January 27th, 2010 - Uncategorized - Comment
Each reading I do from the book brings a new set of stories.
Reading at Mac’s Backs in Cleveland a few nights ago, there were plenty of people in the audience who’d had experience with Alzheimer’s patients. I’d chosen my reading selections for the night around one subject, coercion. It’s “the topic that fascinates me,” as I say in the book, “the one I never resolve.”
In the conversations we had after the reading, two people from the audience struck a nerve for me. One was a woman who was as adamant as my friend Sandy Weymouth in the book: Why, she wanted to know, should we cajole and force dementia patients to do anything? Why not let them choose to spend their days however they wish? Why force them to socialize, force them to attend different programs, force them to eat or drink? If they don’t want to eat, why not let them find their way out of life like that?
The second woman, much younger, worked as a recreational counselor in the dementia unit of a nursing home. In other words, she was someone who spent her days coercing Alzheimer’s and other patients to stay active, to stay involved. If she didn’t urge the residents to participate, she wasn’t doing her job. She liked working in the home, but she was fully aware of how much pressure she and others in the dementia unit put on the patients, almost around the clock.
I was fascinated to hear someone suggest that we just let Alzheimer’s patients drift away into their own worlds. This is a plan few people would accept—perhaps least of all those with relatives in nursing homes. Still, there’s an inherent logic to it, even a kind of respect. As it is, we treat people with dementia as if they were infants or very young children, and to me it often looks demeaning.
I didn’t come any closer to resolving the issue, but I was glad to hear it addressed, and to hear from someone who works, as they say, in the belly of the beast. In the nursing home, every assumption is that we are in charge of those with dementia, and we must manipulate them constantly to keep them involved. Yet when looking after a single person, a relative or spouse or friend, I think it’s rarely so easily decided. Every step of their care is debatable, or should be.
More than that, the entire topic is fascinating—and it’s that fascination which can turn a grinding and repetitive chore into an adventure.
January 19th, 2010 - Uncategorized - Comment
With this disaster in Haiti there must be elderly Alzheimer’s patients in Port-au-Prince and other towns who somehow survived the earthquake that killed their caregivers. If they haven’t died already, they could be wandering around not knowing who they are, not remembering where they live, or how to eat, or where to lie down at night to sleep. Some would be as helpless as infants—only they don’t look like infants. In a country where the most able-bodied are having a hard time getting food and water and medical care, those with dementia must be at extreme risk.
We don’t hear much about dementia in third-world countries. The U.S. has about five million Alzheimer’s patients now, with 30 million in the rest of the world. We have more than our share percentage-wise, in part because we have better reporting of medical statistics, and in part because we live longer. Long life is now that double-edged sword: the longer we live, the more likely our brains are apt to go before our bodies.
Our education about Alzheimer’s is better. We don’t call it “senility,” as we once did, and we don’t call it “tired brain,” as they do in India. There’s a near-constant outcry about the need for better medications in the U.S., for better patient care, for more help for caregivers as they look after the afflicted at home. But what did Alzheimer’s care look like in Haiti a month ago? There couldn’t have been much help from the state—and today there must be none.
Caring for my father as Alzheimer’s took him down has set up a kind of filter for me—rather like the years I spent raising my son. I became a father, I joined the vast community of parents, and now I have joined the community of those who have looked after the elderly and those with dementia. In the case of Haiti, my mind jumps to those who are lost in the midst of chaos, who could make little sense of anything even if they were still ambulatory. Infants and those in the deep reaches of Alzheimer’s are especially vulnerable populations—and on the streets of Port-au-Prince, the latter must be almost invisible.
January 3rd, 2010 - Uncategorized - Comment
After those two hard stories in my last post, here’s something more heartening.
A friend of mine, Michael Daniels, who’s in his mid-sixties, has been thinking about his old age and who might be taking care of him. He’s perfectly healthy and his mind is certifiably sound, as you’ll read. But both his parents died with Alzheimer’s, and he’s concerned that at some point his own brain will come under attack. He’s single, he has no family, and like many of us he doesn’t want to be a burden on anyone, doesn’t want to drift into a long decline in a nursing home, no longer knowing who he is or having any memory of his past.
Michael’s goal is to escape what he sees (and what I see) as a grim scenario. He would rather die before falling into deep dementia.
