Recently I visited a friend at a skilled nursing facility on Phoenix. He has an inoperable brain tumor, and the prognosis apparently isn’t encouraging.
I hadn’t been in a facility like this for a long time, and it took me aback. The physical space itself was first class: clean, plenty of light, spacious and filled with soft colors. But it was the patients there that gave me pause. It was breakfast time when I arrived, and most of them were gathered around small tables picking at their food. A few were slumped over the table; others sat in their wheelchairs staring vacantly off into space or watching one of several television sets tuned to a morning news program.
Most of them were women. They were old, frail and obviously severely compromised by whatever
affliction had brought them there. Nurses’ aides scurried about with trays of food or wheeled patients
in and out of the dining room. Most were young Hispanic and African-American women, and to me they
appeared as disengaged from the people and space around them as the patients themselves.
My friend was eating his breakfast in the third floor lounge when I arrived. “I have some short-term
memory loss,” he said when I sat down. "If I repeat myself, just ignore it."
"No problem," I said. "I get paid good money to repeat myself, sometimes endlessly."
We talked for awhile. He leaned over and said furtively, "You can get lost in the health system.
I found that out. You can be up here in a room, and no one knows where you are. I call my daughter every
day to make sure she knows where I am."
Just then an aide wheeled a tiny elderly woman into the lounge and parked her over in a corner by
herself. "Help me," she began to cry in a soft voice. "Won’t someone help me?"
Aides continued to walk by and pay absolutely no attention to her. I asked my friend why they didn’t
stop to help her.
"Oh, she says ‘help me’ twenty-four hours a day," he explained. "You get used to it."
Scenes from One Flew Over the Cuckoo’s Nest with Jack Nicholson flashed in my mind. Pictures of
patients zonked out on meds, nurses with straitjackets, patients asking for help and getting no
"It’s a logistical thing," my friend went on. "They can’t stop and help everybody. Nothing
would ever get done."
I began to project myself into this scene. Eighty-five years old, the victim of a major stroke,
paralyzed on one side, my memory and sense of identity fading before the day even has a chance to
get started. Then I began to project all of the aging baby boomers into the scene, people like myself
who think medical science and healthy living will stave off the specter of disability and feeble
Some of us will escape, but many won’t. Who will care for us then? Will my children understand that
I would rather die than live a half life in a place like this? Will I have any choice at all, or will
I be wheeled off into a corner and ignored so the staff can get on with their "work?"
The immediacy of the suffering, the human pathos around me, was overwhelming. I had this sense that all
of the talk, all of the research and endless meetings about aging and other health issues that occupy
my professional life was so much useless flotsam on a sea of churning human need and an insatiable
desire for connectedness and meaning.
I looked at my friend and sighed. He smiled benignly back at me. "You can get lost in the health
system," he said.
It was time to go. I had a meeting downtown. On the way out I passed the woman in the corner.
"Would you help me, sir?" she asked.
I had to stop. "How can I help you?" I said.
She immediately lit up and stretched forward to speak. "I’m not supposed to be here," she
said. "My husband is going to come and get me."
I couldn’t think of anything to say. "I’ll ask someone about it," I finally replied, and
At the nurses’ station I stopped and inquired about the woman. "She had a stroke," a nurse
explained. "Her husband died years ago. She doesn’t know where she is."
Who does, I thought. At least she knows she’s not supposed to be here.
Outside, the pathos began to lift. Places to go, things to do. Eight a.m. and already it was 90
degrees. I got into my car, turned on the classical music station, and moved out into a steady flow of
rush hour traffic that seemed to know where it was going.
Feedback? Send it my way: Roger.Hughes@slhi.org.
*The Drift reflects the views of the author, and does not represent the official view of SLHI’s Board of Trustees and staff.