prone to hospital admissions. And so the decision was made by his case manager that Ted wasn’t safe to be living alone and a nursing home was arranged. This meant district nurses were no longer required.

The abrupt departure of a patient is an aspect of my job I find disorientating. Let me set the stage: we go into the intimate confines of a person’s home, are welcomed and offered tea. We administer care, which by its nature creates a bond between patient and nurse. We talk as we work, and learn about out patient’s lives and families. Then, as inevitably happens, one day they’re gone.

Sometimes it’s due to death, but more often it’s that they’ve been put into a nursing home. Or gone to live with family. Or are in hospital. The latter is the hardest because they disappear into the hospital system and it’s not until months later that you realise they haven’t returned and are left wondering what happened to them.

District nurses are, at best, a band-aid. We are a temporary fix, and the best we can hope to achieve is to maintain the status quo for a while longer until health deterioration catches up with our patients. Please don’t let this observation cheapen the profession. Those extra few years we buy our clients at home are years of comfort in a familiar environment, but it’s still frustrating to know we are a quick, and non-lasting, solution.

So Ted had disappeared into that world of post-district nursing, but because of where he had lived I still found myself driving past his unit most days. (Despite his absence, the demolition has yet to commence). And each day I was reminded of the man and what an incredible life he had led. I would remember the story of how, on an impulse, he quit his job in New South Wales and travelled to Melbourne with a friend to visit his friend’s aunty. And how, six months later, he married his friend’s aunty. She was twenty years his senior and initially refused to marry him, stating that he could stay until he was bored with her. Ted was outraged at the suggestion that he wouldn’t make an honest woman of her and slept on the couch until their marriage day.

And I remembered how, twenty years on, his wife had a stroke and, mentally, reverted back to an infant. And how Ted fed her, and washed her, and cared for her whilst she called him “Mum,” until the day she died.

An encomium is a tribute, either spoken or in text, to a person and their accomplishments. My previous post set out to capture just a slice of what it was like to know Ted. To immortalise a fraction of a fraction of his life, but one that demonstrated his humour, and his vitality, and his kindness. To protect and praise a man who had done some incredible things but who had been largely forgotten by the community he lived in.

Ted will undoubtedly have no memory of me and the small part I played in his story, but hopefully these posts will preserve my memories of Ted and the part he played in mine.

ENCOMIUM – PART 1

I watch my feet as I walk up the cracked and sloped path between the red-brick wall to my left and the overgrown hedge to my right. Ted’s backyard appears before me, a lawn in want of mowing, a small aluminium shed, and the odd sun-faded lawn gnome peering out from the dense brush of a bush. I shake my head and wonder why anyone would want to populate their yard with the eerily smiling porcelain figures.

Ted’s back door is a mess of flaking green paint and I stop a moment to read the sign nailed to it.

WARNING: THIS BUILDING HAS BEEN CONDEMNED AND IS AWAITING DECONSTRUCTION.

Ted told me they can’t knock the unit down until he leaves or dies, and that he has no intention of leaving. I smile at his contentment in keeping the sign in place, his complacency in spite of the words written on it. I glance at the thumb-thick cracks veining the brickwork and wonder if it wouldn’t be better for Ted to relocate. But, as he says, this is his home.

I knock and the door shakes against the brick wedging it open a hand span. The gap is for his ladies to come and go.

‘Ted!’ I call out and enter before waiting for a response. I know where Ted will be.

The stink of putrefying cat food billows up at me and I glance down at the bowl by my feet. Globs of brown muck have spilled over onto the kitchen’s scuffed linoleum, but, thankfully, there are no maggots in the bowl this time. By the smell, they can’t be far off.

‘Ted,’ I say again, ‘it’s the nurse.’ I step through the doorway to my right and into Ted’s living room. The cold and silence of the kitchen is replaced by a thick heat and the whirr of a heater’s fan, and Ted is slouched in a one-person sofa in the corner of the room. His legs are stretched out inches from the glowing filaments. One day his pants will alight.

