Category Archives: Edison Terrell

The Wit and Wisdom of Edison Terrell

 

buddha

 

 

Edison Terrell

Caregiver, author, and occasional contributor to this blog, Edison Terrell offers a unique perspective on caregiving and life. He is currently working on a collection of caregiver related stories and musings titled I Take My Pills with Ice Cream. Edison is a frequent poster on CNA related social media and with his blessing we are sharing a sample of his recent offerings.

*

Telling people to leave work at work is stupid and futile advice in Healthcare, but it’s telling that the advice is most often given by those who have bare minimal to zero patient interaction.

*

I realize now that the greatest obstacle to compassion is compartmentalization. It’s snuffed out like a candle the moment a person’s humanity is boiled away to simplified descriptors. Compassion can’t survive the process of a human being turned into a list of qualities.

*

Some days my motto is “Finish strong!” Most days it’s just “Finish.”

*

I think we may have lost sight of the fact that trust and scrutiny aren’t mutually exclusive. When I put on my scrubs, I expect my quality of work to be under examination, always. I expect that my team’s work is at least up to par, and that we navigate our sometimes ethically muddy road as best we can. I have a duty to my clients, my patients, my residents. Because the nature of my job gives me power over them, and power to make decisions for some of them when needed, such as when they’re extremely aggressive or can’t do things themselves. I think that with power over people comes not just a responsibility from within to do your best, but from without to analyze your behavior–in all reasonable terms–that it’s truly satisfactory. I wouldn’t wish anyone to fully trust anyone in my position to the point they turn a blind eye to what one, a few, or many are doing to bend the rules to breaking.

*

Even people like me who claim to want to observe the truth as it is in all its harshness and starkness at all times, hate learning the truth and living it. It’s far easier to say “l want the truth” than it is to hear it, and most if not all people–including me–who want the truth won’t hear it the first time or even the first several times. Maybe not the first hundred times.

*

Sometimes my compassion overflows to the point everything drops away and it’s just me and the person in need of me… Most times I’m groggy and hate being awake before noon.

*

I think to myself “I’m not as nice as I think I am,” and feel good with that assessment, like I’ve gotten to the heart of it: I’ve pulled back the layers of ego and exposed the shit heel underneath. But it occurs to me that by doing just that I’m letting myself off the hook. I might even be using it unconsciously as a shield. So maybe framing my thoughts in different terms will help me. I can be nicer to people. They deserve my kindness and don’t deserve my meanness; I will be nicer to people.

*

On the seventh day, the LTC administrator allowed her employees a 5-minute break, realizing for one sane moment she wasn’t actually God in human form. Four minutes into the break she angrily cracked the whip with a “Get back to work, slackers!” because she remembered she was actually the devil’s.

*

It’s not the thought or feeling that creates the mood, but my belief and investment in it. A passing cloud is only a passing cloud, no matter how dark or fearsome.

*

My client got the news that he would never walk again today. First time I’ve heard those words in real life and they struck so hard I felt them, too. This is a guy who never gives up, no matter the difficulty or how much of a pain in the ass he is. The droop in his shoulders were like a wall coming down.

*

Who gets a cold in August? Healthcare people, that’s who.

*

I got a call today about a potential new client from a home care agency that found me on Care. They were desperate to get someone but couldn’t match my minimum pay requirement because they “only charge the client a few dollars more an hour.” Bullshit, they bill Medicare at least $45/hour. She said she could give me 10 an hour, so I lied and said I was making 20 at my current job. She said the most she could maybe do is eleven. I waited her out. “Twelve,” she says, clearly getting annoyed. “That’s the best I can do, I don’t pay anyone that much.” I said I’d meet her Friday

That’s how my daddy taught me. Lie like a dog, cuz nobody’s first offer is gonna be what you deserve. 12 isn’t what I deserve, but it’s closer than 10. Whether I take the job or not is no consequence, the most and truly only important thing when dealing with these types is squeezing them for as much as possible.

*

Every aide and PT in this place is in awe that I can work with my client almost every day. They say “How do you do it? He’s so aggravating!” And I reply “I do it so I can leave my wife something behind when he finally drives me to murder-suicide.” We both laugh at that, but I’m not sure I’m not serious.

*

I think if I could ask the heart the value of this kindness or that kindness, big and small, the heart would answer that they have equal value. The ego calculates the weight of goodness but the heart perceives a million dollar donation the same way it does a few pennies.

*

There’s a vast gulf between a simple job and an easy one.

