“Homelessness isn’t just about not having a job or an apartment. Too often homelessness is due to a disordered mind.”― Danielle Steel, A Gift of Hope: Helping the Homeless

“One of the symptoms of senile dementia is suspicion and the other is paranoia.”― Nien Cheng, Life and Death in Shanghai

“Those who are not grateful soon begin to complain of everything.”― Thomas Merton, Thoughts in Solitude

It’s the day before Thanksgiving and I’m at the entrance to the Emergency Room, but I can’t get in.

Not because the intake process – slow in normal times – has ground to a halt due to Covid.

Because a homeless man is blocking the ER door.

A team of medical professionals and two security guards are trying to reason with him, but he’s in no mood to be reasonable.

He wants to see a doctor.

Dr. James.

The staff tells him that there’s no Dr. James in this hospital, but he doesn’t believe them.

He says he’s got “pains,” and only Dr. James knows about them.

When the staff asks where his pain is, he says, “here, there, and everywhere.”

He’s holding onto what appears to be a comforter and two oversized pillows – likely his bed – and despite the staff’s pleas, won’t relinquish them.

They look to have once been white, maybe tan, but are so badly soiled now that they’re black.

“Sir, you have to put those down if you want to come into the hospital.”

“Where’s Dr. James? Only Dr. James knows who I am,” he shouts at nobody in particular.

It’s been 30 minutes since I arrived, and this circular call and response continues.

Who knows how long it went on before I got here?

I study the security guards, trying to game how long they’ll let this stalemate continue.

But they’re not stupid. They’re doing the math.

How much is it worth to risk losing your job – and possibly a lawsuit - to physically confront a clearly insane person holding a king-sized bio-hazard blanket?

Not as much as they’re making.

Meanwhile, Susan, in desperate need of a blood transfusion, is sitting in a wheelchair slowly wasting away.

When she called me this morning, weak and disoriented, I knew she’d waited too long to admit to herself how bad her health had gotten.

Earlier in the week she hadn’t been feeling well but resisted calling her doctor.

Now she knew she was in trouble, but it was too late, the transfusion centers were only going to be open half-day, tomorrow being Thanksgiving, and her procedure would take at least 6-hours to complete.

Now the only option was to go to the hospital.

“I’ll be there in 15-minutes,” I told her.

“Please hurry,” she said.

“Okay, you’re next,” said the admitting nurse, the homeless man having decided to go to the other hospital across the street.

It’s really a 24-Hour Fitness, but I wasn’t going to tell him that.

Covid restrictions prevented me from staying with Susan at the hospital and in all the confusion this morning she’d forgotten her cell phone.

I was about to drop a frail 74-year-old woman at the hospital in the midst of a pandemic, on a holiday weekend, with no way to communicate with her.

But that’s not what I was worried about. I was worried about the same thing she was.

“Honey,” she said. “What about Stan?”

Stan knows me.

He’s known me my whole life.

He was there when I was born, technically.

Back then, fathers weren’t allowed in the room during birth. They weren’t even allowed on the maternity floor.

In fact, by law, they were required to be at a bar no closer than 500 yards but no farther than 1 mile from the hospital, drinking boilermakers with at least one childhood, high school, or military buddy.

Stan was all three of those to my dad and filled his role to perfection on the day of my birth.

Growing up, he was a fixture at our house, regularly dropping by on weekends in his newest sports car.

In the early days it was the Italians – Maserati’s and Ferraris – then when he got older he transitioned to Porsche’s, finally settling into Mercedes after turning 40.

We lived at the end of a long street and as soon as he turned the corner you could hear him coming down the block.

I’d pause our street football game and run inside yelling, “Uncle Stan is coming, Uncle Stan is coming.”

At one point I was convinced that Stan had ESP.

“Did you know I can read your mind?” he said.

“No you can’t,” I replied.

“I’ll bet you a dollar I can,” he said.

“You’re on,” I said, already counting the money in my head.

“Okay, I need a deck of cards.”

