Isabel

ISABEL

Chapter note by author: I believe in what freedoms we, the American People, have left. I also believe in the ones which are not left. I believe in truthful journalism, without compromise; however, I do not believe in suicide by pen. Therefore, the names of the people who participated in this masquerade to investigate the deplorable conditions of a certain Medicaid-paid, long term care facility will not be revealed by me nor by any of my staff.

I tried to report the events at this particular ALTCs - funded residential care facility to the then Arizona Attorney General Janet Neapolitan’s Elder Abuse Taskforce. Janet Napolitano’s deputy, Pam Swobova, interrupted me as soon as I started talking and threatened me with jail or prison. The charges? Fraud and Misrepresentation. I was told that if someone had actually entered the care facility under false pretenses, it was against the law. I was told that I “had no business with my nose in affairs of the state,” and that I had better “leave it to the professionals.” (Months later, I heard through reliable sources that I had been called a “loose cannon” by the AG’s Office. That’s nothing compared to what I think of them.)

I had no intention of leaving it to the professionals, because “left to the professionals,” the elderly people residing (imprisoned) in that facility were daily being abused at the whim of staff. The “Professionals” did nothing, even though there were sworn affidavits from those who had seen the abuse and neglect with their own eyes.

To my great sorrow and shame, I was unable to do anything at all for the residents of this facility. Having been though a living Hell in my efforts to protect an elderly couple in Sierra Vista, Arizona, I was too easily backed down by threat and innuendo from the State Attorney General’s Office.

What you read in these pages is truth. The details, names and places will not be revealed under any circumstance. The Powers That Be weren’t interested then, and any interest now would only be an attempt to discredit what I say in the context of these pages.

The year was 1999. The care facility in question closed its doors in 2001. It is understood around the area that the owner retired with a lot of money, and now lives peacefully in Hawaii (except for her nightmares, of course)

Just because this particular place is no longer operating, it does not mean that others just like it are not operating. They are out there, from coast to coast. Be afraid. Be very afraid.

The Lady at the Window was there every night. Perhaps she was at the window every day as well, but it was only when the purple-hazy Arizona dusk fell that the small light beside her chair came on, illuminating her in silhouette behind a gauzy curtain.
Driving down Orange Avenue on my way home from the office, I saw her every night.
Usually, there were no other lights on in the front of the grand old house, just this small light from a second-story window.

When we started hearing the disturbing stories about what went on in that house, the Lady at the Window began silently screaming, “Help. Help us.”

Isabel was born right after Christmas when she was fifty-seven years old. Her birth weight, at 179 pounds, was rather on the large side, with most of it concentrated in her abdomen and large, pendulous, “old lady” breasts. The breasts, when unrestrained, hung almost to her waist, and when she lay down, they fell to each side of her body like nuzzling puppies.

She learned to walk with the aid of a walker in about a week, slow, shuffling steps, with the right foot dragging just a bit behind.

She learned to talk with grunts and moans. Pleasure, as in good food, was demonstrated by the “mmm-mmmm,” of approval, and displeasure was expressed by “ow,” which became “owwww!” if she was very displeased. She learned to grunt all the time, whether walking, eating, or just sitting and staring out the window.

Being almost deaf, she learned to not respond to her name unless it was practically screamed, and not to turn around or look toward any unusual noise.

She learned to be slightly contentious, which came easily for her and which she rather enjoyed, since the “forgotten persona” was a sometimes-contentious person, herself.

She learned to eat and not be neat about it; she spilled food, ate with her mouth open and used a spoon like a two-year old. She rather enjoyed that part of herself.

The most difficult thing Isabel had to learn was to pee in a Depends.

While Isabel was getting ready for her halting foray into the care facility, I talked to my good friend, Jane, an RN on the home health staff of a small Arizona hospital.

“You know that I think you’re nuts,” Jane whispered across the table as she stirred her latte. “And, Little Missy, if Isabel gets a decub, don’t think I’m going to take care of it!” She laughed, but it was a nervous laugh.

“Okay,” I told her, “stop messing around. Tell me what you truthfully think.”

She sat quietly for a moment, and then looked me right in the eyes. “You really put it on the line, don’t you? That’s what I like about you – nothing is halfway.” She looked quickly around the coffee shop, as if someone just might be listening, and then back at me. “Seriously, I think that Isabel is the ultimate weapon of advocacy. But,” she added in a lower voice, “I am worried sick about you.”

Only three people knew about Isabel and THE PLAN - Jane, my clergy friend, Elizabeth, and I. We had already sent in a caregiver to work at the facility and report back to us, but Wren’s gentle nature couldn’t take it for more than three days. “They are mean to those old people,” she cried. “And today I was reprimanded for giving out too large of a serving of potato chips!”

“What constitutes too large a serving?” I asked.

“Well, they told me that each resident gets a handful, and then they told me to take smaller handfuls because my hands are too large.”

Had it not been so sad, it would have been funny. Wren’s hands were too large to dole out a “handful each” of generic chips to the residents. Her story was not farfetched at all considering the other stories we had already heard, taped, transcribed and filed about this particular facility.

We had reported the abuse of residents to the area State Ombudsman from Nogales. Unfortunately, the care facility knew exactly when to expect him. When he arrived, things were always “just spiffy.” We told him this, but still he kept to his schedule.

We also knew better than to report to Adult Protective Services in that particular small town. The facility would have known about suspicions of their service within fifteen minutes.

Observations and statements from hired caregivers regarding that facility had been reported to AHCCCS/ALTC six months earlier, and nothing had changed. We didn’t know for sure, but surmised that there had been no investigation at all into the accusations of the hired caregivers.

A family ran the facility. Owned by the mother, her two grown children worked for her in the facility. Only one outside caregiver at a time was hired, and the caregivers usually did not last long before quitting. Both the grown children, a boy and a girl, were rumored to be crystal meth addicts, and certainly their reported behaviors toward the elderly residents gave credence to that speculation.

The caregivers hired from outside were required to cook and do the laundry - in addition to caring for the twenty-five to thirty people housed there. It appeared that the “kids” who were the permanent staff, were also the Abuse Squad and willing to do little else.

Families were discouraged from visiting except on regular days. “It’s too hard on her/him,” was the gently chiding explanation.. “He/she gets very depressed when you leave.”

For sons, daughters and other relatives of the “imprisoned,” this was good. They did not want to visit anyway; they only felt an obligation to do so, so Sunday afternoons from 1 – 4 was good for them. Take Mom a little something, have a cigar with Dad, act like we’re listening, tell them how busy we are and, poof! The ordeal is over until next week.

Thirty people over eighty. Thirty people drinking water from their cupped hand at the bathroom sink, because they could not be trusted not to “pee in the glasses.” Thirty people afraid of their own shadows, in constant fear of being cursed or thrown around like rag dolls. Thirty people shuffling about in the great room with a 12-inch TV droning on behind them. Thirty people with pride, dignity, hope and almost all life drained from them. Thirty souls trapped in a drab, gray and frightening place between life and death, just waiting. This is what Isabel found.

Liz and Jane helped Isabel dress. The usually carefully-coiffed hair had not been washed for three days and hung in dank, greasy tendrils about Isabel’s face. Liz pulled up the back of the hair and secured it with a bright purple clip. “Perfect,” she said, taking stock of Isabel who wore an old grayish-white undershirt, donated by Jane’s husband, and a pair of very large panties, bought that very day from WalMart and put on over a Depends. Covering it all was an orange and white muumuu, purchased at the Salvation Army store for fifty cents, and completing the ensemble were rather old anklets and scuffed slip-on house shoes which were cloth, and of an uncertain color.

Jane stood back and looked closely at Isabel. “The eyes are not right. You didn’t use Visine this morning, did you?”

Isabel shook her head no.

“Well, they just aren’t quite old enough…” Jane peered closely into Isabel’s eyes. “Can you make them droop a little more?”

Isabel replied, “Ow!” and everyone laughed.

“Wait here. I’ll be right back!”

Jane returned in fifteen minutes with a large pair of very dark wraparound glasses. “You just had cataract surgery yesterday,” she explained to Isabel and Liz, “and you’ll have to wear these the whole time your sister is Michigan – until she comes back to take you to the eye doctor.”

Jane handed a small bottle to Liz. “Here, put these with her meds.” To Isabel, she said, “Don’t worry. It’s only sterile water, and I washed the bottle out really well.” Jane turned to Liz again. “Remember to tell them to instill one drop into each eye twice a day.”

On the way to care facility, Liz turned into the Sonic. “From what we’ve heard, this might be the best food you’ll have for awhile,” she said with a sad smile. “I hope not, though.”

Isabel wolfed down a cheeseburger, a coke and a hot fudge sundae. A big glob of hot fudge sauce accidentally fell off the spoon and onto the orange muumuu.

“Drat!” said Liz, wiping at the spot with a wet paper napkin. “Now they’ll think I don’t take good care of my sister!”

“Just tell them we stopped at Sonic,” said Isabel. “You’ve already warned them that I’m a pig at the table.”

“Have you peed in that undergarment yet?’

“How about if I just go inside and soak it down with a little water?”

Liz looked over her glasses at Isabel. “Listen,” she said. “I need to remind you that you’ll have one chance at this – don’t blow it or you’ll hate yourself forever.”

Isabel peed in the undergarment a block away from the facility.

The wheel chair came out of the trunk and Liz talked to Isabel (without moving her lips) on the long uphill walk to the center. “Don’t say one word.” She firmly warned from behind clenched teeth. “They might have a microphone behind a cactus or a rock.”

Liz wheeled Isabel inside the air-conditioned office, where they were expected. Presentation of the needed documentation was made, and Liz paid Cathy, the owner, for two weeks in advance.

“You understand, of course, that the payment is nonrefundable,’ smiled Cathy. “Even if you should take her out early or if she should…well, expire….”

“Well, I won’t be taking her out early,” laughed Liz, “and it’s doubtful that she’ll expire while I’m gone.”

“Please sign this document of acknowledgement of that fact,” said Cathy, shoving yet another paper at Liz.

Liz signed the appropriate paperwork, explained Isabel’s routine and medications (including the eye drops) and wrote down both her cell phone numbers in case of emergency.

“We have you rooming with some other nice ladies,” Cathy smiled down into Isabel’s dark glasses. “I think you’re going to have a good time here while your sister is on vacation!” She shot Liz a sympathetic glance, silently saying “you poor thing, you probably really need a vacation from this burden.”

Isabel was busting at the seams; she had noticed a striking similarity between Cathy’s simpering voice and the voice of Nurse Ratchet, of “One Flew Over the CooCoo’s Nest,”
and she was dying to tell Liz. She made a mental note to scream out the information the minute she retrieved her voice.

