This is one more of my friends from the hospice. She has a different real name but she wants me to call her Pauline. A nonagenarian by age, a lot of her cognitive functions are lost. Her brain often misfires leading her to talk to her stuffed cat or relatives that have been long gone.

Except when you put a piano in front of her!! I did not even know that. I was sitting with her in the lobby when one of the staff members mentioned that the facility has a new piano and my friend can play it. I pushed her in her wheelchair to the piano expecting her to fiddle with it.

While I am not familiar with all the songs she played, they were certainly mellifluous – and this is important – she was absolutely keeping to the rhythm of the beats. Her brain clearly knew how to keep count of intervals of time. She got so excited that she had me take videos of her – while she sang full throated to the tunes she played!!

After every song, she would step back and say something like “I heard you play this” which of course meant there was a part of her brain that was misfiring again. All I had to do is encourage her for one more. She would pull her wheelchair up to the piano again and start playing.

And I am not talking about one or two songs. Her memory function for music was sharp enough to remember at least 8 different songs!!

It is amazing how complex our brains are. But it is also instructive to realize that even if some parts of the brain of an elderly person (some of us have had parents go thru this phase) have deteriorated, there are other parts that can absolutely thrill the person and take them to their happy zones! Trick is to find out what it is.

Here in America, today is one of the most joyous days. It is Thanksgiving. A day that celebrates that fundamental cause celebre for humans beings – family relationships. It is a day that reminds us that in spite of some of the strains in family relationships (who amongst us does not have that weird uncle or that seemingly insufferable relative?), there is always a set of people who will be there by us when we need them the most. Even when everybody forsakes us.

And then there are people like Mr. G. Lying in the corner room of the hospice, he has no family, nor any idea that it is Thanksgiving. In fact, when I told him that it is Thanksgiving today, he smiled and said “Merry Christmas!”. In his bouts of slipping in and out of cognitive consciousness, he did answer me right when I asked “What do we eat today?”. “Turkey!”. But had no recollection of cranberry sauce or stuffing!

He literally has no family. He had been in the hospice for a long time before a very distant cousin (second cousin I believe) located him and paid him a visit.

But for all that, he is too preoccupied to miss the love of a family. He needs help for every thing he has to do. He cannot even sit up without somebody helping him. He cannot turn on his sides when he feels sore, he cannot pull his blanket over himself when he feels cold and worse, with his fading speech and loss of memory of words, he can often not express what it is that he wants.

I am not sure what thoughts go thru one’s mind when you are physically incapable of doing anything. Who do you thank when you reflect on life? Are you too unhappy/angry with current state or are thankful for everything you still have? Would it have been better if nobody reminded you that it is Thanksgiving so you will not miss it and the day would pass for you just like yet another day?

Eventually, he got tired and wanted to sleep. As I put the blanket over him, he murmured “Come back again” and went off to deep sleep.

For all the thoughts I was having about Mr. G as I started walking down the corridor, a more important sight caught my eyes. There were about half a dozen staff milling around… helping the residents. These staff, I am sure do have family at home. But they had to adjust their celebrations so as to make sure the residents were cared after.

It was very difficult not to feel thankful for everything I have. And perhaps take them for granted.

Mr. G (name withheld for privacy – although he insists that I put his full name here) is one of my new patients. He has sharp cognitive power. But multiple cerebral infarctions has taken away his ability to speak properly. Which is an unspeakable situation (sorry for the pun). He can hear, he can process and he has the answer – but he cannot get it out of him.

Every trip, I have to be as patient as I can be and yet, more often than not, it is not enough. I hope against hopes that I can catch one or two words and deduce the rest of it. Most of the time I make it work.

Thru his lisp and mumbles, I have put his life story together. From his birth year to early divorce and no kids to the three countries he has visited, I think I have a fairly working knowledge of him. I know this much – he has no family to talk of and nobody has visited him ever for a long long time.

Today was another great day with him. He is most beautiful when he gives his toothless laugh.

I was showing him my dog pictures (he had two himself when he was younger) when I told him that I would like to have a picture of him. “Let’s do it now!”, he said.

I was not prepared for that. I was hoping he would be sitting up and I will be sitting next to him when we take the picture. I am terrible at selfies as you can see in this picture.

But what was really difficult to hear was he asking me after taking the picture… “Are you going to leave now?” Those are the toughest words to hear during a visit.

I lied to him “No’. Although my time was up and I did have to go somewhere else.

It seems he felt reassured by that. After 15 minutes, I finally told him – “I have to go now but I will be back next Sunday”.

“At 2 PM, right?”

“You remember?”

“Of course!”

Funny. He did remember that last time I had told him I will come on Sundays at 2. He saw me and assumed it was 2 PM. Turned out I had made a morning visit at 10 AM.

