The Virus

Thanks to COVID-19, my kids are home from school for the next month or so.  We’ve started making plans for what happens if one of us gets sick, even if all of us get sick.  In that case, our puppy Ollie is in charge.  He hasn’t quite figured out Grubhub and only seems to be able to chase and catch sticks, so our diet is going to suffer.  But at least we’ll know when anyone is approaching the house, and we’ll never be alone.

I’m not a sandwich generation parent anymore.  It hasn’t stopped me from thinking about what we’d be doing now if my father were still alive.

He lived for the most part in an independent living community, which is a far cry from being a nursing home or even an assisted living facility.  He occupied his own apartment and could make his own decisions about when and how he wanted to leave.  Meals were meant to be communal and social, and so of course he decided to self-isolate.  He didn’t really care for most people.  One of the greatest days of his life was when he figured out that room service meals delivered for $6 per day would free him from having to interact.  Best money he ever spent.

Given his history of contracting and beating diseases – colon cancer and C-Diff among them – I am certain that COVID-19 would have found its way into his system.  His subpar hygiene almost guarantees it.  Then, if the coronvavirus could talk, it probably would say something like “Yeah, I see now why nothing kills this guy – it’s way too much work.”  And then he’d recover and marvel at still being alive.

Sometimes I picture the various things that tried to kill him hanging out together in a metaphorical locker room, dripping with sweat and exhausted, swapping stories about how close they came, only to bonk at the last moment at this unkillable giant.  Only Time could get him.

The hardest part for him might have been the forced isolation from visitors.  I get this recommendation.  I also know that despite all the people living together, these communities can be lonely.  On occasional Friday nights, we used to have dinner with Novas’s grandmother in her swank retirement community, and the other residents would mob us.  Yes, we had cute pigtailed blondie 4 year old twins in tow.  They were a sight to behold.  More than that though, we were new visitors in a place that already did not get many.  People were starved for contact with different people from the outside world.  I can’t imagine living in a sealed-off community where your children and good friends are prevented from actually seeing you.

I remember how my father need not only the health to live, but something to live for.  My brother and his kids would FaceTime him nearly every day, which was great nourishment for him.  It was also not enough.

For as much as he didn’t like most people, he too needed people.  He looked forward to visits from his Home Instead helpers and made sure to queue up videos and pictures for them.  We had our weekly Sunday get-togethers.  For months, he and I sometimes had loud arguments about my insistence that he change from his pajamas and robe into actual clothes when I’d come.  Truth be told, it was one way I could check if he was still mentally with it without having to ask him.  Eventually he gave in because he grew to like when I came, and he wanted me to be proud of him. I don’t know how he would have reacted to having those shut off.

I might have sneaked up the back stairs anyway – because like I said, there is no way the coronavirus could have killed him if C-Diff, colon cancer and the Nazis couldn’t do it.

Like everyone else, I hope this pandemic passes quickly.  That would be great.  I hope I don’t get it, and that my wife and kids don’t get it.  I don’t have elderly parents to worry about, which like many blessings is bittersweet.  If I did though, I’d also be reaching for a solution to their loneliness.  It too is a serious condition if left untreated.

The Puppy

About a month ago, Ollie came into our lives.  He’s a mini golden doodle puppy and like other dogs his breed, he is a nonstop source of love.  I flew to Orlando to pick him up from Country Mini Doodle Farms, which is actually located in Summerfield, about 90 minutes north of the airport.  It is hard-core Trump country in the middle of which is a giant 55+ retirement community called The Villages.  One mobile home tract after another suddenly gives way to new construction multi-story buildings and every retail chain and casual dining restaurant you can imagine.  I stopped in at Longhorn Steakhouse at about 3:30 (2 Miller Lites for $4 all afternoon) and the place was jammed; I was the youngest person in there by about 10 years.

Back to Ollie though.

As I mentioned, Ollie is a great dog who just wants to love everyone.  He is also cute – come on, he’s a puppy, the little guy has no choice – and endlessly good natured.  He’ll scamper around a lot but tire quickly and just sit there quietly, sometimes falling asleep and occasionally snoring.  It’s the best.  His favorite game right now is chasing ice cubes around.

The other day I thought about how much I wished I’d had him when my father was alive.  For me: he would have been great to come home to on difficult days.  For my kids: he would have been a great distraction.  More than that, taking care of him now has opened their eyes, a little, to what it’s like to care for someone who is totally dependent on you.  For my nieces: they would have loved him when they were younger and visited us from California.

