On Living by Kerry Egan, “Living in the Gray,” Chapter 6

I wanted to include this chapter from the book On Living by Kerry Egan because it is so good at reminding us, with stories, that nothing is black and white—we live in the gray. What we see is never the whole story.

Transcript

Living in the gray. I set a trap, Frank said, when a commercial came on during The Price is Right. The Price is Right was Frank's favorite show. And after I said some prayers with his wife, Alice, we always watched together for a while and talked. What do you mean? I asked. To figure out who was stealing the medicine, I set a trap, and I figured out who it is.

For the past two months, the hospice team had been up in arms about missing painkillers. At first, the pill count of OxyContin was coming up short at every nurse's visit. Peggy, the nurse case manager, and Christy, the hospice team manager, were the Wondered if Frank was having trouble remembering or seeing how many pills he had already crushed into Alice's pudding when he was preparing her lunch.

She'd been bedridden for the past ten years with a painful neurodegenerative disease, and now Frank himself was quite elderly. Peggy had switched Alice over to liquid morphine, hoping it would be easier for Frank to administer. But then the morphine, too, started coming up short. Peggy thought Frank might be spilling the medicine or pouring out the wrong amount.

She decided to pre fill syringes for him so that there was no chance of his measuring out the wrong dosage or of his arthritic hands tipping the small bottle. He could just squirt the right amount into Alice's mouth. But the next week, some of the filled syringes were missing. In hospice, this is a big deal.

Medicines like morphine are a key piece in battling shattering pain and allowing patients and families to enjoy their time together. They can seem like miracles for people with excruciating and chronic pain, but these are also narcotics, Schedule II drugs that are highly regulated because they are abused by addicts.

Now it was no longer a question of whether Frank was mishandling the drug, someone was stealing it. Suspicion fell on everyone who could possibly have access to the kitchen refrigerator where it was stored, meaning everyone who came into the apartment. The hospice workers, the private aides the family hired, Frank and Alice's children and their spouses, and the grandchildren.

This idea, that the culprit could have been a family member, was just about too much for Frank to bear. So he set out to discover for himself who was stealing the morphine, with an elaborate plan involving locks and timers. He was so happy when he told me that he had figured out who it was. It was Jessica, one of the private aides.

You're sure of it? I asked. Yes! I just told you how I know for certain. Have you told Peggy yet? Why would I tell Peggy? He said, I'm not telling anyone. I just wanted to make sure it wasn't someone in my own family. Frank, I need to tell my boss. What do you mean? You can't tell her. You promised me. I made you promise.

Dread washed over me because this was true. I had made a promise. As soon as I walked in, Frank had asked me if I could keep a secret. Of course I'd answered. You promise? He'd asked. Yes, I'd said. I promise. It was a stupid answer, if I'm being honest. An imprecise answer, if I'm trying to make myself feel better about it.

Because while I certainly can keep many secrets, there are some things that, as a chaplain and a hospice team member, I have to report. Elder abuse is one of them, and someone stealing desperately needed and federally controlled pain medication from a sick and dying woman who needs it to make her life bearable counted as abuse.

Also, it was illegal. Also, it put our work as a hospice at great risk. Also, making unprescribed morphine available to addicts puts them in danger. I had to tell for so many reasons, except for the fact that I had promised not to. You're a chaplain. That's like a priest. If I tell you something in confession, you can't tell anyone.

But I'm not a priest, Frank, and it wasn't confession. I told you things I never told nobody. I'd never share those things. But this is different. She's stealing from your wife, Frank. She's hurting your wife. Your wife whom you love so much. No, she isn't. Peggy will just give me more morphine. If you tell, she'll go to jail.

Her kids will have no mother. Isn't that right? I don't know what will happen to her, I admitted. I never would have told you if I'd known you didn't care about other people. Frank, I do care. He stared straight ahead, past the tiny television in the corner of the room, and out the small, high set windows that let just a faint stream of light into the damp apartment.

Alice's hospital bed took up most of the living room. We sat in two armchairs next to each other, facing her bed. Finally, he turned to face me again. You want to tell a story? You know what story you can tell them? You tell them this story. Everyone needs to know this story, because this story is the real truth.

There was once a kid I knew in our neighborhood growing up, eight years old. He saw his father beaten to death by four cops right in front of him. When they were done, he ran over to his father and saw his brain spilling out of his head onto the street. Nothing ever happened to those cops, not a thing.

After that, his mother had to support his little brothers and sisters. She took in sewing and laundry and broke her back, but there was never enough to eat. He got so angry, he grew up into the angriest kid you ever met in your life. Then one day when he was 14 years old, he saw one of the cops who'd killed his father in front of his eyes.

