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34 Weekly Rounds Another blustery January day, another Tuesday. Walking into the nursing home, I welcometherushofwarmair.Atthesametime,Irecoilfromthemusty,antiseptic smell. I’m two years into my first job as a nurse practitioner in private practice with a group of physicians, and today’s my day to do nursing home rounds. At the end of the afternoon I’ll go back home, but right now I must go from floor to floor, seeking out our patients who linger here. After all my years in nursing, all my years going in and out of hospitals, I can’t get used to this contrast: the world outside, bright and clear with the bustle of winter birds in the courtyard, and the sudden heaviness inside. Out there is sky and low clouds bringing snow. In here are the subtle odor of urine and the muted voices of the elderly patients, a steady low drone occasionally punctuated by a laugh or a cry. Emma is first on my list today, a belligerent eighty-year-old woman who amazes me with verbal barrages that pack more zing than those of a longshoreman . I find her in bed, a rhinestone brooch pinned haphazardly to the bosom of her red nylon bathrobe. As I open the buttons to listen to her heart, I imagine the blood circling endlessly through the valves. “Watch it!” she shrieks when I palpate her abdomen, the skin loose and scarred with striae from six pregnancies . “The baby,” she sobs, “you’re going to hurt the baby!” For a moment I ponder this bizarre scene: a tall, long-haired nurse leaning over a frightened old woman in bed. Perhaps she recalls the first cold probing of a doctor’s hand sixty years ago. Or does she remember another scene, an insistent man’s advances—or an angry husband’s? I sit at her bedside. Sometimes I think my exams are pointless, done to fulfill the state requirements that regulate our nursing homes—rules that mean staff time must be spent filling out forms and checking boxes while patients are bound in chairs or lined up in hallways like old birds balanced on telephone wires, waiting. Yet I must be satisfied that Emma is not in heart failure, that the ulceration on her hip is healing, that her lungs do not rattle with the first suggestion of pneumonia. Davis text.indb 34 11/12/08 10:00:31 AM weekly rounds 35 “Emma.” I say her name, and she gazes my way. Then, a burst of profanity. “Emma!”Thistime,sheseesme.“Hi,”Isay,andshegrins.Aconnection!Acurrent leaping across a rusty synapse! She pats my hand, a rough slap, like punching down dough or smacking dust from a horse’s rump. “I can’t believe it,” she says, shaking her head. “I don’t even know where my house went.” We chat for a few seconds, just a flash in time. Then she is gone again, cursing someone who isn’t there, someone who had the nerve to die before her. I leave the room and her voice chases after me. “And you’d better not forget!” The day wears on. I look out the window, but the trees sway in silence, offering no consolation. I find Ruth in a wheelchair—Ruth who usually looks like a poker in bed, her head held at an angle inches above the pillow. Sitting upright, her crisp hazel eyes stare into mine. “I feel just awful,” she says. “Nothing I can put my finger on.” Then she sighs. “This really isn’t me, you know?” Old Jim, a diabetic with one leg gone, pumps his wheelchair down the hall, an unlit cigar clenched in the corner of his mouth. He asks me to call his wife— she’s two hours late. A nurse whisks by and pats his arm. “Today’s Tuesday Jim. You know Helen only visits on Mondays and Fridays.” Jim removes his cigar. “It’s not Friday?” He looks me up and down and sees Helen, thirty years ago. “You’ll do,” he says and asks for a light. Bylateafternoon,allthenamesonmylistarecrossedoff.I’mexhausted,feeling the creep of mortality. I wonder how long I would survive, tied in a chair, tapping my tray as the aides rushed by, impatient with me because I rebelled against the schedule: tub bath twice a week, music recreation at ten, “reality orientation” at eleven, where some young thing would tell me that today is Tuesday, cold and windy. That it’s a...


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