Chapter 11. December 31, 1998.
Thank God Christmas was over. I submitted my formal letter to the hospital to accept the position as the unit manager of the new Hospice unit, which was being built out of a long un-used meeting room on the 2nd floor. My mom typed it on her old IBM electric so it looked flawless.
The unit floor plan would be similar to the burn unit. Four patient rooms around a central core nursing station. Each room would have a sofa and a narrow recliner that folded down into a bed. Each patient room would look more like a motel than a hospital room.
Electronic monitoring would be minimal and not graphically displayed in the patient's room. Since death in hospice was often a family matter we built a family room with tables and chairs, two sofas, and a refrigerator to store food.
Another reason they picked that part of the second floor was the classroom sat at the end of the hallway near the freight elevator and a small garage was underneath it on the first floor so hearses could load with some degree of privacy.
I was on the schedule like normal for the rest of December which included the New Year holiday. Wednesday the L train was empty on my way to work. Luckily, the deli on Noyes Street was open.
Much to my surprise Patrick showed up at the hospital on December 31st at 11pm and sat in the nurse's station. I had to introduce him to the shift supervisor. He sat in a chair in the corner of the station so he stayed out of the way and never sat where he could see our charting. He left at 1:30am to catch the last train back to Linden Avenue. The CTA always ran late trains on New Year's Eve.
We couldn't talk much because I was busy taking care of two telemetry patients. Both were post surgical but not intubated, both had histories of heart rhythm instability after anesthesia. In a larger hospital they might have been on a telemetry floor but the hospital wanted a higher level of care, somewhere with closer staff and close observation, a nurse that didn't have three other patients. When I was in the nurse's station I kept a close eye on the cardiac monitor display, there was another person also monitoring all telemetry patients, so it was two pairs of eyeballs.
The nurse manager covered for me so I could walk Patrick to the main entrance, we shook hands then he jogged across Sheridan Road towards the L station on Noyes. It was very cold outside, it was sweet of him to join me for the holiday.
In the past I've seen other spouses of nurses come in to visit on December 31st, and some of their kids too.
In the first week of 1999 Patrick's brother got an airtime card and the two texted and talked on the phone a bit, his brother missed him and asked to visit in a neutral place. We picked a restaurant near the L station in Boy's Town and gave that to his brother, meet at Luckey's Diner on Belmont just east of the L station on Saturday January 6th at 2pm. I decided to go along but stay at a distance. They'd meet on the sidewalk outside then go inside and have lunch.
They met outside the front door, I stood by the curb about thirty feet away wearing a disguise as if I was waiting for the Belmont Avenue CTA bus. They went inside, ordered, ate, and left an hour later. After they ordered Patrick texted me that the situation was cool, I didn't need to stay outside. I went inside a book store near the window and watched for them to finish. They paused outside the diner and shook hands.
Patrick told me his brother apologized for hitting him and for lying to their father so he'd take sides. Then he said Matt had a lot more stuff to apologize for, but he was willing to give him to time to apologize for all the crap he started since 7th grade. He also said their father was just diagnosed with stage-4 metastatic liver cancer that had already spread to his organs. They thought he might only have a month or two to live.
He said the family was financially ruined and the house was up for sale and Matt didn't know what he was going to do next, but the reality was the nest he grew up in was suddenly for sale. It sounded to me like perhaps Matt was totally caught off guard. I sort of expected Patrick to suggest he could stay with us but I would object to that. It was time for Matt to grow up and stop using their loser father as a role model.
On the train ride back north we talked about the BVI trip and Patrick said he'd had a few kitchen table discussions with my mother and helped convince her to not go back there ever again. He suggested they consider their next tropical vacation be spent on Saint John or maybe even Puerto Rico. There were some small and very nice resorts on Puerto Rico that were all exclusive with all the 'mod cons' and needed to be booked two years in advance.
After watching the brothers together I got an idea and asked Patrick if he would let me hire someone to professionally photograph him and his brother, sort of like their final twin brother kid photos. He said he'd ask but he thought Matt would go along.
My actual idea was to photo them together at a small gym, weight lifting and maybe in the boxing ring. The idea was to get them hot and sweaty, shirtless, in skin tight wrestling suits that would clearly display boners and body contours. So I did some research looking for professional gay photographers in Boy's Town, one with full make-up, costume resources, and gym access.
The brothers agreed to meet once a month at the same diner in Boy's Town, but I no longer went along. It seemed Matt had done a bit of growing up. When Patrick came home he looked depressed, he said his father was dying and would be gone soon, he was in a nursing home in the city and was on strong pain meds and slept most of the day, he said they told him he might have another month but it was a good time to say good bye because they thought cancer was in his brain now and he might go sooner. Matt told him their mother was not handling the situation well. She stopped going to the nursing home and she seemed confused sometimes in the evening and had problems sleeping. She was scheduled for a head CT and a consult with a neurologist. He said she did poorly on a basic memory test doctors used to see if she could recall something ten minutes after being asked to memorize it. At first they thought it might be alcohol related but her doc suspected something more serious.
Regarding their father's cancer I've seen similar scenarios with patients in the past. A healthy slender guy arrived in the ER with a complaint of vague stomach pain that slowly got worse over several days, but no other symptoms. When we did a CT of the abdomen we found cancer in almost every organ and inside some bones too. Its creepy looking on the CT images and always a death sentence. But the weird part was to go from a healthy middle aged man to the walking dead in less than forty five minutes was a real mind blower. The patient never suspected it was something that serious when they arrived. "I just thought I was constipated."
