I arrive at the Saint Louis airport after a red-eye flight that was too short to sleep and too long to stay up and read. I am here to give a seminar to science graduate students on breaking the “overqualified, under-experienced” PhD job-seekers’ curse.
I walk into thick humidity toward ground transportation where taxis line up. A small gray car bearing a taxi logo is parked aside taxi row. I lock eyes with the driver inside, her eyes claiming me. She leans toward the open passenger side window.
Dr. Chin? She calls out.
How does she know I am the right passenger? Lucky guess? Because I seem to be the only Asian as far as the human eye could see? I conclude it is the latter. I climb into the rear seat, wondering when medical scrubs have become acceptable casual wear.
The ink-gray sky looks more twilight than dawn. There are two hours of corn fields between the airport and the university in Columbia, Missouri, where my seminar will be. Rows and rows of corn. Shall I sleep off some of this fatigue? It’s only five a.m. in the morning and my seminar is at nine. Shall I ask her to take the next exit flanked by golden arches hailing fast food to get coffee? Wait a minute – am I her first shift or her last?
I sit up.
She asks me where I have flown in from (Los Angeles) then says that she used to live in San Diego. She has lived in Missouri for six years but is not yet used to its thunderstorms. She says that this is a place where if you don’t like the weather, you can wait five minutes and the weather will change.
But I’d rather have this than earthquakes, she says.
Why do ex-Californians make a point of reminding us current Californians about earthquakes? Like we have forgotten that too long has lapsed between the last “big one” and “The Big One” and it is just a matter of…
So how did you end up here, I ask.
She made bad choices when she was eighteen. She married and had a baby with a man she didn’t believe could cheat on her, especially when he saw how devastated she was the first time that he cheated. One weekend her husband did not come home at all. When he showed up he asked for a divorce. She didn’t see it coming. Or maybe she didn’t want to see it coming.
I still loved him, she says, that’s why I didn’t go after everything he had; I thought we’d still be a family.
Moving to Missouri brought the cab driver closer to her mother and sisters who had already migrated out of California. The same amount of money went further in Missouri than in California; this was important now that she became a single mother. One of her sisters was also a single mother and they took turns watching the children when one of them worked. Work kept her out of the welfare line.
In the old days, you didn’t get food stamps to get groceries at the store, she says. You drove downtown and stood in line. You got rations of cheese and peanut butter branded with big “USDA” letters that told everybody you were poor.
Even when times were hard, she refused to get on welfare. She is proud of abstaining from government hand-outs. The other day she was at a gas station and a man was advertising free prepaid phones. The man told her that if she were at a certain income level she could get a phone – absolutely free! She challenged the man. Those phones weren’t free. The man insisted she got her facts wrong. These phones are free, man! Courtesy of the U.S. government.
Someone’s paying for free, she says. Taxpayers pay for free. You and I pay for free.
She doesn’t understand why some people can’t get this. She looks for my eyes through the rear-view mirror. I look at her arm, pale and pudgy beneath the white medical scrub top with floral print; her elbow resting on the console behind the gear shifter.
I don’t tell her that the government doesn’t issue food stamps anymore. You get a Visa-logo branded credit card linked to the state’s electronic benefit transfer (EBT) system. You swipe your card at the grocery store like any regular customer using a credit card. You get to keep your poverty a secret, that is, unless you forget to tell the cashier that you are using EBT and now people behind you in line can hear the cashier saying that you should have declared this an EBT transaction before you swiped the card. Then there will be a person whose curiosity gets the better of her and she will ask the cashier, “What is EBT?” And you hope you collect your bags of groceries fast enough and walk out of the store quick enough to not hear the answer.
Mom came to the U.S. to live with us when my child turned one, to help me juggle parenthood and my consulting business. We went to social services to sign her up for food stamps and “General Relief”, which is a loan against what future benefits you will receive from the state. I drove her to the South Los Angeles branch. The four-story structure could pass for an office building if not for clusters of men shuffling and pacing near the glass door entrance. When we walked in we saw armed guards and security screening.
