Suitably scrubbed, whitewashed, obfuscated, fictionalized, muddied, folded, spindled and mutilated to appease the PC sensibilities of any self-appointed EMS hall monitor and patient confidentiality ombudsman…
“Well, she just won’t eat,” the daughter explains. “All she does is just poke her food around. She won’t drink, either.” The daughter clasps her arms in front of her, her face twisted in worry and frustration. The old woman just lies there listlessly, not speaking. She’s awake, but I’m not sure how much she can understand.
“Why don’t you tell me what kind of medical problems she has,” I suggest gently. The daughter sighs, nods. She exhales heavily.
“High blood pressure and diabetes…” she replies, and her voice trails off. Her eyes are red-rimmed from crying.
“Alzheimer’s? Lung or heart problems?” I prompt.
“No, nothing like that,” she shakes her head. “She’s always been pretty healthy, up until Dad died a few months ago. You remember.”
I do remember the call, although so many get jumbled in my head these days. People recognize me as the man that cared for their son or uncle or grandmother. Some of them even call me by name. Yet to me, so many of them are just vaguely familiar faces and half-remembered medical complaints. It bothers me.
I see so many people, Ma’am. The faces just blend together after a while. And when you met me, I was the face you encountered in a horrific time for you. I wish you could forget that day, and forget my face. But I do remember your Dad.
The Abshire name is an old one in Podunk Parish. From Podunk to Hooterville to Pixley and Frog Holler, their names take up two pages in the phone book. They are lawyers and bankers and farmers, loggers, mechanics and businessmen. In the cemetery north of Hooterville, there is the grave of a Confederate soldier who bears the family name. They run long on hardy boys who grow up to be honest and hardworking men, and the occasional girl who finds her own kind of strength from growing up in a household of rowdy brothers.
The Abshire daughter I’m talking to now was referring to a call three months ago. She had called 911 after her mother had called her to tell her that her father wouldn’t wake up. Lillian Abshire had awoken to find her husband still in bed next to her. That in itself was unusual. Though long since retired, Melvin Abshire woke shortly after dawn every day. Life was too short to waste it in bed when there was work to be done. Lillian had told her daughter that she didn’t think Melvin was breathing.
When we arrived, Melvin Abshire was dead, but still warm. There was no rigor or lividity present. Whenever he had passed away, it wasn’t too long ago. At first they wanted us to code him, but I guess my reluctance showed on my face.
“We don’t know how long he’s been down,” I explained as gently as I could. “I could try, but chances are we won’t get him back. The things we’d have to do to him…”
Please don’t ask us to torture this man’s body, my voice said without words. Let him go with dignity. Let him die in peace.
“Let him go,” Lillian Abshire had said, looking up from her chair at the breakfast table. Her voice was hollow, but firm. “I don’t want anything done.” Her daughter and three of her sons were with her, one of them standing behind his mother with his hands on her shoulders. You could see in their faces that they didn’t like it. Abshires were not taught to give up easily, but they were not taught to disobey their mother, either. I remember being struck by the strength in her voice and the pain in her eyes.
Right now those eyes are vacant. I can’t see much of Lillian Abshire in there. She looks nothing like the woman I saw that day. She is emaciated, her skin sallow and slack. I sit carefully on the bed beside her and pick up her left hand. She is still wearing a wedding band. Her veins show up like a blue roadmap underneath her translucent skin, her pulse rapid and thready.
“Miss Lillian,” I call softly. “Can you hear me? It’s AD. We met a few months back.” Her eyes focus and look around briefly, then settle on me.
“I remember you,” she says softly. Her voice is scratchy, weak. “Who called you?”
“Your daughter Elaine called,” I explain. “She says you haven’t had much of an appetite lately. She’s worried about you.” Lillian’s eyes close and her hand pulls away.
“I’m fine,” she says flatly, turning her head away from me. “You’re wasting your time out here.”
“She is not fine!” Elaine insists desperately. “Mama, talk to the man, please! Tell us what’s wrong with you!” she pleads, her voice breaking. I shoot a glance at Pardner, standing nearby with a BP cuff and stethoscope. He nods imperceptibly and puts the cuff and scope on the bed beside me.
“Miss Elaine, why don’t you help me gather up your Momma’s medications and such,” he suggests, wrapping an arm around her shoulders and steering her out of the room. “You can tell me what’s been going on with her lately while we’re at it. I noticed your Momma’s flowers are bloomin’ real purty out there by the porch. I been hoping we’d get some good rain here lately…”
I listen to Pardner’s voice fade away and gently touch Lillian’s shoulder again. “Miss Lillian, please talk to me. I’d like to know how to help you.” I sit quietly and wait for some reaction. Her eyes are still closed, but she can hear me. There are tears beneath her eyelids. As if noticing it, she squints her eyes shut and shakes her head.
