Here is Chapter 14 of Dreaming Out Loud, the book about my mother’s stroke.

Chapter 14

The days proceed in a regular, predictable, almost hypnotic pattern. I am pleased at how quickly everyone has adapted to the new circumstances and the radically-altered terrain.

Karola typically arrives by 9:00 a.m. Mom usually is asleep, but she wakes up to the smell of fresh bacon frying on the stove. Sitting up, she mumbles a series of unintelligible phrases — we call it “speaking in stroke” — and shinnies into her wheelchair. Although she can only use her left arm — her right arm is permanently molded into a seemingly arthritic claw — she has become adroit at maneuvering from bed to wheelchair to toilet to wheelchair again.

We have removed the leg fittings from the wheelchair so mom can propel herself into the kitchen using her feet as an accelerator and a brake. She would not be able to steer with only one arm in service. Consequently, she uses her legs as instruments of navigation.

It is not all smooth sailing. Although I have removed the door to mom’s bedroom from its hinges and stored it in the basement, any obstruction becomes a major obstacle in her path. She constantly crashes into the dresser, the nightstand, and the kitchen table. The door frame bears innumerable battle scars from repeated collisions with woman and chair. Friends and family are warned to lift their feet when mom rolls into the vicinity lest they suffer a crushed toe as a memento of the visit. The grand dame may have regained a measure of mobility, but she is hardly a precision driver.

If someone tries to push her wheelchair and she does not want to move, she digs in her heels and resists. If a person tries to pilot her chair and she wishes to move faster, she flails her legs and searches for suitable traction. She may be a stroke patient, but she refuses to be a helpless victim.

Assuming the old lady cooperates — a big assumption, in some instances — Karola attaches a bib around mom’s neck, serves up the food, buses the dirty dishes, and gets her ward dressed and ready for the day. She also makes up the bed, washes clothes, vacuums the rug, and keeps the house in order. If all does not go well — and on some days, it does not — order collapses and chaos reigns supreme.

During the first weeks of the new arrangement, I am heartened by the soothing rhythm of our lives. Mom seems to be well cared for and enjoys a reasonable quality of life. Would that such a routine could be maintained indefinitely.

I never understand Karola’s character. She is nice enough, but something about her demeanor remains oddly formal and unapproachable. She appears promptly at the appointed time, performs her chores conscientiously and efficiently, and departs exactly on time. I cannot fault her for ignoring her duties because she does as she is told, but she seems untouched by our family. Perhaps I am naïve, but I assumed she would develop a feeling for us and become an adjunct family member. She appears impervious to our charms. We are her employers — nothing more.

To make matters worse, Karola is profoundly unhappy with the terms of employment. She bursts into tears whenever mom yells at her, which is often. Where is the stoic Prussian I thought we had hired? She is as dead as Bismarck. I spend almost as much time soothing Karola’s hurt feelings as I do dealing with mom’s extreme mood swings. Somehow, I have become a de facto psychologist and counselor.

My only parent always has been an assertive person, for how else can a single mother with limited formal education and almost no money successfully navigate through the world with a semblance of dignity intact? In her infirmity, she retains her stubborn streak, but she has added the impetuousness of a child to her personality. It is an enervating combination of traits for everyone involved.

Most of mom’s complaints involve food. She is a woman of no small circumference, and food has always been important to her, especially following her stroke. Food seems to be the one area of her life she can still control, at least marginally. If the mashed potatoes are not cooked to her satisfaction, she screams. If the rice is undercooked or overcooked, she shrieks. If the turkey and stuffing are subpar, her howls reverberate throughout her apartment, rattling the walls. Her ability to sling world-class epithets may be impeded by her aphasia, but she can shout in a unique, unintelligible mish-mash of guttural grunts and groans that communicates the central message of her dissatisfaction with the meal in particular and the world in general. As a fitting denouement to the tantrum, she sometimes hurls her food to the floor when words fail her, as they often do.

Her frustration knows few bounds. Dressing is difficult because one side of her body refuses to respond. If Karola struggles to slip the blouse over mom’s dead right arm, the patient lashes out with her good left arm. On two occasions, her blows connect. Despite my angry lectures, mom will not be dissuaded from reacting violently when she believes that violence is an appropriate response.

