PAIN BOSS | Suzanne Travis

 

Michael showed me his paintings when we met. A crocodile knitting an afghan was one of my favorites, a small canvas displayed over the toilet. His art was bold, irreverent and colorful. The kind of art that inspires and makes you laugh at the same time. I loved how he showed the absurdity of life, portraying it with a paintbrush.

In 1989, the AIDS epidemic was killing off thousands. Back then, we said victim or statistic. We didn’t say living with AIDS like we do now. Michael was a survivor, living with AIDS long before we knew how to say it.

He was also one of my first patients when I started working as a home health nurse. My job was to change out the morphine pump connected to the IV in his arm. I taught Michael to give himself a bolus, an extra dose to stay on top of things and manage the pain.

He said managing the pain was a funny way to say it, like a supervisor at Taco Bell managing the staff. From that day on, I became the Pain Boss.

The morphine pump reminded him of the Swanson's TV dinners he ate as a kid. Convenient, fast and practical. He called it his very own handy dandy opioid in a box. Something he could discreetly carry around in a fanny pack. And all he had to do was press a button and life became somewhat bearable.

We ate sliced tomatoes from his garden, drenched with olive oil and salt on turquoise ceramic plates. Slices of crusty sourdough bread from the Saturday Farmers Market or homemade oatmeal chocolate chip cookies from his grandmother’s recipe.

We sat in the kitchen at the orange Formica table with his one-eyed rescue cat Pirate curled up in his lap. Gossiping about his infectious disease doctor looking younger than “Doogie Howser M.D.” Or our favorite show “Twin Peaks” and how gorgeous the lead actor was.

I was performing stand-up comedy and he helped write my material. When I asked about annoying things nurses say, he said there were too many to count. But his favorite was Don’t worry, this will just be a little bee sting. We howled, and he did an impression of a bee landing on his arm.

“Uh Oh. An enormous hornet with a barbed stinger just landed on my arm. Oh well, I’ll leave it alone. It’ll just be a little bee sting.”

Michael used to be a dancer. Now his chiseled legs were swollen, propped up on pillows with absorbent pads placed underneath for the open blisters. Getting around with his walker was getting harder.

His partner Ben would stop by the house during lunch breaks. Where we privately discussed Michael needing more help and how stubborn he was. And how he didn’t like the idea of strangers staring at him, having nothing to do but watch game shows all day.

It was mid-morning on a fall day, almost cool enough for a sweater. I hadn’t been there for the last two days. The house was uncharacteristically quiet. He usually had music playing, George Winston or Gershwin. Or sitcom soundtracks like “Gilligan's Island” or “The Beverly Hillbillies” just to irritate me. Laughing when I begged him to turn it off.

Walking into his bedroom, I stumbled over a spilled urinal on the floor. One of his legs was dangling over the edge of the bed and he was lethargic. I listened to his chest with my stethoscope and checked vitals. I noticed how the purplish Kaposi sarcoma blotch on his left cheek stood out against his pale face. He used to take time to cover it up, disguising it with thick beige concealer. He was probably too weak to remember that morning. The mark looked like a spider I wanted to swipe off but couldn’t.

Being in a patient’s home is an entirely different experience than a sterile room in a hospital. Where you smell bread baking instead of antiseptic. Where you sit on a living room sofa instead of a hard chair next to a computer.

When you wash your hands in their bathroom and see what brand of toothpaste they use. When you meet their pets and see the grocery lists on their refrigerators. When you eat the brownies they bake just for you. When you allow yourself to share funny stories because you have the time. When you treat someone as a person and not just a patient with a diagnosis.

It’s easy to cross the line, to blur the boundaries. You don’t wear hospital-issued scrubs and a pager to trained staff readily available. You’re on your own, wearing a flowery dress and sandals. Or jeans and a sweater like I had on when I found Michael confused with slurred speech.

It was less common in those days for patients to die at home. Or to have advanced directives signed and ready. Michael didn’t have a DNR. He wasn’t ready to die at home or the hospital. He wasn’t ready to discuss dying at all.

We spoke at length about the importance of making his wishes known. He said he wished he didn't have AIDS and could find the TV remote. Changing the subject every time, asking where I colored my hair or how my act went the night before at the Rose Tattoo. Asking if I needed to work on my timing. How timing was everything.

That morning, I was afraid he was dying in front of me. He tried to speak but the words were jumbled. Maybe his confusion was from the opium drops he was taking for the diarrhea. Maybe he was getting too much morphine.

I did what nurses are trained to do, shaking his shoulders and performing a neuro check. I asked if he knew where he was, what his name was, who the President was.

He opened his eyes and started straight at me, speaking slowly and enunciating his words. Saying something like “I’m not exactly sure. But I’m pretty certain I have just been insulted.”

He had a witty comeback even when he was altered. Even when his confusion turned out to be from the cancer spreading to his brain.

Michael moved back into his parent’s house. He wasn’t safe to be left alone anymore and he had run out of options. I had never been to Boyle Heights, a suburb in East Los Angeles. A neighborhood with homes in need of repair and yards filled with car parts and old tires and stray cats.

There weren’t smartphones or navigation systems back then. Only Thomas Guides, a bulky spiral- bound book with maps and confusing coordinates, impossible to read. I was running late, lost with all the narrow winding streets, slamming on the brakes when loose dogs ran in front of me.

