Here is Chapter 18 of Dreaming Out Loud, the book about my mother’s stroke.

Chapter 18

Anyone who cares for a person faced with daunting physical challenges is well aware of the fear that accompanies affliction: fear of a recurrence or a worsening of the condition; fear of an adverse reaction to the medication; fear of financial insolvency as a result of the illness or injury; fear of falling. It is the last one that confronts our family during one crisp autumn day in 2004.

We never quite glean how it happened, although we have our pet theories. Perhaps it is inevitable that mom will fall to the floor at some point during her long, slow recuperation. Her body has never fully recovered from the stroke; she is unsteady on her feet even when she tries to walk with assistance from a three-pronged cane.

As for our theories, I think she had to use the bathroom and did not put on her glasses, trying in vain to find the wheelchair in the dark. Paula thinks she became confused and disoriented as she struggled to get to her feet. Shirley thinks Miss Laura is just plain crazy and is likely to do anything at any time.

However it occurred, and for whatever reasons, she falls at a time when her caregivers are absent. Paula and I cannot be on hand at every moment. Shirley has fixed hours — typically two hours in the morning and two hours at night. Mom spends most evenings between midnight and nine a.m. alone.

She usually manages well, or at least adequately. On most evenings, Shirley feeds mom a heavy dinner and dresses her in her nightgown before departing around 9:00. Propped in bed with a soft drink at her bedside, the television remote control on her bed, and a bed pan for emergencies, normally mom is good to go until the next morning. If she feels the need to visit the bathroom, it requires her to remove the bed covers, swing her legs onto the floor, and slide into the wheelchair. Unlocking the brakes, she rolls into the bathroom, stands as she holds onto the arms of the three-in-one potty chair, turns her body, and plops onto the toilet.

It is a procedure she has performed multiple times, almost always without incident. The worst thing that usually happens is she does not time the move right and her diaper needs to be changed. The indignity is no small matter, but under the circumstances it is not catastrophic.

Because she lives alone in her downstairs apartment and has no way to call for help, after she falls she has few options but to wait. She does not wear a “Medic alert” bracelet, although we have talked about getting her one. We have tried a baby monitor so we can hear her cries if something happens, but mom watches television all night long, frequently sleeping in front of the tube, her eyeglasses askew on her face. The noise from the endlessly repetitive infomercials that play through the night is more than we can bear.

I have considered providing mom with a cell phone that she can leave beside her bed. In theory, she can push a single digit to speed-dial my number upstairs. This plan seems ideal until we try it. On the few occasions when we perform a test run, she knocks the phone onto the floor and almost falls from the wheelchair as she tries to retrieve it. Even when she does not drop the phone, her ability to maneuver the wheelchair while holding the receiver is limited. Unless we find a device she can always wear around her neck or strap to another part of her body, a phone is not practical.

Because we have not found a suitable communications strategy, when mom falls that night she has no realistic options. She is forced to curl into a ball and spend hours lying next to the plastic trashcan in the kitchen. She is fortunate in some respects. Although she cannot shinny her hefty frame off the linoleum, she can slide close enough to the bedroom doorway to use the carpet as a pillow.

Hours pass. When Shirley arrives at work at nine the next morning and unlocks the door, she is startled to see her friend and employer fast asleep. Mom’s cat Lucky lies next to the supine form as though all is right with the world.

“Oh, my God, Miss Laura. Now whatcha doin’ layin’ down there on that dirty floor?”

Mom stirs and looks around, but cannot focus. Her eyeglasses are still lying on the end table next to her bed.

“And you done messed your drawers, too!”

No question about it. This is a worrisome situation, and one we have dreaded since mom was released from the nursing home. We know stories of loved ones who fall, break a hip, and never fully recover. Whether the descent is long, slow, and torturous or swift and precipitous is only a matter of timing.

“You ain’t broke nuthin,’ has you? How’s your hip?”

Mom gestures wildly with her left arm as she rocks gently on the floor.

“I know that, Miss Laura. I know. How’s your hip? Your hip okay? You ain’t broke it now, has you?”

“How’s your hip? Lord no, how’s your hip. No.”