I’m reminded of the plans made by the protagonist in Lisa Genova’s novel about early-onset Alzheimer’s, Still Alice. Alice is a professor at Harvard, only in her early fifties, but her mind is fast failing her. She knows where she’s headed, and doesn’t want to subject her family to a long period of care for a wife and mother who eventually won’t even know them. So she devises a test for herself which she puts on her computer, a series of questions:
What month is it?
Where do you live?
Where is your office?
When is Anna’s birthday?
How many children do you have?
If she can no longer answer these questions, she directs herself to go to a file in her computer, which will tell her what to do. She is planning a suicide.
I won’t give away what happens (read the novel), but the heart of her plan is to enable her to act when she still can, even though her mind is falling apart.
Michael, too, is trying to figure out a way to take control of his death when he no longer knows what he’s doing. His first step has been to establish a baseline of his mental condition, and to this end he has taken an extensive neuropyschological evaluation, administered by the Department of Psychology at Ohio State University. This was a four-hour set of tests and evaluations, far more extensive than Alice’s five questions—but the goal is the same, to determine, after future evaluations, at what point he will have passed some divide, with the knowledge that soon he will be unable to end his life, because he won’t remember his plan to do so.
Michael’s plan, however, involves help from his friends. He envisions a coach, or several coaches, who will help him when the results of his mental evaluations fall below a certain level. These neuropsychological exams are given all the time. My father had one, not as long and extensive as Michael’s, and the result was clear to the PhD who administered it: Dad had “advanced second stage dementia, most likely caused by Alzheimer’s.”
The tests are fairly dependable. Michael, or his coaches, will know where he stands.
The problem is figuring out what to do next. Michael is still working on that one. Alice, in Lisa Genova’s novel, plans to take care of it herself, by taking some pills. Michael hopes that his coaches will help him get to Oregon, where the doctor-assisted suicide laws might enable him to end his life.
One trouble is, you have to be a resident of Oregon for this to work. And most likely, you have to be of sound mind to request the suicide. There are some problems here. And Michael can’t simply ask friends to administer some drug when he no longer understands what he’s doing—for anyone who did that could be tried for murder. It’s a difficult question—but one many people have thought about. I have. What to do, in order to avoid years of life in the deep shadows of dementia?
“I’m just pursuing a plan,” Michael says. “It’s on the assumption that I’ll go somewhere where assisted suicide is legal—or perhaps it will become legal here.”
Michael has read Still Alice, and “if anything it enhanced my convictions to do something about this. The derailment of her plan is what encourages me to have a plan in place that cannot be detailed. The only trouble is that it leaves the coach vulnerable.”
Clearly, Michael does not have all this figured out. But who does? I find it fascinating that he has taken some steps, that he’s thinking about it, that he knows absolutely that he does not want to be living without his memories, his self-awareness, his ability to listen to stories and tell them himself. I’ll keep talking to him, and see where this leads.
January 1st, 2010 - Uncategorized - Comment
A journalist I was doing an interview with last week told me a couple of amazing stories. The first was about an old guy with dementia, probably Alzheimer’s, who was slowly descending into the disease. He’d always been a good man, a good husband, and his wife was looking after him as he grew more worried, more upset, more obstreperous. What a change in him, and how painful for her. But she continued looking after him, trying to take care of him, trying to keep him calm at times. He grew violent, and probably she was scared. But he had always been such a good man.
And one day he lashed out at her hard. He beat her and beat her until she died.
This can’t be the only story of it’s kind. I know there’s a movement to try to get guns and ammunition out of the houses of Alzheimer’s patients. Lots of guns in America, and they’re a bad combination with dementia, which can have violent aspects. But even without a gun, a still-strong Alzheimer’s patient, no matter how kind and gentle he might have been in the past, can wreak some havoc. Can kill someone he loves, or used to love and no longer even recognizes.
Then, a second story, about a man who apparently dragged his father into the water off a Florida beach—to hide his nakedness, to clean his dirty body and diaper, the story isn’t entirely clear—only to have his father die the next day.
Bobby Yurkanin and his father
This story I tracked down on line, and you can read a full account here. It’s the story of Bobby Yurkanin, a man in his fifties who had, in spite of the troubled family of his youth, had returned to look after his mother, who was dying of cancer. Shortly after she died, in 2001, his father showed the first signs of dementia, and Yurkanin began to look after him, as well.
His caregiving went on over years—and his father was a far more difficult patient than my father was. He wandered through the condominium where they lived, sometimes nude, sometimes entering into other people’s apartments. He went out on the street wearing only a diaper.