The lines of people stood so long that they snaked through rows of seats filled with more people in the waiting area. A group of young African Americans walked in and sat near where mom and I were waiting. They looked like friends, the way they laughed and made fun of each other. They weren’t like me, tense and anxious and shifting in my seat. They looked completely at ease, their limbs relaxing in familiar surroundings. One took out an iPod. Another took out an iPhone. I thought about how I still held out for an iPhone because it was too expensive, and how I had recently redeemed two years’ worth of credit card reward points for an iPod.
I grew irritated in this place where time was useless, where people sat however long they needed to sit because leaving this glass cage meant they went back to a world obsessed with time. Here, you didn’t care about how much money you lost per hour of non-productivity or how much time you saved with multitasking.
A commotion broke out in the adjacent waiting area. Two security guards with batons and guns at their hips were restraining two young men from lunging at each other. I scanned the young men for signs of a knife or a gun; these would have been caught at the security screening, right? Still, mistakes happen, and I had a young son and husband at home. Should I duck behind my seat? My fear turned to anger and I turned on mom.
I didn’t know I’d be here for five hours! I said. What a waste of my time! What place is this?
Mom was sorry and offered to wait by herself. But if she were self-sufficient we wouldn’t be here in the first place.
The cab driver’s family belonged to the wealthy middle class. Her parents’ home faced a golf course seven miles north of the Tijuana Mexico border. Her father owned a trucking company and her mother was a homemaker. The seven children were raised proud and strong on Irish work ethic and religion. Then her father got sick.
They didn’t have catastrophic health insurance. Stroke. Heart attack. Prostate cancer that left her father incontinent and impotent. Medical bills from hospital stays and multiple surgeries drained the family savings. She went from a private Catholic school to a public school where no uniforms served as the great equalizer. In public school, you could tell if a student came from a rich family or a poor family. Children could sniff out the poor and the different among their peers.
When her father lost the trucking company, her mother had to stand in the welfare line. People in town talked and pointed. Knowing that he could no longer support his family broke her father’s spirit and vacated his eyes and started his drinking.
This was what killed my dad, says the cab driver.
I don’t ask what she points to as the murderer: poverty-shame or alcohol.
Mom’s childhood was haunted by poverty and alcoholism. When her father came home drunk in the middle of the night, he woke up the family so he could beat them. She ate porridge thinned with so much water that the remaining rice kernels were tokens so you could still call it “porridge”. Mom would bulk up the watery gruel with cheap yellow sweet potatoes. The sweet potatoes bloated her stomach and doubled her over in stabbing gas pains. I saw fear clutching mom’s clouding eyes when she talked about the gruel in her childhood.
Mom’s mother – my Ah-ma – would leave home for weeks at a time, peddling herbal medicine. Ah-ma had to support a young family that her husband abandoned when he wasn’t around to beat them. Mom went to school and took care of her two young brothers. Paying school fees meant going hungry, and once the situation was so dire that mom was certain she would have starved to death if a neighbor hadn’t come by offering one bowl of rice. In 2005, I visited the neighborhood of mom’s childhood in Taiwan. Mom grabbed the arm of an old lady who had a shy smile and brown skin speckled with liver spots.
This is the neighbor who saved my life, mom said. If it weren’t for her, I would have starved to death and no one would have known.
Mom brought us to America in 1984. She had saved cash from home businesses she had started selling donuts, spring rolls, and Chinese cabbages in Saudi Arabia over the five years we lived there. This money was to secure our family’s future here in America and to keep her safe from the poverty that she feared was still stalking her. Mom lost this security-and-safety money through one bad investment after another, until there was no money left for our college education. She returned to Taiwan in 1993, a new shame of staggering debt amplifying the old shame of being poor. Mom gained American citizenship but lost her American Dream.
