It’s not that I didn’t like Ruth, she just got on my nerves.

Other residents detracted from a nurse aide’s more unpleasant tasks. There was Minnie, self-appointed greeter of the visitors that entered the nursing home, who thought that she was still in her teens and spent much of her time in the armchair nearest the door, waiting for her long-deceased husband to pick her up for a date. There was stout Margaret, who greeted me with a twinkle in her eye and a “Hi, Toots,” every time I peeked in her room door, and skinny Mattie, whose foul mouth made the ladies who lined the east wall of the dining room for Wheel of Fortune every evening twitter and shake their heads disapprovingly. One hundred and three year old Marie, Ruth’s roommate, insisted on keeping her white stuffed cat, “Nice kitty, nice kitty” with her at all times. Sharon, a nurse aide whose vocabulary rivaled Mattie’s, enjoyed getting a rise out of Marie by snatching “nice kitty” by its fluffy tail and swinging it in circles above her head.

And then there was Ruth.

Ruth’s room was the first room on the right side of North Hall, the hall with the residents who needed the most involved care. Her room door was right next to the drinking fountain, straight across from the employee entrance. Several times a week I changed into my scrubs in the locker rooms at school and drove to Pleasant Acres to punch in for the 3:30 – 10:30 shift. Once there, I hung up my coat, peeked into the kitchen to tell Marcela to figure on me for supper, and then entered North Hall. I would stoop for a drink of water before heading to the nurses’ station, and today, before I straighten, I sense Ruth standing in the doorway of her room.

The single black and white wedding photo that sits atop the small television on Ruth’s night stand depicts a young woman with dainty features and striking pale eyes. In person, Ruth’s eyes are light blue, and they water almost perpetually, the tears pooling in the wrinkles on her face. Her hair is pure white, and continual rubbing on her easy chair flattens the curls on the back of her head into stiff rays. The waxy skin stretched tautly over her pointy nose and her hands are almost transparent, revealing a network of spidery blue veins. She stares blankly at me for a moment, and her bony fingers twitch as she stuffs the crumpled handkerchief in her right hand into her left hand and then moves it back again.

“Hi Ruth,” I say, trying to sound nonchalant as I wipe a few drops of water from my face with the back of one hand and adjust the gait belt around my waist with the other. I place both hands firmly on my hips, steeling myself for Ruth’s approach, but she is not deterred by my stance. She shuffles stiffly up to me, reaches jerkily for my forearm, and grasps it tightly with both white-knuckled hands.

“What’sa matter, Ruth?” I sigh, noting two of the other nurse aides walking past the end of the hall with the ice cart. Ruth tentatively rests her nervous head on my shoulder.

“Oh girl, oh girl,” she quivers. Then again, this time a wail, “Oh, girl, oh girl.”

“Oh, Ruth, come on, don’t get all worked up,” I say, shrugging her bony head from my shoulder and deftly loosening the gait belt from my waist and tying it snugly around hers. I grasp the belt at the small of her back and use it to steady her as I steer her back into her room. Marie is dozing in her mauve-colored geri-chair, her square head cocked to one side, fingers unconsciously stroking “nice kitty” as she mumbles unintelligibly. I maneuver Ruth to the left, align her with the armchair next to her bed, and tug gently on the gait belt until her rigid body bends at the waist and she drops into the brown chair. She cries out as if the plop into her chair hurt her, and I lower myself, leaning on one armrest. The other nurse aides are at the door, filling the two water pitchers that sit next to the sink with fresh water and ice. I glance up at them, and they roll their eyes at me as they move on down the hall.

“Are you OK, Ruth?” I ask, tipping my head to look into her face as I untie the belt and slip it out from behind her back. She closes her eyes and wearily, methodically pats my arm.

“Well, if you’re OK, I’m going to go help the other girls fill ice, and then it’ll be time to head to the dining room for supper,” I say, moving to stand. Instantly her fingers lock on my forearm, and her panicked eyes fly open.

“Oh girl, oh girl, don’t leave me,” she cries, and then again, gently rocking herself back and forth, she repeats, “Don’t leave me.”