To quote the AP story about the Yurkanins, “The son assumed his caretaker role out of necessity, friends said, despite a strained family history and a less-than-perfect childhood. And those who observed him and his father together often describe the younger Yurkanin with similar adjectives of praise:
Dutiful. Patient. Dedicated.”
Others describe times when Bobby Yurkanin lost control of himself, screamed at people, yelled obscenities. He was clearly under great stress: the natural stress of a caregiver overwhelmed with the extended, year-after-year obligations of looking after a difficult dementia patient. No one accused Bobby Yurkanin of abuse: “For all the unraveling that now seems apparent in Yurkanin’s life, many who observed him with his father say they saw a son who, yes, would grow frustrated by his dad and sometimes raise his voice, but whose care was undeniably loving.”
The great unraveling came on a Fort Lauderdale beach when the elder Yurkanin started to take off his clothes, and Bobby pulled him into the waist-deep water, where he pulled down his shorts and dirty diapers. There was a struggle, Bobby hauled his father out of the water, he lay on the beach, an ambulance came—there are many more details to this in the link above—and the next day he died.
Bobby Yurkanin was charged with murder.
It’s another story that seems completely believeable, completely understandable. The pressures that caregivers are subject to, day after day, month after month, year after year, often with an apparently-endless life of restrictions and trials ahead of them, make it inevitable that sometimes people are going to crack. In Bobby Yurkanin’s case, almost a decade of support and care for his parents ended on a Florida beach with his father dead on the sand.
The last paragraph of the AP account reports of the younger Yurkanin: “Only in retrospect has he become aware how overwhelmed he was as a caretaker, his lawyer says. Under the circumstances, he adds, Yurkanin feels no burden lifted.”
It’s one of those stories about which even the best of us might think, That could have been me.I never came close to any kind of violence against my father—but I certainly felt the frustration, an occasional madness that would drive me upstairs to my room, there to lament any harsh or cold words I had uttered to my father, the man who had done so much for me my entire life. But what if my father had been as much trouble as the senior Yurkanin? I cannot know how much frustration I could have withstood.
Two stories, two brutal stories.
Other than that, a Happy New Year to all!
December 27th, 2009 - Uncategorized - Comment
A scene from the Christmas beach vacation I just took with my son and his family, including my grandson, the just-about-to-turn-two Maximo. Max, at the hotel beach, has pretty much everything he needs: food, warmth, two pools, a sandy beach with the soft waves rolling in, plus the affections of his father, his mother and two grandparents.
Max in a good mood
And still he fusses. He has entered the ancient battle of the two-year-old, common if not inevitable: a test of will that continues, intermittently, from early morning to late at night. He wants things the way he wants them: exactly the right level of care and attention from his family, particularly his mother and father, as well as access to anything he deems interesting—such as the ball or plastic fish or toy cell phone of the people near us who have left those toys lying on their unoccupied beach chairs, and which we don’t want him to play with.
So what I see from Max, right there in paradise, is lots and lots of fussing. Mainly, I supposed, it’s his age, only days from turning two. But here he is complaining to his mother, demanding and complaining. He throws his little fire trucks down on the sand—the Tonka trucks he cannot do without. His mother has had enough of this, and doesn’t pick them up. He’s testing her patience, her love, her control.
Did kids do this in 1909? In 1409? Or is it a syndrome of a society where kids have everything? I don’t remember children in the indigenous parts of Guatemala, where they grow up swaddled and strapped to their mothers’ backs, throwing little fits of will like this. Of course, they didn’t have little Tonka trucks to toss about. But at the table, did they throw their food on the ground when they didn’t like it, or wanted some attention? I don’t remember seeing that, in my many travels through Central America..
In any case, Max is now driving his mother and father crazy, so I make him an offer: “Do you want to go in the water? We could go see the waves.” I’m sure he understands this, as I gesture toward the blue sea—but his answer is “No.” He’s after something right here, and has no interest in being sidetracked.
We have arrived at the rub, at the eternal question: Do I respect what he says and drop the idea of taking him to the water? Or do I just step in dominate him, pick him up bodily and make him do what I think will make him happier? One word from his mother—Please—and he’s in my arms, squirming and crying the forty steps to the water, crying as I wade in and stand in the small waves, then crouch down with him and put his feet on the sandy bottom. I’ve done this before and I know it works, because he loves the water. He stops crying. He feels the warm water slap at him as the waves come in, swirling with sand and bits of seaweed, pushing in and sacking out again, the tug of it pulling the sand out below our feet. He’s completely absorbed.