For my dad though, he would have been the highlight of our visits.  My parents had a chocolate lab when my younger brother was finishing high school and then when he went off to college.  My father loved that dog.  He would have loved this one.  He would have sat in my dad’s apartment and just kind of looked around.  We could have had him chase ice.  Ollie would have loved him too.  Of course he would – he loves everyone!  That’s what he does!  He would not have cared that my dad sometimes had questionable hygiene, or ate “weird” food, or dressed like someone for whom putting on clothes was an hour-long ordeal.  He would have looked at him with that loving face just the same.

It is challenging to get unconditional love at any age, maybe impossible, and especially so when you are old.

Ollie would have been great for all of us and for him.

The Pharmacist

I was wandering the aisles of CVS one night recently in search of salt tablets.  I couldn’t find them so I ambled back to the pharmacy department and waited so that I could ask where these might be.  Standing there, I flashed back to the moments where I’d stood in line many times to fill my dad’s prescriptions.  Also to the moments where I’d loaded up on Diet Coke for him… but that’s another blog post.

While waiting, it dawned on me just how important these people had been in my life when my father was alive.

When caring for an elderly parent, you are often at the whim of people you don’t know.  Their landlord and/or the person who runs their housing community and gets to decide whether their incontinence is a nuisance or a reason to evict them.  The nurse in the hospital when they find themselves there after a fall who gets to decide whether or not they suffer from dementia, which affects the whole care path.  The person at the DMV who can see that they can’t read the bottom line of the eye chart and gets to decide whether or not they get a driver’s license.  Most of them know more than you do about the subject matter of caring for the elderly, and almost nothing about the particular human being in question.

To this list, add the person who fills their prescriptions.

It’s going to happen at least once, and hopefully not more than once, that the doctor will have written a prescription that doesn’t make sense as written.  I spent hours in a compounding pharmacy in Hopewell, NJ one rainy summer night when my father had been discharged from physical therapy post his first C-Diff scare and his doctor had written a scrip for liquid vancomycin.  No one prescribes that, I didn’t know what a compounding pharmacy was (more on this another time maybe), and it’s $6,000 per course because it’s not covered by any insurance of any kind.  I was scared to death.  But he convinced me that pills would be fine, he’d call it into CVS and get them to cover the prescription even though it’s not what the doctor wrote, and there was a way to write the prescription such that it would be a different class of medication that Medicare looked at differently.  It was technical and confusing and made me wonder how people who don’t have advanced degrees figure this out.  Also, I was frantic and it was closing time.  He calmly explained that waiting 12 hours would be fine, really.

Then I left, drove to pick up Chinese food, went back to my father’s house where he was already asleep, and drank 50 beers to calm down.

And the next doctor, here in Massachusetts, made a similar mistake.  Again I found myself in front of a pharmacist who could have just shrugged and told me to just deal with it.  Instead, he chased down the doctor, got him to re-write the prescription, and helped me navigate the byzantine Medicare prescription classes again.  All while I stood there feeling frantic but grateful that he would help me when so many other people seemed to be uninterested in him, and in me.

This same pharmacy in Wellesley at the end of my street had filled his prescriptions so many times.  After a while they recognized me and would say “Hello Mr. Biro, are you picking up for your father today?”  I don’t know why that made me feel less alone but it did.

I dealt with many people who had more power than I did and tried to bully my father and me into a particular course of action.  Rare was the figure who both had authority and was empathic at the same time.  These people are gold.  Pharmacists were first among them.

The Reunion

I got back this past weekend from my 20th business school reunion in California.  I miss California so much… but that’s a whole other blog.

Anyway, I had a number of people approach me and tell me that they used to read, and really appreciate this blog.  It’s been a year since I wrote and 2 years since I really wrote often, so that was surprising.  I also noticed that this reunion was more “real” than, say, our 5th or 10th.  Back then many of us were posturing about how great we were doing professionally or flexing (my daughter Lily’s favorite word this week) how little we had aged.  This time though, it felt different, and I think it’s in part because most of us have had life punch us in the face over the past 5 or 10 years.  In particular, many people lost parents, or had parents who were sick, or parents who were in the homes that they’d lived in for 40 years and “I know I should move them out, but I don’t know how to go about it…”  It sounded very familiar and I knew I could help by sharing some of my experiences.

