Every Wednesday afternoon I visited Lena. She lived in a two-story walk-up where she had become homebound since a stroke partially paralyzed her. She was nearly deaf too, and I had to knock so loudly to announce my arrival that my knuckles hurt. She struggled to open the door, breathing heavily, murmuring all the while, “Wait. Wait.” Then she turned away without looking at me, took a few steps, pivoted, and collapsed into a chair at her kitchen table a few feet away.
Lena was a stout 86 year-old woman with wispy gray hair she rarely bothered to comb. She wore dentures when she had visitors. They were loose and moved while she talked, giving her voice a nasal, whistling quality. The stroke affected her left side: she wore a leg brace and kept her left arm in a sling. The stroke also affected her emotions. Her moods were in constant flux. She screamed out one moment and cried the next. But mostly Lena was anxious. To calm herself, she picked at her skin. Her arms and legs were a patchwork of scabs at different stages of healing. Some were covered with band-aids, but most of these were peeling off. They flapped when she moved, like flags. Lena was always hot, even when it was cold in her apartment. She wore a simple cotton shift and didn’t bother with underwear, except for an adult diaper her home health aide put on her each morning. By the time I arrived, though, she had already removed it, letting it drop wherever she happened to be. Her shift rode high on her legs and I asked her to pull it down.
Visits with Lena were predictable like this. I was her psychiatric social worker, assigned her case because her cries and screams had alarmed her neighbors and because she had become paranoid. She’d fired one homemaker and health aide after another, accusing them of stealing. The elder service agency was hoping if she met with a therapist she’d become more cooperative so they could find a replacement. But on this particularly memorable visit, no one had come for two weeks and it showed. The entire floor was covered with rotting food, discarded tissues, and adult diapers soaked with urine. The stench was overpowering. The mess formed a path between her, her bed, and the bathroom. The worst of it, though, surrounded her chair at the kitchen table. Lena was upset about this, but was oblivious to her part in her predicament.
I asked Lena’s permission to tidy the place up. “Okay,” she said. Lena was going blind and I was afraid that if I left her in this mess, she would fall and get hurt. This meant that I spent an extra hour with her, even though I couldn’t bill for it. I washed dishes and scrubbed pots cluttering the sink and countertop. I found a broom and swept the floors and filled three garbage bags with trash, which I brought out to the dumpster behind her apartment building. Lena was grateful for my help. “God sent you to me today,” she said.
God was Lena’s reference point for everything that happened to her. Every day, when Lena had reached a point of despair, she called the prayer line. Nuns who answered her call prayed with her. Lena found this comforting, if only for a few minutes. Then her feelings overwhelmed her again.
When I finished cleaning, I sat down at the table. Lena wanted to talk about her early life. She liked to tell the same stories again and again: that she was beautiful once, that she married young—“We all married young then”—and that after giving birth to twin boys and a girl in three years, her husband deserted her for another woman. She was only 22. She divorced him and believed this was a terrible sin, a sin for which she worried God was still punishing her.
Lena’s parents took care of the children during the day while she worked as a stitcher in an illegal sweatshop to support them. She told me her boss locked the doors to the factory and would not allow the workers to leave their stations. “Not even to use the toilet,” she whispered, rolling her eyes and raising her eyebrows for emphasis. When Lena’s father died, her mother moved in with her and the children. She was proud of how hard she worked to take care of her family. But she insisted she didn’t expect this of her own children. “They have their own families,” she said. She believed their spouses would resent her if she moved in with them. Still, I wished they would offer. She really didn’t seem safe at home.
After she finished talking about her past, Lena turned to her other preoccupation: questions about God. Usually she asked, “Why is God doing this to me?” But on this day she had a different question. She wondered if God could really hear her prayers:
“How could He? There are so many other people praying too.”
I am a lapsed Catholic—if that’s what someone is called these days who no longer believes—but I easily recalled the Catholic catechism lessons of my childhood. I reminded her of what she was taught: that God is everywhere, that He is all-powerful, and that He forgives. Lena smiled at hearing this, relieved.
But then she grew pensive again and asked another question:
“There are so many people in the world. So many people have died. How can they all fit into heaven?”
It occurred to me then that Lena might want to die, but was afraid. I reassured her that heaven has lots of room in it. In response, she smiled and said again, “God must have sent you to me today.”
A few months after this visit, Lena had a fall. She pressed the Lifeline button on the pendant she wore around her neck. Medics arrived with an ambulance and took her to the hospital. While there, at a meeting with her family, hospital staff convinced Lena that going back to her apartment was out of the question. Upon discharge, she was transferred to a nursing home. I visited her there a few times. She sat in a chair in the hallway, amused by the nurses and aides rushing by and gossiped with me about the other residents. She had no complaints. “I had to come here,” she said. I was glad she seemed content.
Less than a month later, Lena felt a bit unwell and asked the nurse to put her to bed. As she dozed, a blood clot in her leg dislodged and made its way to her brain. This was how her life came to an end. But this wasn’t the end of my relationship with her.
Lena’s memory has stayed with me for a long time. What was it about her that made such a deep impression? Perhaps it was because she challenged me to think more broadly about what it means to provide therapy. Long before I became a psychiatric social worker, someone said to me, “All people want is to be accepted and understood.” When I wonder about my role and someone’s capacity for change, I recall this bit of wisdom. For Lena there was no introspection, no deep reflections on the meaning of life, or what other choices she could have made. She just wanted to know that God forgave her and that when she died she would not be punished for doing what she did to protect herself and her children. She was satisfied that she had done her best. Yet, she could not reconcile what she had to do to survive with what she presumed God had wanted of her. If I couldn’t completely fix that, at least I could accept her fears, let her ask her questions, and give answers that soothed her.
Lena looked forward to my weekly visits. The things I said and did made her feel better, less afraid and less alone. One day, Lena asked me to make some instant mashed potatoes for the two of us. Why not, I thought. Mashed potatoes is a comfort food, and what does Lena need if not comfort? I followed the directions on the package, adding milk and butter. Then I filled two small bowls with the rich and creamy mixture. Lena seemed happy. I felt happy too. We sat together eating in silence. There was love in the silence between us. And, I thought, if Lena wanted to believe God had sent me to her that was fine with me.
I grew up a devout Catholic, but in my teens my faith fell apart. A seeker by nature, I tried many spiritual practices—Native American, Zen, Hindu—before finding Vipassana or Insight Meditation in 1979. I attended multiple silent retreats at the Insight Meditation Society in Barre led by teachers who taught that a life truly lived is one where we are open to whatever arises in the present moment. Mindfulness and loving kindness are now integrated into my daily life. Practicing presence of my own experience with aging, sickness, and the inevitability of my own death, teaches me to hold even my most difficult moments with courage and love.
I grew up in Queens, New York. In 1975, after receiving my BA from Queens College, I moved to Cambridge, Massachusetts, where I worked at Harvard as a secretary. I became the confidante to many co-workers until one of them suggested, “Why don’t you get paid to do this?” I had been considering graduate school anyway. I received my MSW from Simmons School of Social Work in 1988. Until my recent retirement, I worked mostly in community mental health with older adults, where I experienced an abundance of love. I live in Arlington, Massachusetts, with my husband Tom of 25 years and my dog Luca. I now enjoy long walks, reading, painting, and writing. I have a lot of stories to tell.
A version of “Comfort Food” first appeared in Auscultations, 2018.