To give proper credit where credit is due here is a link to Steve Smith's personal writing portfolio. I cannot take credit for his beautiful work. He is an amazing soul and brilliant human being.
http://stephenasmithportfolio.wordpress.com/media-arts-page/
Without further or do:
“The Creature that Lifts
the Bed”: Steven Fosmire, MSII
The
nights were rarely silent, so Steven rarely slept. At the Maine Veterans’ Home
in Paris darkness crept the hall with bells.
From
other rooms leaked the too-loud laughter and blue conversation of television
families; sterile companions who had never spent a moment in a nursing home and
who would never come to visit. There were the regular soft knocks at the door,
the cool swish of curtains drawn suddenly back, the gurgle and whinny of
Steve’s Alzheimer’s roommate as nurses checked his midnight vitals. “Moron!”
the man would yell, to no one in particular, “Moron!”
And every
night there was the metallic grinding-creaking-crackling of the other man’s bed
raised and lowered, the nurses concerned that if he fell, he wouldn’t fall far.
To Steve, the sound seemed faintly feral. The creature that lifts the bed,
he thought. It was a silly thought, a midnight thought, but in the unquiet
darkness it somehow fit. And so did Steve.
Too Intriguing
The
idea was too intriguing to overlook. “I met Dr. [Marilyn] Gugliucci at the
faculty advisor dinner last fall during Orientation,” Steve recalls. “She
talked about her geriatric research and how several students had lived for a
couple of weeks in a nursing home. I thought, ‘Oooh, interesting,’ and filed it
away.” The project, as near as he could tell, was a perfect fit.
A
veteran himself, Steve was born in Utah but doesn’t remember the desert. His
dad was Air Force but Steve’s parents split when he was six weeks old and he
didn’t meet his father until years later. Steve’s mom - overwhelmed but trying
to cope - joined the Army and her parents offered to look after Steve for a
little while, until she settled down. A little while turned into most of his
life: “I definitely had a non-traditional upbringing,” Steve smiles, his voice
tiny for such a bear of a man. “My grandparents raised me in Saratoga Springs,
New York, and I consider that my home. My grandfather was a World War II,
Korea, and Vietnam vet; he served in the Air Force for almost 30 years.”
Steve
received his BS degree from Binghamton University before working at the Center
for Functional Genomics as a research technician in charge of performing DNA
sequencing and DNA synthesis. That egged him on to engage in pre-health
studies, which then spurred him to pursue a Doctorate in Physical Therapy at
Sage Graduate School in Troy, New York. To pay his way up the escalator of
schools, Steve worked as an aircraft mechanic on LC-130s with the 109th
Airlift Wing, Stratton Air National Guard Base, Scotia, New York, from February
1997 until September 2005.
“I
have traveled from pole to pole on this wonderful planet with the 109th,”
says Steve, “supporting the United States Antarctic Program’s research efforts
via the National Science Foundation in Greenland and Antarctica.” He has stood
at the actual geographic South Pole and visited CFS Alert in the Canadian
Arctic, which is the northernmost permanently inhabited settlement. Currently,
Steve is a 2nd Lieutenant in the United States Air Force Reserves’
Medical Corps, on a full, 4-year health professions scholarship at UNECOM.
Final Billet
In front
of the neatly kept Maine Veterans’ Home, flags sprout from the green island
that lolls in the center of the entrance circle: American, of course, Maine
State, and the melancholic POW/MIA flag that quietly demands its memories. On a
brass plaque in the front lobby, a visitor reads: “Maine Veterans’ Home: A
tribute to all veterans of this state. Dedicated by Gov. Angus King, Jr., Sept.
24, 1995.”
“When I
checked in, we ran through a ton of paperwork with a social worker,” Steve
says, “way more than you would think. It was daunting.” With the paperwork
squared, Steve watched another worker catalogue his valuables – wedding ring,
watch, movies, laptop - the few personal things he decided he’d like to keep
during two weeks as an embedded resident. The lobby had fake plants and lots of
natural light. Bricks alternated with spic-and-span white walls.
After a
nurse checked and documented his vitals, Steve was assigned a ward, a room, and
a malady. The 90-bed Home is divided into three units: skilled nursing,
residential living, and a dementia wing. “The residential side has more
freedoms, even mountain bikes and scooters if the residents want to use them,”
Steve explains. “I was assigned to the skilled care side with lower functioning
residents, including many in wheelchairs or with moderate Alzheimer’s. For
many, it is their final billet - but they don’t act like they know they will
die there.”
