"Mamacita," my little Mama, many years ago on a sunny day.
It's around midnight and my almost 77-year-old Mamacita phones me from her room at St. Joseph Hospital.
"A-lee-sa-bet," she says my name in a whisper, her soft voice floating into my ear in the melodious tones of her native Spanish. "I have to pass gas and I do not want to offend the other woman in my room who is named Alma or the nurses who have been so kind to me. Still, it is very hard to hold. My stomach feels like a rock and I would very much like to expel some gas, but that would be very rude. Also, I do not have any air spray so I cannot hide the aroma afterwards. What should I do?"
I rub the sleep from my eyes, pondering the etiquette of gas passing when you are a well-mannered, elderly Hispanic woman who is in a hospital recovering from a serious illness.
"Well, Mamacita, I think you should just fart and be done with it."
There is a pause before she responds.
"Oh, I do not think I could do that! I guarantee you it will be smelly and it will be loud. It will wake Alma!" She says the name again to emphasize her point. "ALMA!!"
Ah, yes, dear Alma! I had met Alma, my mother's roommate, the previous afternoon while helping Mamacita get settled into her new room after having been transferred from the ICU to the Progressive Care Unit, the step-down unit for patients who were improving. She looked to be in her 80s, a slightly deaf woman with a very bad cough. Mamacita's eyes grew wide as Alma introduced herself, hoarsely saying her name, which means "soul" or "spirit" in Spanish.
I understood Mamacita's dilemma. To fart in public is always a cause of concern for her, but the idea of passing gas next to someone with such a religious name horrified her Catholic sensibilities. In her mind, it was an omen that she was roomed with someone with such a significant name and it would undoubtedly be bad luck to pass gas in such a situation. And the last thing she needed was more bad luck.
"Maybe Alma won't wake up," I venture tentatively. "She looked tired when I saw her today and she's probably a sound sleeper. And she doesn't hear very well anyway."
For the next few minutes we discuss the possibility of waking Alma with one loud fart versus Mamacita emitting a series of tinier, secretive farts that would be less disruptive. She questions her ability in her weakened state to control her emissions. The urgency in her voice begins to rise along with her increasing discomfort.
Finally, I convince her to push the button for the nurse and quietly request to be taken to the bathroom where she can hopefully relieve herself without awakening the awe-inspiring Alma. When the nurse arrives, Mamacita hands over the phone and I explain the situation, going into great detail about her desire to not offend and even suggesting they give her some medicine to head off future gassy episodes. At the end of my spiel, the nurse, who listens quietly without interrupting once, says somewhat incredulously, "So, your Mom woke you up from a sound sleep to talk about passing gas?"
Strange things happen to your relationships with loved ones when their mortality is threatened. Goofy behavior you would not tolerate in normal circumstances somehow becomes . . . well, oddly OK. Being jarred awake by my Mamacita to have a conversation about the intricacies and social conventions surrounding gas passing now seems like a worthwhile way to spend my time, something important enough for me to lose sleep over.
Compared to the conversations I had with her on the day she was admitted to the emergency room at St. Joe's, chatting about farting was actually a pleasure. On that day, Mamacita was hallucinating, weak, trembling, unable to walk, stand or comprehend simple questions. Basically, she was a mess.
Prior to that, the last time I had been at St. Joe's emergency room was a year and a half earlier when Dad had his final stroke, the big one that would eventually lead to his death in a local nursing home ten months later. The night of Dad's death, I was awakened by a call from Greg, the charge nurse for the "B" wing at the nursing home. I wasn't able to answer quickly enough before the call dropped into voice mail . . .
"Hi, this is Greg at the nursing home. I'm sorry to tell you this but your Dad isn't having a good night and we don't think he'll make it to morning. He's breathing heavily, delusional, his vitals aren't good. We're following the orders in his DNR protocol, doing what we can to make him comfortable. He could go anytime. You'll need to get here soon if you want to be with him before he dies."
I saved the message and replayed it twice before calling Greg back to tell him I was on my way and to ask him if he would lean over Dad's bed and whisper in his ear that I would be there soon. Over the next three months I would replay this message every few days, hypnotized by the sound of Greg's voice delivering the news I had anticipated -- yet dreaded hearing -- for so long.
