Making Rounds and Oscar (2010) (2 page)

"God, you're a baby. He barely even touched you."

"The truth is, Mary, I really don't like cats. And from the evidence I can honestly say that I don't think he much likes me either."

Mary laughed. "Cats don't hate you, they just know if you're afraid or not. If you are, they respond accordingly."

"Don't laugh," I said, "but I had a bad experience with a cat while I was a kid and it left me a little traumatized."

For a moment I contemplated telling her the story of my grandmother's cat, but the look of mock sympathy on Mary's face convinced me that it would be better to keep the past in the past.

"Some cats are just ornery," she said breaking the silence. "Some people too, I suppose. But you can't forsake every cat because of one bad experience. Besides, you know we wouldn't have a cat here if there was even the slightest chance it would hurt anybody. Even a doctor!"

"Very funny." I looked back at Oscar and Mrs. Davis. "You know, maybe he likes patients who are dying because they don't give him any trouble."

"I don't know, David. I really think there's something more to it."

"So does that mean that Mrs. Davis is going to die today?"

"I guess we'll see."

I LEFT THE HOSPITAL
and drove across town to my outpatient clinic. Unconsciously I found myself thinking of the cat at my grandmother's cottage. His name was Puma, and appropriately so. In my mind, he was a thirty-pound behemoth of a cat--as any fisherman will tell you, size tends to get larger over time--and for years he terrorized me every time I entered "his house." As I thought of his eyes burning with hatred toward me, I told myself that my fear of cats was not irrational.

Mid-reverie my cell phone rang. It was Mary.

"Mrs. Davis died a few minutes after you left."

It had been less than an hour since I was standing in her room watching her breathe. Even after years of seeing it happen, I still feel a sense of humility at being so close to a death.

"Look, Mary. Don't make too much of that cat business. She was going to die soon anyway. She had two horrible diagnoses."

"Yeah, she did, but I'm telling you that this is happening with some regularity up here. In fact it's pretty much happening every time someone dies. Even some of the residents' families are beginning to talk about it."

She was quiet for moment.

"David," she said, "I really think the cat knows."

CHAPTER TWO

"A man who carries a cat by the tail learns something he can learn in no other way."

MARK TWAIN

HAVE YOU EVER HAD A REALLY BAD DAY, THE KIND THAT
makes you question everything you've done and causes you to worry about all that the future holds?

I was having just such a day about six months after my initial encounter with Oscar. I was sitting in my office, staring out of the window. On a clear day my window offers a spectacular view, especially in the summertime when the blue water of Narragansett Bay shimmers beneath a bright sky and marshmallow clouds. In January, though, the view is more likely to be cold and bleak, the water an uninviting slab of asphalt. That's how it looked on that day, and it was a perfect reflection of my state of mind.

My eyes were fixed on a tanker unloading cargo, but I wasn't paying attention. Instead, my mind had been going over the events of the last few days, playing over one scene in particular, like a damaged DVD. Three weeks before, I had learned I was a finalist for a major research award from a prestigious New York foundation. Such grants are more than gravy for me; my research in the field of geriatrics and nursing home medicine is what keeps me going, and receiving an award like this wasn't merely a matter of recognition. I saw it as a validation of everything I did.

Two days earlier I had boarded a train bound for New York. The meeting had gone well, or so I had thought. I left the interview brimming with confidence, and maybe a little pride. This award was mine; I could feel it. I had worked tirelessly on the application, putting in hours late at night after the daily grind of work and family responsibilities. All that midnight oil was going to pay off. The board would see the importance of my work and fund my research, and why shouldn't they? It was crucial and unique and the board must have understood that. On the train back to Providence I had begun plotting how I would use the award as leverage to get my boss to give me the raise I deserved. If I'd had a cigar I would have fired it up (or would have if I smoked and they still let you do that on trains).

But one call had changed all that. The moment the phone had rung that morning I felt a cold stab of dread. There was something about the ring. Perhaps it had come too early. Maybe it was just a premonition. Breathlessly, I had picked up the phone and said hello. The woman on the other end was immediately grim; listening to her, I understood how my patients' families must feel when I call them with bad news.

"We want to thank you for coming to New York to meet with the board. They were very impressed with your work."

