Well. I’m not sure I “found” joy today. If I did, it was mixed with other things. I started out my day with a kale smoothie, which, although I love it, didn’t really float my boat. I took pictures anyway, trying to feel festive. They didn’t do it for me, either. Picture a green smoothie atop a Magic Bullet. You got it.
On to my work day. I guess the high point of the day was meeting Sam (not his real name), my patient. I also met Sally his nurse, as we were doing a joint visit, opening him to home care services. So there we are, Sam, Sally, me, and Sam’s sister Mary who’s taking care of Sam since he came home from the hospital a few days ago. No actual joy here, but there were moments of enjoyment. But other things stand out: respect, good humor, admiration, and analysis. Lots of analysis. That’s what I’m there for after all: to evaluate, gather info, and analyze it, and to form a coherent plan of care for Sam’s occupational therapy. Sally’s doing her nurse-y thing; Mary’s doing her sister-thing, and Sam’s doing his patient thing.
It’s going well. Sam is pleasant, even though he doesn’t feel well. He’s a retired ICU nurse, so he’s favorably inclined toward Sally and me. I ask if he’s up for doing some walking and showing us how he’s getting around. He takes his walker and makes his way to the living room, turns in a wide circle, and gets back to the kitchen chair. I can tell that the kitchen chair is command central for Sam. His basket of medications, his blood sugar monitoring kit, and his TV are all right there. He can’t see well enough to read the labels on his medicines, but he remembers each one at the correct doses. When he plops back into his chair, he’s out of breath. I check his oxygen, and it’s low. I coach him through some breathing until it gets up over 90%. He’s a good student. He gets it when I say to blow out longer. I tell him I don’t want him to hyperventilate, and his eyes light up, and he laughs.
He and Mary have had a tough morning. Sam waited too long to start for the bathroom and had an accident. Mary said, “I feel terrible saying this, but I can do just about anything but deal with that!” Sam pipes up, “Oh, I don’t mind shit, it’s drool I can’t stand!” Sally jumps in with: “Wet phlegm!” I chime in, “Feeding tubes!” We get to laughing as the gross-out talk reaches a crescendo. Sam laughs loudest. He probably misses being on the unit, doing charge, taking care of all those very ill people. He worked up until 5 years ago, when he developed an ulcer on his foot that wouldn’t heal. That led to his first amputation. A year ago, the second leg was taken.
This is what Sam has to walk on now:
This is not Sam, but another bilateral amputee named Joe Arsenault, at University of Hartford.
While Sam’s resting and Sally’s taking his other vital signs, I ask Mary to show me his bedroom and his bathroom. The bedroom is on the second floor. Up until he was hospitalized Sam was climbing upstairs to sleep in his bedroom. He was also driving. Mary and his other siblings want him to move up north, where they all live. Sam’s adamant about staying in his own home. “It’s all paid for!” he says, with pride.
I understand. I’ve wanted my own house, a home, a forever home, as they say in the humane societies, forever, and Sam has one and wants to be there. I hope nobody’s looking to me to weigh in. I can see both sides, and it’s not up to me to tell anybody what to do. What is up to me is to find out what Sam wants to do and help him get there. In this case, I don’t doubt that he can, although, sadly, I won’t be there to see it, one way or the other. After all the fact-finding, the joking, the arduous walking 50 feet from kitchen to living room and back, the analysis of the shower seat and toilet height, and the shared laughter and intimacy of getting to know someone where they live, in all senses of the word, this will be my one and only visit with Sam.
For reasons that would take up another whole essay (about healthcare, no less!), I do the initial evaluations, and someone else does the rest of the therapy. I tell Sam this, when I’m summarizing what we talked about working on. There is a flicker in Sam’s eyes, but, like everything else, he takes it well. He knows the system, too. And I must say, he handles being a patient far better than I think I would, if the tables were turned. But I do feel sad as I say good-bye and let myself out, leaving Sally to finish up her nursey things.
Now that I’m writing this, it makes sense that I indulged in a nice lunch at the A1 Diner in Gardiner and that it, like my smoothie, left me full but unsatisfied. Today, I’ll take my joy where I can find it: in the places where it isn’t, in the things that are sad or empty, and hope that these experiences will lead me to find it where it is, as this Thirty Days of Joy is meant to do.
And for the record, and because I can’t resist, here are the very nice meals I had today, even though they didn’t bring me joy.
Breakfast: Kale, banana, almond milk, flax meal, cherry juice smoothie
For lunch, fish tacos (had to taste it first!) at the A1 Diner. And for dessert, their pineapple pudding cake!