Can you imagine – being old, still having cognitive power but little ability to move around or give expression to your thoughts? How frustrating can that be? One thing I have realized… at that age, you want company, you want to talk to somebody… but most people are too busy..

Reminds me the same question my dad used to have after my quarterly visits… “you are coming back in 3 months right?”

Old age is a tough thing. Not being around people who can give you company is a terrible thing.

I wish that every such person get the company they desire…

The folks who manage the hospice services where I volunteer have always been a very grateful crew. They regularly arrange for lunch outs, gift cards and what not.

The thank you card this time had a special line that hit a note for me.

“The last good thing that may happen in a person’s life is a hospice volunteer”

Driving back from the hospice every Sunday is one of those pensive periods in my week when the mind wafts away to deep thoughts. With mostly unanswered questions.

Patricia is my nonagenarian friend. She is frail as frail can be. It used to be that we would get her in the main area for her meals. These days, even that has become too onerous for her. Every time I go to see her – she is invariably in her bed, doubled down like an unborn baby, deep in sleep.

Or so I used to think. I have realized over the months that she is often awake but too tired to open her eyes. If she did open her eyes to answer any of my questions or ask me for something, it would be only for a fleeting second. One trick invariably perks her up is when I fish my phone out and show her pictures of our dog. Without exception, she will have that blissful smile in her face.

Today too, she was crumpled up in her bed. Too frail to get up and eat. The staff told me that instead of normal dinner – which for others was soup, salad and rice with shrimp and vegetables – she was just going to have a bottle of Ensure and a piece of chocolate.

The feeding was fairly mechanical and uneventful. I would hold the straw up to her lip and she would take a few sips and pull her head away. A minute later, we would go thru the movie again. And kept repeating till we had almost finished the bottle. She opened her eyes and looked at me. That was her silent way of saying she was done. Switched her up to a piece of chocolate. She readily opened her mouth.

A couple of minutes later, I grabbed a wet wipe from her bathroom and cleaned up her face. She was still tired and had not uttered a single word the whole time. I left the room for a brief moment to call the nurse to put the respirator in her nose. (She needs that help in breathing and I do not have the training to handle that device).

It appeared that she had gone off to sleep. The nurse was rearranging a few of the stuff near her machines. I gathered my stuff and started walking out. I had barely cleared the door when I thought I heard something. The nurse immediately called out – “Roy?”

“Yes?” I had turned around and responded.

“She said ‘Thank you’ to you”.

“Really?”

“Yes, she opened her eyes, looked at you going away and said Thank You”.

A little surprised that she was not asleep, I came to the other side of the bed and bent over to be close to her ears and said “Patricia, good night!”

Taking both the nurse and me by surprise, she held her right arm out.

Thinking about it now, I think she was just trying to wave at me. At that moment though, I thought he was holding her hand out to be held. Involuntarily, that is what I did.

The nurse left soon. A couple of minutes later, I was still there by the bedside bent over holding her hand. It was hurting to stand like that. But my mind was racing thru what was going on in Patricia’s mind. She certainly had more cognitive understanding of what was happening than was apparent with her constantly closed eyes and not much of limb movements.

I decided to come to the other side of the bed and sit in a chair next to it. But I was afraid that she might think I was leaving her. So, gently, I told her “Patricia, I am going to come to the other side and seat by you”. She opened her eyes and closed. I realized that she had understood what I just said.

Letting go of her hand, I quickly switched to the other side, sat down on her wheel chair and held her hand again. I talked to her a couple of times but there was no response. For about ten minutes, I just sat there. Our only company was the gurgling noise of the respirator. All the time I was wondering what was she thinking? If somebody has so much cognitive power left – but has little to no physical strength, what kind of loneliness does one go thru laying in the bed hours after hours, days after days?

I also realized how lucky my parents were. They had each other till pretty much their last day and were surrounded by my sister’s family and my brother’s.

Eventually, I let go of her hand. She did not stir.

I convinced myself that she was asleep. Or was she?

In any case, not to take a chance, I did not even say Good night. Just got up, waited for half a minute to see if she would open her eyes and then tiptoed my way out.

On my way out, I reported back that she had finished her dinner and had gone off to sleep. The staff waved me good bye and I promised to come and see them next week again.

Back behind the wheel, thoughts just kept coming in and out. Perhaps like Patricia’s mind swims into active consciousness and out.

When she wakes up again at night, will she remember that I was there? Will she be looking for me? Or has she realized after so many days in a hospice that she has little say over anything? Even if she was to look for something, she was not going to get it. She is at the mercy of other people’s generosity.

What does one go thru listlessly laying down in the bed at that age when you hit that level of physical inability? How painful is it if the mind is active but the body cannot sustain any activity? What does it feel like to be completely dependent on others? How painful is the transition to that acceptance?