‘Ted!’ I say louder, and the crumpled marionette of Ted’s form becomes animated as he jerks awake and looks around. Even with his advanced age he is a tall man and his knees come up high as he straightens in his chair. His watery blue eyes find mine and a smile spreads across his narrow face, his white stubble parting to either side. He blinks a few times, orientating himself.

‘Oh, hello!’ His voice still has a northern English accent despite forty years of living in Australia and I’m charmed by it immediately. ‘I must have dozed off. Now, who are you?’

The question is asked with a carefree attitude. Ted is completely unfazed at being awoken by a stranger in his living room.

‘My name’s Jonathan. I’m the district nurse. I’m just here to help with your tablets. How are you doing?’ I wonder how many times I’ve introduced myself to this man. It’s probably in the hundreds.

‘Oh, just fine. A pleasure to meet you, Jonathan. Can I get you a drink?’

His hands are already moving, looking for his cane and preparing to hoist himself from his seat. I wave a hand and assure him I’m fine. ‘I’ve already had my morning coffee, so I’m all fuelled up. Thanks anyway, mate. I’ll just have a look in your book and get your tablets ready.’

I drop my bag to the floor, place my work laptop on an empty seat, and turn to the table set against the opposite wall. Ted’s medical folder is spotted and splotched with stains, a testament to the meals he’s eaten on this small square table. I open it and put it to the side, then unlock the metal box that holds Ted’s medications. I peruse the list of drugs in the folder and begin the process of picking through the packets and bottles jumbled in the box.

‘You’re a strapping young lad,’ Ted says from behind me. I smile and turn and await his next sentence. ‘You’d make a fine soldier.’

‘You reckon?’ I ask with a smirk and he nods emphatically. Ted has told me daily for the past year that I would make a fine soldier. I don’t know what he bases this statement on; I’m not particularly tall nor heavily muscled. Still, I get a small flush of pride every time he says it, as if I’ve passed some sort of test.

‘Oh yes. I was a soldier, did you know?’

I knew. ‘Really?’

‘Queen’s guard.’ He straightens as he says it, his chest full. ‘I used to parole Buckingham Palace. Spooky place at night. Haunted, you know?’

‘That’s incredible, Ted.’ I turn back and shake a warfarin tablet from its bottle, rattling as it hits the medicine cup, then grab a box of omeprazole. ‘So you wore the hat and everything?’

‘I did, I did. And you couldn’t move.’ He raises a finger as he says this, his whole body joining in the telling. ‘Tourists would come and tie our laces together, and you had to stay perfectly still. They’d send out guards every hour to give us a drink and untie our laces.’

‘They’d tie your laces together?’ Having heard the story so many times before my incredulity is a little forced. ‘The bastards.’

Ted chortles a laugh and nods, and his eyes unfocus as he sorts through his memories. ‘And then I worked as a soldier out in the desert. Oh, it’d get cold at night out there.’ He chuckles. ‘One time I lit myself on fire!’

His declaration is designed to spark my interest and by now I know my lines well. ‘You lit yourself on fire? How did you manage that in the middle of the desert?’ Having memorised the stories means I can concentrate on sorting Ted’s tablets while still giving the appropriate responses.

‘Well, each night when we’d set up camp it would be one man’s job to dig the fire pit. This night I had dug the pit and put the fuel at the bottom,’ he stands to do the reenactment justice and I have to resist the urge to step over and stabilise him as he wavers on his feet, ‘and I lit it.’ He squats and mimes throwing a match into an imaginary hole. ‘We used oil, you see, and the fire roared.’ His hands spread in an imitation of high-burning flames. ‘I turned to get the pot,’ he chuckles at this point and does another shaky squat, ‘and my shirt tales went right in the fire.’

My face is an open expression of disbelieving shock. Of course, I know this story, but Ted is a good story teller and he has me engaged.

‘I hear a fellow call out, “Ted, you’re on fire!” I say, “What? Fire!” and I bolt off into the desert.’ He claps his hands and he’s wheezing with laughter and I laugh along with him. ‘Three men had to chase after me through the desert to put me out.’

