Editor's Note: Continued from part 1
By Dick Weinman, The Thin Edge of Dignity
Now it’s time for Step 2 - the shower itself.
It’s straightforward and simple, but complicated by the options of anatomical identification.
Once the toileting is done, I sit on the lid of the toilet facing the open shower area. Being naked and cold – I’m reminded of the prisoners at Abu Ghraib – I tense. There is no shower curtain, for if there were, the showerer couldn’t get to me. (And we’re not on intimate terms so she can’t come inside the shower area with me; besides it would be quite uncomfortable since she’s clothed.)
The caregiver flips on the heat lamp, which, due to a quirk in rest/bath room engineering, shines and burns directly down on the showerer, who is standing outside of the shower area, rather than on me, the showeree, who’ll be sitting on the seat inside the shower area. Once the light shines and the bathroom starts to get warm, I gently grasp the metal support rail, rise from the toilet lid, and snake shakily into the shower area, where I try to firmly grasp the back of the shower chair. It shakes from side to side; I quickly plop on it. A fall would do damage – a broken hip, perhaps - and hurt. Equally important, it would require filling out an accident form. That’s the procedure when residents have a fall. ( Why do old people have a fall, and everyone else just falls?) A fall causes the caregiver grief; it’s time consuming and a hassle. To keep me from slipping, I stand on a rubberized mat, which suctions to the shower floor.
The caregiver toys with the hot and cold settings; she sprays her glove and my bare, outstretched hand so we can agree upon the proper temperature. Then she points the shower head at me. Bullets spray on my shoulders. With a shudder, I adjust to the wetness and the temperature. The warm water relaxes me. I say “OK!” We’re off!
We start at the top. My hair is shampooed; then the conditioner applied and allowed to soak in until the rinsing ends. Then, body wash is squirted on a luffa. This soft, squishy interior of a squash plant is like a sponge. It’s gently glided over my skin -– well not always gently; roughly sometimes, on that rare occasion when a male caregiver is my showerer – and scrubbing replaces gliding. He also presents no problem of language: mano-o- mano, in true locker room fashion; the language is more direct than with the more sensitive female caregivers.
Now that my hair and beard are washed, rinsed, sweet smelling, and my upper body and legs are bubbly-soapy white, it’s time to turn the luffa loose on my midsection.
This is the time to rise, right? You can’t get to my – here we go again: gluteus maximus, buttocks, back side, butt, cheeks, or ass, while I sit. “Back side” (and “front side”) seems to be favored. After all, the term(s) is innocuous. But “butt” is gaining popularity fast – it’s so commonly used.
So, I’m standing, holding on to the handicap rail in the shower area, as my – whatever-you-call-it is gently scrubbed.
Now comes the tricky part – the rhetorical game again: scrubbing has to be done within the whatever-you-call-it, which leads directly to another anatomical regional whatever-you-call-it: the inter-gluteal cleft, the glutaneous cleavage, the crack. So I spread my legs and bend over – another crumble of dignity. Once the cleansing is complete, I turn to face the showerer.
Now it’s time for – OK. What do I say? “My privates,” my area, my front side, my thing, my genitals, my penis, my four letter word that is my nick name, or an early rising fowl? Worse, the luffa has to drop down to my inner thigh and push up to the genitalia, the testicles, the scrotum, or the synonym for courage, bravery, manliness, or sometimes referring to a person who doesn’t have any or has those of steel. I compromise. I reach down, and do it myself.
Even more tantalizing, dangerous, or delicate is washing and later, drying, the perineum, one of the most sensitive, pleasurable, and erotic parts of the human anatomy. Research reveals that in Taoism, the area is the Hui Yin Chakra, which, of course, I wouldn’t say to the caregiver. Not having the slightest idea of my remark, and thinking perhaps it was an insult – she’d probably walk out, leaving me dripping.
Then after hosing off the body wash, the whole decision about what is said and what is done to has to be repeated with a towel standing in for the luffa. First, the non-controversial body parts: face, head, beard, armpits (there’s a decision even here: which is more polite – “underarm area” or “arm pit”), shoulders, chest, back, arms, legs, and – then . . . (sigh) whatever’s left.
