The Making of a Nurse (4 page)

“I think Willie DeGroot prefers the company of women, if you know what I mean,” Dad told my mother with a wink, after the first appointment.

My mother put her trust in her. “I’ll do whatever she says. She’s the one who will help me.”

“You can’t do better than Chief of Neurology at a world-class
horse pistol
. Dr. DeGroot is the head honcho! Now, I’m all for Women’s Lib, but it does take some getting used to.”

Sometimes I took my mother to her appointments by myself. We went through the same routine at each visit. First, I would hand over to Dr. DeGroot the clipboard with all the charts my father had set up for me to log my observations of my mother’s condition. The doctor would glance at them while my mother smiled at
her coyly, as if by ingratiating herself she would be rewarded with a better diagnosis. Then I was expected to stand back and let her struggle solo through the rest of the exam. I felt like a traitor, as if I were letting her down. I was used to covering for her but now, in front of the doctor, her infirmity was exposed. From time to time, I lurched forward to offer my arm, but Dr. DeGroot waved me away. At the doctor’s request, my mother took ten steps forward, ten backward, tried to hop on one leg, swung her arms over her head, scissored them at her sides, clapped her hands, one, two, three, sat down in a chair and then attempted to get up out of the chair by herself. She performed these actions with weak and faltering motions as if moving against resistance, like she was pulling her limbs through water.

Once, Dr. DeGroot brought in medical students to observe this interesting case. “Now, I will demonstrate the Babinski reflex,” Dr. DeGroot said. She used a key to gently scratch the soles of my mother’s bare feet. “Can you feel that, Mrs. Shalof?”

“I’m not dead
yet.”
She rolled her eyes and smiled at the students, who appreciated her joke.

Dr. DeGroot went on to check her reflexes, her handgrips, tongue muscles, eyebrow movements, and her ability to identify samples of peppermint, lemon, and vanilla. “Testing the twelve cranial nerves is an essential part of a complete neurological examination,” the doctor explained.

I thought of offering them the useful mnemonic my father had taught me to help remember those cranial nerves: “On Old Olympus Tiny Tops, a Finn and German Viewed Some Hops,” for olfactory, optic, oculomotor, trochlear, trigeminal, abducens, facial, acoustic, glossopharyngeal, vagus, spinal, and hypoglossal. (He told me a racy version, too: “Oh, Oh, Oh, to Touch and Feel a Girl’s Vagina, Such Heaven!”)

“Now, Mrs. Shalof, I want you to write something for us.” She handed her a pen and paper.

“What shall I write? A sonnet? An epistle? My last will and testament?”

“Anything will do. Why don’t you make a list of your daily activities?”

The way my mother picked up the pen and positioned herself on the chair I saw immediately that she had become Tatiana, composing the letter to Eugene Onegin in Tchaikovsky’s opera. Dr. DeGroot took a look at the page and passed it to the students, who nodded. “Micrographia,” she said gravely.

Bingo! A point scored in the diagnosis game!

Dr. DeGroot explained to the students the complex process of examining the mind. “First, establish the patient’s level of consciousness. It is the most sensitive indicator of neurological status. Then, observe whether the patient is alert, drowsy, confused, stuporous, or comatose. In a true coma, if you lift the eyelid it will gradually cover the eye. In a hysterical coma, the eye rapidly closes.”

My mother blinked a few times to demonstrate that she was experiencing neither type of coma.

“Now, we will perform the functional inquiry to examine cognitive function. In other words, speak to the patient.” She turned to the subject at hand. “How are you today, Mrs. Shalof?”

“Ever so much the better for your asking, Dr. DeGroot.”

“Mrs. Shalof, can you please tell us in which direction the sun sets?”

I saw how desperately she wanted to give the correct answer, but was either confused or simply didn’t know. She looked at me helplessly. Behind the doctor’s lab-coated back, I mouthed the answer, but she had looked away.

