“I need you to see Eddie,” the social worker told me, “He keeps throwing himself out of bed, and you know how the administration is about falls.”  Falls were bad.  They get reported to the State.  “You hear that moaning down the hall?” she asked.  “That’s him.  He’s driving all the other residents crazy.”  She escorted me to his room, introduced us, and then left me alone with 50-year old Eddie, who could barely move or speak, but had stopped moaning long enough for me try to talk with him.  He was lying in his bed, which had been lowered almost to the floor, and blue foam mats were on either side of the bed, presumably to buffer his “falls.” 

“It’s going to take me some time to figure out what you’re saying,” I told him, “but I’m going to try really hard, so I hope you’ll give me a chance.”
He stared at me, then muttered something unintelligible.  
“I’m sorry.  Can you say that again?”
He muttered louder.  There was a knock at the door and Dr. Waldren walked in.  Eddie’s eyes opened wide and a smile slowly spread across his face.  An excellent sign, I thought to myself.  He can connect.
Several weeks later, Eddie and I could hold a conversation, though it usually took several repeats for me to understand him.  He was remarkably patient.  We talked about music, and sometimes sang Smokey Robinson tunes together.  
“There was something I’ve been meaning to talk to you about,” I said to him one day.  Our eyes met.  “What’s with all the moaning you’ve been doing?  I could hear you from the third floor as I was coming up the stairwell.  Do the nurses come when you moan like that?”
He fixed his eyes on me, and I repeated the question, “Do they?”
“No,” he said sullenly.
“So why do you do it?  It seems to me like you’re only teaching them not to pay attention to you.  You’d be better off just calling them when you need them.”  
Our eyes met again.  “Well, think about it,” I suggested.
The elevator doors opened and Eddie’s mother emerged slowly, breathing heavily and leaning on her cane. She was accompanied by Eddie’s teenage nephew, Leon, who wore an oversize army jacket and a forbidding expression. Puffing, she eased her bulk into a chair across from the elevator and gathered her strength for the next leg of the journey. She stopped to rest again at the nursing station, halfway to Eddie’s room. The nurse examined the bags she brought for her son.
“He can’t have this, Mrs. Jones, I told you,” the nurse was saying, holding up a ham and cheese sandwich. “He could choke.”
“I know, but he asked me.” She held her hand to her chest, and sighed. “It’s hard for me to say no.”
“And this soda! He’s diabetic! Can’t you bring diet?”
“He doesn’t like diet soda.” Mrs. Jones stared down at the desk, and Leon glowered and shoved his hands deeper into his pockets.
“Well, I suppose he can have these cheese puffs.  As long as he moistens them in his mouth before he swallows them.”
Groaning from the exertion, Mrs. Jones pulled herself up from her seat and made her way toward her son’s room.
“I tell her this every time she comes, which isn’t often,” the nurse said to me, “but she never listens.”

I opened the blinds in Eddie’s room, letting the light flood in and revealing a view of the Manhattan skyline and a bruise on his forehead from his latest fall.  “You know, the nurses tell me you throw yourself out of bed.  Is that true?”
“Really?  Because I don’t see how you could actually fall with the side rails up.  I’ve been thinking about it, and it seems to me that in order for you to wind up on the floor, you’d have to hurl your leg over the side and let your body follow.  That’s quite an accomplishment.”
He laughed.  
“So I’m thinking, if you want to get out of bed that much, maybe you can let them get you into the wheelchair you’re keeping in the bathroom, and then I can take you downstairs to the computer room.  We can look up Smokey Robinson.”
“Please?  It would be fun.”
I spoke to the nurse about twelve weeks after I launched the Get Eddie Out of Bed campaign.  
“He finally agreed to get in the wheelchair,” I told her, “so do you think the aide could do it on Thursday?  That way I can take him downstairs.”
“He’s not going to get out out of that bed, Dr. Barbera.  He’s been in there for over a year.”
“Yeah, I know.  But he was moaning for over a year, too, and he hardly does that anymore.”
Months later, Eddie and I sat outside on the patio, drinking Diet Cokes.  I held the can up to his mouth, holding the straw steady with my fingers while he took long pulls of the beverage.   “Hey, look at this one, Eddie.”  I nodded in the direction of a young woman in a red dress, heading our way.
It took him a minute for his gaze to focus, and a grin spread across his bruise-free face.
“I guess she’s your type.”  I watched as he visually followed her down the block.  “Are you ready to call your mother?”
I flipped open my cell phone, scrolled down my contact list to Eddie’s Mother, and held the phone up to his ear.   
“Hi, Ma,” he said.  “Bring me some shrimp fried rice.”

2 thoughts on “Sunshine”

  1. Funny how we have a disconnect from the ideal. The resident should get out of bed, but doesn’t want to do so. You worked hard to get the resident to want to get out of bed, and then when they expressed the “want to” the staff tried to put the kaibosh on it. We need to remember that even if the resident is difficult, we need to work within their boundaries and then take action to expand them slowly as they are ready to do so.

  2. K. Tree, Your comment reminded me of an oft-repeated saying from one of my old supervisors, “Be where the patient is at.” I love your blog, by the way, and I’m adding it to my blogroll.



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