It’s two a.m., and sleep is avoiding me, as it has for the last two hours. Frustrating, but one must work with what one has.

Working at the hospital as I do, it seems that at least once a week I am confronted with something powerfully bittersweet, usually to do with the elderly. Today—or rather, yesterday, I suppose, since technically it’s now the morning of the next day—it involved a lost old lady.

Everyone gets lost at the hospital, old or young, male or female. Partly it has to do with the construction going on with the hospital, but mostly I think it is because the hospital was built up over the years in pieces. This means it is a complete hodge-podge with no real rhyme or reason to where anything is or how to get to it. So it begins utterly mundane; she is looking for the Breast Care Center, she is upset that she thinks she will be late for her appointment and they will cancel it on her. She’s been there before, but she came in a different entrance, and doesn’t know where she is.

I could just hustle her down to the Breast Care Center—on the entirely opposite end of the hospital, with many twists and turns— but since she is concerned that she is late, I take her first to the desk so we can call ahead and let them know she is on the way.

She continues to be agitated.

She feels so stupid to be lost. We comfort her that everyone gets lost over here. She begins to tear up, eyes beginning to well. She says she’s getting old, she thinks she might be starting to loose her mental abilities. She forgot her papers, her doctors orders. Loosing one’s mental capabilities is a very real fear for the elderly, and my heart goes out to her, but honestly, the number of perfectly capable people who forget their important papers is rather high.

Finally the root of the problem slips out—she left her husband home alone. He has Parkinson’s; someone was supposed to come and stay with him at 2 o’clock so she could leave; the someone never showed up. She never leaves him, except to do the grocery shopping. She feels awful to have left him there.

So far it is merely bitter; it becomes bittersweet as she defiantly insists she will keep him home. She’s had him 58 years, and she’s not going to give him up now. They don’t make them like that anymore, she says, and sadly, she’s right. She dared us to say how many of us had been married 58 years (an empty question, really, since no one in her presence had even been alive that long).

It makes you want to cry, even though you know there us nothing unusual about her situation. They had moved back to this, in her words, god-forsaken area at his request. She has no one up here; he has a brother up here, and wanted to be near family. The brother has a sick wife, though, so she doesn’t feel right turning to him for help. They have no children. They are, essentially, alone, but they refuse to give-up.

Far, far more rare are the people I hear, voices full of marvel and gratitude, as they describe how they, even well into their advanced years, are still able to live at home. One lady told me how she is surrounded by neighbors on all sides, front, back, left and right, who all look after her. This one mows her lawn, that one sees to something else. Her cousins take her out grocery shopping or to her appointments. She is not alone, and she is being cared for. I think she said she was 94. It amazed me. But rarely do I get to hear such good news.


Sometimes I think about how this job has changed me. I think it has made me into a more “friendly” person, but no more capable of quickly making friends.

All day long, I have to be friendly and cheerful. I smile so much, I’ll have utterly chiseled dimples by the time I’m 30. My position of grease-on-the-gears means I have no luxury of being in a bad mood. I have smile at the patients, who sit glowering in the waiting room, either from pain, or boredom, or the bother of having to attend an appointment. I need to be sympathetic to the therapists, who are sick of work and really don’t want to deal with any patients, least of all this one, and besides they have too much paperwork and not enough time. I need to be sympathetic toward the patients, who don’t really want to waste even 5 minutes doing nothing but waiting for the therapists. I need to be cheerful and happy toward the receptionists, who deal with malcontents all day long. I smile at the staff that comes down from the floors looking so tired they might have forgotten how to smile. I smile at random people in the hallway. And I make every effort to be the most understanding and empathetic I possibly can be toward lost people, who will undoubtedly go away in a snarling mood and loathing our general establishment if the are not thoroughly soothed.

This being my job, I do find it tends to effect the rest of my life. I am much more likely to talk to random strangers, even when off the job. I am more likely to smile at people who trudge on by. Cashiers are comrades, not just people doing their job.

But sometimes it’s just plain hard. Sometimes you feel all smiled out by the time you get home. Sometimes you get up in the morning, and you just don’t find a smile in there to give. You spend your whole drive in wondering how on earth you’ll be able to get your mouth to cooperate. Sometimes you don’t have an answer by the time you’re walking in the door; but usually you can fake it by the time you reach your department if you remember to say “Good morning!” to everyone. But by lunch time, you know you’re scraping the bottom of an empty well, and you sit alone in the darkened classroom and stare blankly out the window, off into the hills and trees. And there is no smile then, and you hope no one will come into the room, because then you will have to smile. And then lunch is over, and you have to go get up and smile anyway, but I’d be lying if I didn’t say I did a worse job of it in the afternoon.

But for all that being friendly, I am basically alone. I see people all day long, but rarely get to say more than empty pleasantries. The therapists talk to the patients; the patients talk to the therapists. The therapists ask me to put their patient on heat or ice for 15 minutes, and then they go into the office and talk with other therapists. My job is to give them two minutes to talk, instead of running around like chickens with their heads cut off all day long.

They say very nice things about me, and they’re always glad to see me, but you can’t shake the feeling that it’s entirely unpersonal. They aren’t so much as glad to see me as they are glad to have the two minutes of free-time to talk to someone else.

