Wednesday Ramblings: Mr. Charlie

 

I'd like you to know Mr. Charlie.

Mr. Charlie was admitted to our facility after a hospital stay.  He reminded me keenly of a man I liked quite a lot.  The only difference was that Mr. Charlie was about 30 years older and of a different ethnicity, but the two men were so similar physically in both build, facial features and in personality that I was always a bit surprised one wasn't the other!  To add to their similarities, they both preferred jeans and a plaid shirt and each man wore a ball cap pushed back from his forehead in the exact same way!  The resemblance was truly uncanny, and I was hard pressed at first not to refer to Mr. Charlie by the other man's name.

Mr. Charlie had sparkling black eyes, a quick and ready smile, a playful deference for the opposite sex and an easy-going manner.  He was mischievous as a child and blithely ignored rules which were meant for others and not for himself.  We had smoking 'times' but I'd often come across Mr. Charlie sitting with his hand held down under his seat and discover he had snuck an extra cigarette and was having himself a solitary smoke.  He always went to the smoking area to do this extra smoking and often had a companion or two he'd bribed to come along with the promise of sharing a cigarette with them, so at first it appeared it was a gentleman's parlor, but there was always just something about Mr. Charlie's manner that told on him.  An extra additional twinkle in the eye or sparkle in the smile?  I can't tell you but he made all my Mama nerves tingle with the knowledge that something was amiss whenever he was doing something that was against the rules.

The truth was, once Mr. Charlie was fully recovered from his time in the hospital, it was evident that he was too lively for a nursing home.  Eventually he convinced me, whom he called "Big Nurse", to act as his advocate and convince the doctors to let him go back home.  Once we were sure he was indeed fully recovered and all his labs said as much, I agreed to go with him to his next appointment and so we went to the doctor's office together.  

I've always felt the very best advocate for a patient is almost always the patient.  Mr. Charlie made an impassioned speech to the doctor, but I could see he wasn't quite convincing enough.  I put in my opinion, asked Mr. Charlie pertinent questions about whether he'd eat properly, who might provide meals, how he'd manage household, personal care, who in his family would be checking on him routinely, etc.  In the end, Mr. Charlie was told he might go home.  We went back to the nursing home and put all the arrangements in place.  Mr. Charlie said his goodbyes with eyes that fairly danced and a grin that nearly split his face and off he went.

About a year later, a call from another nursing home in the county with a request from a patient.  This patient was looking for a staff member he referred to as "Big Nurse".  As it happened, I was the one who took the call from that facility's social worker.  I arranged my schedule and set up an appointed time when I might go out to visit with the social worker, the RN and Mr. Charlie.  

When I arrived, I was given his history by the Social Services Director and RN.  Mr. Charlie had done very well at home for almost a full year but had gotten sick, his health had rapidly declined and he had ended in the hospital once again.  This time, the diagnosis was not good.  He was dying.  He was sent to the other facility by another hospital to end his days.   

Mr. Charlie however, was not convinced. He was not only upset but he had become more than argumentative.  He'd thrown tantrums and generally acted pretty poorly.  And amidst all his raging was the constant urging to get 'Big Nurse' and let her sort things out.

I knew firsthand that the disease that had sapped his strength was already making rapid inroads into what was left of his physical integrity and that had already been severely compromised by his last illness.  His care would be too great for any of his family to handle, even if they had been knowledgeable enough and willing to handle it.   

When I met with Mr. Charlie that morning, I was shocked at the change.  He was a little thinner and a little greyer but not surprisingly so, given his illness.  No, the shock was because the sparkle in his eyes had been replaced by fear and a pleading look, pure and simple.  He no longer had a mischievous sparkle in his eye nor an engaging grin. He shared his frustration at being kept in the nursing home but I could also see that most of all he was looking for reassurance that this thing would go away and he could again return to his normal life.  He wanted very much for ME to believe that he could do this because then it would be so.   

I think he knew, when he looked in my eyes, that this time I could do nothing.  He started to talk once more, but his voice wound down and he stopped mid-sentence.  

He sat looking at me, and I shook my head.  "I can't do it, Mr. Charlie.  You're going to need every bit of the care you'll get here to be comfortable in the days ahead.  No doctor would agree to let you go.  And I couldn't, in good conscience, try to convince him.  I've seen how this disease progresses.  You'll be glad of the comforts you'll have here."  

I was near tears telling him this and I suppose that was what convinced him at last that he'd come to the end.  I saw the fear in his eyes but I also saw acceptance.  He nodded slowly.  " I had another year because of you letting me go home, last time.  And I thought  if anyone could have done it, you could have, Big Nurse.  You could've convinced them if I hadn't been too far gone!"   His confidence in my ability to reason with others on his behalf was touching but I confess I was grieving as I walked out of that room.  

Six weeks later, the social services director called to tell me he'd passed away in the night.  And as I so often did, I sat at my desk and wept.  He lives on in my memory.   Good rest, Mr. Charlie.  Good rest. 

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