I asked mom how she felt about receiving welfare. She said that there was “a little bit of hope left” for her. Qualifying for welfare made mom believe that she still mattered as a human being, that she wasn’t yet forgotten like a piece of trash on the sidewalk.
But she couldn’t qualify for Medicare, at least, not yet; not when we inquired at social services. Even though I worked through college and borrowed and repaid student loans for a graduate education – even though I became “a career professional” and moved up to “Upper Middle Class” – I couldn’t afford an uninsured elderly parent getting sick in America. This could only be a visit to meet her grandson. Mom went back to Taiwan.
How did you get into driving a cab? I ask the cab driver.
The cab driver looks up at the rear-view mirror and this time I look at her. Her long brown eye lashes frame her brown eyes and her long straight hair is a grayish blond; she must have been very pretty when she was young. When I lean forward I see the reason for her raspy voice and the cloying smell of car deodorizer: a bright red-and-white pack of cigarettes lies in the center console.
The money is good and I’m in nursing school right now, she says.
Mystery of the medical scrubs, solved.
Her classmates have to work five nights a week as nurse’s aides or waitresses to make the same amount of money she makes driving a cab two nights week. This gives her more time to study. She already has an E-class driver’s license from working at a nursing home; she got the license so that she could transport the nursing home residents. Driving a cab is an easy transition.
But if you told me thirty years ago that I’d become a nurse or drive a cab, I’d say you’re crazy, she says.
Shortly after she transplanted to Missouri she became a housekeeper at a nursing home. One of the nurses saw how she interacted with the residents and suggested that she become a nurse. She scoffed at the idea until the nurse told her that she would get paid more as a nurse than as a housekeeper.
You really have to love what you do or else you’re not going to survive this job, she says. The money is good, but you’re never going to be paid what you’re worth as a nurse. And you’re always short-staffed.
Her elderly residents can be divided into two groups: ones with clear-minds but deteriorating bodies, and ones with dementia or Alzheimer’s disease.
She loves hearing her clear-minded residents tell stories about how the world has changed. Some of her residents are over a hundred years old: they have seen the world change with televisions, computers, the internet, and cell phones. One resident condemns cell phones as the reason why today’s young people are so rude.
You have to remember that these people are scared because they’re losing control of their bodies, she says. The worst thing that can happen is when someone has an accident, and I make a face or gag at the smell. It’s not their fault that they can’t get to the bathroom in time.
She has learned a useful trick on the job: she applies a thin film of Vicks Vaporub under her nostrils. The vapor forms an invisible barrier against the odor of shit and pee. She reapplies the ointment several times a day. Sometimes she smears on too much Vaporub and the vapor makes her eyes water. She will tell a joke and get her residents laughing while she cleans up their feces and urine. She will explain what’s happening to their bladders and how these have grown so old that the bladders drop from their normal position in the body or can no longer close. It is a way of externalizing and taking a step back: “here’s what’s happening with one of my organs” as opposed to, “I can’t even hold my own shit.”
She says it’s all about giving people dignity.
Mom’s mother – my Ah-ma – is dying in the hospital. She has had a stroke and has lost command of much of her body. Mom tells me that Ah-ma keeps yanking out needles stuck in her body – 5 or 6 needles feeding her keeping her body alive. Mom and uncle try to reinsert the needles that Ah-ma yanks out but the doctor says they should ask the medical staff to do this or risk Ah-ma getting an infection. My uncle is barely able to support his young family; he has to work and can’t stay with Ah-ma to take care of her. Cleaning Ah-ma after she has soiled herself is out of the question. Mom tells me that she can’t keep doing this, either, her voice recoiling as if she is shown a fresh memory of wiping up Ah-ma’s shit and pee.
