The Blog

Reform School


In the adjacent room,
Across the hall from the health care clinic,
The old timer stares at his knees, gingerly raises his right hand, and blesses himself.
His peers—fellow kidney disease patients—sit beside him,
Blankly
Many deep in thought, fraught with worries, massive and menial,
Some minds kept in line by meds,
Others flowing unevenly by advanced age and the din of CNN.

Through the windows outside the main building
Where their Nissan blocks the front entrance, alongside the wheelchair ramp,
The elderly woman watches solemnly as her husband makes the sign of the cross,
An unexpected act of desperation—or is it newfound faith—that frightens her.

Partly blind and unaccustomed to driving, mostly in deference to her spouse,
She grimaces and hobbles a few dozen feet
To their car where she gets behind the wheel and coyly turns the ignition.
As her sons see it, their father’s failing health has triggered a sudden jolt of defiance.
(“She’s half-blind, she doesn’t belong behind the wheel, she’s a danger to society.”)
As their mother sees it, the old man’s demise has required a reclamation of her independence.
Her eyesight, she says, has “never stopped me in the past,” only her patriarchal mate.

Their town, she learns, has done away with taxi transfers covered by Medicare,
Cab fare, she insists, is extravagant, particularly for a retired couple on very fixed income,
So with the assertiveness of a Driver’s Ed instructor at recess,
She grips the wheel, puts the transmission in reverse, and steps
On the gas pedal
For what passes today as home.

All the while her lifelong partner, a newcomer to the world of dialysis,
Waits to be called by name and shown to his seat,
Where a nurse with the help of an orderly
Will stick him good with a needle
And hook him good to a machine built to cleanse and purify his toxic blood.

Like a kindergarten student on the first day of classes,
He checks his backpack for snacks.

When he gets the call to enter a roomful of gurneys
He is stopped and weighed by a technician
To see how much water he has retained
From the previous visit
And then he receives with no intonation
A scolding from the nurse practitioner
About his excessive fluid intake, salty diet, and lack of exercise
Before another nurse preps the fistula and sticks a needle in his arm.

As if he needed the prick, a sullen reminder
As if he was unaware that dire events await.
Serious consequences,
Dead serious.
More serious even than the time he stole money from Daddy’s wallet.
Mama grounded him for the summer, remember?
Daddy never forgave him.
Is there a statute of limitations in the afterlife?

The blood pressure gauge strapped to his arm slaps him out of his whitewashed daydream,
Reminds him of his barebone reality,
With the ironclad grip of the Velcro
Tightening and Releasing Tightening and Releasing
Until his left bicep pulsates with the rhythm of a snare drum.
They say these are the golden years, he mumbles to the monitor.
They say with age comes wisdom.
They say. They say. They lie. Them bastards. They lie.

Following a second round of treatment after the first round failed due to blockage at the entry point,
Mother arrives promptly at the Dialysis Center
To pick up the man who once held his bladder for 418 miles just to prove he could
And as the Office Manager prepares the patient’s updates for the Nutritionist
And the Nutritionist shares test scores with the Social Worker
And the Social Worker adjusts her blouse, fixes coffee, and calls on the Kidney Specialist
And the Kidney Specialist furrows her brow and recommends further evaluation by the Phlebologist
And the Phlebologist coughs, demurs and opts for consultation by the Cardiologist
And the Cardiologist wipes his glasses, examines the results, and seeks the counsel of the Primary,
And the Primary swings his stethoscope, decides on Mexican for lunch, and punts the final diagnosis
To God knows who,
After all of this all in a day’s work of productive inaction,
The Nurse, bless her heart, checks Father’s vitals while Mother finds parking
Next to the shaded entrance behind an idle emergency vehicle
And as fast as a jackrabbit could travel through the eye of a space needle,
Father’s pin-sized pupils brighten and then depart
For good

Photo source: Driver Education.

About Dan Cafaro

Dan Cafaro is the founder and publisher of Atticus Books, a small press based in Madison, N.J. When Dan is not following his wife around the country, he is known to sit for long periods of time pondering how to live off the grid. Atticus Review is his first literary journal.

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