Memento Mori

Please check Author's Note before reading - it is a slightly dark piece from my past.

It’s a very surreal thing, being in a residential home. You look around yourself and you’re struck by the very impossibility of existence, their existence. You catch yourself thinking ‘how is it even possible for you to be alive?’ But of course they are, we’re just not used to seeing them is all. Instead they’re locked away in converted prisons where they stay invisible to the outside world; out of sight and out of mind.

I still remember my first week. I had 3 induction shifts, in which my training included being introduced to the needs and preferences of over 50 residents and the unique approach to them of 30 staff on 3 microcosmic floors (whereafter if you dare forget the number of sugars in a tea or fold a sheet incorrectly then god help you), before being told that I was on my own.

Over time I began to note the wretchedness and hopelessness of the place. I starting going to work each day dreading being confronted with those big double doors, standing there like teeth in the mouth of Moloch, awaiting it’s sacrifice. And I left work each day speechless with the wretchedness of it. What never wears off is the shock of the old. Dealing all the time with the most piteous of people - most of them in pain from various sores over their body, in misery and despair, sans teeth, sans eyes, sans taste, sans everything, and many wishing to die - strikes you through the heart.

Depression in the wider world is seen as something of a mania, an inappropriate response to the condition of life. But in a residential home depression is the appropriate response to the condition of death, which lies all around, stinking of stale piss.  ‘Second childishness and mere oblivion’ is a phrase used by Shakespeare to describe the seventh - and last - act of life. And such dementia is compounded in a home where the fool is king.

These people were those who had outlived their minds. That which remained, was, more often than not, not them. Every now and again you might catch a glimpse of lucidity behind some desperate eyes, before even that receded, as though dragged by a kraken into the depths. Where once you could have sworn you saw life, now only a ghost remained.

No amount of potted plants or daytime television could alleviate them or you from the awfulness of those conditions. Their previously proud and varied lives that had been reduced to the narrow confines of getting up, getting washed, getting fed, and getting put back to bed again. That small routine was all they had left, and watching over the fragile remnants of life made the job hard to bear. No prison is so lacking in hope. This is, quite literally, death row.

You see, doing a job well meant taking time, being patient, chatting. But in the absence of time, when there are so many in need of help and so few able to provide it, it becomes impossible to do a job well. Efficiency becomes the reluctant standard bearer for the quality of care provided, and working there reminded me of working in a factory. In this sense quality of life for the resident had become subordinated to quotas for the staff, and in that shard of truth we see the industrialisation of the care sector, stuck like a splinter in one’s mind. And when you can do only so much to improve quality of life, you try hard instead to find satisfaction in the little things: A smile, a nod, a ‘thank you’, or just a look of recognition. Failing that, simply getting through the day is enough.

But when it comes down to getting through the day two options lie ahead of you. One is to simply stop thinking about it, to give in to the systemic pressures and motivate yourself primarily for the fulfilling of quotas. There are, admittedly, two benefits to this. One is that at least it is egalitarian; everyone gets the bare minimum. The other is that you retain your sanity (though it is paradoxical - and a reflection on the absurdity of the place -that in not thinking about your state you maintain sanity, and in thinking about your state you lose it). But doing this makes it all too easy to become a product of the system, a factory worker processing people on the conveyor belt of palliative care.

The other option is to think about it more and be conscious of yourself, those around you and your environment. But this just heightens the depressiveness. So the choice, simply put, is between sanity and morality. What would you choose?

Whilst there I chose the latter option, and resigned myself to the thought that I would maintain a standard of care that I was happy with providing, even if it meant not fulfilling the quotas demanded of me. But in the end the heightened senses and the dissatisfaction of my co-workers, as well as the numerous tiny attempts throughout the day to preserve some semblance of humanity, only served to remind me of how little I could really do.

When a man I had become friends with died (his lifeless eyes staring up at me from the floor where he had fallen), I couldn’t take any more. I quit. I resolved then that I didn’t want to be part of a world where it was necessary for me to sacrifice whatever compassion, empathy or desire for human connection I had in order to gain a wage. Had I wanted to be a doctor, or a nurse, I would have been able to put a degree of separation between the work and myself; I’d be able to understand the situation through the lens of medicine. But I didn’t; and I couldn’t.

For sure, there were moments of magic, when human nature managed to shine through. Those times when you could sit with somebody and hear their stories of times gone by. Or when you’re thanked by the family of a resident, who manages to defy the odds and notice all the hard work you do. Or when you drag a heavy chair across the home so that one little old lady could sit and watch TV with her friend, the look of contentment on their faces being priceless. Those moments make the job almost worthwhile, but they were few and far between and were generally outweighed by the sheer numb drudgery of it all.

On the day I resigned I was told by the manager that I was a good carer, but the thing that was a strength in that sense was a weakness in another. For whilst I tried to go to work with empathy and humanity, like any good carer might, it put me in a direct line with the plight of the people resident there. But it’s a plight with no chance of success; residential homes are where the elderly go to die, and each death sees a part of you go if you are fool enough to be open to the experience.

Perhaps it was the particular home I worked in, which was privately owned and cared visibly for the margin, that was so dispiriting. But I think not. The likelihood is that all residential homes share the same fundamental conditions: scarcity of staff, scarcity of funds, and the absurdity of life juxtaposed with the ever pounding drum-beat of death. For my part, I think when I find that I’m dying or that my mind is being taken over by the creeping disease of Alzheimer’s, I will pack a suitcase and buy a one way ticket to somewhere far away, and then find a last remaining pleasure in the pathless woods. Just anything but this. Please let it not be this.

Author's Note

Quite recently I found myself in a residential home for the elderly. And although this last occasion was a happy one, I was plagued with memories that reminded me how negative my time working in a home had been, now almost exactly a year ago. The below is what happened when I put those memories onto paper and the result, as you can see, is pretty black. Don’t say I didn’t warn you!

Reviews

[Sujash I. Purna]

I can't say in words how much this piece of writing shook me up! I never found (nor do I hope I ever will find in future) myself in this type of situation when I have to see someone die whom I've just befriended...I understand from your narrative that it pains a lot and I think I have grasped what you meant when you said, "each death sees a part of you go if you are fool enough to be open to the experience"

I can also imagine why you thought being a doctor could have been less painful...the part where you've mentioned how fleetingly some magical moments lingered when "you could sit with somebody and hear their stories of times gone by" hit me in a bittersweet way...

In the ending lines your wishes seemed to me rational...and personally I think it's better to spend the last days of your life that way than ending up in a residential home and mimicking some friend of a boy who like you have to experience the Slough of Despond of the place...

I really liked the writing! Something quite different at Writerscafe I have ever come across...a very great concern to speak about...
I liked the influence your writing got from the Shakespeare's As You Like It...and the title Memento Mori should be thanked cos it took my attention first :)

Goodluck with your writing!