“That’s right, Miss Laura. How’s your hip? Mrs. Bremer broke her hip that one time, and she like to never get over it.”

Mom gestures wildly. “Your hip. How’s your hip?”

“I can’t get that, Miss Laura. Let me see.”

The big black lady leans over the big white lady and pokes at her hip.

Mom speaks through gritted teeth. “How’s your hip?” She bats at Shirley, taking aim at her face.

Shirley leans up and out of range. “Now, there ain’t no call to be gettin’ ugly, Miss Laura. I’s just tryin’ to make sure you ain’t broke your hip, ‘cause if you broke your hip we goan to hafta go on to the hospital. Course you don’t wanna go to the Walton County Hospital on account of they kill you there.”

Despite her predicament, mom finds the scuttlebutt fascinating. “They kill you there?”

Shirley mops water from her brow. “Sure enough. Carolyn one time knowed a guy who went in there with the sweats. That was it; that was all. It was night sweats. He went into that place but let me tell you sumpin.’ He did not come outta that place.”

Mom’s mouth forms a perfect "O."

“They don’t mean to kill you or nuthin’ like that. They ain’t evil. They just don’t know what they’re doin’ half the time.”

“Don’t know what they’re doin’ half the time?”

“No, they don’t. So if you broke your hip, Miss Laura, we best tell Michael to be takin’ you some place other than the Walton Hospital.”

Mom gestures that she is ready to be lifted back into her wheelchair or into the bed. This talk of injured hips and hospital malfeasance, while fascinating, can resume on a later occasion.

“I know, Miss Laura. I know. I can get you a new diaper if you want, and get you changed. You want that now, Miss Laura? We can do that right here on this floor so Michael don’t hafta see you like that.”

Mom’s right arm moves rapidly. “Diaper changed. Yes, but there is something to be told first. And I can tell you the secrets of the children.”

“Say what now, Miss Laura?”

“If it’s not too late to say the secrets of the children.” She pauses, her lips pursed in frustration. “Not that. But that’s the secrets of the children. The secrets of the children.”

“You don’t want me to tell Michael? I gotta tell Michael now, Miss Laura. He’s got to help me get you up offa this here floor. But do you want me to change your diaper before I go get Michael?”

Mom screams in frustration. “I want to know the secrets of the children!”

“All right, Miss Laura. Now don’t be goin’ to have another stroke or nuthin’ like that.”

Mom leans back, resting her head on the floor. “It is with great enmity that I tell you the good sats for the baking.” She points at her face.

“Your glasses? Is that what you tryin’ to say?”

Mom’s eyes light up. “Yes! Yes! Your glasses!”

“They must be ‘round here somewhere.” Shirley stands, lumbers into the bedroom, and finds the eyeglasses on the end table. She returns and slides them onto the woman’s face.

“That better now?”

“Yes, yes. That better now. Thank you!”

“You’re welcome. Look here, now, Miss Laura. We has gots to get you offa that floor. You stay there now, and I’m gonna go get Michael. I can change your diaper after we get you up from there.”

“You stay there now.” Mom is angry that her employee is moving for the door. “You stay there now!”

“I ain’t leavin’ you, Miss Laura. I gotta get Michael to come help get you up offa that floor. So don’t you go gettin’ yourself mad ‘bout that. You be sweet.”

Mom gestures wildly and protests, but her words are unclear.

“I know you know how to be sweet, Miss Laura.”

“I know you know how to be sweet. Lord, yes!”

“Go on, now, Lucky. Get away from her now. I’ll be back in a minute. Don’t let no cats and dogs get into that dirty diaper, now, Miss Laura.”

Before mom can protest further, Shirley lumbers through the door and follows the sidewalk up the hill toward the main house. Pressing her face against the kitchen window, she raps on the door.

“Michael! Michael! Your mama done fall down!”

It is early on a Saturday morning, and I have left to teach an American government class at Kennesaw State University. I am not at home, but Paula is there.

Our dog Daisy immediately erupts into barking when she hears Shirley pounding on the door. Outside, our beagle Hortense hears Daisy and responds in kind. It is call-and-response barking.

