Two weeks after returning from China, I was spending a sunny Saturday afternoon on my boat when suddenly I was overcome with intense pain in my gut. This quickly led to diarrhea and bleeding. A trip to the Satellite Emergency Room got me Morphine and an ambulance ride to the hospital where a labyrinth of back halls and patient elevators obscured the FACT that I was being taken to the ACE Unit: Acute Care for the Elderly. ELDERLY! Didn’t they notice that I was armed with a mobile telephone and a PDA to run the office and take calls?

I didn’t figure it out at first but I finally got curious that I was the youngest person there, and that some of the PCAs were commenting on muscle tone and what good shape I was in.
Post-realization, while telling a visitor that this was an elderly unit, a nurse asked who told me.
I wasn’t supposed to know. What other secrets did they have I wondered.

So I sat on my bed and bled all over everything. Totally embarrassed, I called for help and an African American PCA came down to reassure me that it was fine, that I was sick, and that she would clean my bottom. .Five minutes later it had happened again. It was then she suggested DIAPERS. That did it. I was ELDERLY, incontinent and wearing DIAPERS. Something was going radically WRONG.

It was a hard fact to reckon with. Two weeks ago I climbed the Great Wall and yesterday I was on my boat. How did this happen to me? I mean the people around me were old. How did they make this mistake? What are the criteria for being in this unit.?

I lay there and took in the sounds of the unit. A doctor came to do a mental status exam on the patient in the next bed. As part of an MSE, one asks the patient to remember three things which the doctor will ask about at the end of the exam to determine the functionality of short term memory. I smiled when the doctor left without asking the patient the three things he had been asked to remember; and laughed out loud when the doctor returned and said “I forgot something. I need to listen to your heart” That wasn’t all she forgot. But I remembered. I knew the three things. Wasn’t that proof that I wasn’t elderly? That they had made a mistake?

The doctor had asked the patient what day it was, what date. I realized I was a bit confused on that point so I quickly looked on my wall chart where they write the day and date. Then I was even more confused because while they changed the date, the day hadn’t changed. Ahah! This is actually a plot to confuse us, to make it appear that we are elderly.

Every night for four nights in my delirium of fever I am back in China. On the fifth night I get these ideas which are leading to the writing of this story. Is this for real or the continued ramblings of my febrile brain?

So I’m elderly. They have me. Not semi-retired; not older; not senior: ELDERLY!

The next shocker comes when they send me out for a sigmoidoscopy. Elly, the nurse in the radiology department admires my red socks that I have been wearing all over the hospital on the various excursions for tests and x-rays, and asks if I know what they mean. ‘RISK OF FALLING’ she tells me. Attached to my gurney is a sign with two red high heel shoes and a line: ‘Fall prevention”. Wait a minute guys.I work out at the gym every day;but the ACE Unit is sending out all these clandestine ways of telling the entire hospital that I am ELDERLY.

Now there are family traditions about my being in the hospital and this one is not to be ignored. My wife and kids all come in to visit me and announce that they are all going out to dinner. On me of course! It is as if they are actually happy that I am in the hospital so that they can enjoy this ongoing custom. How many times has it happened now?

I get a new room mate. A Chinese man who is visiting his family. However he has only two words in English:“No English”. Oh this is good. I have only two words in Chinese. Ni hao and Xie Xie, (“Hi”, and “Thank you”.).So each morning we exchange greetings. He says “ No English” and I say “Ni hao and Xie Xie”.We actually did get a bit further than that. I had answered his phone which rang frequently while he was out for tests. When he returned I pointed to the phone and said “telephone” He said “No English” .Then I counted on my fingers to seven and he got it. .We could communicate without language. He made it a point to come by to say good bye when he was discharged.

There is the comfort of family, friends and neighbors who come to visit, or call and share in these stories, but it confirms for me that we are all crossing the border into being elderly. One friend said that in her 20’s, she used to talk with her girlfriends about love. In her 30’s it was sex. . Now it’s about bowel movements.

My grandkids come to visit and I find it fascinating to watch how each handles the problem of Papa in the bed. The oldest, 7, sits on the floor pretending to be reading a book, but carefully tuning in to what is happening in the room. His younger brother, 4, has a bunch of questions about what is wrong with Papa’s tummy. Does it hurt? Can you eat? Are you coming home soon? Oldest granddaughter, 3 ½ comes over, finds a band aid on my wrist and kisses it and goes off to play. She has done her job. Another grandson age 5, calls to ask if my heinie hurts, a malady he, himself, has been dealing with for a while.