When we had patients that got really bad news I would always sit with them and talk honestly about the diagnosis. That really helped them and I often got hugs before they left. Some of the doctors here didn't have the time to sit and talk like that. I made time for my patients.
Nurses seldom used the word Constipated, to nurses it was called: F.O.S. for: full of shit.
I located a photographer in Boy's Town and agreed on a ($1,500) price. He would shoot the brothers in the gym lifting weights, boxing, swimming, and in the locker room showering. Matt also agreed to participate but clearly said he wasn't going to do any faggy stuff. But he agreed to be photographed a few hundred times naked from the pubes up, and from behind naked, but no dick or butt crack pics. The series would be shot over two hours in a gym in Boy's Town he'd rented for this purpose, he was a paid member and agreed to shoot them two hours before opening on a Sunday morning, starting at 4am. There was an extra charge for access to the gym outside of normal hours.
Patrick and I discussed the best ways to photograph them, so he took off his clothes and showed me how they were shaped differently. He said Matt's belly button was smaller around and his nipples were more like mine, but their chests were shaped the same. Today, Matt was huskier and stronger then Patrick. They were the same height and had the same brownish-red hair and pubes. Matt had beefy muscular thighs and larger buttocks, and a hint of stomach muscles. He said he didn't think Matt shaved his pubes because he believed that was for fags. I rolled my eyes when he said that, Matt obviously hadn't received many blow jobs. Trimming pubes was often done out of respect for the person whose face was in your crotch, it generally wasn't done for looks.
Two days before their father died the brothers arrived at the gym on North Halsted Street and did their pre-dawn photo shoot, the images would belong to me but I would give each brother the entire collection on a DVD as a gift. They looked super sexy together in the boxing ring sparing for three rounds of fake boxing. But Matt got in a few hits on Patrick's eyebrow line that got swollen. I tried to stay out of their way and keep my mouth shut but it was also neat to watch.
I'd never seen Patrick show his full strength and speed before, but his reflexes were impressive and he had an amazingly fast and powerful right punch. It looked like he didn't know how to use his left arm except to block incoming blows. Both of them were in fantastic shape. He said being twins made them more competitive than most brothers. When they first started boxing they wore those ultra tight wrestling uniforms that showed everything. They were narrow on the front so both of them showed tits, but in the third round they stripped naked except for jock straps. That was when I got out my little digital camera to shoot video of the four men in the ring: the twins, the ref, and the photographer.
I spent $1,500 on that series of 1,272 photos. I had two blown up and framed for us and Matt, those were shots in the boxing ring that showed lots of stuff including dick ridges, arm muscles, chest, and shoulder size and of course plump red titties, swollen from the surge in hormones. Patrick said they were very flattering photographs.
The colors looked incredible. Being red headed boys their skin tended to be slightly pale, their lips, gums, dick heads, and tits looked pinker than mine. The contrast of the pale flesh, their large pink tits, and the jet black skin-tight wrestling suits looked amazing. On some of the final boxing shots I could zoom in on the photo and see individual hairs in their pubes. The photographer had three different lights set up outside the ring to make them look like models. Then he added silhouettes of fake people as if dozens of gym rats were there watching the match.
Two days after the photo shoot at the gym their father died and three days after that their mother was diagnosed with Alzheimer's. It seemed like 1999 was going to be a sad year for the brothers.
Matt moved in with a girl he met at the men's clothing store where he worked. They shared an apartment in Lincolnwood near Pratt and Lincoln Ave but money was tight. She was six years older than him and she worked as an accountant at a car dealer.
My belief was Patrick was lots better in bed due to extensive training, so she was probably not getting properly fucked, but at least he looked hot and probably tasted the same as his brother. When we met her I knew immediately what size and shape dick was being poked in her puss.
After the commotion over his father's passing quieted down I re-started talking to Patrick about moving away from the Snow Belt. He still was interested in Colorado but I told him to focus on warmer weather. We dedicated a legal notepad for both of us to jot down ideas, we kept it on the table by the sofa so we could add ideas anytime.
In mid-February the hospital started work on the new Hospice unit on the 2nd floor, almost directly below our step-down/burn unit. I got training videos for Hospice nurses to learn how they handled relatives and what kinds of drugs they used.
They mostly used the same meds we had for pain: Morphine and Fentanyl, they're functionally the same but IV Fentanyl wore off a little faster, and fewer people had allergic reactions to Fentanyl.
There was also much discussion about assisted suicide. Many patients that were terminally ill were helped along with lethal doses of narcotics, but only to hasten their demise by a few days. And it was always done at the request of the family Power of Attorney (POA), and sometimes by the patient.
Nobody in the USA talked about it but euthanasia had been quietly done in hospice forever.
My employer also arranged for me to spend two shifts observing at a hospice facility in Mount Prospect. In our hospital they were in the process of demolishing walls for the new unit. Our chief of staff had previous hospice experience but was studying the legal aspects of the practice to create a new mission statement and acceptance guidelines. They asked a group of students at our law college to create an operating guide for us.