Cathy took the old brown valise from Isabel’s lap and put it on the top shelf of a green metal locker. The walker was unfolded, and Isabel was seated in a straight-backed chair with a cushioned seat. “Comfy?” Cathy cooed to Isabel. “Dinner is about an hour away, Dear, so you just sit here and get acquainted with the girls while I see Elizabeth out.”

Liz bent to kiss Isabel’s cheek, and through the dark glasses, Isabel could see that Liz’s eyes were brimming with soon-to-be-shed tears. “I’ll see you in two weeks, Honey,” she choked.

Cathy patted Liz’s arm. “There, there. We’ll take very good care of her.”

Isabel looked up at Liz and tried to smile “Owww!” she said.

Isabel looked around the austere room at the “girls.” One girl was sitting on the edge of her bed, knitting her fingers in and out of the air as if crocheting. Another girl was deep in a one-sided conversation with another girl, and the fourth inhabitant of the room was sitting at the window, behind the sheer curtain, not saying anything and concentrating, it seemed, on the highway outside. There she was. The lady at the window.

She was petite in frame with patrician cheekbones and small hands and feet; the thick bun of gray and black streaked hair caught up at the nape of her neck gave her an air of elegance, and Isabel thought that she looked exactly like the cameo she wore around her neck on a black velvet ribbon. Her ankle-length rose-colored dress was worn but clean, and upon her tiny feet were scuffed ballet slippers. Isabel realized that this beautiful woman was the “silent silhouette” that she had seen so many times; this woman was the call for help that no one heard but Isabel.

Isabel watched the clock on the wall circle once while the occupants of the room remained trapped in a tableau painted by the hand of loneliness.

Abruptly the door flew open and a thin young man in a dark blue shirt and white pants entered the room and stood in front of Isabel with folded arms. “I’m Jack,” he smiled. “I’ll probably be your worst nightmare.” He laughed out loud and turned to the woman sitting on the bed. “Isn’t that right, Muriel?”

“That’s right,” Muriel parroted, obviously not knowing what she was saying, thought Isabel. Or did she?

Roughly, Jack hauled Isabel to her feet. “Well, Isabel, they tell me that you piss your pants but you don’t shit yourself often as long as you’re taken to the bathroom.” Isabel grabbed the walker bar as he half-dragged her across the room.

He opened another door and pulled Isabel inside. “Commode!” He yelled in Isabel’s ear, so loudly that she could feel the vibration all over her head. “Shit there!”

He pulled down Isabel’s panties and then her undergarment. “What the hell are these for?” he muttered, wadding up the new WalMart panties and throwing them into the overflowing trashcan.

He ripped the undergarment off Isabel and tossed it in the same place as the panties. “Pissed yourself already,” he griped. Again he yelled in Isabel’s ear, “Sit down here and shit. Don’t move until I come back.”

Isabel had had a bowel movement that morning, and was frightened that she would not be able to have another one for Jack. She was half-afraid of him, and the half of her that was not afraid was humiliated and angry.

The bathroom was filthy, and the door was left open; Isabel on the pot was visible to all the other women, but it did not seem to matter; Isabel was the only object moved from the tableau (chess board). The woman knitting air on the bed was still knitting air; the one-side conversation was still going on; the beautiful lady still sat at the window.

There were two commodes in the bathroom, one on each end of the room with an open shower in between. Two trashcans were in the room, both standing together and overflowing at the other end of the room.

The recipient of the one-sided conversation got up and shuffled toward Isabel, with the conversationalist right behind her, still talking. For a moment, Isabel thought that the quiet one had to use one of the commodes, but she walked to the sink and turned the water on, cupped her hand and drank from it. She repeated this movement three times, then dried her hand on her zip-on robe and walked out, the other woman still trailing and talking.

Isabel thought it strange that the woman should drink from her cupped hand, but looking about, she saw neither paper cups nor plastic glasses anywhere. “She was thirsty and had no choice,” Isabel thought.

From her seat on the bathroom commode, Isabel could see the clock on the wall. She sat there while the clock made another complete circle. She dared not move, not knowing if there might be a camera somewhere, and not knowing if one of the women would notice and tell. Her rear-end began to ache from sitting. (hidden camera)

At quarter till six, after sitting on the commode for one hour and forty-three minutes, the door to the bedroom opened and Isabel saw the back of a chubby woman in dark green scrubs. “Hi ladies,” she said pleasantly. “I came to round you up for dinner.” She walked over to the woman sitting on the bed and gently touched her shoulder. “Muriel,”
She said softly, “Muriel, it’s time for dinner, dear.”

Muriel looked up at the aide. “Okay.”

The aide patted Muriel’s shoulder. “How’s the afghan coming?”

“Good.” Muriel said, tonelessly. “See?” She stretched out her hands as if holding something.

“That’s beautiful!” the aide exclaimed. “Your mother will love it! Let’s take a little break and go to dinner, okay?”

As she helped Muriel to her feet, the aide locked eyes with Isabel, still sitting on the commode. “Oh, you poor thing! How long have you been sitting here?”

“Owww!” said Isabel as she was helped up. Her legs ached badly from sitting in the same position for such a long time. “Owww!”

“Oh, that darned Jack! He said he had you on the pot, but that he would take you off. I’m so sorry!” The aide quickly got Isabel into a clean undergarment and lightly washed Isabel’s face and hands with a damp washcloth. “We’ll go down to dinner now, Isabel.”

In the hallway, the aide stopped. “Wait right here, please.” She turned back into the room and took the beautiful lady by the hand. “Leticia,” the maid said. The beautiful lady turned her head from the window, and the aide spoke softly to her in Spanish.

Unassisted, the beautiful lady arose and walked lightly to the door with the aide, her face expressionless. Walking down the hallway, Leticia was a little ahead of Isabel and the aide. Isabel guessed Leticia to be between seventy-five and eighty, but the fluidity of her movements and grace in her posture and gait belied her age.

The dining room was bright, with large windows on two sides, and Isabel had no trouble making out the red and white checked plastic tablecloths through the dark glasses. There were three long tables, with ten residents, men and women, seated at two of them, and seven people seated at the third table.

The aide seated Leticia and Isabel at the third table, along with a red-haired woman and six men. Isabel could not help but notice that the dining room was quiet; no music, no talking, no laughter…even the “trailing conversationalist” was silent.

Sandy, one of the caregivers who had quit with quite a story, had been right, Isabel mused. There it was on her plate – Spam –the thinnest slice she had ever seen (“They must have cut this with a cheese grater”), exactly seven green beans, about half a cup of macaroni and cheese (the “four boxes for a dollar” kind), and half a slice of white bread smeared with margarine. There was one chunk of canned pineapple sitting on the Spam slice, and a green fly sitting on the bread and butter. Isabel hoped they would give her a beverage (“Some coffee would be so nice!”) because she knew if she ate that food she would throw up.

Isabel stole a glance at Leticia. She was eating a green bean, holding it with her fingers and chewing it like it would be her whole meal. The residents within her sight (without turning around to look, of course) all had a similar disinterest in their meal. The little man at the end of the table took a bite of the macaroni. “It’s cold.” He announced.

A young woman in pink scrubs, wearing a tattoo on her right hand and a nametag on her right breast reading, “Candy,” came out of the kitchen. She leaned over the man at the end of the table. “Well, Homer,” she said sarcastically, “You should have eaten it when it was hot.”

Muriel asked for water. “You’ll get a drink with desert like always, Muriel,” Candy replied before she flounced back into the kitchen.

Isabel picked at what food the fly didn’t eat, and secretly wished for a piece of pie and cup of coffee for desert.

She could hear laughter and talk from the kitchen, and every now and then she would catch a glimpse of Jack, Candy and three or four rowdy-looking young men. They were eating pizza and drinking beer from blue cans. “I’ll flip you to see who stays tonight, Candy,” Jack told his sister. Laughter. Then, “Okay, let’s make it the best two out of three.” Laughter again.

Oh no, thought Isabel. That bozo Jack is going to be in charge of this place tonight.
The aide brought in a pitcher of something wet, and put individual packettes of two graham crackers in front of each resident. The liquid in the pitcher was lime Kool Aid, and warm at that. Isabel was horrified. The stories of meals at the facility were true; that meant that, most likely, the rest of the stories about the facility were true. She felt a cold sweat of fear on the back of her neck. “I can do this,” she confirmed in her thoughts. “I can do this. These people do this 365 days a year. I can do this for two weeks for their sakes.”

There was table clearing and then shuffling back to the bed quarters. Isabel was determined to hold her bladder because she could not just amble into the bathroom, and she did not want Jack to change her. Tonight, she would be quiet as a mouse and as invisible as she could make herself.

She lay down on her bed and tried to sleep, even though it was very early for her to retire. Everyone else lay down as well, except beautiful Leticia, who took up her post at the window by the light of a small, dim lamp. Isabel noticed a Rosary in Leticia’s hand, its crystals sparkling in the lamplight.

Quiet, so quiet. Not even the humming of an air conditioner or cooler broke the stillness of the night. Isabel drifted off to sleep despite the early hour and the creeping fear she felt in her stomach.

Bright overhead fluorescent lights hit her like a sledgehammer, and Jack’s voice, loud and boisterous. “Passing meds, ladies. Pay attention now!”

Isabel looked at the clock. 11: 15. He’s passing meds this late? Why? She knew soon enough. As he handed her a paper cup of pills and a small Dixie cup of warm water, Isabel caught a strong whiff of alcohol. He’s drunk! She thought. “Toss ‘em down, old girl,” Jack told her before he turned to Charlotte the Conversationalist.

Isabel looked at the pills. These were not the placebo sugar pills that had been brought in for her! She recognized ½ tab Risperdal, Lisinopril and 10 milligrams of Valium. He had given her someone else’s meds, and there was no way to correct the problem. Her only comfort was that her own medications would not hurt anybody. She was thankful that he did not even notice that she did not take the pills; when his back was turned, she put the pills down an air vent behind her bed. She was not even offered the “eye drops” that Jane had given her; she would get angry about it later. Right then, she was simply relieved.

To her surprise, Isabel noticed that Leticia was still at her post by the window. Her face wore no expression, but she seemed to be rapidly counting her Rosary prayers.

Jack turned to Leticia after he had cleared his cart of tiny paper cups. To Isabel’s surprise, he took the Rosary from Leticia’s hands and put it on the windowsill. “You know what time it is, Leticia,” he crooned, while pulling her to her feet. “It’s time for your treatment.” With a smirk on his face, he led Leticia from the room. Was that fear in her eyes? The overhead fluorescents went suddenly out as they left the room. Jack laughed and closed the door. “G’Night, Ladies!”