And he killed him. With a knife. He stabbed him until he killed him. If you were to hear about some teenager who killed a cop, you would think he was a horrible person. You would say, throw him in jail forever. But that's because you didn't know the whole story. You didn't know what had happened to him. You didn't know what he saw.

You didn't know. And you don't know what you don't know. Instead, you just judge. That guy grew up to be a good man who took care of his family. He started on the scallop boats and broke his back and worked his way up to first mate. He wasn't a bad person. You see what I'm saying now? It wasn't so black and white as it might seem to somebody from the outside.

It was gray. It's the same with Jessica. I know her. She knows my wife. Jessica is Alice's favorite. She's gentle and patient with her. She's never rough. She's got little kids and nobody to help her. Nobody. Do you know how much money she gets paid by that agency? Eight dollars an hour to raise those kids by herself.

If she's selling that medicine so she can buy shoes for her kids, I'm okay with that. I can get more medicine for Alice. I know what it's like to be a kid with no shoes and then you can't go to school. That's why I'm not reporting her and that's why you can't report her. He paused for a few seconds to catch his breath.

He was crying. The world is not black and white. There is no black and white. There's only gray. You have to live in the gray where you got no kindness in your heart. You gotta see the gray. You tell them that. You tell everyone that. I walked out to my car and sat in the driver's seat for a very long time.

I knew the aide too, having met her a few times when our appointments overlapped. She always showed me and Frank pictures of her babies on her phone. Once she asked me to help her because she just didn't have enough strength in her arms after working double shifts seven days in a row to turn Alice with as much gentleness as she would like.

She asked me at Christmas time if I wanted to buy some food stamps at a discount so she could have money for toys to give her children who were still young enough to believe in Santa Claus. I stammered and blushed, confused at what she was offering. I declined, not because it was illegal, but because I didn't know how to use food stamps.

My life may have been hard when my children were babies, but hers was precarious and vulnerable in a way that mine never was. Finally, I called Grace a fellow chaplain. Perhaps the greatest benefit of being a hospice chaplain is that you get to work with other hospice chaplains. Grace was much older, much more experienced, much wiser, and in general just a much better chaplain than I was.

Grace was my chaplain, just as I was my patient's chaplain. I told her the whole situation and asked her what I should do. Christy needs to know this, she said in her quiet gravelly voice. I know, I know, I just feel horrible telling her because he asked me not to. But there are other things at play here, other things besides his wishes.

You need to act in the best interest of the patient. You need to follow the law. You need to think about our agency and the other patients who need us, who would be impacted if we were shut down. You need to think about the addicts who are being sold this medication. I know. I just can't get his voice and his face out of my head.

I can't get his story out of my mind. Grace cut me off. It's done. I already told her. Well, I never promised not to tell Christy and Peggy. You did, but I didn't. So I sent an email while we were talking. It's done. Before I could say anything, my phone beeped. Another call. From Christy, my boss. I have to go, I said to Grace.

Good luck. Christie was not happy. Were you really not going to tell me, Carrie? No, of course I was. I just needed to sort it out in my head. What was there to sort out? It's pretty clear cut, Care. There should have been nothing to sort out. It's black and white here. But to Frank, and to me, it wasn't. You have to live in the gray, or you got no kindness in your heart, Frank had said.

What did he mean by the gray? And what did that have to do with kindness? I can't answer for Frank, but I can say why his words made me sit in the car for an hour. When I was diagnosed with postpartum psychosis, I was put on a medication called Zyprexa. While it saved my life, it also made life difficult to live.

I was better off than when I was suffering from bouts of catatonia that left me unable to move for hours at a time. But now I slept 16 hours a day and gained 60 pounds in three months. I developed shooting pains up my legs and uncontrollable twitching in my feet. Walking felt like wading through waist high wet concrete.

My head felt like it was full of wet concrete too, and even the most basic thought emerged only after intense concentration and struggle. I lived my days through to do lists that reminded me to brush teeth, wash face. Get dressed. Change baby diaper. Any movement was exhausting, physically and mentally. So though I was better, going shopping with a nine month old baby by myself was still beyond my capabilities.

I needed new shoes that might help the pain in my feet, though. So my mother took me to Macy's, as if I were her little girl again. While I tried on ugly shoes, slowly, slowly, slowly trying to get my muscles to move the way I needed them to. and attempted to force my brain to focus enough to make a choice about which shoes to buy.

A task that seemed so difficult I didn't really understand how it could be done by anyone ever. My baby in his stroller grew frustrated. He began to squawk and twist around. While my mom went in search of a saleswoman to get a few different sizes for me to try, he began to cry. I sat there, one shoe on and one shoe off, confused, exhausted, and feeling utterly defeated by what my life had become, and what I had become.

and watched him cry while I waited for my mother to return and tell me what to do. A woman sitting not too far away began to comment on the situation to her friend, loudly enough that I could hear her. What kind of mother just sits there and lets her baby cry? She said. Have you ever seen anything like this?