At their February lunch Matt said their mother was going to retire on the 28th, she'd already applied for disability, she had a living will and wrote a will and named Matt as her executor and POA. Their childhood home was already sold and the contents auctioned. He said they expected their mother would pass within 14 months since she had the faster type of Alzheimer's. She reported worsening symptoms almost every month. Patrick said his brother seemed totally unemotional as he spoke about their mother's decline.
Matt said his mother described being in a demented state was like being stuck in a nightmare, nothing made sense and everything caused more frustration. In March she started wearing an anti-psychotic drug skin patch that lasted a week and she didn't know it was there. He said it was called Zyperdol-TD and each one cost sixty bucks but it really improved her life.
He said he purchased a burial plot beside their father in a Catholic cemetery in Des Plaines. Matt said he was up to his ears in debt now and needed every penny from their life insurance just to cover the burials and pay for her meds, but he never asked us for money. I'd offer to pay for one part of the burial if he asked nicely.
The costs in dying were: the plot, the burial vault, the casket, the headstone, and the funeral (funeral home expenses often included embalming, the funeral service, transport, and graveside services). My research showed about the cheapest you could bury someone today (1999) was $3,500. But that meant no priest, or services. They were embalmed, buried, and a flat headstone was engraved and placed.
I think the main point of their discussion was when life insurance checks arrived Patrick could forget about getting any money. Once Patrick realized that I whispered to him that he didn't need their money, but I never elaborated. I think he quietly understood that I meant with me as his husband he'd see a lot more wealth than those insurance policies, and ours would be long term.
The notepad by the sofa collected our thoughts on moving south of I-40 and so far we'd written lots of nice ideas that suggested the area between Tallahassee and Houston. It would be humid like Chicago, and hot/muggy during the summer but rarely got any snow or temps below freezing. Being on the coast they got weather similar to the BVI. We called it the I-10 Corridor. I told Patrick my dream would be fifteen acres of trees where we could build a house and a barn and maybe get a horse, a dog, some chickens, and maybe some pigs too. He thought I was kidding.
In March demolition in the hospital was done and they started the process of building the new unit. It involved a lot of big holes being drilled for plumbing and electrical conduits. I stopped in once a week to check on their progress. It was a small crew doing the work, just five guys. I told them I was going to be the key employee so they let me come in and take photos a couple times a month. They expected it would be finished by mid-July.
That summer Patrick's mother was hospitalized after a TIA but she recovered quickly. They could see it in her eyes that sometimes she looked like a zombie, like her soul had left her body. It was sad to watch because she really wasn't that old, just 61. She understood what was happening but sometimes she was so confused and upset she needed to be medicated, on Labor Day she was put in a nursing home because she couldn't be alone any more. She died in late November, she passed in her sleep one night and was buried beside her husband. Patrick was relieved but sad. They didn't have a funeral but they met at the grave for a brief ceremony with a priest. I stayed in the car but the brothers stood side by side along with two people that knew her from work.
Earlier that year after my final exams we planned a trip to Louisiana to check out the area, the weather, the people, properties for sale, and local governments, laws, etc. We decided to fly down and rent a car. We looked at rural houses near Baton Rouge and the history of flooding and hurricane damage, but it was far enough from the Gulf that the biggest problems were flooding (and tornadoes), not so much the hurricane wind. We found some rural properties with acreage, barns, horses, and grazing land. The idea of owning rural acreage and maybe someday a horse was very attractive to both of us even though we were both city kids that never rode a horse.
In May University Hospital started having weekly meetings about the new hospice unit. Construction was moving along nicely. All the new walls were up and they were finishing up the air ducts, sewer, and water lines. There were always oxygen, suction, and air lines run to every hospital room. Hospital rooms were very expensive to build due to all the required stuff. All of the rooms had the plaster work finished and the painting came next, then the wallpaper. The area that would become the nursing station was a jungle of hanging network cables and electrical wires.
They had stacks of metal parts for the ceiling tiles and the new light fixtures. I spent an entire day working with a hospice doctor at a unit in Chicago to learn the new charting software and to observe talking with relatives. They decided to take me off my regular night shift since we were within one month of the ribbon cutting ceremony.
Two weeks after that the department was mostly finished and looked very nice. It would take weeks to set up our stuff and work on our internal procedures. I had more than a little anxiety about dealing with my first relative's melt-down.
The beds would be standard hospital frames, motorized with built-in call buttons and TV controls. The mattresses would be different to lessen bed sores since some hospice patients already had bed sores. The burn unit invited me to attend a party to celebrate my promotion, it was very nice gathering, almost everyone showed up. I nearly cried seeing so many of my coworkers proud of what I'd accomplished. They had a cake and lots of munchies to share.
In June I started my next semester of my master's degree program. Summer semesters were accelerated and took a ton of extra time. Patrick handled it gracefully, being #2 to my text books and laptop. And at the theater Patrick added hot dogs to the menu at the concession counter, they were immediately popular and sold out every night. He decided to go with less profit and more sales because they were so popular and didn't create as much trash as popcorn. The main goal was to increase paid attendance, more seats occupied. He also pushed for tickets on a subscription basis. Pay a monthly fee for so many admissions at no charge during any month. For people that watched lots of movies it was a fantastic deal.
They learned the old people on small pensions would come to the theater to eat because their dogs were the cheapest meal available around downtown Wilmette.