Isabel wanted to follow him to where he was taking Leticia. She wanted to jump on his back and bite him and hit him to stop whatever “treatment” he was planning for Leticia.
If only she could have managed to hide a cell phone in her belongings! Isabel realized immediately that there was nothing she could do about the current situation, not without jeopardizing the future of Leticia and the other residents. She could tell, she could file a report with the Attorney General’s Office, she could scream from the rooftops, but she needed proof. She had to ride out her time here, and then get busy on tearing this place down brick-by-brick.

Sleep would not come. She needed to urinate, but dared not, neither in the undergarment nor on the commode.

Two hours later, Leticia returned. She did not turn on a light, but Isabel could see in the small, dim area of lamplight by the window that she was crying, her beautiful face contorted in what looked like grief. There was no trace of anger there, just grief.

The bun was gone from Leticia’s hair, and it hung heavy and thick to her waist, the silver streaks almost shimmering in lamp glow. She took her Rosary from the windowsill and sank into her chair at the window, hushed tears running like Holy water into her lap.

Isabel wanted to comfort Leticia, and was seriously considering crossing the room with her walker and whispering in Leticia’s ear, but surprisingly, Muriel went to Leticia. She put her arms around her and stroked her hair, murmuring softly, and then led Leticia to her bed. Muriel covered her with the blanket (there was only a bottom sheet on each bed) and then spread her arms out wide. “Look, Leticia,” she said cheerily, “You’re the first person to use the new afghan!” She spread the invisible covering gently over Leticia, tucking in her feet and chin. “There, there, Dear One,” she soothed. “Everything looks better in the morning.”

Leticia spoke something to Muriel in Spanish. Isabel was not fluent, but understood “Gracias Majita.” Thank you my friend.

Isabel fell into a troubled sleep, her own pillow wet with tears.

Breakfast the next day was unidentifiable cereal; Isabel decided it had to be some sort of stale, generic bran. The aide served it already poured with powdered milk (Isabel knew that it was powdered because of the white lumps), turning it into a soggy clump like wet papier-mâché. A hard-boiled egg and unbelievably, orange Kool Aid, completed the meal. Isabel decided that it would take a ream of paper just to report on the food, and her fingers were itching to type that report.

After breakfast, everyone shuffled to the commons room, found a chair and just sat. Rosa, the pleasant aide from the day before, was giving showers and had been at it all morning, except when she had served breakfast. Muriel returned from her shower to the commons room. “Thank you Rosa, that was very refreshing!” Her hair was damp, but combed, and she was in a fresh gown.

“You’re welcome,” said Rosa brightly. “If only the hot water would last so that everyone could enjoy their shower like you did!”

“What did you say, Rosa?” Cathy entered the room, wearing a lime-green business suit and a cruel expression.

“M’am, I was only wishing for more hot water,” Rosa stammered.

Cathy grabbed Rosa’s arm. “I’ve told you not to use up all the hot water on a few residents. I’ve told you and told you, “lukewarm water and shorter showers.” Why don’t you listen?”

“I’ll do better, Ma’m” Rosa apologized as she wrenched free from Cathy’s grasp. Isabel thought that Jack came by his sadistic streak honestly, at least. He had obviously inherited it from his mother.

“Who’s next?” Cathy snapped.

“I was going to shower Isabel, the new lady.”

“Do Clyde next. No one is visiting Isabel tomorrow; you’ve got two weeks to clean her up.”

Isabel didn’t know whether to be relieved or disappointed that she wouldn’t get a shower today. And tomorrow was visiting day. Apparently, at least Muriel and Clyde would have visitors.

The morning just hung around like a gray cloud. The clock moved slowly, as slowly as the thirty people in the room. Occasionally someone would get up and shuffle to the bathroom to get a drink of water from their cupped hand. It seemed that there were no provisions at all made for thirst beside the provision that God had made when He gave the residents hands. Isabel could not understand this; as a cost-cutting measure, paper cups could only amount to pennies of operating expense.

Two men sitting near one another conversed a little, but it seemed to Isabel that it was more like polite conversation than the discourse of friends; it was as if no one in the room really knew anyone else in the room. She made a mental note to talk to someone in social services about this strange phenomenon.

Leticia sat alone, erect and elegant in the worn brocade chair. Isabel took note of the very dark circles under the lady’s eyes, and the large red place on her wrist, which was turning to bruise. “She must have tried to get away from Jack,” Isabel thought, anger rising inside her breast. Isabel took a great deal of pleasure in spending the next hour imagining what the AG’s office would do to Jack. “Perhaps,” she dreamily mused, “he’ll find someone in prison to give him “treatments”.”

Occasionally, Rosa would approach Leticia, murmuring low in Spanish. Leticia would return a fleeting smile. Rosa picked up the bruised wrist and said something. “Nada,” whispered Leticia. “Nada. Por favor, Nada.” Isabel noted the fear in Leticia’s eyes.

The small TV in the big room droned on and on with no one watching it nor showing any interest in any program. The Cartoon Channel was on all morning; the governing staff obviously mistaking octogenarians for five year olds. Isabel wondered ruefully if they were watching CNN news across town at the Happy Apple Day Care.

Obviously, the residents were not allowed anywhere but where the staff put them. Harve, the very tall bald gentleman, wandered into the kitchen area after his shower. A female voice, Isabel could not tell if it were Cathy or Candy, screamed, “Get the hell out of here, you old f___!”

Rosa had just brought him back from his shower, and quickly jumped to his defense. “He’s a little disoriented…” she ran to the kitchen door explaining.

“It’s time for you to fix lunch! You’ve dawdled at showers long enough!” came the loud reply.

Rosa scurried into the kitchen, and Isabel heard Jack’s voice. “You’re fifteen minutes late! What were you doing, j_____ing them o___ in the shower?

Lunch was ½ a peanut butter and apple jelly sandwich, a “small handful” of potato chips and lime Kool Aid again. Isabel’s mind wandered to the Happy Apple Day Care again.
They were probably having roast beef au jus.

Despite the meagerness of the meal, most of the residents left at least half of it on their plates. Isabel left all of it.

Harve, the tall thin bald man, asked for more. Jack simply picked up Isabel’s plate and put it in front of Harve. “Can’t afford to waste food, and we don’t have any hogs to slop, Harve, so you get it!”

Someone had changed the channel on the TV when the mass shuffle left the dining room.
Bette Davis was striding around a black-and-white movie set and taking long quick puffs of a cigarette. The volume was so low that it could not be heard from where Isabel was sitting.

“Isabel Honey, you want to lie down awhile? I’ll take you back to your room and change you and you can rest.” Rosa spoke kindly to her, and gently led Isabel away from the Hall of Sorrows.

Rosa changed the undergarment and washed Isabel up using a basin of soapy warm water. “Tomorrow I’ll make sure to give you a good shower,” she promised. “That is, if I’m still working here tomorrow.”

Isabel wanted to ask her so many things. She wanted to ask about Leticia and the “treatments,” she wanted to ask why the residents did not have access to paper cups for water. She wanted to ask about the awful meals, mistakes in passing meds, the profanity,
the apparently insufficient hot water supply…she wanted to ask so many things, but Liz’s words, “You’ll have one chance at this – don’t blow it or you’ll hate yourself forever,” rang inside her head.

Gwen, one of the previous hired aides, had told the story of “two cans of Spam feeding thirty people.” Isabel had not thought that possible, but as she stared at her Spam-again plate, she realized that these people made it possible. The Spam slice was almost transparent and placed on a half-slice of bread with white gravy over it. Instant mashed potatoes and a cooked carrot rounded out the meal. Isabel ate the carrot. “Oh goody,” said a cute little man at one of the other tables, “an open-face hot roast pork sandwich.”

The whole room stiffened in fear at what he had said. Everyone anxiously watched the kitchen door expecting Hell to fly though it, but, apparently, no one heard but the residents in the dining room.

Emboldened, Charlotte whispered, “That’s a great thought, Frank. Let’s all pretend!”

There was muffled laughter from around the room, sparkling and dancing on the red-checkered tablecloths. Isabel was astounded. These people were not as “out-of-it” as she thought! They knew – at some level at least – what was going on! They laughed together!

For a fleeting moment, Isabel pictured herself standing up and ripping off the orange muumuu to expose a spandex body suit and thigh high black boots. Breaking the walker apart, she would make it become a James Bond-like weapon with which she would rush the kitchen. “Alright, you evil people,” she would shout while holding the staff at bay, “the jig is up! You’re all going to the big house for a long, long time for serving Kool Aid to octogenarians, and numerous other crimes!” In her little daydream, Isabel looked just like Jamie Lee Curtis as she barked, “Rosa! I need backup! Call the police and tell them to bring the wagon. These slime-wads are goin’ down!”

Across town, Elizabeth had an uneasy feeling. Nothing she could really put her finger on, but some sort of fear had gripped her stomach. She called the care center with her cell phone and asked to speak with Cathy.

“She’s not here right now,” The woman’s voice that answered the phone said. “This is Candy, her daughter. May I take a message?”

Liz identified herself, said that she was in Michigan, and would like to speak to her sister.

“Oh,” Candy responded, “Isabel’s at dinner right now. She can’t hear you if I give her the phone…”

“I promised her I would call her, and your mom said it was okay. If you put the phone to her right ear, and I yell just right, she’ll know it’s me.”

“Okay, then,” said Cathy. “Rosa! I’m busy. Take this phone out to Isabel and put it in her right ear.”

Liz was relieved and thankful that Rosa would be taking the phone to Isabel, and listened intently for an extension to pick up.

Isabel said “Ow,” so that Liz would know she was on the line.

Liz had no intention of yelling so that others could hear. “I’ve got a bad feeling. Pay attention to everything around you, and at the first possible moment, you’ve got to leave. Can you hear me?”

“Ow,” was the reply.

“Just get out and run to the Circle K and call me. I’ll come right away. I don’t care how you do it, just do it! This is way to dangerous – you have to leave!”

Liz knew that the Circle K was five full blocks north, then two blocks east from the facility, but it was the closest telephone. She also knew that Isabel could probably outrun anyone on their staff.

Isabel took Liz seriously, but wasn’t about to leave before the two weeks were up. Jack did not work that night; Candy passed meds, and Isabel did get the appropriate placebos.
The other ladies in the room seemed to fall asleep all at once, except for Isabel and Leticia. Leticia had taken up her post by the window, starring into the darkened streets and praying her Rosary.

Later, Isabel heard laughter and profanity from the far part of the house. The party was in full swing, and she just hoped that Jack did not return.