“Can’t help me,” she says, almost inaudibly. “I wish everyone would just leave me alone and let me die.”
Now what do I say to that? Start asking her pointless psych questions about suicidal ideation? She’s not crazy. Do I play the guilt card and point out what this is doing to her children?
“Well, I wouldn’t be a very good paramedic if I just let you die,” I say, trying to make a joke of it. She opens her
eyes and looks at me.
“You’ve done it before,” she says flatly. There is no accusation in her voice, merely a statement of fact. “Just leave me be and let me go.”
“Miss Lillian, your husband was already gone,” I point out. “You’re not.” There is nothing else I can say. I refuse to make trite, clichéd observations to this woman. She deserves better.
But Lillian, you have so much to live for. You have children who love you, grandchildren who wouldn’t understand. Yeah, and you’re close to ninety years old, and your husband is dead. You live in an empty house with nothing but memories. Who the hell am I to question your choices?
“Miss Lillian, don’t make me leave you here. You’re dehydrated and malnourished. Let us take you to the hospital, please.”
“I’m not going to be fed through some tube,” she snaps, her eyes glittering. There is life in her still.
“You can refuse whatever care you want, at any point you want,” I inform her, sensing the possibility of a compromise. “Just let us take you to the hospital.” She sighs, shrugs. Closes her eyes.
“Whatever you want to do,” she sighs. “I don’t care.” It isn’t so much consent as acquiescence.
“Pardner!” I call out. “Let’s go.” Presently he appears, holding only a couple of medication bottles and a small vinyl wallet containing Lillian’s Medicare and insurance cards.
“These are all she has,” he says, handing them to me. A bottle of antihypertensive medication and a bottle of Actos, just as we’d been told. “Elaine wants to ride with us,” he adds.
“Fine with me,” I say, “but up front. Let’s get her on the stretcher and go.” Pardner moves to the other side of the bed and pulls the fitted sheet free of the mattress. He steps up gingerly onto the mattress and bunches the sheet around her.
“Now Miss Lillian, don’t you go telling those ladies over at Mount Pisgah that you had a strange young man in your bed. They’d all die of jealousy,” he jokes. Elaine chuckles, but Miss Lillian acts as if she hasn’t heard. We gently package her on the stretcher and wheel her outside, muscling the stretcher down the porch steps.
The Abshire house is surrounded by shade trees off a bend in Highway 138 in Hooterville, the southern corner of Ignorant Thicket. Forty acres of cleared hardwood bottom slopes gently away behind the house, ending at Hawg Creek. When Melvin was alive, these fields were tall with hay, and a small section contained a lush vegetable garden. Now it’s fallow and choked with weeds. Just to the left of the gravel driveway sits a huge white oak tree, with the obligatory tire swing hanging from one branch. Ten years ago, when we first opened an ambulance station in Pixley, we had sat at a picnic table under this tree and drank tea so sweet it threatened to shut down my pancreas. Melvin had told us of the history of the area, where the best fishing was on Hawg Creek, and given us permission to hunt on his property.
“Just don’t shoot toward the house,” he warned sternly. “My grandbabies play around here.” Before we left that first day, Lillian sent us off with a mess of fresh picked corn, tomatoes and squash. It was not the last time she did so over the years.
We load Miss Lillian in the rig without much difficulty. At 89 years old, she probably weighs less than her age. I follow the stretcher in and settle on the bench seat beside her. Pardner pauses before closing the rear doors, raised eyebrows asking if I need anything.
“I got it from here, bro. Give us an easy ride to Big City Regional Hospital,” I tell him. Pardner grunts in affirmation and closes the rear doors. Presently I feel the rig lurch as he turns around in the yard, and Lillian and I watch her house fade in the distance as we ease back out onto the highway. I reach into the IV cabinet and pull out a bag of saline and an administration set. I spike the bag and give Lillian’s left arm a glance. The veins are easy to see, but sticking one may be another proposition entirely.
“An IV and some fluids wouldn’t be a bad idea, Miss Lillian,” I say quietly. “You’re pretty dehydrated.” Without a word, she raises her left arm and places it across my thigh. She still says nothing, just stares passively out the back window as I gently slip a 20 gauge in her left forearm. I tape the catheter down, using paper tape on her fragile, translucent skin. I open the roller clamp wide and let the fluid run as I wrap the blood pressure cuff around her arm and attach the cardiac monitor leads. During all this, Lillian says nothing. It’s as if she doesn’t even care what I do to her.
