On a cold morning at the end of January I am driving to a small town twenty miles away to visit one of my home-healthcare clients. We’ll call her M. She is eighty-nine, has one daughter who rarely visits, and is fairly healthy aside from a diagnosis of mild senile dementia. Her old New Hampshire farmhouse is at the top of a snowy hill and has drafty doors and uneven floors. M. and I have agreed that I will come at eleven on the days that I help her, but she rises late and is never ready. She can’t seem to grasp that I have a limited amount of time to spend with her.

When I arrive, she is making breakfast: a woefully under­done boiled egg, toast with jam, a cup of tea, and a large hunk of expensive cheese. Her brindled hair is cut short, and her body is slightly bent. Her face is a riot of wrinkles and pouches, and as always she wears a red bathrobe covered with bits of her previous meals. She will not let me wash it.

Because she uses a walker, she is slow in the kitchen, and by the time the tea is hot, her toast is burned, but she seems content as she sits down to eat and read the paper.

I pause near the kitchen table. M. often asks me about my writing, though I’ve told her I don’t write anymore. She also asks about my daughter, a successful singer. Frequently M. will mention that she knew jazz singer Billie Holiday. I think she does this to remind me of her glorious bohemian past, when she lived in New York City. I see the story of Billie Holiday, who died of cirrhosis of the liver, as a cautionary tale about the perils of addiction, but M. sees it only as the trajectory of genius.

After we’ve chatted, I go to M.’s bedroom, where I dispose of the aged contents of the portable commode, pick up the tissues she leaves everywhere, sweep the floor, and empty the wastebaskets. By then she is done eating and ready for me to help her with her bath. She has trouble getting in and out of the tub by herself. Though it’s warm in the house, she always wants me to set up the clunky space heater she keeps in her room. Once I’ve wheeled it into the bathroom, there is barely space for both of us and her walker. To plug the heater in, I have to get down on the floor, which is littered with strings of dental floss.

M. sits down in a rickety chair, and I pull off her bathrobe and threadbare nightgown. Then I work on her stockings, which are as tight as a second skin — to prevent edema in her legs. Finally she steps out of her adult diaper and into the tub.

Recently I began caring for a nine-month-old baby, and I am enamored of his plump legs and silken skin. Even his little man parts are like something carved from ivory. M., on the other hand, is a wreck of dewlaps and burst veins and brown moles. She asks me to wash her back, and I give it a good going over while she sighs with pleasure. Then I move on to her hair, which is surprisingly thick and streaked with black. She says her Italian blood is the reason why her hair isn’t all white. (She is still vain about her appearance and often shows off her small waist by wearing wide, elaborate belts.) She likes for me to massage her scalp, and she has me lather and rinse her hair twice, as the directions on the bottle say. I am amazed that she feels free to make so many requests. I was raised to take what I got and be grateful for it. Yet I must admit there is something charming about the way M. lies in the tub, waving her hands in the water as if she were floating. When she closes her eyes and smiles, I know she will stay in the water for ten minutes or more. This is my chance to get some real cleaning done. I tell her I’ll be back as I head for her bedroom.

“Don’t touch anything sacrosanct!” she calls after me.

M. has been a writer all her life and has manuscripts everywhere. Only a few have ever been published, and she has no agent, but M. is not daunted. As far as she’s concerned, she is a grande dame of letters, every bit as important as May Sarton or Margaret Atwood. On one side of her bed is a bookcase stuffed full of papers and books, and on the floor are several piles of bulging envelopes and magazines. Next to the commode are a stack of incontinence pads and a carved wooden screen hung with ragged nightgowns and scarves. On the other side of the room is a desk covered with loose paper: M.’s writing mixed with ancient news­letters from the senior center and outdated solicitations for support from public radio. There is also a table strewn with reading glasses, hearing aids, face creams, hair clips, pieces of bark, feathers, and stones. (She likes to pick up objects she thinks are pretty on her walks.) In short, the room is a nightmare of disorganization, but M. claims to like it this way and says that if I tidy up, she won’t be able to find anything. When she is feeling irritable, she will imply that my “mania” for order is evidence of my conformist soul, and that my urge for cleanliness is an attempt to “sterilize” her. There is no need to “categorize” her anarchic abundance, she’ll insist; she has been messy all her life.

M. is often busy writing, and many of the scraps of paper in her room are filled with her lacy, crooked script. I’ve read some of them: her thoughts are as jumbled as her possessions. Even so, she refuses to let go of her idea of herself as an artiste. I imagine that this self-image has comforted her all her life: when bad things have happened — her daughter became an addict, her sister died of cancer — she has told herself that all artists suffer, and someday her pain will be part of the story of her greatness.

But the fact is, it’s too late for her to achieve the acclaim she desires. M. is unable to write for any sustained length of time. She grabs a memory and writes about it for twenty minutes or so until her eyes grow tired and she has to rest. Then she puts the paper atop the pile by her bed and dozes, and when she wakes up, she starts to write of another memory on a different piece of paper. Her process is so haphazard as to be pitiable, but she certainly does not see it that way. She sees herself as triumphing over entropy and the certainty of death.