More secure now, Isabel waited until after midnight and then approached Leticia. “Do you speak English?” she whispered.

“No,” said Leticia, startled, with surprise showing in her big round eyes.

“Su tengo familia?” Isabel faltered. She was not good at Spanish.

Leticia understood. She shook her head, “No,” she whispered. “Una hermana en Mexico City.”

Isabel understood that Leticia had someone in Mexico City, but they were too far away to help. “Jack…el te lastima?”

“…a veces…” Leticia replied softly.

There was a clattering in the hallway, and Isabel grabbed the walker and put her finger to her lips. “No decir, por favor,” she whispered.

“No,” Leticia said softly. “Nunca.”

“Te ayudare…” Isabel thought she said the phrase correctly because she saw hope leap like a flame in Leticia’s eyes.

“Si…yes…por favor…”

Isabel was snoring in her bed when Candy walked into the room not thirty seconds later.
A big man was with her. He looked none to clean, with a scraggly light colored beard and a baseball cap. They walked straight to Leticia, who was still praying by the window.

“Isn’t she as beautiful as a little china doll?” Candy purred. She loosed the bun of hair at the nape of Leticia’s neck and it cascaded down her back.

Isabel could not see Leticia’s eyes, but she could sense the fear in them. Isabel was ready to spring out of bed fighting and racing to a phone to protect Leticia.

“Yep, she sure is,” the man agreed. “She’s also old enough to be my grandmother.”
He backed away from Leticia with a slight bow. Then he turned on Candy. “Ain’t you got no respect for anybody? You and Jack are a couple of sick m______f_____s!”

Candy was angry. “You said you’d trade the meth for “some!”

The man turned and hurried out of the room with Candy screaming profanities all the way down the hall behind him.
Isabel fell instantly asleep. Leticia was safe this night.

She awakened in the middle of the night because of her bladder. She had been sneaking to the bathroom, and except for Rosa checking her undergarment during her shift, no one else had even approached her to change.

It took a moment for her eyes to adjust to the darkness. Leticia was in her bed and the small lamp was out. A tiny nightlight beside the bathroom door was the room’s only illumination.

Just as she was preparing to get up, the bedroom door swung open and a flashlight beam slashed the darkness. Quickly, she lay back down and feigned deep sleep with her eyes slit slightly open.

There were two people in the room, then at her bedside, shining the light on her feet and legs. The light jerked around the room, then her old green valise was taken from locker and its contents rifled by female. “Nothing here,” the woman’s voice whispered. “Just clothes.”

“You sure?” The man’s voice said. “No I.D.? No paper?”

“Nothing,” the woman replied. “That stuff is on file in the office, though. You saw it.”

Isabel tried not to stiffen nor show any sign of fear, though her heart was racing. Her lungs wanted to hyperventilate, but she forced a steady low snore as if in deep sleep.

“I didn’t see it, that’s the point. There’s no real I.D. there, just admission papers. Mom’s getting sloppy.”

So it was Jack and Candy! Isabel’s mind back-flipped to Catherine’s words, “You understand that the money is not refundable even if she should…expire…”

Abruptly, the light hit Isabel’s face like a slap. She moved a bit, smacked her lips and continued snoring, as if only mildly disturbed in her sleep.

The light lingered on her face while her mind raced. “One Mississippi…Two Mississippi…”

“Where are the extra pillows?” Jack asked.

“Twenty Missipi…why did he want a pillow?…twenty five Mississippi…”

“Down by the kitchen, in the linen closet.”

The lamp by the window flicked on. “Ayuda!” Leticia cried. “Ayuda! Soy enfermo!”

Jack turned off the flashlight. “What now?” he said, obviously annoyed.

Isabel could see that Leticia was bent over holding her abdomen. “Ayuda! Llamar
una amulancia!”

The women were all awake, so Isabel forced herself up on one elbow as if just waking up. Candy turned on the overhead fluorescents, and went to Leticia.

“What’s wrong with you?” Candy’s voice sounded edgy and stiff.

Muriel chimed up, “She said she’s sick and wants you to call an ambulance.”

“Go get some Pepto,” Jack commanded his sister. “She’ll be alright.”

As if she understood, Leticia started screaming and fell to the floor. “Llamar una ambulancia!”

“Okay, okay,” Jack said impatiently. “Candy, bring the car around. We’ll just take her in. Shit!”

Candy ran out of the room, and Jack carried Leticia out of the bedroom. The women all gathered at the window, watching as Jack put Leticia in the back seat got in front with his sister.

As the taillights sped away, Muriel turned to Isabel. “You need to go now. As fast as you can.”

Isabel stammered, “But…how did you know?”

Muriel hugged Isabel. “It doesn’t matter. He’ll be back soon. Go while you can.”

“But Leticia…”

“She’s not sick. Go now!”

Muriel was right. The hospital was only a few blocks away, and what if Candy stayed with Leticia and Jack came back? Isabel turned to run. “Take the walker! They’ll think you just wandered away!”

“I’m going to help you all,” Isabel said to the ladies. “Some changes will be made around here.”

Charlotte laughed bitterly. “Don’t you know who runs this town? You can’t help us. No one will listen to you. But thank you for trying.”

“Yes, thank you,” the others echoed.
“Go!” demanded Muriel.

The orange muumuu flapped about her ankles as Isabel ran down the darkened streets. A block or away, she lost a shoe and could not find it in the darkness. She kicked off the other slipper and ran on, trying to anticipate which way Jack would come back from the hospital.

She cut through backyards, following the glow in the sky from the lights of the Circle K,
and placed the folded walker in a copse of Oleander bushes; it would be well hidden there.

She had a cactus spike in her foot and she was cold, dirty and hungry when she limped into the shadowed light behind the convenience store. The two payphones outside the store were vacant, and there was only one car in the parking lot. “Probably the clerk’s car,” she thought as she placed the collect call.

Liz was on here way, but it would take about forty minutes for her to get there. Isabel summoned up her courage and walked into the deserted Circle K. “Hi, she told the clerk. “As you can probably tell, I’ve just had a really bad time, and I wonder if you would be kind enough to allow me to have a large coffee on credit until my sister gets here? She’s picking me up.”

“Of course!” the clerk said. Then, “You must be freezing! I’ll be right back.”

Isabel poured a large cup of fresh, steaming coffee while the clerk retrieved a cotton Indian blanket from her car. “Here,” she handed the blanket to Isabel. “Wrap up in this.”

The clerk cocked her head and looked at Isabel. “Hey, do you want a cigarette?”

Isabel had quit some long time back, but yes, she did want a cigarette.

“We have to smoke these outside on the bench there, but I’ll come out with you since I’m not exactly overrun with customers right now.”

It was heavenly to be sitting on the bench outside the Circle K wrapped in a warm blanket, drinking hot coffee, smoking a cigarette and making small talk with the clerk.
“You’re very kind,” Isabel said to her.

“No, I’m not,” laughed the clerk. “I’m lonely! Things are slow this time of the night.”

Car lights cut across the street and into the parking lot. “Woops!” said the clerk, “I got a customer!” She ran back into the store and took up her post behind the register.

Isabel was horrified to see Jack step out of the car, which he left running. He looked straight at Isabel, and then walked inside. He hadn’t recognized her, Isabel realized. She could see him through the window, talking to the clerk, and then watched him turn around, leave the store and get back into the car. Isabel held her breath. Even though Jack had looked straight at her a second time, he still did not recognize her.

As she watched his car make a right turn at the red light, she let out her breath.

The clerk picked up her still-lit cigarette from the standing ashtray/trash can. “He wanted to know if I’d seen an old lady in an orange house-gown using a walker. “I told him no, I ain’t seen nobody like that.”

Golly, that coffee tasted good!

EPILOUGE FOR ISABEL (FUN WITH THE A.G. AND ME)

We tried to report to the Attorney General. In retrospect, it might have been better to allow the A.G.’s office to follow through on their threats and put me in jail. When I tried to tell them about Isabel’s experience, the words “fraud….misrepresentation…prison time…leave it to the professionals…” flowed from Deputy Pam Swvoda’s mouth like indifferent water from an unconcerned fountain.

After what the state of Arizona had heaped upon my head in my quest to defend two elderly friends in Sierra Vista, I had no doubts that the horrible wrongs of that care facility would be swept under the rug, and I would be prosecuted to the fullest extent of the law.

The Beautiful Lady in the window kept her vigil for the next year, and then, one night, the window was dark and she was gone.

Isabel passed away quietly with Liz and me in attendance. She never even filed a report, much less became Wonder Woman. Rest In Peace.



















ISABEL

Chapter note by author: I believe in what freedoms we, the American People, have left. I also believe in the ones which are not left. I believe in truthful journalism, without compromise; however, I do not believe in suicide by pen. Therefore, the names of the people who participated in this masquerade to investigate the deplorable conditions of a certain Medicaid-paid, long term care facility will not be revealed by me nor by any of my staff.

I tried to report the events at this particular ALTCs - funded residential care facility to the then Arizona Attorney General Janet Neapolitan’s Elder Abuse Taskforce. Janet Napolitano’s deputy, Pam Swobova, interrupted me as soon as I started talking and threatened me with jail or prison. The charges? Fraud and Misrepresentation. I was told that if someone had actually entered the care facility under false pretenses, it was against the law. I was told that I “had no business with my nose in affairs of the state,” and that I had better “leave it to the professionals.” (Months later, I heard through reliable sources that I had been called a “loose cannon” by the AG’s Office. That’s nothing compared to what I think of them.)

I had no intention of leaving it to the professionals, because “left to the professionals,” the elderly people residing (imprisoned) in that facility were daily being abused at the whim of staff. The “Professionals” did nothing, even though there were sworn affidavits from those who had seen the abuse and neglect with their own eyes.

To my great sorrow and shame, I was unable to do anything at all for the residents of this facility. Having been though a living Hell in my efforts to protect an elderly couple in Sierra Vista, Arizona, I was too easily backed down by threat and innuendo from the State Attorney General’s Office.

What you read in these pages is truth. The details, names and places will not be revealed under any circumstance. The Powers That Be weren’t interested then, and any interest now would only be an attempt to discredit what I say in the context of these pages.

The year was 1999. The care facility in question closed its doors in 2001. It is understood around the area that the owner retired with a lot of money, and now lives peacefully in Hawaii (except for her nightmares, of course)

Just because this particular place is no longer operating, it does not mean that others just like it are not operating. They are out there, from coast to coast. Be afraid. Be very afraid.

