A History of the Present Illness (16 page)

“Sorry,” Ralph added. “But she got good care, right? Time to move on.” Then he softened his voice and added, “Q , I've got like fifty old ladies just like her here in my clinic, and anyway, if you let things like this get to you, you'll never survive residency.”

Late that afternoon, Quentin jogged along the Crissy Field promenade without paying much attention to the dogs frolicking on the beach or the windsurfers leaning low on their boards off Fort Point. Since Ralph was on call and not coming home, he reheated leftover spaghetti for his dinner and curled up on their bed with a textbook to study the surgical management of hip fractures. He would have liked to read about the nonsurgical management of hip fractures as well or, more important, about how to approach patients who can't talk, or what to do when you've made an inexcusable mistake, but his book didn't have chapters on those topics.

* * *

At the nursing home, Edith Picarelli shared a semiprivate with a woman young enough, at seventy-four, to be her daughter. In one half of their room—Edith's half—sculptures rested on every flat surface, poked out from beneath the bed, and stood like barricade soldiers against the walls. There were tropical plants with bladelike leaves and ostentatious flowers, miniature replicas of each of the Picarelli family's now-deceased forebears and four-legged companions, and an abundance of child-size chamber music instruments, many in the orange brown of clay that had been fired but not glazed. In the other half of the room, across the statuary demarcation
line and surrounded by white, unadorned walls and blond institutional furniture, her young-old roommate slept in an oversize wheelchair before a blaring television.

Earlier that afternoon, shortly after Edith's return from the hospital, Frank Picarelli had noticed the blinking light on his answering machine. Now Edith's family gathered around her bed.

A nurse came in. “Hello!” she said, smiling first at Frank and then at the children. “But so many people. You did not need to come all at one time!”

Edith's grandson, Frank Junior, who went by FJ, rubbed his beard with two fingertips. “I called the hospital. They said she might die?”

“Oh yes, of course,” said the nurse. “But it is very slow at this age.”

All eyes turned toward the bed. Already the necessary painkillers had made Edith smaller, paler, flatter. She'd forgotten even the basics, such as who they were and how to stay awake.

Still scratching his beard, FJ itemized the changes. “Seems quick to me,” he said.

“You will see,” said the nurse. She looked at her watch. “I come back after.”

“After what?” asked Lily, Edith's ten-year-old great-granddaughter.

FJ put one hand on the top of his daughter's head and another across her mouth. “Terrific,” he said to the nurse. “We'll see you then.”

“What'd I do?” asked Lily once she'd wriggled free.

When nobody replied, Lily walked over to her nana. Close, but not too close. Not scary close. And Nana was scary today, even more so than usual, but in a different kind of way. Usually
Nana might say,
Come here
, and grab Lily's ponytail and pull off the elastic band and start brushing Lily's hair in a way that hurt at first (that was the scary part), then felt kind of good. Next, without discussing what Lily wanted (that was the other scary part), she'd put in some bobby pins with bows and flowers on them, and when she'd finished, Lily would see in the mirror that she looked better, maybe even pretty, but she wouldn't get to stay that way long because as soon as they left Nana's room, her mom would sigh and look at her dad and pull out the bobby pins and remind Lily that Nana had used those exact same pins and bows on the little white fluffy dogs she always had until she moved into the home.

“You didn't do anything, honey,” Melissa said now, and as if she'd read her daughter's mind, she ran her fingers through Lily's bangs and tightened the elastic band on her ponytail.

On Edith's roommate's television, a man's voice said,
We're getting word now of hundreds, maybe thousands, of refugees driven to the border and forced at gunpoint . . .

“Oh joyous, happy world,” said FJ.

Lily's younger brother, Frankie, lifted a small cello from the clay string quartet on Edith's dresser. For the first time in his six and a half years as a member of the Picarelli family, no one said,
Don't touch
. He threw it up into the air, caught it, and looked around. Then he grinned and slipped it into his pocket.

