It was the look of the place that attracted Lou—there was nothing dispiritingly institutional about it. But when Lou moved in, the way of life became what he valued most. He could go to bed when he wanted and wake when he wanted. Just that was a revelation to him. There was no parade of staff marching down the halls at 7:00 a.m., rustling everyone through showers and getting them dressed and wheeled into place for the pill line and group mealtime. In most nursing homes (including Chase Memorial, where Thomas had gotten his start), it had been thought that there was no other way. Efficiency demanded that the nursing aide staff have the residents ready for the cook staff, who had to have the residents ready for the activity coordination staff, who kept them out of the rooms for the cleaning staff, et cetera. So that was the way the managers designed the schedules and responsibilities. Thomas flipped the model. He took the control away from the managers and gave it to the frontline caregivers. They were each encouraged to focus on just a few residents and to become more like generalists. They did the cooking, the cleaning, and the helping with whatever need arose, whenever it arose (except for medical tasks, like giving medication, which required grabbing a nurse). As a result, they had more time and contact with each resident—time to talk, eat, play cards, whatever. Each caregiver became for people like Lou what Gerasim was for Ivan Ilyich—someone closer to a companion than a clinician.
It didn’t take much to be a companion for Lou. One staff member gave him a big hug every time she saw him, and he confided to Shelley how much he loved the human contact. He had got so little of it, otherwise. On Tuesday and Thursday afternoons, he’d go down to the coffee shop and play cribbage with his friend Dave, who still visited him. Plus he’d taught the game to a man paralyzed by a stroke who lived in a home on another floor and sometimes came by Lou’s place to play. An aide would hold his cards or, if necessary, Lou would, taking care not to peek. Other afternoons Shelley would come by. She’d bring the dogs, which he loved.
He was also happy, though, to spend most of the day on his own. After breakfast, he’d retreat to his room to watch television—“see about the mess,” as he put it.
“I like keeping up on what’s going on in politics. It’s like a soap opera. Every day another chapter.”
I asked him what channel he watched. Fox?
“No, MSNBC.”
“MSNBC? Are you a liberal?” I said.
He grinned. “Yeah, I’m a liberal. I would vote for Dracula if he said he was a Democrat.”
A while later he took some exercise, walking with his aide around the floor, or outside when the weather was good. This was a big deal to him. In his last months in assisted living, the staff had consigned him to a wheelchair, arguing it wasn’t safe for him to walk, given his fainting spells. “I hated that chair,” he said. The people at the Florence Center let him get rid of it and take his chances with a walker. “I’m kind of proud that I pushed the matter,” he said.
He’d eat lunch at noon around the big dining table with the rest of the house. In the afternoon, if he didn’t have a card game or some other plan, he’d usually read. He had subscriptions to National Geographic and Newsweek. And he still had his books. He’d finished a Robert Ludlum thriller recently. He was starting in on a book about the defeat of the Spanish Armada.
Sometimes, he pulled up to his Dell computer and surfed YouTube videos. I asked him which ones he liked to watch. He gave me an example.
“I hadn’t been to China in many years”—not since the war—“so I said, let me go back to the city of Chengdu, which happens to be one of the oldest cities in the world, going back thousands of years. I was stationed near there. So I got onto the computer, and I punched in ‘Chengdu.’ Pretty soon I was tripping all over the city. Did you know they have synagogues there! I said ‘Wow!’ They tell you there’s one over here, there’s one over there. I was bouncing all over the place,” he said. “The day goes by so fast. It goes by incredibly fast.”
In the evening, after dinner, he liked to lie down on his bed, put on his headphones, and listen to music from his computer. “I like that quiet time at night. You’d be surprised. Everything is quiet. I put the easy listening on.” He’d pull up Pandora and listen to smooth jazz or Benny Goodman or Spanish music—whatever he felt like. “Then I lie back and think,” he said.
One time, visiting Lou, I asked him, “What makes life worth living to you?”
He paused before answering.
“I have moments when I would say I think it’s time, maybe one of the days when I was at a low point,” he said. “Enough is enough, you know? I would badger my Shelley. I would say, you know in Africa, when you got old and you couldn’t produce anymore, they used to take you out in the jungle and leave you to be eaten by wild animals. She thought I was nuts. ‘No,’ I said. ‘I’m not producing anything anymore. I’m costing the government money.’
“I go through that every once in a while. Then I say, ‘Hey, it is what it is. Go with the flow. If they want you around, so what?’”