The lights turned green. And I put my attention back to the road as I navigated thru a crowded left turn.

** all names are cooked up to protect privacy

“Betty, my patient is still sleeping in her room. Why don’t I take this gentleman off your hands?”, I asked.

Well, my hospice patient was sleeping. I was not sure what to do. I came down to the lobby level and saw Betty – at the front desk – struggling with all the calls to the front desk, buzzing visitors in and paying attention to the impatiently walking John (also a patient).

“Thank you”

“No problem”

The next 30 minutes was an eye opening exercise. Gave me a window into what my dad must have gone thru. And what I might too, myself.

You see, John has been suffering from a lot of old age issues. At a macro level, his kids have been great to him. They pay for the hospice facility, they visit him religiously every week and make a big deal on special days.

At a micro level, he has no idea about any of that. He needs them with him NOW!

The walk up and down the corridors was mostly pleas from him to see if I could get his kids to pick up from that place. (He thinks he lost his way and one of his kids just needs to take him home).

When somebody is totally daft, it is one thing. You just talk past each other. The only purpose is for the other person to think you are listening. They have no ability to judge otherwise. But when you swing between the real and unreal worlds like John, it becomes dangerous.

It is a delicate act of balancing between soothing him down when he is angry because he thinks I am not helping and supporting him when he thinks that his daughter is going to call him back moment she is done with work.

He had a mobile phone on him. That had a lot of saved numbers. And he fumbled his way to high heavens trying to call any of those numbers. All this time, walking up and down with me in the corridors.

“Why don’t we go out and sit?”

“Okay”

We settled down. But he was fixated on his phone.

Then I heard the “click” “click” noise!

“What did you do?”

“I think I took pictures.”

“Of what?”

“I have no idea”

Apparently, he was totally lost in the phone options.

“Listen, Mr. John. Why don’t you let me take a picture of you and me so I can show my daughter?”

“Is she in Stamford, Connecticut?”

“No. she is here, in Georgia”.

“This is not Georgia”

“You are right. I meant she is in Georgia. You and I are in Connecticut”. (I had to play along with his memory)

“Will you send it to my daughter?”

“Moment I meet her, sir!”

“Okay”

And of course, the instant I take the picture, he starts calling his daughter again!!

The evening went on like that…

Here is what I learnt that evening – When you grow old, you do not want anything more than being surrounded by your near and dear ones. You do realize that they have more important things to do in life. But you really, really want to be with them.

If you ever get a chance to make a difference to an old person by just being with them, please do. You do not have much time left. I know I do not!

The good news is that after fourteen months, I got the message that I am finally cleared to go back to hospices to spend time with people who are in the last stages of their lives. Need to still get the painful subcutaneous Mantoux test done (to test against TB), but right now I have been assigned two young ladies (both 87) pining away their last days in two different hospices. And I have a brand new mask to show off too!!

The bad news is of course, none of my old friends that I got abruptly sundered from are there any more. In fact, most passed away without even being able to see their loved ones at the height of the pandemic.

Nikita had asked to accompany me to one of the hospices during the holidays. Finally, our times matched today. (You will be surprised how busy a high schooler can be even during the Christmas holidays). I am glad she came today.

When I arrived, one of the patients was particularly agitated. We will call her Maria for privacy reasons. I sat her down and started talking to her. She just wanted to go home. Of course, being a memory care unit patient meant most of her memory and cognitive power has been fried. She tried explaining that her dad was supposed to come and pick her up and he has not come yet.

“How old is your dad”?, I asked her softly
“Oh! mid seventies, I think”.
“How old are you?”
“I think I am older than him”.

You get the idea about how the conversations go. Nikita, who was patiently watching all this time, drew a chair and sat next to us. I introduced her to Maria. Within seconds, they were chatting like old buddies. Most of the discussions went in circles. After some time, I left them to do my rounds with other patients. When I left, they were having a discussion on who looked prettier. Each insisted the other did.

Half an hour later, I came back and these two were still talking. Nikita asked if she could stay for some more time.

Eventually, I had to tell her that we needed to go home for dinner. Maria immediately asked if I could give her a ride.

“Where do you want to go?”
“I live in Ohio”
“And what when your dad shows up?”
She thought for some time and said “I think I will stay”.
“No problem. He may take some time. The weather outside is not good”, I lied thru my teeth.

The hope was that the sleep medicine would soon do its trick and one more day will come to an end in her life.

Also, the further hope is that Nikita got a sense of the cycles of life we go thru and how blessed we are now. The proudest moment for me was when the staff – and one particular patient too – asked her to come back.

When I left your bed at 8 PM on Monday with your beautiful family around you, I promised you that I will visit you the next morning. Perhaps you did not hear me with all the struggle you were going thru – gasping for breath. Or perhaps I should spoken up a little bit so you could hear me.

The next morning came for me. But not for you.