*

Gotta say, for a guy who recently learned he may never walk again, my client has been killing it in the gym. Privately to himself, and occasionally out loud at the end of his sessions as he collapses in his chair sweating from exertion, he tells me in a hoarse voice “I can’t believe what she said. What a discouraging notion.” But he still puts his feet on the modified exercise bike, still glances at the bars now and then from his position on the mat, and unfailingly puts everything into the workout, no matter how banal or degrading it might make him feel. This guy pushes all my buttons every day but I can’t help grudgingly admiring the guy and raving about his determination. I hope he keeps it up to the end and I get to witness one of those miracles I only see on television.

*

I’m more make-believe than solid on closer inspection.

*

I find sad/sappy music is the best for my drive to work. I tried my workout playlist a few times to psyche myself up but it just made me more tired. Downbeat stuff, though, paradoxically lifts my spirits. Maybe misery really does love company.

*

I have this prank I do at work where I sign up for tons of doubles and extra days and shit and this one part of my brain is like “Dude, what are you doing we’re gonna have no time off!” and I’m like “Lol don’t worry about it, bro, I’m pulling a prank. I’m not actually gonna do any of these shifts.” But then the day of the shift rolls around and I realize I’m broke and need my job more than I need to sleep and I go in anyway and it turns out I was pranking myself the whole time.

*

Changes that threaten me, when looked at a little more deeply, don’t actually affect me at all. Just the ideas that I hold to be me. What I want. Everything that bothers me only does so because it conflicts with an idea of the way things ought to be. But me, the closer and harder I look for me, the less I seem to exist as I believe I am. Fear is the glue that holds this false identity together, and when that fear loses its grip, so do I, and I disappear in the best way.

*

Every day is another priceless lesson in patience and compassion, and I mean that sincerely.

 

Boundaries

buddha

 

Edison Terrell

It’s all hypothetical right now, but my grandfather was diagnosed with Alzheimer’s a year ago and it’s progressed sharply since then, prompting the “home health talk.” He’s there enough to know something is seriously wrong, that he needs help with basic things he could do before this, but he won’t allow for help from outsiders. My mom asked me today without verbalizing it, would I be willing to step in when the time comes? 

Normally, my answer would be no. I have boundaries and I think it’s important to have boundaries. This isn’t the first time it’s come up, but things are different now. There are a whole new set of issues to deal with back home; on top of those and her meager job and keeping her family afloat she’s trying to keep her father’s head above water at her own expense. Now my mother is drowning, and here I am, a veritable lifeguard who’s choosing to stay on shore and see how it plays out because I don’t like getting wet. 

It’s selfish, right, to do nothing when you’re capable of doing something? Isn’t that someone’s definition of evil? But I’ve got a family now, living with my in-laws. I was hundreds of miles apart from my fiancée, now wife, for years and we’re just starting to make up for all the lost time. I also have clients here who need me, and whose families depend on me. And to be completely honest I never really liked my grandfather. He was a bore when I was growing up, and had a quick temper with nothing but a fixed smiley veneer over it. He’s different now, I’ll grant you that. The Alzheimer’s took more than just his memory. In a way he’s a proper grandfather now, just one that doesn’t remember your name. 

I don’t feel much for the man or his wife, except discomfort. I can barely muster up the effort to call him Nonno. That word is a grenade loaded with implications and a deafening reminder that for all our culture’s emphasis on family they did everything for their sons and nothing for their daughter except make life difficult at every turn, impose their will on her, and when they had her, neglected her love and adoration. They’ve done so little to deserve respect and even less to deserve anyone’s help at this time, least of all from the same person they neglected and abused, publicly humiliated on a regular basis. 

It’s so easy for me to say Healthcare professionals shouldn’t be affected by what a person has done in the past but only deal with them as they are now in a time of need. The words rise to my lips now but they’ve last all their meaning. There’s only the stark reality of my situation: I can act or I can let this play out.

Life Goes On

buddha

 

Edison Terrell

My dad was recently diagnosed with cancer. Acute chronic leukemia lymphomatic scary sounding things that don’t sound like real words. I talked to him on the phone and he related how scared he was, that I was going to lose him and his parents would outlive him. He’s always said it’s a tragedy when a parent has to grieve for their children. And I, in my childishness, never really considered my mom or dad mortal. They’re my rock; his cancer, coming on the heels of recovering from a car wreck that put him in the hospital for almost two years now, crushed me. Now my rock is crumbling, and I’m all kinds of disoriented and listless for it. 

Meanwhile, I’ve got a private client on Tuesday mornings from 10-12. It’s usually no big deal, and we’ve had a good thing going for a month now. Last week he said he wanted me to come on Thursday instead—again, no big deal—but I messed up the dates and forgot to go in Tuesday this week, thinking it was Wednesdays. I took what I thought was a morning off to get some work done and didn’t see my client’s voicemail until that night. I called to apologize, said I’d be there Friday instead, and everything was cool.

I got this message from his wife today: “Hi Edison, I am just wanting to confirm that you will come over tomorrow for J and then go back to the regular Tuesday 10AM schedule.”