The pause that followed was endless.

"But...we are sorry to tell you that you were not selected for the funding."

The woman had continued for several moments chirping on about the many "talented candidates" they had interviewed, but I had already stopped listening.

All I could think about was the failure.

No promotion. No raise.

Another career setback.

I felt like the numbers had all been reset and I was back at zero.

Hours after the phone call, I still couldn't get it out of my head. You know the expression "What part of 'no' don't you understand?" I couldn't understand
any
part of it. How could
they
not understand how important this work was? So few people were interested in the nursing home environment and the proposal was good, perhaps the best I'd ever submitted. What could the other candidates possibly be doing that was more important?

Was it my notes?

The way I talked?

My suit?

I tore myself away from the window and forced myself to sit at my desk. I looked at the blinking prompt on my computer. I had been in my office for over an hour and hadn't even logged on. I watched it blink like a failing heart monitor.

Maybe it was my tie?

I picked up the phone to dial the foundation, determined to find out what the problem was. I dialed the number hellbent on finding someone, anyone, who would listen to my plea for reconsideration.

Suddenly my pager went off. For a moment the world seemed to stop spinning, giving me pause to reconsider my actions. I looked at the numbers on the display.

It was Steere House.

I ignored the page and retreated back to my internal dialogue. Was I really going to learn anything by calling? What part of no did I not understand? Maybe they just weren't interested.

The pager went off again.

Same number.

Don't they know this isn't a good time for me?

Frustrated, I picked up the phone and dialed.

"Hello, Dr. Dosa, how are you?"

"Fine, Mary, what do you need?" There was a distinct edge to my voice.

"Well, someone got up on the wrong side of the bed today. Is something wrong?"

"It's just been a bad day, Mary. What's going on there?"

"Do you want to tell me about it?" she asked sincerely.

I was in no mood to explain myself, let alone apologize. "Not today. But thank you for asking."

"Well, anyway, I wanted to let you know that Ellen Sanders has passed away."

"At least someone is having a worse day than me."

There was a long silence as Mary probably wondered how, or whether, to respond.

I put my hand on my forehead. "I'm really sorry, Mary. That was uncalled for. Pay no attention to me."

"Okay, David." I couldn't tell if Mary was holding her tongue or had just cut me some slack. I knew that she'd had worse days than I could imagine. She tactfully switched gears.

"By the way, I wanted to let you know that Oscar was there."

"Where?"

"At the bedside. Oscar was there when Ellen passed...just like all the others lately."

"Come again?"

"You know, our cat friend. Oscar's still making his visits. He's made about five or six since Mrs. Davis died."

On any other day I probably would have just laughed, as I had six months earlier. But there's something about particularly bad days that makes you reconsider your preconceived notions of life. And this was definitely one of those days.

As Mary rattled off some instructions to me about filling out the necessary paperwork, I pictured Oscar sitting next to Ellen and her daughter Kathy.

"Where is he now?" I asked.

"Who? Oscar? Oh, he's still hanging out in Ellen's room. The funeral director hasn't been by yet. In fact, the hospice minister just got here, but Oscar's just sitting on her bed. You know, you should probably give your condolences to Kathy. She really likes you. Why don't you come over and say hello?"

Then she laughed.

"On second thought, given your mood, maybe you should just stay where you are."

I laughed myself. Nothing like the loss of someone else's loved one to put your own problems in perspective. I didn't need to tell Mary this: Her husband took his own life shortly after the birth of their second child, leaving her a single mother who now made the adult children of Steere House her life. My parents were alive and well, my wife and children were healthy--even if my own health was sort of day-to-day.
Carpe diem
, or as the song goes: Get it while you can.

We talked for a few moments about Mrs. Sanders and her family before I rang off. For the first time that morning I thought of someone other than myself.

While Ellen Sanders's death was not surprising, the timing of it was rather unexpected. She had given no indication that she was terminally ill. There were no nasty infections or any of a number of other disease processes that shorten life. Other than her dementia, she was a poster child for good health.

But while none of the medical staff, myself included, thought she was even sick, let alone close to death, that cat sensed something else. While my faith in science and my own intellectual vanity made it easier for me to reject the notion that some errant feline could know more than we as medical staff did, I felt strangely elated by the notion that I could be completely wrong.

