She wore a brown wig over her long, but sparse, wispy hair. The wig didn’t stay on well and she was constantly adjusting it. No matter how many times she moved it forward, or pushed it up out of her eyes, her natural wiry white hair flowed out underneath and to the sides. For appearance sake, it resembled a hat, more than a wig.
Midway through her 80th decade, this woman presented in my professional landscape like many others – strapped on a stretcher. As an ER nurse, I am desensitized to visual extremes. While, at the same time, I am tuned into visual nuance with an intensity that is difficult to match. My new patient, with her tilted muddy brown wig, attracted me from the onset.
With her appearance, came a degree of judgement of what I would encounter when I entered the room. I fully expected to engage with this individual, who was trapped in the confines of Alzheimer’s disease, on the outer levels of rational.
She did not know what state she was in, nor did she know why she was in the emergency room. Dressed in a red flannel shirt, polyester stretchy pants with two different white sneakers on the appropriate feet, she laid on her bed with her eyes closed.
From the first question I asked her, down to my very last exchange with her, the response was unpredictable. Yet, regardless of WHAT she said, every single word she spoke was with clarity and great intent and often with an accompanying wig adjustment. Her intellect, obviously crafted throughout a lifetime, was evident in her vocabulary.
Every time I asked her how she was, I received a different answer. I soon found myself drawn to her, simply to see what she’d say.
“How do you THINK I am, laying in this uncomfortable bed!” She denied any distress whatsoever; aside from being in the emergency department that is. She had absolutely no complaints. She was sent to the ER from the Alzheimer’s unit of a local nursing home because: “she had fallen while walking in the hallway”. Nursing homes have a responsibility to ensure – ENSURE – that their residents are kept healthy. Any abhorrent event requires them to send the resident to the ER to rule out broken ribs, pneumonia, or a urinary tract infection. All these diagnosis are arrived at via multiple tests, sometimes repeatedly, thus resulting in lengthy stays.
Wig vacillated between cooperation and irritation. She was able to get up out of the bed and walk. Sharp-tongued, she admonished me continually throughout the day, starting with “I can get up by myself!”. Hunched over,with an odd combination of movements and holding onto a walker, Wig took off down the hall. Nearly every bone in her body was twisted, bent, or locked into place through obvious joint surgeries. Yet her biggest inhibitor was her Wig which moved about with every jerky step this fast moving woman could make.
Oh, and by the way, she was a lifelong nurse.
I discovered I held a beautiful gem in my hands with each and every prickly interaction. Wig spoke with clarity and accuracy (confirmed by nursing home) of her nursing career, where she trained and her speciality. She looked me dead in the eye and declined the catheterization of her bladder to obtain a sterile urine sample stating “Why in the world would you want me to do THAT, when I can just clean my boo with wipes”….and she was 100% correct. Catheterization is reserved for those who are physically inhibited to clean themselves. Wig got up out of the bed and provided crystal clear sparkling urine.
Yet, she didn’t remember asking for the tea I’d brought her, she didn’t know what state she was in, she liked me, she didn’t like me. As afternoon turned into evening, she became more agitated and wanted to walk continually which is problematic in a busy ER. I had two options: “force” her to stay in her room which had a good chance of irritating my passionate Wig to the point of restraint albeit physical or chemical, or I could ‘let her be”. This is when I discovered that Wig preferred rolling chairs to walkers. Indeed, she could get around even faster. Spastic, faster and scary, it was during these Walks with Wig, that she spoke about her nursing career with clarity and confirmed accuracy. She was also very sweet and pleasant.
She believed me when I asked her to help me “fold laundry” (to keep her occupied and safe while I did paperwork). “I don’t know why I’m helping you when I’ve got a household of my own to keep” as she angrily, but, meticulously, folded the pile of socks from our geriatric resource bin.
At one point, I gently touched Wig’s wig to help her adjust it. She slapped my hand away and said “I don’t care if my hair shows, I’m OLD for crying out loud” Wig went onto say she’d wore a wig for 15 years, had ‘at least’ 10 or 20 of them and I could get my own wig anywhere. During this willing and open wig-exchange, her irritation at my Wig-norance was self-evident.
“For god’s sake, HOW in the world did you get to be 53 and NOT know about wigs?”
Wig left our ER with a clean bill of health. She was in a good mood when the ambulance came to pick her up and I actually never said good-bye to her as I was caring for my other patients. It’s apparent to me I’ve no intent of letting Wig go.
Wig was a gift. Wig IS a gift, and Wig is very very challenging as Wig doesn’t care one whit about what anyone thinks of her.
I am a nurse; I am also an artist, drawn to fresh perspective, or as some would say, altered realities. Abstract thinking is a skill I hone. I also watched my beloved grandmother succumb to Alzheimer’s disease. So, it is not a stretch to imagine my future aligning with Wig. Further, to effectively practice the Art of Nursing, one MUST walk in another one’s shoes.
I saw Wig as a visual gem: mismatched, crooked, wrinkled, vacant and emotionally precise. Although she is not connected to the here and now in any dependable way, it is clear that Wig still contributes to this world: opening eyes, broadening smiles, evoking curiosity, disproving judgments and trying patience. The beauty of nursing is that, from time to time, it gives back to us in spades.
I received way more from Wig than I gave her and she could care less WHAT I gave her (which, by the way, is a requirement of Sainthood). Among the many enlightments I received, I treasure most, now knowing the underestimated value of a decent and varied wig collection.
“They even ‘got em at the grocery store!”
joanneorrdotme 