Then she added: “When a handicapped person relies on a caregiver, he often ‘panics’ when the caregiver is late. That is how J gets. So please do continue to call to notify him if you are ever running late.”

Embarrassment—shame, really—hit me like a freight train. Followed immediately by thought-blocking anger. Didn’t she know I felt bad enough from my profuse, groveling apology when I called Tuesday night? No, she had to take another dig at me, make me feel worse before I had to leave for my other job, piss me off and leave me with nothing, no one, to turn my anger on. I turned it on myself and her ghost.

I started to write a reply, ignoring her advice (How dare she, anyway? Does this chick know how long I’ve been an aide? Honestly? Really?), just “I’ll be there,” but decided it wasn’t enough. I deleted it and wrote another draft, taking her apart line by line, ending with “This is going to be my two weeks. Your husband is fifty-five-frickin’-years old; he’s a big boy. He should be able to take change by now, and if he can’t, it’s not my problem.”

I didn’t feel any better to get it out, but the thought of hurting and confusing them, like their message did me, was delicious.

Before I could hit “Send” I was cut down by a glimmer of insight, an ugly, rancid bit of compassion I hate so damn much: How would I feel in J’s situation? If I was practically paralyzed on one side and had to set aside a chunk of my day just to get a shower and not be told it wasn’t happening. I’d be confused, and hurt, and probably angry at my time being wasted. I really, really didn’t want to let that in.

I want nothing more right now than to make people hurt as badly as I do, when I feel like doing anything. As a kid that would’ve been an option, sort of. I could be moody and isolate myself, simultaneously wishing for someone to come check on me so I could break open the shell, wishing for them to check on me so I could lash out at them, and wanting to be left alone forever. I was a child for a very, very long time. But now I’m an adult. I’ve got a family, and clients that need me. Bills to pay, food that I have to buy myself, and worst of all I need to grow up. I really don’t want to do that. I want to be vacillate between selfish cruelty and dejected neediness. But I can’t do that. Life goes on even when we pause and feel like it won’t. And I like my client. He’s a good guy, I don’t want to lose him, either.

Sometimes that’s what caregiving is: pushing forward. Owning up to your mistakes, acknowledging the deep hurt and listlessness, but moving forward anyway, cuz life goes on and you’re still needed. 

Sunrise, Sunset

buddha

 

Edison Terrell

I went in to my old work to volunteer with activities this afternoon before work. My last day at this place, but I’ll spare the choked-up emotion for later. Maybe cry into a cup of Americone Dream. Anyway one of our residents was sent to skilled a month ago after he broke his hip, and he looks so different since I saw him I didn’t even recognize him until he started grumbling angrily at the door to the living room. It was the pomp British voice, and the way he called the door a “f____ wanker” that clued me in.

The difference was, in a word, shocking. Disturbing, really. He was a lawyer in his past; not in the best of shape when he moved to Personal Care from Independent Living, but he was walking, talking, and speaking his mind confidently to us. Sometimes he didn’t make much sense, but I took it as part of his charm; the way he vigorously and skillfully defended his own nonsense perception was admirable in its own way, as well as frustrating. Today he’s wheelchair bound, kicking and pulling on already opened doors, grabbing feebly at the air, at the sleeves of his woolly sweater, even at his own hands, like they’re alien things at the ends of his arms. Mumbling incoherently the whole time. He grabbed at a cooler of ice at the nurse’s station and shook it violently until an exasperated aide came to steer him away, then scooted aimlessly around with his eyes barely open. He’s so delusional right now they may as well be closed.

Seeing him in that state shocked me further to the core than almost any other experience I’ve had on the job. He went from a gentlemanly annoyance to a maniacal monster in less than four weeks. The sharp decline is horrifying to see, a fate worse than death. It almost makes me not want to go back.

I know I can handle future residents like him thanks to this experience. Clinical and months of work have shown me that if the shock doesn’t kill you, it’s a recoverable one. There comes a time when you start to question how many more shocks you’re willing to take, though. You start to slowly turn a corner then, if you’re like me. I’m confident I could work almost any aspect of this job after a little adjustment, but is it worth it? Am I so needed that I should sacrifice my comfort and drive to come back and keep being horrified and saddened? Or do you just hold on the good and keep going?

Fran had a mini victory tonight when she was able to put both her arms in her shirtsleeves and take off her pants and briefs before sitting on the toilet without me urging her or showing her how. Little moments like that keep me here. Tomorrow she may be different. She might break her hip as soon as I leave the unit, and maybe an ambulance will zoom into the parking lot while I’m driving away around the other side. It’s pointless to ponder like that in this work, though. In that moment she was exemplary, and I was so proud of her.

