It is 6PM and Papa is in a great mood! He is dressed, he’s been showered by the home health aide – which he described as the most humiliating moment of his life (of which I can’t believe) – and he’s shaved without nicking himself (with the aides help).

He lumbers slowly down the stairs, humming some old show tune…moon river?

“Papa!” he calls out to me. “Oopla, this cat, he goes crazy.” The cat races by his feet, by inches. “Eh, what’s going on?”

He makes his way to the kitchen, where I am cooking dinner. “Papa, this is a fantastic smell”. He closes his eyes and breathes in with extra aplomb. He smiles.

Without waiting for my response on anything, he chatters on for the next ten minutes. He covers the subject of grocery shopping, farming, Italian olive oil, winning the lottery, Vic’s barbecue, my daughter (the girl), young love, and winning the lottery. Winning the lottery is the glue of his thoughts.

“Papa, we will have a touch of, eh, you know…” He smirks and wiggles his eyebrows.

“You want some wine?” I move to pour us all a glass.

Papa comments on Vic outside at the grill. He comments on the birds at the feeder and the dogs begging for food at his feet. He comments on the grass and what I looked like last week mowing it on the John Deere. He’s never seen anything like it he claims, and laughs.

He makes his way to the French door to the back porch, he opens it and pokes his head out “Victor, you’re not burning it, are you?” He lingers with the door ajar.

“Papa, watch the cats” I remind him.

“Eh, what? Oh, yes, yes.” He closes the door, not fully latched and walks to the front door. I leave the boiling rice to close the french door more fully.

I hear the front door open. “Ah, what a beautiful evening. I love this time of day, no sun, but still warm air. It’s lovely.” I wait a few seconds, to see if he’ll close that door before we lose an animal out it. Nothing.

“Papa, do you want to sit outside?” I inquire.

“Yes? Oh, ok.”

I turn down the flame on the stove to help him outside, set up the cushions on the chair, get him settled. I return to cooking.

No less than two minutes later the door from the garage opens and Papa is back inside.

“Was it not good outside?”

“What? No, no it was nice, but it was too humid. The dampness…I don’t want to catch a cold.”

He wanders to the cabinet that is ajar. “Hmmm, these are nice.” He has a bag of chocolate covered raisins in his hand. A bag of candy I missed, when clean sweeping the house. Three nights ago, I had awoken to the sound of Papa downstairs. I called out, “Everything ok?”. He assured me he just needed a glass of water. The next morning I found a trail of white chocolate chips from the cabinet, across the kitchen floor, onto the rug near the steps. Papa was sneaking candy. Or anything sweet that passed as candy. At 2am. Papa has diabetes.

The next morning, I took a large grocery bag and threw everything I could find that had any sugar in it into the bag and hid it in basement near the pantry. I missed the chocolate raisins.

“You can’t have those, you know that.” I smile.

“Oh, why, papa?” He looks disappointed.

“Because you have diabetes.”

“Oh, really?” I’d think it funny, if he truly wasn’t surprised.

“Yes, and sugar makes it worse.”

“What a crazy thing papa, that an old man loses the ability to enjoy life.”

He heads toward the stairs. I call out and remind him I am cooking dinner. “Oh, ok. We eat soon?”

Like a child, he is everywhere, into everything, unfocused, talking nonstop. He is a distraction a minute. I bless the days his companion is here to contain him in some activity. I also bless the days he is happy.

“I’m directing a freaking army here!”

I am speaking with my aunt, while I wave a nurse through the front door. Ever since Papa’s fall, the VNA, the Agency on Aging, and the myriad other organizations who claim to be there to help us with Papa’s care have really stepped up their game. My humble home suddenly resembled Downton Abbey. The cast of characters amuses and entertains Papa. But they were hard to come by.

After the fall and the ride and visit to the clinic, Papa goes up to his room, with help from me, and stays there for the next two days.

On day three, I call one of the agencies that have been visiting over the last few months, collecting information on my father. I explain the situation- the fall, the dementia, the leg, the pain. I ask for help. I am transferred to the supervisor, Beth. Beth asks me to hold, returns and states that if Papa is in that much pain we should go back to the clinic.

On day four, Vic tells me that he got through to the Agency on Aging and that Papa has a companion who will start on Monday, at 9am. She will be with us daily for four hours.

On the fifth day, Vic leaves for travel on another contract. I’m navigating this alone – at least until tomorrow.

On the sixth day, the companion doesn’t show up. I think she’ll come tomorrow

On the seventh day the companion doesn’t show up. I call the VNA. No companion listed there. I call the Agency on Aging. Wrong town. I call the other Agency on Aging. I hit the right one.

“I’m sorry,” the woman with a heavy accent says “Did no one call you on Monday?” She tells me the companion has been ill, but will absolutely start on Wednesday. Her name is Norma.

The woman at the Agency on Aging calls me back and tells me, no, its not Norma, its Louidalyce – but call her Nana.  She’ll be there tomorrow.

Nana. I like the name already, its so – comforting.

I go upstairs. Papa refuses to get out of his chair.  “My leg”, he moans.

I lift the blanket from his legs. The angry looking hematoma stares back at me. Something fluid and jelly like undulates beneath it’s thin surface. The area around it is flaming red.

I call Dr Thomas, who is out until tomorrow, and book a 2pm visit with her then.  Hanging up I stare at the wall.