Having been a writer myself, I should admire her refusal to give up. Instead it makes me impatient with her. I believe M. lives in this myth of greatness in which her every habit or quirk is worthy of the autobiography being written in her head. It is the endless soliloquy of the interior paramour. Why do I believe this? Because I used to be that way myself.

 

I grew up poor. My family did not have a television, but we had plenty of books, and my parents read for both edification and pleasure. Because we couldn’t afford dance or piano lessons, it was clear to me that, if I were going to distinguish myself, it would be through my skill with words. To be a poet, all I needed was a pencil and some paper.

I can still remember my first poem, written in second grade. It went:

Dinosaurs were big and tall.
Tyrannosaurus Rex was the biggest of all.
He ate other dinosaurs, as we can see.
I’m glad I wasn’t there, or he would have eaten me.

I have a dim memory of being invited to share my immortal verse in front of a classroom full of children, and my grandmother sent it to her hometown newspaper in Brandon, Vermont, where it was published. As the fourth child of five, I was often hungry for praise and attention. So it’s no wonder I became hooked. From that moment on, I thought of myself as a writer and dreamed of success and glamour. I received enough encouragement in college to cement the vision, and I even got into the MFA program at Cornell, but I decided to be practical and went to nursing school instead. I earned my degree, traveled, married, and had a child. And through it all I wrote. I published poems and essays here and there but never a book, and none of my publications resulted in the desired acclaim and recognition. By this time, however, writing was a part of my life. It was my therapy, my outlet, my armature — along with alcohol and drugs.

Six years ago I was employed as a nurse at a Veterans Affairs hospital and drinking every day. I often had a shot of vodka first thing in the morning. I was in desperate straits and knew it, but I couldn’t manage to stop for more than three days. In a last-ditch attempt to get sober, I stole some clonazepam — an anti-anxiety medication — from a patient and took a pill one morning, hoping it would calm me enough to alleviate my need for alcohol. It didn’t work. I ended up both drunk and stoned on clonazepam. Impulsively I took about ten more, added some sleeping pills, and curled up in the loft of my shed to wait for death. As I lay there, I realized I didn’t want to die. I wobbled back down the ladder, called my sister, and passed out.

I came to while lying on a stretcher in the emergency room. A big, gloomy state trooper entered holding the pill bottle he had found at my house. It still had the patient’s name on it. He asked me where I’d gotten it, and, too loopy to lie, I answered truthfully. He notified the VA hospital, and I eventually lost my nursing license.

To my amazement, after my life had been blown to smithereens, I was able to get sober. Not right away, of course. I had to learn patience first. Looking back, I don’t know how I got through the anxiety and shame of early recovery. Sometimes the pain was so great it felt physical, and I sat twisting and moaning as if cloven feet were stamping through the chambers of my heart. But as the tiny pieces of my detonated life slowly drifted back to earth, I began working as a home-health aide, helping the elderly and caring for kids on occasion. A peaceful, sane existence began to take shape. The only problem was, I could no longer write. Somehow in sobriety I just didn’t have the juice to pump out pages and judge them as good or bad. Forced to acknowledge that I was a failure as a writer, I learned to live with my dashed dreams. That’s when it occurred to me that I didn’t have to write to prove to the world that I was a worthwhile human being or that all my pain and turmoil had a purpose. I wasn’t special — or, no more so than anyone else. It was time, finally, to grow up.

I sometimes think that M. and I have been brought together for a reason. If I can forgive her delusions, then perhaps I can forgive myself for the many years I spent harboring dreams of literary renown. Some days I fall short of forgiveness. I want to shake M. and tell her to get real, to stop seeing herself as a Writer, as if that were the only thing that could save her. Other days I respect her for continuing to put pen to paper at eighty-nine despite everything. Maybe the world needs us unsuccessful artists to form the compost upon which others sprout and grow to greatness. Or maybe the act of writing itself shifts humanity infinitesimally toward a higher consciousness. It’s like prayer: useful in the moments when we face uncertainty and our own mortality.

 

When M. is done with her bath, I haul her out of the tepid water, dry her carefully, and squat to put her tight stockings back on. She places her hand on my head to steady herself and asks, “Have you heard of phrenology?” She is always trying to have intellectual conversations with me, as if to let me know that her mind is still active and her interests wide ranging.

“Yes,” I answer. “It’s the ‘science’ of judging someone’s personality by the protuberances on their skull.”

“Your bumps say you should try writing again,” she says.

I laugh.

When I’m ready to leave, M. is propped in bed with a pad of paper. She says she’s going to write about driving to Montreal in winter and sleeping in the car with six other people, their breath coating the inside of the windows with a thick rime, so that it was like being in an igloo.

“That’s a good idea,” I say. I am feeling impatient with her again, but I could never tell her so. That would be mean.

And as I drive home, past the peeling houses and dirty snowbanks and chained-up dogs and blue hills, I try to think of a way to put this grim, bittersweet landscape into words, to fix in time this mixed ache of being human.