A Really Hard Day

Today is the day we go meet Dad’s new doctor. It’s been over a year since he’s had a check-up. His old doctor has retired and her office told me about a new clinic that’s opened up in town. There are two practitioners in the new office that are currently accepting patients. 

Dad and I drove over there last week and picked up the forms he needed to complete in preparation for his visit. I filled them out as best I could, but there was a lot of information I didn’t have. Much of the paperwork was left blank because he couldn’t recall most of the information they requested. 

I’ve never understood why these forms continually need to be filled out over the course of a lifetime. It seems to me that in terms of medical and family history, filling them out once should suffice. It’s not like the family history will ever change. It’s annoying having to answer these questions over and over. These types of inefficiencies in the human experience drive me crazy. But, I digress. 

I tried to drop off the papers last Friday, but the new office is only open Monday through Thursday. I can always tell how well I am managing my own emotions by how these things affect me. It was a minor irritation, but it wasn’t a big deal. I was happy to have an errand to run that got me out of the house without Dad. The 20 minute round trip was a moment of freedom in a day that would otherwise be full with caretaking duties.

What I am realizing is that it’s not the physical labor that takes a toll. Certainly, there’s a lot of work in caring for someone else. It’s the mental and emotional exhaustion that saps me. Constantly thinking about what’s going on with him, his future, the plans that are being made, and what it’s going to take to execute them. The concerns for his physical health and finances. The daily repetition of reminders and conversations that have been had many times before. Explaining things time and time again to him in hopes that he will understand and retain even a small portion of the information. Add to that the requirements of my own life and managing my personal day to day and it piles up fast. It’s draining in ways I didn’t know were possible.

I am looking forward to the appointment this morning. I’ll get to meet his new doctor and sit in on the exam. Through this process I’m discovering just how important clear and objective information is. With Dad’s failing memory and tendency for denial and delusion, getting first hand knowledge is priceless. 

I’ve been up for a while. I hear Dad stirring in his room and check the clock to see what time it is. He’s up with just enough time to fill his thermos with coffee and head out the door. 

I walk into the kitchen to greet him and remind him of our timeline. Surprisingly, he remembers the details clearly. It’s amazing how sobering the past few weeks have been. When I first arrived, moments of clarity like this would’ve given me false hope that maybe things weren’t as bad as I thought. Now, I am grateful for the periods of lucidity, enjoying them as long as they last. Knowing that fuzziness and confusion will soon return.

I go to my room to start getting dressed. I brush my teeth, tie my shoes, and grab a jacket since the morning is chilly. I come into the living room but he’s nowhere to be found. I check the hook where he hangs his keys and see that they’re gone.

This is typical Dad behavior. He’s always had this annoying habit of vacating the building and going to sit in the car when he’s ready to go. He doesn’t tell anyone he’s leaving. He doesn’t announce his departure or wait for you to walk out with him. He waits in the driveway, checking his watch, impatiently drumming his fingers on the steering wheel. He’s done this as far back as I can remember. It almost like he resents the fact that you’re going with him and that he has to wait for you. I always feel like I’m running late and slowing him down. Like if I don’t hurry up, he’ll just leave without me. It’s maddening and I fucking hate it. 

I rush to close the door behind me, realizing that the house keys are on his keyring. This means I’m leaving the house unlocked. It doesn’t bother me, he’s out in the middle of nowhere. It’s not like anything is going to happen. I know it will freak him out unnecessarily because anxiety is always lurking around the corner with him. I project into the future, envisioning the 20 minute laborious conversation I’ll have to endure when we come home and he discovers that the door has been left unlocked. “Fuck it.” I mutter under my breath. “I’ll just deal with it later.”  

I shut the door and walk towards the garage as he’s backing out. He brakes, fiddling with the garage door opener trying to remember which button to push. I open the passenger door, and slide in. He turns to me, his face is half surprise and half disdain. 

“I didn’t know you were coming.” He sounds annoyed. I am instantly peeved. A 1,000 sharp retorts come to mind, but I choose the high road. “I am. I’m going to sit in on the appointment with you today.” 

He’s still wrestling with the garage door opener and mutters something in frustration. I am getting the impression he was looking forward to being on his own this morning. I completely sympathize. I don’t want to be here either, but here we are. 

He finally gets the garage door to cooperate and we’re off. A few yards down the road he begins to make small talk in an attempt to soften his previous saltiness. This is also typical of him. He lashes out in irritation, and then almost immediately begins to retreat in regret. Offering tokens of conversation or humor as a meager attempt at an apology without ever actually apologizing. I’m not having it. I hate this passive aggressive shit. 