That summer my parents discussed vacation this coming winter, I said I'd have to skip it with my new job and college classes. I was attending internet classes three days a week and hoped to finish my master's degree a year from this Christmas. The school I signed with could get me done in two years with one summer semester, they had three semesters per year, August to December, January to May, and June to July. My parents pre-paid for the entire thing. I had to show up on campus each semester for final exams on two days, but the flight was to Las Vegas. Nevada was a nursing compact state.
After my summer semester was successfully finished (four days before Labor Day Weekend) and I kept a 4.0 GPA I asked Patrick to marry me, by then we'd been friends for over a year and living together for half of that. Gay marriage wasn't recognized in Illinois yet but it was in Nevada so we flew there for our ceremony. For our honeymoon we got a hotel in Chicago flew back to O'Hare the day we got married and had a great weekend in Boy's Town but it was expensive. We stayed at an old hotel on Belmont Avenue, not too far from where the twins met every month for lunch. The room was two hundred twenty bucks a night but we spent most of those evenings at a bar on North Clark Street.
Since same sex marriage wasn't recognized in Illinois yet or by the university it was mostly ceremonial for us, but it was still very important. There was a jewelry store two blocks from the hotel so we went to look at rings. I never mentioned a limit but he wanted a small plain gold band, I told him I couldn't wear a ring because of being a nurse and wearing gloves. The plain gold band he picked cost $500 and would have our names engraved on the inside.
Two weeks after we got married was the ribbon cutting ceremony for the hospice unit at University Hospital. We still had a while to go setting up things and getting ready before we could take our first patient. We even had practice shifts with fake patients. Some of the computers still didn't work and we didn't have bedding or gowns yet.
You would be surprised how much work there was in setting up a new department in a hospital. Just for a four-bed unit the amount of linens, towels, blankets, pillow cases, and IV supplies, diabetic stuff, body bags, teeth brushes, and stuff like that is amazing. We had to assemble shelving and put stuff into groups by type and make sure the supply room computer worked. Like I said, it took weeks just to get the unit ready to go. That is why we had practice patients so everyone would see what we forgot to get.
During construction of the new unit I learned a lot of the history of Northwestern University and the doctor school.
Back in the 1850s (Chicago had a population of 30,000 in 1850) when the college was proposed the region around Lake Michigan was the northwestern extent of the settled part of the United States. Much of what became the suburbs wasn't even mapped yet. It's hard to think of a place like Illinois being the western frontier but it was once considered like Nevada and Alaska were today. Earlier than that, Ohio was once the western U.S. Only a brave few ventured west of Chicago to Omaha and Indian attacks were always a danger.
At the time the university was licensed by the state Abraham Lincoln had a private law practice in Springfield, his son Willie was just born, and their four year old son Edward just died of TB.
The college was established by a group of Methodist church leaders from Chicago and granted a charter by the state in 1850. A beautiful Christian looking church with large stained glass windows was finally built on campus in the 1960s and was always non-denominational but was directed by a local group of nuns based at St Athanasius School in Evanston. That group of nuns were also part of the school faculty, so the connection between religion and the university went back to the 1840s. Most NU students have seen Catholic nuns in uniform walking across campus, even in the dead of winter.
One senior Nun was Sister Mary Ellen McGrath, she was born and raised in Evanston. She attended Mallinckrodt College and lived for thirty years at Maria Immaculata Convent. Sister was now 104 years old and lived in a nursing home in Evanston after suffering a stroke in 1997 which left her unable to speak. Tests showed she had little brain activity left, however she was able to swallow soft food, drink, and she maintained normal blood pressure and heart rate. She did not respond to pain or sound, and hadn't for almost one year. She had no living relatives.
Recently, her vital signs had begun to trend lower and she no longer swallowed food. Her doctor signed the order making her a DNR, only comfort measures and basic hydration would be allowed, she was expected to pass within the next few days so she became our first patient in the new Hospice unit.
I was present when she arrived by ambulance, strapped down to an ordinary gurney they rolled her into room # 1 and we slid her over onto our bed, but like they said, she showed no signs of awareness, she did not respond to being moved, nor to human speech, even when people spoke directly into her ears.
She was on a standard vital sign monitor, three monitor leads on her upper body and a sensor on her fingernail. Her initial vital signs were 101/49 @ 52, and 14 respirs, O2 sat of 91% on room air. They said last week those numbers looked nearly normal.
She came with a huge paper chart and on top of that was her DNR form. There was to be no CPR or other attempts to resuscitate her, nature was to take its course and she would be allowed to die naturally.
Her papers also listed a person to call after she was 'pronounced,' by the hospitalist. That man was the director of a funeral home in Evanston. Her burial was pre-paid and fully arranged, just call the number after she passed and they'd do everything else, 24 hours a day.
After the transport people left I was alone with the Sister and did a head to toe examination, especially to check for bed sores. My first impression was she smelled and looked like she had not received the best care recently so I decided to clean her up. I talked loudly to her as I closed the curtain and acted as if she was awake and alert.
I told her I was going to give her a bed bath. Much to my surprise her mouth moved so I stopped and leaned over her and said again what I was going to do and she actually whispered, "Thank you." So I guess some of the information on her chart was wrong, she did respond to speech. I told her my name was Brad, her nurse and I would be with her the next two days. She smiled and slightly nodded her head.
