I am Introduced to a Valuable Nursing Skill: How to Place a Plastic Bag in a Trash Can.

Chapter 5/ 2007

I am Introduced to a Valuable Nursing Skill: How to Place a Plastic Bag in a Trash Can.

Much to the displeasure of the straight boyfriend, my balls have shrunk to their normal size.  The bottle of Vicodins waits on the shelf of my medicine cabinet should the balls swell up again and bring the nausea inducing pain back.  I have charged the month off work to credit cards, covering their unyielding demands for minimum payments with the scratch I make doing insurance interviews.  A few twelve hour shifts a week and I can start paying the principal down.  The realization that–on top riding the perfect storm of having to shell out more for groceries, bills, gas, car repairs, co-pays and deductibles–my rent was just raised causes my intestines to coil into knots which only hours of sleep can unwind.

I am assigned by the agency on Sunset to weekend shifts caring for another man with Lou Gehrig’s.  Driving to the case for my first shift, I get lost in Century City and use the last of my cell phone minutes to call for directions.  A voice mail recorded before my patient was trached and put on the ventilator picks up, a deep languid voice with a hint of the bad boy insists I leave a message.

My patient’s exhausted wife opens the glowing yellow door to their home.  She is in her early thirties, dark eyes, long stringy hair, skinny, haggard but stunning, nevertheless.  Pottery Barn and Bombay Furniture have colonized the young couple’s living room, kitchen, den and bedrooms.  Bits of Crate and Barrel are scattered throughout, interspersed with hints of Target and Pier One.  Each room’s walls are painted a different shade of hunger inducing chocolate.

“My fear is his trach will come out when the dog jumps up on the bed,” the wife tells me as she staggers down a hallway whose darkness makes me feel like I am sliding down the descending colon of Nursing Hell.  “Sometimes, the alarm doesn’t go off when the trach disconnects.”

The wife brings me into the den, turns on the miniature flat screen and hands me a notebook, between whose sea foam green covers lie her profoundly thought out and lovingly researched treatise on life amidst the chocolate walls with her hedge fund manager husband.  It is like reading “The Secret” for people who can no longer manipulate the financial markets.  Each laminated page is illustrated with brilliant sunsets or melancholy half-moons.  The wife postulates that caring for her husband will transform his caretakers into spiritually connected human beings, glowing with a vitality whose lightness will bounce off the shadowy walls.  I read about how tending to this master of the universe will teach me what love is.  I knew what love was when I sat up until dawn with my own friends as they lay dying.  I am fifty-five, but I still have that to give.  All the love buzzing around Century City can not explain why, for the past year, the wife has been unable to fill the weekend shifts.

Like a silent submarine, the happy couple’s bone white Akita enters the room and devours my morning yogurt in one wet swallow.


“Why do you keep coming in here?” the wife asks.

She is sleeping on a small bed next to her husband, who is on a queen sized bed, propped up on two pillows.  As with the professor, the only functioning muscles left in the bad boy’s mid-thirties body are attached to his eye balls.  To the right is “Yes.”  To the left “No.”  Bad boy’s massively bloated gut is dripping a thin orange fluid onto the flannel Bed Bath & Beyond sheets, the veins beneath the stretch marks on his abdomen are swollen blue with anger.  If the Akita hits the bed, I fear my patient’s body will explode.  In my thirty years of nursing, I have never seen anything like this.

“I like to check every fifteen minutes to make sure the dog didn’t mess anything up,” I tell the wife.  “He ate my breakfast so quickly.”

“He’ll do that.  Don’t come in here for anything until we’re both awake.”

The wife does not open her eyes when she talks to me.

“Don’t ever come in here without Purelling your hands,” she says.

“Got it,” I respond.

Her husband’s yellow waxy skin is not covered with a sheet or blanket, but at least he has his tighty whities on.


A caretaker, who I’ve been told by my denim jacketed Nursing Supervisor is supposed to assist me, arrives at noon.  He is late.  He never once arrives on time.  The still sleeping couple hired him off of Craigslist to help out before the paralysis, trach, G tube and vent came on board.  Before he came into this home, the caretaker had no patient care training under his thick leather belt, no experience caring for anyone, not even a boundary challenged Akita.

“How about you and his wife orient me this weekend?” I ask the caretaker.  “It’ll be great to have someone to work with…so much easier to move a man like him around.”

“It’s all about taking care of him,” the caretaker says.  “It’s been so hard to find a nurse who fits in here.”

