I Understand

Alicia Schaffer, MS3, Family Medicine

Nineteen hundred forty-eight. Sixty-four years. I squint through the glass at the spidery cursive, through a thin sheen of dust, through countless hushed memories and the ceaseless tick-tock of the grandfather clock down the hall. A young couple gazes back, austere in their buttoned-up black-and-white best, a hint of a smile playing at their lips. The wheels of the walker are silent on the plush carpet, but the old man’s feet shuffle softly with a muted swish-swish as he rounds the corner. “She’s back in the bedroom,” he says in a tremulous voice that rises and falls with his steps in time with the tick-tocking and the swish-swishing.

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I have a reprinted photograph from 1940 on my desk in a plain wooden frame that I bought for $15 on sale at Target nearly 10 years ago. Before the frame, the photograph lived in the back of a binder full of silly faces and forgotten high school classmates whose names I don’t remember anymore. From behind the glass, my grandparents smile back at me in blurred black and white. They had met a little over a year before the picture was taken. He had seen her in church, where she sang in the choir with a soaring soprano that had earned her a music scholarship. He was in college too, studying science and agriculture, as befit the youngest son of a Missouri farming family, working part-time as a groundskeeper on campus. He would laugh when he told the story, saying he’d never remembered going to church more in his life. In the photograph, my grandfather grins down at the camera, one hand in the pocket of his camel suit, the other entwined with my grandmother’s. She is wearing white gloves with her dark red woolen dress. I remember the dress from my childhood, hanging in the back of her closest in a row of hopelessly glamorous plastic-encased finery from years long past before I had been born. In the picture, she is standing up straighter than I had ever seen her in life, a pillbox cap balanced jauntily on the crown of her head, taller even than my grandfather. She is squinting in the bright August sun, the glare masking the smile that I’m sure was there. It’s hard to imagine the woman who wouldn’t be happy on the day she marries the love of her life.

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The man parks his walker at the edge of the hospital bed occupying the center of the room, carefully setting the brake and positioning himself on the seat. On the end of the bed, a neatly folded stack of well-worn crocheted blankets is piled in an organized riot of goldenrod and olive and burnt orange chevrons, echoing the bygone era in which they were crafted. The early afternoon sunlight filters in through the lowered blinds, and the bottles atop an embossed leather jewelry case on the dresser are filled with light, casting glittering refractions of brilliant topaz and emerald onto the glossy wood below. Faint flecks of gold wink out from the spines of a collection of Reader’s Digests arranged in tidy rows of maroon and brown on a nearby bookshelf. Greeting cards with cheerful renderings of daisies and roses dance in a line in front of a vanity mirror, trumpeting salutations and well-wishes in metallic script. The tick-tocking is left out in the hall, muffled by the cozy warmth inside the room.

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When I was young, I visited my grandparents at their cabin in the mountains at least three times a year. During the summers, my grandfather grew strawberries, stretching thin sheets of black netting over the wire fence and grumbling about the deer and the rabbits and their ceaseless assault on his hopeful harvest. In the house, my grandmother would make lemonade and iced tea that we drank from sweating, frosted glasses on the porch during the warm afternoons. When the strawberries were tended and the deer held at bay by the sunlight and the noises radiating off the porch, my grandfather would come up on the deck and we would play “bones” with a heavy set of ivory ceramic dominoes that went all the way up to nine dots per side. During the winter, my grandfather arose before my grandmother to light a fire in the woodstove and chase the chill from the air before she got up. Every afternoon, summer or winter, she sat for what seemed like hours in a chair against her bedroom door, her chin hoisted upward by the pulley weighted by steel balls on the other side of the door, a thick volume of the most recent Reader’s Digest on her lap, a tasseled cardboard strip marking her place. I would sprawl on my belly with my feet in the air in front of her, poring through dog-eared copies of Put Me in the Zoo and Green Eggs and Ham. On rainy afternoons, she would let me pull the jewelry case from beneath the edge of her bed and dig through the bright baubles and strands of beaded costume necklaces, trying on each in turn and modeling them for her as she smiled at me and assured me that each new look was breathtakingly beautiful.  When my grandfather went into town for twine or more netting or a carton of ice milk, I would sometimes help my grandmother in the kitchen as she mixed and chopped and peeled before dinner. She would sit in a high stool at the counter and I would nestle against her, breathing in the smell of her powdery skin and the perfume from the row of elegant cut-crystal bottles that lined the top of her armoire. I didn’t understand why she had so many different vials. I thought they all smelled the same; they all smelled like her.

