Nuts and Bolts

Jennifer C. Miller

Palliative care nurse

I prayed.

I prayed he knew how I felt, because I never took the time to say it. He had to know how hard I fought for him, how hard I worked just to get him here to this room on this day. All of the calls, the emails, the back and forths to check on him. Desperate pleas for any information about his condition, because COVID kept us out of the building. It was a draining process, day in and day out, but somehow it made me love him even more. My heart was fully invested in the mission of saving him – it became one of the biggest fights of my life.

***

My father-in-law, JR. I can so easily imagine him over on Buckeye, living with his brother and his parents in the predominantly Hungarian neighborhood. If I close my eyes, I can almost smell the warm strudel from Lucy’s, layers of crisp dough wrapped around apple, cherry, cheese or poppyseed filling, see him reaching up for the white box and having a taste on his way home. Nothing brought JR more happiness than a home-cooked meal and dessert. 

***

He had been in the facility for a few weeks by now. My daughter Caroline and I were going to try a window visit even though he happened to be on the 2nd floor. She made him a “get well” poster. We were so excited to see him, it felt like ages since the last family dinner. We parked around the back of the building and called to see if someone could help him stand up by the window. A few minutes later his wife Joan arrived. We had to wait a bit, but finally he appeared at the window with the help of a nursing aide. We were waving and shouting; Caroline was holding up her sign and I was trying to record the encounter on my phone. In that moment there was such joy at seeing him and hearing his voice. The joy slowly faded as I looked a little closer. He couldn’t stand up on his own. He appeared weak, unshaven, not like his old self. He didn’t have his glasses on. He was wearing a plain white T-shirt (typically was dressed in a polo or button-down) and he looked so pale. I tried to tell myself that it was early, that he was still sick, that he needed time to get better. Our visit was short because he didn’t have a lot of energy to stand. We walked around to the main entrance and dropped off the sign for him. I wasn’t beat down yet by not being able to get into the building, to go into his room and see him face to face. That would come later.

***

JR was in his early 20s when he opened Solon Valley Hardware – he dropped out of Miami University when this opportunity presented itself. He borrowed a little money from his parents, Betty and John, who lived just a few streets over from the store. His dad helped him with some of the work getting the store ready. There’s a newspaper clipping about the business which shows JR – balding already (a Miller trait) – dressed in a short-sleeve button down shirt, khakis and sporting thick black glasses. 

***

The days dragged on with JR imprisoned in the nursing facility. Every day was a rollercoaster ride. Whenever the phone rang, I braced myself for more bad news – especially in the middle of the night. A call to say he’d fallen but was okay, another call early on a Saturday to tell me he had to go to the ER, he was septic and declining. He’d climb up the hill only to fall back down again and again – hourly, daily, weekly. At the highest point, he actually recovered enough to come home. He spent one night at home, slid to the floor trying to stand up, and went back to the ER. He didn’t come back home again until the end.

***

It was getting later in the summer, probably August. JR was declining. He had given up on life because he was stuck there, alone. I tried calling the admissions person at my old job – it was a new person, someone who didn’t know me and didn’t know everything I had given to that company. Through tears, I said “So you’re telling me we can’t come in and see him until he is actively dying, until he won’t be able to recognize us or respond to us?” In so many words she said yes. 

***

Things were getting worse at the nursing facility; COVID was in the building. Every day when the phone rang and Wellsprings lit up on the caller ID, I felt sick. “This is Wellsprings Nursing Facility. We are mandated by the State of Ohio to notify families of COVID cases in the building. Currently there are 10 cases.” This was up from just a day or two ago. As the number crept up, so did my anxiety. Was he going to get this and die from it, alone? I – we – were all stuck on the outside, unable to do anything to help. 

I dreaded the ring of the phone and sometimes would wait for the answering machine to pick it up.

We got another call on Saturday with the number of cases even higher. I called an old friend who still worked there and she said, “Get him out.”

***

What else can I tell you about JR? He was a “man’s man,” loved a good cigar and a glass of whiskey. He dragged his boys to numerous car shows. In his younger days, he was an avid skier and enjoyed fishing. There were other family vacations, too, many to Kiawah Island – but mostly he stayed close to home, close to his center, close to his family.

***

Things started to happen quickly. There was so much to do – set up the live-in caregiver, get the medical equipment delivered, go grocery shopping, get all of his medication ready … but it was a good kind of busy, purposeful. I was so happy – this moment had been a long time in coming for all of us, but most importantly, for him. 

***

There’s this picture of JR that stands out in my mind for some reason. He’s sitting on a bench, leaning up against the wall of the lodge. He’s got a blue puffy coat and ski hat on. Sunglasses too, I think. His eyes are closed, face toward the sun – content with life, happy, kids probably out on the slopes.

