Moral Hazard (9 page)

Today, while he tore his bread into pieces and rearranged the cutlery and glassware, Chuck enlightened me on the latest advertising campaign. At that time, banks went in for big-picture, pious ads; they’ve since returned to selling products. The tagline for our new campaign:
NIEDECKER BENECKE. BRIDGING THE GLOBE. BUILDING TOMORROW
.

“That’s a bit Clinton-ish,” I said. Bridges were figuring large in White House speeches. This was before Monica, and the prudes of America began their year-long torture of the rest of us.

“He hasn’t got a monopoly on the metaphor.” His tone was warm, but it was a reprimand nevertheless; my opinion wasn’t being solicited. Chuck was invariably good-humored, no matter his message, which is why he was liked. We were accustomed to the dissonance.

From then on, I limited my remarks to “Excellent!” as he outlined Niedecker’s critical role in creating the infrastructure to ready the world for the twenty-first century. Providing financing for schools, hospitals, factories, dams, power plants, highways, railroads. Instrumental in making every nation competitive. I listened attentively, hoping to give the impression that I was a good worker ant, masticating the information, turning it into wads of useful speech material.

After lunch, as he jabbed at the elevator button and bounced on his heels, Chuck asked, “Now, what were the take-aways from our discussion?” A consultant had given Chuck and his lieutenants some management pointers, among which was the advice to get us to repeat in our own words whatever it was they had said, in case we were inattentive, hearing selectively, or plain dense.

“Niedecker is serving humanity, sir. At its beck and call.” We often added “sir” to our verbal communications with him, some of us spiking it with more irreverence than others.

“Please, Cath. Call me Chuck.” Half-smiling, a little irreverent himself. Another jab at the elevator button. And another.

Bailey had a new room: fresh paint, crisp curtains, a view of the East River and Sotheby’s. Prime New York real estate. But when I arrived after work, expecting to find him settled, he had disappeared. I searched. He was in his old room, curled in a fetal position on the bed, which had been stripped to its plastic mattress covering.

I placed geraniums on the windowsill of the new room, bought soaps and lotions, provided colorful patterned sheets, hung his collages on the wall, propped up photographs of his mother, of me. Out the window, I watched the limos and Town Cars arrive for auctions and entertained sour, uncharitable thoughts:
Spend your money, collect the finest. It’s no insurance. You will all end up here, or somewhere like it. In ignominy.

Within weeks of Bailey’s moving to the new room, his legs gave up altogether, making him dependent on a wheelchair. But whenever the chair was produced, he’d ask, “Who’s that for?”

“You.”

“Not me!”

“Your chariot awaits you, kind sir.” Silliness still worked. He’d laugh and forget what had come before.

One day he pointed at his name on the door to his room and said, with great satisfaction, “An advertisement for me.”

The next day, when we passed a linen trolley covered with a blue tarpaulin, he said, “A baby elephant lives in there.”

“Really! That’s interesting,” I said.

Later, I told Evangeline about the baby elephant, expecting her to smile. Instead, she became thoughtful. “In the middle of the night,” she said, “one of the ladies comes out into the hall and makes a ruckus. It sounds just like an elephant.”

One of the stops on our perambulations was the home’s chapel. Neither of us was Catholic—Bailey had been brought up a Quaker, and I, Church of England—but the chapel was quiet, and its stained-glass windows pretty. We’d sit near these windows, and I’d remember for him his childhood in New Orleans, our friends, our life together.

At Easter, Christmas, and important saints’ days, to demonstrate my willingness to be part of the community, I took him to services in the chapel. The nuns would form a processional and walk down the aisle, giving their all to a hymn. Not a measured step among them. They tottered, lolloped, sloped. Some were round as toby jugs, others slight as sparrows. None could hold a tune. (Somehow I had thought that an ability to sing, because nuns did so much of it, was a requisite for taking the veil.) I loved them for it. And for their ready acceptance of Bailey and me.

Navigating the bureaucracy of the home required the same skills I was honing at Niedecker. The nuns were the administrators. In this role, tough cookies. Under them, in descending order, were doctors, nurses, aides, cleaners, with the ancillary staff—social workers, therapists, nutritionists—forming a caste of their own. An unbending hierarchy wasn’t the only similarity to Niedecker. At meetings about Bailey’s care, held every few months, the staff used the same language as my managers. They strategized, prioritized, everybody had to be on the same page. Heck, I just wanted the aides to wash between Bailey’s toes, monitor his bowel movements.

