Norbert's toenails

I watched Norbert edge his way out of bed. I’m not so good at transfers, but I thought I could at least help by getting him up to the edge of his bed. My occupational therapist partner would be there in a few minutes to help move him from the bed to the wheelchair.

He flipped off the malnourished hospital blanket with the back of his wrist, but the sheet snagged on his feet and stuck there as the sour, sweet smell of morning gas-passing escaped from under the covers. Norbert was much too old to be embarrassed. Many delusions like pretending our farts don’t stink have to be abandoned when you check in to acute care.

Realizing that he wasn’t down far enough in the bed, the guard rail with the bed control buttons was in the way, he propped himself up on his elbows. It was like he was lifting a cement sidewalk block into the back of a pickup. Once he had the leverage, he shifted his rear down the bed. His diaper had a plastic cover, but it still didn't slide easily along the rug burn sheets.

After three one-inch bum slides, he was far enough down. He took hold of the sheet and tried to yank it off his feet. Still snagged, he yanked and yanked until he was finally able to free his trapped feet and hoist himself to vertical on the edge of the bed.

“My arms are just cotton-pickin’ useless these days,” he said.

I only nodded. My eyes were simultaneously compelled and revolted by his newly revealed feet. Each toe was capped with a half-inch nail. They were yellow, the colour of nicotine stains on the Marlborough man's fingers, and they curved to dangerous points like mini daggers. They looked like they could shred those bleached white sheets, never mind harmlessly hook them. Images of freak show wannabes like the Californian grandmother with seven-inch toenails who likes the attention she gets when she takes a stroll in Compton (what kind of shoes could she possibly wear?) or the Indian in Poona who’s left hand is disfigured by four-foot long nails that twist and curl as if they were blackened branches on an irradiated apple tree.

But this was just Norbert Walker. He wasn’t trying to be famous. He was just trying to get out of bed so that he could be wheeled down to radiology for a video x-ray of his disordered swallowing. He was deaf as an antique telephone, but he had the voice of an auctioneer or an evangelical radio preacher. Powerful, chesty, and driven by a melodic intonation.

I got a good look at his pale pink head fuzzy with post-comb hair as I yelled in his ear. “Can you get to the wheelchair?”

“Well, I can get in alright, you see. But gettin’ out might be a whole ‘nother story.”

Then before I could do anything to help, he slid off the edge of the bed and swiveled into the chair. It was more of a fall than a transfer and I immediately regretted not waiting for help to move him. Luckily the chair’s brakes were on and he landed squarely on the seat,

“Can you still wear shoes?” I asked, wanting to keep the process moving so that nothing bad would have time to happen.

“Yes. Yes. I do believe I can.” He gestured with gnarled fingers to his jaunty deck shoes, stashed under a nearby chair.

Later when I was charting, I mentioned to the ward nurse that his toenails were pretty long.

“I know,” she said. “Dr. Mohamed, the podiatrist, is coming in two weeks.”

She looked at me filling in my part of the conversation and responded before I my wheels had a chance to turn. “Nurses don’t do nails.”

A call bell sounded before I had a chance to raise my eyebrows.

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