 

Fran is Lonely

buddha

 

 

Edison Terrell

I went to sit with Fran for a while, because she’s been unhappy lately. I don’t use words like “declining” around her, but anyone can see she’s going downhill. She knows something is wrong, but can’t put her finger on it. She’s gotten more confused the past few months, a lot weaker, and she didn’t had much self-confidence when I started here; this new development has her putting the brakes on trying at anything, even putting on a shirt. She’ll just fumble with it, groping both arms through the head hole or let it sit on top of her and look pitiful, not making any attempt until you put your foot down.

Fran’s little apartment is divided into a cozy living room/kitchen, a slightly bigger bedroom and a tiny bathroom that barely fits us and her walker. No stove, but there’s a counter and cupboards and drawers with silverware and cups, and a little fridge like you’d see in a dorm room. Coming in through the front door—always unlocked and ajar, because she fears she’ll lose her key—the kitchen is to the right, next to Fran’s electric recliner, a nightstand with a lamp and across from there are two tiny rocking chairs that somehow support my weight, though the arms pinch my girth. A subtle reminder I need to get back on a diet. Or “change my lifestyle” as chronic fat people like me tend to put it. I knocked on the door as I came in, she said she was happy to see me, which I took to mean I could have a seat. I took the chair looking directly at her.

“How you doing, Fran?” I said loudly. She isn’t hard of hearing, but speaking loudly and slowly helps her understand what you’re saying. She talks lower and slower than she used to. Takes time to ruminate on her words. I try hard not to check my watch when I’m around her. She doesn’t get a lot of talking done because we’re all rushed, almost all the time.

“I’m lonely, but I don’t know why,” Fran said finally. “People come in and out, but it’s not the same.”

“Nobody talks to you?”

“Yeah, people talk, but it’s all the same thing. They all their own way of doing things. And they creep up on me with things to do. PT. What you do—not you, but you know. The others. They want me to go watch old movies.” Fran has a perpetually sour look on her face like she was sucking on lemons before you walked in. Her skin is dry all over, no matter how much moisturizer I put on it. The flaking whiteness all over her scalp, her cheeks, and on her chin only adds to the gruesome texture of her face with her mouthed pulled back dryly in a near permanent grimace that forcibly reminds me of a skull.

“You don’t like the old movies?” I ask loudly.

“I saw them all years ago and don’t want to look at them again. That’s us. Old people. Old movies. Old things. Remembering. The sum of our parts; old, old, old; us in a nutshell.”

“Oh,” I said lamely. “I’m sorry to hear that.”

Before I could offer up an alternative, Fran verbally reached into my guts and squeezed them, twisted them. “I’m not used to being dirty,” she moaned. “I’m used to being clean all the time, but they’re not cleaning me as much as I’d like. You’re one of the only ones who does.”

I didn’t know what to say. I started to speak, to tell her she needs to tell someone about this, but she rambled on. I’ve learned sometimes it’s best to just let people talk; they don’t necessarily want advice or solutions as much as someone to grieve to.

“I don’t know what to think or where to go or how to solve anything. I used to know. This is my walker,” she said, rattling its aluminum frame. “My pouch is on it, and those are my pads. But it doesn’t feel right. It doesn’t look like my walker. I wouldn’t know it was if you didn’t give it to me. And you have to take me all the way to the bathroom if I have to go. Nothing is normal anymore. And I don’t know how to get it back to normal.

“My bottom is sore. I shouldn’t say that in front of gentlemen.”

“I know I’m gonna fall. I don’t want to fall again. It’s really bad. It’s bad when that happens. No hospitals. That’s the worst. You don’t get to live in your apartment if you go there too much. All my friends are in Independent Living and I need help with everything. That’s not normal. None of this is normal.”

If I could find words, I don’t know what they’d be. All I could think to do was validate that it’s “normal” at this stage of her life, and some people are at different levels, or some crap I was taught in orientation or class. But I’m twenty-nine. What do I know about any of that? Anything I said would come off as hollow and unhelpful as telling a dying man to cheer up, it gets better. I let the silence stretch on painfully.

Fran croaked that she was thirsty. “There’s a can of ginger ale in the fridge. Take half and we can share it,” she said.

Her fridge was barren but for a few bottles of V8. “There’s only V8 in here, Fran. I’ll have to go and get you one from the kitchen.”

“Please make sure you come back,” she whined. She had turned around in her chair to look at me, fingering the big button on her pendant, not quite pressing it. “I don’t want to be lonely.”

“I’ll be back soon,” I said, stepping out. I had a feeling it was a bad thing to say, and was rewarded for it moments later when someone else hit their pendant. Duty called, and “soon” was almost twenty minutes. I got her ginger ale in the end even though she only vaguely remembered asking for it, and she gulped it down, burping, which she remarked was very unladylike with a little laugh.