“So how are you feeling?” I venture again. “Any nausea or vomiting? Weakness? Are you just not hungry, or can you not keep food on your stomach?” Lillian just stares listlessly out the back window and gives no sign that she has heard, her left hand still limply resting on my thigh.
She hears me. I know she can. She just doesn’t care any more. She has given up, and nothing or nobody is going to change her mind. She wants to die.
I sigh and gently place her hand by her side and shift over to the jump seat at the head of the stretcher. The monitor shows a sinus tachycardia, maybe 110 beats a minute. Aside from the slow rise and fall of her chest beneath the sheet, the beep of the cardiac monitor is the only sign she’s alive. Ambulances are not built for comfort, and Louisiana highways are not friendly to fragile little old ladies with no subcutaneous fat, yet she shows no reaction as the rig bumps and sways over the potholes and ruts of Podunk Parish’s back roads. Pardner is taking one of his patented shortcuts to Big City and holding a lively conversation with Elaine in the front seat. I hear laughter and catch a few snatches of the conversation – something about his uncle Shorty, a drunken mule, and the ladies Sunday school class. Elaine erupts into riotous laughter.
The man never meets a stranger. That’s his gift. By the time we get to Big City, they’ll be the best of friends.
“My partner and your daughter seem to be getting along,” I say. “He’s got a million stories, and all of them take three hours to tell. Betcha twenty bucks he drives Elaine crazy before we get to the hospital,” I tell Lillian, half jokingly.
In the rear window, I catch Lillian’s reflection as she opens her eyes. She says nothing for a long time, and then her mouth breaks into a wry smile and she chuckles. “I’ll put my money on Elaine,” she says, her voice dry and
cracking. “She started talking at eleven months old and hasn’t shut up for sixty-three years. Drove me and her daddy to distraction.”
“Oh really?” I ask dubiously, grinning at her as I move back over to the bench seat to sit beside her. “She may be a talker, but Pardner’s the champ. What makes you think she can take his title?” I tease.
“That child made straight A’s all through school, except for conduct. Wouldn’t stop talking. She came into this world caterwaulin’ at the top of her lungs, and she’s had something to say ever since,” Lillian says, shaking her head wryly at the memory. “Melvin tanned her hide a few times when the teachers gave her bad marks for talking in class, but we gave that up. She was such a bright child in everything else, it felt wrong to whip her. We figured she’d grow up to be a lawyer.”
“So she’s an attorney?” I ask. “Does she practice in Podunk Parish?” This prompts a burst of outright laughter from Lillian.
“Heck no!” she says ruefully. “Met a fella that liked to talk almost as much as she did, and got married right out of high school. Worked as a hairdresser for forty years and gave me four grandbabies along the way, and wouldn’t you know it, not a one of ‘em has much to say.
“Maybe they grew up knowing they couldn’t get a word in edgewise,” I wink. “Or maybe the talkative gene skips a generation.”
“Lord I hope not,” she laughs, slapping me on the knee. “I’ve got great grandbabies who are gonna start talking any day now. At my age, I need the peace and quiet.”
That’s it, Lillian. Keep talking. Tell me all about those grandbabies.
“So you have great grandchildren?” I ask, intrigued. “How many? For that matter, how many Abshires are there? Y’all are a big clan.”
“Lord only knows,” Lillian sighs, smiling. “I have enough trouble keeping count of my own brood. The Abshire boys took that ‘be fruitful and multiply’ verse to heart. Melvin was the youngest of six boys, and all of them raised big families themselves.”
“Okay, so how many in your brood?” I ask, winking at her. “Impress me with your powers of procreation.”
“Well…” she answers, her voice trailing off as she does a mental count. “Melvin and I had seven – all boys except Elaine. She was our middle child. Lost Melvin Jr. to polio before he was two years old, but I have six children still around.”
“It must have been hard to lose a child like that,” I sympathize. “It was,” she sighs. “For a while I didn’t want to have more kids. Then Brian came along, and we had two more back to back. Then the war came along…”
“Melvin served in World War Two?” I ask. “What branch of service?”
“Army Air Corps,” she answers. “He was a gunner on a B-17. He probably could have gotten out of going overseas, but he felt like it was his duty. We managed without him, but Lord it was hard. Seemed like forever.”
