unable to assist one another in their most basic needs.
Their lives had been uncluttered of all but the most basic appliances and technology. A phone was their one link to the outside world if an emergency arose, and that link was broken. As the mirror had saved me when I was lost in the forest, it saved them through David and me. Or had it brought me to them, not as much for their sake, as mine.
Emily started to weep softly. I went and stood by her side. I asked her if I could do anything to help her. She did not even look up.
ASurely there must be something I can do to help,@ I said softly, trying to comfort her in her obvious pain.
She was silent for a moment. Then necessity made her speak. AI am soiled and I need to be changed,@ she said in a barely audible whisper. AHiram, too, needs to be cleaned up and changed. I can=t do anything.@
Now she was sobbing. AWhy this? Why this?@ she repeated again and again.
My knees grew weak. How humiliating it must have been for her to tell me of her intimate need to have her clothes changed because she had soiled them.
Hiram had heard his beloved wife=s request. AIf she needs help, you may give it to her. I trust you, son. When you finished helping Emily, please clean me up and change me too. The clothes are in the closet on the far wall opposite the bed. You=ll find an ample supply of diapers in the bathroom.@
I was at a loss how to begin, and I was terrified of causing Emily more pain. I still didn=t know if her ankle was broken. Her shoe had fallen off when we brought her into the house, and I could see that the ankle was discolored and swollen.
Hiram saw my distress and offered advice. AFirst, you=ll have to try to keep her ankle from twisting more. You=ll find a straight ruler in the desk drawer in the parlor. Take a sheet from the linen closet in the bathroom and tear a long strip from it. Put the ruler against her inside leg so that the ankle is not bent and then secure the ruler by wrapping the strip of sheet around her leg, ankle and foot. But don=t make it too tight because the ankle may still be swelling. This should help keep the ankle from being damaged even more.
AThen you=ll have to take off her dress and her soiled pants and clean her up as best you can. She can help by pushing herself up with her hand from the chair and standing on her good leg.@
Hiram spoke without hesitation in giving me directions. His stroke may have affected his mobility, but it affected his speech only slightly and has left his reason intact. That he knew what to do told me this had happened before. But then he could help Emily. In the past, only one of them had been disabled at a time. Now that both needed help, all he could do to assist was to tell me what needed to be done.
I followed his instructions, and when I hesitated, he encouraged me and gave me additional guidance. Emily was patient throughout, although I could tell from her expression that my actions caused her pain, particularly as I tried to wrap her ankle.
After what seemed like an eternity, but was only some 45 minutes, I completed my work on Emily. She thanked me graciously, although I had no doubt the entire process was as deeply humiliating for her as it was for me. I then assisted Hiram as he guided me through what I had to do to change his diaper and help him move up higher in his bed.
At the end of these efforts I found myself exhausted both mentally and physically. Once more I had done what I did not want to do but had to do to help someone in need. Indeed, I did something that I never thought I would ever have to do, something, in fact, I would not have been able to do without Hiram=s instructions and Emily=s patient assistance.
I felt both pride in this unanticipated accomplishment and grief that these dear people found themselves in such a predicament that they had to depend for help on someone such as I. At the same time, I felt bonded to them both in a special way that I could not put into words. I seemed part of their family now, and they had trusted me as if I were their son.
Just then the telephone rang. David must have reached the phone company and they had repaired the line. I rushed to answer the call in the parlor.
Yes, it was David who was calling to tell me that the trouble with the line had been found and fixed. He had also called the daughter, and, although she could not come immediately, she was going to come in two days. In the meantime, she had arranged for someone to come later in the day to take charge of the farm. David had also spoken with the home health people, and they too were sending an aide out to look after Hiram and Emily, and, if necessary, to arrange for their transfer to an assisted living facility where they could get whatever care they needed. David also told me that he was himself coming back to the farm shortly.
I conveyed this good news to Hiram and Emily, assuring them that matters were now under control and that they and the farm would be well taken care of by competent people. I expected them to be pleased with the news, but they did not even smile.
I asked them what was the matter, but I did not have to be told. They knew, as did I, that they were entering a new phase in their lives. They knew that the health care aides would want them to move into assisted living where they could be taken care of more efficiently than at home, where they would have nutritious meals prepared for them three times a day, where they could find companionship so they would not be alone any more, where their rooms would be cleaned regularly, and entertaining events would be scheduled throughout each week.
They knew that this was the end of the lifetime they had spent together, helping and supporting one another to build their successful farm and to keep it going. From now on they would no longer be independent, but would be dependent on having their needs met by others. They would not follow their own schedule, but would be constrained to follow the schedule of the facility that housed them. The rhythm of their lives would be broken, the bonds to their land and their animals shattered, even the joy that they found in one another=s presence diluted by a loss of privacy.
