Hell is a Four Letter Word

I want to tell you what I am experiencing – what I see and hear, and what I know. This would have been impossible without the help of Reuben, my outrider, who is sitting beside me, transcribing my streaming thoughts and impressions.

Perhaps you have trouble accepting the idea that I have my very own outrider. I’ve never believed that non-corporeal nor even semi-corporeal beings existed. But now, beyond rational explanation, my thoughts are being transferred into readable form. The proof is right before you.

Reuben says, “Go on.” I glance peripherally towards him, but the hazy light from the grimy window washes out detail, except for a translucent, faintly amorphous hominid shape sitting with legs crossed. I suppose he’s getting annoyed at this digression, for he clears his throat and says, “Let’s get on with it, already.”

Nobody seems to know, here in Blueberry Cove – who comes up with these names? – that I am still a rational, sentient being. That I can actually think and feel – feel in the emotional sense, and in the ever-dwindling tactile sense of the word – because I can no longer outwardly express myself. When I first moved in I was on the Assisted Living wing. As my physical condition deteriorated, my level of care and the cost were steadily upgraded. Now I lie in bed on Skilled Nursing while life in Blueberry Cove blithely goes on around me.

Kaydene, a volunteer from the Second Baptist Church, was once sitting next to my bed, twiddling her pigtails and prattling on about her church programs, her high school classes, her teachers, her boyfriend, her girlfriends, her favorite rock groups, and on and on. Perhaps I should have been more grateful for her visit, for nobody from my own family had visited in ... well, I can’t even remember exactly how long it has been. She took a compact from her purse and started to touch up her makeup. Through facial tics and eye movements, I was somehow able to convey the idea that I wanted to see myself in her mirror.

She held the round mirror up close. I couldn’t believe it was me. My face was gaunt. My cheeks were shrunken, and my skin had a grayish pallor. My hair had lengthened and thinned and my ears stuck out prominently. My nose looked like a Nazi cartoon caricature. Worse, my lips were quivering – something I hadn’t even realized. I guess it explained why staff members used to try, but had long ago ceased, to ask me what I was trying to say. If they only knew all the things I had wanted to say.

I noticed a tear rolling down my cheek, but did not feel its wetness. When an aide entered the room and scowled at Kaydene, she hid the mirror away. Kaydene later confided that it was maybe against the rules and then giggled. She chattered a bit more and as she left, she promised to visit me next time. I never saw her again.

There’s little that I can will my body to do. My tongue still moves and I can still swallow and digest food. And yes, I can still breathe on my own, but I don’t know for how much longer. Sometimes I get agitated when an extremity twitches. I’m capable of maneuvering my eyes slowly from side to side but it takes ever more effort. Until recently, I had been able to communicate like a human semaphore by blinking my eyes for yeses and nos – one if by land, two if by sea, so to speak – but I’ve been losing that ability. Thank goodness there’s a DNR order on file and orders specifying that no heroic means should be used to prolong my life, such as it is.

Because no one thinks I can communicate, the logical conclusion is that there is nothing inside to communicate. They’re mistaken. And now, Reuben is here.

He came one midnight just after I woke up drenched in sweat. One moment, there was silence, and then a melodic voice: “David Grossman? ... Don’t worry ... I’m here with you now.” I didn’t know if I was imagining the voice, hearing it or just sensing it. But the words were clear.

“Angel of Death! That’s a good one. A grown man and you still believe in angels?”

If you are the Angel of Death, go away. I’m not ready yet. Or maybe I’m too ready. Most of the time I’ve got no idea.

“Listen, David. I know where I am ... and what I’m doing. Just think of me as ... uh ... an outrider. That’s it. Your outrider. And my name is Reuben.”

“You’ve got a lot on your mind. Isn’t that right?” ... I nodded inside ... “Well, this is your chance to get it all off your chest.”

All right, all right. Sorry. Where are my manners? I cleared my figurative throat. It’s very nice to make your acquaintance.

So where was I? In my previous life – my real life, I like to think – I loved to eat. Who doesn’t? Skip the gourmet portions and give me quantity! Why buy a dixie cup when I could speed-scoop through a quart of vanilla fudge? Here in the Cove, my pre-chewed food is bland and tasteless. Maybe someone could think of sprinkling my pre-measured portions with a little salt and pepper, or maybe some garlic or onion powder – anything to relieve the monotony of this pablum, this baby food for adults living out their last days.