Then there is the conference that I was to attend and have to cancel:: Aging Body Aging Mind.
How ironic is that?

In spite of having to come to terms with being elderly, and being on the Acute Care for Elderly unit, there is a very positive side to the experience: the intensely warm, respectful, competent care these men and women give to each patient. From warm friendly hellos, offers to help, “call me if you need anything”, all contribute to a healing environment. I have had a lot of experience in hospitals and clinics where “what can we call you” results in giving our nickname which we are called by the 20-somethings who are trying to be helpful. It just doesn’t sit right. Here I am called Mr. H. but introduced to room mates by our first name.

Drs. Ghassemi and Kahlid were the GI doctors whose cheery and enthusiastic manner I loved. Dr. Corey Brown and her wonderful smile and her competent team answered all my questions. The nurses: Valerie from Montego Bay, Kurt, competent and serious; Pat who spent a lot of time talking with me in the middle of the night; Elizabeth whose family came from Portugal;

Members of the ACE Unit staff celebrate the opening of the new unit with a ribbon cutting. Shown are (l-r): Dr. Leo Cooney; Catherine Bursey; JonathanHarris, PCA; Marjorie Menze, L.P.N.; Gloria Wallace, R.N.; Margaret Drickamer,M.D. (kneeling); Hattie Primus, EA; Judith Lyon, R.N.; Grace Jenq, M.D.; PatriciaAntonopoulos, B.A.; and Lisa Walke, M.D.
(photo from Atrium Auxiliary, The Newsletter of the Yale-New Haven Hospital Auxiliary, Summer 2004)

Audrey from the Philippines who knew some Mandarin language; Dean who checked on me in the night; and Dee;. the PCAs who were so kind; Tony would get me anything with a smile and liked the ladies; Edward, gentle, kind and serious, with three kids, took blood at 5 a.m.; Shante with the big beautiful smile; Trina and her energetic walk and go get ‘em style; Sonya, from Yugoslavia who is now a US citizen and happy and is working to become a nurse; Tom, who came when I was asleep; and Jennifer, studying at Gateway to become a Radiologist Tech. Each of these men and women gave exceptional care and made the time pass quickly with their openness about their lives.

Last we have Dr. Jenq with her probing eyes, and a facial expression exactly in sync with my situation when my body was not cooperating and taking downward turns. Her asking me if I would let her students examine me offered some potential entertainment. She and the students actually looked foreign to me, so I, the world traveler, like to explore the wheres and the whys. The male student was from Atlanta, the female from Boston. Dr.Jenq said she was no help as she was from Oklahoma. I felt she was mother ACE with her flock of med students around her.

The staff seemed surprised that I was working taking calls and making appointments for my colleagues but were all very respectful of my need to do that. We had some confusion with the food, as orders were being constantly changed. Clear liquid diet became full liquid, then changed to no lactose, no flour, no pasta and ended up at clear liquid. Sometimes I got two trays. It is amazing how great warm soup tastes after days of Jello and juice.

My friends and neighbors who wanted to reach my wife would call our home/ office and find the call forwarded to my cell phone. When I answered they were confused because they were told I was in hospital. I didn’t sound so elderly to me!

There were many laughs. One quiet afternoon when I had the three bed room to myself, my wife and grandkids came. She tried to turn on the TV near the bed across the room and instead pressed the call button for the nurse. . “How may I help you” sent us all laughing. I laugh because for the first three days I had done it many times, bumping it, rolling on it, laying on it. One exasperating but wonderfully assuring thing is that my wife asks me to remember people’s names, and I actually do. (Who is more elderly now?)

I am reminded of her recent surgery after which she awoke feeling dizzy with blurred vision. We all attributed it to the anesthesia, but later in the day when it persisted, I noticed that she looked different and asked if she had new glasses. She looked at them and discovered they were not her glasses. I called the hospital staff who were terribly apologetic and assured me they would look into it, calling later to tell me that they belonged to a doctor. He had put the glasses down to write a prescription and the nurse picked them up and put them on my wife. Later they found my wife’s glasses in the bottom of a garment bag. She didn’t look for them because she had glasses on her face. My wife said she would drop the doctor’s glasses off the next day. The staff there asked if she wanted her own glasses. Who’s elderly?

So what is the conclusion of this wandering tome? I think I have found that I am very prejudiced. I don’t want to be in that class of people. But there I am. Maybe I just need acute care for the elderly. But whatever, if one has the ability to laugh at it all, it can’t be too bad.

rwh, sr.

10/15/2007