Chapter Three
Adelle knew something horribly wrong had occurred, knew she’d suffered some debilitating illness, but did not know the extent of her condition until after she regained full consciousness a full five days later.
She’d come awake slowly, in fits and starts. She recognized that she was in a hospital immediately, and when the night duty nurse came in and saw that she was awake, a doctor was summoned.
“How do you feel, Ms. Smith?” the doctor asked as he stood over her bed, checking her vitals.
Adelle could only make out a hazy image, enough to tell her he was a young doctor, of Middle-Eastern descent perhaps. She tried to tell him, tried to convey how she was feeling and perhaps ask how she wound up here, but she couldn’t speak. Her mouth was dry and as if the medical team had second sight, one of the nurses brought her a cup of water.
“Easy does it,” the nurse murmured as Adelle sipped.
That helped quench her thirst and calm her parched throat, but it did nothing to help further her speech. By then another team of doctors had entered the room, and it was the older one—white, graying hair, over six feet tall—who seemed to be in charge.
“Ms. Smith, I want you to listen to me very carefully. You’ve suffered a stroke.”
Somehow, the news didn’t affect her the way she thought it would. Her first reaction was one of courage.
Okay, I’ve suffered a stroke. But I’m alive. And I’m going to get better.
She listened as the doctor told her that they would run a series of tests—among them a CT Scan and various MRIs—to determine the extent of damage. Some of those tests were conducted while they were attending to her and it was quickly discovered that she’d not only lost the ability for speech, her left side was completely paralyzed. Tears of frustration welled out of Adelle’s eyes as she tried to make a fist with her left hand at the doctor’s urging.
“It’s okay,” he said, patting her arm gently. “Now we know, and we’re going to do what we can to see that you regain use of your left side again.”
As frustrated as she was by being unable to communicate verbally, she still had full use of her right side and that was at least something she could be thankful for. She was able to answer simple yes and no questions by tapping her finger on the bed’s guardrail. She could also write.
Through writing down questions, Adelle was able to learn that she’d been out of it for five days, that she was at Philadelphia General Hospital in Center City, and that the blood clot that triggered her stroke had been treated and that she would likely undergo a long course of post stroke therapy. But first, they had to learn how much damage the stroke had caused.
At some point somebody must have called Tonya because while Adelle was in Radiology getting prepped for the first of a series of MRIs, her daughter was at her side. Tonya hugged her.
“Oh momma, I was so worried!”
And with her daughter at her side, in the midst of all those machines and computers, her worry and emotion gave way and Adelle allowed herself to cry in her daughter’s arms. It was a cry of relief. She was still alive.
Chapter Four
Three days later Tonya Brown sat at the nursing station’s front desk filling out the paperwork and making the final preparations for her mother’s discharge, ignoring the disapproving look from the Patient Admissions nurse.
“Are you sure you’d rather not have your mother admitted directly into a Hospice Nursing Facility?” the woman asked.
The nameplate on her desk identified her as Georgina Spaulding and she was a large woman with an olive complexion and coal black hair going gray in spots.
“I mean…I understand why your mother would feel a bit apprehensive about entering a nursing home, but I assure you Hospice Nursing is the best in the state.”
“I’ve tried convincing my mother to just stay there but she won’t hear of it,” Tonya said. She was filling out the last of the paperwork. “Trust me, I told her there was no use going back home when she could simply get all the care she could ever want at a full-fledged hospice and rehabilitation center, but she made it clear that she wasn’t going to an old folks home.”
Georgina rolled her eyes.
“Big difference between a hospice and a nursing home for old folks. Besides, there are resident physicians on staff twenty-four seven. The nurses are board certified, too. They aren’t just nursing assistants.”
“I know,” Tonya said. She met Georgina’s gaze over the cluttered desk. “But she wants to be home. In a way, I don’t blame her.”
Georgina sighed. “Believe me, I understand but…well, that neighborhood your mother lives in isn’t the ideal situation for someone of her age and…well, her condition.”
Tonya nodded. She agreed with the woman, but debating it wasn’t going to change her mother’s mind. Nothing would.
“Are you sure about this?” Georgina asked again.
Tonya looked up from the forms. “I’m sure. They’ve already arranged for a home-care nurse for my mother.”
“And they had no problem with…the neighborhood?”
Tonya resumed filling out the paperwork. Was that a hint of disapproval in the Admissions Nurse’s voice? “They had no problem at all.”
Tonya had been worried that Hospice Nursing would balk at sending home care nurses to her mother’s apartment for her care, but they hadn’t. She originally wanted to put her mother up in her basement, in nearby Lansdale. Had talked about it with her husband, in fact, and he was supportive of the idea. Their basement opened out onto the backyard and was completely finished, with a full bathroom. Currently they used it as an extra family room and a rumpus room for the kids. Turning it into a temporary apartment for momma would have been a snap, but she wouldn’t have it.