I’ve always loved listening to all kinds of music. I used to lose myself in jazz riffs on a beat-up upright. On one of their rare visits my sons brought me a Bose Wave radio. Jerry fastened a wire antenna up the window jamb, and Richie tuned the pre-sets. I listened to NPR and the college FM stations when I was able to press buttons on my remote. Later, aides who remembered turned it on in the morning. Because of a crackdown on illegal immigration, new workers were hired, and the replacements never knew how much I was attached to that radio. Now, it sits lifelessly on the windowsill, gathering dust, next to an empty flower vase. Its light blue readout, changing every minute, silently shouts out the time as my own minutes are counting down. The correct time is an hour later.

I hear Reuben sigh. Maybe he might take the hint and turn the radio on. But he only “tsk tsk’s.” The room remains silent.

There’s a benefit to the quiet. At least I’m not assaulted by noise I can’t turn off, can’t close my ears to, like the home shopping network or the game show woo-wooers when the mounted-on-the-wall television is clicked on. It’s basic cable for the basest baseless.

I smiled and shrugged inside and went on. But odors – they’re the worst. My window faces the interior courtyard and when they’re airing out the room, the cooking smells waft up from the basement kitchen. As unappetizing as the unpalatable food is, I can still feel and hear my stomach growling until the meal cart is rolled around. But there is another odor that I can’t avoid. When Jimmy, one of the housekeepers, comes to mop the floor, his body odor accompanies him and stays behind when he has gone. I’m left not only with eau de Jimmy, but the abrasive smell of bleach, which never completely disappears. But chlorine is still better than the pervasive smell of urine and lost hope.

“Hmm .... ‘emanates from the emanation.’ Another nice choice of words,” he says with a chuckle, as he continues to transcribe the outpourings of my soul.

Besides the hospital’s own discordant music and rhythms, the room might be quiet and music-free, but it’s not soundproofed. I do hear, maybe too well. Perhaps my senses have been heightened. My heart pounds when doctors confer about me in the hall outside my door, supposedly out of earshot, and I can hear their false concern and their indecision and their fatalistic way of counting me out. Talk to me, damn it! Don’t make decisions about me behind my back, like scared little mouse-children!

And I hear too much about the private lives of the hospital workers – like who’s doing whom – if you catch my drift – whose husband has landed in jail, which new employee has a bee-you-tee-ful ass, or which one is a dike or a faggot or a bitch or a hard-assed nigger. Too much information. But I do enjoy eavesdropping on their conspiratorial whisperings. It’s a diversion. As if I had a choice.

A few nights back, the lady in the next room had gotten up from her bed to change the television channel because, as I overheard, her remote wasn’t working. She slipped and fell. I heard the whole thing, even the thud of her body hitting the floor. She had been crying out in pain for hours before someone heard her cries. After the flurry of activity, and after the gurney with the creaky wheel was rolled past my door, I heard several hospital administrators “strategizing” – their crappy word! – about a possible lawsuit, since her son had complained earlier that day about the faulty remote. All because someone had not bothered to change a couple of double-A’s.

In the lull, the enormity of dread plows into my consciousness. My defenses have become overrun and the awareness of my mortality is overwhelming. And that I can see and hear and feel and smell and taste, but cannot respond or communicate.

L-dopa and some newer derivatives and incarnations were able to “unlock the person within,” but only for a while. Nothing has helped stem the degenerative tide of my condition. When the air conditioning is turned on too high, or the heat is not turned on enough, I shiver. But I can’t bring my arms or legs into a fetal position to ward off the cold, let alone pull a threadbare blanket up over my body.

Neurologists and other specialists could describe the steady progress of my condition, but could do nothing except pat my arm and tell me not to worry. Not to worry! For chrissakes – I can only worry. They could name the symptoms, but not associate the syndrome with a conveniently abbreviated known disease or cause, such as a tumor or a blood clot. To fill in a diagnosis code, they’ve referred to it as unspecified Parkinsonism. In their own insular way, the doctors are like you, Reuben – mere transcribers – examining my mind and body and translating their results into the neutral and impenetrable language that could then be entered into my chart.

So I lie on my back until I’m moved, which happens once a day, if I’m lucky. An aide comes in to wash me, checks for bedsores, and then turns me on my side. Only then can I watch television – if she remembers to slip the eyeglasses with the broken temple ear piece back on my head – and if she turns the television set on. Sometimes she sits next to me, engrossed in whatever soap opera is on, until her break is over or until she decides to get off her ass and go earn her pay. It’s “quality time,” Reuben! I wonder if watching television-trash is written into my individualized treatment plan. It is so annoying to catch only snippets of soap operas, even when the storylines are so insipid. And CNN, which is sometimes left on all day, is another matter entirely. Why should I give a damn about what’s happening in the rest of the world?