I should be working. I should be writing one of the four past due reports for my clients, or finalizing the P&L’s for our quarter of a million dollars in financing, or doing laundry. But I’m exhausted.

And then the phone rings.  Papa loves to answer it on the extension in his room. He enjoys talking with the telemarketers.  But of course, he can’t answer it now, he is anchored to his chair.

The answering machine picks up and I hear the voice of Marcia, a VNA nurse.  Her voice moves me to action, I’m up and at the handset before she finishes her sentence.

“Marcia?!”

I realize I sound like a lunatic, desperate and mad. And of course, I am.

“Marcia, I’m SO glad its you!”

Marcia seems startled into silence. One beat, two beat, and then a tentative “Hi…”

I find some composure.

“Marcia, hello, I’m happy you called.”

“Hi, I’m calling about my visit with your Dad. I’m scheduled to come out twice per month for vitals and blood sugar, and I’d like to come out on Wednesday.”

“Oh, Marcia, Papa fell down the stairs, at first I didn’t think it was bad, but then he threw up, so I called 911…”   I tell Marcia the whole sordid tale. She is rightfully appalled that not one VNA nurse has visited since the accident seven days ago. I confess to her that maybe I was not clear when I called them last week, and she admits that might be, but this is not how they operate and she is apologetic. She says she’ll see me tomorrow.

Marcia is coming! I’m as excited as a 15 year old on prom night.

At 10 the next morning, Nana arrives. She is as positive and nurturing as Mary Poppins, and cute as well. Papa loves her. I love her. What is not to love?

At 11:30, Marcia walks through the door. Efficient, assured and with a bag of tricks, she assesses Papas leg and declares that our visit to Dr. Thomas this afternoon is critical. She directs me to call her after the appointment and that she will be back out on Friday. She has also ordered a home health aide three times per week to get him in and out of the shower, and a physical therapist to assess his gait and help him heal.

I love Marcia. I love Nana. I even love Papa.

 

 

 

 

 

How many people are qualified for really, life scary emergencies? How many people know when it’s the right time to push the button, call 911, cry out for help?

I think like most people, that moment for me is only clear in hindsight.

When I got back from errands, having left Papa alone for forty minutes, I found him seated with his leg up…and a garish, large, black purple hematoma growing on his shin. Twice the size of an overripe plum, and just as black.

“Ok, we have to get you to Dr Thomas!”

I place the call to her office, can I come right in?, they ask.

“Papa, let’s get your shoes on, we are going to see Dr. Thomas.”

“Oh, right now? Why, papa, my ribs hurt, I can’t move.”

“Your ribs hurt too? Can you breathe ok?”

“Well, yes, but every now and then a sharp pain.”

As if on cue, he starts and cries out, reaching for his right side.

I get his shoes on, then get him standing. He is a bit shaky. We head out into the hallway toward the stairs.

Each step down causes some pain. At the bottom, he is ashen faced, sweating.

“Papa, I feel sick….”

I wheel him toward the kitchen sink, where he proceeds to vomit for two minutes.

I call 911.

“Hi, this isn’t a lights and siren emergency…” I explain the situation to the dispatcher. He oddly keeps telling me to calm down, while I am remarkably calm and speaking slowly. I realize he is reading from a script. I play along.

Within four minutes a police officer is at our door. I have Papa in an easy chair in our kitchen.

Over the next thirty minutes our kitchen fills up with three more officers, two paramedics and three ambulance attendants. Lots of bags and equipment and a gurney too big for the back porch. So out the front door Papa goes. Neck brace, heart monitor, IV.  Bumping and jostling along the stone path.

Talking and telling jokes the whole way.

I follow along in my car, register him at the emergency clinic front desk and then I am escorted to the back. With my cell phones last battery juice, I call my mother to cancel the DC hotel for the night and text my Manhattan client to cancel our meeting.

The clinic medical staff care for Papa, who is now growing irritated. No more Mr. Entertainer. He is mad about the wait, the bed, the neck brace. He’s done.

A physicians assistant comes into his room, tells him he doesn’t need X-rays, tells him to keep the leg elevated and to see Dr. Thomas in a week. Call if it gets infected. She leaves.

Papa, glaring after her, swears in Italian.

Then two orderlies arrive to take him to X-ray. Confusion ensues about yes or no on the X-rays. In the end they whisk him off to X-ray his shin only, no rib X-rays required.

He arrives back in time for the main nurse to give him discharge orders. Papa has to pee. She directs him to put his pants on. He whines that he can’t walk. I draw the curtain to step outside and give him privacy.

“Where is my daughter going?! Why is she running away?!?” His voice echoes loud in the almost empty cavernous clinic bay. He is in a panic, crying down the hallway, shouting out my name.

The nurse tries to calm him. He is having none of it.

“Mr. Manocchia, please, just have a seat there and put your pants on. Your daughter is right outside. We’ll walk to the bathroom.” Part of a nurses training must be in voice modulation. I’m in awe of how tempered hers is right now, in the face of this screaming maniac.

“I’m falling!” He yells, “I’m FAAAALLING!!!”

The nurse croons “You’re not falling, you’re fine. When you say you’re falling it makes us nervous. But I’m watching you and you are fine.”

In the end, Papa is wheeled to the bathroom in a chair, and then out to my car, which I have brought around to the front.

Mr. Charming has returned.

“You nurses are remarkable, truly. Thank you. My daughter is remarkable as well. Such a hard worker.”

I turn on the radio and drive us home.