Fragments From Floyd

I remember now my love-hate relationship with home health visits. It's like a box of chocolates: you never know what you're gonna get. Yesterday, with the first tentative knock, my chocolate offered a snarling pitbull slamming up against the decrepit door of a sagging trailer that turned out to be yet another of Google Maps "close but no cigar" wrong addresses.

You take the bad with the good. Other times, my destination as a roving physical therapist has been a quaint gingerbread house at the peaceful end of a winding, shady lane in a beautiful part of the Blue Ridge where a little old lady has lived alone since her husband died. She is in her best house dress and slippers, expecting me. After we have our ten minutes of formal introduction in the parlor, we are friends. Never mind that I'm not from here, and don't talk exactly like other folk in this holler. She says "son, everybody just calls me Gran, so you should too." And when I leave, she asks "Do you and your wife like fried apple pies? I just made these this morning" and a few disappear from the paper plate before I make it back to the office.

Yesterday, on my quick walk back to the car from the wrong-address pit bull, I remembered one of my first home health visits in Floyd County, back in 1997--my first year of box-of-chocolates home care. The address was close to town and I was sure I was near to the address on the paperwork. Right there was the mailbox with the house number on it, but where was the house? Opposite the mailbox, back up through the shadows of a dense stand of tall, feral scrub pines a rutted, barely-graveled road ascended steeply into the underbrush and disappeared. Surely not, I thought, knowing surely so. I steeled myself to what I must do, put the truck into 4WD and started into the unknown.

Several side trails branched off left and right as I inched my way forward in first gear, but each seemed to be less rutted than the main path and I hoped this meant less traversed than the one I chose to follow to whatever dwelling might lie at the crest of this inaccessible place. No wonder the patient couldn't get to the clinic for treatment, I thought. He'd need a helicopter! Finally, up ahead, a shaft of light penetrated the gloom. The pitch of the road dropped, and I made out something--not a dwelling exactly. Maybe this was a neglected outbuilding of some kind and the house would be somewhere beyond.

But no. The road ended at a bramble patch and I had gotten where I was bound to go. Two Dobermans lunged at their chains, barking viciously. The dwelling was almost obscured by piles of old batteries, by ancient truck fenders in various shades of rust; by tangled bales of orange bailing twine. And over there were what appeared to be several pickup-loads of asphalt shingles covered in moss and lichen; and divers once-painted farm implements fixed in place since my children were born. Dotting the devastation were a dozen dog houses rotting where they stood in the shadows of what had once been a clearing around the "house". To the left were stacks of fertilizer melted into an amorphous mass on what was left of the original pallets. I was in awe, even as I wondered if the snarling dog's leashes would hold, should I have to get out of the truck, which of course, I had to do. Dear Lord in heaven, I thought, somebody lives here. My patient lives here. Don't judge the book, I thought.

An unshaven elderly man came to the door, limping, and shouted for the dogs to hush. Yes, I was at the right place, come on in. And I made my way up the steps past mountains of dog kibble in bags, cases of canned fruit, boxes whose labels had long since disappeared under the awning of an overhang the length of the faded pale green and rust colored trailer. "Sit down" he offered, shifting three piles from here to there as best he could to uncover an empty surface. He'd just had a total knee replacement, and it wasn't going so good for him. I tried to focus on the paperwork and the patient, and a half hour later, had the range of motion and strength measures I needed to complete my visit. I went back a half dozen times to see John. Got to where the dogs didn't even bark. And I never left without carrying something home, at John's insistence.

"You and your wife like apple butter?" he asked, as he excavated his way to the far corner of the room where he spent almost all his time since his wife left him. Moving case after case, he finally found the half-gallon mason jars of apple butter. "And here, take one for that nice nurse who came to see me before you started a-comin', he insisted. "Y'ever get bee stings or cut yourself when y'shave? This is the best stuff I ever found. I have to send to North Clina for it." And he dug down into the warehouse to find three cases of Resinol Pine Oil Ointment. I still have the two bottles he gave me. I haven't had all that many shaving cuts, what with the beard and all.

I can't tell you how many times in one version or another, I learned that good people come in all sorts of skins and boxes. While I've encountered a few exceptions to the rule in my years in the pain clinic and home health and outpatient care, if you just listen and care and withhold judgment til you get to know them, there's a worthwhile soul inside just about every wasted body and every neglected shanty you'll ever drive up to, Dobermans or pit bulls notwithstanding. Turns out, that books and covers advice is a pretty good piece of wisdom. Sometimes, you just have to turn a few pages to get into the story.