Before I was moved into this private room, a new patient had been wheeled into my semi-private every week or so. If you thought that daytime TV was inane, you never had to listen to the dying patient ranting 24/7, or to be awakened at three in the morning when his fear of death was strangling him and he was crying out with rage and guilt. I don’t know if it was better if they were coherent or incoherent. The coherent ones criticized and blamed people, places, things and whatever else was sticking in their craw. The incoherent ones babbled out streams of consciousness. It was all so goddam tiresome. And hopeless.

One of the incoherent ones, a guy named Mordecai – I remember because that was my grandfather’s name – kept repeating one word, “mamale,” over and over again. “MAAA-muh-luuuuh” and weeping. As pathetic and heart-wrenching as it all was, I just wanted him to get it over with already. He had had enough? I had had enough. “Die already,” I kept pleading, but only to myself, of course. “Die already.” It was another horrible situation I could not escape. It took him more than a week to finally “pass,” as they say around here.

“The things you’ve had to endure,” Reuben notes. My outrider is truly sympathetic.

Mordecai was one of many. Ray, on the other hand, was still mentally intact – relatively speaking, of course – but, as he put it, “had the depression.” Ray had been a pharmacist in real life and had developed a tremendous dislike for doctors. He distrusted what they told him, what they prescribed for him, and what they advised him to do. His high blood pressure went untreated because he refused to take medication. When one of his closest friends had been placed on dialysis, Ray’s worst fear was to end up similarly hooked up to a machine three times a week.

Ray’s high blood pressure caused and worsened his own kidney disease which, in turn, caused neuropathy. Because he did not have feeling in his extremities, and because he insisted on wearing his most worn-out sneakers at home – as he said “why break open a new pair if I could still make use of the old ones, huh, David?” – he had slipped and fallen on worn carpeting, damaging his left hip. At the time, he was lucky he hadn’t broken it. That came later. Congestive heart failure and chronic depression accompanied and made it all worse. But his depression wasn’t vegetative, as you might think. Rather, he was irritable and agitated. He was nit-picking, angry and judgmental. No one, nothing, was good enough. He took his meds only when he wanted to; after all, he knew better. His depression was a tyrant.

So Ray lay there in bed, his hip set with pins. He had to undergo physical therapy, respiratory therapy, and kidney dialysis. In the meantime, he railed against know-nothing doctors, ungrateful children, back-biting neighbors, free-loading relatives, the “goddam do-nothing Democrats,” the Jews, his congregation, and, of course, God. I was his unwilling captive audience. The head-in-the-ass thinking from the medical staff was that I would somehow benefit from his talkativeness. I couldn’t communicate so his verbosity would somehow do me good. They evidently never sat through one of his diatribes. The tirades ceased when he stroked out while watching The Price is Right. Although the apparent cause of his final showdown was the rupture of the artery in his brain, it was actually the eruption in his psyche that did him in.

But now, Reuben ... now that I’m in a private room, the silence is deafening. There are moments when I wish that Ray was lying next to me regaling me with one of his never-ending harangues.

I again wait a few moments to let Reuben catch up, to respond. I know that referring to Hell would get a rise out of him. Sure enough ...

“Not really,” he replies. “It’s not in the job description. I’m here to transcribe, not to converse. Just go on.”

When there is nobody in the room, all I can do is think and fantasize. Or stare up at the ceiling. I’ve counted and recounted all 126 of the ceiling tiles. If my eyeglasses were better, as if I could have a proper eye exam, then I could count the pockmarks on each tile, and then multiply by 126 and, taking into account the fractional tiles, get the total number of pockmarks. I suddenly say to myself: Enough! Nobody should care what the number is. It’s just a brain game to keep my mind agile, like my mental use of the Sieve of Eratosthenes to compute five- and six-digit prime numbers and calculating my favorites – perfect squares and numbers evenly divisible by 99.

Because it’s Friday, Reuben can witness the local rabbi’s visit to perform the mitzvah of bikur cholim, the good deed of visiting the sick. He’s never considered that I’m not observant, let alone a non-believer. He knows little about me, except what he can surmise from the checked “J”-box on the intake form, from gossip, and from the social worker’s routine briefing. When he is accompanied by a trainee, he waxes poetic and struts his rabbinic stuff. Putz. I wonder if the acolyte sees through the baloney or if he’s blinded by the rabbi’s stature and consummate faith.