Two pelicans come gliding by and Max says “Birdy.” I say “Pelicans,” and he says something like “Pe-cns.” He’s happy, and all his complaints are forgotten. So the lesson would seem to be: Just do what I know is best for him. Don’t pay attention to what he wants or doesn’t want, just pick him up and move him bodily to a better scene.
But what if he’s not two, but five? Can I still pick him up and remove him bodily and plunk him down in the water? I could easily handle a five-year-old. But what about a ten-year-old? That would be a hopeless battle. Even a five-year-old would understand what I was doing, and would probably resist it fiercely. With a ten-year-old, forget it.
Now think about it with a fifteen-year-old. No, no, this dominance, this coercion only works with very young children, ones who aren’t old enough yet to hold on to their wills, their resentments, their sense of outrage.
And that is what made it so difficult to make my father do what he didn’t want to. The story was not so different. He’d be sliding down into a four o’clock sundowning, feeling lost and confused and depressed. The Cape Cod beaches weren’t far away, and if I could get him in the car we’d be there in ten minutes, and his mood would change completely. I knew this, I’d seen it many times. But I couldn’t sling my father over my shoulder and plop him in the car. I couldn’t lift him up by the belt and push him toward the door. I had to persuade him, and that did not come easy. I had to press him hard, I had to go against his will, his desires, his unhappiness.
The more I decided for my ageing father, the more powerless and helpless he became. And as I decided things for him, I felt that I was reducing him, that I was treating him like a younger and younger child. My father didn’t want to go to the beach. He didn’t flail around in my arms the way Max did, but he did not want to leave the house. If I could get him out to see the sunset at Red River Beach, I knew he’d forget about his malaise and hopelessness. But the next day he wouldn’t remember any of it and would fight me all over again about going back to the ocean, or to Cape Cod Bay where we watched the ducks and the lovely sweep of the gulls.
Coercion. It’s a fascination to me—and not just with kids or parents with Alzheimer’s. We coerce people all the time. We coerce our friends. We coerce, through politics, entire groups of people. As a nation we’re constantly trying to coerce other countries to do what we deem right. All this, as I’m walking over the beach past other hotel guests in their chairs, with Max crying and twisting in my arms as if I’m torturing him, makes the whole childraising debate more interesting. Over and over, Am I doing the right thing?
All in all, I had a lovely, soft, warm vacation with my family. Santa arrived in a convertible, the Grinch rode around on a bicycle and plunged into the pool with it, canned Christmas music played on little speakers disguised as stones—and I was entranced with the willful, gorgeous Maxito, who wound up with his arms around my neck, holding me as the warm waves pushed him around, and as he gained some confidence in the miniature surf.
December 17th, 2009 - Uncategorized - 1 Comment
The Washington Post, in last Sunday’s edition, cited The Last of His Mind as one of the Best Books of 2009.
I bless their literary hearts. Carolyn See’s, really, who wrote the original review in The Post.
You can see the full list here
December 15th, 2009 - Uncategorized - Comment
Five months after I moved into my father’s house on Cape Cod to look after him—because he could no longer manage on his own, my brother Al came down from Vermont to stay for eight days so I could have a break. I headed back to Ohio to look after the houses I rent out, but wrote out a detailed list of jobs to take care of while I was gone.
I had quite a routine going with my father by then—and I’m kind of stunned, even now, to look back at it. This isn’t the kind of list that made it into the book, whose evolution, over the years of writing and editing, was always away from the specifics of care and into family stories and larger themes. But this is the real scoop on caregiving, the heart of the matter, the moment-by-moment and less-than-glorious daily round.
Of course I explained everything to Al before I went, but it was complex enough to set it all down in print, so he could consult it:
Al–
Itl ’s still cool enough in the mornings to turn on the heater in the bathroom in the morning; probably always will be. Be careful, though, about leaving it on when he’s in there and the door is closed: he can sit for a long time on the toilet and I think it cooks his brain.
Remember the cardinal rule: Bad things happen in the bathroom. I do leave him in there on his own, and I think there’s something comforting to him about being in there. But I keep track of him. I definitely never go off anywhere when he’s in the midst of his morning routine. When he’s just taking one of his long pisses, during the day, that’s another story.
I find I usually have to undress him these days. Otherwise he can get hung up and just wait there in the bathroom, either sitting or standing.