Part of this reunion was about ways of giving back and doing things you really like to do.  This blog is definitely the latter and it seems like it might be a little bit the former as well.  So, I’m going to pick this back up again.  Rather than guess what direction it will go, I’ll just write and see what happens and for how long.


The Last Errand

On Friday, I ran the last errand for my father that I’ll ever do.  He passed away about 16 months ago, and I think after so many years of running around, phone calls, lawyers, doctors, you name it, I’m finally done this time.

Briefly: I visited the bank and closed out the last few dollars of his estate account.   In the past I’ve lacked proper court papers, or the court papers were hard to get, or I didn’t know I needed court papers.  I also knew that to complete even the most mundane transaction at Bank of America requires an appointment, so I made one.  I was in and out in less than 10 minutes.  It was anti-climatic in a way that so few things were over the years.

So I think that’s it.  Actually the only thing that could pop up now is that my dad’s “estate” (in quotes for a reason) is audited somehow.  So — if you’re reading this and are from a taxing authority of any kind, you *definitely* don’t need to waste your time on this.  It was all above board and believe me, there are much bigger fish to fry.


The Cartridges

I just got back from a trip to Israel where I did a cross-country bike ride – sounds impressive until you realize that Israel is 65 miles across where we traversed it.  We also went down to the southernmost point, which added about 300 more miles.

Before we left Jerusalem, I realized that I was out of toothpaste, so I hit a local drugstore on Ben Yehuda street.  I barged in like I was on a mission, like I owned the place, while of course I don’t speak the language and didn’t know where I was going.  Needless to say, toothpaste was way up in a corner on the second floor.  It makes sense actually; I had to pass by a lot of other items I might otherwise buy, similar to how milk is always placed in the back of a supermarket.

One of these was plug-in air freshener cartridges.

Once upon a time, I used to have these on auto-order for my father’s apartment.  I hoped that they would cover the certain smell that had permeated the rug, the furniture, his clothes, everything.  It didn’t really work.  What did work, eventually, was a thorough scrubbing of the place, new pants, and a number of temper tantrums by yours truly.  Sometimes as a caregiver, only a strategically timed tantrum will do to get your way.  Over time, he tried harder to be “clean”, in his words, when I came over.  He could see that it was important to me, and what was important to me gradually became less unimportant to him.

As I mentioned a couple of posts ago, I no longer see things like this and seize up with emotion.  Most times now, I smile and remember.  Still, the details come flooding back.  I am guessing that my standing in front of an Israeli drugstore shelf and smiling to myself made me look even less of a local than I already did.  Which is fine.  I gladly traded that for some of the memories of the better times that we had, and the day that I could stop buying air fresheners.

The Picture

There’s an old cliché that a picture is worth a thousand words.  Often, clichés become that because they are true.

My brother texted me a picture from 2 years ago (it’s the one that’s part of this post).  To anyone else, it would look like a pretty standard picture of a smiling grandfather with his granddaughter.  That’s because it is.  And yet –

I remember finding that apartment for my father, way back in 2013, and being happy that his community abutted a park.  That’s the park they are riding in.

I remember what it took to keep him going when he got sick before that so that he would fight to stay alive and live to reach that moment at all.

I remember buying that scooter for him.  I don’t love that memory; truth be told, it was kind of a nightmare.  Not just because the process of selecting, ordering, assembling, re-assembling and then figuring out how to make the battery work was grueling.  To say that I am not mechanically inclined is the understatement of the century.  The other difficulty was that I resisted buying that thing, and then it turned out to be a great purchase for him.  It bought him a year of mobility and happiness.  He was right, I was wrong, and I didn’t like it.

I remember buying that blue, button-down, collared shirt for him at Target, along with other clothes he had requested.  He insisted on Target; actually, that’s a lie.  He insisted on Wal-Mart and I’m enough of a snob that I went to Target to instead.

I remember that he had wanted to lose weight.  You can see that his face is pretty found for a 92 year old man.  But by that age, it’s more important to put weight on; you never know when you are going to need those extra 15 pounds to stave off the effects of laying for a month in a hospital bed that you didn’t expect.  His weakness for unhealthy food kept him alive many times, it turns out.