But today, the rabbi slips in by himself. Sitting next to me, I can smell cheap aftershave and stale cigarette smoke. I also catch a whiff of booze and breath mints. Hmm. Maybe even he has to take a snort before making his rounds.

Reuben must be standing behind the rabbi, or sitting on the windowsill just out of my diminished line of sight. It will be good for him to see all of this mishegas, this crazy stuff, first hand. At least he’ll know I’m not making it up.

The rabbi talks about God, about Heaven and Hell, about doing mitzvahs, about redemption, about our souls, and about the afterlife – what I have to look forward to. How we pass our consciousness, our very essence, down the pipeline of the generations through our progeny, our hope for the future. This time, it takes him eight minutes, according to the radio’s readout, to finish the same canned speech, as if I – the know-nothing, the no-nothing – would remember from last week’s visit. At the foot of the bed he stands over me, with the same regal stance he must use on the bema when he swirls his richly-embroidered prayer shawl around himself. He removes his hat, runs his fingers through his thinning hair, and places it carefully back on his head. He makes sure to look directly at me and intones a blessing in Hebrew. And then says, “You be well, Daniel.”

“That was intense. I was shaking in my boots,” he says. And then he starts chortling.

I, too, start laughing inside. A real tzaddik, a real holy man. Having to take a shot of schnapps before he visits. I wonder if his mitzvahs will move him to the front of the line when he gets to the pearly gates.

So here I am, in this infernal place, where even the rabbi doesn’t know my name. Cheers, this place is not, and I never wanted to be anywhere but home. I was always so jealous of people who were able to pick and choose where they died, not that I was looking forward to dying, mind you.

But I am going to die in this god-forsaken place. I know that. I really wanted to be home at the end, but there was no one to take care of me. My wife had died some years back, and I insisted on living on my own. Maybe that wasn’t such a good thing, because when my health had started to deteriorate, I didn’t at first realize it. You know, a little ache here, a little stiffness there, a little tremor here, a total paralysis there. Maybe if my wife were alive, or my two boys took the time to visit, they would have noticed. Oh shit. I gotta stop. I sound like so many other whiners who nag and complain about their children. Children should be left out of it. They have their own lives to live.

Ruth, a widow from next door, knocked on my door every day to look in on me. She had me over for dinner plenty of times and sometimes we got pissing drunk together on screwdrivers and Bloody Marys. A couple of times, I woke up naked next to her in bed. It’s not exactly like we had the hots for each other. We were just meeting each other’s needs. Taking care of each other. Caring for each other. Or maybe it was more than that. Maybe we did really love each other. Who knows? I never gave it much thought. I took it as it came. And was thankful.

Ruth helped me through a lot. When the first symptoms appeared, she told me not to worry. When my hand started to tremble, she stopped serving me soup. When I started carrying a cane, she said that it gave me a royal demeanor, and we played a game called “The King and his Courtesan.” When I started twitching and, later, spasming, she held my hand, held me close and reassured me. And when things got so bad that I couldn’t live on my own, she helped me through the transition to Blueberry Cove.

If it wasn’t the best choice, it was the least worst choice. The cost of 24-hour live-in care was too prohibitive, since I hadn’t purchased long-term-care insurance. And Ruth was not about to propose tossing her life away on my behalf, nor did she really have the physical or emotional stamina. My younger son, Jerry, who was the more realistic of the two, and who happened to be visiting at the time of the move, tried to insist that it would be better if I had stayed at home, but he knew I couldn’t afford to. He offered to help, but if I had taken him up on his offer, I wouldn’t have been able to live with myself. It would have bankrupted him financially, and bankrupted me emotionally.

In one afternoon, we cleared out the few papers I kept in a safe deposit box and we got a bank officer to notarize a durable power-of-attorney form, the DNR order and the health care proxy. My signature, such as it was, was gibberish.

The next day, I was wheeled into this place. Within a few months, the furniture and the piano were disposed of and my apartment was sold. The proceeds have gone into the so-called care I’ve gotten in this place. With no home left, I’m homeless. I have no place to go back to.

There’s no immediate response from the outrider. How could he respond? What could he say? So I waited.

