He Gave His Best

For all I talk about my “peeps” in the lockup, and speak of the funny things they do, I have to take time this morning to recount one of the most beautiful expressionss of human compassion that I’ve ever had the privelege to witness. Naturally, names, etc, have been changed to protect patient identity.

Working in gereatrics, especially memory care, is always an interesting experience. The effects of old age, especially dimentia, have no respect for educational level, social class, or economic status. A memory care community is one of the few places where you might see the rich and the run-down living literally side by side, eating at the same tables, sleeping in the same wings…you might say that Alzhiemers is the great equalizer in that respect. There are certain small differences though….for instance, some of the “richer” patients bring their own beds with them, while the others sleep on standard issue hospital beds.

Let me introduce to you Frank and Otto. Frank is a “bed bringer”. He earned a living as a psychiatrist. He earned a ph.d [which hangs on his wall in his room]. He has traveled the world and seen beautiful things. And he brought his own bed with him to the unit. That bed is the envy of every patient and every staff member in the whole place. It is a full sized, visco-memory foam, craftmatic adjustable bed, and MAN is it comfy. [I know this because I sit on it to take Frank’s blood pressure every night] Add to that some 750 count egyptian cotton sheets, feather pillows, and a down comforter, and you have the absolute epitome of old man luxury. Clearly, Frank wants for nothing in this life.

And then there is his neighbor, Otto. For everything Frank has, Otto hasn’t. Otto came to us as a ward of the state, with one tiny backpack containing two pairs of pants, three shirts, a few socks, and a toothbrush. Because of his mental condition, he had been chronically homeless for most of his life. If he had any family, they were long gone. He never finished school – his chart read “highest grade completed: Grade 5”. Otto had been homeless for so long that, for the first month or so he was with us, he slept on the floor of his bathroom, unable to adjust to sleeping “so high up” in the hospital bed.  He couldn’t read, used simple words [when he spoke at all], and constantly looked in trash cans for food.

Under “normal” circumstatances, you wouldn’t picture Frank and Otto as friends, but that’s exactly what they were — best friends. Where Otto was, you could always find Frank — they would sit in the dining room together for most of the day, Otto pouring cups of coffee, and Frank reading the newspaper out loud so that Otto could “read” it too.   They were absolutely inseperable, so when Otto’s health took a turn for the worst Friday night, Frank held vigil at his side, reading him the paper and talking to him just as though he would respond at any minute.

Last night, as it became very apparent that Otto was not going to live through the night, Frank became visibly distraught. Through the haze of Alzheimers, he understood that he was losing someone who held a piece of his heart. He sat in the chair next to his friend’s plain hospital bed, with it’s institutional sheets and standard issue flannel blanked, held his hand, and cried as Otto struggled to breathe. Though it was after midnight, we didn’t attempt to separate them. Otto was given his hourly dose of roxinal, and I quietly slipped out to do rounds at the other end of the hall. Almost 45 minutes later, I peeked my head back into Otto’s room….and found it empty.

Otto’s bed was unoccupied, his flannel blanket missing from the room. Frank also was nowhere in sight. In a semi-state of rising panic, I began checking the rooms around Otto’s, and stopped dead in the doorway of Frank’s room. There, in the glow of the nightlight, was Otto, carefully tucked into Frank’s bed, his feet elevated, his head at the perfect angle, his body wrapped in the luxury of egyptian cotton and down. And at his feet, wrapped in a white, institutional flannel blanket, with his head on a hospital pillow, was Frank – on the floor next to his friend, holding vigil at his bedside.

I gently shook Frank awake, and, still stunned, asked him what he was doing. “Otto’s dying,” he said, “he slept on the ground enough.” He shrugged, “he’s my best friend. This is the best I can give him.”  That bed was Frank’s greatest posession of value, and he, through his dementia, was able to lower his friend to the floor and drag him across the hall on the flannel blanket, and somehow get him into the luxurious bed. I couldn’t help but think that it was sheer love and compassion for another human being that fueled that journey from hospital bed to luxury. And it was obvious that Otto was truly comfortable, laying in the nicest bed he had probably ever seen.

I didn’t even try to stop the tears. The very thought that this man would give up his very best for the love of a friend simoultaneously broke and lifted the very depths of my heart, and I suddenly felt like a voyeur – intruding on this very private moment between dear friends. Death, like living with alzhiemers,  is an intimate experience. It leaves you open and laid bare, with defenses gone and pretenses fallen……and if you look past the behaviors, past all the “crazy”, you can see straight into the hearts of people like Frank and Otto. Death, and alzhiemers, demands honesty, requires an inordinate amount of courage, and watching Frank care for Otto reminded me that we should always give of ourselves…before we disappear.



In memory of Otto, Time of Death: 04:43 10/1/12


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