I proceeded to do a modified bed bath, and rolled her on her side and cleaned her back side. Her chart said she stopped accepting food days ago, along with sips of water. They said the last time she drank water it went in her lungs and she coughed endlessly. I did her entire bed bath, except I did not touch her hair, other than to brush what hair she had left, and she even smiled and again whispered, "Thank you Brad." You really had to be a decent lip reader to understand her.
I asked if she wanted water or food and she smacked her lips so I got a cup of water with some ice cubes and a flexi straw and held it by her chin and she closed her lips around the straw and drank the entire cup and never coughed or gurgled or anything.
She thanked me for the water and when I asked if she wanted anything to eat she shook her head no. I used my stethoscope to listen to her lungs but they were clear, diminished but clear in all five lobes.
I found her ears were plugged with impacted wax and looked sore, but when I tried to check her pupil response she pinched them tightly shut and told me to leave them alone. I gave her soothing eye drops to lubricate her eyes, she said they felt better.
I got her gown changed after the bed bath and she was clean and good as new. The nasty stink was gone and she even smiled a crooked but honest smile.
When I asked if she knew where she was she said no, so I told her she was the first patient in the new Hospice unit at Northwestern University Hospital. She smiled and said she was proud to be the first, but she wouldn't be here long, she was going to die very soon.
I introduced myself and told her I was going to be her day shift nurse, she slurred "Nice to meet you Brad."
I put the call button in her right hand and told her I had charting to do that I would be back every hour to turn her, she smiled and nodded yes and mouthed the words: Thank You.
At the nurse's station I read her chart and it supported everything the transfer people told me except for her mental condition. They had her as unresponsive, non-verbal, and unable to eat or drink, GCS of 3 (Glasgow Coma Score). For me she knew the month, year, and some current events but not the specific day of the week or date. I called the hospitalist and told him about the discrepancy, he said he'd be up soon to have a look.
I gave her a GCS of 8, she arrived with a reported GCS of 3 (the lowest possible score). That meant they thought she was mentally Gonesville. I found her to be slow but responsive, and she answered questions appropriately. She squinted open her eyes if I asked, but she had limited physical movements with her arms and legs, but she could squeeze a finger on command with either hand. It made me wonder if she was the victim of neglect or why there was such a discrepancy. I even considered that maybe she had a terminally ill twin sister in Evanston. As a joke I think your average healthy dog would easily score a 15 on the GCS scale, I had no idea why everyone else gave her a 3, which is the lowest score.
When the doc arrived I got permission to try to clean her ears and offer to trim her nails.
Forty five minutes later the hospitalist went in to talk to the Sister and gave her a GCS of 4 (did not open eyes, made no deliberate movements, and made incomprehensible sounds). I told him she spoke to me, answered questions, said please and thank you, drank an entire cup of water and said thank you, called me by name, and also thanked me for a bed bath. The doctor was at a loss for the discrepancy but also seemed upset that I was getting a totally different result than him, but he was the doc, I was just a nurse, so his GCS score ruled the day, her treatment as a hospice patient would move forward. I carefully charted all her responses and the amount of impacted wax I irrigated from her ears.
Later that afternoon I brushed her teeth and gave her a few drops of breath freshener, which made her try to whistle and she opened both eyes and said "Wow, that's strong!" I reached down and held her hand and she squeezed mine back, which raised her GCS up another notch or two from 8 to 13. She looked in my eyes and with a twinkle in hers she told me I was very kind, and handsome too. I noticed she had a small droop on one side of her face from her stroke.
That evening I made it home a little late, 8:30pm. Patrick was home watching ESPN on the sofa, he was in his sleeping pants with no shirt. He was scrunched down on the sofa eating some Doritos off a paper towel on his lap but his tits still puffed out rather far, which turned me on.
I sat beside him and we talked for a while. I noticed he reached up several times to gently rub his tits, I don't think he was aware he did it. If I had his tits I'd be rubbing 'em all the time, mine were flat but still very sensitive and connected directly to my dick.
We showered together and went to bed at 9:45pm, alarm set for 5:30am. It took less time getting to work for a 7am start time because more trains ran at 7am than 7pm!
I had enough time to stop for a small breakfast to-go from the deli by the train station, and sort of ate it while walking (eight blocks) to the hospital. The thought crossed my mind that Patrick could earn a fortune if he could get a permit to run a breakfast burrito cart on the sidewalk near the train station entrance.
During report they said overnight that the Sister was unresponsive, she urinated twice, they changed her diaper and turned her every two hours. She had no bed sores from head to toe, which was a great sign.
After night shift left and the early morning rush was over I asked her what schools she worked at and I had to lower my ear to her chin to carefully listen to her talk, she whispered a list around Evanston and Wilmette, she was a kindergarten teacher at Saint John in Morton Grove. Later on I texted Patrick and asked him where/when he had Kindergarten and he texted right back he went to Saint John School in 1985. So I asked the sister if she was there in 1985 and she nodded yes, she squinted open one eye and looked at me.
I told her I was married to a guy that might have been in her class, could I mention his name to see if she remembered and she nodded yes so I told her, "Patrick Flynn." She opened her eye wide and whispered, "Oh good Lord, the Flynn Twins! They were a handful, full of energy!" I asked if she'd like to meet Patrick, now he was 19 and he was my husband. She smiled a crooked smile and nodded yes. I gave her swallows of water and let her rest, she was soon asleep. I texted Patrick to call me on the hospital phone.