He collapses back into his seat, a grin of reminiscence riding his lips. I’m always amazed this man can describe being burnt and find it amusing. His optimism is inspiring. I drop his final tablet into the medicine cup and carry it to him.

‘There’s your tablets, Ted. Can I get you a drink to wash them down?’

‘Oh, sure, that would be lovely.’

I nod and hand him the plastic cup, then step back through the doorway into the kitchen, careful to give the dish of cat-food a wide berth. I open his ancient fridge and pull out a carton of milk and take it to the sink. A tin of nutritional supplement power sits on the bench and I pop the lid while taking a glass from Ted’s drying rack. I study the glass and find a cosmos of dried foodstuff clinging to the walls of it. The water is icy as I turn the tap and give the glass a quick scrub, and behind me I can hear Ted standing from his chair. I glance over my shoulder and see him leaning in the doorway. He’s come looking for conversation.

‘So, tell me, Ted, what happened after you were burnt?’

‘What’s that?’ His brow furrows. He’s forgotten already, my brief absence wiping his memory clean.

‘In the desert. You were telling me you lit yourself on fire.’

‘Was I? Well. I ended up in a hospital in Libya. For a month I had to lay on my belly while the nurses changed the dressings to my back each day.’

‘A month?’ I say and look around for a tea towel. The only one in sight is dried and crusted with a lifetime of wiped-up spills. I decide a wet glass is preferable and scoop two spoonfuls of powder into it, followed by a large pour of milk.

‘A month! And then—’ I pause in stirring the mixture and look at him as he says my favourite line, ‘—my old fellah got septic!’ His cackle is infectious and my brows are high in my hairline as I laugh with him. ‘Blew up to the size of an eggplant.’

I carry the glass to Ted and place a hand on his back as I guide him into the warmth of the lounge room and to his chair. ‘No luck at all, mate. I’m sure the nurses were impressed, though.’

He chortles and knocks his tablets back like a shot, takes a gulp of his drink and settles into the cushions, a stain of milk marking his top lip. A soft curious meow sounds from the doorway and a mottled long-haired cat slinks into the room. She gives another quick meow and rubs her body against Ted’s leg. Ted’s hand drops and his long fingers run from head to tail.

‘Oh, there’s my lovely lady. How are you, darling? Hmm?’ He looks at me. ‘I’ve got three ladies: Evelyn, Lucy, and Dot. This here is Evelyn.’

‘She’s a beautiful cat, Ted.’

‘Oh yes. You are, aren’t you? I don’t where the other two are, but they’ll show up. They always do.’

I know where they are. Ted’s told me he buried Dot in the south corner of his backyard, and his case manager phoned two weeks ago to let me know they had to put Lucy down. I don’t bother reminding Ted of their deaths; he’d only forget again anyway, and he’s not disturbed by their absence.

I smile as I watch this man enjoy the texture of his cat’s soft fur, a smile on his milk-lined mouth, and listen to the low rumble of Evelyn’s purr. Ted looks up at me.

‘You’re a strapping young lad. You’d make a fine soldier.’

That persistent flush of pride reawakens again and I smile. ‘You reckon?’

‘Oh yes. I was a soldier. Queen’s guard.’

I tilt my head. ‘Impressive.’ I glance at my watch and sigh. ‘Sorry, Ted, I had best be moving on. But I’ll see you again this afternoon, okay?’ I hoist my bag from the floor to my shoulder and pick up my laptop.

‘No worries, lad, my door is always open.’ He spreads his hands wide, a universal gesture of welcome. The generosity of this man who has so little is humbling. ‘And thanks for coming by.’

I extend my arm and give him a firm handshake. I feel hard muscles in his palm amongst the knobbly joints of his fingers. ‘Thank you, Ted. You’re a good man.’

‘Not a worry.’ He gives me a grin and I nod back with one of my own.

I step into the kitchen and pause. ‘Oh, and, Ted?’ I call out. ‘I think the cat food’s about due for a change.’

‘Will do,’ his call comes back.

I pull open the door, walk past Ted’s backyard, and head down the path beside his house, my eyes finding the cracks that spread like rivers between the brickwork.