There were no sidewalks so I parked by a broken TV.

The house didn’t look like the art museum he used to live in. There were clothes drying over the railing upstairs with weeds growing in front. Steep wooden stairs led up to the front door with what looked like a garage underneath. There was another level on top with a cat sitting in the window.

I had a gnawing pit in my stomach when I climbed up. I didn’t want to see Michael anywhere but in his own home. The man who answered the door had two gold-capped front teeth. His face was puffy and red like he had been crying before I got there.

I assumed it was his father. Michael had mentioned him before, how he was on disability from hurting his back at his factory job. And he stayed at home to help since Michael’s mother worked nights plus overtime to pay the bills. And how guilty he felt that they both worried so much.

The man nodded and patted my shoulder, leading me down a narrow hallway to Michael's room. It was quiet except for the sound of something boiling on the stove. Maybe stew or a soup, something that smelled homey and delicious, and I realized I hadn’t eaten.

The stairs creaked as we walked up another flight of stairs and into Michael’s room. A picture of Jesus with a crown of thorns and a red heart hung above his head. He looked more like a patient now with a hospital bed with railings and rumpled sheets.

He still hadn’t signed a DNR. It wasn’t as common in those days for patients to die at home. Some of them went to Hospice. A lot of them spent their last days in the hospital. AIDS patients were often estranged from friends and family and died alone.

There were new purple splotches on his face and legs. His respirations were shallow and it was an effort for him to breathe. I propped his head up on the pillow and turned up the oxygen. Whatever was on the stove was still boiling. I felt like running in there and turning off the stove, anything but make the phone call.

I could barely hear a blood pressure and he looked frightened. I sat on the edge of the bed and called 911.

I patted Michael’s shoulder, reassuring him, saying he would be back. He was just going to the hospital to make him more comfortable. The soup was still boiling when the paramedics arrived.

I held onto Michael’s hand and squeezed it when I heard them stomping up the stairs.

When I looked outside, I said, “Oh my God! It’s Laurel and Hardy trying to get up your stairs with the gurney!”

I helped lift Michael’s shoulders so he could look out the window. Two men in white uniforms were struggling to carry the gurney up the stairs. One of them was overweight, perspiring through his clothes. The other one was lanky and balding and one of his black shoes was untied. Michael laughed. A weak laugh but it was a laugh. I squeezed his hand harder.

They made it into his tiny room with a lot of bumping into furniture. His father and I helped Laurel and Hardy slide Michael onto the gurney.

I threw an extra blanket over him and told them to be extra careful with his legs. They maneuvered him down the rickety stairs, yelling “Go right! Go straight!” Finally, they reached the bottom, moving him from the gurney into the ambulance and slammed the door. I listened to the sirens blaring, stopped holding my breath and started crying.

The father was speaking in rapid Spanish and pointing out the window. The gurney was left behind in the middle of street. In the distance, I could hear a roar from Dodger Stadium just a few miles away. I thought of the fans eating Dodger hot dogs and drinking beers and the surreal feeling of life going on. His father held a rosary and cried with me. Then we both started laughing and crying at the same time. Michael would have loved this. This perfect absurdity happening during his last hurrah. His final farewell.

His father motioned for me to follow him into the kitchen. He turned off the stove and pulled out a chair. We sat together and ate albondigas soup with wedges of lime and corn tortillas.

I remember Michael listening intently to my stories during our visits. After his dancing career, he became a philosophy professor. His brain was logical and tried to make sense of things, while I believed in synchronicity and coincidences not being random at all.

One day when I was particularly excited, saying something like “You Wouldn’t Believe It! This serendipity thing that just happened…,” he interrupted.

“Suzy, the only true coincidence would be if there were never any coincidences at all.” He loved to tease me. And I loved him for that.

Michael died that same night in the hospital. With Ben at his side, holding his hand when he took his last breath. I was reluctant to go to his Celebration of Life but I went anyway. I wrote a long speech, planning to talk about being his nurse and how honored I was to have met him. How he made the best chocolate chip oatmeal cookies and his grandmother would be proud. How his art stunned me. And how he made me laugh and helped with my comedy routines. I even thought about performing the Just a Little Bee Sting act he helped me write.

I planned to tell the story about the forgotten gurney. How it reminded me how life can be so damn funny, even when it’s heartbreaking. And when sadness is so overwhelming that we want to die, we laugh anyway.

I didn’t share any anecdotes or memories like I had planned. Instead, I excused myself and left early.

The balloons and streamers didn’t feel right. There was nothing to celebrate and the speeches made me too sad and I couldn’t stop crying. Ben understood and sent me off with a plate of leftover macaroni and cheese, Michael’s favorite dish.

I like to think that if Michael didn’t actually die laughing, at least he knew about the gurney escapade and how funny it was. Maybe I’ll ask him myself one day.


Suzanne Travis is an RN living in Los Angeles with her husband and four rescue dogs. She is a former stand-up comic and a mother of two adult children. Travis, who is semi-retired, runs an infusion center part time as well as organizing fundraisers for various cancer organizations.  She worked over twenty years in oncology at UCLA and loved using humor with her patients and their families. Travis enjoys having more time to pursue her passion for writing, both memoir and humorous essays. Her non-fiction essay, Room 4512, was published in the Spring 2024 Intima.