Usually, the patients I see are elderly and most of them are poor or on very low fixed incomes.
Many years ago, I used to be a home care nurse and saw many types of patients in their homes, including middle aged persons and even newborn babies.
A one point, I saw a patient two times a day (to administer insulin)for two years without ever missing a day except for one time when I missed 4 days due to the birth to my third son. I worked part time. A few steady patients allowed me to supplement my husband's income adequately and I was able to stay home all day with my little sons.
Walter lived in the Rittenhouse Square neighborhood of Philadelphia. His home was a four story townhouse of about 4500 Square feet. He was wealthy and eccentric and gay. He was unlike any other patient I ever had to visit. He was soon bed bound and delirious from pain medication and the harsh AIDS medications of that time. During his brief lucid moments we laughed and chimed in together about bad T.V. and foi gras. He was my first chore of the day and my last. He never concerned himself with how I was there every day and night or what my life was like and for two years never really asked me a single personal question.
His affect was dramatic, his persona regal, his personality expecting, his lifestyle lavish. His live-in cook was Spanish but she learned to cook haute cuisine as he expected. His eggs were soft boiled or poached every morning, his lunch was served on a domed covered tray, his dinner always included champagne. He insisted on a continuing an array of dinner parties that took hours to prepare as he needed an extra long nap and assistance with bathing and dressing and then getting in the elevator and down to the first floor and as time progressed he would be seated prior to his guests arriving in a seat that would hold him for the entire evening. He insisted on rack of lamb and caviar and oysters and zabaglione even when he could no longer eat much of it. He continued to drink for as long as possible saying "the day I can no longer enjoy champagne will be the day I die".
His home soon began accommodating live-in nurse's aides. His private limousine and chauffeur wisking them off to the New York City ballets and operas with stops in Little Italy for carloads of special food items. The aides were only too glad to work for him. There was a special one, of course, that was his favorite, who, with me, marveled at the sumptuous bedspreads and curtains imported from France and artwork from Prague and hand carved and commissioned faucets in the bathroom and kitchen. He worked her to the bone without concern for her lack of sleep. He needed her. His self- centeredness seemed a life long trait. She, in turn, got treated very well as far as housing accommodations, food, trips around the city and to NY, and yes..she was left a nice little something in his will! She spent the last 6 months of his life at his bedside, 24/7.
Walter had an outdoor advertising company. He owned the large billboards seen on the freeways of the world that influence our needs and desires. His tunnel vision was very clear to all of us around him. Goals. Desires. Strength. Full Speed Ahead.
Walter was different than most of us for most of his life but at 54 years old he was just the same as anyone else with a deadly disease. His money helped keep him in his lavish surroundings. His nurse's aides kept him comfortable and dignified. He would say "Hello, Donna! (or Diane, or Denise)(never my correct name) and then, "I'm still here"! Referring to his impending death with a chuckle. Everything was always about him. His caretakers and servants gathered around his large, high bed like armored soldiers waiting for instructions: not seen or heard just obedient and dependable. I don't think he even knew or cared what the heck I was doing to him, just as long as it was was done correctly. He never bothered himself with the details of his blood sugar, insulin dosage, or disease maintenance. It did not concern him. Comfort and the ability to enjoy some part of his day and his ability to have his needs met were his only concerns. His friend and personal physician, who was also gay and HIV+, controlled his plan of care.
When he died we all cried. I still miss him. I look at his house every time I am in his neighborhood. We were not family or lovers or even friends. We were nurse and patient. To this day he has left a mark on a small part of my brain. I wonder about the reason for that lingering effect. It was a very easy, well paying job for a while. I was glad for the work, but as I always think, I know the experience was much more than a day's work. It was an influence, an education, a glimpse at another's world. We were all a tiny bit different when we worked for him. Maria, the housekeeper, was a highly regarded expert keeper of the house and able to forget she was an illegal immigrant (for 10 years) that eventually she went back to Mexico; Ty was the pristine, superior nurse's aide, only she had the ability to maintain professional expert care for long, demanding days and nights that without Walter no one can know how great she really can be; Carlos, the driver, was sleek and polished and after his job ended here he went to work for a company that drives people to and from the airport... unknown, impersonal people with boring, lifeless agendas. And me, well, I had to get a real job. His successful business dealings gave me the push to open my own business that year (a home care agency). I remember holding myself to a somehow, somewhat higher standard in some ways....
The glimpses into how others conduct their lives, what makes them tick, how they achieve their happiness and contentment, the reasons for their anxiety and the way it influences others...it is why I love my job at times, it is why I write, it is what I think about, it is what I need. It is what influences my life.
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