On Vanishing. Lynn Casteel Harper
Cape by the time he had relocated, I could still situate him there. There had history for me; I knew the borders, the landmarks, and the people.
Long before Jack’s move to Cape, my parents had decided that eventually they would uproot to be near their most rooted kids—my two siblings who lived in Columbia, a town four hours northwest of Cape. They were in no rush to relocate, wishing to spare Jack another upheaval. However, through an unexpected series of events, my parents received an offer on their house, before it was for sale. With the housing market still tenuous after 2008, they accepted the offer. Two years after settling in Cape, Jack would need to be moved again.
Jack’s new home was not to be in Columbia, however. He was moved forty miles northeast of Columbia into the Missouri Veterans Home in Mexico. He was a proud WWII veteran, and the facility was known for providing good, affordable care (and Jack liked nothing more than a good deal). A bed had just become available. These factors outweighed the fact that Mexico was a place distant from and unknown to my family, a place in which Jack likely had never set foot.
I had no stories of Mexico, Missouri—no memories in it, no mental or emotional anchors—which made Mexico hard to map onto the geography of my mind. It felt vacant, empty. In some ways, Mexico, Missouri, felt as distant to me as Mexico the country, also a place I had never visited. But I could at least conjure some images of the country, however partial, based on media depictions and the photos and stories my friends from Mexico had shared. I drew a total blank when it came to Missouri’s Mexico.
I often had trouble remembering that Jack lived there. I had to remind myself he was there somewhere, in a little room, in a small town, in a part of the state unfamiliar to me. I could never remember how to get there exactly. Even though I regularly sent him cards, I always had to look up his address, his precise Mexico residence never imprinting upon my memory. He was not entirely gone from me as long as I could write to him, I thought. I imagined my notes, a row of triangles erected on his dresser, forming a little fence against isolation. I longed for attachment to the place, to him.
I saw Jack in Mexico only a few times. I lived in New Jersey and visited Missouri infrequently. The second to last time I visited him, I thought it would be the last. It was a beautiful fall afternoon. The floor nurse, who kept her little dog on a leash by the medication cart, told me Jack was still in bed. When I entered the room, he did not seem to register my presence. In the weeks prior to my visit, my mom had noticed his flat affect and increasing remoteness, but I had hoped I could inspire a different response. I had brought him M&M’s, which had been his favorite, but he refused to open his mouth. I played big band music on a little CD player by his bed and held up old photos for him to see—all activities that had seemed to resonate with him in previous visits. He closed his eyes or stared straight ahead, his body motionless. I assumed he was tired of this world and ready to take his leave before too long, so I shut off the music and put the albums away. I sobbed quietly and said goodbye and prayed near his ear and kissed his head and had trouble walking out the door. It took the fifty-minute drive back to Columbia for my puffy, red face to lighten.
The last time I saw Jack was on Memorial Day weekend. I did not permit myself goodbyes or tears, now convinced that his fundamental hardiness would sustain him beyond all reasoning. This time, he was dressed and in the television room. It was another beautiful day. Flags lined the driveway up to the facility. I pushed his wheelchair outside on a concrete walking path and stopped at a bench with a small canopy for shade. I told him it was Memorial Day. I sat facing him and gestured toward the flags, but he peered past me to the magnificent pin oak in the open field. I told him I remembered the big trees in his yard in Bonne Terre and how he had dubbed his house “Oak Pointe” and had engraved a wooden OAK POINTE sign, affixing it to a tree at the end of his driveway. (How strangely domestic the French “e” had become in that most unpretentious region.) I told him he made incredible things out of oak, cherry, and walnut in his woodshed. I lightly touched his hand. He made no visible response to any of my overtures—the pin oak drew his whole attention. I stopped talking.
We had never before sat together in silence. When I was a child, he was forever in motion: playing his trombone for me, teaching me a new computer program, working in the yard. I was forever trying to find some entry point into his activity—some way to connect beyond his showing me something, making me something, teaching me something. Here we were now at rest—and I was squirming. I had trouble knowing what the stillness meant: depression, apathy, serenity, emptiness, resentment, peace? The small awning offered no cover; the relentless sun, coming at a late afternoon angle, struck us entirely.
When I brought Jack back inside, the nurse with the dog asked him if he had a headache. He made no motion. “Oh, yes, your head hurts. Here is some Tylenol.” She gave him the pill and he took it. I wondered if she saw a response that I could not. I knelt beside him at the table, looking him in the eye. I did not know what to do or say, but I wanted a sweet sign—a smile or word from him I could report to my mother to make her feel better, to make myself feel better—to believe nothing was hurting. Instead, he narrowed his eyes and frowned. He scrunched his nose and forehead and shook his head, making a little mocking face back at me. This smirk was the first visible reaction he had made to my presence during the visit—a retort I read as possibly playful but mostly bitter, even sarcastic. I don’t need your pity. I took the sneer as a sign to leave. I gave him a peck on the cheek, told him I loved him, and slipped out of his view for the last time.
Here is one way I read our final visits: Jack was tired of trying to find and refind his social footing, and was no longer trying. I don’t mean he consciously decided to become apathetic, but perhaps he sensed how difficult it was to relate and how close failure was at every attempt. I think it became easier, less painful and exhausting, to be docile. The speech pathologist Rosemary Lubinski notes that when individuals with dementia “perceive that their responses are futile, they stop responding.” Tom Kitwood makes a similar point, warning that if the person’s need for inclusion is not met, he or she “is likely to decline and retreat, until life is lived almost entirely within the bubble of isolation.” By this view, Jack’s withdrawal was not due to his disease process alone. Rather, it was a response to an entire social environment unable to support him.
It was not that Jack’s caregivers were particularly negligent, or that, had he been surrounded by more solicitous conversation partners, he would have been able to communicate proficiently. But it seems that when little is expected from persons with advanced dementia, little is given to or received from them. The sneer Jack gave me was an expression of unnamable anger—not so much with me personally, I like to think, but with the forces that had brought him to this place of exile, a bubble of isolation, cut off from anything and anyone who had ever signified even a semblance of home.
Mexico was the site of dislocation: Jack’s final removal from his former life. In Mexico, he was not the man who stitched up bleeding heads and treated snakebites, nor was he the decorated pilot. Although he was surrounded by veterans, he no longer recalled his war stories—or, at least, no longer told them. He was not the jazz musician, or the Rotarian ambassador, or the philanthropic donor. He was Jack who didn’t say much, who liked his morning coffee, and who sang on occasion. He was Jack with glowing skin and a full head of soft, white hair, who was a “Total Assist,” requiring help with every daily activity from dressing to bathing. Once he had delivered babies, now he was diapered. Once he had traveled the world, now he shared a room, divided by a retractable curtain, with another slight, contracted man.
In this more pessimistic light, I saw Jack’s successive moves, farther and farther away from anyone or anything familiar, as stripping him of any grounding in who or where he was. The insidious extraction of his life unfolded in sequence: his own home (fifty-seven years), assisted living near his hometown (nine months), assisted living near his daughter’s home (two years), a nursing home in unknown Mexico (two years). He lived his final days in a place detached from any place he had known, cared for by strangers. His emotional distance should come as no surprise—what handle had he to grasp, what anchor served to hold his rocking vessel?
Each move was not intended to do any harm; inertia simply took over. While my grandfather may have had the financial resources to allow him to stay in his home by hiring round-the-clock caregivers,