“But, Ruth, I’ve got other people to take care of, too,” I try to reason with her, knowing what she’s about to request.

“Sing with me,” she whispers, and I comply.

Janelle, one of the nurses, told me once that when Ruth came to Pleasant Acres, she would sing many different songs throughout a day. Now there are only two songs that Ruth ever sings. One is an old, Dutch psalm, and the other is the hymn that she begins now. Thanks to Ruth, I, too, know it by heart, and we sing together: “Take time to be holy, speak oft with the Lord. Abide in him always, and feed on his Word. Make friends with God’s children, help those who are weak, forgetting in nothing his blessing to seek.”

I unfold as we near the end of the stanza, and I can’t help but smile as I look down at Ruth. She sings with her eyes closed, her head resting on the back of her chair, wiry white hairs fanning out to form a halo around her head. She sings loudly, sometimes so loudly that Dottie, who lives down the hall, will hobble over and slam the room door shut, which startles Ruth and makes her sing even more noisily, punctuating her song with little yelping sounds. Now she folds her hands together as we finish the song, and I tiptoe out of the room as she, gently rocking herself back and forth, begins to murmur out loud, praying the same prayer she always prays:

“Thank you, Lord, thank you, Lord, thank you, Lord…”

Half an hour later, as we serve the first shift of residents their supper, Ruth’s voice carries down the hall to the dining room. This time she begins with the Dutch psalm, after which she switches to the hymn that I sang with her only a short time before. Then, as is routine, we can’t hear her for a little while as she prays, and then she breaks into song again. Kim, one of the other nurse aides, turns to me while she waits for Marcela to scoop potato wedges and corn onto the next tray.

“Saw Ruth catch you right when you walked in. Too bad for you.”

“Yeah,” I say with a shrug, “She can’t help it, it’s just her Alzheimer’s, you know.”

“I know, but she’s so annoying,” Kim snickers, rolling her heavily-lined eyes as she turns to deliver the full tray to the next resident on the list. I watch her stiff yellow curls spring as she walks. Though she’s only a few months older than I, she’s been working here for almost a year more, so she doesn’t hesitate to give orders and entitles herself to frequent “smoke breaks” without punching out. On one of my first nights at Pleasant Acres, Lindsey and I were putting Ray and Elsie to bed when I happened to glance out the window as I pulled the curtain shut. Kim was out on the patio at the rear of the building, near the employee entrance, sitting on some boy’s lap, cigarette in hand, laughing loudly. When her eye caught my sight of me in the window, she grinned even wider, and winked at me. I have dreaded working with her ever since.

It’s 9:45 PM and Lindsey, Janelle and I are sitting at one of the tables in the dining room, munching Lorna Dunne cookies and charting what percentage of their meal each resident ate, if they had a bowel movement, and whether it was small or large. The hallways that branch out in three directions from the dining room are quiet and dark except for the red EMERGENCY EXIT signs at the end. Once charting is done, we start with rounds, moving first down East Hall, then West, then North. It’s while we’re changing the pads on the bed of Magdalena Jacobmina, affectionally refered to as “Mac” by the staff, that Ruth’s terrified screams ring out through the otherwise still halls. Lindsey and I startle, and Janelle scurries into Mac’s room, urging me to go try to calm Ruth while she and Lindsey finish with Mac. I hustle down the hall, heart pounding.

Ruth is completely uncovered, her thin nightgown twisted around her neck, bare legs flailing, hands clinging to her bed rail. Her frantic yelling has wakened Marie, who starts hollering, “Who’s there? Who’s there?” I reach down to cradle Ruth’s neck in one arm, and stroke her hair as I lower her head onto the pillow.

“Shhh…Ruth…shhh. You’re OK, Ruth, you’re OK. Everything’s going to be alright,” I murmur softly, hoping that Marie will quiet down and go back to sleep.

“What’s wrong with her?” Lindsey is standing next to me.

“I don’t know, she’s pretty worked up, though.” I respond, reaching a tentative hand to feel the pads below Ruth’s body.