While my mom and dad looked on, Stan placed nine cards on the kitchen table in the shape of a rectangle – three rows across by three columns down.

“I’m going to go into the other room, and while I’m gone. I want you to choose one of these cards,” he said.

“Don’t pick it up, just tap it with your finger. When I get back, I’ll read your mind and guess your card.”

“No way,” I laughed, and off he went.

“Tell me when I can come back in,” he yelled from the back bedroom.

I picked my card and told him he could return.

Upon doing so he walked over to the table, slowly studied the cards, and after tantalizingly hovering over a few wrong choices, went directly for mine.

“You chose this one, right?” he said.

Stunned, I said, “do it again. Double or nothing,” to which he proceeded to repeat the feat – five more times.

I couldn’t figure out how he did it.

At first, I thought my finger was leaving a print on the card which only Stan could see with his ever-present – and obviously specialized - tinted sunglasses, so I switched to using just the tip of my nail to select the card.

Then, I thought I might be slightly moving the cards when I picked one, so I changed to just pointing at it, while glancing at my dad to make sure he could verify my choice.

At one point I thought he really could read my mind and tried as hard as I could to think about anything else when he came back into the room.

Hey, I was just a stupid kid.

But nothing worked. Every time he picked my card, though in the end, he always let me keep my money.

For years, whenever he came over, I’d ask him to repeat what I was sure was a trick, positive that, eventually, I’d figure it out.

But I couldn’t, and finally one day I just begged, “C’mon Stan. I know you can’t read my mind. Tell me how you do it.”

“Okay,” he said, taking pity on me. “Let’s do it one more time and I’ll tell you how it’s done.”

He left the room, I walked over to the table, put my finger on the card dead center in the middle of the pattern then told him he could come back in.

Once again, he walked over to the table and held his hand above the cards, but this time, paused, and in an overexaggerated motion, turned and looked at my dad who was casually sitting in his easy chair in the corner of the room.

On his lap was a magazine, which as most magazines are, was in the shape of a rectangle.

And on top of the magazine was his left hand, lazily draped across the cover, with his index finger extended – and pointing right to the dead center.

We could always count on Stan for Thanksgiving and Christmas, when in addition to showing up with a different sports car, he’d show up with a different girlfriend, usually of the stewardess persuasion.

On these occasions, we referred to him as “The Buffer” – the person who would intercede and distract my grandfather when he invariably decided that a holiday gathering was the right time to start giving my dad shit for his career choice, car choice, butter choice, etc.

“Hey Ken,” he’d say upon spying the familiar sight of my grandfather cornering my dad in the kitchen, “can you show me how to make your famous vodka gimlet, I can’t remember if it’s a half or a full jigger of simple syrup?”

One year Stan showed up to Christmas Eve with Susan.

She too was a stewardess, pretty, but there was something else that made her stand out from the previous parade of sky hostesses I’d seen pass through our door.

She was also smart, funny, interesting, and I could immediately tell by the deference he gave her that Stan saw her as something special.

This is why it was no surprise when he married her a year later, with yours truly as the ring bearer.

After my dad died, Stan filled in as a father figure when I needed advice, and after my mother died, Susan became like a second, but better, mom to me.

As they had no children of their own, my sister and I filled those reciprocal roles for them.

And now they’re both dying.

He from dementia and she from cancer.

When we left for the hospital Stan was asleep on the couch.

“He’ll be like that for a while,” said Susan. “Maybe you can drop by and check on him in a couple of hours. By then I should be ready to come back home.”

I didn’t have the heart to tell her the reality of the situation.

That despite what she wanted to believe; things were going to play out like four-of-a-kind against a royal flush – on autopilot.

I called my wife from the car as I headed back to the house.

“Hi. We’re going to have to cancel Thanksgiving,” I said.

Susan was right, when I got back Stan was still sleeping in the same spot on the couch.

But not long after he was up and wandered into the kitchen where I’d set up shop on the nook table.

“Hi Stan,” I said. “How are you feeling?”