The Lady at the Window was there every night. Perhaps she was at the window every day as well, but it was only when the purple-hazy Arizona dusk fell that the small light beside her chair came on, illuminating her in silhouette behind a gauzy curtain.
Driving down Orange Avenue on my way home from the office, I saw her every night.
Usually, there were no other lights on in the front of the grand old house, just this small light from a second-story window.

When we started hearing the disturbing stories about what went on in that house, the Lady at the Window began silently screaming, “Help. Help us.”

Isabel was born right after Christmas when she was fifty-seven years old. Her birth weight, at 179 pounds, was rather on the large side, with most of it concentrated in her abdomen and large, pendulous, “old lady” breasts. The breasts, when unrestrained, hung almost to her waist, and when she lay down, they fell to each side of her body like nuzzling puppies.

She learned to walk with the aid of a walker in about a week, slow, shuffling steps, with the right foot dragging just a bit behind.

She learned to talk with grunts and moans. Pleasure, as in good food, was demonstrated by the “mmm-mmmm,” of approval, and displeasure was expressed by “ow,” which became “owwww!” if she was very displeased. She learned to grunt all the time, whether walking, eating, or just sitting and staring out the window.

Being almost deaf, she learned to not respond to her name unless it was practically screamed, and not to turn around or look toward any unusual noise.

She learned to be slightly contentious, which came easily for her and which she rather enjoyed, since the “forgotten persona” was a sometimes-contentious person, herself.

She learned to eat and not be neat about it; she spilled food, ate with her mouth open and used a spoon like a two-year old. She rather enjoyed that part of herself.

The most difficult thing Isabel had to learn was to pee in a Depends.

While Isabel was getting ready for her halting foray into the care facility, I talked to my good friend, Jane, an RN on the home health staff of a small Arizona hospital.

“You know that I think you’re nuts,” Jane whispered across the table as she stirred her latte. “And, Little Missy, if Isabel gets a decub, don’t think I’m going to take care of it!” She laughed, but it was a nervous laugh.

“Okay,” I told her, “stop messing around. Tell me what you truthfully think.”

She sat quietly for a moment, and then looked me right in the eyes. “You really put it on the line, don’t you? That’s what I like about you – nothing is halfway.” She looked quickly around the coffee shop, as if someone just might be listening, and then back at me. “Seriously, I think that Isabel is the ultimate weapon of advocacy. But,” she added in a lower voice, “I am worried sick about you.”

Only three people knew about Isabel and THE PLAN - Jane, my clergy friend, Elizabeth, and I. We had already sent in a caregiver to work at the facility and report back to us, but Wren’s gentle nature couldn’t take it for more than three days. “They are mean to those old people,” she cried. “And today I was reprimanded for giving out too large of a serving of potato chips!”

“What constitutes too large a serving?” I asked.

“Well, they told me that each resident gets a handful, and then they told me to take smaller handfuls because my hands are too large.”

Had it not been so sad, it would have been funny. Wren’s hands were too large to dole out a “handful each” of generic chips to the residents. Her story was not farfetched at all considering the other stories we had already heard, taped, transcribed and filed about this particular facility.

We had reported the abuse of residents to the area State Ombudsman from Nogales. Unfortunately, the care facility knew exactly when to expect him. When he arrived, things were always “just spiffy.” We told him this, but still he kept to his schedule.

We also knew better than to report to Adult Protective Services in that particular small town. The facility would have known about suspicions of their service within fifteen minutes.

Observations and statements from hired caregivers regarding that facility had been reported to AHCCCS/ALTC six months earlier, and nothing had changed. We didn’t know for sure, but surmised that there had been no investigation at all into the accusations of the hired caregivers.

A family ran the facility. Owned by the mother, her two grown children worked for her in the facility. Only one outside caregiver at a time was hired, and the caregivers usually did not last long before quitting. Both the grown children, a boy and a girl, were rumored to be crystal meth addicts, and certainly their reported behaviors toward the elderly residents gave credence to that speculation.

The caregivers hired from outside were required to cook and do the laundry - in addition to caring for the twenty-five to thirty people housed there. It appeared that the “kids” who were the permanent staff, were also the Abuse Squad and willing to do little else.

Families were discouraged from visiting except on regular days. “It’s too hard on her/him,” was the gently chiding explanation.. “He/she gets very depressed when you leave.”

For sons, daughters and other relatives of the “imprisoned,” this was good. They did not want to visit anyway; they only felt an obligation to do so, so Sunday afternoons from 1 – 4 was good for them. Take Mom a little something, have a cigar with Dad, act like we’re listening, tell them how busy we are and, poof! The ordeal is over until next week.

Thirty people over eighty. Thirty people drinking water from their cupped hand at the bathroom sink, because they could not be trusted not to “pee in the glasses.” Thirty people afraid of their own shadows, in constant fear of being cursed or thrown around like rag dolls. Thirty people shuffling about in the great room with a 12-inch TV droning on behind them. Thirty people with pride, dignity, hope and almost all life drained from them. Thirty souls trapped in a drab, gray and frightening place between life and death, just waiting. This is what Isabel found.

Liz and Jane helped Isabel dress. The usually carefully-coiffed hair had not been washed for three days and hung in dank, greasy tendrils about Isabel’s face. Liz pulled up the back of the hair and secured it with a bright purple clip. “Perfect,” she said, taking stock of Isabel who wore an old grayish-white undershirt, donated by Jane’s husband, and a pair of very large panties, bought that very day from WalMart and put on over a Depends. Covering it all was an orange and white muumuu, purchased at the Salvation Army store for fifty cents, and completing the ensemble were rather old anklets and scuffed slip-on house shoes which were cloth, and of an uncertain color.

Jane stood back and looked closely at Isabel. “The eyes are not right. You didn’t use Visine this morning, did you?”

Isabel shook her head no.

“Well, they just aren’t quite old enough…” Jane peered closely into Isabel’s eyes. “Can you make them droop a little more?”

Isabel replied, “Ow!” and everyone laughed.

“Wait here. I’ll be right back!”

Jane returned in fifteen minutes with a large pair of very dark wraparound glasses. “You just had cataract surgery yesterday,” she explained to Isabel and Liz, “and you’ll have to wear these the whole time your sister is Michigan – until she comes back to take you to the eye doctor.”

Jane handed a small bottle to Liz. “Here, put these with her meds.” To Isabel, she said, “Don’t worry. It’s only sterile water, and I washed the bottle out really well.” Jane turned to Liz again. “Remember to tell them to instill one drop into each eye twice a day.”

On the way to care facility, Liz turned into the Sonic. “From what we’ve heard, this might be the best food you’ll have for awhile,” she said with a sad smile. “I hope not, though.”

Isabel wolfed down a cheeseburger, a coke and a hot fudge sundae. A big glob of hot fudge sauce accidentally fell off the spoon and onto the orange muumuu.

“Drat!” said Liz, wiping at the spot with a wet paper napkin. “Now they’ll think I don’t take good care of my sister!”

“Just tell them we stopped at Sonic,” said Isabel. “You’ve already warned them that I’m a pig at the table.”

“Have you peed in that undergarment yet?’

“How about if I just go inside and soak it down with a little water?”

Liz looked over her glasses at Isabel. “Listen,” she said. “I need to remind you that you’ll have one chance at this – don’t blow it or you’ll hate yourself forever.”

Isabel peed in the undergarment a block away from the facility.

The wheel chair came out of the trunk and Liz talked to Isabel (without moving her lips) on the long uphill walk to the center. “Don’t say one word.” She firmly warned from behind clenched teeth. “They might have a microphone behind a cactus or a rock.”

Liz wheeled Isabel inside the air-conditioned office, where they were expected. Presentation of the needed documentation was made, and Liz paid Cathy, the owner, for two weeks in advance.

“You understand, of course, that the payment is nonrefundable,’ smiled Cathy. “Even if you should take her out early or if she should…well, expire….”

“Well, I won’t be taking her out early,” laughed Liz, “and it’s doubtful that she’ll expire while I’m gone.”

“Please sign this document of acknowledgement of that fact,” said Cathy, shoving yet another paper at Liz.

Liz signed the appropriate paperwork, explained Isabel’s routine and medications (including the eye drops) and wrote down both her cell phone numbers in case of emergency.

“We have you rooming with some nice other ladies,” Cathy smiled down into Isabel’s dark glasses. “I think you’re going to have a good time here while your sister is on vacation!” She shot Liz a sympathetic glance, silently saying “you poor thing, you probably really need a vacation from this burden.”

Isabel was busting at the seams; she had noticed a striking similarity between Cathy’s simpering voice and the voice of Nurse Ratchet, of “One Flew Over the CooCoo’s Nest,”
and she was dying to tell Liz. She made a mental note to scream out the information the minute she retrieved her voice.

Cathy took the old brown valise from Isabel’s lap and put it on the top shelf of a green metal locker. The walker was unfolded, and Isabel was seated in a straight-backed chair with a cushioned seat. “Comfy?” Cathy cooed to Isabel. “Dinner is about an hour away, Dear, so you just sit here and get acquainted with the girls while I see Elizabeth out.”

Liz bent to kiss Isabel’s cheek, and through the dark glasses, Isabel could see that Liz’s eyes were brimming with soon-to-be-shed tears. “I’ll see you in two weeks, Honey,” she choked.

Cathy patted Liz’s arm. “There, there. We’ll take very good care of her.”

Isabel looked up at Liz and tried to smile “Owww!” she said.

Isabel looked around the austere room at the “girls.” One girl was sitting on the edge of her bed, knitting her fingers in and out of the air as if crocheting. Another girl was deep in a one-sided conversation with another girl, and the fourth inhabitant of the room was sitting at the window, behind the sheer curtain, not saying anything and concentrating, it seemed, on the highway outside. There she was. The lady at the window.

She was petite in frame with patrician cheekbones and small hands and feet; the thick bun of gray and black streaked hair caught up at the nape of her neck gave her an air of elegance, and Isabel thought that she looked exactly like the cameo she wore around her neck on a black velvet ribbon. Her ankle-length rose-colored dress was worn but clean, and upon her tiny feet were scuffed ballet slippers. Isabel realized that this beautiful woman was the “silent silhouette” that she had seen so many times; this woman was the call for help that no one heard but Isabel.

Isabel watched the clock on the wall circle once while the occupants of the room remained trapped in a tableau painted by the hand of loneliness.

Abruptly the door flew open and a thin young man in a dark blue shirt and white pants entered the room and stood in front of Isabel with folded arms. “I’m Jack,” he smiled. “I’ll probably be your worst nightmare.” He laughed out loud and turned to the woman sitting on the bed. “Isn’t that right, Muriel?”

“That’s right,” Muriel parroted, obviously not knowing what she was saying, thought Isabel. Or did she?