“My Dad and an uncle served on B-17s in the war. I had another uncle who flew P-38s,” I tell her. “So were you ever worried about him? Scared he’d get shot down?”
“Every day,” she sighs with a half-smile. “But I figured the good Lord would bring him home, and he did.” She closes her eyes and stops talking for a while, but the smile still hovers around her lips.
“So you took a few years off to help save the world for democracy,” I prompt teasingly, “and when he came back you got back to the serious business of populating Podunk Parish. How long before you had the other three kids?”
“Just about nine months from the day he came home,” she laughs, her eyes twinkling. “Leo came next, then Eli and James. All of them born and raised right here. The oldest three were born right there in our house.”
“So you and Melvin managed to build a house, run a farm and have four kids, and all that before he fought in a World War. That’s a lifetime’s worth for most people. I’m impressed.”
“Well the house was there before we got married, or some of it was,” she allows. “It was his folks’ old home place, and we moved in there when we got married. After his parents died, we stayed in it and built on as the kids came. It’s the only home we’ve ever lived in.” Her voice breaks and tears come to her eyes. I simply sit beside her and wonder what to say.
And now that house is empty except for you, and you’re scared you’ll never see it again. Either that or you’re not interested in living there without your husband.
“So his parents took you both in after you were married?” I ask, searching for a way to keep her talking. “That was generous of them.” She blinks her eyes several times and looks at me. She gives a shuddering sigh and pats my hand.
“It was during the Depression. We didn’t have it so hard as some. Money never was in great supply in my family or his, and his family owned all this land free and clear. The farm used to be a lot bigger than it is now. Took a lot of people to work the land.”
“So you had all those kids for the free labor,” I reply, winking to show her I was joking.
“Oh, I don’t know about that,” she chuckles. “It might have been cheaper in the long run to hire some hands.”
“But hired help can’t give you grandkids to spoil. Or great grandkids,” I point out.
“Or great-great grandchildren,” she agrees. “I have four of those. Or is it five? I can’t seem to remember some times. No,” she says firmly, nodding her head. “It is four great-great grandbabies. I’m sure.”
“So the grand total is…how many?” I press.
“Seven children, twenty-nine grandchildren, sixteen great grandchildren…” she recites, her eyes closed in concentration.
“And four great-great grandchildren,” I finish. “I’m impressed, but not nearly as impressed as I’d be if you could name them all,” I challenge. She looks at me in surprise and I hold her gaze for a few moments, then wink.
“Lord no!” she laughs. “We haven’t got enough time for that!”
“We have five minutes or so,” I say looking out the window. We’re entering the outskirts of Big City. Pardner and Elaine are still chatting animatedly up front. “If it takes longer than that, we’ll make the block a few times. I could talk to you for hours.”
“I’m too tired,” she sighs, closing her eyes, “nothing much more to tell anyway.”
“Still, it sounds like a good life,” I say. “One anyone would be proud of.”
“Yes, it was a good life,” she agrees, her eyes still closed, but with a wispy smile on her lips. “It was a life well-lived.” She says nothing else for the next several minutes, and I am alone with the steady beep of the cardiac monitor. Presently, the rig lurches as we back into the ambulance bay at Big City Regional Medical Center. Pardner opens the back doors, still laughing and talking over his shoulder to Ela
“I called report,” he says. “Looked like y’all were having a deep conversation back there.”
“We were,” I assure him. “Thanks for doing my job for me, anyway.”
“If I didn’t look out for him, Miss Lillian, he wouldn’t be able to function,” he winks at my patient as he rolls the stretcher out of the rig. “I swear, that boy gets to talkin’, and you can’t shut him up. Prob’ly drove you to distraction all the way down here, didn’t he?”
Lillian opens one eye and looks at me, then winks. We both break up laughing. Pardner and Elaine stare at us both as we wheel the stretcher inside, trying to get the joke. After we move Miss Lillian to the ER bed, Elaine thanks Pardner and hugs his neck as if they’re old friends. Somehow, I’m not surprised. Lillian and I just share a smile, and she clasps my hand and nods before I leave. I hope for the best for her. I hope she has another ten years of good health and watching her brood grow older and larger, but I wouldn’t be surprised if she never made it out of the hospital.
Five days later, I read her obituary in the Podunk Journal. Lillian Abshire, age eighty-nine, preceded in death by her loving husband, Melvin. Survived by numerous children, grandchildren, great grandchildren, and great-great grandchildren.
I read closer, and it turns out she was wrong.
There were indeed five great-great grandchildren.
Until next time…