“Hey,” he said, trying to disguise his confusion. “How are you doing?”

I saw through this for the ruse it was, because though Stan had been able to fool me in the past with his version of a practiced deception, for this one I was the originator, the pioneer, the master.

I’m bad with names and faces. It’s the ADHD in me.

And in those unfortunate situations in life when I have to interact with people, like the holidays for example, I’ve often found myself at a loss when greeting someone I’ve met before.

So after engaging a group and being greeted with “Hello Brian, good to see you,” I pull out my version of the “you” card.

“Hey there,” I say. “How are you doing?”

Then turning to greet another, “It’s so good to see you.”

Then onto still another, “What have you been up to?”

I know Stan’s game.

He has no idea who I am. But I play along.

“I’m doing great,” I say. “What have you been up to?”

“Oh, just this and that,” he replies.

“Where is that lady that stays here?” he says.

“You mean Susan?” I say.

“I don’t know,” he replies. “I think that’s her name.”

For the next few hours, I play a game of cat-and-mouse with Stan, as he drifts about the interior and exterior perimeters of the house.

He checks the mailbox every 30 minutes or so, even though the mail has already come.

He neatens up the garage, then sweeps the alley, then repeats the process over and over.

At one point he decided to “clean” Susan’s car, spraying it all over with Windex, then wiping it down with an oily rag.

“Is that yours?” he said, pointing to my car, parked next to Susan’s.

“Yep,” I say.

A few minutes later I peek out into the alley and watch as he turns his attention to my car.

He’s thorough in his process, spraying a section at a time and wiping it down with that same oily and now increasingly dirty rag.

It’s not until his third time around that I notice he’s switched from spraying Windex to Shout - the laundry stain remover.

“Eh, it’s just a VW,” I say to myself.

It’s now 5 O’clock and I finally get the call I knew was coming but hoped wouldn’t.

“It looks like we’re going to have to keep Susan overnight,” says the doctor. “But she’s worried about her husband Sam.”

“It’s Stan,” I say. “Tell her not to worry.”

“I’ve been with him since I left the hospital and I’ll stay with him overnight.”

“When is that lady coming back?” Stan asks me.

“Well, it looks like they are going to keep her at the hospital tonight,” I say. “They want to give her some medicine to make her feel better.”

“Oh, that’s good,” he says, but I see the fear rising in his eyes.

“Did you grow up around here?” he asks.

He has no idea who I am.

I’m a stranger in his home.

And I’ll be spending the night with him.

The next few hours are occupied by a strange dance between Stan and me.

In one version, he drifts away, and I try to catch him before he wanders out the front door or down the alley.

In the other, whenever I move out of sight, he slowly and silently shuffles behind, almost stalking me.

He’s confused.

In the first version, he’s got things to do, people to see, and must get on with it.

In the second, he doesn’t understand who this interloper is, what he wants, so he’s got to keep an eye on him.

And it only gets worse when the sun goes down.

Known as sundowner’s syndrome, or sundowning, it involves a pattern of sadness, agitation, fear, delusions, and hallucinations that occurs in dementia patients in the late afternoon, evening and at night. This increased confusion around twilight can be distressing for both patients and caregivers alike.

Stan has Sundowners in spades.

Though it’s hours past his usual bedtime, so far, Stan has rebuffed all my gentle suggestions that he might want to retire for the night.

So there we sit on the sofa, watching “Forged in Fire” together.

“I think I knew your mother,” he says out of nowhere.

“Yes, you went to school with her. And my dad too.”

“What was his name?” he says.

“Kelly Lund,” I reply.

“Kelly Lund,” he says. “Kelly Lund? He’s my friend.”

“Yes, he is,” I say.

“Where is he now?” he asks.

“He died,” I say. “About 30 years ago.”

“Oh,” he replies. “I think I’ll go to bed.”

“Okay,” I say.

“You’ll stay here, won’t you?” he says.

“Yes, Stan. I’ll stay here. I’m not going anywhere.”

“Good,” he says.