Ah-ma begs her son and daughter to ask the doctor for poison. She wants to die. She doesn’t want to live in pain anymore. Through the last ten years of weekly dialysis for diabetes-related renal disease, she has suffered near-fatal drops in blood pressure and has had to be resuscitated on three occasions. Ah-ma’s recent open heart surgery left her hallucinating; she insisted that she was in her own apartment and tried to get out of the hospital bed to find her own clothes to wear. Now this stroke has left Ah-ma struggling to speak. But Ah-ma’s diseased body won’t let go of her and it holds on like meat hooks in Ah-ma’s soul. Mom says this is karma: Ah-ma is burning through karma accumulated from lives past and present. As painful as it is to watch Ah-ma cry, suicide is not an option.
When I saw Ah-ma in 1996, she was dressed up in a sparkly purple blouse and long silky black pants for my brother’s wedding. Ah-ma’s voice was loud and clear with life; she boasted to her friends that I would make a great match for a wealthy man. She had grown up in a different era and meant what she had said as a compliment. I took it as an insult. I told her that I didn’t need a wealthy man and that I could make my own money. When I visited Ah-ma in 2005 with the man I did marry, her face had sunken in, her head looked like it had shrunk. Her hair was no longer styled in the rounded popular pouf of waves. Her hair was dry and brittle; it looked like it too had retreated from life.
I sat on the wooden chair in the disheveled studio apartment where she lived, my body stiff and awkward among a decade of clutter. We didn’t hug. I don’t remember what we had talked about, but it was barely a conversation with stops and starts, my tongue tripping over Taiwanese and Mandarin. We took pictures. Then I got into uncle’s car and waved goodbye to Ah-ma through the car window. I knew that this would be the last time I would see the only living grandparent I had left. I couldn’t stop the tears dripping off my cheeks as uncle pulled the car away from Ah-ma’s lonely silhouette.
Thank you, Ah-ma, for bringing me treats coated with sesame seeds when I was a little girl living in Taipei.
Thank you for giving me memories of being a granddaughter, before I said goodbye to childhood and moved away from Taiwan forever.
Interstate 70 has come alive with morning traffic. The highway is bounded by verdant rows of trees and grass and green corn stalks glinting against the sun. We are more than half-way to Columbia and I regret not napping. Fatigue is siphoning away my energy and pulling down my eyelids. The cab driver cranes her neck toward the rear-view mirror and I know she’s about to speak again. I clamp down my jaw to stop a yawn.
I don’t think I’ll get Alzheimer’s, she says, but I told my son that if I ever get Alzheimer’s he should put me in the nursing home where I work because it’s one of the best.
She has noticed that a common early sign of Alzheimer’s disease is hydrophobia. Her residents with Alzheimer’s disease become scared of bathing because they no longer understand water. They are scared that a stranger they have never met or a person they barely know wants to help them disrobe and help bathe them. Logic about cleaning or hygiene makes no sense when they cannot grasp the words that are supposed to reassure or calm. The world becomes alien: nothing makes sense to them and they make no sense to the world, and when they cower and cry for their mother, they can’t understand the gibberish strangers give about them no longer being twelve years old or about their mama being dead for a long time.
People suffering from Alzheimer’s disease and dementia can be aggressive and unpredictable. She has heard the foulest curses from women whose harshest swear words were “darn!” before Alzheimer’s disease overtook them. She believes the disease is harder on the family members than on the patient. Family members see that they have been forgotten or are no longer recognized; they bear the brunt of their mothers and fathers shouting at them to “get the hell away from me!”
She recalls trying to help a resident get dressed one morning. The old woman began to scream and curse. She decided to leave the room before the old woman’s screams became slaps and spit. Even though the old woman probably weighed eighty pounds sopping wet, rage can make people superhuman in the damage they can cause to another person. When she returned five minutes later to the room, the same old woman smiled and greeted her.
I’ve been hit, bitten, pinched, kicked, cursed at, she says. I’ve had all kinds of body fluids thrown at me.