“Be a man and either apologize or own your annoyance.” I think to myself. “Be annoyed or be apologetic, but don’t fucking fence sit.” 

My window is currently unrolled and he has the AC on. I notice the side eye he’s giving me as we move down the road. I can tell the window being rolled down is bugging him. I am not sure if it’s because the is AC on, or if he’s just trying to exert control over his environment, but I don’t care. I’m waging my own passive aggressive battle and am not going to roll it up unless he asks. I’m suddenly 13 years old again, sitting in the passenger seat seething with adolescent rage. We continue on for a bit and he finally speaks up. 

“Do you mind if I roll up your window?” 

“Suit yourself.” I reply blankly. 

I notice he’s fiddling with the controls, trying to figure out which one is which, and I immediately soften. 

“Here, let me.” I offer, pulling the small lever in the armrest to guide the window shut. 

We continue down the road, weapons currently holstered, and arrive at the doctor’s office with time to spare.

The office is brand new. When we were here last week they were still hanging the artwork. The waiting room is spartan, but clean. The large bottle in the water dispenser glugs as we enter. The glass window slides open and the receptionist chirps “Good morning!” in a happy sing-song voice. 

We approach the desk and Dad introduces himself. Our arrival is confirmed and we take our seats. He offers small talk, and my annoyance has abated. We chat about this and that, marking time until the appointment. 

A door opens and a young woman with dark hair and kind eyes scans a clipboard before calling out Dad’s name. We rise and proceed towards her. I slow my steps and hang back so Dad can take the lead. I do my best to give him a sense of authority and respect as often as I can. I try not to assume that he always needs my help. I want him to feel independent whenever possible. He struggles with the heavy door and I reach from behind to hold it open. He follows the assistant cracking jokes and smiling. Even though he perceives himself as an introverted loner, he seems to crave interaction. Almost anytime we go anywhere, he lights up and engages in conversation with anyone who is willing. 

We slowly make our way through the small maze of doors as Dad shuffles along. The examination room is organized and bright. The medical assistant motions for Dad to sit on the edge of the exam table. The paper crinkles and crackle as he sits. I find a chair at the end of the small counter next to the door. Melanie introduces herself and begins to flip through the paper work from earlier that week. She explains she’s going to take his vitals and has a few more questions before the doctor arrives. She fills in the blanks in his medical and family history. I like that she addresses him directly. It makes me uncomfortable when people speak to me like he’s not in the room. The few times that Dad doesn’t have an answer for her, she turns to me, and I offer what I can. She asks him to take off one of the 4 shirts he’s wearing. Saying she needs to get his blood pressure and hear his heart. 

“Why is he wearing so many shirts?” I wonder. I don’t know if he’s cold, or if he just likes to layer his outfits. Another thought passes through my awareness that maybe he doesn’t realize he’s wearing so many. He takes off his belt and his too large pants begin to slide from his waist. I’m not sure why he’s removing his belt when she asked him to take his shirt off. He fumbles with the heavy, hand tooled leather belt. The even heftier belt buckle of silver and turquoise clanks loudly on the small table as he sets it down. He manages to get the outer most layer of his multiple shirts off. Still struggling with his pants, he sits back on the edge of the exam table. 

Melanie moves in to begin taking his vitals. She is patient and kind. I notice his hair looks unwashed and wonder when he last showered. Suddenly, I feel a bit guilty and a tad embarrassed. Then I remind myself that there’s only so much I can do. The list of things to do for him is long and keeps growing. “When will I reach a plateau?” I wonder. I make a mental note to address this later, and shove the thought aside. 

We wrap up the pre-exam and are left alone in the tiny room. Is it uncomfortable for him to be alone with me? Does he feel a sense of awkwardness without someone else here? We weren’t close when I was a kid. I avoided one on one time with him as often as I could. As I've grown up, I’ve come to appreciate him for who he is. He has a wide range of interests and experiences. He’s pretty fascinating to talk to. However, the shift in our power dynamic and the overwhelming amount of change I have created in his life has woven some tension between us. I am not sure how much of it is me projecting my discomfort and how much of it is actual. 

I start to offer conversation when there’s a soft knock at the door. Jessica, his new doctor, enters quietly with a big smile. She’s petite and self assured. Her blonde hair is pulled back efficiently. Her warm eyes are focused and direct. She introduces herself to Dad, then turns to me with her hand extended. Shaking her hand, I comment on her colorful clogs and she shares how comfortable they are. 