Paula has never been a morning person. Hearing the ruckus, she screams for the animals to shut up and let her sleep. She turns on her hip and pulls the pillow over her head.

Daisy is relentless, as is her outside companion. They simply will not let up. They continue to howl in what becomes a monotonous cacophony.

“All right! All right!”

Paula drags herself from the contours of her bed with its enormous down comforter and freshly cleaned sheets. Stepping into the bathroom, she sits on the toilet seat. Afterward, with a sigh, she examines her face in the mirror as she washes her hands.

Daisy and Hortense will not be denied. Their incessant barking calls for some kind of human intervention.

“I hear you!”

Paula shuffles from the master bedroom into the living room. She catches sight of Shirley’s broad face pressed against the window.

Flipping the latch, Paula yanks the back door open. “Shirley, what’s wrong?”

“Miss Laura done fell and she can’t get up. I come to get Michael.”

“He’s teaching this morning, but I’ll help you.”

“I dunno, Miss Paula. What with your bad back and all.”

Slipping her house shoes onto her feet, she waves away Shirley’s concerns. “It’s not that bad. Let’s go.”

“Now you don’t have to worry none about her hip. It ain’t broke, but I think she’s got a dirty diaper.”

“Okay.”

The women climb down from the back deck and follow the concrete walkway to mom’s basement apartment. Daisy and Hortense follow behind, no longer barking but curious as to what new surprises this morning holds.

As they enter the kitchen, Paula gazes down at the woman writhing on the linoleum. “So, Laura, I hear you decided to nap on the floor.”

Mom shakes her head. “Nap on the floor, yes.” She pauses, frowning. “Nap on the floor? No.”

“A joke. I was joking.”

“We’s goan try to get you back up in the bed, Miss Laura.”

Mom gazes around the room. “Where is the Fruit Top?”

“What you talkin’ ‘bout now, Miss Laura?”

Paula laughs. “Fruit top had to teach his class this morning. But I’m here.”

“Yes, I’m here.”

“Shirley and I are gonna try to get you up off that dirty floor.”

“Dirty floor, yes. Dirty floor. What about?” Mom pauses and then wildly shakes her left arm. “What about her? What about her?”

“Her?”

The left arm gyrates in circles. “The secrets of the children?”

“Her? Shelby? She’s still asleep, I guess, although I don’t know how she slept through all the barking. Teenagers.”

“Yes, teenagers! But you can say something for yourself with Dill Pickle?”

“I don’t follow you.”

“You can say something for yourself with Dill Pickle?”

“Dill Pickle? You mean Shelby?”

“Yes, Shelby.”

“Well, can we talk about it later? Right now, Shirley and I need to try and get you off the floor. Is your knee gonna be okay, Shirley?”

“Yes, ma’am. I got the arthritis, but it ain’t actin’ up right now. It’ll be okay. How ‘bout your back?”

“If I don’t strain it too much at once, it should be fine.”

Mom squints. “It should be fine.”

“Yes, I know, Laura. We are gonna get you off the floor.”

“Yes, get you off the floor. Get you off the floor.”

It is a delicate matter to lift a heavy woman from the floor. If Paula and Shirley are not careful, they might lift mom part of the way, only to send her tumbling back to the linoleum. In such a case, even if she did not break a hip previously, she might break it when she falls a second time. This is not to mention the possibility that Paula or Shirley might be injured.

Recognizing the numerous pitfalls, Shirley rolls the wheelchair over to where mom lies prostrate. “Let’s get you in the chair now, Miss Laura.”

“Get you in the chair now, Miss Laura.”

Paula snaps her fingers. “I just thought of something.” Standing, she charges over to a small combination stool and stepladder that the pre-stroke Laura bought to help her retrieve items from the top shelf of her kitchen pantry.

“This should help.”

Mom wrinkles her brow. “Sats good ladies for the baking?”

Paula places the stool next to mom’s head. “If we can lift you to the first step of the stool, you can rest there for a minute. Then we’ll lift you to the next step. By the top we get to the top, it should be about the same height as the wheelchair. We can then shinny you across into the seat. That way, we don’t have to try and lift you the whole way at one time.”

