Originally published in Portland Magazine
Winter 2004

Listening to the end of life.Ella is ninety-five years old, by far the oldest resident at The Pines. She is blind, frail, incontinent, arthritic and talks a blue streak. I know very little about her, only that she used to work as a clerk back in the days when there were such things as Dry Goods stores, that her husband died long ago, that she has a son nearing retirement age and that her favorite song is “The Old Rugged Cross.” Oh yes, she loves barber shop quartets. I know this not because Ella tells me – she is beyond being able to communicate such facts – but because her chart, filled out by her son, says so. It’s not clear that Ella has Alzheimer’s – she may suffer from another kind of dementia -- but it is clear that her mind is as fragile as her eighty-eight-pound body.I make the rounds of the west corridor, where Ella lives, sitting for a while with Janet and Dorothy as they watch a John Wayne movie and fold and refold someone else’s laundry, listening to Dan scat-sing as he gets his toenails cut, watching Bob and Carrie nod off, their fingers entwined. Ella is seldom out here in the spacious common area where the others spend most of their days. She would have to be wheeled out by one of the staff, and the caregivers don’t see much point to it. Ella has little interest in others. She has, in fact, very little awareness that there are others. And her incessant talk unsettles the residents. So I go to visit Ella in her room.“Hello,” I say, interrupting whatever she was talking about to whomever she thought she was talking. ‘I just came in to see how you were doing.” I put my hand on her shoulder, then sit down opposite her and take her gnarled hand in mine. I figure if I maintain physical contact maybe she will be aware that there is someone else in the room. Ella’s head is slumped forward, her chin almost touching her collar bone. Her eyes are three-quarters closed. The lids look like swatches of tan corduroy. She has stopped talking, which is so unusual that I assume that she has fallen asleep. Ella sleeps much of the time now, like a newborn baby. But I am wrong. She is just assessing the situation.“Who are you?” she asks sharply.“I just came in to see how you’re doing,” I repeat.“Who are you?” she says again. “Are you a doctor or a nurse?”“No,” I say, “I am a writer.”“You take care of the meals?” she says.“No,” I say, “I am a writer. I write books.”“You cook?”“No. Books. I write.”“Oh,” she says, “a waiter. Yes. I am hungry.”After that, she loses interest in me and goes back to wherever she was before I interrupted. I sit quietly, listening to her. She doesn’t just talk to herself, she carries on lengthy dialogs between different people, meanwhile telling little stories about a girl who is supposed to be in charge of something and some men who need to bring water from the well.“The menfolks are not caring about anything. They don’t want to work,” she says, addressing someone who lives inside her head or is maybe just passing through.“So what do they want to do?” asks this other person.“They want to come in and have something to eat.”“The other night, they had the best meal.”“Well, I don’t know.”“I was supposed to open it up and get everything going.”“How do you know?”“I don’t.”“Did she work?”“Hell, no.”The “hell” startles me. I have been listening, but not really paying attention. I am lulled by the steady stream of language, by the incessant, uninterrupted dialog. I am wondering how long she can keep this up, when her throat will dry out, when her crackly, old-lady voice will catch. But the hell, no gets my attention. She says it vehemently, with a back-country twang, as if she’s channeling a Texas dust bowl farmer. I study her for clues. Where is she? Who is this person who says hell, no? But her long, bony face, a skull loosely upholstered in skin, is expressionless. And her body doesn’t move. She is sitting in her wheelchair, which is padded on the bottom and sides with cushions and blankets to keep her as comfortable as possible. Just sitting hurts.She has no fat, no muscle, no meat. There is almost nothing between Ella’s bones and the padded chair seat except a thin layer of skin. Her upper thighs are thinner than my forearms. She has to be moved every two hours or she will get bruises and sores.Everyday Melanie, the daytime caregiver on this corridor, hand feeds Ella breakfast and lunch, trying to tempt her with strawberry waffles or beef stew or a soft, just-baked cookie. “I just want to fatten her up,” Melanie tells me as she carries a plate of food into Ella’s room. Melanie is a robust, big-boned, fair-haired young woman who looks like a Norwegian milk maid, if there is such a thing. Everything about her is soft and comfortable: her ample body, her muted voice, the calm, purposeful way she cares for the residents. A while ago, Melanie was given the chance to take a desk job out front. The move would mean no more changing Depends, no more giving showers, no more hauling people in and out of bed, no more doing laundry or cleaning the kitchen or carpet-sweeping the floor ten times a day. She would instead answer phones, greet visitors and take care of paperwork. She endured the desk job for two days before she asked to be transferred back to the west corridor.Melanie comes out of Ella’s room a few minutes later. Most of the food on the plate is untouched. “She ate a few bites,” Melanie says, shaking her head. “But now she says she’s full.” An hour later, Melanie will try again.Meanwhile, Ella has not stopped talking.“I did not know,” she says.“You didn’t pay any attention,” she answers.“I was busy with that.”“I just stayed away from her.”“You did?”“I went down there and she told me to get the hell out of there.”Again, hell. Out of the mouth of this tiny, old Christian lady whose favorite song is The Old Rugged Cross.“She did?”“I have to get a job somewhere else.”“Is that what you’re going to do?”“No. This is my home. Now do you understand what I’m talking about?”“I think I do.”“I feel better.”“Maybe you do.”It is hard to keep listening. I came to pay a social call, to see if I could get to know Ella, to offer the solace of a hand or a friendly voice. But now I am just an eavesdropper. I have no business being here. Ella sits in her wheelchair. I sit across from her on the bed. The afternoon light pours through the window. Outside, the lawn is bright green, and the cherry trees are just beginning to flower. But Ella is somewhere else entirely. It is disconcerting – and scary – to sit across from a human being who is there but not there. But I want to feel something other than pity, or fear. And so I begin to think that for her, these endless self-conversations might be comforting. She is alone, closed off to the world by blindness and age and dementia, half awake, half alive. But the half that is alive is alive. It is reaching out, or maybe reaching back, to capture experience, to re-create it, to make sense of it, to work it through. She is not finished living. She is just finished living with others.I get up quietly. I do not touch her as I leave. She keeps talking.