The nursing home was an Augean stable. Anyone with extra dollars hired a private aide if they wanted one-on-one attention for their “loved one.” Now that he was in a wheelchair, I followed suit. He refused to cooperate with the first two I hired, glaring at them, sullen and refractory no matter what the inducement. Then I found Gwen. My age, Jamaican, she intuitively knew how to treat Bailey, according him boundless respect, swaddling him in affection. Her easy empathy matched Bailey’s own. I often thought, watching Gwen, he should have married her and not me.

If it was sunny, Gwen took Bailey outside, to the East River or to an ice-cream store; if not, she found some activity in the home to distract him. If lunch was unappetizing, she wheeled him to a neighborhood coffee shop and fed him there. Gwen patronized Victoria’s Secret, so they sometimes dawdled amid the store’s lacy negligees and satin bras. She washed his clothes and linen, made sure he was always clean, his diaper fresh. “Girl, I’m here to give you peace of mind,” she’d say.

I like to remember them having afternoon tea in his room, eating chocolate chip cookies, watching Oprah, companionable as spinster sisters. Their TV viewing was often interrupted by the latest news on the Monica Lewinsky scandal, in full swing by this time. Gwen was an ardent fan of President Clinton, as were all the aides. He was
their
president. She didn’t mind explaining to him for the umpteenth time what was happening. Bailey listened closely, pretending great interest but completely baffled. Then she shared with him her opinion that Clinton was being a man, no reason to get all heated up. Uncomprehending but vigorous agreement from Bailey. Expressions of disgust for Kenneth Starr and speculation as to what
he
did for kicks. Wide grin from Bailey.

Gwen had allergies. Her eyes reddened, she snuffled and sneezed. Seeing her like this caused Bailey to cry and fret. “She’s sick,” he would say to me, solemnly. “Is she going to get better?” We tried to tell him it was only allergies but couldn’t dispel his anxiety. He broke his cookies clown the middle, proffering half to Gwen. Ate only a little of his ice cream and then handed it to her. Spooned some of his lunch into the aluminum cover that kept it warm and wordlessly pushed it toward her.

Now, when I came to the home after work, instead of fussing with the one hundred and one things his care entailed, I could sit quietly with him, watching the news or reading to him, usually poetry. If he didn’t understand, he enjoyed the sound of my voice. There always came the moment when I had to leave. I’d learned to lie or else risk anger or tears. “I’m just going out,” I would say, “to get something to eat. I’ll be back in a few minutes.” When I returned the next day, he would clap his hands in pleasure. Sometimes, though, he would start crying, tugging at me, a five-year-old with his mother: “Where’d you go? This is
our
house.
Our
apartment. Where’d you go?” Or, his voice loaded with meaning, he’d asked, “When are we going to be husband and wife again?”

On the way home, I’d catch myself watching people hurrying along the street, preoccupied, places to go, missions to accomplish. Whatever their purpose, momentous or mundane, I envied them.

Looking over what I’ve written about Bailey in the nursing home, I realize I’m giving you the pathos of the situation, not the awfulness. A sanitized version: Alzheimer’s sufferers say the darndest things. I want you to think of Bailey as sweet, as straining with all his being to keep his dignity, to stay true to his personality. Yet, as the illness advanced and his medications became less effective, there were days when he seemed to say, in effect, screw sweetness, screw dignity. Days when neither Gwen nor I nor anyone at the home could go near him. Days when he was barbarous, his room bedlam. Days when we shut the door and allowed him to remain filthy, unfed. Days when he spat, swore, snarled. Days when he smeared excrement on the wall, played with it. Days when he was black with paranoia, his mind coiled, suspecting even the vegetative residents of God knows what. Days when he inhabited a dim cave where the regrets, frustrations, and sadnesses from his life flew in skirling circles, clicking and squeaking, brushing their wings against him. Days when his face became sunken, hollow, his eyes feverish and haunted—a death’s head.

“They can’t do this. I won’t be able to pay my rent.
Half
my income goes on rent. This is New York City, for chrissakes.” I was in my office, on the phone, shouting at an eldercare lawyer. His name was Arnold Krooks, and he charged $400 an hour. When I hired him, I had found his surname amusing. Not any longer: I was in a bureaucratic vise. I could not afford a nursing home without Medicaid; not many can. On the other hand, to have Bailey placed on Medicaid, the law required that I, the “spouse in the community,” be pauperized. (Unlike “strategize” or “incentivize,” “pauperize” is a real word. And a real government policy: To impoverish.) I had no assets, no savings, only my income, and the Department of Health wanted half of it.