Roughly, Jack hauled Isabel to her feet. “Well, Isabel, they tell me that you piss your pants but you don’t shit yourself often as long as you’re taken to the bathroom.” Isabel grabbed the walker bar as he half-dragged her across the room.

He opened another door and pulled Isabel inside. “Commode!” He yelled in Isabel’s ear, so loudly that she could feel the vibration all over her head. “Shit there!”

He pulled down Isabel’s panties and then her undergarment. “What the hell are these for?” he muttered, wadding up the new WalMart panties and throwing them into the overflowing trashcan.

He ripped the undergarment off Isabel and tossed it in the same place as the panties. “Pissed yourself already,” he griped. Again he yelled in Isabel’s ear, “Sit down here and shit. Don’t move until I come back.”

Isabel had had a bowel movement that morning, and was frightened that she would not be able to have another one for Jack. She was half-afraid of him, and the half of her that was not afraid was humiliated and angry.

The bathroom was filthy, and the door was left open; Isabel on the pot was visible to all the other women, but it did not seem to matter; Isabel was the only object moved from the tableau (chess board). The woman knitting air on the bed was still knitting air; the one-side conversation was still going on; the beautiful lady still sat at the window.

There were two commodes in the bathroom, one on each end of the room with an open shower in between. Two trashcans were in the room, both standing together and overflowing at the other end of the room.

The recipient of the one-sided conversation got up and shuffled toward Isabel, with the conversationalist right behind her, still talking. For a moment, Isabel thought that the quiet one had to use one of the commodes, but she walked to the sink and turned the water on, cupped her hand and drank from it. She repeated this movement three times, then dried her hand on her zip-on robe and walked out, the other woman still trailing and talking.

Isabel thought it strange that the woman should drink from her cupped hand, but looking about, she saw neither paper cups nor plastic glasses anywhere. “She was thirsty and had no choice,” Isabel thought.

From her seat on the bathroom commode, Isabel could see the clock on the wall. She sat there while the clock made another complete circle. She dared not move, not knowing if there might be a camera somewhere, and not knowing if one of the women would notice and tell. Her rear-end began to ache from sitting. (hidden camera)

At quarter till six, after sitting on the commode for one hour and forty-three minutes, the door to the bedroom opened and Isabel saw the back of a chubby woman in dark green scrubs. “Hi ladies,” she said pleasantly. “I came to round you up for dinner.” She walked over to the woman sitting on the bed and gently touched her shoulder. “Muriel,”
She said softly, “Muriel, it’s time for dinner, dear.”

Muriel looked up at the aide. “Okay.”

The aide patted Muriel’s shoulder. “How’s the afghan coming?”

“Good.” Muriel said, tonelessly. “See?” She stretched out her hands as if holding something.

“That’s beautiful!” the aide exclaimed. “Your mother will love it! Let’s take a little break and go to dinner, okay?”

As she helped Muriel to her feet, the aide locked eyes with Isabel, still sitting on the commode. “Oh, you poor thing! How long have you been sitting here?”

“Owww!” said Isabel as she was helped up. Her legs ached badly from sitting in the same position for such a long time. “Owww!”

“Oh, that darned Jack! He said he had you on the pot, but that he would take you off. I’m so sorry!” The aide quickly got Isabel into a clean undergarment and lightly washed Isabel’s face and hands with a damp washcloth. “We’ll go down to dinner now, Isabel.”

In the hallway, the aide stopped. “Wait right here, please.” She turned back into the room and took the beautiful lady by the hand. “Leticia,” the maid said. The beautiful lady turned her head from the window, and the aide spoke softly to her in Spanish.

Unassisted, the beautiful lady arose and walked lightly to the door with the aide, her face expressionless. Walking down the hallway, Leticia was a little ahead of Isabel and the aide. Isabel guessed Leticia to be between seventy-five and eighty, but the fluidity of her movements and grace in her posture and gait belied her age.

The dining room was bright, with large windows on two sides, and Isabel had no trouble making out the red and white checked plastic tablecloths through the dark glasses. There were three long tables, with ten residents, men and women, seated at two of them, and seven people seated at the third table.

The aide seated Leticia and Isabel at the third table, along with a red-haired woman and six men. Isabel could not help but notice that the dining room was quiet; no music, no talking, no laughter…even the “trailing conversationalist” was silent.

Sandy, one of the caregivers who had quit with quite a story, had been right, Isabel mused. There it was on her plate – Spam –the thinnest slice she had ever seen (“They must have cut this with a cheese grater”), exactly seven green beans, about half a cup of macaroni and cheese (the “four boxes for a dollar” kind), and half a slice of white bread smeared with margarine. There was one chunk of canned pineapple sitting on the Spam slice, and a green fly sitting on the bread and butter. Isabel hoped they would give her a beverage (“Some coffee would be so nice!”) because she knew if she ate that food she would throw up.

Isabel stole a glance at Leticia. She was eating a green bean, holding it with her fingers and chewing it like it would be her whole meal. The residents within her sight (without turning around to look, of course) all had a similar disinterest in their meal. The little man at the end of the table took a bite of the macaroni. “It’s cold.” He announced.

A young woman in pink scrubs, wearing a tattoo on her right hand and a nametag on her right breast reading, “Candy,” came out of the kitchen. She leaned over the man at the end of the table. “Well, Homer,” she said sarcastically, “You should have eaten it when it was hot.”

Muriel asked for water. “You’ll get a drink with desert like always, Muriel,” Candy replied before she flounced back into the kitchen.

Isabel picked at what food the fly didn’t eat, and secretly wished for a piece of pie and cup of coffee for desert.

She could hear laughter and talk from the kitchen, and every now and then she would catch a glimpse of Jack, Candy and three or four rowdy-looking young men. They were eating pizza and drinking beer from blue cans. “I’ll flip you to see who stays tonight, Candy,” Jack told his sister. Laughter. Then, “Okay, let’s make it the best two out of three.” Laughter again.

Oh no, thought Isabel. That bozo Jack is going to be in charge of this place tonight.
The aide brought in a pitcher of something wet, and put individual packettes of two graham crackers in front of each resident. The liquid in the pitcher was lime Kool Aid, and warm at that. Isabel was horrified. The stories of meals at the facility were true; that meant that, most likely, the rest of the stories about the facility were true. She felt a cold sweat of fear on the back of her neck. “I can do this,” she confirmed in her thoughts. “I can do this. These people do this 365 days a year. I can do this for two weeks for their sakes.”

There was table clearing and then shuffling back to the bed quarters. Isabel was determined to hold her bladder because she could not just amble into the bathroom, and she did not want Jack to change her. Tonight, she would be quiet as a mouse and as invisible as she could make herself.

She lay down on her bed and tried to sleep, even though it was very early for her to retire. Everyone else lay down as well, except beautiful Leticia, who took up her post at the window by the light of a small, dim lamp. Isabel noticed a Rosary in Leticia’s hand, its crystals sparkling in the lamplight.

Quiet, so quiet. Not even the humming of an air conditioner or cooler broke the stillness of the night. Isabel drifted off to sleep despite the early hour and the creeping fear she felt in her stomach.

Bright overhead fluorescent lights hit her like a sledgehammer, and Jack’s voice, loud and boisterous. “Passing meds, ladies. Pay attention now!”

Isabel looked at the clock. 11: 15. He’s passing meds this late? Why? She knew soon enough. As he handed her a paper cup of pills and a small Dixie cup of warm water, Isabel caught a strong whiff of alcohol. He’s drunk! She thought. “Toss ‘em down, old girl,” Jack told her before he turned to Charlotte the Conversationalist.

Isabel looked at the pills. These were not the placebo sugar pills that had been brought in for her! She recognized ½ tab Risperdal, Lisinopril and 10 milligrams of Valium. He had given her someone else’s meds, and there was no way to correct the problem. Her only comfort was that her own medications would not hurt anybody. She was thankful that he did not even notice that she did not take the pills; when his back was turned, she put the pills down an air vent behind her bed. She was not even offered the “eye drops” that Jane had given her; she would get angry about it later. Right then, she was simply relieved.

To her surprise, Isabel noticed that Leticia was still at her post by the window. Her face wore no expression, but she seemed to be rapidly counting her Rosary prayers.

Jack turned to Leticia after he had cleared his cart of tiny paper cups. To Isabel’s surprise, he took the Rosary from Leticia’s hands and put it on the windowsill. “You know what time it is, Leticia,” he crooned, while pulling her to her feet. “It’s time for your treatment.” With a smirk on his face, he led Leticia from the room. Was that fear in her eyes? The overhead fluorescents went suddenly out as they left the room. Jack laughed and closed the door. “G’Night, Ladies!”

Isabel wanted to follow him to where he was taking Leticia. She wanted to jump on his back and bite him and hit him to stop whatever “treatment” he was planning for Leticia.
If only she could have managed to hide a cell phone in her belongings! Isabel realized immediately that there was nothing she could do about the current situation, not without jeopardizing the future of Leticia and the other residents. She could tell, she could file a report with the Attorney General’s Office, she could scream from the rooftops, but she needed proof. She had to ride out her time here, and then get busy on tearing this place down brick-by-brick.

Sleep would not come. She needed to urinate, but dared not, neither in the undergarment nor on the commode.

Two hours later, Leticia returned. She did not turn on a light, but Isabel could see in the small, dim area of lamplight by the window that she was crying, her beautiful face contorted in what looked like grief. There was no trace of anger there, just grief.

The bun was gone from Leticia’s hair, and it hung heavy and thick to her waist, the silver streaks almost shimmering in lamp glow. She took her Rosary from the windowsill and sank into her chair at the window, hushed tears running like Holy water into her lap.

Isabel wanted to comfort Leticia, and was seriously considering crossing the room with her walker and whispering in Leticia’s ear, but surprisingly, Muriel went to Leticia. She put her arms around her and stroked her hair, murmuring softly, and then led Leticia to her bed. Muriel covered her with the blanket (there was only a bottom sheet on each bed) and then spread her arms out wide. “Look, Leticia,” she said cheerily, “You’re the first person to use the new afghan!” She spread the invisible covering gently over Leticia, tucking in her feet and chin. “There, there, Dear One,” she soothed. “Everything looks better in the morning.”

Leticia spoke something to Muriel in Spanish. Isabel was not fluent, but understood “Gracias Majita.” Thank you my friend.

Isabel fell into a troubled sleep, her own pillow wet with tears.

Breakfast the next day was unidentifiable cereal; Isabel decided it had to be some sort of stale, generic bran. The aide served it already poured with powdered milk (Isabel knew that it was powdered because of the white lumps), turning it into a soggy clump like wet papier-mâché. A hard-boiled egg and unbelievably, orange Kool Aid, completed the meal. Isabel decided that it would take a ream of paper just to report on the food, and her fingers were itching to type that report.