I will my mind to slow down; it is one thing over which I still have some control. If I don’t let my thoughts fester and pour out, then I won’t be overwhelmed. Or so my theory goes. But today that tactic doesn’t work for long. My mind betrays me and begins to spin up again. The mind is sometimes a dangerous thing, and in my case, it’s a treasonous son of a bitch.

“Hey! ... Mr. G!” It was Charlie, the always-bubbly, physical therapist announcing his presence. “How ya doin’ today?”

Fine. Just dandy. Never felt better. That’s what I would’ve said, for sure. I hear Reuben suppressing a laugh.

“You know the drill, Mr. G. Today we’re gonna start off with your toes, then your feet, then your legs, and so on. When we’re done, we’ll feel a whole lot better.”

Charlie starts manipulating each toe and always takes his time to work his way up to my neck, methodically massaging and stroking. His touch, as much as I experience it, is both firm and gentle.

He begins humming a song. Answering my unasked question, he says it’s “Give a Man a Home” and adds that he’ll be singing it with his church choir. “Want to hear how it starts?” And his deep voice begins: “Have you ever lost your way ... have you ever feared another day?”

As he gets into the rhythm of kneading and rubbing my body, he loses himself in the melody and lyrics. “Have you ever misplaced your mind ... Watching this world leave you behind ...” It is impossible to avoid getting caught up in his fervor. Each time he works on me, we join together in our own special pas de deux. As his Lord’s messenger, he is singing to Jesus, his Savior, and I am dancing with the Angel of Death.

When Charlie gets to my fingertips, I feel much better, as promised. Intellectually, I know that his ministrations help with my circulation and muscle tone. But Charlie’s presence and intensity take me a step beyond. I feel energized and psychically renewed.

“Well, that’ll about do it, Mr. G,” he says. “You take care of yourself. Don’t do anything I wouldn’t do.” He bellows out a laugh and then walks out of the room, humming, leaving the room a lot emptier than before.

I’ve never liked it when anyone so freely wore his religion on his sleeve or when someone preached at me. Of course, variations of this went on here, because I couldn’t object. Before the Cove, when the briefcase-wielding Jehovah Witnesses came a-knockin’ at my door, I used to point to the mezuzah on the door and add my own warning that “proselytizing was a sin.” They’d always answer with, “Have a bless-ed day,” or some other graciousness, and then turn and walk on. But when I saw how much joy Charlie experienced, how he was saved, and how much he had been able to forgive and forget in his life, I was more than a little bit jealous.

Reuben waits a few moments before commenting, “Yes, he is quite a guy. Makes you wonder.”

Maybe the key is to wonder, not to lie back angrily but reluctantly accepting what is happening to me, as if I have much of a choice. So I let go and allow my wondering mind to wander. I stumble through my own darkness, and my thoughts and fears become formless and unshapen. Blindly, I grope at them. It’s impossible to wrap a mental structure around them. They’re out there in the ether, flitting and floating around, like feathers in a gentle breeze. Then they’re all around me, rudely tossed and strewn about, like newsprint and detritus caught up in gusts of wind.

It’s all just too much. It’s enough already. I can’t take it anymore. If I could just maintain the status quo, just keep things on an even keel, then maybe I’d have a chance at staying in control. But I’ve lost even that last remnant of self-determination.

“Perhaps it’s time to go,” says my outrider, as he gently places his hand on my arm.

I feel myself being lifted up, weightless. I’m soaring on updrafts over a pristine lake. I’m racing downhill on my bicycle, accelerating, wind whipping through my hair. My skin is drying in the warmth of a summer breeze. I’m doing a cannonball off the high board. I’m soul-kissing my teenage girlfriend for the very first time. I’m having the most intense orgasm of my life. I’m breaking the glass and cutting the wedding cake. I’m watching my sons being born. I’m at their bar mitzvahs, their performances, their games, their graduations, and then at their weddings. Little ones are running around, yelling, “Look at me, Grandpa!” I’m sitting quietly by my wife’s bed. I’m throwing a shovelful of dirt onto her coffin. I’m being wheeled into Blueberry Cove.

And now, I’m watching from above, as the sad old man lying inert on the bed in room 328 finally takes his last breath.

Reuben smiles and beckons to me. Now I can gaze at him. Now when I look deeply into his eyes I see pure truth and unadulterated beauty. He takes my arm and we leave the Cove together.

Rev 12 / July 11, 2013

Up to the beginning of the story

-- Appeared in Grassroot Reflections Issue 28, August 2013

July 2013 …Copyright © 2013 Lloyd B. Abrams

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