"Hi. You're never going to believe who I am taking care of as our first patient."
"Santa Claus?"
"No, but you're close. What about Sister Mary McGrath, your kindergarten teacher, she gave me permission to tell you."
"Oh good Lord, I forgot all about her! She was mean as a snake."
"If you want to, buzz on down here and come in the hospice unit. She said she'd like to see you."
That afternoon at 4pm Patrick wandered into the unit dressed in the same suit he wore when we got married. He was smiling broadly and looked around for me, my first impression was he looked stunningly handsome in his black suit with his white shirt and narrow black tie. I told him she spoke softly, he may have to lean over and keep his ear near her mouth to listen. So we went in the room, from across the room he loudly proclaimed, "Sister McGrath, nice to see you!"
She raised one hand as if to gesture for his. Patrick sat on the rolling stool at the bedside and held her hand and leaned into the railing and listened as she spoke about him and his brother in Kindergarten, she remembered all sorts of stuff that he forgot. I saw him lean over and kiss her forehead.
He spent over two hours at her bedside with a big smile on his face mesmerized by the sister's recall of them in Kindergarten. I could hear him laughing loudly all the way in the nurse's station.
She told him she always suspected Matt was abusive towards the family, including Patrick because he was so submissive. Patrick cried listening to her describe how they were as five year old boys. I handed him a box of tissues but left them alone to talk in private.
She fell asleep around 6pm and I finished my shift and reported off to the night nurse. Once again she stopped talking and responding to anyone but me (and Patrick). It made almost no sense. I even recorded her answering questions and squeezing my hand to show the doctor, otherwise he wouldn't believe me. Patrick and I went home together.
On the ride home on the train I saw he still had that smile on his face, he told me that was the greatest conversation he had in his life. He said he could have sat beside her for days listening to her, it was like going back in time.
Patrick told me she gave him advice for talking to his brother and how to deal with his jealousy. He said the Sister told him Matt acted like he did because he was jealous of the people closest to him, so he hid his feelings of inferiority by acting tough and abusive.
Then Patrick reached in his pocket and pulled out a tiny necklace and a tiny cross pendant and held it up and showed me, "She gave me this." He said with the cross pendant swinging in the air below his hand. I had no idea how that was possible because she hasn't been able to walk or even turn herself in bed without help for months now, where did that come from? At home I put it on him in the shower. After I closed the clasp I leaned forward and kissed his back, after showers we went to bed.
It had a been an exhausting day but spending time together in the shower and rubbing my hands all over his body certainly calmed me down. The only things I let him do in the shower were to brush his teeth and wash his face and hair. I hand washed the rest of his body down to and between his toes.
On my last day of the week the Sister was still our only patient and she'd had a rough night, they thought she might have had another stroke, her GCS was back down to three and her head CT looked worse, like a whiteout. But she still maintained decent vital signs, considering her medical history and 104 years of age.
At 2pm her vital signs started going downhill, I paged the doc and sat at the bedside and held her hand. The doctor arrived at 2:25pm as her heart slowed to twenty beats then down to six then zero. He pronounced her at 2:41pm. I held her hand the entire time. I swear that I felt her squeeze my hand in the final seconds of her life and then she started to cool off and became stiff, so I lowered her hand and pulled the sheet up to her chin. The doctor called the funeral director.
At 4:15pm they moved her onto their gurney and took her downstairs to their hearse. She'd be buried in a few days. No autopsy was needed, the doc signed the death certificate and her case was closed. After the doc left I sat in the nurse's station and wept briefly. I called the night shift nurse to not come in, we were empty but she'd be on-call if we got a new patient overnight. The university maintained a confidential list of patients they would accept. People had to apply for admission to our hospice unit.
Two days later Patrick and I attended the Sister's funeral, which was also attended by the priest from Saint Joseph. She was buried in the tiny private cemetery on Ridge Road near the convent where she lived most of her younger life, she already had a headstone in place that showed she was born in 1895.
On the drive home we discussed all the huge changes she saw in her life, how exciting it must have been to be alive back then, she witnessed the invention of: home electricity, airplanes, telephones, radio, TV, cars, trucks, indoor plumbing, diesel locomotives, highways, x-rays, modern medicine, refrigeration, atomic energy, appliances, the computer, color photography, and the polio vaccine.
When she was a kid if you travelled somewhere you went on a horse-drawn cart or a steam powered train. News from the world came by mouth or a newspaper if you could read. And you could eat like a king at a restaurant for less than fifty cents.
At the cemetery the priest read a magazine article about Sister Mary. It recalled how during the 1930s she volunteered to work at a convent in northern Poland and was caught up in the 1939 German invasion and ended up in a labor camp in East Prussia with a number tattooed on her arm, but was kept alive to work in a German factory making bullets.
She escaped to freedom when the camp was liberated by the Russians (1941). She said the Russians drove a huge tank over the fences and flattened one entire perimeter fence of the labor camp. She escaped with other women and literally ran to Baltic Sea and eventually made it to England and eventually back to Chicago in 1946.