“They have memory foam!” She exclaims with delight as she surveys her feet. 

“Ooh, soft and squishy.” I reply with a smile. 

“Yes! Soft and squishy, exactly what I need!” She comically feigns exhaustion.

She sets her laptop on the counter and takes a seat, leafing through the paperwork she brought with her. After a few moments, she turns to Dad and begins her line of questioning. She’s succinct and compassionate. She also directs her comments and questions to Dad first. I like this. Not only because it lets me off the hook for a moment, but it gives him another opportunity to be the authority in his own experience. 

I shift into observer mode and find myself watching more objectively. As Jessica begins her physical exam, I  notice how much he has aged since the last time I saw him. 

Dad was so vibrant and vital in his younger years. I recall the summer he single handedly built the large cedar deck behind our first house. Images of him hoisting a canoe overhead on one of our family camping trips move through my mind. I suddenly remember he’s an Eagle Scout. Flashes of him playing drums in one of the numerous bands he was a part of come back to me. He was so alive! Now he’s pale and thin and his zest for life seems absent. He has very little muscle tone. His skin folds and twists around his arms hanging loosely. 

Jessica is very gentle with him and it touches me deeply. Her compassion fills the room. I’m holding back tears as a new layer of acceptance at the reality we are facing descends into my awareness. I am trying not to cry and I pray that Jessica doesn’t address me directly. I’ll lose it if she does. 

She completes the physical exam and begins asking Dad another round of questions. They are clearly an attempt to assess his cognitive function. She guides him through several simple tasks and basic tests. Some of them he gets right, some he gets wrong. Others befuddle him to the point where he can’t even begin to formulate a response. His face furrows with frustration when he can’t find an answer. She smiles patiently, never outwardly showing an ounce of concern. She’d be an awesome poker player. 

Our visit comes to an end and it feels a bit anticlimactic. She confirms that there is some memory loss but won’t offer details until she has more information. I don’t know what I was expecting, a miracle I suppose. I feel my emotions return to the surface, but manage to keep them at bay. She says she’s ordering a full lab workup and wants an MRI too. As we wrap up she quietly asks me if she should call me directly with the results. I smile and nod silently. I feel like if I open my mouth to speak, the floodgates will unleash a river of tears. 

As we make our way to the door, Dad is all smiles. He seems recharged by the interaction he’s had with the staff. They wish us well and we slowly move to the car. 

We arrive back home and I get him settled in front of the TV. Even on his good days he can’t make heads or tails of the remote. I find ESPN for him and retreat to the back of the house to do some work. Thank god for my practice. It keeps me sane and offers something else for me to focus on. A few hours later, I’m feeling like a nap. I close my laptop and move to my bedroom. As I drift off to sleep, I hear him in the living room. He’s on the phone with someone. My ears perk up for a moment, but I can’t glean any details. 

I awaken about 30 minutes later and decide that I’m going to head into town for a bit. There’s a new hamburger place that boasts locally sourced ingredients and I've been craving a cheeseburger. I figure I’ll stop there before I go to the grocery store. It will also give me some alone time. Something I don’t get a lot of these days. I sit on the edge of the bed, yawning as I lean down for my shoes. I grab my reusable grocery bags and make my way to the kitchen. I come around the corner and see Dad at the sink. I tell him I am going into town and he reminds me that he likes whole bean coffee. I tell him that we don’t need any coffee right now, and he snaps back. 

“I know we don’t need coffee! I’m saying that when you do buy it, buy the whole bean kind!” he barks. He’s clearly keyed up about something. I don’t think I’ve ever seen him so agitated. 

“You seem upset.” I state gently. “Is everything ok?”

“No! I’m not ok!”  He protests. “I just got a call from Regional Health saying that my new doctor ordered an MRI!” He’s anxiously fussing with the objects around the sink. He picks up a dishrag, folding it and refolding in an attempt to make sense of things. “Why do I need that?” “I don’t want that!” He continues fearfully. “You know I am claustrophobic!” 

I didn’t know he was claustrophobic. That’s news to me. 

“The new doctor ordered your MRI so we can figure out what’s going on in your brain.” I offer calmly. “I thought you heard her when she said that today during your appointment.” 

Now he’s running the sponge under hot water and wringing it out repeatedly. 

“But why does she need to know what’s going on in my brain? I still have rights, you know! I can refuse a procedure if I want to!”

“You absolutely have rights” I reply. “You can refuse it if you want to, but we need to know what’s going on in your brain because of your memory loss.” 

