Limitless nice

I was headed for Gunnar's room. I had heard that Gunnar's doctor made him NPO on Friday and ordered feeding through an NG tube. Nobody likes an NG tube. A nurse has to shove it into your nose with a dollop of lubricant to ease the way. The head of the tube has to weave it's way past the bumps and creases of the sensitive mucous membrane in your nasal cavity and over the back of your velum. And then you have to swallow hard as you try not to gag and the tube makes it's way (hopefully) to the upper esophageal sphincter, which hopefully is opened by your swallowing. How many times can you swallow in a row? Once the tube enters your esophagus, maybe after a few tries, it must make its way with gentle force down to your stomach. If you have a lousy tube, there'll be kinks and even though the tube is all the way down into your stomach, it will have to be pulled back up (imagine a slow retch) and then reinserted. Any nurse who can do this first try deserves a huge box of chocolates.

I was surprised by the NG news and wanted to pop in to see how Gunnar was doing. Three days earlier, we had done a swallow assessment and Gunnar was doing fine with regular liquids and puree food. He has ALS, a disease of deterioration. Things can only get worse with this disease, but usually the changes come slowly, like a gradual accumulation of snow in November. Not like a unexpected blizzard in October.

Inez was standing in the hall outside Gunnar's door. She took me by the elbow and we stood by the rolling cabinet next to Mr. Henderson's room. It holds masks, gloves and the sweat-inducing yellow paper gowns that cover your clothes and keep you from taking bacteria out of a super-bug contaminated room. My glasses always fog up when I have to dress up, but I don't complain. I'm glad Gunnar doesn't have to deal with an antibiotic-resistant infection on top of everything else.

"I wanted to talk to you before you went in to see Gunnar," she said.

Inez looks tired. Her hair has a flat spot on the back and her natural eyebrows are growing back around her tattooed arches. The tattoo is a gold-brown colour that makes he powdered face look pale. She always smells like Bodyshop grapefruit soap.

"What's the deal with the tube?" I ask.

Inez told me about Gunnar's sudden turn for the worse, about how ill he was, about how she had to leave the room when they put the NG tube in because he was so miserable about it, how she's at the hospital from 9 to 9 because he needs her so much, about how Gunnar doesn't want visitors because he doesn't want them to see him like this (I thought, but didn't say that he was going to get worse and that now might be a good time for visitors), she told me how she likes to take 15 minutes to slip outside to drink a coke and breathe some fresh air, then she told me how she went to the doctor for her blood pressure and the doctor told her that Gunnar wasn't going to leave the hospital alive.

And we paused. She wiped her eyes with a kleenex she pulled from her watch band. I gave her a hug and used all my concentration to stay under control. She probably heard the truth in my voice.

I was about to say something about respite care, but Inez started talking first.

"I got a call yesterday," she said. "This old customer of the car dealer I worked at called me up out of the blue. I barely knew him. I was just a bookkeeper. Anyway, he calls me up and says 'Inez, I heard about your troubles and I just wanted to tell you that if you need anything, anything at all, you just need to call me.'"

All I can say is, "There sure are a lot of nice people out there."

"Yes. The worse things get, the more I notice all that's good," she says.

"It seems limitless," I say, looking at my new Clark's, feeling the cushion under my toes.

Inez gives my hand a squeeze and goes downstairs for a coke. I stand in the corridor for a moment wondering what I should do next.

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