Mom catches on immediately. Beaming, she turns to Shirley and points at Paula. “This one is too smart for your britches.”

Shirley chuckles. “Miss Paula sure is smart, all right, Miss Laura.”

“Don’t speak too soon, Laura. Let’s see if it works first.”

Paula and Shirley kneel in front of mom and Paula motions toward the step stool. “Remember, Shirley, we just want to lift her onto the first step. We’ll rest a minute and go to the next one, okay?”

“Okay, Miss Paula.”

They help mom lean up as though she is performing a sit-up. When she is in position, Shirley steps around to one side while Paula stands on the other.

Pointing to her injured claw, mom frowns. “This one is the neighbor’s wife.”

“I know, Laura. We’ll be careful of your injured arm.”

Satisfied, mom nods and braces herself.

“Ready, Shirley?”

“Ready, Miss Paula.”

“One, two, three.”

The women strain. Paula turns beet red and Shirley issues a short grunt, something akin to a bark. Even as it appears they do not possess the strength to accomplish the task, mom’s behind slowly inches from the floor.

“Now, back!”

They lean back with their burden and slide mom’s butt onto the first stair of the ladder-stool. They have succeeded.

“Lord, Miss Laura. We gotta hold off on all that bacon for your breakfast.”

Mom finds this remark unaccountably funny, and she laughs heartily. “Hold off on all that bacon.” She pauses, her face alarmed. “Hold off on all that bacon?”

“She’s teasing you, Laura.”

Mom whips her head toward Shirley. “She’s teasing you, Laura?”

“I just mean that you gotta lose some weight, Miss Laura. You’s heavy!”

“Yes, you’s heavy.”

“I know, Miss Laura. We both need to lose weight.”

“Okay, Shirley. Ready to go again?”

“I reckon so, Miss Paula.”

The women kneel and put their backs into the task. Beads of sweat pop out on their faces, but they successfully hoist Laura to the next step.

“Hold on. Hold on.” Placing her hand on the small of her back, Paula walks around in a circle, grimacing.

“Didja hurt yourself, Miss Paula?”

“No. No. I’m all right. I just need a little breather.”

Mom nods. “A little breather. A little breather, Lord, yes!”

“We could call the rescue squad if you want to, Miss Paula.”

“No, Shirley. That’s okay. We’re almost there.”

They return to their battle stations. They are determined, proud, capable women. They will master this challenge as they have mastered so many challenges in their lives. Paula and Shirley are very different women, born at different times and under different circumstances, but they share a tenacity that will not be denied. If anyone can hoist mom’s girth from the floor and into her wheelchair, it is these two capable caregivers.

“Okay, now, Laura. Here we go one more time.”

Mom laughs. “Okay, now, Laura. Here we go one more time.”

“One, two, three.”

And so, gradually over several minutes, they hoist her from one rung to another, each time pausing to rest and regain their footing. After the wheelchair is adjusted and the brake is locked, they swing mom’s frame over and into the seat.

Perched on her familiar throne, the queen breaks into a triumphant grin. The crisis has ended. “Now, then. That’s good sats for the baking!”

Paula rubs the small of her back as she walks around in circles, gently trying to soothe the muscle spasms that wrack her body. Nothing feels damaged, but only dumb luck has gotten her through the ordeal.

For her part, Shirley reaches for a paper towel to wipe the sweat from her brow. She leans over the sink, cupping her hand to capture water and take a huge slurp from the faucet. She is closing in on 60, and out of breath.

“How’s your knee, Shirley?”

“It ain’t too bad today, Miss Paula. How ‘bout your back?”

“It’s okay. I’ll live.”

“That was sats for the baking.” Mom congratulates her colleagues on a job well done.

Shirley looks at her friend and employer and shakes her head. “You is sumpin’ else, Miss Laura. I tell you what.”

“I tell you what!”

“I don’t know what you be laughin’ ‘bout. We still got messy drawers to change, and you know that ain’t gonna be no fun!”

Mom nods. “You know that ain’t gonna be no fun. Scootch on that!”