“I always tell my children, don’t let the sun set on your anger. Resolve your differences before the day is done.” She saw from the doctor’s frown that that wasn’t the desired response.

How could she not know that the sun sets in the west? She knew every word of La
forza del destino
and could name every aria that Renata Scotto had sung at her La Scala debut
. Sometimes I wondered if she was playing a game. Perhaps the joke was on us?

“Please count backwards from one hundred by threes, Mrs. Shalof.”

“Higher mathematics has never been my strong suit.”

Dr. DeGroot went on to check “expressive functions” by asking her to use words in a sentence, first
apple
and
donkey
, and then
microscope
and
guillotine
. When she got to
chattel
and
amanuensis
, my mother’s energy flagged and her voice began to fade. We could hardly hear her.

“Now, I will test the patient’s abstract reasoning,” the doctor explained. “Mrs. Shalof, what does ‘people who live in glass houses shouldn’t throw stones’ mean?”

Despite her fatigue, she sat up tall and tried her best. “It is a parable about resolving conflicts peacefully. It is never necessary to resort to violence.”

“What about ‘a rolling stone gathers no moss’?”

“Oh, the Rolling Stones! I can’t stand their moaning and caterwauling. They are ruining their vocal cords. Oh, let’s see. It’s about discipline. Stay true to your dreams and you will succeed.” She looked up hopefully into Dr. DeGroot’s stern gaze. “Perhaps this is all a dream and there’s nothing wrong with me. Is that possible?”

“You most definitely have a degenerative neurological condition.” Dr. DeGroot washed her hands at a little sink and ushered us to the door. On the way out, I glanced back to see what my mother had written.

THERE WAS ANOTHER
occasion when my father asked me to go with my mother to her appointment because he had a business meeting. Again, Dr. DeGroot put my mother through her paces. Afterwards, the doctor stood washing her hands and looked back at us in the little mirror over the sink and said, “You may get dressed now, Mrs. Shalof. I have arrived at a diagnosis. Please wait outside until I call you back in.”

My mother turned to me to dress her. For the examination she had worn a paper gown that flapped open at the back and a pair of floppy paper slippers. As I put her clothes on her and zipped and buttoned everything, I pretended she was a doll and we were playing dress-up. We went out to the waiting room, where there was a television on that no one was watching. The Watergate investigation was underway and it was on all the time, for weeks now, non-stop. “Let’s stay here and watch this. It takes my mind off my own problems.” She pulled at my sweater to bring me down to sit beside her. “Those guys are in worse trouble than I am.” We sat watching and after a few minutes, Dr. DeGroot called us back in. I offered my hand to help my mother out of the chair, but she wouldn’t budge. I tried to pull her up. Her body was a tug of war between us.

“Come on, Dr. DeGroot wants to see you again.” I yanked on her arm. “Come on! Get up!”

“You go. Come back afterward and tell me what she said.”

“Where is your father today?” the doctor asked when I returned to her office.

“He couldn’t make it. He had a meeting.”

“Well, you seem very grown up for your age. What are you, about thirteen, fourteen?”

“Twelve.”

“You have a very close relationship with your mother, I can see that.” She looked sad, which seemed her way of being kind. “Your mother is a fascinating case. Sit down, Tilda.” She pointed to a chair. “She has a serious brain disorder that is uncommon in a woman in her mid-forties. It is likely a sequela of an infective encephalopathic process that manifests in Parkinson’s disease. In addition, she exhibits a number of concomitant components of motor neuron disease and cognitive and psychiatric derangement.”

It sounded bad, though not nearly as bleak as when Dr. Ben Casey closed the patient’s chart and sadly walked away. “Is it contagious?” I asked.
It felt like it was
.

“Of course not, but her condition is unusual. I will be publishing an account of her case history in the
Annals of Neurology
. Your father can read it in the next issue. Now, she’s not too far gone yet, but she will get much worse. There is no cure, but there are medications for the symptoms and promising new developments on the horizon. Now, go out there and tell your mother what I’ve just told you and if she has any questions, bring her back.”

