by Bill Foley
The last time Walt peed in the bed, Brenda’s pajamas were the collateral damage.
“Walt, wake up!” she whispered. “Are you wearing your Depends?”
“Huh?” he grumbled.
“Oh my God, not again.” Now shouting disgust and frustration, Brenda ran into the bathroom, pulled off her pajamas, and stepped into the shower. No sooner had she begun washing herself than a crash and thud occurred. She threw a bathrobe around her and reentered the bedroom.
Walt lay there half naked like a barely breathing fish at the bottom of a boat. His naked legs were fallen tree branches as his hands tried to cover his scrotum and penis.
“Help me up,” he demanded.
His right hand reached for the bedpost, trying to raise himself like a turtle on its back.
“I can’t lift you. I’ll call for Lift Assist from the rescue squad.”
“I can get up myself if you help me.”
Brenda got behind him and tried pushing him forward, but Walt slid along the floor.
“I can’t do it, Walt. I’m calling the rescue squad.”
“I’m not a helpless child.” He had felt humiliated the last time they came, when one burly squad member lifted him like an invalid without dignity. “I’ve been a teacher, a football coach, and a high school principal. I’m somebody! Give me some clothes.”
Brenda diapered Walt and helped him put on shirt and shorts. Then she made the call, tears pouring down her face. “Hello, this is Brenda Cassie at 23 Chevron Road in Clearwater. My husband has fallen, and he can’t get up.”
She knew the drill and answered the questions of the dispatcher, who told her the team would arrive in about thirty minutes since her husband was conscious.
Walt was admitted to Overlook Hospital for three days with a urinary-tract infection. Brenda worried about her husband, but his hospital stay offered a respite from her caregiving duties. She felt exhausted.
While Walt recuperated, Brenda met with the hospital social worker to discuss her husband’s future. As she took a seat in the tiny office, she broke into tears.
“Walt and I have been married fifty years, and I love him to pieces, but I can’t care for him alone. He’s cranky and impatient, demanding my full attention. I can rarely leave the house, speak to friends, or just rest. I’m guilty about wishing for his death and angry about his relentless need for my attention. It never stops. Our son and daughter live in the Northeast, visit us for the holidays, and make occasional phone calls, but everything falls on me.”
“How long has Walt suffered with dementia?”
“I’m not sure. I knew he wasn’t himself after he turnedseventy, but I just thought he was depressed. I remember one day we were driving to the beach; a place we visited hundreds of times, and he got lost. He started missing appointments and forgot to pay bills. Two years ago, when he turned seventy-five, he was in a terrible automobile accident while making a left turn and was T-boned by a delivery truck. He spent a week in the hospital before being sent to a rehab facility in Largo. He’s never been the same.”
The social worker was sympathetic but reminded Brenda that Medicare and Medicaid had ended in 2036. Under the new Medical One program, dementia patients were required to be cared for at home until ready for hospice. A panel of doctors would determine that the patient was terminal, with less than six months to live.
“The good news is caregivers like you are entitled to $25,000 a year to pay for health aides and a one-time grant of $10,000 for medical equipment,” the social worked explained. “Like everyone, Walt’s annual medical expenses are covered up to $100,000.”
“So Walt’s not eligible for placement in a memory-care facility? He can barely walk or use the toilet himself.”
“You are free to choose nursing-home care for your husband anytime at your expense. The cost, however, is steep. On average, about $15,000 a month.”
“I can’t afford that!” Brenda began to tear up again. “It’s hopeless.”
“Few people can, so they have to wait for a terminal diagnosis for their loved one. When the patient is classified as terminal by a panel of doctors, they can then be transferred to a hospice facility, where the Medical One program will pay fifty percent of the cost for six months.”
“That’s so unfair. Paying half the cost will be difficult enough. What if Walt lives more than six months?”
“Families would have to provide the care. Of course, assisted suicide is an option if the patient agrees or his guardian when the patient is incapacitated.”
Brenda was stunned by the new regulations. The social worker droned on about a two-month appeal process, but after that, she was stuck for the full cost of Walt’s care if he continued to live.
A hospital bed was delivered, and Walt slept in the living room. Brenda’s sleep remained dry and uninterrupted. The arrival of an aide for fifteen hours a week offered her some break from caring for Walt. Her husband’s neurologist warned Brenda, however, that Walt’s dementia was irreversible.