After breakfast, everyone shuffled to the commons room, found a chair and just sat. Rosa, the pleasant aide from the day before, was giving showers and had been at it all morning, except when she had served breakfast. Muriel returned from her shower to the commons room. “Thank you Rosa, that was very refreshing!” Her hair was damp, but combed, and she was in a fresh gown.

“You’re welcome,” said Rosa brightly. “If only the hot water would last so that everyone could enjoy their shower like you did!”

“What did you say, Rosa?” Cathy entered the room, wearing a lime-green business suit and a cruel expression.

“M’am, I was only wishing for more hot water,” Rosa stammered.

Cathy grabbed Rosa’s arm. “I’ve told you not to use up all the hot water on a few residents. I’ve told you and told you, “lukewarm water and shorter showers.” Why don’t you listen?”

“I’ll do better, Ma’m” Rosa apologized as she wrenched free from Cathy’s grasp. Isabel thought that Jack came by his sadistic streak honestly, at least. He had obviously inherited it from his mother.

“Who’s next?” Cathy snapped.

“I was going to shower Isabel, the new lady.”

“Do Clyde next. No one is visiting Isabel tomorrow; you’ve got two weeks to clean her up.”

Isabel didn’t know whether to be relieved or disappointed that she wouldn’t get a shower today. And tomorrow was visiting day. Apparently, at least Muriel and Clyde would have visitors.

The morning just hung around like a gray cloud. The clock moved slowly, as slowly as the thirty people in the room. Occasionally someone would get up and shuffle to the bathroom to get a drink of water from their cupped hand. It seemed that there were no provisions at all made for thirst beside the provision that God had made when He gave the residents hands. Isabel could not understand this; as a cost-cutting measure, paper cups could only amount to pennies of operating expense.

Two men sitting near one another conversed a little, but it seemed to Isabel that it was more like polite conversation than the discourse of friends; it was as if no one in the room really knew anyone else in the room. She made a mental note to talk to someone in social services about this strange phenomenon.

Leticia sat alone, erect and elegant in the worn brocade chair. Isabel took note of the very dark circles under the lady’s eyes, and the large red place on her wrist, which was turning to bruise. “She must have tried to get away from Jack,” Isabel thought, anger rising inside her breast. Isabel took a great deal of pleasure in spending the next hour imagining what the AG’s office would do to Jack. “Perhaps,” she dreamily mused, “he’ll find someone in prison to give him “treatments”.”

Occasionally, Rosa would approach Leticia, murmuring low in Spanish. Leticia would return a fleeting smile. Rosa picked up the bruised wrist and said something. “Nada,” whispered Leticia. “Nada. Por favor, Nada.” Isabel noted the fear in Leticia’s eyes.

The small TV in the big room droned on and on with no one watching it nor showing any interest in any program. The Cartoon Channel was on all morning; the governing staff obviously mistaking octogenarians for five year olds. Isabel wondered ruefully if they were watching CNN news across town at the Happy Apple Day Care.

Obviously, the residents were not allowed anywhere but where the staff put them. Harve, the very tall bald gentleman, wandered into the kitchen area after his shower. A female voice, Isabel could not tell if it were Cathy or Candy, screamed, “Get the hell out of here, you old f___!”

Rosa had just brought him back from his shower, and quickly jumped to his defense. “He’s a little disoriented…” she ran to the kitchen door explaining.

“It’s time for you to fix lunch! You’ve dawdled at showers long enough!” came the loud reply.

Rosa scurried into the kitchen, and Isabel heard Jack’s voice. “You’re fifteen minutes late! What were you doing, j_____ing them o___ in the shower?

Lunch was ½ a peanut butter and apple jelly sandwich, a “small handful” of potato chips and lime Kool Aid again. Isabel’s mind wandered to the Happy Apple Day Care again.
They were probably having roast beef au jus.

Despite the meagerness of the meal, most of the residents left at least half of it on their plates. Isabel left all of it.

Harve, the tall thin bald man, asked for more. Jack simply picked up Isabel’s plate and put it in front of Harve. “Can’t afford to waste food, and we don’t have any hogs to slop, Harve, so you get it!”

Someone had changed the channel on the TV when the mass shuffle left the dining room.
Bette Davis was striding around a black-and-white movie set and taking long quick puffs of a cigarette. The volume was so low that it could not be heard from where Isabel was sitting.

“Isabel Honey, you want to lie down awhile? I’ll take you back to your room and change you and you can rest.” Rosa spoke kindly to her, and gently led Isabel away from the Hall of Sorrows.

Rosa changed the undergarment and washed Isabel up using a basin of soapy warm water. “Tomorrow I’ll make sure to give you a good shower,” she promised. “That is, if I’m still working here tomorrow.”

Isabel wanted to ask her so many things. She wanted to ask about Leticia and the “treatments,” she wanted to ask why the residents did not have access to paper cups for water. She wanted to ask about the awful meals, mistakes in passing meds, the profanity,
the apparently insufficient hot water supply…she wanted to ask so many things, but Liz’s words, “You’ll have one chance at this – don’t blow it or you’ll hate yourself forever,” rang inside her head.

Gwen, one of the previous hired aides, had told the story of “two cans of Spam feeding thirty people.” Isabel had not thought that possible, but as she stared at her Spam-again plate, she realized that these people made it possible. The Spam slice was almost transparent and placed on a half-slice of bread with white gravy over it. Instant mashed potatoes and a cooked carrot rounded out the meal. Isabel ate the carrot. “Oh goody,” said a cute little man at one of the other tables, “an open-face hot roast pork sandwich.”

The whole room stiffened in fear at what he had said. Everyone anxiously watched the kitchen door expecting Hell to fly though it, but, apparently, no one heard but the residents in the dining room.

Emboldened, Charlotte whispered, “That’s a great thought, Frank. Let’s all pretend!”

There was muffled laughter from around the room, sparkling and dancing on the red-checkered tablecloths. Isabel was astounded. These people were not as “out-of-it” as she thought! They knew – at some level at least – what was going on! They laughed together!

For a fleeting moment, Isabel pictured herself standing up and ripping off the orange muumuu to expose a spandex body suit and thigh high black boots. Breaking the walker apart, she would make it become a James Bond-like weapon with which she would rush the kitchen. “Alright, you evil people,” she would shout while holding the staff at bay, “the jig is up! You’re all going to the big house for a long, long time for serving Kool Aid to octogenarians, and numerous other crimes!” In her little daydream, Isabel looked just like Jamie Lee Curtis as she barked, “Rosa! I need backup! Call the police and tell them to bring the wagon. These slime-wads are goin’ down!”

Across town, Elizabeth had an uneasy feeling. Nothing she could really put her finger on, but some sort of fear had gripped her stomach. She called the care center with her cell phone and asked to speak with Cathy.

“She’s not here right now,” The woman’s voice that answered the phone said. “This is Candy, her daughter. May I take a message?”

Liz identified herself, said that she was in Michigan, and would like to speak to her sister.

“Oh,” Candy responded, “Isabel’s at dinner right now. She can’t hear you if I give her the phone…”

“I promised her I would call her, and your mom said it was okay. If you put the phone to her right ear, and I yell just right, she’ll know it’s me.”

“Okay, then,” said Cathy. “Rosa! I’m busy. Take this phone out to Isabel and put it in her right ear.”

Liz was relieved and thankful that Rosa would be taking the phone to Isabel, and listened intently for an extension to pick up.

Isabel said “Ow,” so that Liz would know she was on the line.

Liz had no intention of yelling so that others could hear. “I’ve got a bad feeling. Pay attention to everything around you, and at the first possible moment, you’ve got to leave. Can you hear me?”

“Ow,” was the reply.

“Just get out and run to the Circle K and call me. I’ll come right away. I don’t care how you do it, just do it! This is way to dangerous – you have to leave!”

Liz knew that the Circle K was five full blocks north, then two blocks east from the facility, but it was the closest telephone. She also knew that Isabel could probably outrun anyone on their staff.

Isabel took Liz seriously, but wasn’t about to leave before the two weeks were up. Jack did not work that night; Candy passed meds, and Isabel did get the appropriate placebos.
The other ladies in the room seemed to fall asleep all at once, except for Isabel and Leticia. Leticia had taken up her post by the window, starring into the darkened streets and praying her Rosary.

Later, Isabel heard laughter and profanity from the far part of the house. The party was in full swing, and she just hoped that Jack did not return.

More secure now, Isabel waited until after midnight and then approached Leticia. “Do you speak English?” she whispered.

“No,” said Leticia, startled, with surprise showing in her big round eyes.

“Su tengo familia?” Isabel faltered. She was not good at Spanish.

Leticia understood. She shook her head, “No,” she whispered. “Una hermana en Mexico City.”

Isabel understood that Leticia had someone in Mexico City, but they were too far away to help. “Jack…el te lastima?”

“…a veces…” Leticia replied softly.

There was a clattering in the hallway, and Isabel grabbed the walker and put her finger to her lips. “No decir, por favor,” she whispered.

“No,” Leticia said softly. “Nunca.”

“Te ayudare…” Isabel thought she said the phrase correctly because she saw hope leap like a flame in Leticia’s eyes.

“Si…yes…por favor…”

Isabel was snoring in her bed when Candy walked into the room not thirty seconds later.
A big man was with her. He looked none to clean, with a scraggly light colored beard and a baseball cap. They walked straight to Leticia, who was still praying by the window.

“Isn’t she as beautiful as a little china doll?” Candy purred. She loosed the bun of hair at the nape of Leticia’s neck and it cascaded down her back.

Isabel could not see Leticia’s eyes, but she could sense the fear in them. Isabel was ready to spring out of bed fighting and racing to a phone to protect Leticia.

“Yep, she sure is,” the man agreed. “She’s also old enough to be my grandmother.”
He backed away from Leticia with a slight bow. Then he turned on Candy. “Ain’t you got no respect for anybody? You and Jack are a couple of sick m______f_____s!”

Candy was angry. “You said you’d trade the meth for “some!”

The man turned and hurried out of the room with Candy screaming profanities all the way down the hall behind him.
Isabel fell instantly asleep. Leticia was safe this night.

She awakened in the middle of the night because of her bladder. She had been sneaking to the bathroom, and except for Rosa checking her undergarment during her shift, no one else had even approached her to change.

It took a moment for her eyes to adjust to the darkness. Leticia was in her bed and the small lamp was out. A tiny nightlight beside the bathroom door was the room’s only illumination.