I remember that 2 years ago, my brother and family came out for the Jewish holidays.  Normally, they come for Thanksgiving, but that is an expensive and grueling proposition.  So in 2016, they came for Rosh Hashanah instead.  It was in early October, which is late for “the Rosh”.   I sat with my brother one night and drank bourbon by the firepit in my backyard.  It was a great moment.  Everyone should have a brother – seriously, I highly recommend it.

I remember that about 10 days later, on Yom Kippur, my father fell and broke his hip.  We still had good moments after that, but that was the beginning of the end.  He recovered from the broken hip.  He was determined that it wasn’t going to kill him, and my brother and I were determined not to let it.  The true harbinger was the stroke that had caused him to temporarily lose consciousness and fall, the one that had set the end in motion, the one that preceded all the others that would come that we didn’t know about.  They were small and he was strong.  Eventually they were stronger than he was.  Whatever the “they”, they always are.

Mostly, what I remember, what this picture brings up for me, and for my brother, is that we worked really hard to make him happy, and succeeded.  There have many times since he passed away that I have thought that I worked too hard at this.  He was conditioned to demand this kind of attention, and I was conditioned to give it.  I suppose that because he raised me, this is only natural.  I can observe it more dispassionately now than back when at times I felt it was destiny to help him make a life, to put him in a position to zip around on his scooter in the park on a lovely early fall day near his apartment with his granddaughter.   It was, and it wasn’t.  I am still trying to figure that part out.

By the way – I wasn’t quite right.  A picture sometimes is worth exactly 695 words.







The Facilities

Over the summer, I took a lot of long bike rides.  One feature of going 20mph — OK, it was more like 17 — instead of 50 is that you notice things that you’d otherwise miss.  You also notice which roads are smooth vs. perenially under construction or have so many potholes that you’re guaranteed to get a pinch flat.  After so many miles of trailing, I could write a blog on this topic alone.

One thing I noticed, for the second time, was the sheer number of facilities for seniors in the area.

The first time was while my father was alive.  He lived here for 4 years in a community that during his tenure had 3 different owners.  It went from simply being called Farm Pond, to Emeritus Senior Living, to Brookdale Cushing Park.  This is a community with a feature euphemistically called “Aging in Place”, which I know now is a highbrow way of saying that they provide both independent living and assisting living apartments.  It’s a benefit when you have to move suddenly as we did – but assisted living is a totally different experience from its independent living counterpart.

Farm-Pond-Emeritus-Brookdale, however, did not have a “skilled nursing” section.  This is something less than a hospital room, but not by much. I saw enough of those during his hospital recovery stints in various rehab centers.  The rooms are spartan and full of medical gear.  It smells like disinfectant.  The lighting is industrial.  There often are a lot of people shouting because ownership typically keeps nurse to patient staff ratios high to manage labor expenses, so the residents do what they can to get more attention.  That is: they yell.

I would pass by places that offered skilled nursing and hope never to walk in the lobby with his belongings.   Not long before he passed away, I took him to a rehab center (skilled nursing plus exercise facilities) as part of what we hoped would be a path back to this independent living apartment.  It’s close to the gym where I now belong, and although it’s been over a year, passing by the Salmon Health and Rehabilitation Center still takes me back to that final week.

Passing by a community like my dad’s, I would wonder about their fee structure, whether or not they had a waiting list, whether they had vacancies, and if so, why.  Quickly cycling turning this thought sequence became second-nature to me, even zipping past at 50mph or more, and nearly anywhere I went in America.

There also is an Alzheimer’s center not far from my house that I would pass several times a week, and die a little each time.  I knew there was almost no chance we would end up there.  Didn’t matter.

Not every place is like that.  Near the Natick “Collection” (I think when you add a Nordstrom’s, you can’t call it a mall anymore) is a orthopedic office where we had a check-up after my father broke his hip.  It was healing so well that the doctor didn’t quite believe it.  It was a nice surprise during a process that has fewer and fewer as time goes on.

Now that a year has passed, seeing facilities no longer fills me with dread or racing thoughts.    Mark Twain is noted for having said that “I’ve had a lot of worries in my life, most of which never happened.”  Most of mine never happened either.  My dad lived in one facility for almost all of his time here, and he was happy there.  And yet – I still notice them anyway.


The Cioppino

I had an unexpected night to myself for dinner the other night, so I hit Legal’s.