Partly, anyway. But partly it is because I still am not much for making friends. Everyone else is kvetching and moaning, and I don’t join in, because I figure everyone else has enough drama in their lives without hearing me whine. People ask questions, and I assume only polite interest, and know full well they’re too busy to hear the real answers anyway. I remain amazed at these people who walk into a room and start talking about their life as though of course you would be interested. I will talk your ear off, but first you have to convince me you really want to hear it. So far, no one has.

And partly it is because I’m kept busy enough that I enter into the state of “working mode”. I am focused on what I’m doing. If at any given moment you ask me to do a simple arithmetic problem or what I did with my weekend, I stare at you blankly and scrounge for a vaguely coherent answer. I was working; I was thinking about work. I certainly wasn’t thinking about my weekend; that was filed away for later reference, cleared off my mental desk for an uncluttered workspace. It certainly wasn’t there when you asked for it. Blank stares are not good conversation starters.

So that leaves being friendly. It means making puns with the old guy who comes in and thinks his puns are clever—not because you like puns, but because he’s stuck here bringing his sister who had her hip replaced, and he has utterly nothing to do but sit there and think up puns. It means saying “Ok, next time I’ll try to do better!” when a therapist complains that she was 10 minutes late for her patient and next time don’t leave without telling her. Really you want to tell her, “Look, lady, a lost man with advanced dementia wandered down the hall and I spent the last fifteen or more minutes trying to figure who he was with, find his wife, get them down to the lab, communicate with the receptionists because he couldn’t, taking them up to their doctor, once again navigating the receptionists, making arrangements for the wife to get wheeled out by someone else, and bringing our wheel chair back. You knew perfectly well when your patient was coming, and half the time you make them wait 10 minutes even when I do tell you tell you they’re here. Go complain to someone else!!”

But that wouldn’t be nice. Or friendly. Or helpful to the therapists. But it’s what I really wanted to do.

The whole situation leaves you with a lot of pent up emotions. You don’t feel at liberty to let any of them out at work, and by the time you get home, you just want to forget it all and move on to something else. But emotions have to go somewhere, if they don’t come out your mouth, I guess they all bunch up between your shoulder blades. Or race around in your head at 12 o’clock at night and keep you from getting up at 6:30 in the morning.

It’s not that I don’t like my job, and it’s not that I don’t like they people I’m working with. It’s just that sometimes I get so sick of dealing with people on such an entirely superficial level. It feels so empty, and on top of that, it starts to feel pretty dishonest. Like when an occupational therapist tells you “You’re always so happy,” and all you can do is squawk indignantly that you are not always happy. . .you just spend all day faking it, trying to get everyone to think that you’re happy. And that sounds wrong. I am perfectly ok with you knowing that my life is not perfect and I’m in a really bad mood today. It’s just that it makes for a very suck-y work place if I don’t try to put a straight-jacket on my moodiness, and I think you all have enough to deal with already.

It’s very hard for me not to empathize with them. Even the therapist who wants me to tell her every time I sneeze, and complains when I don’t. She comes to expect and rely upon me doing certain things, and when I go all AWOL, she has no way of knowing if the certain things aren’t being done because I’m not there or if it’s because there’s no need for it to be done. If I always tell her when her patient is here, and I don’t tell her, does that mean I’m not there or the patient isn’t there? Besides which, she’s pregnant. You have to give allowance for being tired and full of hormones, knowing full well you are capable of being both yourself.

But being empathetic does not smooth out all the emotions; it simply adds more to the mix. It means that I can both, at the same time, feel sorry for them that shortly I shall be leaving for school and I won’t be there to take care of them any more, and to feel sorry for myself that I shall probably be utterly forgotten in 6 weeks or as soon as they get new help (whichever comes first), as no one really likes me—just the work I do. {Editor’s note: They probably won’t forget me; when their in their 80’s they’ll still be saying, “One time we had a girl working with us who was one of twelve children. Can you imagine? Twelve!”} I don’t want to abandon them, but I feel certain that I shall be (or already am) abandoned. Isn’t that the female thought pattern that keeps them hanging around abusive males? Yikes.

So I mock myself a little, but honestly, the most draining, wearing part of the job is not the walking 3+ miles a day on concrete with a thin layer of industrial carpeting thrown on top. It’s the emotional load. And when the emotional load starts to feel a little too heavy, you wish you didn’t have emotions so you wouldn’t have the load. You wish you didn’t care that the therapists didn’t have the “Now what?” look on their face every time they see you coming.

But I guess what it comes down to is that if you won’t pick up some of the load, you become some of the load. I can’t take away the unreasonable expectation of management, I can’t make the annoying patients go away, I can’t make the missing patients show up. But I am, daily, confronted with the choice being a stingy aide, one who only does exactly what is required, and no more, or being more than stingy. The first option puts me in the same column of unreasonable management and annoying patients—something to be borne. The second option I flatter myself to think makes the emotional load of annoying people easier to bear.

I hesitate at my use of the word “choice”, however, as it makes it sound like one simply has to make up one’s mind, and that’s hardly the case. Nor is it a question of direction by principle, as though one simply has to decide the principle and everything else falls easily into place. In reality, it’s easy to decide the principle, but it’s a moment by moment struggle to actually live by it.

Well, it’s been two hours, and I’m finally beginning to feel the stirrings (or lack thereof) of exhaustion. Hopefully this foray into sleep will be more successful than before.

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