Paul was Here

ImageI don’t know why I didn’t stop to talk to Paul that day.  I said a quick “hi” as I charged on past into the commissary.  I could see that he was troubled, but I didn’t stop.  I didn’t want to intrude.  It wasn’t my business.

How stupid.

Everyone said Paul was “two days older than Moses.”  He looked it.  In actuality, Paul was around 75 – some 10 years younger than he appeared.  He was retired Navy and came in to our clinic for his all-too-frequent dental care. 

Military retirees are entitled to continuing medical and dental care on base.  They are worked in “space available” between treatment appointments for active duty marines and sailors and their dependents.  I was a dental technician and a third class petty officer (DT3).  I sat chairside, took x-rays, cleaned teeth, worked the front desk, ran supply, and whatever else was needed. 

Yuma was a unique community.  About 30,000 civilians living in modest, ranch-style homes in suburbs scattered around the desert town.  The balance of the population worked and largely lived on base at the Marine Corps Air Station.  There was another contingent as well: the Snowbirds, or as we called them, ORFs.  That stood for “Old Retired F—-s”.  We weren’t very sympathetic to the plight of the old geezers on walkers.  They lived in northern states during the summer.  When the cold weather hit, an estimated 80,000 of them migrated en masse to Arizona and California. Yuma’s population more than doubled during the winter months.  On Saturday mornings, a few of us from the clinic would go down to the “mall”  – a short strip of stores that was the center of commerce in Yuma – sit in our booth at the diner, eating Belgian waffles with strawberries and watching the ORFs playing bumper cars in the parking lot.

 For sheer entertainment value, Paul was the best.  He had shrunk in his old age – shoulders and back a bit hunched, legs bowed – so he was a good foot shorter than his youthful height of almost six feet tall.  Now, probably less than 5’ or so, he couldn’t even see over the steering wheel of his massive V-8 sedan.  He’d peer under the top curve of the steering wheel and gaze down the mile long hood.

On the firing range we’re taught to not look directly at the target but only focus on the sights at the end of the barrel.  The target would still be visible sitting right on top of those sights.  I could imagine Paul squinting down the barrel of his sedan, his fading eyes only focusing as far as his hood ornament.  Then, when his aim was right, his foot stomped down on the pedal and off he went.  As good as that was, what we really lived for was when he’d back up.  Paul never looked behind him.  He’d just slam it into reverse and go.  Whatever was there had better just get out of the way, cuz his yacht was a’comin’ through!  It was better than Saturday morning cartoons.

Winter 1987 was like any other Yuma, Arizona winter: typically in the 70s during the day. After a summer of 120 in the shade, that was downright cold.  We might even have to put on jackets at night.  The day Paul came in was no different – not remarkable in any way.  Even the reason for Paul’s visit was just another in a long line of chronic complaints.  They come with age.  It starts with the knees or hips, then the elbows, then the eyes or hearing.  If the hands shake, brushing teeth may be a challenge.  Gum disease is a given.  A lifetime of mediocre dental habits brings periodontal pockets that trap microscopic bits of food.  Those require deep scaling with hand instruments or an ultrasonic Cavitron. Nothing a technician like myself can’t do, but on an older patient, the risk of injury or loosening teeth grows, so the dentists (“dental officers”) handle them.

We didn’t have a true Commanding Officer at MCAS Yuma.  Our boss was a Lieutenant Commander who would probably never make Captain.  He had ticked someone off somewhere along the way, or maybe he just failed to impress the right people.  Still, he had his clinic; he had two other DOs working under him, along with half a dozen techs.  So, he had his little kingdom.  We didn’t think a lot about it.

The commander saw Paul that day.  That was normal.  Old people like routine, and this was Paul’s.  He came in, the tech got him seated in the chair, and the dentist slid up on his stool, big smile and friendly greeting at the ready.  A quick look around and a few x-rays later told the commander that this wasn’t going to be the normal routine after all.  Paul’s gum disease had gotten out of hand. He had rampant infection and it was eating into his already pencil-thin jaw bone.

Infections in the mouth are nasty enough in healthy people. The smell, the taste, the pain, are all great motivation to do whatever the doctor says to get rid of it.  Most conditions are very treatable and curable.  In older patients, it’s different.  Dry mouths, poor blood circulation and impaired immune systems make fertile ground for infection.  Bones are brittle and thin.  In older patients, the boney sockets set like concrete so pulling teeth is risky, frequently requiring sectioning with the drill.  Heart conditions can turn into full cardiac arrests when infections enter the blood stream.  All in all, they’re just bad news.  Still, Paul had a problem, and the commander had to do something about it. 

I try not to second guess people too often, especially when they are far more educated and experienced than I. Besides that, in the military, you just don’t question, period.  The officer decides his course of action and that’s that: no discussion. It’s hard for civilians to understand, but this is just the way it is.  To do otherwise may be construed as insubordination – a serious offense. So, when I heard that the commander wasn’t going to just treat the infection but he was going to pull all of Paul’s teeth out, I did my best to choke down my shock and go on about my day.  This was, after all, his patient.  He was the doctor, and I wasn’t even his technician.   I went on with my work while the commander and his tech pulled every remaining tooth in Paul’s ancient mouth then sent him home.  Paul would come back in a couple weeks to be fitted for full dentures.  In the mean time, his mouth needed to heal.  He would be fine.  Really, he would.

That was two days before I saw Paul at the commissary. 