I haven’t been there much in the past year; for one, the average age at the location in Framingham is about 65, and that’s including the young families who somehow think that it’s a good idea to bring their squirmy 2 year-olds to an upscale casual seafood restaurant (pro tip: it’s not).  My 5 Guys business partner loves to go to Ken’s, which is a steakhouse not far from Legal’s that I think he used to frequent because they would serve him and his underage friends.  That was 40 years ago now and I don’t think they have gained any new customers in 40 years.  The place is terrible.  But I digress.

Legal’s was my father’s favorite restaurant when he lived here.  We went there for his birthdays, for my kids’ birthdays, for my birthday, for Washington’s birthday.  You name it.  I used it as a motivator when he was doing physical therapy in New Jersey after his near-death experience with C-Diff and he wanted to quit.  So many times my brother and I convinced him not to quit.  We sat and ate chowder when he finally made it up here, weakened and still sick, but alive.  It was our place and for many months, it hurt too much to consider eating there again.

Recently, I have been thinking of him a lot.  It’s been about a year since he passed away, which I’m told is a milestone.  I have an unusually good memory for dates, and this summer I relived the sequence last summer where things really fell apart.  This was the Tuesday that I took him to the doctor who hospitalized.  This was the triathlon I did last year while he was in the assisted living apartment for the first time begging me to let him go back to his old place.  This is where I was standing when I got the call from the hospital that he was back, and barely responsive.  This was the time of day when I said the last thing to him I ever would, which is asking him if he was thirsty.  He was.  He didn’t suffer much until the end and it was hard to watch.  This is the time last year that I was in Rome and my brother had called to tell me he was gone.

Now though, I can feel that the memories are there, but the debilitating impact doesn’t accompany them.  It’s like they exist on their own, and I can choose how I want to pay attention to them.  I am starting to come to terms with what all the years as a caregiver meant.  Sophie, who suffered a bad concussion about a week before he died, is finally healing.  She is a brave and amazing kid, and her positive attitude has been inspirational, but all the same, it hurts to watch your child suffer.  We didn’t know then how hard her year would be, and ours with it.  It was a hard year.  It is finally passing.

A few times in the past few weeks, I have caught myself recently feeling strangely at peace.  I like it.  It says something that this sensation unfamiliar enough that I noticed it.

So although I drive past Legal’s regularly on Route 9 (just before passing Ken’s on my right), it felt different recently.  To celebrate that, I decided to treat myself to dinner there next time I had the chance.

In case you’re wondering, I had a Jack’s Abby Hoponius Union with my cioppino; this is one of the beers with which I would stock my father’s fridge in the days that he insisted that I keep beer there.  As for the cioppino, I can report this: it tastes good again.


The Birthday

Hello remaining Sandwiched Man readers!  I’m actually no longer a member of the sandwich generation, but despite that, I have a few more entries saved up that I’m going to try to extract. It’s been almost a year since my father passed away and more than a few times, something small will happen (a “small moment”, as my kids learned in elementary school), and I’ll think to myself that it would have made a great blog post.  Then on more and more occasions recently, I’ve wondered why it should matter, that a good story is a good story, and that I might as well it.

I’ve had on my list of “things I’d like to do for myself” for some time now to restart writing.  I usually wrote as an outlet or if something particularly struck me as unusual and interesting.  So, since today would have been my dad’s 94th birthday, I figure it’s as good a day as any to revive this.

It is a strange day.  For one, Google and Facebook are working overtime to remind me that it’s his birthday today.  Why did we sign him up for Facebook again?  I’m sure it seemed like a good idea at the time, and like a lot of those things we started on his behalf, maybe it wasn’t.

I’m also reminded of the dinners we had on his birthday, the cakes I bought, the cards my kids used to make, usually in a mad scramble before we shlepped over to Framingham to visit him.  This picture is from his birthday lunch last year at Legal Seafoods.  He told a rambling and inappropriate story and it was obvious already that he was changing for the worse.  He had about 60 days to go.

By now, I’ve gotten used to not getting his strange political emails; today though, I thought about those more than usual.  Whatever you think of Trump, reading about him certainly would have kept my father busy.  At least he didn’t have to live to see what became (or didn’t) of Megyn Kelly.

More later – mostly I wanted to get something down in writing, and just start.  Sometimes the hardest thing in any endeavor is to do that: start.  Or restart.  My father always liked doing exactly that.  So, it seems like a fitting birthday tribute to do it myself.