The church owned a large home on Milburn Street just north of the University. She lived there with five other nuns and taught at Catholic schools in Evanston and Wilmette until she retired at age 72, back in 1967 (but still taught one kindergarten class). She lived there until the last year when she had her first stroke and needed help with her daily activities.
The single biggest risk factor for having a stroke was having had one in the past. So her first stroke begat another and each subsequent stroke robbed her of more function until she was no longer able to speak or respond to people, or so they said.
After reading the letter the priest nodded at the funeral home person, he flipped a lever on the chrome rack and the casket gently lowered into the concrete burial vault in the bottom of the grave. Her funeral announcement was mentioned on page-1 of the Chicago Tribune for two days.
Most of what he read I never knew and then I felt privileged for being able to comfort her in her final days. But I still could not explain why her mental capacity changed so much when I took care of her. I was the only person that spoke with her and got her to drink water. I was also the only person that bathed her and brushed her teeth. She spoke to Patrick too, she even smiled at him and they talked for two hours, but late in the day it was like a switch was thrown and she disappeared again.
I kept up my work and added a four-hour day to my schedule so I worked Monday, Tuesday, Wednesday, and a few hours every Saturday to resolve any employee or supply problems.
After Sister Mary was gone we started a slow trickle of hospice patients, most lived less than a week and were routine. I also learned a totally new way of speaking to patients and their families. Patrick told me I started talking like an Undertaker! I told him the idea was to protect the atmosphere inside the unit. There could be no yelling or hurried events.
I also maintained my school work and my GPA (4.0) as I worked towards my MSN (Master Science of Nursing). One Saturday afternoon my father called my cell and asked me to meet him outside in our driveway. I half expected to see my car had a flat tire or something but he was out there in his work suit and brief case, he had this to say:
"Bradley, your mother tells me you are working hard towards your degree, you're about half-done. I wanted to tell you we are very proud of you and tell you something but please just think about this, keep it in mind as you work towards graduation. After you finish schooling you might consider working for me, in sales."
"I understand you've mentioned wanting to move to a warmer climate, I don't blame you. We'll have an opening in sales for the southeastern USA in a couple years. It's a job that requires a bit of travel. The territory covers seven states east of the Mississippi. Even if you did a mediocre job you'd easily make triple what you're earning now and your experience managing a department, placing and connecting IVs, ordering, scheduling, and promoting are key skills a successful sales rep needs in our industry, so keep us in mind, let's talk again next summer. Okay son?" He extended his large hand.
I think that was the first time he called me son since the day Mom saw my dick in Phil's mouth. The winds have certainly changed! I simply said, "Yes Sir," I shook his hand firmly and tried hard not to smile much.
Two days after that brief conversation Patrick received a Fedex letter and signed for it and showed his ID to the driver. It contained the settlement check from his suit against the company that made his gas stove that leaked and exploded. The check was for $135,000, tax free. His lawyer got a bigger check because he declined the first settlement offer. The hospitals and docs got paid too, Patrick got what was left over. The day he cashed the check we drove to Malnati's Pizzeria on Lake Avenue and got two frozen pizzas to go, and one cooked with pepperoni and cheese to eat at home with forks. We cashed his check and put the bundles of hundred dollar bills in our dresser and told me to help myself. To me it was a good sign that he had that much money but still wanted to stay with me. He didn't know I had much more than that in my savings account. Living in my parent's basement meant I had very few monthly bills so most of my paycheck went to savings.
Later that year we hired two more nurses and the hospice unit was making an actual profit despite the fact that less than one year ago it was a dusty old classroom! We seldom had fewer than three hospice patients in the unit and always tried to keep one bed open.
The university was very picky about who they accepted and used each case to promote putting the University in your will to grow the endowment that financed growth of the school. Last I heard they had billions in the bank but it was a very expensive campus to operate. Imagine heating four dozen drafty old stone and slate buildings (with single pane glass windows that rattled in the wind) literally on Lake Michigan. It might have been cheap swampland in 1850 but today it's some of the most valuable real estate in the Evanston. Too bad the winters were particularly harsh there.
There was a joke petition around the campus that the school should be moved to Florida and the Evanston property turned into a movie studio or a redneck re-education camp.
By the end of 1999 Patrick was working evenings instead of nights. I was working days and we still lived in the tiny apartment in my parent's basement.
He was now manager of concessions and ticket sales and was enrolled in Community College over in Morton Grove working towards his two-year supervision degree. I was over half way through my master's program and our unit was at capacity most of the time. We had an actual waiting list for beds. And we were very particular about who we hired to work in our unit.
One of the nice things about working hospice was I no longer needed certifications for ACLS and CPR. If a patient suddenly changed their mind and wanted to leave the program they were moved out as soon as they signed the form. Part of the reason for carefully screening patients was to reduce the chances of a patient that changed their mind about dying peacefully in a hospice room, but it still happened a few times a year.
There were some odd circumstances that brought patients for hospice care, not all of them were circling the drain, but all of them required round the clock care and tons of empathy. The worst thing about hospice was the relatives of the patients.
Due to many causes there were some patients in care homes that required round the clock 1:1 attention. Some of them were extremely difficult to handle, including violence. Their caregivers were given a rest from that burden once or twice a year and that patient was taken elsewhere for a few weeks but later returned.
On December 31, 1999 we booked a room at that same hotel in Boy's Town and had a reservation at a club that promised a helluva nice party to usher in the new century.