I’m going to my home
! Momma wrote in the spiral bound notebook she now kept beside her bed. No amount of arguing or persuasion would change her mind. She was going home and that was final.
“I’m surprised,” Georgina continued. “Last time we had a patient discharged to that area who required home care, a nurse was mugged on her way home. Was almost beaten to death.”
“My mother’s very well known in the neighborhood,” Tonya said quickly. “I don’t think we’ll have that problem.” She met Georgina’s gaze, daring the woman to continue. Georgina nodded and averted her eyes, suddenly becoming busy with her own paperwork.
“Very well,” Georgina said. She reached into a file beside her desk and pulled out a series of pamphlets. “I have some information here on
ischemic
strokes, as well as a guideline sheet on diet and exercise for your mother. Hospice Nursing will be more than happy to help you if you need any more information.”
And with that, the subject of Adelle Smith returning to her neighborhood in her now disabled condition was finished.
Chapter Five
Doris had been watching Natsinet all day as she’d gone about her rounds, changing bed pans and sheets, giving sponge baths and exercising the less ambulatory patients, checking vital signs, doling out medications and making notations in their charts. The woman was careful and meticulous and, despite her comments about African-Americans, showed no favoritism as she went from patient to patient.
“Can you cook?”
“Excuse me?”
“Do you know how to cook? Many of our patients are on specialized diets and sometimes our nurses are asked to prepare meals for them.”
“Yes. I can cook.”
“Good. Come into my office when you’re done with your rounds.”
The old nurse walked away and Natsinet followed her with her eyes until the old woman reached the end of the hall and exited the ward.
“Nurse? Nurse? Can I have my meds now please? My arthritis is starting to hurt.”
An old Black man, one of the few patients who was actually older than Doris, was tugging at the sleeve of her nursing jacket. Natsinet jerked her arm away, scowling in contempt.
“Don’t touch me! Don’t you
ever
put your filthy hands on me!” She glared at him murderously as she cradled her arm, sheltering it from his touch.
The old man recoiled, startled by Natsinet’s sudden inexplicable fury. “I-I just wanted my medication.”
Natsinet checked his chart, still scowling at him. His name was Thomas Adamson, and he’d been in the care of the nursing home for four years. He had both osteo and rheumatoid arthritis and was scheduled for a shot of Remicade, the brand name for infliximab, a tumor-necrosis factor inhibitor. He was also recovering from his sixth heart attack and was taking an angiotensin receptor blocker called Diovan to open up his blood vessels, Eplerenone, a diuretic to remove excess fluid from his body (which would explain why she had to change his bed pan so frequently), and Carvedilol, a beta blocker to lower the adrenaline levels in his blood stream.
An expensive arthritis drug and three different kinds of heart medications for an eighty-nine year old man with no hope of ever getting out of his bed. That is just ridiculous
, Natsinet thought. She looked further down Mr. Adamson’s chart. He was a smoker. She chuckled to herself and shook her head.
I bet tobacco isn’t the only thing this old coon has smoked in his day.
It seemed silly to waste so much expensive medication on someone who was clearly on his deathbed. She wondered how many purses he had snatched in his youth? How many other Black men he’d stabbed over card games, crap shoots, and drug deals? How many illegitimate children he’d fathered? How many welfare dollars had been spent over the years keeping Mr. Adamson’s worthless heart pumping after he’d spent most of his life smoking and drinking, eating fried greasy food, no doubt taking drugs, and not exercising? How much money was his family spending now to keep him in this place?
His grandkids are probably out there selling drugs right now to pay for his care.
Natsinet thought.
She could read his story in every wrinkle of his face. She’d heard it time and time again. Now that they were old they looked so sweet and innocent, they were so full of remorse and regret and old cautionary tales of misspent youth, but when they were young they raised all kinds of hell. She wasn’t buying it. Too much money had been spent on this one already.
She handed the old man an aspirin and walked away without even giving him a glass of water to wash it down with. Before going to meet Doris in her office, she returned all of the old man’s heart medication to the bottles she had retrieved them from.
Natsinet walked down the hall to Doris’ office cautiously. She wasn’t sure what the old nurse thought about her. Natsinet knew that she was more than capable, in fact, overqualified for her job. But she was a smart woman and extremely self-aware. She knew that she was missing something inside and that some people were able to sense the void in her, the lack of empathy and compassion. Most of them excused it as some type of cultural difference, a result of her African heritage, and she could fake these emotions well enough to fool all the others. Still, every once in a while, she ran across someone she could not fool, someone who saw through her mask of normalcy to the dark emptiness inside of her. That’s all she could think about when she walked into Doris’ office.
Did the old woman know about the pills? Had she seen her give that old man aspirin instead of his prescribed medication? Had someone else seen her and told on her?