I try to be patient. I know it must be frustrating to be trapped in a body that will not respond to simple commands, to feel helpless to dress or feed oneself, to not always get to the toilet without assistance. Nevertheless, mom cannot strike Karola whenever she is upset with the world. I reinforce this point repeatedly, but mom only glares at me and mumbles monosyllabic gibberish.

Exasperated, I feel my temper rise and my blood boil. Sometimes I, too, am reduced to a shrieking banshee. We have swapped roles, my mother and I. I am the stern, frowning, rigid disciplinarian, a role that feels unnatural. I hate the authoritarian figure I have become.

It is only a matter of time before matters come to a head.

“Your mother is a tough one.” Karola tells me this late one afternoon after she has unloaded on me. Who am I to disagree?

“I know.” I must be gentle and soothing in our conversation. I cannot afford to lose our caregiver or the task will fall to Paula and me. My relationship with Paula is secure, but the strain of caring for an invalid can fray even the strongest bonds of affection.

“I do not know how much more of this I can take. It is not fine that I am treated in this way.”

“Think of her as a child. A child doesn’t know what she’s doing.”

“She is stronger than a child. She is willful. I have caught her spitting out her medication three times. I have my suspicions that she has done it more times than that. She tries to hide the pills in the trash or in the bottom drawer of her bureau. When I find the pills, she becomes furious. I do not know how much more I can take.”

“Give it another week. Another week, and let’s see how it goes. I’ll talk to her.”

She sighs. “Another week. But I do not know how much more I can take.”

The week passes and the episodes increase in frequency and duration. Karola retreats upstairs to my house at least once a day, sometimes more often. Her tales of woe, while understandable, leave me stressed and anxious. We hired her to relieve our burdens, but she adds to them.

Finally, inevitably, one day Karola gives notice that she will depart. She tells me she needs to undergo surgery and she does not plan to return for many months, if ever. I feel sick in the pit of my stomach.

“What about your daughter, Kathy? Can she fill in until we find someone else?”

“Kathy is already booked with other patients. She might give you a few days, but only a few. This is the way of the world.”

I sigh. Perhaps I can call the Parkwood Nursing Home & Rehabilitation Center and ask for another referral. Perhaps Polly can return for a few weeks to lend a hand — except that she already is in a wheelchair herself. Perhaps...perhaps.

Perhaps I can run away from home.

“Karola, what am I gonna do? I can’t take care of mom myself. I have to work, and so does Paula.”

Something in my plaintive tone must awaken Karola’s inner empathy because she actually looks as though she feels sorry for me. She wrinkles her brow. “There must be someone you know — some family member who can perform these services.”

“There’s no one. It’s just us chickens.”

She nods. “I know of a lady that may assist you in resolving this predicament.” Karola reaches into her sweater pocket and retrieves a pen and a crumpled sheet of paper. She scribbles on the paper and hands it to me after a moment.

Practically snatching the paper from her hand, I glance at the name: Shirley Hardrick. A telephone number is also scrawled on the paper.

“You should call her at once.”

“This is a lady who can work as mom’s caretaker? You're sure?”

“You will have to call her. I cannot promise this thing.”

“Thank you. Thank you.” I mean it, too. I ooze sincerity, for I am most sincere. I almost hug her, but I know Karola is not the hugging type. I keep my hands to myself.

“You are most welcome.” She stares at me impassively.

“And how do you know her?”

“She sometimes sits for patients at the Walton Regional Medical Center. Kathy knows her. They both have sat with old Mrs. Bremer.”

She explains that old Mrs. Bremer suffered from some form of progressively worsening dementia, perhaps Alzheimer’s disease. Although she was frail and appeared to be one step away from death, Mrs. Bremer, a widow galloping through her nineties at breakneck speed, possessed the heart, lungs, and legs of a much younger woman. Her family was at wit’s end. They could not care for the old lady in a hospital, the insurance coverage having long been exhausted, but neither could they afford to hire a qualified nursing professional for all the hours she required.

The worst thing about old Mrs. Bremer was that she was a “wanderer.” If the person watching her turned away for even a minute, the wanderer was up on her feet, out the door, and scurrying along the shoulder of the highway. Several times the police had been called to search for the woman. Once they found her in the parking lot of a convenience store almost a mile from her home. Another time, she was picked up after she had fallen into a ditch filled with muddy water and weeds. She was contentedly sitting in water up to her waist counting dandelions as if she had not a care in the world.