“My friends who have husbands who have Alzheimer’s tell me their memory has become a black hole. Walt’s not like that.”
“Alzheimer’s is one form of dementia, and even among these patients, their symptoms can vary,” the doctor explained. “They can suffer loss of motor skills and undergo a personality change even when their speech and memory are stable.”
For several months, Walt’s condition remained unchanged. Brenda could go shopping, play cards, and visit friends at the club. She got away twice for a weekend visit to their son and daughter. She didn’t feel trapped and depressed when Monica, the aide, visited.
Inevitably, the neurologist’s predictions of Walt’s decline became evident. Monica first noticed Walt becoming angry and unreasonable, especially when Brenda wasn’t around.
“Yesterday, when you went to the supermarket, Walt had a fit and began throwing his lunch at me. He wanted to know when you would be back. I told him in an hour, and he began pounding on the table, demanding I get you,” Monica told her.
Walt’s oppositional behavior frightened Brenda. Her husband’s aggressive outbursts bullied her. “Brenda! I need you now. My diaper needs to be changed!” When she tried to transfer him from the wheelchair to the bed, he would fight her. “You’re hurting me! Stop!” Once on the bed he would belittle her as she struggled to remove his diaper. She began shouting back at him. “I didn’t sign up for this!” She would leave him lying naked on the bed until he calmed down.
The situation became intolerable when Walt kept using the “N” word when addressing Monica and slapped her as she was trying to help him onto the commode. Monica quit, and Brenda decided to investigate a residential facility specializing in dementia patients.
The Evergreen Hospice and Memory Care Center’s convenient location, a five-star rating by the new Office on Aging, and relatively low cost, about $70,000 annually, made it Brenda’s first choice.
Evergreen specialized in assisting dementia patients. It kept costs low thanks to deregulation of treatment strategies and the use of robots and artificial intelligence. It provided clients with excellent care at a lower cost while still earning a profit.
By selling the house, and with some help from her children, Brenda might be able to make it work until Walt got a terminal diagnosis. She arranged for a visit.
The director of Evergreen, Mortimer Heap, greeted Brenda and her reluctant husband for their scheduled tour. He stood well over six feet and was as thin as a popsicle stick. His face and hands were pale and waxlike, making him resemble a character from a Dickens novel. His blue suit, white shirt, and red tie neatly packaged his conservative gravitas. He mixed the solemnity of a funeral director with the sales pitch of a used-car salesman.
“Your annual fee is enticing,” Brenda said, “but I’m concerned about the use of robots.”
Heap had a well-rehearsed answer. “Robots do not perform any critical care functions. They are used to perform lifting and carrying tasks while assisting patients in communicating their health issues with nurses and doctors. They also serve as companions, offering conversation, entertainment, and physical contact. They don’t get sick and are never late for work.”
Walt sat in his wheelchair, his hands tightly gripping the handles, his mood volcanic, ready to erupt.
“How can a robot offer human companionship?” Brenda asked. “Only real human beings can do that.”
“Yes, of course. Robots are not a substitute for human interaction but rather a supplement. Would you like to visit our community rooms, where robots work as companions with our clients? They are equipped with artificial intelligence that contains an intimate history of a patient’s life, likes and dislikes, and current interests that you provide to us. The robot learns more about the patient with each contact and can bond.”
Walt would have none of it. “Brenda, get me the fuck out of here. No machine is touching me.”
His demeanor unfazed by Walt’s outburst, the director explained, “All our robots are equipped with artificial intelligence, which, within a millisecond, calculates just the right force to employ. They are specially programmed so they cannot hurt a human being.” He pointed to the banner hanging in the lobby that proclaimed, Welcome to the Best Days of Your Life. Staff and robots are not simply care providers but in the happiness business.
Brenda reached for Walt’s hand and faced him. “Calm down, Walt. We haven’t decided anything. We’re just looking.
Brenda and Walt entered a ten-thousand-square-foot community room, with the ceiling and walls painted in warm blue and green pastels. The floors were carpeted to reduce injury from falls, and on the walls were video screens showing various sports, news, and entertainment programs. Patients sat in comfortable lounge chairs with built-in headsets. Next to many of them were furry creatures, sitting with them, holding a client’s hand, massaging their shoulders, and, in one case, wiping tears.
