Playing Cards with Jim

The sun peeks through the blinds and casts a striped glow in the room. I casually shuffle the cards and bring them softly together. Jim looks at his own hands and turns them over as he expresses admiration for my bridging skills. He smiles when I say that it was my grandma who taught me.

When the cards are dealt, I say, “Kings in the Corner. Do you remember the rules?” He nods and we begin our game, as I make small talk about the weather and today’s menu. He takes a long pause on his turn and I think aloud, “We need a red two…” or audibly wonder “Where are all the sevens?” After he takes several turns, I lead him into a topic of conversation that results in a story I’ve heard four or five times already this week. My voice belies how well I know these details as I strive to listen with fresh ears.

Short-term memory. Problem solving. Planning. These are the keywords for my goals when I play cards with my patients. They know I’m doing my job. This is where I work. But for most of them, this is their home.  When I visit their rooms, I am offered refreshments. Hilda gives me a Little Debbie snack in the festive shape of a Christmas tree or a pink heart. Dorothy doles out fistfuls of Hershey kisses from a hidden stash in her closet. Bob gives me a cold Diet Pepsi from his mini-fridge. It’s much like visiting a grandparent’s home.

As I first began working with Jim, he would question the purpose of our activities. That’s not uncommon, and I must carefully navigate the truth—that I am working to preserve their mental faculties—while respecting each person’s dignity. Jim’s questions started to fade away to be replaced by familiar greetings in the hallway and a friendly wave in the dining room. We established a routine of meeting in the afternoons. Besides knowing that Jim is not much of a morning person, I purposely wait until the end of my day to see him. It gives me something to look forward to at the end of each work day.

After a few weeks of working together, I arrive at Jim’s room to find a table and chair already set up for our game. I feel a little flutter in my chest as I realize he’s been waiting for my visit. He has prepared his home for our card game, and he’s sitting in his arm chair waiting for me to arrive. Jim cannot remember what he’s eaten for lunch 5 minutes after the meal. He has a sign posted on the door to remind him to always use his walker when leaving the room. But he looks forward to our afternoon visits so much that he has remembered to prepare the room for me.

I’ll admit that I’m trying to throw the game. I’ve already won a hand and I’m withholding plays as I try to secure a win for Jim before the end of the session. Our scheduled time has run out, but I remain as we play out the hand. For the moment, I’m just playing cards with Jim. Faint beeps and voices travel in from the hallway, causing us to glance up occasionally from the table. Finally, the last card is placed and Jim’s hands are empty. He’s won the game. I shake my head in mock disappointment at my loss and announce that we’ll have a tie breaker tomorrow. We hug and exchange “I love you” before I emerge into the bright hallway. Even as I prepare to leave work for the day, I’m already looking forward to my next afternoon of playing cards with Jim.

(*Please note that the names have been changed to protect the privacy and dignity of my patients.)

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