Update: Fran moved out of her apartment in assisted living to skilled about two weeks later, skipping right past personal care. Did not pass Go, did not collect her $200. This place would have taken it anyway. She died less than a week after that. I hope she was surrounded by family when it happened. I hope she wasn’t alone. No one told me or I would have been there. She was a huge pain in the final months I knew her, a physical and emotional tax more than a person, but the last few days in her company humanized her again. I’m thankful for that.

I’m sure someone would remark at how wrong it was for losing sight of her humanity. I can only shrug at it, look away. I feel exactly what you’re feeling for me, but it was never a conscious choice… No, I can’t honestly say that. I saw it coming like I’ve seen it so many times before, the moment where acquaintanceship either becomes friendship or sours slowly while you watch in a mix of anxiety and anger. Anxiety because it means a dark spot on your day, anger that swallows you up, pulls you down. Anger at the resident for being such a fuss, so much a dependent pain in the most tender part of the gluteus. The tailbone area for me, that’s the most tender area. She was a pain in my tailbone.

It’s a blind corner that you take with faith or your eyes closed tight. Every time I meet a resident like her I shut my eyes and hope for the best. Sometimes I take a hit. Sometimes I meet residents who are demanding, heavy, angry or mean. And I’d fight against it. I can’t say I did my best because I know I could’ve done a lot better. I could have smiled, forgiven them, rather than taking their meanness into me and holding onto it, hurting myself with it. I guess the more often it happened, the less I fought it, until Fran the human being with wants and needs and a personality was shrunk down to Fran the confused, shrieking harpy who depended on me for everything. Fran, My Future Back Problem. It’s hard to shake off bitterness like that after it has seeped into your skin. I still had some love for her, though, for whatever insane reason I couldn’t put my finger. Maybe because she reminded me so much of myself. A hypochondriac, dependent, whiny, pitifully scared person facing what she’d feared she would face her whole life. Trying to save her from the fear that came on at night when she was all alone—the same kind that creeps up on me when all my distractions are gone—was like saving myself. Working with her put that fear, and all the dependence, the whininess that came with it front and center. It made me take a long hard look at myself. I didn’t like what I saw.

Fran was my zen teacher, in a way, and I hated her like one, for showing me all the ways I was coming up short. I’m only realizing it now as all the confused emotion and mixed up thoughts unwind, smooth out. She was probably one of my very best teachers. 

Just a CNA?

buddha

 

 

Edison Terrell

I‘m not “just a CNA,” but I’m not so bothered by people saying that’s what I am. Other people are taking snapshot judgments of my entire life stories and personality based on a glimpse when they say I’m only an aide, and I do that to them, too. It seems like an evolutionary device to tell potential friends from foes, and as we got more sophisticated, a way to determine someone’s value to you, or lack thereof. It’s deeply ingrained in the mind, passed on and perfected by thousands of generations of reinforcement. Something like this won’t go away by arguing with it. That’s literally the opposite but equal side of the thing. On one side is “You’re ‘just’ a CNA,” on the other is “I’m MORE than just a CNA, I do blah blah blah.” I’m not saying I don’t agree with either stance, but we’re just banging hammers here. You’re fighting one mindset with its equal, an unstoppable force meeting an immovable object.

I don’t know what the answer is, but it isn’t this. I honestly think it’s just to let people hate and not to give in. That’s a pill I haven’t swallowed, I’ll totally admit it. One of the reasons I’m going back for a degree is because on some level I believe that “Just a CNA” bullshit. And that’s OK, too, if you have that same thing going on. It’s just your mind. Mind is like a water glass with dirt at the bottom, and this stuff, arguing the merits of what we do, is stirring up the glass, clouding the water. There’s no taking the dirt out, though, it’ll always be there. You just have to notice when your mind get shaken like a paint mixer and understand what comes up is just a reflection of your shook up mind.

That’s a lot easier said than done, of course. I’m still working on this after almost ten years, and I’ll probably wrestle with it for the rest of my life to some degree, but I’ve found it to be the only thing that may provide some relief. I did a lot of soul-searching before I entered healthcare, fell into Zen, and I think some of the lessons like this one might be helpful for everybody, regardless of the path you’re on. The alternative from what I can see is diving hip deep in the fray, getting pushed around by forces you have no control over, people you don’t know judging you, a person they don’t know, and taking swings at everything that moves. What good will that do any of us? No—what good does that do you? Let’s not make this a global issue. Tell me when doing that has benefited you? When have you jumped into an argument like that and walked away not feeling unclean? I want to meet that person. You might feel like you one-upped somebody because you got in a few good remarks that left them sputtering or pissed off, but you still feel ugly and gross walking away, if not ashamed or mad yourself. Is that worth it?