“You have to be patient and wait for a hearing.”

“What are my chances?”

“I can’t predict that.”

“If they take half my income, I won’t be able to afford pantyhose.” Persiflage.

“They might take your age into account, the fact that you’re still working. We just don’t know. Most of the spouses in the community are in their seventies or eighties. They’re not geared for someone like you.” My office door was closed, but through the panel of glass next to it, I could see Hanny circling. He had the instincts of a vulture.

“So it’s okay to pauperize a woman in her seventies? I knew the American healthcare system was fucked up, but
this
fucked up? Sorry. I swear when I’m upset.”

“I noticed. Look, the Medicaid assessors used to have a heart. But people abused the law, passed all their assets to their children. So they’re cracking down.”

“Pauperize. It’s more like pulverize.” I glanced around my office. Piles of reports and presentations on every surface. The firm spewed these publications: countries and industries quantified and enumerated, predicted and forecasted, every which way. Bankers buried their heads in this stuff like proverbial ostriches or pulled it up over themselves like a down comforter, even though the methodologies and biases involved didn’t bear thinking about. The material dated so fast that I requested a mini-dumpster every few months and threw it out. I kept only my dictionaries of famous quotations and joke compilations. They were perennial and indispensable, especially the golf quips.

“Out of curiosity, what will you do if you are unsuccessful at the hearing?”

“I’ll leave my job. Then there won’t be any income to halve. Or I could tip Bailey into the East River. No need for Medicaid then.”

He ignored my sarcasm. “Would you do that? Leave your job?”

“Absolutely. What’s the point? I only took it to see us through this.” With the door closed, my office was stifling. Through some quirk, I only got air if the occupant of the office two down from mine left his door open. I glanced up at a piece of tape I had attached to a vent. I monitored it as a farmer watches the horizon for rain. Nothing. Not the tiniest flutter.

“Good. If that’s what you’d really do. I’m asking because we’re looking for a case to test the policy. You fit the bill.”

Just what I wanted, to be a test case for the state’s Medicaid laws. At one time, in another life, I would have come out fighting, but I didn’t have the energy, and that, of course, was what Governor Pataki, Mayor Giuliani, and the Department of Health were counting on. The Job’s wives among us don’t have the time to brush their teeth, much less take on the government, and I was no different. I wanted only to make Bailey as comfortable as possible. I didn’t want to crusade.

Hanny rapped on my door. I signaled for him to go away. “Arnold, if I lose, I’ll have to fire Gwen.” An image came to mind from the home the previous night: Gwen and I changing Bailey’s diaper, Gwen on one side of him, me on the other, levering him out of bed and into a standing position, letting him support himself on the back of a chair, then briskly performing the task. Bailey stared straight ahead, firming his chin. After he was settled, Gwen asked me, not for the first time, if her hourly rate could be increased. Her goal in life was to raise the down payment on a city-subsidized apartment in the Bronx: “I want to make something of myself. Like
you
, girl.” If it had been in my power, I would have given her the pot of gold
and
the rainbow. As it was, I felt as if I were being squeezed from every quarter.

“We’ll cross that bridge when we come to it.”

Hanny kept up his rapping. “I have to go.”

“Try to put this out of your mind.”

“I’ll try.” Fat chance.

I opened the door. “Everything all right?” asked Hanny, oozing solicitude, prospecting for weakness.

“Fine. Couldn’t be better.”

Mike and I were discussing Horace.
Everyone
was discussing Horace. He’d been elevated to president. Next stop: Big-Toe-dom. The firm convulsed, disgorged the also-rans, realigned. Chuck, Bart, and Hanny closeted themselves to read the tea leaves. They’d been happy to leave Horace to me, figuring I’d get chewed up and spat out, but all that now changed. They would throw themselves in his path, high risk or not. My outlook was dim; those boys could ace me in the same time it took to sneeze. As to Horace’s opinion of them, I had no idea. When I ventured something mildly disparaging about Chuck to gauge his reaction, Horace remained silent, although he did raise an eyebrow a fraction at my indiscretion. Of Hanny, who could try the patience of a saint, he merely said, from time to time, “
Unhelpful
man.”