Ruffling my fingers thru your sweaty hair while you lay on the bed, it felt very strange. This was the first time – in the one year that I knew you and have visited you at least forty to fifty times – I actually went in to your room. Every single time I visited you, I found you in the common area and that is where we spent all our time.

It was so strange to see you lying down without any movement. Before that you were the person who could not sit down. The only way for me to spend time with you was to walk next to you as you kept walking up and down the corridors. Purposelessly. Incessantly. Always whispering something to yourself. The only reaction I would get out of you was when I gave you a handshake. Inexplicably, you would burst into a smile. How many ever times I repeated it – that was your acknowledgement. Unfailingly.

You never told me about your son and your daughter. I got to meet them for the first time on Monday night. You never told me that you were part of the armed forces. I saw the certificate in your room. For that matter you never told me anything! Or to anybody else. I learnt from your wife that at the young age of 48, you had started deteriorating. I got to know you about twenty years after that.

By that time, you had lost your ability to say anything. I would ask you simple questions. You would stop. Look at me for a long time. As if you were trying to process what I had said. You would then mumble something – that was barely audible or coherent for me. I would nod. And away we would go shuffling down the narrow corridors of the hospice again.

Last couple of months started being different. Your walks got slower. And for the first time, I saw you tentatively sit down and doze off in the sofa between your walks. It was there for everybody to see that you had started to slow down.

Till you stopped entirely on Monday night.

Ours was a relationship borne out of silence. Its strength was never rooted in words. It was in the time we spent together silently.

Without a word you came into my life.

Without a word you went away.

But I had to put in a few words for you to remember our time together!

As you know, I spend a lot of time on the road for work which means many an evening is spent grabbing a quick dinner sitting at the bar. And the days I am not traveling, usually Sharmila and I go out and get a drink. A common theme in all these settings is that I make friends with the guy or the girl behind the bar and get to know about their life stories.

There is an interesting pattern there. Try it out yourself if you do not believe me. More often than not, it would be a young person in her or his twenties. They would have invariably finished their high school. After that either they could not afford college or are working at a bar to earn money to some day go to college. I know of kids (and I consider twenty year olds – kids) for whom a few thousand dollars is the difference between going to college or not going to college.

A few months back, at the urging of a friend of mine – Aaron, I attended a breakfast meeting of YearUp.org. I had some familiarity with this organization from one of my prior jobs. I would recommend that you read up on them – what they do and all that if you live in the US. In short, they take kids who are done with high school and try to give them a “break” into the corporate world.

Money is not the only issue with the kids. Professional skillsets is also not the only other issue. Most of them do not have the background or exposure to present themselves. They have a hard time writing a reasonably good resume. Because they have no understanding of what corporate America thinks is a “good resume”. They have little to no interviewing skills in a corporate set up. Most of them would not even know how to talk to an executive for a few minutes.

That is what YearUp tries to solve for. They try to give those kids some professional skills and a lot more of the soft skills and try to engage other corporations to give them an opportunity at an internship for six months. In all, as the name suggests, the full program is for a year.

But there is a catch. They have strict rules for the students. No cuss words. Always formally dressed. Always carry a resume. Never be late…. If you play by the rules, the year is free to you. If you get demerits, you are thrown out of the program. Lest you think these are easy… I want to remind you that most of the students can not afford cars. One of my students takes a bus, then a train, switches to another train and then a bus again – a two and a half hour ordeal EACH WAY to go to his internship place. And he cannot afford to be late as long as he wishes to stay in the program.

In any case, late last year, I enrolled myself to give my time to the cause. I came in mid stream but a few folks – like Amrutha and Carla – were very helpful in getting me inducted. I was assigned twelve students. I have to tell you – all of them have incredibly humble beginnings – one girl pushes disabled people in wheelchairs at our airport, one girl worked in the catering section of a local racetrack, one guy mows lawns, one guy worked at the backend of a local retail store… but their determination to be successful someday is jaw dropping to me. I certainly had a humble beginning myself – but nowhere near these folks. My parents gave up a lot in their lives but they always paid to make sure we got college done – even if they had to borrow money. And yet, these kids while not having that advantage, has more determination than I ever had.

Ever since last November, I have been spending one on one time with these new friends of mine helping them understand how to present themselves in a corporate environment, how to behave in a corporate environment, how to write resumes, how to interview, how to think about careers and all that good stuff. I am thrilled to say that due to the efforts of Yearup, six of my twelve kids have scored jobs in the last two weeks. I am still working with the other six.

If not anything else, I would ask you to just go to Yearup’s website and read up about them. They just want to create opportunities. They certainly created a few for me. Who knows? Someday you might create some opportunities for a few of their kids too!!

P.S. In the picture, I am addressing a larger set of students giving them my thoughts on how to work with recruiters …