And I know, believe me, the alternative to that sucks, too, just as bad. That guy called you worthless, but you’re supposed to not snap back at them. It becomes a question of whether you’d rather feel dirty and angry or just angry, and have to examine that anger, the stuff that arises with it, and let it come to rest while the other guy is smugly nodding in the corner like he got you. It takes everything not to verbally crank him across the jaw. After a while it starts looking like the only good option, though, even if it’s not the most palatable one.

Let the haters hate. It’s what they do. Just drop both sides, or try to anyway. Cuz otherwise it’s like thinking you can remove a bullet wound by shooting yourself again. That’s my opinion, anyway. I could be totally wrong, I’ll admit that too. 

Anger Management

buddha

 

Edison Terrell

You’d think anger problems like mine have no place in this work, and you’d probably be right. But I care a lot about my people and try not to let it get to me. 

The problem with saying I have an anger issue is that it instantly identifies me as a terrible person. Pop culture, movies, games love to paint a person with anger problems as a psychopath in waiting, just holding it together long enough to explode in a hail of bullets and crazy when the final straw breaks his back. I have to admit, a small, insistent part of me worries that I could be that guy someday. It’s one of the reasons I refuse to own a firearm. Just in case I snap at some point, I’ll be a hell of a lot easier to take out when I start attacking people in an effeminate, fussy nerdy rage. Probably crying the whole time, too.

Seriously, even saying I have an anger problem forcefully conjures up images of the bad guys on crime dramas, the wife and child beaters, the people who pop out of their cars with a bat if someone accidentally scrapes their bumper. That’s what people tend to think when we think of anger issues. Unchecked, unbridled rage. And I’ll admit, there are brief moments at work where something will inordinately set me off; my vision will blur and narrow almost to pricks at the same time as the rage seems to overtake every other mental process. And it could be nothing at all that sets me off. It could be Fran being her normal difficult self, trying to run away with her brief around her ankles, balls of poop hanging from her knee-length pubic hair. It hurts when I pull them off, but she’s not hearing that it needs doing. She’s pissed. I’m pissed. My anger just keeps rising every step until I’m ready to jump out the window and hug the ground with my face thirty feet below… 

But you know what I do then? I back off. I herd Fran into a corner where I can trap her, yank up her brief, and let her be on her way for now. The poop balls are disgusting but not doing her any harm, and she’s too wild to listen. I want to kill someone, myself, but I have her sit down in her chair as gently as possible, directing her through gritted teeth, and I leave, go calm down in a corner. I can spare a few minutes to chill out. Let the anger run its course, boil itself away like an overheated pot of water left on the stove too long; it leaves me cold, ashamed in the end. I’ll take that over jailed or dead from leaping out the window, though. 

There are people who would try to make me feel like a dirt bag monster for having a problem like this. They’d say I have no place here, I’m a danger to my residents and staff. I promise you, though, as long as I have my wits, the only danger I present is to the Popsicles in the freezer and the Fig Newtons in the cookie jar. If that’s not enough, I don’t know what will be. You have to understand that we’re all one bad crossed wire away from turning into gibbering idiots, or aberrations. We love to say CNAs are angels, and to a point I agree; we can be wonderfully, beautifully humanitarian. We put our health on the line for vulnerable strangers every day, some who won’t live to see tomorrow and some who will never be aware of our presence in this stage of their lives. But you can’t ignore the darker side of your humanity for the bright angelic within.

All of us have fatal flaws. Maybe you care just way too much, to the point that everything breaks you like china. Maybe you don’t work well with certain types of other aides. Maybe you have a tendency to gossip a lot, and tend to unwittingly wreak havoc among staff. Me, I have an anger problem. I have an ugly, horrible issue that I deal with every single day. A thing I’m deathly afraid of anyone in this business seeing. And it has been seen. I’ve walked out of rooms, shaking with fury, on the edge of tears I’ve beat myself down so hard for being so mad, uncaring that other aides get to bear witness to this side of me. Most days I’m relaxed, joking, the life of the party for some of my residents. Every now and then, though, and it might be something stupid, it might be something totally unknown to me, I’ll get very, very angry, and have to walk away from my job for a while to reassess. I need those breaks to examine my rage to try and peek at its source. It might have nothing at all to do with the person who seemed to piss me off, that’s the unnerving thing. But it’s something I have to do. That’s how I deal with my fury.

 If you take anything from this, please let it be that people like me aren’t lost causes on our own. We think of rage issues and that’s what comes to mind. The irredeemable, the awful. Psychopaths, rapists, wife beaters. That one kid who went crazy and stuck a TV remote in his butt when his dad shut off his WoW account. If I need to walk away from something it’s not because I’m going to actually harm the resident. I’d never do that; I have too much empathy for them, too much love, or else I wouldn’t be in this work. It’s because I’m so mad at myself, so guilty, that I need a minute to calibrate my emotions. The only thing in danger is my perpetually rock-bottom self-esteem. 

