Early one morning not long ago, Tatyana Sokolova scurried into room 1222. "Time to get up," she said, her voice rising and falling like a song. "Breakfast time," she sang to the man under the blanket, while at the foot of the bed an oxygen machine hummed and sighed.
Once, a long time ago, the old man read three encyclopedias from A to Z, and the living room in his house on Logan Avenue was filled with chain saws and bowling balls, M-1 rifles and hedge trimmers, all of them waiting to be thrown into the air. In those days, Bill Gnadt was the world's foremost juggler of heavy objects and power tools. One night in 1957 he was the opening act at the Showboat in Las Vegas, and at the point of his routine when he had two axes in the air, three bowls twirling on a stick in his mouth and three rings on his arm and leg, the room began to sway. It was an earthquake, but he didn't miss a beat. Those were the days when his hands didn't tremble.
By the time Sports Illustrated wrote about him in 1990 ("The Utah Chain Saw Juggler: If something can slice or dice or otherwise maim you, Bill Gnadt will juggle it"), he was past his prime but still able to juggle machetes and samurai swords. It was only a few years ago, nearing 80 and suffering from prostate cancer and dementia, that he came to live at Christus St. Joseph Villa.
He lives down a linoleum hallway, on the wing known as Two North, in a room with a bed and a chair. A small shelf holds an American flag and three photos: his brother's family, himself balancing a floor lamp on his forehead and a snapshot of a friend he can no longer identify.
In the country of old age, a man can move 12 blocks from the house he lived in his whole life and end up on a foreign shore, a refugee who has left his old life behind.
Bill turns over in bed and blinks. "Good morning, Bill," says Tatyana in her lilting voice, still a Russian voice after 15 years in America. She is a certified nursing assistant, and like other CNAs on the day shift in other nursing homes across America, she begins her morning helping old people get up and dressed. She gently combs their wispy hair and pulls on their briefs and their sweat pants.
In Russia, Tatyana was an opera singer with the Moscow Philharmonic Orchestra. But even by the time she immigrated to America she had already found something else that made her heart sing, a realization that came to her after visiting a friend from her church choir in Moscow. The friend had been hospitalized, and in Moscow if you wanted a friend or a family member to get adequate care you provided some of that help yourself. Tatyana soon found that she liked caring for people who were sick. When she moved to America, she became a CNA.
In the hierarchy of medical care, CNAs fall somewhere near the bottom, well below nurses and doctors and administrators. In the hierarchy of medical facilities, it is the hospitals, with their high-energy emergency rooms and life-or-death dramas, that inspire the TV shows. Nursing homes, with their chronically ill and wrinkled residents, aren't sexy enough for prime time. To be a CNA in a nursing home is to spend your days, like the residents who live there, in a place where most of the rest of us don't want to be, on the fringes of the American consciousness. Almost invisible.
Old age is a place we may all eventually immigrate to but that many of us prefer, in the meantime, to ignore.
At St. Joe's there are several dining rooms. Bill eats in an informal one called "Social Room," where on this particular morning he is sitting at a table with two uncommunicative women, including one who is both blind and deaf. In the feeder dining room, as it is also known, the diners are generally lost in thought, or simply lost.
No one is talking and the TV is on. It's the CBS "Early Show", which is airing a series called "Living Longer." Today's segment includes some upbeat, breathless advice for using blusher as an instant pick-me-up and wearing jeans that create a youthful silhouette. In the world outside this room, people are struggling to look younger than they really are.
The first day Tatyana tried to dress Bill almost three years ago, he told her, "I will never let a woman help me." But not long after that he got sick, and Tatyana was there to comfort him. "If you have ever been in the hospital and helpless and someone comes to help you, this is an angel," is the way she explains it. In Russia, where most of her seven children were born, new mothers had to lie in their hospital beds for a week, so she knows what it's like to rely on strangers.
In old age, if there is no family member able or willing to provide the sometimes difficult dailiness of care, an old man will rely on a stranger, too. "She's my best friend," says Bill about Tatyana. Bill never married and has no close relatives in Utah. His guardian is George Furgis, who has known Bill since George was a little boy. It was Bill who taught George how to lift weights. It was George who made sure that the CNAs and nurses at St. Joe's know that Bill had a past beyond these walls.
Still, no matter your past, life on Two North is mostly about the present, and there is an equality among those who end up there.
On her first day as a nursing home CNA, Tatyana was so disgusted by the diapers she couldn't eat her lunch. But you get used to that, she says. You no longer want to run from the room when it's time to clean up an old woman. This transformation happens, she says, "if your love is bigger than your disgust or fear." And then, she says, "instead of running away you go toward."
And, indeed, she seems to be always running. Up Two North to help a woman get to the toilet, careful to hold onto her so she won't fall as she inches across the floor, then down to the other end of the hall to bring someone else a glass of water. There are people to dress and wheel to the dining room, beds to make, food trays to deliver to those who eat in their rooms.
Like all good CNAs, she knows who likes what and when. She knows that Zelpha wants to wind her clock on Fridays, that Mary Ellen used to be an Army nurse. When the resident down the hall is at breakfast, Tatyana rushes into her room to make her bed, because that woman likes to talk and Tatyana thinks it would be impolite to turn her back on her, so talking would mean taking too long to make the bed. With 26 residents on the floor and only three CNAs, it's not possible to spend very long with any one of them.
To live and work in a nursing home means to spend your days on a few hallways. To have what looks, on the outside, like a small life.
You wouldn't know, without asking, what lives were left behind that Bill Gnadt was once asked to juggle on Johnny Carson's "Tonight Show" but turned it down. That Marica Ljubicic, now a CNA at St. Joe's, studied law in Bosnia. That Larissa Evets, who ladles out food for the residents of Two North, was a pediatrician and medical researcher in Belarus. After the nuclear accident in Chernobyl in 1986, she organized a group of scientists to study the effect of radiation on Chernobyl's children. Eventually her group studied 20,000 children, producing findings that upset the government. The scientists were called enemies of Belarus and were prohibited from publicizing their results. And so, on a trip to Utah to deliver a scientific paper, Larissa asked for asylum.
In Moscow, Tatyana sang on television and radio. But to work in a nursing home, she says, "I think it's much better than singing. Because you more serve God here." There is the miracle of birth, she says, but also the miracle of dying, "when the soul comes back to God."
CNAs don't get paid much. And Tatyana doesn't own a car. So last month she took a full-time job at St. Mark's Hospital, which is within walking distance of her home. Now she takes the vital signs of people who are healing from bone surgeries, which is OK work but not like taking care of old people, she says. She continues to also work two days a week at St. Joe's.
On a recent morning the sky a bright blue outside his closed blinds Tatyana stood in Bill's room, her back straight, her hands on her hips, just above the belt she sometimes uses to help lift an old man out of his chair. Her eyes were bright.