Filling in the frame

Editor’s note: November is National Home Care & Hospice Month. A longer version of this essay won honorable mention in a national competition sponsored by the National Hospice and Palliative Care Organization.

A hot summer morning. The mist had burned off; the temperature was rising along with the humidity. I went to Ruby’s house for an early visit. The earlier the better, since Ruby’s house was a tiny trailer with some add-on rooms, no ventilation and not a breath of air conditioning.

She met me at the front door. “It’s in a bucket on the back porch. I fished it out of the commode.”

“Was it dead?” I asked.

“No! It’s out on the back porch — in a bucket. I got him on the toilet brush. He fell off, but I kinda pushed him between the brush and the lid like, and put him in a bucket to dry out. Come on and look at him.”

There, in a scrub bucket, was a very small creature with a very long tail, looking exactly like a drowned rat until it showed me the unmistakable face of night’s best scavenger, the opossum. Its hair stood up in tufty spikes; its eyes blinked in the unaccustomed sunlight. I suggested that it might need a drink of water.

“I thought I’d let it dry out some first.” And there was no arguing with that — the little creature was soaked as well as stunned from its swim in the commode.

I met Ruby after she’d been admitted to the home-care hospice program. She was living in her daughter’s home, lodged in the gun room. She lay on a single bed surrounded by the glazed eyes of mounted deer heads and racks of rifles. Amid this arsenal and mementos of the dead, Ruby was a blast of life force with a will of pure steel.

She had several goals: The primary one was to “get back home and stop bothering my family.” On that first visit, I privately wondered whether she would ever live on her own again: At that moment, Ruby couldn’t walk.

But she explained to me how much better off she’d be at home, because “the walls are close together, and I can hold on to both sides and keep my balance. It’s good to have a little house.”

That was the beginning of Ruby’s hospice journey. From her daughter’s home she moved to our inpatient facility. After days and weeks of physical therapy coupled with grit like I’d rarely seen before, Ruby went home to her cobbled little house, where she could steady herself by touching two walls at once.

Her favorite at-home activity was working jigsaw puzzles. Some she just gave away; others she mounted on plywood and then gave away. We discussed the fine points of puzzle working: “You got to get the frame done first; then you fill in as you go,” she said. Sounded like a recipe for life to me.

Ruby’s framework was, “I’ve had a hard life, but I’m gonna make it.” Her story was woven through with abuse, physical violence, and a rock-hard desire to survive, to live, no matter what. As a mother, she’d filled in the framework by loving her children and working, working, working. As a hospice patient in her own home, Ruby filled in the framework by baking cakes for the Meals on Wheels folks who brought her lunch and giving paint-by-the-numbers pictures to her hospice workers. She also gave jars of homemade jelly to a wide network of friends and family who brought bouquets of flowers to “poor Ruby.”

The puzzles created order, giving her life meaning, purpose and structure: first the framework, then you fill it in.

Ruby never denied that “my days are numbered.” But the emphasis was always on living: to support her daughter, help raise her grandsons, rescue drowning possums from the toilet, give whatever she had and whatever was needed. She was no saint and would have questioned the sanity of anyone who called her that. She had fought — with words and with fists — for her children and for herself. She was rough and had made her way by working “like a man, like a horse,” as she often put it. “I guess I just used myself up. It’s been hard, but it’s been good too.”

When Ruby couldn’t stay in her “no place like home” as the disease progressed, she came back to the inpatient facility. There she just shut down: Gone were the jokes, the affirmations, the fill-in pieces of the puzzle. What remained was a valiant warrior who was losing the battle even as she was winning the war. For a few days, the victory seemed to feel like defeat to her. In the end there was peace, but it was slow in coming. Fighting with every ounce of life force is a hard habit to surrender.

In remembering Ruby, words come: words like “survivor” and “teacher.” For me she was a vessel — of life, for life — wherever she went and whatever she did.

“Those possums live under the house, come up through the plumbing. I fish ’em out of the toilet, they just go back under the house and do it all again. But you got to get ’em; you can’t just let ’em die. That one’s in a bucket on the back porch. Come on, I’ll show you.”

When we went back to the porch the second time, the baby possum was gone, dried out in the summer sun. Alive and free.

[The Rev. Jane Curran has been the chaplain at CarePartners Hospice and Palliative Care (formerly Mountain Area Hospice) in Asheville since 1992.]