I sat and listened to her go on about me and my child. A crying baby, she noted, ought to be more important than a new pair of shoes. But apparently some people were just that selfish. Or was it lazy? If she had a baby, she would never let him cry like that. Why did women like that get to have a baby? A baby of hers would never cry like that.

My mom returned with a bigger pair of shoes to fit my swollen feet. Just hurry up and try them on, she encouraged as she turned to calm my baby. But something in me snapped. That woman couldn't have known how sick I was, nor could she know how physically disabling the medication I was on was. She only judged by what she could see.

What she saw seemed black and white to her. She gave me no benefit of the doubt. Exercised no empathy to wonder what in the world was going on with me, my mother, and my son. I wanted her to understand that I was sick and that I was doing the best I could. I wanted her to stop shaming me. I wanted her to understand that I was already so ashamed of what had happened and what I had become that I could barely cope.

I wanted her to see that I was gray. I stood up, slowly, and walked over to her, one step in front of the other, as quickly as I could through the concrete. She and her friend looked at me with disgust. I didn't say any of the things I wanted to. I had no language for any of that then. Instead, I said, Babies cry sometimes.

That's what they do. If you can't stand the sound of a baby crying, then it's a good thing you don't have one. Let's hope you never have a baby. Let's hope some baby never has to suffer with you as his mother. She burst into tears. She sobbed so intensely that the boot she was trying on dropped from her hand so intensely that I wondered if she was faking it.

Eventually her friend pulled her up by the elbow, collected her shoes and purse, and said, Come on, let's go. It wasn't until years later that I stopped to wonder why the woman had reacted that way. It was only then that I thought about what might have happened to her. Had she been unable to have a child?

Or had she lost one to stillbirth or infant death? It was only then that I thought about the gray in her life I couldn't see. instead of the black and white I saw. It was only then that I realized that I'd had no kindness for her either. Things are never only as they appear. My hospice patients have taught me that.

There are always layers to people's lives, unseen memories under every face, every decision, every movement or lack of movement. There is always gray between the black and white. I knocked on the door the next week at our regular visit time. Frank pulled it open and stood on the other side of the screen silently.

Hello, Frank, I said. He stood and stared. He didn't look angry so much as he looked empty. We waited in silence for a full minute. Then he pushed the screen door and held it open to me. I stepped in and he turned around and walked away without speaking. I followed him into the living room and went over to Alice's bed.

She smiled and lifted her index finger, a signal that she wanted to hold my hand. As we always did, I recited the Hail Mary out loud ten times, an Our Father and a Glory Be, a decade of the Rosary, while she mouthed the words. She closed her eyes and released her soft grip on my hand. I turned to look at Frank.

He was sitting in his recliner watching us. He had his arms crossed on his chest and his chin low, and still he said nothing to me. Hi, Frank. May I sit down? No answer. I remain standing. You're angry at me. I'm sorry. Nothing. Frank. I hesitated. Should I go into a full explanation of what had happened? Try to justify my actions?

Argue that I hadn't technically told Christy? Explain that my obligation to my patient's safety and well being overrode his desire for secrecy? In essence ruin the relationship we had built? Instead, I just said, you know, I have to live in the gray too. He sucked his breath in and raised his head up and back.

Yes, he said slowly. Yes, I suppose you do. I waited another 10 seconds in silence. Then I picked up my bag to get ready to go. You can sit down, he said at last. That there is gray in our lives, and not just in our lives, but in the lives of every single person we meet, does not absolve us from having to act.

It cannot prevent life from moving on, for even not moving causes ripples in the world as others move around our stillness. Living in the gray doesn't absolve us from having to do hard things and make hard choices. If anything it makes those choices harder. But perhaps that's the point. It makes judgment of others harder and therefore shaming them harder too.

When we can't shame others it's harder to convince ourselves that they are nothing like us or that nothing could ever happen to make us like them. It means acknowledging that any of us could be both a loving mother and a drug dealer who steals from dying patients. Both of these things can be true. Any of us could be both a husband who took tender care of his family and a man who once killed someone.

Any of us could be a chaplain who spends her days trying to comfort the dying and a woman who once drove a stranger to tears in the shoe department at Macy's. Kindness is not the same as niceness or putting our heads in the sand or avoiding conflict. It is acknowledging that no life is as it seems on the surface.

It is understanding that we never know all the layers in a life and choosing to speak and act from that difficult gray place in all of us. Gray like an oxycontin tablet. Like the hull of a scallop boat. Like concrete.

Jeremiah.