“And tomorrow I’ll go pick up Susan and bring her home,” I say.

“Okay,” he replies. “That’s good. She’s probably very cold.”

I trail Stan as he slowly, methodically makes his way up the staircase to his room.

Close enough to catch him if he stumbles, but far enough away not to let him know.

It’s a guy thing.

And it’s complicated.

I’m the protector now, but even in his compromised state, I don’t want to do anything that would rob the dignity of the one who once protected.

So I wait until he turns the corner into his room and then I go about the business of settling in for the night.

Stan has a long history of getting up in the middle of the night, but as Susan slept in the same bed she’d awaken when he did and could prevent any nocturnal wandering before it started.

But he and I weren’t going to be bunking together.

That was something I was fairly sure both his dementia and my lucidity could agree on.

Unfortunately, the guest bedroom was not an option for me as it was too far away to get to Stan if I heard him attempt to descend the stairs in the dark in the middle of the night.

So I hunkered down on the sofa near the staircase.

The cold leather sofa, covered with a blanket whose thinness was only matched by its shortness, ensured that sleep would not be an easy option.

Not that I would be sleeping anyway.

For nine hours straight, with every settling of the house, every switch-on of the furnace, with every noise - internal or external - I bolted upright, worried that it was Stan, reaching for the balustrade, but missing, and about ready to tumble from the landing down to the floor.

I did get snatches of sleep, but the type of which the more you get, the more exhausted and fatigued you are with the morning light.

Fortunately, Stan slept through the night.

“Hey, Stan?” I said as he wandered into the kitchen. “How’d you sleep?”

“Good,” he said, obviously surprised by my presence. “How are you doing?”

A little more comfortable with me now, Stan settled into his routine.

He checked the mailbox, even though I explained that it’s Thanksgiving and they didn’t mail deliver today.

“No, they don’t, do they?” he said, before checking it again and again.

He swept the alley. He re-cleaned my car. He asked about the lady that lived with him.

At one point I called my wife and asked if she could bring me a change of clothes and watch Stan for a bit while I took a shower.

He’s known my wife for 30 years but still wasn’t sure who she was when she arrived.

“Hey Stan,” I said, “Look who showed up?

“Oh, hi,” he replied. “What are you doing here?”

My fifteen-minute shower was like heaven.

I’d been caretaking Stan for only 12-hours, but I was drained.

I wondered how Susan had done it for 5-years?

After I got out of the shower, I asked my wife if she could stick around and watch Stan for a bit so I could get in a quick nap, and I headed into the guest bedroom to crash.

30 minutes later I awoke to see her and Stan in the doorway.

“See Stan, it’s okay,” she said comfortingly, “Brian is right here. He’s not going anywhere. I promise.”

Soon after, the hospital called. Susan was ready to be picked up.

“I’m going to pick up Susan,” I told Stan, expecting some expression of excitement, or at least relief.

“Who does she belong to?” he asked.

“You,” I said. “She’s your wife.”

“Oh?” he replied and went out to clean my car - again.

I got Susan from the hospital and brought her home.

She had ordered Thanksgiving dinner for her and Stan from the local country club weeks in advance and it was delivered right before we left, so they were okay.

But upon returning home, we realized that there was no food in our house.

Well, there was food – a turkey brining in the fridge, boxes of stuffing, bags of potatoes, carrots, and peas, cans of crescent rolls, and a pumpkin pie – but none ready to eat.

All the stores were closed and the friends and family we’d canceled with were off to other venues.

So we made do with what we had – boiled chicken and white rice.

It was the first time that just the four of us had spent Thanksgiving dinner together, and though I was dead tired, it was kind of fun.

And I was truly thankful.

For my family and for our health.

For the healthcare workers who don’t take holidays off.

For that 15-minute shower.

For the food we didn’t get to eat and the friends and family we didn’t get to see.

For Susan and Stan and the time we still have left with them – however much that is.

Epilogue:

Stan’s time ran out at 4:55 PM on June 13th, 2022.

I’ll miss you Stan.