Was it a coincidence that Oscar had been there for each patient's death? I thought of that Einstein quote: "Coincidence is God's way of remaining anonymous." Suddenly, I felt the lure of a good mystery. I grabbed my coat and walked over to Steere House, determined to find out more about our mystery cat's behavior.

CHAPTER THREE

"What greater gift than the love of a cat?"

CHARLES DICKENS

WATCHING A LOVED ONE'S HEALTH FAIL IS HARD. MOST
families eventually find a way to accept it and move on. Some can even do it with grace and dignity. Mary always spoke of one son who was ceaselessly cheerful in the face of his mother's dementia.

"How do you do it?" she asked him one day.

"Oh, I said good-bye to my mother a long time ago," he told her. "Now I've just fallen in love with this little lady!"

This was an advanced, black belt-level reaction. Maybe it's the guilt, or the fear of death, or simply the heartbreak of seeing the slow decline the disease brings, but many people seem to disappear as their parents or spouses fail, as if they themselves were being diminished.

Not Kathy. Her spirit always seemed indomitable in the face of her mother's condition and she took each slide backward with a glass-half-full optimism that was an inspiration to the staff. She took comfort in the small triumphs, or "little victories," as she called them.

I remembered running into Kathy and her mother seated on a bench in the nursing home's rose garden one afternoon. It was a particularly windy October day and I wondered what on earth they were doing outdoors, huddled in their jackets beside their empty lunch trays.

"Aren't you cold?" I had asked Kathy.

"I prefer to think of it as brisk," she had joked. "You know, for the next three to four months, my mother is going to be cooped up inside. What's a little cold? And look how lovely the leaves are at this time of year."

Kathy had glanced over at her mother and placed an arm around her shoulder.

"Aren't they beautiful, Mom?" she had asked, pointing to the last of the red and gold leaves on a nearby tree. Her mother said nothing, but there was a hint of a smile on her face.

"Little victories, Dr. Dosa," Kathy reminded me as I walked quickly out of the cold that day.

Her last statement echoed through my head as I passed the spot where she and her mother had sat. That October day may very well have been Mrs. Sanders's last time outside.

A sharp winter wind drove me swiftly through the frozen garden and into the nursing home's first-floor dining area. It was almost lunchtime and an aide was busy setting the table. She moved carefully, polishing the silverware as if she were setting up at one of the finest restaurants in town. This attention to detail is part of what makes Steere House unique, I think. Respect for the residents informs nearly every decision here and can be seen in even the simplest of gestures.

In the corner of the dining room, Ida Poirier was sitting patiently in her wheelchair, waiting for lunch to begin. She quietly studied the aide as she polished and placed each piece of silverware. As I entered the dining room, Ida looked up and smiled.

Ida has been a resident of Steere House for many years now, confined to the nursing home because of her rheumatoid arthritis. After years of inflammation, her legs and hands have become a tangled mess, but her mental faculties are as sharp as they've ever been. Despite her predicament, Ida maintained a wry sense of humor that comes from a lifetime of struggling with chronic illness. For the chronically ill the choice seems to be to learn to live with your affliction, and occasionally laugh, or succumb to suffering.

I reached down and gave her a hug.

"What's for lunch today, Ida?"

"Usual crap, Dr. Dosa. I don't know, what is today--Monday, Tuesday?"

"It's Thursday, Ida."

"I think its potpie day, then. Not that it matters; it all tastes the same."

I smiled.

"They try their best, Ida. Unfortunately, they're not working with a budget that allows for filet mignon."

"Maybe not, Dr. Dosa, but could we at least have lobster once in a while? We
are
in Rhode Island, after all."

"I'll talk with the chef."

"Yeah, right!" She shook her head in mock disgust and then tried to gauge my expression. It was nice to have Ida to banter with.

"Dr. Dosa, are you going up to see that patient who died?"

"Why do you ask, Ida?"

"I heard the cat was in there with her when she passed."

I paused before answering. "How did you hear about that?"

"Some of the nurses down here have been talking about Oscar and what he does. Personally, I love cats. I think I've had a cat my whole life. Even now, either Billy or Munchie is always in here keeping me company," she said, referring to the two cats who live on the first floor, "but I don't know about that cat upstairs."