An aide coming into the room talking rapidly into a pink cell phone saw the Picarellis, shoved the phone into her smock pocket, and pulled a curtain that split the room in two. “For more private,” she said, bowing slightly and backing out the door.

. . . and in local news, a drive-by shooting left two teenagers . . .
Edith sighed.

“I couldn't agree with you more, Gran,” said FJ.

Frank signaled to his wife to turn off the television, but Edith had gone back to sleep, so Jean pretended she didn't notice Frank's outsize gesticulations. “Once,” she said, glancing at her mother-in-law, “years ago, after the first hip fracture, when I took care of Edith for two months, she gave me a sculpture. A Yorkie that looked just like our Maxie, who'd died the year before. This was back when she still painted them, and she knew the little dog with his shiny black nose was my favorite. She gave it to me the afternoon she moved out of FJ's old bedroom and back to her apartment, but the next morning she called to say she needed it back.”

Frank laughed. “She can never part with them.”

“It was the only sculpture of hers I ever liked,” said Jean.

“Gran sure does like to have her things around her,” Melissa said, trying as always to keep the peace. She opened Edith's closet door to reveal three double racks of high-heeled slingbacks, pumps, and sandals. “Look at this one.” She blew dust off a steeply sloped wedge. “Such a fabulous red—and those feathers over the toe!”

. . . I just turned away for a second. One minute she was there playing with her doll and then . . . Oh my God, this can't . . .

FJ jumped up, threw open the curtain, and turned off the TV. Edith's roommate opened her eyes. She stared first at the blank screen and then at FJ.

Frankie moved so that his mother stood between him and the roommate.

“Sorry,” FJ said. “I thought you were asleep.”

The roommate looked at the adult Picarellis one at a time. Then she unlocked her wheelchair and rolled out of the room.

A while later, an aide appeared and saw the red shoe on the bedside table where Melissa had left it. “Many times, we try to take them,” she said, “but her feet too crooked, like this—”
She tilted her arm so her elbow pointed at the ceiling and her fingers at the baseboard of the opposite wall. “She walk not good in normal shoes.”

The family stared at the aide, Frankie captivated by the excursions of the woman's exceedingly bushy eyebrows, FJ because even though he didn't want Melissa's feet to end up like his gran's, just thinking about her legs and ass in high heels turned him on, and Frank senior mystified because his hearing wasn't what it used to be and he'd understood only a few words of what the aide said.

Eventually, as promised, the nurse returned. She and the aide leaned over the bed. “Edith! Wake up! You want something please?”

“Scotch on the rocks,” said FJ.

The nurse looked at him, squinted, then turned back to her patient. She repeated the question, louder.

Eyes opened, stared, blinked, and blinked again.

“Hello, Mother!”

“Hi, Gran!”

“Nana, Nana, Nana!”

“We're all here, Edith,” said Jean.

The response from the bed: a grunt, an almost smile.

“We sit her up,” said the nurse. She nodded at the aide. The covers came down. Together, they lifted, one on each side, their fists curled around a sheet that had been folded twice and laid perpendicular to the bed.

The body wobbled. One hand shot out—a flash of pale, cobbled knuckles, a gold band with a small diamond solitaire, long pink fingernails.

“Aya!” yelped the aide, and the transfer sheet jerked to her side before it was lowered hastily back onto the bed. A second
later, they all watched as three parallel red lines bloomed on the brown background of the aide's slim, hairless forearm.

The nurse took a long, audible breath. “Lucky,” she said. “No blood.” And then she and the aide exchanged a glance in which they agreed on a call to the evening supervisor and an early end to the aide's shift, with full pay but no incident report.

That settled, they returned their attention to Edith. Leftside down was exchanged for faceup, the head was elevated, the pillows were puffed, and the heels were floated. Finally, from one of the large front pockets of her smiley-face-patterned scrub top, the nurse produced first a syringe of pain medication, then a squat purple box into which she inserted a thick white straw. She extended her arm, rested the bottom of the box on the ruffled collar of Edith's pale yellow nightgown, and carefully positioned the straw.

The mouth opened, a fault line between cracked lips. Edith drank.