For a
simulated condition, Steve “contracted” pneumonia, which meant that he was at
risk for aspiration. All-pureed foods and thickened liquids made for a safe but
exquisitely unappetizing dining experience. Steve’s first pureed meal was roast
beef and mashed potatoes. He smiles weakly. “It looked like something my cat
threw up,” he offers finally. “I folded the mashed potatoes into it, emptied
four pepper packets, and choked it down. The thickened water was even worse. It
was like drinking gelatin, but thicker – it doesn’t quench your thirst.
Thickened coffee is sick! The apple-sauce was ok.”
After
several days of aspiration precautions Steve was given a clean bill of health
and placed on an unrestricted diet. “Normal food was great!” he says. “It was
dining-hall quality.” A maroon board
with gold letters offered each day’s menu: Monday’s breakfast was cereal,
French toast, sausage, and a melon cup. Dinner at 5:30 was chicken stew, a
cinnamon roll, and mandarin oranges. Or a roast beef sandwich. Steve chose
chicken.
To Better Understand
Few
medical students would jump at the chance to live in a nursing home. Steve is
that rare student. “I did it for two reasons,” he says quickly, his answers
well thought-through. “I wanted to re-connect with my grandparents, and I
thought it would be good to get insight from a professional perspective about
what life is like for an older person. At some point, I’d like to work with
veterans. And as my grandparents age, it seems harder to relate to them; I
wanted insight into how to relate to folks their age.”
“You
would think that relating to older people would be common-sense,” Steve
continues, “You listen to them respectfully and really try to hear what they
say, just as you would with anyone else. But for some reason, many physicians
have a hard time with that.” Miscommunication plays a significant role; some
senior citizens tend to speak more slowly, can be hard-of-hearing, and
sometimes process instructions with difficulty.
Doctors,
Steve thinks, may easily tend to infantilize older patients, talking at
them, or down to them, without understanding that they are real
people with mental acuity. “I didn’t experience any of that at the Maine
Veterans’ Home,” he says, “Everyone was very respectful.” But the danger of
misjudging another person, without having walked a mile in their slippers, is
real. “I wish every physician could spend some time as a ‘resident’ in a
nursing home,” Steve says, “It is very educational.”
“The Greatest
Generation”
Indeed.
The showers were supervised – no exceptions. Steve wasn’t sure who was more
embarrassed: himself, or the cute, red-headed CNA just out of high school.
“What are my choices?” he stammered, before learning that he could take a
whirlpool shower which covered everything awkward.
Some of
the nurses were young and pretty – they were tan and smiled a lot. The older
nurses were strong and heavy-set, veterans of a thousand bedside and dining
room skirmishes that left them with whimsical smiles and an efficient manner.
They were all the same to “Dan.” A salty-mouthed, wheelchair-bound Air Force
veteran, he offered unprintable comments with equal ardor to any nurse in the
room. “He chose the strong but pretty ones to help him,” Steve laughs, “and
most of them would dish it right back.”
“Sparky,”
a retired naval electrician, was matter-of-fact when he first met Steve. “He
didn’t ask why I was there or why I was so young,” Steve says, “he just asked
what branch I had been in. I said ‘Air Force,’ and he groaned and said, ‘Aww,
you damn fly-boys are everywhere around here!’ It was pretty cool to hang out
with “The Greatest Generation” as if I were one of them.”
The Perfect Melding
Steve
pursued osteopathic medicine at the behest of Tanya Hanke, a friend from Saratoga
Springs who gained entrance to UNECOM in the class of 2008. “She was the first
person to introduce me to the field of osteopathic medicine,” Steve recalls. “I
felt that osteopathy was the perfect melding of everything I enjoyed about
Physical Therapy, personal training, and medicine. UNECOM provides a strong
foundation in osteopathy and what it means to be an osteopathic physician. The
facilities are top notch. Wi-fi is everywhere on campus. The learning
environment is team-driven. Everyone here works together very well; we all help
each other out in many ways in order to level the playing field. Plus, the
ocean is a few stone-throws away from campus. UNECOM and the ocean, two
brilliant reasons to move to Maine!”