I grimace, trying to imagine the horrors of dealing with an Alzheimer’s patient on top of my already difficult problem with mom. “That must have been terrible. So how did” — I glance at the slip of paper again — “Ms. Hardrick handle the lady?”

Karola’s daughter, Kathy, had started as Mrs. Bremer’s caretaker, but she was quickly overwhelmed. The woman needed far more care than Kathy, a wife and mother of two, could provide. Even with Karola filling in, they could not meet the family’s expectations. Finally, before Kathy and Karola exited the scene, they recommended Shirley Hardrick.

It was Ms. Hardrick to the rescue. Maybe she could save the day again!

“I do not wish to provide a mistaken impression.” Karola speaks in her customarily precise, clipped voice. “Shirley is not the miracle worker. She cannot be available twenty-four hours a day. That must be clear.”

“I understand.”

“But when she is available, she can control the patient. Calm her down. She has a way about her. A way.” Karola pauses as her eyes become moist. “I do not think she will have the troubles I have had with your mother.”

“Thank you. I hope you are right. I am sorry about mom’s behavior.”

She nods. “It is understood.”

At this point, I don’t care if Ms. Hardrick is a convicted serial killer. If she will show up for work on time for the price we can offer, I will hire her.

Karola nods. “I am sorry it has not worked with us.”

“I am, too.”

We bid each other farewell, and Karola Kinney strolls out of our lives. We see her again from time-to-time — she stops in to visit mom once, and I run into her shopping for groceries at the Super Wal-Mart store — but for all intents and purposes, our association has ended.

With a tight chest and a dry mouth, I dial the number for Shirley Hardrick. The phone rings for what seems an eternity until, finally, a voice answers. “Yeah.”

“I’m trying to get in touch with Shirley Hardrick.”

The voice suddenly sounds hostile. “Who’s this?” It sounds male, young, perhaps an adolescent. That would certainly explain my frosty reception.

I describe my situation in a nutshell. Before I can finish the synopsis, another voice interrupts. “Todd, get off this phone.”

I hear the sound of a receiver slammed down on its cradle.

“What you want, now?”

“I don’t know how much you heard — ”

“I heard what you said.”

“ — But I am calling to find someone to help take care of my mother. Is this Ms. Hardrick?”

“Yeah. This is Shirley.”

“Ah, yes, well, Karola Kinney gave me your name.”

“I know Karola. She's good people.”

“Is that something you could do? Take care of my mother, I mean — could you help out?” I detest the sound of desperation in my voice, but I have never been one to hide my emotions. I do not sport a poker face even on the best of days.

“Well, that’s okay. I ain’t got no job.”

“All right then. Perhaps we could set up an interview.”

“Where you stay?”

I spout out the directions, and we agree to meet the next morning.

At the appointed time, Shirley shows up. It is a promising sign.

She is a large woman in her mid-fifties. I recognize at once she has lived a hardscrabble life. With chocolate-brown skin, a lumbering gait, a non-existent education, and limited employment prospects, she is a stereotype in the flesh. Shirley’s daughter is deceased, and her husband is gone. She has struggled to raise two grandchildren — Mack-Mack and Todd, the latter with whom I spoke a day earlier — and eke out a subsistence living. For some reason that never becomes clear, she left her previous employer, Dr. Prokay, and is eager to find a job.

She is exactly someone we need — and she needs us as much as we need her.

I lead Shirley into the downstairs apartment. The woman walks with an awkward shuffle suggesting that her knees are bad. During a later conversation, she confirms that “I got one new knee and another one that needs the operation.” Her physical girth cannot be good for her knees, to say nothing of her joints, blood pressure, and general health. I keep these comments to myself.

Mom is not prejudiced at all, but I see her appraising Shirley with a skeptical eye. Shirley stares back. They remind me of two predators circling and sniffing each other.

“What’s with this one and this one?” Mom points. She is nothing if not direct.

“You talkin’ ‘bout my knee? Oh, honey, it’s just the time of year when I ache. I got the arthritis.” She pronounces it arth-a-rite-us.

Mom nods. They are on familiar ground discussing ailments.

“Ms. Hardrick is here to talk about taking over from Karola.”

