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the nurse will want to hear directly from my parents so that she can assess their emotional and cognitive impairments as well as their physical disabilities. I understand my job as facilitative and plan to stay in the background as much as possible. At the same time I am eager to monitor my parents’ storytelling so that the medical details, diagnoses, and limitations of their functioning insure their eligi-bility for Medicaid.

I need not have worried. My father does a full and complete job of recounting the last years. He subtly and coolly displays his intellect and connectedness to the world. Before my arrival he has even located the 1989 MRI documenting his spinal stenosis, the disease that has made his walking so precarious, which the nurse will look at gravely but respectfully return to him for safekeeping. He will also pull items from a notebook overflowing with health updates, information about stocks and investment options, and news clippings about research on the radiation scarring that has left his throat burned and filled with mucus. The experienced nurse quickly adjusts to my father’s speech, which is very slow and barely audible. Surprisingly he doesn’t mind when I add dates or resequence events. At times like this, after the battle about applying for Medicaid has long passed, we can work like a team. He knows that Medicaid assistance is the only m y fat h e r ’ s k e e p e r n 127

way to pay for his fifteen-hundred-dollar-a-month drug bills and to secure partial reimbursement for the around-the-clock health aides that keep him out of a nursing home.

My mother’s performance is more mixed. She overstates some aspects of her physical condition and underestimates others. She can recite the days of the week but does not know the date, can subtract seven from one hundred continuing back to fifty-one but cannot repeat a simple series of numbers. My mother is skillful at hiding her cognitive deficits, the result of many small strokes, and I am relieved when the nurse recognizes them. Because we have started so late and the interview moves so slowly I cannot stay until the end. As I prepare to leave I catch a final glimpse of my father lying on his bed, waiting for the nurse to examine the feeding tube that he now needs to assure that sufficient liquids and nourishment reach his system.

On the bus ride to work, I am unexpectedly swamped with emotions, proud of how well my parents have told their story and weighed down by how much time and energy is required to keep their household afloat. The nurse makes good, practical suggestions: My father should be on liquid medications, which will be easier to swallow. But who will contact three different doctors to arrange such a change? My mother should go out for twenty minutes every day. But who will fight that battle? Certainly not the single caregiver who must supervise my father and remain on good terms with my mother.

On the day of the nurse’s visit the storytelling seems to have been cathartic, if exhausting, for everyone. But on so many other occasions my father disregards my well-intentioned, if misguided, invitations to revisit the past. From his perspective, he knows only that something has gone terribly wrong. He will not settle until it is fixed. Like an infant’s primary caregiver, I am the recipient of powerfully ambivalent emotions evoked by his new dependence. He does not offer any philosophic renderings of a life well spent. I am loved and feared, respected and hated, seduced and abandoned when I don’t do his bidding. As the chosen target of his resentments, I am also the one who enables him to keep his story alive. For as long as my father insists and refuses, 128 n jonathan g. silin

plots against me and strategizes to undermine my new powers, his drama continues. I understand the many small crises, the excitements, as self-induced incitements to stay the final curtain from falling.

Unfortunately, all this understanding cannot quell my sense of inadequacy, of not being up to providing the care that my father needs.

As he rages over a misplaced doctor’s bill, bank statement, or phone number, I envision him gasping for one last breath before succumbing to a heart attack provoked by my clumsy and inept response to his diatribe. Aspirations of revenge punctuate my thoughts. I imagine his funeral, the few remaining friends and family, and the kind things that others will say. I am silent and experience only a tremendous sense of relief.

No matter what the origins of his anger, or how it functions to insure his survival, I cannot tolerate the situation any longer. In the hope that some modern pharmaceutical miracle might ease his discomfort and enable me to care for him and my mother, I persuade my father to consult with a psychopharmacologist. We no longer have the luxury of the time required for the more traditional talking cures.

My determination to make things better for all of us, however, is quickly deflated as I approach the building where we are to meet with the doctor that autumn afternoon. From across Madison Avenue I see my father, assisted by Marlene, his health aide, just emerging from a taxi. My mother, impelled forward by her own anxiety, is already at the entrance of the building. My father, who refuses to use a wheelchair in public, leans into his walker. Marlene shadows him from behind to prevent a backward fall. His heavy winter overcoat, buttoned high around the neck against the cold November day, conceals his shrunken frame and emaciated body. He moves slowly and distractedly toward the sidewalk. I watch from a safe distance as he tackles the curb. I imagine Marlene telling him, in her kindly yet authoritative Jamaican accent, “Lift your foot, Mr. Silin. Lift your foot now.” It is as if she must coordinate his physical movements by sending to vari-m y fat

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