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Another Flew Over the Cuckoo’s Nest

Recently the nurse from the dementia facility where mother lives called to say mother was complaining that her neck and shoulder hurt… a lot. To be on the safe side, the nurse had called an ambulance. What ensued was two days of Who’s on First?, the classic Abbott and Costello failure to communicate routine, with a touch of One Flew Over the Cuckoo’s Nest. As I drove like a wild woman the 40 minutes to the hospital, I vacillated back and forth from fearing the worst, to a steely resolve that I could deal with anything. Two days later, I was ready to strangle everyone involved.

Blood tests, x-rays and an MRI showed nothing was wrong with mother. She had not suffered a heart attack, but to be on the safe side, they would keep her overnight in the hospital. While neck and shoulder symptoms can signal heart problems, the nurse at the dementia facility was careful not to use the words “heart attack” with me or the ambulance drivers. Nevertheless, those two words dictated everything for the next two days.

Several hours after mother was admitted and settled into her room, I had to leave for a meeting. When I returned, it was obvious the nurse’s aide who’d been assigned to sit with her in my absence had run out of patience. “Thank you for coming!” the aide said. Her tone had a note of desperation. “Is this your mother? I’m afraid of her.” I learned the hospital staff had been unable to take mother’s blood pressure, hook her up to a heart monitor, give her medication, take her temperature, or get her to eat.

“I don’t trust her!” mother was hollering. “She’s trying to sell me something! You never know about people who just walk into your apartment uninvited!” When I explained the woman was a nurse’s aide who was there to help her, mother threw a cup of iced tea at me and said, “Well now she can help you!”

Dementia seems to bring out the worst in mother although even before dementia, mother was a difficult woman. Mother’s always walked a fine line between being a helpless needy victim to someone who delights in creating a scene. Nine months ago I stopped taking her shopping or out to lunch because of her public meltdowns. Her geriatrician says some dementia patients become agitated in unfamiliar environments, and this hospital visit was definitely one of those. It was becoming one of those environments for me as well.

Obsessed with unplugging the leads attached to her heart monitor, mother would tear them off as quickly as they were reattached. Each time the nurse reconnected them and told her not to touch them, mother began tearing them off, again, and would say, “Well I didn’t remember what it was.” The last time, I reconnected the leads and explained it was a heart monitor. Mother tore them off, again, then said to me, “You do what you want with yours, and I’ll do what I want with mine!”

A cardiologist tells me he’s ordered a stress test. When I ask if mother’s had any evidence of a heart problem since the ambulance picked her up, he says no, but tells me mother wants a stress test. When I explain mother has dementia and can “present well,” but doesn’t know what’s going on, the cardiologist tells me he asked her if she had dementia, and she said “No.” When he asked if she wanted a stress test, she replied, “Yes. I want all the tests.” Based on mother’s response, the cardiologist had ordered a laundry list of more tests AND was prescribing morphine for when she returned to the dementia facility!

“Isn’t that right, m’am?” the cardiologist asked mother. “You want a stress test.”

Mother eyed him critically, then snorted like a horse. “You’re going to test me to see if I’m cuckoo. Well I’m not! She is,” mother said, pointing to me. Holding up a bra she’s pulled from the plastic bag containing her clothes, mother asked the cardiologist, “What have you done with my bra? You don’t really expect me to wear this do you?”

The cardiologist ignored mother’s question and said the stress test had been scheduled for later that afternoon. Hello! What planet is this guy living on? My 91-year-old mother may “present well” for a short time, but that ship has already sailed.

“I think her pain’s due to an arthritic shoulder she’s had for years,” I said. “So if she has no evidence, of any kind, of heart disease, why are we doing more tests?”

“Well, she said she wanted them,” the cardiologist replied.

I follow the cardiologist into the hall where I cancel the stress test and the morphine. I understand the doctor was covering his backside, but if physicians have no discerning ability when evaluating patients, it makes me wonder to what degree those of us who are still “with it” must stay on top of what our doctors prescribe for us?

When I return to mother’s room, she’s asking a male nurse if they’ve had sex. “Have we had an affair? I haven’t had sex in a while, and I’ve never done drugs.” My heart breaks for mother. She’s trying her best to make sense of a situation that is making less and less sense to me. I can only imagine how frightening and frustrating it must be for her.

This ordeal has been nothing short of a Who’s on First? routine. I’m angry mother was subjected to this and that I was locked into a nonsensical do loop that was difficult to extricate either one of us from. Every day I ask God to make me the daughter she needs, but it’s days like this that make me wonder if I’m doing a good job? There are moments when I have to walk away because if I have these conversations much longer, I’m afraid I will become another “Who’s on First?” and will join mother and the others who’ve already flown over the cuckoo’s nest.