"Do you believe the cat knows?" I asked.

"Oh, I believe it. When my husband died years ago, I bought myself a cat to keep me company. I called him Patches because he had little patches of white on his black fur." She smiled briefly at the memory. "Anyway, Patches always knew whenever I was sick or my arthritis was acting up. He would jump on my bed and just sit with me. Otherwise, I could never seem to find him. He was always hiding somewhere in my apartment--under a bed, in my closet, always somewhere."

"What happened to the cat?"

Ida's expression changed and I regretted asking her.

"He died of some kind of cat cancer. I had to put him down."

"I'm sorry, Ida."

"No, Dr. Dosa, don't feel bad about mentioning it. I had to do it. Sometimes I think we're kinder to animals than we are to people..." She looked out the window in silence. It was more than a little awkward, but I let it play out.

"You know," she said, eventually breaking the spell, "every day, I sit here and wait. I wait for someone to help me get dressed. I wait for breakfast, then for lunch. After that, it's back to my room for a nap or to watch some stupid soap or talk show on TV. Then I wait for dinner. When I was young, I never had time. I was always on the go, didn't have a minute for myself. Now, all I have is time."

She looked off in the distance again, lost in her thoughts. When she turned back to me I sensed her mood had changed again.

"Dr. Dosa, I almost envy that patient upstairs. At least she is free of all of this."

For emphasis, she held up her hands as if presenting evidence. Her fingers, bent inward at impossible angles, rendered her hands useless.

"I used to love to knit. I'd sit for hours in my sunroom and knit scarves or blankets. It didn't matter who I was knitting for. Sometimes I'd knit blankets for one of my cats. Other times, I'd take them to the Women's Hospital across the street for the newborns. I can't even do that anymore."

Frustrated, she dropped her hands into her lap. I looked at her and racked my brain for something to say that might lessen her sorrow. I had nothing to offer.

"I really miss him," Ida said abruptly. "The cat, I mean," she added. "I miss Patches."

I put my hand on her shoulder and we sat together in companionable silence. She acknowledged my touch with a smile, but I couldn't help thinking that she probably wished I were a cat.

"Dr. Dosa, animals have this sixth sense and they can communicate with us if we understand their language. I'm telling you that Patches wouldn't leave my side if I was sick."

"You mentioned your other cats. What about them? Were they like Patches?"

Ida smiled again. "No, Ginger was friendly as can be. She was always at my feet or on my lap, but she really didn't have that sense of when I needed her. Now Grover, he was--"

"You named your cat Grover?"

"I let my niece name him. I probably should have called him Oscar the Grouch, though, because he could be meaner than a rattlesnake."

"So you believe all of this about the cat upstairs?"

Ida looked up at me with a knowing smile.

"You're not much of a cat person, are you?"

"I can't say that I am, but I'm trying to be."

Then Ida openly laughed.

"I knew it! I could tell you were more of a dog person. You're too damn nice."

Her humor was contagious and I found myself laughing from deep within. I needed that. "Thank you, Ida. I'm not sure you meant it as a compliment but I'll take it today."

"You're welcome."

She studied my expression again.

"Something's wrong," she said finally. "There's something you're not telling me."

"It's just been a bad day, Ida."

She smiled. "You'll have a lot more of those in your life. Forget about it. Most of the time it's not as bad as you think it is. Just go home, kiss your wife and kids, drink a beer, go to bed early, and you'll feel better in the morning!"

"Doctor's orders?" I asked her.

"Doctor's orders!"

RIDING THE ELEVATOR
to the third floor, I thought of Ida's sharp mind and damaged hands and I felt troubled. If I was being truthful--and this did seem to be a day of truths, welcome or not--what bothered me about Ida was a connection we shared. Looking at her sometimes I felt that I was staring at my own future. I glanced down at my own hands and studied my enlarged left thumb. It was ten years since I myself was diagnosed with an inflammatory arthritis very similar to Ida's. I looked at my swollen right wrist and thought of the swelling in my left knee and ankle. The joints were not as painful as they once were, thanks to my complicated medical regimen of pills and injections. Yet the telltale signs of inflammation were there and I knew that, like Ida, my joints would fail me, my own legs would not carry me into my proverbial golden years, and my own arms might not be able to hold my grandchildren.