In another room, clients played bingo with their robot partners, helping to place chips in the correct box. Clients could also join a robot band in the choral room, where their favorite hits were played and a real woman led them in song. A gym contained mostly men playing shuffleboard and miniature golf while robot coaches gave encouragement. Around the gym walls was a track with both a walking lane and a wheelchair lane, with rolling robots shaped like cordless vacuums helping patients complete the circuit.
“Look, Walt! You could really benefit from this gym.”
Walt remained silent.
The director invited Brenda to speak with any patient who was willing to talk to her. “Please wander freely and speak with anyone. I will take Walt and introduce him to one of our robots.”
Brenda approached an obese elderly woman who was almost bald from chemo-treatment. “Hi, I’m Brenda. My husband might be a patient here, and I’m curious how you feel about all these robots.”
“Toby is my best friend. I can tell him anything, and I don’t have to worry about his feelings. My children get upset when I talk about letting go, but not Toby. He listens to me and understands the pain I’m in.”
“Toby is that furry teddy bear you’re holding?”
“Of course. Say hello to Brenda, Toby.”
“Welcome to Evergreen, Brenda. We hope you enjoy your visit.”
Brenda was startled by how lifelike Toby appeared. His blue eyes penetrated Brenda’s consciousness like a happy memory. His lips appeared moist and kissable. His arms gently stroked the woman’s shoulders and hair. His body was soft and fury like a favorite cat.
The dying woman and her robot reminded Brenda that eventually she would face her death alone. Walt would be gone, her children, busy and distant, would call her or send digital get-well cards. As the Bible says in Genesis: From dust you came and to dust you shall return. But now a robot would assist in that transition.
“Walt, I want to introduce you to Helix, a virtual-reality robot,” Heap said.
“Hi, Walt,” Helix said. Helix was about six feet tall and looked more like a shiny forklift with a ball-shaped head with a flashing light. His mouth was a microphone, his ears receivers, and his chest had several ports for input cables. His metal arms were built for lifting, but his hands were plastic and flexible.
Walt’s face grew red with anger. “Fuck you, tin man. I want to leave now, Morty!”
Most times Walt’s consciousness was like a TV test pattern waiting for a signal to commence programming. His rage and fear broadcasted loud and clear. His limbs, however, were lost in space.
The director ignored him. “Helix, take Walt to the Virtual Reality Theater and show him what you can do. If he remains agitated, go to phase 1 for sedation.”
Helix began to wheel Walt into the VRT, which was shrouded in darkness with deep red pulsing lights along the floor. In the middle of the room was a chair that reminded Walt of something from a gamer’s control center.
“Walt, I will help you climb into the driver’s seat.”
He stiffened, hoping to lock himself in his chair. “Take me back to my wife. I’m not playing your fucking games.” Walt felt a slight prick in the back of his neck and fell silent.
Helix typed some codes into a screen in front of Walt, and suddenly the room lit up and Walt found himself driving a Porsche 911 down a mountain road outside of Scranton, Pennsylvania. It was 1980, and a memory of that year played back in real time. The walls around him captured the city below, including the burning slag mountain left there by the Glen Ellen Coal Company. The floor became the narrow-rutted road that students drove to beat each other’s times to the bottom. He glanced at the stopwatch taped to the dash as he played the clutch and manipulated the six-speed shifter in the center console. He drove for a new record: nineteen minutes thirty-two seconds. His fraternity brothers sprayed him with Stegmaier Beer as he exited the car. Suddenly, everything turned dark and quiet, except for his pounding heart.
“What happened to me?”
“I tapped into your memory and uncovered an event in your life when you were young and excited,” Helix said. “I then programmed those memories into an intelligence system that could fill in the smallest details.”
“I’m nauseous and out of breath.”
“No worries. Your heart rate went over 160, so I gave you some ketamine to bring you down. You’ll feel alright in a minute.”
“Wait, you what . . .?” Walt’s breathing was labored, and no sounds came from his lips.
“Yes, of course, to protect you. The new regulations give facilities like Evergreen more discretion with medication to protect patients from themselves.”
When they exited the VRT, Walt sat slumped in his wheelchair. Brenda’s big kiss began to revive him. “How did it go?”
“Get me out of here! They want to kill me. They stuck me.” Walt was breathless.