“It’s jest Shirley, Michael. No ‘Ms. Hardrick.’”

Mom rolls her eyes and grunts. “Karola.”

Shirley laughs. It is a deep, rich, baritone belly laugh that emanates from some dark crevice hidden inside her body. It rumbles up like a fresh spring gushing out a torrent of water. “You don’t like the German lady? She sumpin,’ ain’t she?”

Mom smiles. “She sumpin.’ She sumpin,’ all right.”

“I been knowin’ Karola — mostly, I knows her daughter, Kathy — for a long time now. We used to work for Mrs. Bremer and she help out with Dr. Prokay. Kathy, I mean. Karola fill in when Kathy can’t make it. Mrs. Bremer was sumpin’ else, too. They like to have killed her up there at the Walton hospital. I tell you whut.”

I watch mom watching Shirley. Before the stroke, my mother was a remarkably good judge of character. I would not call her a cynic, but neither could she be labeled naïve. She once prided herself on her ability to walk in another person’s shoes. She could be trusting, but trust had to be earned and verified.

Shirley plops down into a chair situated next to mom’s wheelchair. “Hello there, Miss Laura. My name is Shirley. But you done heard that. It ain’t no ‘Ms. Hardrick,’ y’hear?” She extends her hand. “I stay in my apartment behind Quality Foods. You know where Quality Foods at?”

Mom laughs. “Quality Foods.”

“You know where Quality Foods at?” The woman turns to look at me. “How about you?”

I nod. “I have driven past the place, but I have never been inside.”

“I can walk up there from my apartment. Or I make my grandson, Todd, do it. Mack-Mack…well. He ain’t never home. Todd, he’s the one. On account of I got the bad knee an’ all.”

Mom reaches out with her left hand to grasp the offered appendage. “Hey. How you doin’?”

“Okay. How you doin’?”

Mom shrugs as she drops her hand back into her lap. She does not know how to answer that question. She is still alive, which is something, but what else can she say -- literally and figuratively?

I clear my throat. “So, as we discussed, we need someone to help get mom dressed, do a little cooking and cleaning. Stuff like that.”

“Uh huh. You done said that, Michael.”

Because I sense a lull in the conversation, I show Shirley where everything is kept. Mom’s apartment is small and the tour lasts for only a couple of minutes. We navigate through mountains of clutter, so uncharacteristic of my prestroke mother.

Afterward, I sit with the two women and explain what needs to be done. It is a tough job keeping mom functioning in her own apartment. Paula and I come down sometimes at night, but we need help with domestic chores during the day.

Shirley nods as I run through the litany of assignments. Finally, she puts up her hand. “You go on upstairs, now, Michael. Your mama and me’ll be fine. Ain’t that right, Miss Laura?”

Mom looks dubious.

“We just got to know how things gonna be.”

I frown. “And how are they gonna be?”

Shirley laughs. “We goin’ to be fine. We just needs to get a little thin’ goin’ here. A whatcha call it? We do it every day and things be fine.”

“A routine?”

“Uh huh. So you can leave us be and we’ll be fine with our routine.”

I nod. “Okay, then. Mom, are you okay?”

“Okay.”

I reluctantly walk upstairs.

As I sit on my couch, I realize that Shirley has such a loud, booming voice I can hear her baritone shoot up through the floorboards. I also hear mom’s rejoinders, which at times sound angry. She has never been an especially angry person, but since the stroke occurred, her temper is short. She is quick to take offense.

I am afraid for the future of this new relationship.

An hour passes, and my curiosity will not allow me to stay in my house. Their voices have grown silent. I put the book I have been reading (or trying to read, with little success) face down on the coffee table and take to the stairs.

Trundling down to the basement, I hear their voices again. Amazingly, I also hear laughter.

Mom is seated in her wheelchair in the kitchen with a bib fastened around her neck. I see a huge smile plastered across her face. She is in high cotton.

“Why are you so happy?”

Mom points at Shirley.

The black woman beams as she holds up a cardboard carry-out container. “Look here, Michael. My number hit, so I left and come back. Me and Miss Laura got us some shrimps from Long John Silver’s!”

“Yes,” mom confirms. Her smile fills the apartment. “We got us some shrimps from Long John Silver’s!”

I match her smile. Mine is a smile of relief.

Perhaps this relationship will work out after all.