Frances H. Kakugawa
Hawai‘i Herald Columnist

Omoiyari . . . Think of others first and good karma will return to you. — Frances H. Kakugawa

Dear Frances:
Those poems in The Hawai‘i Herald — I’ve been through similar experiences.
Sadly, I’m beginning to think that the older one gets, the less attention and importance she receives as a patient. Dr. Serdahl is one in a million and that he leaves his computer in the other room just confirms it.
Malia
Hilo, HI

Dear Malia,
You are not alone in feeling this. I’ve been receiving stories from other readers about doctors diagnosing, “It’s due to old age.” I’ve asked for referrals from caregivers in my support group for families having similar problems, and you can do this, too. Call around and hunt for a physician among your friends.
Frances

Dear Frances:
Loved your correspondence with Dr. Serdahl. A very, very smart man. I hope the Pellegrino “kids” follow his example in the med world.
See you later. Omoiyari.
Charles Pellegrino
New York City, NY
(Frances’ note: Dr. Pellegrino is the author of “To Hell and Back: The Last Train from Hiroshima.” My review of this book appeared in the Aug. 7, 2015, edition of The Hawai‘i Herald. I have met the three Pellegrino “kids” — all in the medical field — and those apples have not fallen far from the tree.)

Dear Miss Kakugawa,
I appreciate your dedication in bringing your skill as a writer to the process of promoting health. I also appreciate your kind recognition of our school’s commitment to including the humanities in our educational programs for the next generation of clinicians. Best wishes for continued success in your important work.
Robert N. Golden, MD
Robert Turell Professor in Medical Leadership
Dean, School of Medicine and Public Health
Vice Chancellor for Medical Affairs
University of Wisconsin-Madison
(Frances’ note: Readers . . . If any of you are alumni of the Wisconsin School of Medicine, please let either Karleen or myself know so that I can send your name to Dr. Golden. When I asked for permission to publish his letter, he said it was an honor.)

Dear Frances,
I am reading your column on human kindness (May 6, 2016, issue of The Hawai’i Herald) as I sit with my mom in the hospital. She is being transferred today to a rehab center and is scared. I have had mixed experiences with the nurses here at the hospital over the past four days and I don’t know what to expect at the nursing facility.
My mom has lived with me for the past eight years, but fell and broke her hip last Tuesday. I take some comfort from your words and hope there are some kind caregivers where she will be for the next month or so. Of course, I will be there as much as possible, but this is her worst fear, and I am scared, also.
Thank you for understanding what I am going through.
Sincerely,
Juliet
Sacramento, CA

Dear Juliet,
We need to become active and positive advocates of good care, and we can do this. Thank those who are kind and caring, recognize good care, and if there is a lack of good care, sit down with the head nurse or the director and ask how you can help to bring about changes. I’m not advocating Pollyannas; I did have an aide removed from my mother’s facility when I caught her using scalding hot water while bathing my mother.
Frances

Dear Frances,
I read your latest column, and it’s beautiful. I’m not sure that the attached piece would work as a follow up.
Doreen Beyer
Sacramento, CA

INVISIBLE
“What time do you have lunch here?”
“Twelve o’clock. What time is it now?”
“It’s almost lunch time.”
“But I just had breakfast.”
“You did? What did you eat?”
“I had a blintz.”
No response.
“A blintz,” she repeats to the expansive pause. “Do you know what a blintz is?”
“Yes,” I respond noncommittally.

“Her walker catches on the carpet,” reports the caregiver.
I examine the low pile carpet, looking for snags.
“Would you like to see how she walks with it?”
“Sure.”
We head out to the dining hall.

“She’s walking pretty good today. Her feet aren’t shuffling.”
Ettie pushes her front-wheel walker, light-green tennis balls fitted at the ends of the legs in back.
“I want one like hers,” she says, pointing her chin towards a perky woman with short white hair, gliding a shiny new red four-wheel walker. It is fitted with a black seat, a basket and hand brakes. She turns the corner smoothly. I openly admire its design.
“My son found it online for $63,” she says brightly.

Ettie chooses to sit at a lightly populated table in the corner, past the salad bar.
She introduces herself and me, her daughter-in-law.
Betsy introduces herself, then Debbie, the lady with the bright new walker, and her own husband Jack, who had just returned from the salad bar.

The caregiver leaves to prepare Ettie’s salad.
While she is gone, Ettie awkwardly arranges the linen napkin across her chest with hands dancing to a Parkinson’s tremor.
Her caregiver returns with a plate of spiral pasta sitting among lettuce greens and sliced cucumbers, topped with a dollop of cottage cheese and salad dressing. Ettie picks up her fork.
A piece of pasta flips at the roll of the fork, bounces off her napkin, leaving a greasy stain.
“The floor just ate that one.”
The next pasta spiral is speared with the assistance of a younger, steadier hand.

Betsy watches with knitted eyebrows, the uncontrollable shake of Ettie’s diving fork, the spoon nudging food onto it, and its tortuous journey of questionable aim to Ettie’s open mouth. As if to maintain the indelicate rhythm, Ettie drops the spoon, frees her fingers to pinch the edges of slippery lettuce that her teeth immediately snap.

Betsy glares, Debbie is pointedly silent, and Jack seems oblivious as he chews on a cucumber. Ettie focuses on her diminishing salad. The tension is broken by a black-and-white uniformed server carrying plates of sliced turkey breast, mashed potatoes with gravy and steamed carrots.

Earlier, Ettie complained that the residents seemed unfriendly.
“You introduce yourself and they don’t talk to you.”
“Maybe you need to say something to them?”
Uncertainty lurked behind her eyes.
“They don’t talk to you,” she repeated.

There was a time Ettie resisted the idea of nursing homes.
“It’s for old people,” she sneered.
Yes, Ettie, and today it appeared that we were in the company of those who resented the reminder.
© Doreen Beyer

Dear Doreen,
Thank you for your poem. We must have been writing at the same time. Here is one I wrote after an observation. I also had this thought: How can we reinvent nursing facilities so they will not be seen as simply a place “for old people?”
Frances

ONE MINUTE OF KINDNESS
“We’re short-staffed,” she explained.
“I have too many on my shift.”
Without further voice or eye contact
She lifts a woman into sitting position,
Moves her into position
To dangle both legs over the edge,
And with a loud sigh of spent energy,
Shoves the walker toward her legs.

“No, don’t talk to me about
Kindness and compassion. We’re short-staffed
And I have a job to do.”

My first lessons in playing the flute
Was not in fingering, or in the placement of my tongue
Against my teeth. It was holding my breath
For one minute. Sixty seconds turned into an eternity.
My lungs demanded weeks of work, second by
second
To be conditioned to suck in air for sixty long
seconds.
One minute is an eternity only
In an earthquake, underwater or in becoming a
flutist.

Imagine what words can be said
What kindness can be given,
In sixty seconds, transferring a person
From bed to walker.
One minute — 60 seconds
Out of a short-staffed day . . .
Just 60 seconds, one short minute
Of kindness with each contact.
© frances kakugawa

Three things in human life are important:
The first is to be kind;
The second is to be kind;
And the third is to be kind.
— Henry James (writer)

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