After his shower, if left to his own devices, he may put back on the same incontinence underwear from the day before. I try to whisk it out of sight while he’s showering.
I generally dry his ankles and feet with a towel, then the hair dryer. Then the Loprox gel with a Q-tip, between his toes.
Keep an eye on how swollen his ankles and feet are. The more they swell, the more he should sit in the lift chair with his feet raised. My basic rule has become: whenever he’s in the chair, his feet should be up. Occasional applications of Lubriderm to his ankles are a good idea.
Water available at all times: on dining room table, next to his bed, next to his chair. He likes tissues to be close by all those places as well.
He’s generally safe and secure with his walker—but this morning I took him to bloodwork, he got out of the car and onto the walker, but the asphalt there has a slight incline—and suddenly he was falling straight back. He would have gone back hard onto his head, but luckily there I was.
Often after meals (it can happen at other times, too) he shows signs of real distress. He can’t talk about it, so I’ve never figured out if it’s his mind or his stomach, or some other bodily trouble. He might sit at the table, or later in the chair, and groan with each breath. It can sound and look torturous, and I don’t know what to do or think about it. Last night he was exceptionally lost (“I don’t know what I’m doing here”), so maybe that played a role. But sometimes I think it’s his stomach acting up. Dad will basically eat everything you put in front of him, so you have to be careful. It’s great that he eats so well, but it’s possible that he’s stuffing himself and then suffering. I try to give him some ginger ale after both lunch and dinner. It might help sometimes—though how can you ever be sure?
No coffee. If he asks for a cup of “real strong coffee,” I give him a wallop of decaf—and usually he forgets all about it long before he finishes it. Alcohol is not a good idea either, and you can probably manipulate his intake down to nearly zero—if indeed he ever asks for any.
He rarely wants to go outdoors, or even into the sunroom, no matter how nice it is outside. I offer, and on occasion he takes me up on it.
If he can brush his teeth every 3-4 days, that’s a plus.
His new medication is Beconase, for swollen nasal tissues. One puff in each nostril twice a day, along with the Azmacort.
Good luck, and I’ll never be more than 15 hours away!
–John
December 9th, 2009 - Uncategorized - Comment
I first read about the famous patient H.M. in David Shenk’s book The Forgetting. Shenk describes how in 1953 the well-known brain surgeon William Beecher Scoville, in an attempt to relieve his patient’s seizures, removed two sections of H..M.’s brain. The seizures abated, but with them went the ability to store any new memories. As Shenk wrote about H.M., “For the rest of his long life, he was never again able to learn a new name or face, or to remember a single new fact or thought.”
A year ago, H.M. died, and his name was revealed to the public: Henry Molaison. He had lived near Hartford, Connecticut, first with his parents and then in a home, for over fifty years. From what I’ve read he was not an unhappy person. He was much liked by those who took care of him, and by the many doctors who studied him. Even when alive, his brain became the most studied brain in history—and now, the New York Times reports, that brain has been flown across the country to a lab in California, where it will be shaved into 2500 slices, all to be analyzed minutely.
The Times reports that Dr. Scoville “suctioned out two slug-sized slivers of tissue, one from each side of the brain.” A more complete description is offered in Philip J. Hilts’ book about H.M., Memory’s Ghost: “Dr.Scoville inserted a silver straw into Mr. M.’s brain and sucked out nearly the entire grayish-pink mass of the hippocampus and the regions leading up to it. On both sides. He drew out altogether a fist-sized piece of the center of the brain.”
The hippocampus, often described as having the form of a seahorse, is a paired structure, lying in both the left and right sides of the brain, nestled deep within the temporal lobe. In early childhood, as the brain develops, the hippocampus is the last part of the brain to gain a protective myelin sheath to its neurons. It is the hippocampus that enables current thoughts and impressions to be saved as memories, and because it is so slow in maturing, few humans can remember much before the age of three.
With encroaching dementia, the hippocampus is also one of the first parts of the brain to have its myelin stripped—which is why memory loss is almost always the first sign of encroaching Alzheimer’s.
None of this can be studied in vivo, and Dr. Scoville’s operation today would raise a howl of protest. Yet much of what we know about the process of memory comes from the studies on the unfortunate Henry Molaison. He stands as a kind of ultimate dementia patient, whose short-term memories were almost entirely wiped out one day in 1953. I think about this man—only twenty-six when he became, in effect, frozen in the present. He remained part of the human family, of course. But I think of how his parents must have felt, to find that their son had disappeared, that the rich bath of memories we all depend on had been entirely stripped from him.