“It takes a while for Helix to get to know you, Walt,” Heap explained. “Any discomfort you feel will disappear with future mind-bending experiences as we learn to match your thoughts. Medication is offered only when life-threatening symptoms emerge.” Heap turned to Helix. “Take Walt out to the entrance while I speak with his wife.”
Brenda told Mortimer Heap she was very impressed with the visit and interested in Evergreen for Walt. She would have to sell the house first to handle the monthly fee. But she wondered if Walt could be diagnosed as terminal.
The director replied, “Patients require approval from a panel of doctors that their case is terminal. Given Walt’s condition, he fits the criteria for a terminal patient. We have our panel of physicians to expedite the process for a diagnostic fee of $5,000. Should Walt live longer than six months ,when the government subsidy ends, we will continue to house Walt, and your rate will remain the same.”
“You can do that?”
“Absolutely. Our success depends upon offering the best possible care for the lowest price, ” the director replied. “If Walt is determined to be terminal, we will need his signature on our living will stating that he does not want to be kept alive with life support if there is no chance of recovery. You will need to sign a similar document as his guardian if Walt becomes incapacitated.”
The next few months were a whirlwind of preparation to put the house on the market. Brenda decided not to tell Walt she was selling the house and that he would soon be a resident at Evergreen. The upkeep on the house was expensive, and if not for Walt she would have sold it sooner. To Brenda’s surprise, she had multiple bids on her home, the highest one well above her asking price if the buyer could take occupancy in a month. She immediately called the director at Evergreen to make arrangements for Walt’s admission.
Heap explained that it would take about a month to complete the terminal diagnosis and receive sign-off from the Office of Aging. Brenda wired the diagnostic fee and signed the contract to sell their house and purchase a mobile home in Shore Acres. She also sent a copy of the Evergreen Living Will document that she and Walt had signed.
“Why aren’t you taking me home?” Walt said after they finished breakfast at the diner.
“Honey, I’m taking you to your new home. You remember the senior-care facility I took you to visit.”
“No! That’s where you go to die. Take me home.”
“I had to sell the house, Walt. It’s too much work for me to handle. More importantly, honey, I can’t give you the care you need. At Evergreen, you will have round-the-clock care, and, of course, I’ll visit you every day.”
“Take me home! I want to go home.”
Brenda had strategically strapped Walt into the car’s back seat on the passenger side so she could ignore him when he started kicking the seat.
Mortimer Heap entered Walt’s room with a female robot he called an AI Assistant. “Good morning, Walt. I want to introduce you to Gamma Ren, who is designated a human female, approximately 40 years old.”
Gamma Ren could be confused for a human being. Her hair was brown frosted and cut short. Her eyes were deep green and never blinked. Her skin, made from recycled plastics and pig tendons, looked smooth and soft, her nose petite, and her cheeks brushed with rouge. She wore a long-sleeved light blue housedress decorated with images of tiny white flowers. On her feet were white tennis shoes.
Walt was startled by Gamma’s human resemblance, but her most disquieting feature was how much she reminded him of his mother when he was a child. As she approached him, his brain broadcast fight-flight messages. It was as if he had seen a ghost.
“Go away!” he screamed. “Get her out of here!”
Gamma Ren approached the bed and removed the covers. “Now, Walt, you can behave better than that. I’m not going to hurt you.” Her voice was a creepy imitation of his long-dead mother.
“Go away! Get me out of here!”
“Walt, stop it! She’s not going to hurt you.” Brenda suddenly entered his room.
“Where have you been? Take me home. I hate this place.”
“This is your home, Walt.”
“Where have you been? You dumped me here.”
“The staff advised me not to visit you for at least a week so you could make the adjustment to your new home. As for dumping you here, I’m spending a fortune to give you the best care possible.” Brenda started to cry.
Gamma put her hand on Brenda’s shoulder. “Some dementia patients experience bouts of anger. It’s not your fault.” She handed Brenda a tissue to dry her tears.
“Thank you. I feel so guilty that I am abandoning him and yet relieved that he will get the care he needs.”
“I know it must be hard, Brenda, but you are doing what’s best for Walt. You can visit him whenever you want, but you also have your life back.” Gamma squeezed Brenda’s hand as Brenda left the room. It felt odd to Brenda to be comforted by a robot, but she felt relieved that Walt would receive excellent care.
“Don’t leave me!” Walt screamed at Brenda.