The daughter might well sell the farm to help pay for their stay in assisted living. A new development might build on their land, and the road that had protected their way of life would be paved over. Why should they rejoice? Would I have rejoiced had I been in their place? I felt an overwhelming need to shelter them, to envelop them in my arms and tell them that I would take care of them, that everything was going to be all right.
But I knew everything was not going to be all right. And I knew that I could not shelter them. I could not even stay with them because David and I have to resume our search for Robin. I felt tears welling in my eyes. I had to run from the room so they would not see me cry.
I heard a car drive up into the clearing in front of the house, and I knew that David had returned.
A Difficult Parting
I walked toward the front door. It opened before I reached it, and David entered followed by a young woman carrying a small satchel whose white uniform and stethoscope hung around her neck told me that she was a nurse or a doctor.
David introduced to the woman. AAdam, this is Melissa White, a nurse from Home Health Services. They sent her out with me to evaluate the situation and decide what type of care Hiram and Emily might need.@
I shook Melissa=s hand. AI can=t tell you how glad I am you=re here, Melissa. I felt totally incompetent trying to take care of our two patients myself. They=re in the bedroom to the right if you would like to see them now.@
AThanks,@ Melissa replied. AYes, I would like to see them.@
I led Melissa into the bedroom and introduced her to Hiram and Emily. AAre you going to take us to the hospital?@ Emily asked with a worried expression. AYou know that Hiram and I do not want to leave our home. It would be much better if you could take care of us here.@
AI have to evaluate your situation and make a recommendation,@ Melissa answered. ABut you must understand two things. First, I cannot make you do anything. You have to give permission if we feel we need to transfer you to a hospital.
AThe second thing you need to understand
is that sometimes we can=t provide the treatment a patient needs in a home. A hospital is the only place that has the equipment and the trained staff to do what needs to be done to take care of you. If you did go to the hospital, it would only be for the time needed to get you well enough to come home again.@
AThen we will be able to come home again?@ Hiram asked.
AThat would be our wish,@ Melissa responded, Aand we will do our best to make it possible.@
Both Emily and Hiram understood that if it were not possible, if they could no longer safely remain in their home, they might never return. But if they chose not to go, they would put their lives in danger. Whatever choice they made, they stood a good chance of losing something dear.
Melissa took a number of devices out of her satchel. She listened to Emily=s and Hiram=s heart and lungs, took their blood pressures and temperatures, and then pricked each of their fingers in turn, and touched a small instrument to the drops of blood that formed.
AI am measuring how much glucose, that is, sugar, is in your blood,@ she explained. AIf there is too much sugar in your blood, you may have a disease called diabetes which can be very dangerous because many people don=t know they have it until it has done a lot of damage to their bodies. But there is medicine that can control it, but we first have to know if you have it.@
The nurse made notes on a small pad as she took readings and made observations during her examinations. AEmily, I heard you hurt your ankle,@ Melissa send kneeling down beside the leg I had bandaged.
ANot a bad job of splinting,@ she remarked, looking up at me with a smile, Abut I=m afraid I=ll have to take the bandage off to get a better look at your ankle, Emily. I=ll be as gentle as I can.@
Emily grimaced slightly as the nurse unwrapped her ankle. The ruler I had used as a splint fell to the floor. Melissa carefully observed the ankle which was now swollen and colored an ugly mixture of black, blue, purple. Melissa picked up the ruler and carefully rewrapped the ankle.
AI am fairly sure that your ankle is broken, ma=am,@ the nurse told Emily. The only way we can be sure is to have it x-rayed, and that has to be done at the hospital. If it is broken, you will probably have to have surgery to repair it.
AAnd what if I just leave it alone?@ Emily asked. AWill it eventually heal itself?@
The nurse shook her head. AIf you just leave it alone, you might get a serious infection. Furthermore, you would never be able to put any weight on that foot. The bones have probably separated, which means the fracture cannot heal itself.
AI hate to give you more worrisome news, but you and your husband both have high glucose levels, which may mean you have diabetes. Your husband also high blood pressure, not a good thing after a stroke. He will need medication to bring down the pressure.
ABecause he can=t take care of you, and you can=t take care of him, especially if you are recovering from surgery, it would be best for the two of you to be transported by ambulance to the hospital in town where the doctors can examine you more thoroughly and take the steps needed to get your problems under control. Will you and your husband agree to go to the hospital?@
Emily and Hiram looked at one another. Tears formed in Emily=s eyes and began running down her cheeks. Hiram spoke softly, almost inaudibly. AI suppose we will have to agree. We don=t have the choice of staying here, even if we could afford to have someone stay with us full-time to care for us. I don=t want Emily=s foot to get infected. That might kill her. I couldn=t bear that.@
Emily sniffled. AHiram is right. How long will it be before we can come home again?@
AI can=t say,@ the nurse replied. AIf your ankle is broken, you