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The woman in the bed is impossibly thin, a waifish whisper of the woman she had been, a woman I had never known. Her skin stretches tightly over her skull, her eyes closed, and I have a moment of panic that we have arrived too late. The man reaches out and takes her bony hand, holding it gently between both his palms. “Mary,” he calls softly and pats her hand. She opens her eyes to his voice. “They’re here to talk to you.” We ask about her pain, her bowel movements, her shortness of breath. She nods and responds in sparse phrases. Whatever strength remaining to her has concentrated itself in her voice. It is robust and vibrant, colored with the crisp consonants of the Midwest. She is doing well, she says, she has no complaints. The man strokes the thin, delicate skin of her arm and smiles at her, his drooping eyes lifting upward at the corners in an echo of his upturned lips. We count out her pills, each one clattering into the proper compartment, and scribble down the names of the empty canisters, scooping the radiant, light-filled jewels into a plastic sack for disposal. We listen to her chest in turn, one after the other. She smiles at me and nods as I place my stethoscope gently over her jutting sternum to hear the soft gallop of her heart. I thank her and say that I have enjoyed meeting her, and she smiles again, enigmatic in her understanding of all that I cannot bear to comprehend.

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I was twenty-two years old when my grandmother died at home holding my grandfather’s hand, sixty-four years and six months after their wedding day. I was just one month shy of my twenty-third birthday and had only two weeks left before I completed Basic Training in the United States Army. I had known, of course, that she wasn’t well. Each time I saw her, she spoke less and stooped more, her back, her wrists, her fingers gnarled by illness. But I was young and could not truly fathom life in all of its splendor and sorrow.  I was madly, uncontrollably in love with life and the idea of having a grand adventure. The last time I saw her, she was wearing a green dress, and when she smiled her skin strained like tissue paper over her cheeks, threatening at every moment to tear. Her eyes were tired, but she smiled all the same. I left the next day. I was gone the day she fell on the patio outside, gone when she went to the hospital, gone when she told the doctor that he had to discharge her to hospice that very day because she refused to die in the hospital. The message reached me when she only had a few days left. I called home from the phone in my sergeant’s office, perched on the edge of the chair in the corner of the room. He clasped my shoulder and squeezed it once before leaving the room and closing the door softly behind him. It was the most solitude I had had in weeks. The tightness in my throat was strangling, and I choked on the words as they tried to escape. She told me not to cry, that I would understand someday, that she was going home. I wanted to keep talking, but the words caught in my throat and no sounds could emerge. My mother later told me that the twenty minutes she spent on the phone with me were among her last lucid moments before the end. “It was like she was waiting for you,” she said.

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We follow the man back into the living room and count out his pills for him, too.  It isn’t the standard practice, the nurse tells me, but he doesn’t see the harm. We snap the lids shut one by one. The nurse turns to talk with the man, instructing him to call with questions or concerns, as I scrape the leftover pills back into their respective containers. With the clock tick-tocking behind me once more, I fixate on one of the nondescript tablets, overcome by an inexplicable uneasiness. The pill is the same as one of the woman’s, though hers was a different dose. I roll it back and forth on my palm, contemplating it, and realize suddenly that I dropped one too many tablets into each compartment of her case. I apologize and explain my mistake to the nurse, who is kind enough to thank me for noticing without blaming me for the error. I go back into the bedroom; he stays with the old man. Her eyes are closed again, and I retrieve the rattling plastic case as quietly as I can. I dig the offending tablets out of their slots, shaking them back into their sparkling bottles. The case clicks shut, and I stand to leave, glancing back once at the woman, hoping I have not woken her. She raises her hand off the bed in a silent farewell, smiling faintly before closing her eyes, and I finally understand.