She knocked on the door to Doris’ office.
“Come in.”
Natsinet crept tentatively inside the tiny office.
“You wanted to see me? Is there anything wrong?”
“Wrong? Oh no, no.”
Natsinet visibly relaxed. She hadn’t been found out after all. Her mask was still intact.
“Actually I called you in here to tell you what a great job you are doing and to tell you that I’ve decided to waive the normal probation period and send you out on your first full-time assignment.”
Natsinet’s face lit up. She imagined moving into one of the large mansions she’d passed on her way to this home, or maybe even one of the huge estates like the one her mother had grown up in, in Chestnut Hill. She wondered what her room would look like, whether she would be caring for a man or a woman. Maybe it would be some geriatric millionaire who would fall in love with her and leave her all of his money when he passed. Maybe Natsinet would be caring for some businessman’s dying wife and he’d fall in love with her after seeing how well she cared for his family then ask her to marry him after his wife died.
“Have you ever heard of Adelle Smith?”
“Who?” The name sounded familiar. She remembered reading something about a woman by that name in the paper. She’d had a heart attack or a stroke or something.
“Adelle Smith. She was a Civil Rights activist back in the sixties, went to jail for holding a judge hostage in some sort of police brutality protest or something. She just received an NAACP lifetime achievement award. Not for kidnapping judges. She did a lot of work with inner-city kids, welfare reform, equal opportunity and affirmative action programs, stuff like that. Got a lot of the big companies in town to start hiring Black employees. She’s a real hero to many of the people who grew up here. Well, she had a stroke right after she received the award and now she’s practically bed-ridden. She can get around a little with her walker, but she’s partially paralyzed on her left side. She’s coming home from the hospital tomorrow and she’s going to need full-time nursing care.”
Natsinet felt all of her hopes and fantasies come crashing back down to reality. She would be caring for an old Black woman, an activist at that. One of those American Blacks that still blames everything that happens to them on the White man instead of their own laziness and stupidity, waiting around for someone to give them for free what everybody else on the planet has to earn.
“The neighborhood she lives in isn’t the best in the world, but her daughter assures me that you’ll be safe. Apparently, Mrs. Smith is well respected there.”
“What neighborhood is it exactly?” Natsinet was trying her best to hold it together but she could feel her mask slipping as her anger rose. They were sending her into some sort of ghetto to care for some woman who once went to jail for kidnapping. This had to be a joke of some kind, a trick they played on all the new-hires. But there was no humor in the old nurse’s eyes. She was completely serious.
“Mrs. Smith lives in North Philadelphia, right off of Columbia Avenue.”
Natsinet sprang from her seat, startling the old nurse who instinctively raised her arms in front of her face to ward off a blow. “You have got to be kidding me!”
“Natty! Calm down! There is no need for this.”
Natsinet paced back and forth like a caged animal, clearly distraught.
“I thought this would be perfect for you. This family would feel more comfortable with someone their own color and I thought for your first assignment you might feel more comfortable as well.”
“Their own color?” Obviously the woman had not listened to a thing she’d said during their interview or else this was her way of bringing Natsinet down a peg, taking her off her high horse. When she was back in the ER, the head nurse would often make her take care of all the gangbangers that came in, to try to force her to get over her prejudice. It’d had the opposite effect. She’d grown more and more disgusted by them until she’d eventually quit. She’d done other things, too; things that had led to three deaths that she’d never been blamed for. If this woman was trying to force her to confront her biases or prove to her that all people were the same or something, she was wasting her time.
“Look, I’ve already told them about you and they’re excited to meet you. Besides, you’re new and none of my other nurses will set foot in that neighborhood, which means that if you want to work here you will take this assignment. There will be others. We have people coming in here all the time looking for nurses. When you’ve got a little more seniority you’ll get some of the better jobs too, maybe even working for one of those millionaires in Chestnut Hill or Society Hill. We’re the most prestigious hospice in the city, as I’m sure you know. There will be other opportunities.”
Natsinet stopped pacing and plopped back down into the chair in front of the old nurse’s tiny desk. She was still breathing hard, still angry, and she refused to make eye contact with Doris at all, turning her head to stare out the window instead.
“I’ll take the assignment.”
“Good. They will be very pleased. This packet has all of the details of the type of care she will need including her medications and the dates and times for her physical therapy. The daughter’s phone number is in there too. She’s paying for all of this, along with donations from the NAACP and a few charitable foundations, many of whom her mother helped to found.”
Natsinet wasn’t listening to anything the old nurse was saying. All she was thinking about was how to make this assignment as short as possible.
When the phone rang on Doris’ desk and one of the other nurses frantically announced that a patient just had a massive myocardial infarction, Natsinet didn’t even have to hear the name to know that they wouldn’t be spending any more unnecessary dollars on heart medication and arthritis pills.