He sighs a huge sigh and drops the sponge in the sink. 

“We need to know what’s going on so if there’s a diagnosis, we can make a plan. The MRI is also for the neurologist so he can have a better idea about what’s currently happening. If we don’t get one before hand, he’s going to order one anyway.” My tone is compassionate and direct.

He stands at the sink, staring out the window. 

“I understand you’re afraid, Dad. But we have to get this information so the doctors can help you.”

“I just wish they wouldn’t have said anything.” he says softly. “Now I am going to worry about it for the rest of the week.” His anger has given into fear. His shoulders slump in defeat. I often forget how hard this must be for him.

“Well, sometimes it’s an option to be sedated.” I say. “I’ll call the doctor tomorrow and ask.”

“They can really do that?” He asks hopefully. His eyes are finally able to meet mine. In his younger years they were blue like sapphires, now they’re the color of faded denim. 

“Sometimes they can.” I repeat carefully, not wanting to give him false hope. “I’ll call the doctor first thing tomorrow and ask.” 

The possibility of sedation gives him some relief, and I am hoping like hell I haven’t offered him something that they won’t be able to do.

He breathes deeply as his nervous system starts to settle. I ask him again if there’s anything he needs from the store. He tells me he can’t think of anything right now. I shut the kitchen door behind me and head for the garage. I’m feeling my emotions rise again and tears fill my eyes. I close them and breathe deeply.

The burger joint also houses a butcher shop. They offer the same locally raised meat as they use in their food. I’ve been a lazy vegetarian over the past few years. It’s not easy to avoid animal protein in cattle country, but I can do it when I want to. Today, however, I am giving into my craving. I order my meal and sit at the table. I remember when this place used to be a Taco John’s. It’s so strange being back in Cody. In many ways, it looks exactly the same, but it’s definitely not the town I grew up in. All of the newness blurs with the familiar. Like an old house with a modern addition. I recognize some remaining landmarks and remember the locations of places that no longer stand. It’s kind of the same, but not really. 

My food arrives and I tuck in. The fries are salty and hot. Their crispy exterior crunches softly as I bite. My stomach rumbles in anticipation. I realize I haven’t eaten anything since breakfast. It’s so easy to get sidetracked and caught up in caring for him. My thoughts drift to the events of the day.

“How’s it taste?”

A friendly, gravelly, voice breaks my reverie. I look up to see the man who was previously standing behind the butcher counter. He’s got one hand on the back door, ready to push it open. The other hand holds an unlit cigarette. 

“It’s really good!” I reply.

He introduces himself as the butcher, telling me the story of this place. He clearly takes pride in his work.

“I’ve not seen you here before.” He says with a curious tone. “You visiting?”

“I grew up here but I just moved back.” I say

“85, you?” He asks

“Huh?”

“Cody High School, class of 1985! You?”

“Oh!” I say nodding in understanding. “1990.” 

He smiles a kind smile. “What brings you back?” 

“I’m taking care of my Dad.” My emotions start climbing to the surface.

His tone softens. “Oh. Everything’s ok I hope.” 

“We’re not sure yet.” I say.

He pauses awkwardly, then turns to leave.“Well, when you come back tell them you’re local. You’ll get 10% off.” He winks, pushing the door open as he lights his cigarette.

His kindness is almost too much. I realize he’s the first person I’ve spoken to in days that has nothing to do with Dad. I feel my eyes getting watery and I scarf down the rest of my meal. “It’s hard to eat and cry at the same time” I think to myself. I gather the dirty napkins and drop them on the plastic tray. I take a long drink from the glass of ice water and move towards the garbage can. 

The cashier looks familiar. I try to figure out if I know him or not. I hand him a $20 bill and he returns my change. Dropping a few bills in the tip jar I thank him and make my way to the door. I don’t think I know him after all. 

“Thanks again!” The butcher says raising his hand in a wave.

“I’ll be back for sure.” I promise.

As I cross the parking lot, my tears finally break. I choke back a sob and slide into the car. Tears fall salty and hot as the pressure of the day moves in. My emotions pull me under and I don’t fight. Resting my head on the steering wheel, I cry hard. My body convulses with the release. 

“This is so fucking hard. Today was a really hard day.” I say to the empty car. 

A moment of clarity brings everything into focus and I laugh at the absurdity of the situation. Crying in my car in the parking lot of the burger joint that used to be a Taco John’s. I pull out of the lot and head up the hill to the grocery store. 

“Yeah, a really hard day.”