Just as she was preparing to get up, the bedroom door swung open and a flashlight beam slashed the darkness. Quickly, she lay back down and feigned deep sleep with her eyes slit slightly open.

There were two people in the room, then at her bedside, shining the light on her feet and legs. The light jerked around the room, then her old brown valise was taken from locker and its contents rifled by the female. “Nothing here,” the woman’s voice whispered. “Just clothes.”

“You sure?” The man’s voice said. “No I.D.? No paper?”

“Nothing,” the woman replied. “That stuff is on file in the office, though. You saw it.”

Isabel tried not to stiffen nor show any sign of fear, though her heart was racing. Her lungs wanted to hyperventilate, but she forced a steady low snore as if in deep sleep.

“I didn’t see it, that’s the point. There’s no real I.D. there, just admission papers. Mom’s getting sloppy.”

So it was Jack and Candy! Isabel’s mind back-flipped to Catherine’s words, “You understand that the money is not refundable even if she should…expire…”

Abruptly, the light hit Isabel’s face like a slap. She moved a bit, smacked her lips and continued snoring, as if only mildly disturbed in her sleep.

The light lingered on her face while her mind raced. “One Mississippi…Two Mississippi…”

“I need a couple of big pillows.” Jack said.

“Twenty Missipi…why did he want a pillow?…twenty five Mississippi…”

“Well, go get them yourself. They're in the linen closet.”

The lamp by the window flicked on. “Ayuda!” Leticia cried. “Ayuda! Soy enfermo!”

Jack turned off the flashlight. “What now?” he said, obviously annoyed.

Isabel could see that Leticia was bent over holding her abdomen. “Ayuda! Llamar
una amulancia!”

The women were all awake, so Isabel forced herself up on one elbow as if just waking up. Candy turned on the overhead fluorescents, and went to Leticia.

“What’s wrong with you?” Candy’s voice sounded edgy and stiff.

Muriel chimed up, “She said she’s sick and wants you to call an ambulance.”

“Go get some Pepto,” Jack commanded his sister. “She’ll be alright.”

As if she understood, Leticia started screaming and fell to the floor. “Llamar una ambulancia!”

“Okay, okay,” Jack said impatiently. “Candy, bring the car around. We’ll just take her in. Shit!”

Candy ran out of the room, and Jack carried Leticia out of the bedroom. The women all gathered at the window, watching as Jack put Leticia in the back seat got in front with his sister.

As the taillights sped away, Muriel turned to Isabel. “You need to go now. As fast as you can.”

Isabel stammered, “But…how did you know?”

Muriel hugged Isabel. “It doesn’t matter. He’ll be back soon. Go while you can.”

“But Leticia…”

“She’s not sick. Go now!”

Muriel was right. The hospital was only a few blocks away, and what if Candy stayed with Leticia and Jack came back? Isabel turned to run. “Take the walker! They’ll think you just wandered away!”

“I’m going to help you all,” Isabel said to the ladies. “Some changes will be made around here.”

Charlotte laughed bitterly. “Don’t you know who runs this town? You can’t help us. No one will listen to you. But thank you for trying.”

“Yes, thank you,” the others echoed.
“Go!” demanded Muriel.

The orange muumuu flapped about her ankles as Isabel ran down the darkened streets. A block or away, she lost a shoe and could not find it in the darkness. She kicked off the other slipper and ran on, trying to anticipate which way Jack would come back from the hospital.

She cut through backyards, following the glow in the sky from the lights of the Circle K,
and placed the folded walker in a copse of Oleander bushes; it would be well hidden there.

She had a cactus spike in her foot and she was cold, dirty and hungry when she limped into the shadowed light behind the convenience store. The two payphones outside the store were vacant, and there was only one car in the parking lot. “Probably the clerk’s car,” she thought as she placed the collect call.

Liz was on her way, but it would take about forty minutes for her to get there. Isabel summoned up her courage and walked into the deserted Circle K. “Hi, she told the clerk. “As you can probably tell, I’ve just had a really bad time, and I wonder if you would be kind enough to allow me to have a large coffee on credit until my sister gets here? She’s picking me up.”

“Of course!” the clerk said. Then, “You must be freezing! I’ll be right back.”

Isabel poured a large cup of fresh, steaming coffee while the clerk retrieved a cotton Indian blanket from her car. “Here,” she handed the blanket to Isabel. “Wrap up in this.”

The clerk cocked her head and looked at Isabel. “Hey, do you want a cigarette?”

Isabel had quit some long time back, but yes, she did want a cigarette.

“We have to smoke these outside on the bench there, but I’ll come out with you since I’m not exactly overrun with customers right now.”

It was heavenly to be sitting on the bench outside the Circle K wrapped in a warm blanket, drinking hot coffee, smoking a cigarette and making small talk with the clerk.
“You’re very kind,” Isabel said to her.

“No, I’m not,” laughed the clerk. “I’m lonely! Things are slow this time of the night.”

Car lights cut across the street and into the parking lot. “Woops!” said the clerk, “I got a customer!” She ran back into the store and took up her post behind the register.

Isabel was horrified to see Jack step out of the car, which he left running. He looked straight at Isabel, and then walked inside. He hadn’t recognized her, Isabel realized. She could see him through the window, talking to the clerk, and then watched him turn around, leave the store and get back into the car. Isabel held her breath. Even though Jack had looked straight at her a second time, he still did not recognize her.

As she watched his car make a right turn at the red light, she let out her breath.

The clerk picked up her still-lit cigarette from the standing ashtray/trash can. “He wanted to know if I’d seen an old lady in an orange house-gown using a walker. “I told him no, I ain’t seen nobody like that.”

Golly, that coffee tasted good!

EPILOUGE FOR ISABEL (FUN WITH THE A.G. AND ME)

We tried to report to the Attorney General. In retrospect, it might have been better to allow the A.G.’s office to follow through on their threats and put me in jail. When I tried to tell them about Isabel’s experience, the words “fraud….misrepresentation…prison time…leave it to the professionals…” flowed from Deputy Pam Swvoda’s mouth like indifferent water from an unconcerned fountain.

After what the state of Arizona had heaped upon my head in my quest to defend two elderly friends in Sierra Vista, I had no doubts that the horrible wrongs of that care facility would be swept under the rug, and I would be prosecuted to the fullest extent of the law.

The Beautiful Lady in the window kept her vigil for the next year, and then, one night, the window was dark and she was gone.

Isabel passed away quietly with Liz and me in attendance. She never even filed a report, much less became Wonder Woman. Rest In Peace.

The Day the Angels Cried

We were broke, no doubt about it. In considering the entire situation, I decided that we could not keep our contract much longer without some intervention; it seemed unlikely that a mountain of money would rain down on Angel Team.

On Wednesday, February 26,2003, Cochise Health Systems began calling our clients’ homes and speaking with our contracted (to us) caregivers. They told our employees that “Angel Team is filing bankruptcy and won’t be in business very long,” and, “if they wanted to keep working, they would have to sign on with Evercare or Heartfelt Help.”

I reasoned that Cochise Health Systems could not legally solicit our contracted employees for a “favored” company. I would later research the Sherman Act and anti-trust laws, which confirmed that they could not legally do that. But they did.

We have since been told that Heartfelt Help went under Evercare’s “wing” for awhile, since Evercare is a huge conglomerate known to the world as United Health, and therefore, capable of handling both payrolls for a long time. I cannot prove this, but it seems logical.

Our entire company was in mourning. Our employees did not want to leave us, and we did not want Cochise Health Systems’ Doomsday Prophecy for us to come true.

On Friday morning, February 28, 2003, I went alone to the offices of Cochise Health Systems – to beg, bargain or borrow time – I just knew that something had to be done. Fast.

The reception staff of Cochise Health Systems seemed surprised to see me. When I told them that I needed to see Dee Dee Pederson, the Director of Cochise Health Systems, they were all aflutter, not knowing what to do – it was clear that they were unprepared for my visit and did not know if Dee Dee would see me.

I was seated to wait in the reception area, but walked back to the restroom to splash cold water on my face. The mirror told no kind lies; I looked beaten, hungry and hopeless. “I look like
I just crawled out of a dumpster in the back of a Circle K,” I mused to my reflection.

In contrast to my humility and hopelessness, Dee Dee was confident and flippant, leaning back in her chair and eyeing me coldly, a stone figurehead whose own job was the only thing on her mind.

I sat down across the desk from her, hugging my purse to my belly to try to stop the wild beating of my heart. “Dee Dee,” I implored her. “Please don’t do this.”

“Would you be willing to drop Carolyn?” She slammed me right in the stomach with that one.

“Drop Carolyn?” I was incredulous. Was this a case of 1920s, cross burning, Alabama bred, KKK, non-affirmative action prejudice?

“No,” I replied firmly. “I will never do that.” I swallowed hard and continued (not having a clue about “Carolyn” - Carolyn – for Pete’s sake! Was she trying to divert any bloodhounds that I might have on the trail?) “Please don’t make us lose everything we’ve worked so hard for.”

She stared at me, obviously enjoying this moment of absolute power. “Who runs the Safford Sector?”

“I do,” I replied truthfully.

“And the Douglas Sector?”

“I do,” I lied through my teeth. That she, for some unknown reason, hated my partner was obvious.

“Well, I just might let you keep those two sectors; that is, if you align with another company without Carolyn.”

I had no clue as to why she wanted me to align with another company. Of course, now it is all crystal-clear, but that day in Dee Dee’s office, my mind was spinning out of control and I could not grasp the spaces between the lines of what she was saying.

“Write me up a letter stating that you will correct any problems that you are having and that you, personally, will oversee billing. Have it on my desk by Monday morning.”

On the drive back to Sierra Vista, I cried like a two-year old. How could I tell Carolyn all this? She was so sensitive; this could destroy part of her. I wouldn’t tell her yet, I thought. I would just tell her that we could keep the Safford and Douglas sectors.

When I reached our office, Carolyn came running out to meet me. “Mary, Jane from Heartfelt Help is blowing up the phone for you.”

I was sick to my stomach. “I don’t want to talk to anyone,” I said, and put my head down on my desk. (Looking back, not answering Jane's call was the fatal blow for our company. Months later, Cochise Health's head case manager, Maureen, told my former office manager, Julie Romero, "If only she had have aligned with Jane (under Evercare, I presume)!"

That night, I wrote the letter that Dee Dee had demanded. I emailed it to her, and called her office at eight a.m. Monday, March 3, 2003 and told her secretary that the letter was there, on her computer.

On Monday afternoon, March 3, 2003, Cochise Health Systems faxed a letter to us terminating our contract for “financial insolubility.”