Gina* is a problem.

Her suffering cries drive you to her side, anxious to save an aging damsel in distress. “Help me, please. The pain is so bad. It HURTS! Please, can’t you give me something for the pain?  HELP! Is anyone listening?”

Newbies at The Fortress immediately blame the caregivers, “Where the HELL are they? Why aren’t they helping this lady?”

And that’s the problem: They are, but it’s not working, not for people like Gina.

Within minutes, there will be caregivers at Gina’s side, asking her what she needs, where it hurts. Offering her options, trying new solutions, calling for an RN who calls the doctor, asking for new ideas.

Whatever they do will work, eventually…for about 15 minutes. Then Gina’s cries resume like an eruption from Old Faithful.

Your sympathies slowly shift to her caregivers. The range of what they can actually do to make this lady comfortable is constrained by doctors’ orders… and they did all that an hour ago.

“Gina, Gina, honey, you had the maximum dose we can give you. We can’t give you anything else for three more hours. Can we try ice? Or maybe heat? Would you feel better in your wheelchair (or lying down)?”

“Why won’t anyone give me ANYTHING for this pain, this paaaaayn?” she moans.

Now you think: What the hell are those doctors doing? Where ARE they? Why won’t they help this suffering lady?

Gina’s diabetic and in her late 80s, with hiccuping kidneys, a dicey heart, and more. She’s had difficult surgery to solve some of her problems, but it’s looking as though recovery may be more than she can bear. Her faltering systems simply can’t handle much narcotic, and even when her surgery heals, her body will betray her.

The doctors argue and pontificate while the caregivers bear the brunt of everyone’s anger.

“Can’t you do SOMEthing?” wails a niece, while the RN tries to explain.

The doctors push the limits of safe, adding sedation and as much painkiller as they dare. Gina quiets, starts to heal, but now her anxieties have locked her into a neverending crisis.

If her pain eases, she urgently needs the bathroom. Help with lying down. Getting up. A snack. More blankets. Fewer blankets. Medication to be crushed and mixed with applesauce because she can’t bear to swallow any more pills. Foul-tasting applesauce she won’t eat.

Each time, she moans, “Why won’t anyone listen? Why are they so mean?” The cries come like clockwork. Her call button by the bed is wearing thin. The call signal above her door shines bright, never off except when a caregiver is actually in the room.

Other patients complain about the noise. Slowly, she shifts from damsel in distress to old lady, crying wolf.

The caregivers’ voices remain sweet and patient by her side, but down the hall they sigh and mutter and throw up their hands. Gina is too frightened and pained and angry at her condition to be alone, but staying with her all the time means other patients must wait.

And The Fortress is a crossroads, not a destination. Once Gina’s stable, she will leave.

Gina’s family has decided she can’t go home, and everyone agrees, except Gina. They’ve found an assisted living place, not far from her house, offering a small apartment, 24-hour caregiver service, swimming pool, restaurant, and movie theatre.

“It’s so wonderful, Aunty GeeGee,” says her nephew, a portly suit with a beard, “If I had that kind of money I’d give up OUR house and live next door. And the minute you’re well enough to live on your own, you can go back home.”

“But you won’t want to,” says her niece, chortling, “I sure wouldn’t.”

They’re overselling it, I think. But Gina’s one of the lucky few in this country: She has money, and assets, enough to spend the rest of her days in relative luxury, with attendants, medical help, and a great view.

Why are we so good at treating stuff you get over, like my busted femur, and so bad at chronic, killing-by-millimeters problems of aging?

Gina raises objections, but at last it’s arranged: She will move to the dream condo next Sunday. Her family will order a special Sunday dinner at the condo’s restaurant, with welcoming cake and champagne.

Everyone breathes a sigh of relief while Gina calls, and moans, and pushes that button.


*Gina, obviously, isn’t her real name, and those aren’t her real ailments. But I’ve been watching her for the last seven days, and I just frankly don’t know what to do.