 But I can’t tell this to my boss, or my coworkers, without fear that I’ll be put on some kind of watch, at the very least. And hell, maybe I’d do that too, if I were them. Part of the reason I take it so hard is purely because a part of me that logic can’t reach believes all the awful stuff people think about rage issues. I’ve been dealing with it for years with my zen practice, meditation, mindfulness, but part of me still thinks I’m a ticking time bomb just waiting to go off… no matter how many times I’ve proven the opposite. It plain sucks to live like this, it really does. I feel trapped by my anger and by my worries of what people will think if I come out about having it… 

The Definition of “Fast Food”

buddha

 

Edison Terrell

 

Dinner here for our residents is from 4:30 to 6 o’clock. For us that means getting all the residents up and in the dining room by 4:20 at the latest, half of them still bleary from sleep, morosely taming flyaway hair with the brushes and combs they’re used to taking to the dinner table. Some bring mirrors and little bags of makeup, applying a fifth or sixth coat of lipstick. It’s that or rouse them early from their naps, or not let them take naps at all, and I like to let my people do what they want, for the most part.

From 4:30 to 5:30 I try to help the dietary aides in the dining room with the residents. Their job is tougher than it looks. I know, I’ve bussed and served tables, and we’re talking about feeding the blind, deaf, plain ol’ crazy people shredding their menus into confetti and pissing off their neighbors, and the one obstinate curmudgeon whose damned well going to get eggs and sausage with his mashed potatoes, even though it’s dinner time and he’s on a pureed diet and knows it. 

At my last job they didn’t have dietary aides, but nor were there as many residents to feed, or such a varied menu. On paper it looks like an amazing smorgasbord: everyone has at least two menu choices for their appetizer, entrée, accompaniments, and desserts, and then half a dozen extra things on an “All Day Menu” that can be ordered up. In practice it’s a mess. When you’re not hustling around to scream out what was written in sloppy cursive font on the menu to one resident while another to her left is leaning in to listen, and the one to the right is about ready to scream right back at you to shut up, you have to listen to the residents tell you that this isn’t what they ordered, what is this? Clam chowder? I ordered the rice pilaf! When you’re not doing those things, you’re reassuring residents that their food is coming. Just because someone else got their entree first doesn’t mean yours isn’t on its way. And pouring coffee. You have to learn fast that some of these people have an architect’s eye for every aspect of their life, especially the amount of coffee you need to put in their cup. When they say three quarters full, they mean not a goddamn drop more, and you better thrust out your palm to catch that rogue drop of scalding liquid or else endure their unending wrath.

When it looks like everyone has been fed and watered, the complaining about the food and Tom constantly getting up from the table to teach the dietary aides how they should be serving or make a general nuisance has ended, you can go downstairs to the café, praying there’s something half decent on the menu. 9 times out of 10—no. Not only will it sound bad on the big digital menu, the smell and look of it as you turn the corner into the brightly lit, homey cafeteria will dissuade you from anything but your usual French fries and a burger, or a tuna on wheat with potato chunks mixed in. Why do they do that? you think, for the millionth time. Who puts potato in tuna? Did they hire the Joker to run this place?

You grab a to-go box, get your food and hurry back upstairs to get the stragglers out of the dining room because it’s time to reset the tables. Like clockwork, someone from dietary comes up with a big steel box on wheels to retrieve trays and trash, chat with the dietary girl while you put your food on the nurse’s station and get Fran out of her seat. She’s heavy and unstable, so it takes some time to get her up, but eventually she’s good and can walk back to her room across the hall on her own. You wipe your brow and look out in time to see Gretta’s silver and grey afro of curls bobbing over the spot where you left your meal. She’s trying to get it open. You gently shoo her away, but you know it’s still not time to eat. Because now everyone has eaten they’re cranky and ready to get back to bed. Some of them have been out of the dining room for a half an hour already, which is an eternity in old people time. You hide your food box and go do rounds, stomach growling.

This job is sacrificial in nature, and whether that means holding it until your shift is done or scarfing a few bites of food in between showers, our people come first. We go hungry to keep them fed, to make them warm and comfortable. Our stomachs growl, but at least our residents are safe and happy. If we’re not happy to make those small sacrifices we’re at least willing out of a deeper love for people who need more help and attention than we do. That sacrifice is one of the things that separates a good aide from a bad one for me.

“Matt”

buddha

 

Edison Terrell

It is our pleasure to welcome Edison Terrell as a guest contributor on CNA Edge. We think his stream of consciousness style is both entertaining and thought provoking. Terrell is currently writing a book based on his experiences as a caregiver in a long-term care facility. The working title of the book is I Take My Pills with Ice Cream.