Gamma’s right hand touched Walt’s, and it was warm. With her left hand, she rubbed his head, and in a melodic, soothing voice, she reassuringly said, “You’re safe, Walt. Brenda had to go. Now sit up and let me massage your shoulders and neck.”
Walt felt like he was ten years old, when nightmares about the death of his Marine father in a training accident haunted him. How was this happening? It wasn’t real, but neither was it a dream. His heart was thumping like a basketball, but her soothing caresses touched all his memory points, and he began to feel warm and safe.
“Now I want you to take a nice hot bath. When you’re scrubbed clean, I have some new clothes for you, and we’ll go for a walk.”
Two robot aides took Walt to the bathroom, where he showered first and then stepped into a bubbling hot tub. He lay back and heard birds chirping, water rushing down a waterfall, and wind blowing through the trees. The walls and ceilings had scenes of his beloved Adirondack Mountains as he hiked a familiar trail to Pharoah Lake. He recalled diving into the crystal-clear waters as the hot tub drained and a cool rinse began to fill the tub.
He dried himself, and Gamma helped him onto a massage table, where a robot therapist applied pressure to release various muscles in his legs and back. He was given a white terrycloth robe and pushed back to his room.
Gamma was waiting for him, holding a colorful Tommy Bahama shirt, white shorts, and sandals. She helped Walt dress and then took him for a tour of the grounds. As Gamma rolled him down the hall, an automatic door swung open, and Walt was bathed in warm sunshine and a light breeze. The sky was a blue so deep he felt he could touch it. The sounds of birds, rushing water, and the rustling of trees filled him with a sense of peace.
“Isn’t it wonderful, Walt?”
“Is it even real?”
“It’s real for you. You are in the solarium center, which captures all the beauty of nature you have witnessed.”
Walt wanted to visit the real outside, but the beauty within the solarium was like an opioid that he couldn’t quit. Gamma filled her tour with Walt’s memories and how the happiest times in his life were his nature walks.
Gamma rarely left Walt and was ready to engage in conversation whenever he had the urge. He couldn’t always remember his past, but suddenly something would ping in his brain, and a memory would reload.
“You look sad today, Walt.”
“I always wanted to have children, especially a son,” he recalled.
Gamma remembered Walt’s life better than he did and frequently contradicted him. “Walt, you have a son, Michael, and a daughter, Emma.”
“Are you sure, Gamma? I can’t remember them.”
“I can help you with that.” She handed him a cup of water and a pill. “Sleep now, Walt, and I will help you dream about them.”
Gamma placed her hand on his forehead and her finger in the monitor attached to Walt’s bed. She closed her eyes and played for Walt a family summer vacation on an island in Lake George. Walt slept for twelve hours, dreaming of the children he had forgotten.
Six months passed, and as Walt’s condition deteriorated, his dependence on Gamma increased. He could no longer distinguish between reality and the virtual world. The pain in his back and legs did not ease even after he took the painkillers. “Everything hurts, Gamma.” He shed some tears.
Gamma hugged him and reminded Walt that his happiness was all that mattered to her. “Soon you will be crossing into a new form of existence without pain.”
“Is there such a place?”
A team of doctors downloaded Walt’s information from Gamma and began to plan for Walt’s departure. Evergreen beds were in high demand, and consistent turnover was the key to profitability. The process started by reprogramming Gamma into Heaven’s Gate mode. Gamma was taken offline, and Walt was left alone for much of the week. The nurse told him the doctor ordered a reduction in pain medicine for his safety. He became agitated and called out for her until he was sedated. Gamma would rejoin him soon, the nurse explained.
One night, Gamma appeared in Walt’s room as an apparition of his mother.
“It’s time, Walt.” His mother reached out with her hands and cuddled with Walt in his bed. “Come with me, darling. You’re safe now.”
“I’m cold, Mom. Warm me.”
“I’ll keep you warm, my darling.” Gamma massaged his back and legs.
Walt felt her swaddling him in a heavy blanket. She continued to rub his head and shoulders and calmly whisper in his ear.
“It’s time Walt. Just let me take care of everything. No more pain; light and happiness every day.” He didn’t feel the needle.
Brenda received word from Director Heap that her request to end life support had been executed, and Walt had passed away that evening. She was grateful that he died peacefully, without pain. She mourned the man she loved, but she had buried him a year ago. Most of all, Walt would have been happy to end his pain. Indeed, Brenda was happy too. These were the best days of their lives.