“She’s wet,” I whisper, nodding my head toward the rounds cart heaped with clean pads. “Let’s change her bedding, and then I’ll stay with her for a little while if Janelle is willing to help you finish rounds.” Lindsey nods in agreement, and quickly, methodically, we roll Ruth’s trembling frame from side to side to change her bedding, straighten her nightgown, and tuck her in.

I wriggle between Ruth’s nightstand and the bed rail to perch on the top corner of her mattress. Except for an occasional whimper, she’s quiet now. I gently begin to stroke her hair again and then bend close to whisper, “Ruth, did you want to sing?”

“Oh, yes…” she whimpers, and so we sing. This time I start, and she joins in. We sing “Take Time to Be Holy,” and I then follow her lead through the Dutch psalm she loves so well. Her voice grows fainter as she reaches the last strains of the song. Her hands find one another on the top of the bedspread, and I almost mouth the words as she begins:

“Thank you, Lord, thank you, Lord, thank you, Lord…”

I stay there, perched on the head of her bed, running my fingers through her coarse hair even after she falls asleep. I’m still there when Lindsey peeks in to say goodnight, and I don’t stand to leave until I hear Jan, who works the night shift, punch her time card and trot past Ruth’s room door. Ruth is curled on her side, hands still folded, eyes closed, releasing her breath in short, rhythmic bursts. I wave down the hall at Jan and Janelle and punch out. The exit door clicks behind me as I unwrap the gait belt from my waist and raise it above my head, using it to stretch my back and shoulders as I walk toward my car.

I walked out that door for the last time a little over a year later. Before I left I hung my gait belt on one of coat hooks that line the wall next to the time clock. The buckle swung gently back and forth, knocking the wall as I put on my coat, tied my scarf snugly around my head, and slipped outside. The night was still and bitterly cold, and the snow on the ground squeaked beneath my white tennis shoes as I made my way slowly to my car. Above, abundant stars reeled in an inky sky. I looked up as I wriggled the key into the car door lock, and I remembering wondering at their names.

I know some former employees of Pleasant Acres who return regularly to bring goodies for the staff, visit the residents, or provide entertainment for an evening. I wonder if they notice that few of the people living there are the ones for which they provided care; or if it bothers them that the few residents that they do recognize do not know them. I have never gone back.

I tense and glance out the kitchen window as a truck roars past on our gravel road. My son, asleep in his crib in the next room, wheezes and rolls over, and my daughter, tucked in her bed, stops turning the pages in her book long enough to glance in the direction of the window. The whir of the humidifier and the drone of the stereo on the counter threaten to lull me to sleep, but I load the sink with dirty plates and cups, child-sized spoons, and a casserole dish encrusted with remnants of macaroni and cheese. As I methodically swipe and rinse each dish, the radio DJ reads the three-day forecast and introduces “an old gospel hymn.” I pause as a clear, sweet voice breaks through to my weary mind, “Take time to be holy, speak oft with the Lord…” I listen to the words with my chin tipped up and my eyes closed. First one tear, and then another, slides down my face, and I remember Ruth and her watery eyes.

I turn the stereo off as the final strains of the hymn are drowned out by the rousing pulse of the DJ’s next selection. For several minutes I stand, chapped hands limp in the soapy water, tears flooding my vision. I draw in a deep breath, and the waistband of my jeans digs deeper into my gently swelling belly. And there, at the whisper of my Savior’s Spirit, my quiet kitchen becomes a closet, and I bow my weary head before our gracious Father in heaven, the One who not only counts the stars, but knows the number of the hairs on my head; the One who has given me the two breathing softly in the next room and forgives me when I fail to be to them the mother that I ought to be; the One who has placed and tenderly forms this baby in my womb, and who gently assures me that he will be faithful to provide us all we need to care for another covenant child; the One who forgives this woman who so often uses housework or laundry as an excuse to not speak with him; the One whom Ruth never forgot, and before whom she now stands, singing an endless repertoire of praise.

Thank you, Lord.