They had scantily dressed young men as waiters delivering drinks and food. We had a small round table far from the band. The dress theme for the evening was 'Black and White,' but it was actually not enforced, just requested. The band played jazz and looked like the party in the (1999) movie Thomas Crown Affair.
I saw several lines of cocaine snorted off tables, and around the perimeter I also saw some oral sex and nudity, but none of it was allowed on the dance floor. The food was top notch and so was the music. I had no idea people performed that type of music any more.
Our waiter was named Miguel, he wore a white apron from the waist on down but nothing else. Patrick could not take his eyes off his body every time he walked up to our table. When he walked away we always watched his large buttocks jiggle. His belly button was a sexy round hole and his tits were smaller than Patrick's but still made me thirsty for a tall glass of milk.
At midnight a large net full of balloons was released from the ceiling and everyone went crazy cheering that the power didn't go out. Around 12:45am we walked back to the hotel and up to our room and fucked in the shower. I sucked on his tits so hard I actually made a bruise. I also think I actually emptied his semen reserve that night, he asked to stop and wanted to go to bed. It took us two days to recover from that party. Again, it's not a hangover it's Wine Flu.
In my book when your husband said he had to stop fucking because he was out of semen then I did my job correctly.
Our fifth patient was a more common type he had Cystic Fibrosis, he was a 28 year old Caucasian male, never married.
Like most he was diagnosed with CF in elementary school, then later confirmed by genetic testing. Those guys were living a lot longer than they used to. Back in the 1960s you were lucky with CF to live to see your twenty first birthday. Today, they stood a decent chance of celebrating their 40th birthday.
This young guy had more problems than just CF. He also had a seizure disorder, hearing loss, and also had a history of heart failure.
He contracted pneumonia that turned into sepsis and his body simply could not win the battle. They flooded him with antibiotics and IV fluids but it wasn't enough, his body just gave out and by the time he arrived he only had 24-48 hours left to live. He was on BiPAP for breathing and a saline/dextrose drip but his vital signs were horrible, his O2 sat was 91% max, his heart rate was 105 and his blood pressure was 99/45.
His lungs sounded like an air hose inside a bucket of mushroom soup with two people standing nearby playing harmonicas.
His name was Keith Turner and he arrived with his mother, she was in her late 50s and I could see his pending death fell heavily on her soul.
We got him cleaned up but his GCS was maybe 8, his mom said he knew he was dying. His father was dead and they had no other children. The funeral was already arranged and the home knew he was with us and everything was ready for him. He was to be cremated, his ashes spread on the horse pasture near their home where he spent many hours talking over the fence to the neighbors horses.
His mother said he'd pluck handfuls of grass the horses could not reach and hand feed it to them. She said the horses spoke by telepathy to Keith and he always understood what they wanted and over time they became friends, even though he never rode any of them, but the owner let him walk around the pasture and brush the horses. They would stand around him and seem to protect him if they saw an animal like a coyote or a fox nearby.
I only had one shift with Keith, he passed on my day off but I still went to his memorial service at the funeral home in Wilmette near where we lived. They lived out in the northwest suburb of Lake Zurich.
In February for our vacation we took nine days off work and rented a van and drove from Chicago to New Orleans then along the I-10 Corridor to Jacksonville Florida, then back to Chicago. Were looking for possible areas to move to but the trip was so short that we couldn't linger very long in any one place.
On the trip down on I-55 we took turns driving and got there the next day. We spent two nights in Baton Rouge and toured southern Louisiana with two realtors then drove east towards Florida, then back home.
We looked at property prices and asked about flooding and insurance in towns around Biloxi, Mobile, and Tallahassee. Patrick said he didn't want to spend the rest of his life handwriting Tallahassee (or Mississippi), they were too fucking long but we could live nearby. Tallahassee was a very nice area with great properties, high rise condos on the ocean and crowded streets and parking problems.
We spent one night in Mobile and two nights in the panhandle then raced home on Route 84 and I-65. On the way back we only stopped for gas and toilet breaks. We toured two interesting rural properties, fifteen acres of trees but no swamp. Both had barns but the houses were torn down because they sat empty for decades. We'd have to build a home and a new life.
On the long drive home Patrick drove most of the way because he liked driving. He had the radio cranked and was bouncing on the driver's seat singing out loud. We rented a cargo van so one of us could sleep in back and carry almost anything we wanted but the one thing we should have brought along was a camping toilet, but we both forgot.
I was on a pool flotation mat on the floor in back staring at him being silly at the wheel. I watched him sing and wave at other motorists on the highway unaware I was in back watching his beautiful body with my hand down my pants. I realized that we've been together for almost three years now how much I loved him. At age 20 he's still gorgeous and always feisty and full of energy and fun. He still had those big puffy red nipples and a dick that could spit seven times a day.
I'd say the brothers patched up their relationship. They texted at least once a day, even if it's just one word. On the wall in our living room hung the big print of them in the boxing ring.
I realized how fortunate I was to have met Patrick and had him as a burn patient. The Flynn Twins had a lot of bad shit happen to them but they seemed to have overcome those tragic events.
I told him at least once a day that I loved him : 'I love you Patrick and always will.'
The End
By Boris B. "Bees" Chen
comments to: borischenaz at gmail