With the in-shower drying accomplished, the wheel chair with a dry towel on the seat is retrieved from my living room by the caregiver. She pushes it into the bathroom, and parks it adjacent to the shower area. I delicately step backwards until I feel the seat with my calves; then plop down. Whirled around, I face the mirror. Recognizing my outrageously wet and frazzled hair, I request further drying with a smaller towel. I reach for my brush on the sink counter, brush my hair with the range-of-motion left to me into the well-accustomed style of long hair-hanging-over-turned up collar - John Travolta in Grease-wise - that I’ve worn since my snobbish days as a theater major in college. At my age, it can still reach my shoulders, but, alas, the thickness has thinned away. Then I ask the caregiver to brush the back of the hair and dry behind and within my ears. Next I’m wheeled into my living room, where the ritual will conclude. Step 3 - the final stage of drying.
Step 3 - the final stage of drying.
Two areas require special drying. The first is the palm of my left hand. In the accident which sent me in and out of hospitals, leading me here to the ALF, the radial nerve in my left arm had been damaged. Thus, the fingers of my left hand are stiff and unmoving, formed into a quasi-fist so that air can’t flow over my palm – essentially it’s sealed. Without a flow of air that normally occurs through spread fingers, there’s no way for moisture in my hand to evaporate; the palm remains moist and can, therefore, brew bacteria. My left palm has to be especially dried.
The caregiver pulls back my dead fingers and wipes my palm with the smaller, thinner hand towel.
The other drying requirement is my “second belly button.” After the accident while I was in a coma at OHSU, I was surgically opened up, in order to create an entry into my stomach for a feeding tube to be inserted. During my time at the hospital, that’s how I was fed. Later, at the Skilled Nursing Facility, that’s how my meals were supplemented. Supplementation, an Ensure-like “drink,” continued through most of my stay at the SNF. When I was released, the tube was pulled out, but a wound formed in the hole and remained for over a year before it healed. No more wound, but the hole remains. The circle is smaller than a belly button, but narrower, slit-like. This “second belly button,” has to be dried, softly and thoroughly, to prevent infection.
Now we’re ready for the endgame. Lotioning is a legacy from my days at the SNF. The Head Nurse made it her mission to strengthen my skin. It had been torn by wounds and burns, fragmented into areas of graft exchanges; areas with no top skin. The nurse instructed the caregivers to lotion the skin daily, to strengthen the epidermal coverage. Thus, the final ritual of my bathing includes a nightly post-shower lotion.
I sit naked in my wheelchair in the living room, a towel separating the soft skin of my “whatever” from the abrasive wheelchair cover. The caregiver is poised in vinyl gloves to make the first pump from the flower or fruit named aromatic scent of body lotion - this night, aloe-chamomile. Waiting in the wings for the time that bottle runs dry is coconut milk and orchid extract.
She first sweeps up each leg from top foot to knee. Since the accident, my left tibia is covered in a sheen of scar tissue, a plastic-like veneer which prevents any sensation. The lotion glides over the shin and knee. To the contrary, on my right leg, I feel the moisture of the lotion as it sinks into the skin.
The right and left quads are next. Since most of the skin for grafting was removed from my thighs, much of the surface skin isn’t there, just large sections of white subcutaneous flesh. It takes but one sweep from knee to crotch, sliding left and right to moisten the skinless white areas of my thighs. Bottom half finished.
The arms are next: the withered, bony left arm with the bumpy terrain of the broken radius and ulna, and the deep cavity where a forearm muscle once was. The lotion takes a roller coaster ride, covering the tiny islands of whiteness from which surface skin had been taken by burns and for grafts.
The lotioning is done. I remain in my chair. Then in a flash: pajama pants pulled up to my knee, left arm stretched through tee shirt arm hole, then the opposite arm and hole, head squeezed through neck hole, stand, pants pulled up bouncing along, as they stick to the lotioned skin, towel swooshed from its resting place on the seat of the chair. I am clothed, at last. I collapse into the wheelchair – the shower is done!
Rub- A- Dub –Dub! I was once in a tub--- all alone: in the glow of candles, slowly squishing down to soak in hot, silky water; suffused in the smoothness and tenderness of soft, sweet smelling oil, in an aura of mystical aromas. My dignity intact.
All by myself! Blissful!