“Atta girl,” whispered Frank.

“You drink more now,” the nurse said, gently patting Edith's arm with one hand as she squeezed the box with the other.

There was a gurgling sound and the hint of a cough, but soon enough Edith drank more.

On a paper taped to the wall above the head of the bed under the word “In,” the nurse noted the time, the product name, and the amount consumed.

“She doing good,” the nurse announced to the family with a big, encouraging smile.

“Now can we go home?” asked Frankie.

*

Sunday morning, the family met for breakfast before heading to the nursing home. When they got to Edith's semiprivate room, her bed was empty.

“Holy . . . ,” said FJ as Melissa grabbed their children and pushed them back into the hallway. On their way out, they had to squeeze between the doorjamb and Frank, who stood frozen in the entryway, staring at the naked mattress.

He was sixty-seven years old and wholly unprepared to become an orphan.

Maybe his mother hadn't been the best parent—certainly she hadn't been as attentive to him as he and Jean had been to FJ—but he felt sure she'd done her best. On the second-to-last day of the war, when his father died—not from the injuries he'd sustained in France, which had included the loss of half of his left leg, most of his hearing, and all of his sense of humor, but from a car accident—his mother had become a pregnant thirty-one-year-old widow. Ancient by the standards of the day when she married for the first time, there seemed no chance she'd get lucky a second time, so she'd gone to work. As he grew up, her job had changed from telephone operator to sales clerk to ticket agent to office girl. The office job, her last and best, was where she met James Michael McMurray, the closest thing Frank had had to a father. Mac taught him how to throw a curveball, how to check the tires and change the oil in his mother's car, and why he might want to consider shaving a second time on Friday and Saturday evenings. For the better part of a decade after Mac moved in, Frank hadn't caught on that the reason his stepfather spent so much time away from home had less to do with job-related travel than with his wife and six children across town. After Mac's death, his mother retired and shifted her focus
from people to pets. The sculpting had come later but with equal passion.

Frank heard the rapid, staccato click of heels on linoleum and turned to see Melissa hurrying toward him, flushed and excited.

“I found her,” she panted. “She's out here. She's fine.”

He closed his eyes and exhaled. Then, for only the fourth time in the thirteen years since Melissa Wong had joined the family, Frank Picarelli smiled at his daughter-in-law. She took his hand and led him down the hall to a bed-shaped chair by the nurses' station.

Jean watched Frank latch on to Melissa and had a vision of him—of herself—debilitated and dependent in one of these places. They were nearly old enough already. If it weren't for Edith's characteristically stubborn hold on life, they'd already be next on the chopping block.

The family stayed all day, though there wasn't much to do but watch TV, flip through magazines, or play card games.

Pillows and blankets hung off the recliner's edges like the drooped leaves of a dying plant. Edith's hair, tinted and usually perfectly set, resembled the surface of a once-beloved throw, bobbled in some places and desperately worn in others. Unlike the previous evening, she no longer moaned or sighed or swatted away the aides who returned at regular intervals to poke a thermometer under her tongue, wrap a blood pressure cuff around her arm, and clip an oxygen sensor to the tip of the one finger from which the hospital had removed the polished fake nail.

“I'm so glad she's more comfortable now,” said Melissa. Edith, unlike Frank, had welcomed Melissa into the family,
giving advice on the care and feeding of Picarelli men and sending small checks for the kids whenever she could afford to and whether or not it was Lily's or Frankie's birthday or Christmas.

In the late afternoon, a nurse told them that the doctor would be in early the next day and suggested that they head home for dinner and a good night's sleep.

Edith Picarelli hardly noticed when, one after the other, her family kissed her good night.

Just before noon on Monday, most Picarellis having now missed a half day of work or day camp, the doctor ambled into the semiprivate. His stylish goatee and round, rimless glasses glistened in the fluorescent light, competing for the family's attention with a Grant Wood
American Gothic
necktie.

He leaned over and loudly announced himself to Edith's right ear.

“She hasn't been doing much talking,” offered Frank.