“Old age is no place for sissies.”  Bette Davis

I am just getting adjusted to the latest adjustments.  When I was in medical school, I heard that word “adjustment” used as medical terminology for the first time, as in “He’s just having an adolescent adjustment reaction.”  Before that, I had experienced the word more frequently applied to inanimate objects—cars in particular, such as “the driver’s seat needs adjusting,” or “please adjust the timing belt.”  As my education progressed, I learned about chiropractors and how they “adjust” the spinal column to relieve back and neck pain, or even foot and ankle misalignment in my friends who were dancers.   But somehow I must have missed the lectures on adjusting to the natural process of aging, since I never gave it much thought until recently when I began to make the rounds of retirement communities here in San Diego.

After my mother passed away in early January, my eighty seven year old father received the news that his heart and lungs were no longer able to tolerate the 8,500 foot elevation of their Snowmass, Colorado home.  Previous bypass surgery and a stenotic aortic valve had taken their toll, and the prospect of wearing oxygen 24 hours a day, seven days a week was not appealing to this man who had been performing cleft lip and cleft palate surgery in Africa and Viet Nam as recently as last fall.  And so a month ago, down from the mountains  he came.  The improvement in his breathing was immediate—so much so, in fact, that he has agreed to come to live here in San Diego.  Although he has been staying with us, and is welcome to do so indefinitely, he longs to reestablish a social life amongst his peers—to play bridge, to discuss great books and current events, and hopefully, to resume his golf and tennis games.  He had been half-heartedly looking at facilities for the past two years of my mother’s dementia—full service facilities that take the elderly from independent living through skilled nursing, and ultimately, if needed, to dementia care.  This time around, he is free from the constraints of her limited options, and we’ve broadened the search a bit.

For the last few weekends, we have dutifully and diligently set off to see the best that Southern California has to offer. We’ve toured low rises and high rises, condominiums and apartments, mansions and villas.  We’ve seen covered heated swimming pools, exercise rooms and movie theaters, casual coffee shops and formal sports coat requiring dining rooms.  We even saw an apartment at Casa Manana, a retirement community in La Jolla, where the floor to ceiling picture window in the all-purpose one room living/bedroom gave up a spectacular ocean view and the sound of waves so close we could almost feel them crashing against the shoreline.  But each time, my father turned away.  Neither of us spoke of the sights that gave a small nagging voice to our fears—the squeak of a walker being lifted and set down again, a palsied hand reaching for a glass of water, the faint smell of mildew in a recently vacated apartment with a silent cane propped in a corner, long ago abandoned for a wheelchair.  My father was pleasant and polite to our tour guides.  I, who will turn sixty years old this year, looked out over the gray heads and stooped shoulders in the dining rooms, and saw my future.

A week ago, after spending most of Saturday and all of Sunday morning looking at potential places for Dad to live, I had had enough.  There was one more visit to be made, to a retirement community very near my workplace.  My husband graciously volunteered while I stayed home to do laundry.  Much to my surprise, when they returned from the excursion, my father was very excited.  The community was new, beautiful, and laid out like a country club, with low slung buildings connected by gardens, grassy areas and well-tended walkways.  There were two dog parks, and folks were out and about on a sunny day.  When I asked my father what he liked so much about the place he exclaimed, “Everybody looked so YOUNG!”

I suspect that my father will adjust to his new life just fine, once his medical conditions are straightened out and the path to that future is clear.  As for me, I am adjusting  to the fact that my pantry and freezer are now stocked full of his favorite foods—oatmeal raisin cookies, bagels with strawberry cream cheese, salty potato chips and Klondike bars.  It looks like my wardrobe is going to need an adjustment soon!

The Purple Bathing Suit

“April is the cruelest month”  T.S. Eliot

Although I have spent my professional career battling cancer, cancer is not the cruelest disease.  Tonight I was looking through old photographs that my father had taken to a print shop to be scanned on to a disk.  He sent me a copy, but I had not had much time to look at the pictures.  When I finally did, last night, I was disappointed in the sloppy job that the print shop or camera shop had done—photos were scanned in upside down, backside forward, reversed, random and unlabeled.  There was no chronology or logic—it was just willy-nilly, get the job done.  And I am sure that they charged him a lot of money for that service.

Looking again tonight, there is joy and sadness in those old and out of order family photographs.  My sister smiles as she receives her diploma from Stanford.  My little brother, now long dead of a drug overdose, blue eyed and perfect as a three year old sitting next to my 5 year old pony-tailed self.  Me, in my favorite “car-coat” as my mother called it, felted and toggle tied and warm.  I remember that time it snowed in Houston—I was in first grade and I had pretended to be sick to stay home from school and then it snowed, beautiful white fluffy snow, and my Nana would not let me go outside to play because, of course, I was “sick”.  By the next day, the snow was gone.

Of all of those old pictures, there is one that jumps right off the screen at me.  It is a photograph of my mother, just graduated from college, in a purple skirted Jantzen bathing suit.  I know it is a Jantzen because I remember the logo from my childhood—a little diver with a swim cap covering her head, doing a swan dive into a pool, ubiquitously sewn onto every Jantzen suit of the 1950’s.  My mother is at the beach, sitting demurely on a beach towel that appears to be engulfed by a foamy wave which creeps just past her delicately crossed legs.  She is brunette, petite, beautiful and smiling.  She is 21, and her whole life is before her.  I like to think that my father, deeply in love, took that picture just before they married.

Sixty years later, my mother is a two time cancer survivor.  She was treated for breast cancer in 2001, and then for a disease of the blood, Waldenstrom’s macroglobulinemia, which involved her brain in 2005.  At that time she received chemotherapy directly into her central nervous system.  Five years later, in 2010, she began to lose her memory, and her will to walk, and to speak, and to eat.  Now, in 2012, she has advanced dementia.  She does not recognize me or my sister, and my father dutifully visits her at least every other day in her nursing home, where she receives excellent care, completely dependent on others for her survival.  Because her nurses are so attentive, she has not had a life threatening pneumonia or urinary infection or infected bed sore which would cause her demise.  And so, we wait.

I never got along very well with my mother, but despite that I wish fervently that she could be herself again, older and wiser, waiting out the tide in her purple Jantzen bathing suit. Cancer is not the cruelest disease—dementia is.   I am waiting to see which shoe will drop for me.