***

On his homecoming day, Mark and I went over early to help. His mom had been out to the grocery store, filling up the refrigerator. I went through all of the medications and put them in a pill box. Then we moved on to filling and labeling insulin syringes. I was so optimistic, sitting there with a pile of syringes and a tidy pill box. If we prepared enough, had all of the supplies, got everything set up just so, then maybe everything would be okay. Maybe he would go back to napping in his recliner with the TV on.

***

When the first grandchild, Samantha, was school-aged, she asked grandma and grandpa to get a cat for their house. And so entered Annie – a mean little black cat with no tail who would hiss at everyone but JR. His lap was the only one good enough for her. As he pet her, she’d purr in delight while simultaneously shooting daggers into the rest of us with her beady eyes. Poor little Annie, she’s probably still looking out the window, waiting for him.

***

I remember seeing the ambulance pull up. It was raining, I think. Mark went outside to greet the drivers. They got his dad up the front step ok, but once inside the house there was a problem – the stretcher didn’t fit around the corner where his hospital bed was. So, they picked him up by the sheet, Mark and the two gentlemen, while JR cried in pain. They got him into the room and onto the bed – what misery. Joan couldn’t watch – she sat in the other room. Things settled down for a bit. For dinner, the caregiver moved him using the Hoyer lift to the recliner and he cried again, but at least he was back in his favorite chair. Before we left, almost as an afterthought, I took my phone and coaxed JR into saying “I love you Caroline” so that I could record it. It was very important to Caroline to have something to hold on to. 

***

JR and Joan had been married for over 50 years. The summer months he spent at the nursing facility were the longest they had ever been apart. 

***

He made it through Sunday okay. All of his sons had come over to see him. On the drive home, I was relieved. Mark was quiet, hiding whatever he was feeling. When we got home, Caroline asked me how much longer I thought he had to live. I was so generous, so optimistic – Weeks? Months? Surely, I was ignoring my own training as a nurse, seeing him back in his recliner just as I had so many times before. Some time later, Mark told me that he recognized his dad’s blank, far-off stare - he’d seen it before during his grandfather’s last days. He knew it wouldn’t be long.

***

JR meant different things to different people. As his daughter-in-law, being a step or two removed, I saw things from my own point of view. For me, JR always had a quiet, calm, steady presence. He wasn’t always expressive of his emotions, yet I felt that he had a deep love for his family. He was a provider – if the house needed new windows, the driveway needed replacing, your oldest child needed a used car to get around – he would not hesitate to pitch in wherever he could. 

And my favorite thing about him? I always loved the conversation – he would ask a million questions and drive everyone else crazy but it never bothered me. And now I can’t remember that last family dinner, what we talked about, the questions he asked. What I wouldn’t give for another chance to sit down and talk with him. 

***

Tuesday night we drove over to the house to say good-bye; he was declining quickly.

I still didn’t quite believe that this was happening. When we got there he was lying in bed, sleeping, snoring as he always did when he took a nap in the recliner. Maybe he still has some time. Maybe this wasn’t the end. It certainly didn’t seem like it by looking at everyone else’s response – they were sitting in the other room while he was in here all alone. 

The den had now been transformed into a sick room; the room where he would take his last breath. Hoyer lift, bedside table, hospital bed. Pink toothettes next to a cup of water to moisten his mouth. Baby monitor on the shelf above him in case he called out in the night. Overhead lights on, casting a harsh artificial glow on skin that was already dull and pale. 

Caroline and I walked into his room; it was just the three of us now. Next to his pillow sat Charlie, the stuffed dog Caroline had given grandpa while he was sick. She wanted him to not feel so alone. In the corner of the room sat the “Get Well Grandpa” sign she created about a million years ago. I nudged her to get close to him. She said goodbye to her grandfather and my heart shattered into a million pieces.

***

After Caroline left, I sat with JR. It was just the two of us. I told him I loved him, we all loved him. His caregiver came in to see if we needed anything. How could I tell him I wanted these last few moments to myself? I guess it really didn’t matter. It was my turn now. I couldn’t put it off any longer. I finally realized that once I walked out of the room that would be it, JR would not ever be there again, sitting in that recliner. 

All of the calls, the emails, the back and forths to check on him, to see how he was doing, to see if he was getting any better. Desperate pleas for any information about his condition. COVID did not allow us the luxury of seeing him in person. It was a draining process, day in and day out, but somehow it made me love him even more. My heart was fully invested in the mission of saving my father-in-law, one of the biggest fights of my life.

But you know, in the end, I realized there wasn’t anyone left to fight. I gave him a kiss, smoothed back his crazy white hair, and walked out.

Author Bio

Jennifer C. Miller was born and raised on the west side of Cleveland, only living outside its borders for a few years in her mid-20s. She was a teacher and met her husband Mark while taking a college course. Two children soon followed; Jack and Caroline. She did medical transcription at home for the next several years. After that, she went on to pursue an associate’s degree in nursing, eventually obtaining a bachelor’s and a master’s as well. Currently she works as a palliative care nurse helping patients with chronic illness.

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