It’s maddening that so many executive directors are seat-of-the-pants drivers in a business that inherently only runs when it’s running perfectly. You can talk all you want about aides not doing “enough”; about there being a dissonance between aides and nurses that shouldn’t exist; about how the financials don’t add up for us to have another aide on a floor, but our nonprofit made $50 million last year and you should be proud of yourselves! At the end of the day we’re the invisibles keeping the machine greased and powered, noticed when things go wrong, when there’s a buck to be passed.

I don’t feel unappreciated, that’s not what I’m saying. I don’t expect the CEO to stop calling me “Matt” when I’m clearly Will. I don’t even look like a Matt. I’m one of a sea of faces, recognizable maybe because of my lazy eye or the fact my black scrubs, hefty imposing frame, big beard, and curled in, defensive, timid shoulders make strike a schizophrenic figure. And for all his comradely bullshitting, reminding me we’re both from Massachusetts, putting on our annoying accents, talking about “‘cahs’ and ‘pahks’ and how we like to drive ‘thehe’ to eat ‘frankfahtas'” I know he’s just a bullshitter. I can see it in his eyes. They shine in an over-bright sort of way, backlit from within like he’s got a lightbulb for a brain, painted green for money. That’s all he sees in me. Not a large pair of scrubs, just a means to an end.

It doesn’t bother me so much that my CEO smiles too big, too toothy, too tight around the corners like a mask, to be real. I’m not bothered by the way he fusses a strand of silk on his lapel and worries every wrinkle and crease in his suit. Nor does his silver crew cut bother me too bad. He likes to tell us he was raised in Southie and Dorchester (“Dohchestuh”), tough towns in their time, and I think the cut is to remind himself, and us, that even though his nails are professionally manicured and his face is soft-looking, he’s as tough as ever. I’m not a fighter, but this guy is 5’4, tops. Looks like the last time he could be in the ring with anyone was ten years in his rearview mirror. I’m not even all that bothered by the fact that he subtly guides you into the elevator when the doors open, putting his light, cream-color tanned hairy hand on my broad shoulder, as if without him to lead I might stand there like a dumb animal until the door closed.

Piecemeal my CEO doesn’t bother me, but taken as a whole entity, he and his cliquey little crew piss me right the hell off. Like the activity director with her tinkling, condescending little laugh. There’s nothing I can do about it, and on the whole things run semi-decently because of these towering titans at the top of the food chain. But for the most part it’s because of the people in middle management and below, sweating the tasks and responsibilities they’re given against the reality that we’re forcibly crushing two, three people jobs into one eight-hour shift some days. When we have a full allotment of aides we’re still short, somehow. A combination of our reckless executive’s practice of keeping wanderers in a unit without locks, putting the crazies in with the general population, basically.

I worry about what will happen here when I go back on full duty. While I’m on light I can be called upstairs to keep an eye on Gretta, whose husband is in skilled and who has crumbled mentally to a puppy-like state, following the aides, the dietary people, other residents, going into rooms looking for her spouse. It’s actually somewhat beneficial my back went out right around the time her husband Greg declined, but as soon as I go back Gretta will be unchained, free. Residents who don’t lock their doors will find her in their rooms when we’re not looking, and we’ll have to go running to turn her around, dropping whatever important thing we’re doing that can’t just be dropped to hump it back out into the hall and listen for wherever the sound of cursing is coming from. Stuff like that happens in memory care, too, where I’d argue she belongs, but there at least everyone is stealing everyone else’s stuff, or they’re not with it enough to care. We’re drilled to respect these people like they’re family, like we’re working in a microcosm, a small slice of Americana and this unit is their neighborhood. A sentiment I wholeheartedly, one hundred and ten percent agree with. Then the guys upstairs turf someone like this over here. Or hell, have a few.

When someone declines mentally, we write notes in the care plan, write notes to the administrator, talk to the nurses. If it’s not bad enough for state to put us in their sights nothing gets done. A person might bring it up at town hall to the director himself and he’ll give us the run around. There’s no place on the premises for them to go. We have to keep making money on them, we don’t have a memory care unit, so do your best until we break ground at the end of 2015.

It bothers me how hands-off these guys are. You never see them in your unit. I catch him canoodling with the independent people in the cafe, but they represent only a part of our community, and let’s be honest, the one needing the least of your attention. He tries to be like a father-figure, but if that’s his thing, he’s a father that dotes on the smartest, ablest sons and daughters, and leaves the others to the nanny. I know I’ve said this before, in different ways, online and off. I’m sure it’s everybody’s complaint. This isn’t anything new or incredible. It’s practically a requirement that getting to the top means becoming a cajoling sleaze bag. But it still bugs me…

Really, if he didn’t call me Matt I don’t think I’d have even written this.