And then one day, something strange happened. The message announcing my father's impending death -- the message I had so meticulously saved each time after listening to it -- disappeared, vanished. I checked old messages, new messages, scoured the instruction manual to my cell phone and selected all the voice mail options available on my phone in a fruitless search for the missing voice mail.
I am positive I did not delete the message and angry that my phone has kept useless messages from telemarketers and people who have dialed the wrong number, but has failed to keep safe the one message I had been irrationally clinging to for three months. I contemplated calling my phone carrier for assistance but stopped short when I realized there was a manic feeling growing inside me that would not be appeased even if I did somehow retrieve that last message.
Prior to the stroke that took away my father's ability to speak, he would frequently call me in the middle of the night just to chat. His voice would be halting and slurred, the result of previous smaller strokes. He would want to talk about whether I would be bringing pizza for lunch the next day or if I had noticed there were weeds growing in his backyard flower bed. Initially, I was annoyed at these nocturnal interruptions, begging him to please, please call me back at a decent hour, reminding him that I had to go to work the next day. He invariably would apologize, truly surprised that I would be snoozing at 2 in the morning.
As his illness progressed, however, I began to take his calls with patience and resignation, suspecting that the night hours were restless and frightening ones for him and that hearing my voice and talking about mundane topics for a few minutes somehow soothed him through the stillness and darkness. He would start these ghostly calls in the midst of some thought he was having and end them just as abruptly with a swift click, cutting himself off at some random verb or adjective.
These calls were like sound bites into the inner workings of his brain, a brain whose landscape had been ravaged and fragmented through a hard life and stroke and dementia. Always a laconic, difficult-to-read man, these new communications of his were more cryptic than ever, often snippets of phrases cobbled together in a haphazard fashion that sometimes seemed like language, sometimes not.
Eventually, Dad stopped calling me, later admitting he could no longer figure out how to use the phone and had inadvertently called several wrong numbers only to be met with angry words from the hapless folks whom he had jolted awake with his requests to talk about pizza or flower beds or his favorite movies.
Fast forward two years later, and the nighttime ghost in my phone has resurfaced, this time with a lilting Spanish accent and a sweetness and innocence of spirit that has always been part of my Mamacita's personality. Because opposites do indeed attract, where my father was often gruff and sad in his commentary, my Mamacita is almost always friendly and warm.
After her condition stabilized, her first few nighttime calls to me from the hospital were about her confusion over how she landed there in the first place. Even though I would visit her for hours during the day and update her on what the doctors were saying about her condition, she would still call me at night, astounded and needing additional confirmation that her life-threatening illness was caused by a sodium and potassium deficiency.
And, of course, I understood her befuddlement completely. After caregiving for Dad during his declining years, Mamacita and I had worked out a health plan to do everything we could to protect her from all the big illnesses. She exercised daily, monitored her blood pressure, took medication for her osteoporosis, saw her doctor every 3 months and got all her vaccinations. Who knew that a lack of sodium and potassium could land you in the hospital and then a nursing home? While we had been vigilantly looking for signs of stroke, heart attack and cancer, could it be that Mamacita was being derailed by a food seasoning?
Since this revelation into the world of electrolyte imbalance, I am tempted to carry packets of salt with me and press them into the hands of elderly people I see mumbling to themselves on the street. I want to take out a billboard proclaiming "Got salt?" or "Do YOU know your potassium and sodium levels?!"
A brief review of world history reminds me that wars have been fought over salt and whole civilizations have fallen in pursuit of this mineral. Too much or too little salt in your diet can lead to serious health problems and even death.
The longer I live the more I realize how little I know about anything. Despite taking Dad to dozens and dozens of doctors' appointments and exams with specialists, I was not able to stop the last stroke that eventually killed him and now it appears I will not be able to halt Mamacita's advancing ailments. In the end, I was left with a single haunting message announcing Dad's last moments, a message that appeared and vanished as quickly and mysteriously as life itself.
Since moving into the nursing home to regain her strength and receive therapy, Mamacita has fallen and broken her right wrist. She also contracted pneumonia and was sent back to the hospital for three days of treatment.
Now back at the nursing home, she has settled into a routine of physical therapy, occupational therapy, bingo, making friends with the nurses, regaining her strength and looking forward to the day when she is discharged back home. She is more confident now and no longer calls me at night to tell me she is lonely or confused or shy about farting in front of a stranger. So, for now, the ghost in my phone is quiet, slumbering the night away.
I hope it stays like this for a long time.