What could I make of that mumbo-jumbo? At least it wasn’t like when Dr. Ben Casey dropped a bombshell of “subarachnoid hemorrhage” or “astrocytoma, malignant, inoperable” and from his hard-set expression and dark eyes, you knew it was game over.

I went back out to the waiting room. The television flickered and the investigation droned on. The sad, grim faces of the Watergate men loomed large on the screen, reflecting the miserable faces of the patients sitting around the room, also worried about their fates. My mother was staring at the screen, still sitting in the chair where I had left her, her elbows cradled in her hands, held close like someone might take them from her. I thought about turning around and running away, never to return.
What if I leave her here? She’s too much for me. I can’t handle this!
I went over to her. Her eyes stayed fixed on the
TV
set as I repeated the doctor’s words, but with a more upbeat delivery. She turned away and it looked as if she was crying, but there were no sounds or tears. “Are you okay?”

She shook her head, part yes, part no. “Dr. DeGroot said that with certain conditions, patients are not able to produce tears. I must have one of those.” She wiped her face of tears that weren’t there. “But believe me, it doesn’t mean they don’t cry. You can cry without tears. I can vouch for that.” I sat down with her to watch the defendants with their shamed faces getting grilled about their devious activities. We laughed at the earnest men, their implausible alibis, and their circuitous explanations for obvious wrongdoings.

“And I thought
I
had problems,” my mother said, and we laughed even more.

We sat in the waiting room until the Commission broke for lunch. I helped her up out of the chair, and she leaned into me. “My nerves are shot,” she said softly. We walked slow, tiny steps to the subway station, my mother clinging to me every inch of the way. As the train roared into the station, she held on even tighter. Suddenly, she swayed forward and I reached out to pull her back from the edge. “Don’t worry, I won’t jump. I can’t even whip myself up into enough of a frenzy to commit suicide.” She sank into the nearest seat on the train and pulled me down beside her.

“We’ll be home soon,” I told her.
Please wait until we get there before falling apart!

She cuddled my arm and stroked it like it was a kitten. As soon as we got home she was seized by a bolt of energy. She pushed me aside and marched ahead, still in her coat and boots. She went into the den where there was a hi-fi stereo and a metal rack filled with record albums. She flipped through them and grabbed Maria Callas singing Norma and Leontyne Price’s Aïda. She pulled each album out and cracked it over her knee. The brittle seventy-eights broke easily, but the flexible
LP
s required more force. She looked odd, standing on one leg, the other bent up high, like a flamingo.

“Don’t break your records!” I pulled the pieces from her hands.

“Life is nothing to me if I can’t sing.”

“But Dr. DeGroot didn’t say you wouldn’t be able to sing.”

“What does that numbskull know about music?” She plunged her face into her hands. “I can’t bear to listen to great voices and be reminded that I can no longer produce my best. What is more pathetic than the artist who can no longer perform? I might as well be dead. Will you find a way to kill me?”

I took her hand, like Dr. Ben Casey’s Nurse Wills did with a patient after surgery. It might be “curtains” for the patient, but the nurse always stayed at the patient’s side, even after the doctor left the scene. I put my mother to bed, imagining myself as part of a long tradition of noble caregivers who kept vigils at the bedsides of the infirm. I was Jo March from
Little Women
, who waited all night for Beth’s fever to break, but by morning Beth was gone.

“I feel better when you’re with me.” She snuggled up close.
“Don’t go to school. Stay here. I need you more than that silly old school.”

“What do you mean? Not go back? Quit school?”

“Why not?”

“It’s against the law for one thing. I have to go back. I’ll never catch up. I’m missing everything!” The only other kid I knew of who didn’t go to school was Pippi Longstocking. I turned the
TV
on to keep my mother company and went downstairs to wait for my father to come home.