I should have known something wasn’t right.  He just sat there, his eyes staring vacantly at his softly quaking hands, his normally cheerful countenance downcast. No, let me restate: I did know. I just didn’t take the time to stop. I didn’t want seem pushy. Besides, I was busy. I needed to buy milk or dog food or bread or some such earth-altering thing.  My world loomed huge in my own sight.  The rest of the universe could wait.  It would be okay.  Paul was fine, really – just tired or sore. That happens.  He’d get home, rest and be up and around again by morning.

A few days later, a clerk at the commissary told me what had happened that morning.  It seems that Paul had driven his “yacht” in to the commissary parking lot then walked to the door – all before they even opened.  When the clerk saw him, Paul had his pants down around his knees.  His hands were bent in a permanent curl, like he was holding a couple of eggs in each one.    He was crying.

She asked him what was wrong.  His voice, shaky enough on good days, was barely intelligible.  “I can’t fasten my pants.”  The clerk, kind and gentle by nature, helped Paul hitch his pants up to where they belonged, then fastened them.  She asked if he needed anything from the store.  “No,” he had said.  There was nothing.  He just needed help and had no one else to turn to.

I don’t know where Paul lived – how far off the base, how long a drive he had made that morning to find someone, anyone who could help him fasten his pants, but there was no one else.  He had no son or daughter living close by, no neighbor with a willing hand, no fishing buddy across town. The closest thing he had left to a community of friends were the people who bagged his groceries or sold him postage stamps or pumped his gas – those who smiled because they had a job to do and wanted to treat their customers well.  These were the last vestige of community Paul had.  When he needed help, this was his only place to turn.

Paul had gone home after the clerk had helped with his pants.  She knew she shouldn’t have let him drive, but she didn’t want to seem presumptuous.  Besides, he had come back a few hours later, so he must have been okay, right?   That was about the time I had seen him.  No, he wasn’t okay, but I didn’t do anything, either. 

Paul died that night.  The infection in his gums had gotten into his blood stream through the open wounds of oral surgery.  His body was in shock from the trauma of a difficult and extensive extraction.  In hindsight, Paul’s fate was sealed as soon as the commander decided on treatment – maybe before.

More than once, people have asked about my reaction. I could go on about the proverbial “punch to the gut”, the sudden dizziness, the denial…  Paul, dead?  Impossible!  I just saw him the other day!  In retrospect, though, what does it matter what I felt?  Of what good were my feelings at this point?  What service could they possibly give now when I never bothered to share them with him before? To use lines and effort to express my own remorse or shame or whatever seems inherently self-serving and arrogant, continuing the self-centered egotism that is the crux of the problem in the first place.  Are we not so completely drawn up in our own feelings, our own needs that those then become the focus?  What about this man I passed up?  What of Paul’s feelings?  Where is his chance to express, to be heard?  Who was listening when breath still filled his lungs?  Who can now raise his voice from its eternal silence?  My reaction?  Irrelevant – just as I had caused him to be.

Like everyone, I’ve known people who have died. Grandparents, friends of my parents, even some of my own.  It happens.  Death is the fraternal twin of birth.  The tragedy comes when a person faces that darkest hour utterly, hopelessly alone.  We come into this life with all the attention, the love, the companionship that can possibly be heaped upon a seven pound lump of drool.  We are the center of the universe.  Even as we grow past that into childhood, we have siblings and friends and cousins and teachers and, and, and…  We go to school, we date, we play sports, we attend church, we serve others, we work, we live in a community, and we are known.  When we don’t make it to the office or a 4-H meeting or French class, someone calls to ask if we’re okay.  We gather for holidays, we share events and vacations.  We connect.  When something major happens – good or bad, we come together.  We celebrate, we lend a hand, we mourn, we cheer, we pull together.  We share more than our hand-me-downs and cups of sugar. We share ourselves.

But Paul sat alone.  His last days, last hours slipping by, his pants lifted up by a virtual stranger.  He went home but then came back.  Why?  Was it because in those, his final hours, his soul cried out for the companionship he hadn’t known in untold years?  Just as he entered this world among those whose lives were bound to his, did his very being cry out to be among them again? Did he yearn for a hand to hold while his own grew cold and stiff?  Whose tears would silently run as he quietly removed from this life? When none could be found, a stranger would do.

But strangers didn’t stop.  With the bench as his only companion, did Paul know the approach of that great night?  Did he welcome it, hoping for the foretold reunion with those who truly loved him? Or did he just return to an empty home and slip away, unmarked in the world?

Someone much wiser than me once said, “A rose to the living is more sumptuous than a wreath to the dead.”  To let someone know while they live that they matter, that they have value, is so much better than all the flowering eulogies after they are gone.  What possible good do such eulogies do besides trying to placate those who didn’t take the opportunity when it first arose?  Of what value is that to anyone but ourselves?

No, to speak now while we have the chance, to call someone “friend”, to say “I love you” while that person can feel the glow of amity and affection, the lift on a bad day, the balm to loneliness in old age; even if we do nothing more than to telephone and say “Hi. I was just thinking about you.”  Is this not so much better than telling his surviving family how special he was, when we never let him hear those words himself?

I still live in a hurry.  Life, always too short, becomes a constant struggle to cram in as much learning, as much growing, as much life as I can, not only for myself but now for my four children as well. The difference is now I try now to notice more.  I search faces around me and listen to that inner guide inside us all; a smile, a kind word, a gentle touch on the arm, a friendly inquiry– not too probing, but kindly personal. A note to a divorcee who lost her old dog – her only companion; a phone call to my friend who just moved to a new city; a quick visit a widowed neighbor because my daughter loves to see her doll collection; these aren’t too much trouble, after all. Meager efforts to try and answer in some small way that greatest need of all – to know that we exist, that we matter in someone else’s eyes.

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