Blonde, blue eyes, tanned skin, pale pink lips.  I have trouble looking at the caretaker at first.  Good health, strength and defined muscles breathe through his jeans and V neck tee shirt.

Then the caretaker opens his mouth.  He opens his mouth a lot.

“You Americans are so lazy,” he says after eating his breakfast at 1 PM.

He follows this statement with his afternoon nap.

“You Americans are so shallow,” he whines after discovering the wife has not TIVOd that week’s “American Idol” for him.

“You Americans are so devious,” he says, sucking on a big red strawberry.

The caretaker is as easy to read as the wife’s Oprah inspired musings, his story is that he was brought to California by an American woman he hooked up with in Europe.  His plan is to move back home after he completes his studies as a Doctor of Acupuncture and Oriental Medicine.  The next day I suss out he is planning to skip out on both his hookup and the student loans financing his education.

The caretaker has many questions.

He starts asking them on day two:  “Why do you ask him if he wants a pain med before you give it?”  “Why ask if the pain med worked?”  “Why do you tell him what you’re doing before you do it?”  “Why do you look him in the eyes when you talk to him?”  “Why do you ask him if he likes the music playing in his room or what’s on the television?”

I have my own question.  On both days, I have watched the caretaker shoot, in rapid succession, two cups of hot coffee, two glasses of ice water and a nutrition shake into our patient’s G tube with a pistol syringe.  The caretaker accomplishes this in less than two minutes.

“Let me understand this,” I begin.  “You jam this stuff into his stomach even though he can’t taste any of it?”

“That’s the morning routine,” the caretaker answers.

My gut twists, but I do not volunteer that it is late afternoon on what had been a cobalt blue sky day in the City of the Angels.

“What do you mean he can’t taste it?” the wife asks.

“Your husband’s taste buds are in his mouth, not his stomach.  All he’s getting is a feeling of fullness and the sensation of hot and cold.  Could explain why he’s bloated and passing so much gas.”

“He can’t taste it, he can’t taste it,” the wife repeats.

The wife looks at the caretaker, her eyes tearing up.  The caretaker Purells his hands and notes the shake on the flow sheet taped to the bedroom door.  I add the coffee and water and initial that he administered all three.

I Purell my hands and announce to my audience:  “This sheet is a great tool for us.  Since we’re all working together, let’s each write down what goes into him.  That way he won’t get something twice.  I’m real old school with this type of thing.”

The wife and caretaker stare at me.  Their eyes, which soon stop looking into mine, blink uncontrollably.

My gut quiets down as I continue:  “I’ve noticed that his narcotics and tranquilizers are being given quite frequently…and way too close together.   This sheet can help us keep on top of his meds, we wouldn’t want to overmedicate him.”

The wife grabs the half full Purell bottle.

“That’s what happens when you have a Virgo in the house,” I say to the wife as she massages the clear goo into her hands so vigorously her huge diamond engagement ring cuts into her palm.


Later that afternoon, the caretaker asks me another question:  “Have you ever been to my country?”

He has tuned in yet another program on the flat screen without asking me if I want to watch it.  Which is fine, I did not come into this house to watch television.

“I kind of avoid Germany when I’m in Europe,” I answer.  “Most of my family was killed in Bergen-Belsen.”


The soon-to-be pin puncturing doctor catches on quick.

On the Saturday of my second weekend on board the Lou Gehrig love express, the caretaker arrives at two in the afternoon and reads the flow sheet before eating his strawberries or changing the channel on the flat screen.  Without taking a break to eat fruit, watch television, drink coffee or take a nap, I have completed the entire day’s work by nine in the morning.  The caretaker stops smiling, but he does not stop talking about the deficiencies he observes in every American he encounters.  He rambles on and on about how “You guys” expect so much without being willing to work for it.  After his nap on Sunday, the caretaker, the wife and I sit at the kitchen table perusing the Sunday papers.  The caretaker Purells his hands and makes coffee.  He and the wife drink from their steaming mugs without asking if I want one.  I don’t.

For the next three weekends, every time I get up from the couch and move in the direction of either the kitchen or bedroom, the caretaker glides past me with the agility of Roger Federer running to lob a ball over the net,  always making it to the kitchen before I do, where he proceeds to prepare the next scheduled medication or feeding.

“I’ve been assigned here to do certain nursing tasks…sit down, relax…there’s more than enough work here for the two of us,” I tell the caretaker at least once a shift.

He eyes flash light.  He Purells his hands and eats any variety of fresh fruit.  He never answers me.


I bypass the Nursing Supervisor and call the head of the agency to get advice on how to deal with the caretaker.