Dementia is not a disease, but a syndrome: a constellation of overlapping symptoms that can make diagnosis difficult. What caused my paternal grandmother’s dementia was clear: mis-folded proteins that punched holes in her brain. When I started college in the fall of 1989, mom called to let me know that grandma was in the hospital. Grandma’s body was seizing, her legs jerking. The doctor had written on a piece of paper what got grandma.
Prions. Creutzfeldt–Jakob disease. Human variant of mad cow disease. 43% of brain infected. Fatal.
But I’d seen her only weeks ago in Vancouver, when I visited her with my parents and we sat at a big round table for a family dinner. I was careful not to sit next to grandma. I didn’t like that she was strict and formal. Whenever grandma looked at me, I felt like I was being looked over and assessed. I didn’t like how she was eager to show that she spoke English, Mandarin Chinese, Cantonese, and Taiwanese. I didn’t like how she found ways to tell people what cakes and pies she could make. I didn’t like how she showed off the vest and scarves and mittens she had knitted.
During dinner, I found grandma’s laugh loud and pretentious. Why was she acting like this with family, like she was trying to impress? It didn’t occur to me that maybe she was putting on a show for us –for me – the granddaughter whom she hasn’t seen in so long, whose silence casts cold critiques. I had not yet realized that I didn’t like grandma because I saw the same insecurity and thirst for approval in myself. I did the same when I believed that people could tell I wasn’t really all that, that I was a nothing, that underneath this parading was the fear of being called a liar by people who must see right through me.
After dinner we went out for a walk. Grandma lagged behind limping a little. One of her knees had been giving her problems and she was getting some type of injection. I did not volunteer my arm: she has a closer relationship with her other granddaughter, she should be my cousin’s burden. Within weeks grandma’s uneven gait became seizures and slurred speech. Prions had invaded her brain. She was tied to the hospital bed for safety. Prions had stolen her humanity. Grandma could no longer recognize people. Prions had taken her life.
Mom told me that as grandma lay dying she grabbed mom’s hand and said my name again and again. But mom never found out what grandma wanted to say. Grandma couldn’t summon the words that prions had eaten away.
What did you want to say, grandma?
I’m sorry, grandma. Can I tell you that I’m sorry? I’m sorry that I didn’t want to know you, that I turned away from you, that I scorned you. I’m sorry I didn’t see how alike we were, back when you were alive and my seeing could have done us any good.
I ask the cab driver what she finds hardest about working in a nursing home. Is it losing a resident to death or cognitive deterioration? She wishes she has more time to give to each person she cares for.
I think about Ah-ma, who is in her eighties, who is given time she does not want.
For many of them, I’m the only person that entire day who asks ‘how are you’, she says.
I think about Grandma, who was in her sixties, whose time was ripped out from her brain.
Loneliness knocks down some of the residents, who stay on the floor sulking angry refusing to get up. Their youth and vigor have spurned them. Their children have grown up and moved away from them. They throw themselves on the floor to show the world this is how they feel: discarded, useless, and forgotten. They cannot partake in the lie that “life goes on.” Their own life has dissolved away with the bones in their bodies. They find their existence trapped in a sinkhole caused by a life that is eroding before their eyes. For them, the pain of this natural process doesn’t feel natural at all.
I think about mom, who is in her sixties now, who is afraid of what time may extract from her.
I think about turning forty next year, and I wonder about my time.
The cab driver takes the Stadium Boulevard exit. She says that if I have time during my trip, I can go downtown and eat at the Sycamore restaurant, where the chef makes dishes with seasonal ingredients. I tell her that my flight leaves tonight because I’m only here for the day. She drops me off in front of the Bond Life Sciences Center, where I will be delivering my seminar. I get out of the cab and grab my bag and turn toward her to say goodbye. And I see her. I see her oval face plumped by age. I see softness around her eyes, these eyes that see human beings through their shriveled skins, these eyes that water from Vaporub.
Thank you for staying up and talking to me! She says.
No, I say. Thank you.