Rehab, Part 3: Economics

I had a fitful, sleepless night with little relief from my pain medication. Earlier, I mentioned the two unused desks in the room, each of which had an equally-unused trash can in the kneehole. I had asked an attendant to move one of the trash cans near my bed, so that I could discard the tissue I used whenever I employed the urinal.

Early in the morning, a woman came in to replace the plastic liners in the trash cans. This was a fruitless task, because there was normally nothing in either can. She looked slowly around the room for the missing trash can, eventually finding it next to my bed. She replaced the liner, and then, as she had done hundreds of times before, put the trash can under the desk across the room, where it was useless to me.

“Miss?” I called to her, “Will you put the trash can next to my bed where you found it so that I can use it to dispose of these tissues?”

She nodded, picked up the trash can and then, perhaps from force of habit, slid it underneath the bedside commode, where I couldn’t reach it. I had slumped back onto the bed, and didn’t notice until she had gone. I spent the morning tossing used tissues onto the floor in frustrated attempts to make a Larry Bird hook shot.

I use this example to illustrate a sad reality I had begun to observe about the nursing home: After my stay in the hospital, everything seemed substandard, cut back to the thinnest veneer of quality. Nursing homes take the Social Security check of each resident to pay for their care. It's not much, probably less than $30 a day. To make a profit, they have to reduce costs.

The bed was narrow and uncomfortable, the sheets were rough – seemingly a blend of burlap and asbestos. Believe me, you notice such things when you’re bedridden.

There was a pervasive odor – a mixture of urine and cleaning products – that I’ve decided to call “pissinfectant.” The food was all canned glop poured over pasta.

But the worst example of nursing home economics was the staff. There was an administrator and a nurse on duty during the night. Everyone else appeared to be trained zombies.

They were undoubtedly minimum-wage jobs, which were boring, repetitive and demeaning. So the quality of people who take those jobs are the borderline retarded - those who take comfort in routine, unchallenged by novelty or crises. They plod numbly through their days, changing diapers and bed linens, moving patients to the dining room or the TV room, bathing the patients occasionally, and then returning them to their rooms for the night.

Earlier that night, before I tried to sleep, I asked an attendant to strap on my leg straighteners, which are reinforced wraps that are closed by Velcro straps. She held one up and turned it around and around, trying to figure out how to put it on.

“You lay it flat on the bed,” I instructed, “with the foam pad facing up. Narrow end by the ankle, wide end by the upper thigh. Then you lift my leg onto it and strap it closed.”

She continued to turn it around and around, her brain struggling with the complex geometry necessary to distinguish “wide” from “narrow.” Eventually, I had to pull myself up painfully and arrange it for her.

I had complained about the stifling heat in the room, so they sent a maintenance guy later that day. He looked at the air conditioner and declared that it was set to 60 degrees. “Yes, I can see that,” I said, patiently. “But it’s not 60 in here, is it?”

He and I stared at each other, a classic Mexican standoff. He eventually mumbled something and left, but it was a moot issue. I had made up my mind.

When my wife arrived around 10 a.m. to see how I was settling in, I pulled her close to me and said, “I want out of here right now. Right now. Sign any papers you have to sign, get me in a wheelchair and take me home. I’m not staying here another night.”