I look at his photo, taken years after the operation. He seems mild, congenial, benign. A little like my father, but without any edge. Because I know what happened to his brain, I find it a terrifying portrait..
December 2nd, 2009 - Uncategorized - 2 Comments
A journalist, doing an interview with me today, asked among other questions if I had any regrets about the year I spent with my father as he sank under his dementia.
None came quickly out of my mouth. And that is surely true about that year. I arrived at my father’s house on December 21st, 2004, and left it, after cleaning things up following his death, on December 20th, 2005. An exactly full year. The only year—or anything longer than a couple of weeks—that I spent with him since I graduated from college. I grew frustrated and antsy at times: I can see that in the journal I kept, though now I can barely remember it save for what I wrote down. I have a few minor regrets (I forgot to tell the journalist this) about contradicting him when he was sure that people had gotten into the house and stolen things, or that Mitt Romney had come to visit and was in the refrigerator. I could have been more inventive. I could have gone to check to see if the state’s governor had actually come to call, then reported back truthfully that he wasn’t there.
But those are minor regrets, to be sure. What I would have regretted would have been not leaving my life in Ohio that year, and not going to stay with him.
All that is predictable. Who ever says they regretted spending a year with their parent or spouse or sibling? A year is short enough that the sacrifice is not that great, and there’s apt to be little time for regrets to build.
But what if it were three years, or five, or ten? Who could devote their life to someone for so long and not feel regret that too much of their own life was passing them by? I’m stunned by people who stick with it year after year, whether they are looking after someone at home or have put them in a dementia unit in a nursing home. I think of what Mary Gordon wrote in Circling My Mother, after her mother had been in a nursing home for eleven years: “My mother’s body is inexorably failing, but not fast enough. She is still more among the living than the dying, and I wonder, often, what might be the good of that.”
She writes, “The sight of her blackening teeth, now only stumps; her hair, scraped down almost to her scalp; above all the smell of her made me panic, made me want to cover my face with my hands and cry out, ‘I can’t, I can’t, I can’t do this.”
The grinding care, the pure duration of it, makes me wonder how long I could have gone on with my father. A year was easy. (Well, I didn’t think it was easy at the time, especially because I didn’t know how long it was going to be.) But to continue year after year: how do people do it? We all want to know that, don’t we? Could we do it? What are we capable of? I did it for a year, and still don’t know if I could do it for five or ten years.
Mary Gordon did have a life apart, and a good thing, too. She had her writing, and she explains, even after showing her panic around her mother, that she writes about her to witness “to the mystery of an impossible love.”
What advice, the journalist asked, would I give to others in my situation, with a parent sinking into dementia.
“Go do it for now,” I said. No one can say how long it’s going to last, or how long you can stand it. “Start now, or whenever you’re truly needed, and do it for as long as you want to, or as long as you can stand up to it.”
I know this, that there was never an minute during my time with my father that wished I’d done something else that year.
November 25th, 2009 - Uncategorized - 2 Comments
My father kept everything. Old magazines, skis from the 1960s, a box of keys carefully labeled Unknown. But above all he kept paper: my fingerpaintings from kindergarten, hundreds of boring letters from his parents when he was a young man working in New York, clippings from magazines and newspapers, research he’d done. He must have put a lot of time into it—though as a kid I was oblivious, I never noticed him filing anything.
But I’m glad he did. Especially glad this morning, as I have discovered again the bill he kept from the LeRoy Sanitarium, a Manhattan hospital on East 61st Street, for my mother’s stay from Nov 6th (the day I was born) through Nov 20th, 1942. Two weeks of room, board and nursing care, plus charges for the delivery room, anaesthesia, circumcision and medications.
The total charge: $348.04. (For that money today, I don’t think you could cough inside a hospital, much less give birth.) Here’s the beakdown:
Room and diet for two weeks 225
Board of day nurse 30
Board of night nurse 8
Operating room 25
Delivery room and circumcision 10
Nursery 15
Anaesthesia 20
Medications 10.75
Telephone 4.29
Total: $348.04
I’ve long tried to figure out the connection between my father’s compulsive gathering of facts, artifacts, dates and stories, and the fact that all this fled from his mind once Alzheimer’s set in. My conclusion: there is no connection. Nothing one could measure or be sure of. He was a guy who loved words and history, and a guy from whom all that was taken away.
But I do have the papers.
