The Boating Life

Wednesday night, after the employee had committed suicide earlier in the week, after I read about M.I.’s relatives who won’t help her, after I was asked to confront Mason, and after I found out I should be seeing eight times as many patients as I’d seen the week before, I cried and cried. When I thought of M.I., I cried even harder. On Thursday morning, I got up and cried some more, and then F. and I got in a fight, at 6:30 a.m.

Things were terrible between us last week. He stomped out of my place soon after arriving and went home, and on the phone on Sunday night, we actually broke up, though we patched things up an hour later. I mentioned to a colleague that we’re really having a hard time and she said that clinical pastoral education is famous for finishing off relationships.

On Thursday morning, he could hear the distress in my voice and asked, “What can I do?”

I said, “You can say, ‘Bugwalk, I’m sorry you’re feeling sad.’”

“I understand the science of transition—”

“No! You can say, ‘Bugwalk, I’m sorry you’re feeling sad.’”

“I understand the science of transition—”

Here I lost my temper and hung up on him. Why on earth did he ask what he could do if he wasn’t going to do it? When I called back ten minutes later, he said, sounding very wounded, “You hung up on me! Please don’t ever hang up on me again.” I said I wouldn’t, and that he for his part should please not ever stomp out of my apartment again. He agreed to that, and then he explained that he simply didn’t hear the instructions I had given him. It’s the first evidence I’ve encountered of hearing loss on his part, but I’m not surprised. He is 62 and has spent many hours with earphones on, probably with music or the radio turned up way too loud. So that explained that, and we soldiered on.

I assumed Thursday would be a really lousy day at work, but it actually was quite good. I thought of a way to change my workflow so that I can visit more patients, and saw an impressive (to me) number of them. I realized I was shying away from engaging interpreters because why should I bother to do that for a two-minute conversation? But if I’m going to see more patients, I have to include the ones that speak Arabic or Cantonese or Chinese, so I did call an interpreter that day for a two-minute visit to a Toisan-speaking patient. I went again to visit the team whose colleague committed suicide, and I used my own rudimentary Spanish when visiting another patient, which was satisfying.

On Friday, I visited a patient who had a plastic bulb of blood in his lap, that which was draining out of his surgical site. That totally did not bother me! Whereas reading “Patient was given instructions for how to use bulb to drain surgical site” actually has given me a twinge. Weird.

I visited M.I. and realized that responding to her empathetically, which is what we’re trying to learn to do, actually is not helpful. Perhaps this is true of patients with dementia in general. It made her cry, and then she went into the bathroom to wash her face “so they won’t see.” So sad. At the end of our visit, I was joking around with her instead—she said that I should give her my car so she can escape and that I can walk home myself; I said she’s too smart for me and that next time I visit her, I’d better bring my attorney—and when I left, she had a big smile on her face.

M.I. has been in the hospital for 25 days now, and is probably right when she says her bruise doesn’t warrant her continued presence there. Samantha said this may be something for the ethics team to review—sometimes the hospital really is detaining someone improperly. But I saw in M.I.’s chart that there already has been an ethics review, and it was concluded that she cannot take care of herself and that a conservator must be assigned, which is a time-consuming process. Meanwhile, she has been moved from a room with a nice view to one with no window at all, which is really bothering her. Samantha said that is too bad—that people with dementia benefit from natural light and being able to see out the window.

Yesterday my walking friend and I spent six hours together. We walked and walked, and we sat in the Civic Center, and we had lunch at Ananda Fuara, and we went to visit San Francisco’s second Navigation Center, which just opened. The Navigation Center finds permanent housing for homeless people. My friend, who runs the soup kitchen where I volunteer, said people love living there because there aren’t rules about when you have to arrive in the evening and leave in the morning, and you can bring all your stuff and your dog, and couples can live together. The city is acting quickly to open more Navigation Centers, six total.

We walked along a stretch under the freeway—where F. slept for three years himself—and saw several RVs parked at the curb—one with a large motorboat on a trailer. My friend knew the person who lives in the RV and inquired about the boat. The guy said it belongs to a friend of his, a woman who is currently “living out of it.” Someone is living in that boat.

I assumed F. and I would have another terrible weekend, but it has been wonderful. He arrived evidently determined to do everything he could to help us have a nice time together, and we did. For instance, he was wearing a shirt he knows I really like, and had neatly trimmed his mustache, and said that he was planning to skip going out to smoke his customary half a joint before bedtime. It was quite touching. I thought he was getting to the point where he was giving up on us, but I saw from all of his efforts how important our relationship still is to him. For my part, I will continue trying to practice acceptance and understanding, and I will appreciate and enjoy everything that can be appreciated or enjoyed.