“Observe and record,” she says.

“Isn’t this against the law?  Him handing out narcotics?”

“We don’t want to upset the way their household functions,” she answers.

She puts me on hold.  After a ten minute loop of Nazi composer Carl Orff’s “Carmina Burana,”  I hang up.


I ask the wife what I am supposed to be doing in her home.  She Purells her hands, reloads the CD player and smiles.

“You’re my right hand guy,” she answers.

I would not want to be either of her hands.  Every afternoon, she and the caretaker hoist her naked husband up on the Hoyer lift.  She positions herself below her husband and, with her bare unPurelled hands, disimpacts him of large amounts of stool.  The wife does this every afternoon for a half-hour to an hour, as Elliott Smith and John Mayer sing heartbreaking ballads from the bedroom speakers.

I watch in silence, thinking:  “Wait till the boyfriend, with his various anal issues, hears this one.”

Knowing in my gut that I am nearing the end of my run walking the intestine like hallways and tired of watching the wife’s knuckles going into her husband, I move into the den to sit on the couch.         I wait to feel the breeze blow on my shoulders.  The curtains covering the open sliding glass door a few feet away move gently as the air hits them, it has been weeks since the air touched my skin.  The Akita slides in and eats the caretaker’s strawberries and melon slices.  I should laugh, but my gut will not let me.  I can not react to anything the way I did a month or two ago.  I have not thought about writing since escaping the crone and becoming trapped between the pages of the wife’s sea foam green notebook.  The air of the City of the Angels refuses to caress me.  I want that more than the straight boyfriend’s lips on my neck.

Lucky man, the rent is getting paid, I’m buying healthy food.


On my last weekend of the bare knuckle vaudeville show, the night nurse informs the caretaker that I have been documenting on both the nurse’s notes and the medication sheets that he is giving the meds and doing the treatments.  Awakening from his after lunch nap, his sensual lips ask me why.

“You’re talking to me today?  Shocker.  Your story is that you’re in acupuncture school?  You must have some sense you’re breaking the law administering big time narcotics without a license.  Bottom line is I’m not going to jail because you’re pumping this guy full of controlled substances without bothering to ask if he wants them.  At least try giving them at the right time.”

“You Americans are so dramatic.  What could happen?”

“He could overdose.”

“He’s on a ventilator…he can’t stop breathing.”

“Right, he’ll be a brain dead guy the vent breathes for.”


Having my own gut problems, I skip the afternoon’s bowel show to fold the laundry.  In the bedroom, the wife and the caretaker perform the nursing work I was hired to do.  I place folded towels, sheets and underwear on the creviced surface of the dining room’s faux antique table.  I return to the den, where the breeze fondles the curtains, but not me.  Uninterested in the flat screen, I watch the caretaker standing in the dining room.  He shakes his head, his hair falling over his shining eyes, his long fingers picking up the wife’s red thong from the top of one of the piles of lavender smelling laundry and snapping it against her nicely curved butt.  The wife turns around and looks up at his face, her fingers lightly brushing his hair away to get a better look at the deep blue pools of his peepers.  The two smile and move closer to each other.  They are pure white against the darkest wall in the house.

So, that’s the deal.  I close the door between us.


“I need to show you the right way to put a plastic bag in the garbage can,” the caretaker tells me an hour later.

I brush the hair off of his face.  I stare up at his eyes.  I take a good look.  I understand the wife’s attraction to him, he possesses the stuff us lesser mortals make sacrifices for.

“No way in hell,” I say.

I pack up my books and what is left of my food for the trip home.  I am in a rush, tonight is the final episode of “The Sopranos,”  I’m leaving early to watch the East Coast feed.

“See you next weekend,” the wife says.

“No way in hell,” I repeat.

I open the door.  My car, shining pools of red light, is waiting for me at the curb.  I turn around and walk to the dining room table.  I Purell my hands.

“You know this stuff is totally useless against really deadly viruses,” I say.

The wife and the caretaker take a step back.  I walk out.

Lucky man traffic-wise, I get home in time to catch “The Sopranos” finale, its blackout ending less elusive than my attempts at landing an upright gig, a downright ongoing  job.


Leave a comment

Filed under Memoir, Personal Essay

Leave a Reply

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out /  Change )

Google+ photo

You are commenting using your Google+ account. Log Out /  Change )

Twitter picture

You are commenting using your Twitter account. Log Out /  Change )

Facebook photo

You are commenting using your Facebook account. Log Out /  Change )


Connecting to %s