His
wife, Senta, is very supportive of Steve’s decision to pursue a career in
medicine. She dropped him off at the Maine Veterans’ Home and came to visit
like any other family member. Steve has appreciated her support, especially as
he has jumped into leadership positions at the College. Those positions tend to
chew up any time he has left after studies.
Steve
has served as a Student Government representative and Parliamentarian,
co-chaired the SGA legislative committee, organized UNECOM’s “Physicians’ Day
at the Legislature” and “D.O. Day on the Hill” trips last spring, co-edited The
Synapse yearbook, and served on the ethics and special events committees. He
currently serves as SGA vice president, is co-president of the Wilderness
Medicine Club and the Physical Medicine and Rehabilitation Club, volunteers at
the Soup Kitchen, has been nominated to the Sigma Sigma Phi Honor Society, and
works as a tour guide and student contact for prospective students to UNECOM.
He also occasionally sleeps.
1970 and Winter
Steve had
lunch in the dementia unit one day. “The lady sitting across from me thought
that I was her son,” he says, “she was more willing to eat as the nurse fed
her, because she wanted to impress her ‘son.’” One resident flung his tray and
got milk on another resident’s head. “Some of the people in the dementia unit
are not that old,” Steve says quietly, “they look normal. But to them, it may
be 1970 and winter.”
The days
could seem washed out. With little outside activity and nothing to be
responsible for, there was rarely a sense of urgency. High points were
predictable. “Residents look forward to family visits,” Steve says, “or outings
into town. Family visits depended on the person – some families came once a
week, some people came every day. One fellow always fell asleep at dinner or social
events, but then his sister called and he was animated and alert. It’s like he
came alive.”
Other
times were gray. “You kind of lose track of time,” Steve muses. “You live meal
to meal or meal to activity. Evenings were tough. There weren’t many people
around, since the older residents went to bed early. You lived in the present,
day-to-day. People didn’t talk much about the past, and you didn’t think about
the future. We talked about current events, or who had won bingo that day.
Bingo is strangely cathartic.” Also a newcomer to cribbage, Steve suffered a
string of humiliating losses, leaving him to shake his head and exclaim, “I’ve
never seen so many cribbage boards – I lost every game but one!”
By 7pm
his roommate was in bed and Steve walked the gleaming halls alone. A squat
bookshelf in the social room hoarded several dozen titles. They ranged from War
in the Pacific to James Herriot’s Dog Stories and Wuthering
Heights. A partial row of encyclopedias struggled to stand at attention.
The entertainment room had a large flat-screen TV, shelves of DVDs, a polished
hardwood floor, pleasant secondary lighting, and reading tables with blue
tablecloths, placemats, and vases with cut flowers.
The History of Doughnuts
Some of
the residents were good friends, taking every opportunity to spend time
together and hang out. “It was almost like a dorm,” Steve chuckles, “where you
would go to each other’s rooms to watch TV.” He played cards with several of
the other vets, especially Roger St. Hilaire, a one-legged WWII veteran who was
Steve’s best friend.
The
two-dozen staff members did their best to keep things interesting. “We made
doughnuts one day,” Steve says, “and they gave a history lesson about
doughnut-making, and we shook sugar onto them. Every day after exercise, a
staff member would read The Daily Chronicle, which was a blurb about
current events. They also organized mini-bowling with bright plastic pins.”
Steve had to bowl with his left hand and sit in a chair as a handicap.
“The
staff was outstanding,” Steve says. “They were very friendly and professional.
They knew everyone by name, and some had developed long-term friendships with a
number of the residents.” He stops for a moment, brightens (this sounds like
I’m about to smoke a cigarette), and continues, “It’s amazing how much of an
impact you can have on someone’s life just by being their friend. Learn how to
respect someone by listening. Learn by doing it. I guarantee that if you do
something like this, you will have more respect for your patients, your
colleagues, and the nurses.”
Steve
plans to go back to the Maine Veterans’ Home this fall, but this time he’ll be
a visitor, not a resident. He’d like to go on Veterans’ Day and wear his
uniform. He wants to see his friends, though there’s no guarantee they’ll all
be around. And he has another motivation, too. Roger St. Hilaire, the WWII vet,
was once a dance instructor. He promised that he would teach Steve and his wife
to dance sometime.
Roger
promised he would – if he can just find a prosthetic he can dance on.
- Steve
Smith, Summer 2007
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