I felt a shiver as I thought about Ida and the curse of not being able to do the things you once liked to do. I allowed the feeling to wash over me, felt the self-pity rise and fall like a fever, and then shrugged it off. Instead, I thought of Kathy and what she had said about the importance of little daily victories in combating chronic illness. I've had over a decade to think about chronic illness in my own life and know that she is right. There are more important things in life than careers and grants. There are the day-to-day victories, the gifts of the here and now. Instead of worrying about my old age and my grandchildren, couldn't I just rejoice in being able to carry my newborn daughter up the stairs and play soccer with my son? I was still able to bend over and tie my own shoes. Tomorrow's problems would have to wait.

I exited the elevator onto the third floor, stepping directly into a meeting between several aides and a hospice nurse at the front desk. They were in the midst of an intense conversation, one that I quickly realized revolved around Oscar.

"So he did it again," I interjected.

"Yes, he did," Lisa, the hospice nurse, replied. "He's developing quite a unique talent."

We were joined at the front desk by Sally, one of the hospice ministers. She had just returned from Mrs. Sanders's room.

"How is Kathy doing?" I asked her.

"She's upset, but I think she'll do fine eventually. She's had a long time to come to grips with today."

I left them and walked down the hall to Mrs. Sanders's room. Kathy was holding her mother's hand, crying quietly, while Oscar sprawled out on the bed, his front and hind legs extended, his spine resting gently against Mrs. Sanders's leg. Kathy turned to greet me. Beneath her swollen eyes she managed a slight smile and rose to give me a hug.

"I'm sorry," I said.

She began to cry again and I felt her warm tears through my shirt. We held the embrace until it became uncomfortable. Kathy's eyes were bloodshot and she looked like she hadn't slept in days. Her blouse was wet from her tears and wrinkled from the vigil she passed in the chair beside her mother's bed. I tried to think of something to say that might make her loss easier but came up blank again. Thankfully, Kathy broke the silence.

"Dr. Dosa, I want to thank you for everything you have done for my mother."

She wiped her eyes with her sleeves and turned to sit back down in her seat by the bed. She picked up her mother's hand again and cradled it in her own. The movement stirred Oscar, who looked rather tired himself. He blinked and looked at Kathy.

"Can you believe this cat?" Kathy said.

"I heard that he was here when your mother died," I replied. Through her tears she smiled slightly.

"Yeah, he and I are buddies now," she said and reached over to pet Oscar on the head. Oscar accepted the attention and nuzzled Kathy's hand.

"The hospice nurse and the minister told me he's done this before," she said.

"For the last year or so, from what I'm told," I replied.

"Well, he's a really special cat."

"I suppose...," I said, and realized that a small part of me was starting to believe it.

I put my hand on Mrs. Sanders's hand and said a private good-bye to my patient. Neither Kathy nor I spoke. On the bed next to us, Oscar sat quietly purring. Finally, after several minutes, I asked the question I'd been contemplating since my conversation with Mary.

"Kathy, were you okay with Oscar being here at the end?"

She looked at me for a moment and then said, "Dr. Dosa, I think of Oscar as my angel. He was here for my mother, and here for me, too. With Oscar at my side...well, I felt a little less alone. It's hard to explain, but some animals, well, the sense they give you is that they understand what's going on. More than that, they just accept. I don't know, but Oscar gave me a feeling that this is all natural. And it is, isn't it? If birth is a miracle, isn't death a miracle too? My mother...well, her struggle is finally over. She's finally free."

Kathy stared at me, waiting for a response, but I gave her no indication of what I was thinking. I guess I really didn't know.

"My mother never wanted to live the way she did in the end," she added. "She was a proud woman. You didn't know her before, but she had a tremendous sense of pride. She always dressed fashionably and she was quick with a joke."

She smiled, perhaps remembering one of her mother's jokes, one that she did not share with me.

Looking at Kathy, I realized that she would be fine. The coming days would be hard on her, but she would move on to the next chapter in her life--one that wouldn't involve daily trips to Steere House.