“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.

I heard the absence of sound first. Then a tremendous crash.

Tuesday, a sunny spring morning. Papa takes the bus to his favorite place- Stop and Shop.

Peace, quiet, a few hours of undisturbed work to be accomplished in my office.

Noon. I hear the bus backing up the long gravel drive. It’s electronic warning beeping loudly, competing with the robins chirping. I here Papa enter through the garage into the mudroom. Then Papa is in the kitchen, bags on the counter, and then he is at the stairs.  One step, two step…his heavy feet rhythmically beating out each elevation.

And then…nothing. Three seconds of silence.

In that nano time frame my mind thinks “Stopped walking for what? Turned around, forgot something? Falling?”

And then the unending crash, the disturbed universe of chaos and confusion, of pain and fear. Bang, bang, bang. Silence.

I rush to the top of the stairs to look down on the crumpled frame of my 6’3, 250 pound father.

A moan, a quiver. He lifts his head and with child eyes looks up at me. “Papa, what happened?” He whines up to me. I rush down the stairs, keep him still. “Move your fingers, your toes. Does that hurt?” I flutter over him, finding the pieces that might be broken.

No. So far so good. “Ok, stay still. How about your arms, does that hurt? Your legs, can you straighten them out? Does your hip hurt?” Taking inventory of every frail piece on his 80 yr old body, which survived a direct hit from an American bomb in Italy in 1943.

He sits up, resting his back against the wall. I realize he was inches from hitting his neck against the windowsill at the base of the stairs. I check his head. No bruise. But a good one growing on his hand.

“Stay here, ” I direct him, and go for a bag of frozen peas and a kitchen towel. He holds the peas against his bruised left hand.

“Papa, what have I done? I was so sick from that stupid bus, he drove everywhere, Clinton, Madison. The swaying made me nauseous first time in my life!”

I rotate his shoulder, no pain.

“I was angry, and then between the stomach sick and my temper, I felt my foot rock back and I grabbed the rail. But it was not there.” A bottle of ACT lays on the last step, cracked, it’s blue liquid oozing into the oriental runner.

“Papa, what hurts?”

“No, nothing papa, maybe this hand a little bit. Oh, God, why am I still here?” He starts to whimper, holds his frail hand over his eyes. The skin is crepe paper thin, his fingers knobby and blue veined. I stroke his thick hair, as I look for knots from the fall. Nothing. No head injury. One in our favor.

“Papa, can I help you get up? Let’s get you up and into your room.” He positions his back against the bottom stair. I squat behind him, arms under his armpits.

“Ok, on the count of three, I’m going to lift and you lift with your arms. Let’s get you seated on the second step. One, two, three….”

Success. Checking for pain. Nothing yet.

“Let’s do another step and then there will be leverage for you to stand, one, two, three…” And he is up, wobbly, holding me and the rail. I guide him upstairs, settle him into his chair, turn on the television.

“Papa, you need to eat, I think you haven’t eaten since last night. And when did you take your blood sugar last?” I already know the answer. A new glucometer came four weeks ago, with no test strips. And he didn’t order any, because of the expense.

I make him a sandwich, chips and some diet ginger ale. He eats. Still no real pain. My day is closing in on me. 12:30, I need to leave for my Manhattan client meeting at 3pm, then on to a three day trip to DC for a board meeting. Vic is due home from Calgary at 10pm tonight. Can I leave Papa alone for… 7 hours? These are the questions of my days.

“I have to run to the bank and post office, Papa, I’ll be right back.” He seems fine.

My errands take me less time than imagined, maybe it’s the adrenaline. I climb the stairs to his room.

“Papa,” he calls out to me “Papa, come look at this…”

Papa feels always conflicted, always less than a man, given his circumstances. He grew up in a different culture, in a different time. The evolving role of women, the changed family dynamics, were lost on him. Being single for most of his life, and isolated to his cultural network of Italian men, he never had to adapt for any great part.

And now, he lives with us. In a family that has perfected the art of modern living. A wife and mother who runs her own business and has authority to pay bills, drive to Washington DC-alone! – and can buy a car without her husbands signature. And a husband and father who gets push back from his kids, washes clothes, and takes responsibility for caring for the families menagerie of pets.

And these kids. One in L.A. (So far away, will he never come home?), one in Brooklyn and a daughter who lives home, but doesn’t have an obligation to care for the home and can come and go as if she were her own person…..

These things are just a few of the things that confuse and confound Papa. “I don’t understand”, he says often.

And so he writes his own narrative, fabricating wildly to place all that is in disarray into proper context for his life.

“Papa, Victor shared with me, while you were gone, that he did not like you leaving without doing the laundry.”

“My Victor?”  I ask, looking to see my fathers reaction to my questioning his statement.

“Yes, papa, I would not make these things up. Sometimes a man cannot say what he wants because, you know, you women can have great emotion, and, well, we don’t always want to hear that.”

“Oh, I see. Well, I’ll apologize to him when he gets back.”

“No, papa, don’t say anything, he will be embarrassed that I mentioned it.”

When Vic travels for contract work, Papa always assumes a self directed role of “man of the house “, taking on all of Victors ‘duties’, as Papa calls them.  It pleases him, but stresses me.  He is up at the crack of dawn to feed the animals- cats, dogs and birds alike. But invariably he puts cat food in the dog dish and dog food in the cat dish or some combination therein. And kitty litter in the bird feeder. Then he starts the tea kettle for coffee, but only fills it half way or less, in spite of instructions to fill it to overflowing so he knows it’s full. And then he tries to walk the dogs, who just wander around in circles, confused as to who and why this person has them out at all. Then they come in and pee on the furniture.

After the feeding he makes the coffee, and leaves the burners on. Then he brings the recyclables to the garage, where he hides them so they cannot be found until we clean on the weekend. He brings the compost bag to the compost pile, but never in a straight line, wandering our small yard looking for it for well over five minutes. Each and every day.

It’s quite the morning. But he feels in charge. The man of the house. And so it is worth it.

After cleaning this all up, I will usually remind Papa that I have a work day and ask him to put on his Life Guardian tool. It clips on his belt and detects falls, as well as acts as a LoJack if he were to wander off.  He always asks what it is. We go through the instructions each time and press the button. The attendant on the other end is kind and patient.  I love her. I don’t know if she realizes this.

Papa is a busy man when Vic is gone. I am a busy woman when Vic is gone. I don’t know who is more relieved when Victor comes home- me or Papa.