Joyce, born just after my father, always reminded me of him when we talked. We’d been close, but since Dad’s passing, I’d consciously stepped back. I make myself available for Aunt Joyce, but as a second or last resort. Shortly after my father’s death, I realized I needed a break from being the ‘primary’—the first call, the one who arranges and manages. That role takes a toll. After wrapping up his funeral, moving to a smaller home, and finding myself parentless—a single man nearing retirement, wanting to stay connected to my four children—I had reached my limit. Caring for Aunt Joyce felt like a continuation of caring for my dad, especially when I’d drive her home after family events. But he was gone, and I needed rest. Just as he had.

The younger of the two visiting sisters lives in a row home just off Greenmount Avenue, near my favorite farmers market and two ‘red’ bookstores. She has ‘a guy’ who makes a fix or improvement every few months, so after fifty years, the house is undoubtedly ‘different.’ But aside from the paint and the artificial turf on the porch, it’s essentially the same. My other aunt, my father’s oldest surviving sister, lives differently. Both were retired civil servants with pensions that afforded options for their final years, at least in Baltimore’s slow-moving real estate market. She chose a modern, exciting part of the city near the harbor. With views of the water, the science center, and the Inner Harbor, her place stood in stark contrast to the row home or my own. Built when the Inner Harbor was new, her building was over thirty years old—yet still young compared to our century-old neighborhoods. It lived in my old memories of Baltimore, not from my boyhood, but from a family trip to the Harbor after my graduation from Annapolis—the final days of my youth.

Today was one of those rare days where plans made months earlier unfolded with seamless precision. After my waking routine, I texted the older aunt that I’d leave at 8 a.m. sharp for the 8:30 pickup. And so it went: I left home, put a $20 bill in the tank of my small Veloster, picked up both aunts, and drove to Frederick without a single delay. Aunt Brenda’s inner door was open, signaling she was ready. One knock, and her short frame blocked the view of her pristine, plastic-covered white furniture. We carefully navigated the steep front steps and sidewalk to the car. Aunt Vivian was similarly ready. I didn’t even have to cross the large harbor promenade to her building. As soon as we pulled into the loading zone on Light Street, her elegant, winter-ready dark wool coat moved smoothly toward us. I grabbed her bag, helped her in, and stowed it behind my seat before following signs past the Science Center to I-95.

How strange, in modern times, for human families to coordinate with such grace and clockwork precision. And yet, a big part of my genes—my ‘autism,’ as I call it—must reside in them, too. So perhaps not so strange. The smooth ‘rush hour’ traffic along routes 395, 695, and Interstates 95 and 70 was unusual, but my dad’s siblings were almost always punctual. I say ‘almost,’ considering their health issues over the past decade, as the original eleven dwindled to three and transports increasingly involved wheelchairs. But I’ve never arrived to find anything but a folded chair and a willing occupant, ready to go. Delays, if any, came from my own early clumsiness shifting bodies between chair and car. Now I know to offer two firm hands, to plant my feet, to anticipate the angles and flows between curb and seat. In recent years, they move quickly and easily into my small Burning Man van or car.

One might ascribe my dad’s precision to his Army training, as with two of his siblings. But the truth was simpler: working parents with eleven children, later adopting two more, trained the horde into chaos-free order within their three-story rowhome. Like a premium batch of advanced robots, each member of this family of Negroes largely self-navigated through final finishing, mastering the precision workflows needed for meal and bath ‘evolutions.’ All were nourished, presentable, and able to reach schools and jobs via the low-cost transport of 1940s–60s Baltimore, which demanded military timing. They could have been retasked as an Army special operations squad and probably gotten more sleep and bigger food portions. My grandparents weren’t so different from Asimov’s vision of robot-driven production: a new child every eighteen months. The others would make space and train the newcomer’s positronic brain in basic autonomy, conflict resolution, grooming, and phrasing, preparing each for a service role. Between home and courses in welding, history, home economics, math, mortuary science, or teacher training, they rotated in and out of the small home using Baltimore’s busses and streetcars. The oldest, who chose ‘teacher,’ took the rail to New York University for a master’s degree.

The frictionless journey to the senior home took precisely one hundred minutes. Per our agreement, I left home at 8:00 a.m. to fuel up and check the car. Gas was cheap; seven gallons cost just a single $20 bill. That fuel would cover the aunts’ reunion and last until… when? I have fewer and fewer reasons to drive these days. Unless I start dating again. As the pump clicked, I considered it. I don’t lack people to call, but I haven’t felt the need. My social neighborhood and weekly dinner with a friend seems enough. I’m also cautious because of my ‘retiring poor’ experiment. I spend too much when I date. Sure, I spend when traveling about the world, but those are one-off expenses I can halt anytime. A relationship changes everything. For now, I like living where everything is walkable and cheap. My cars are just machines I need to start and move from time to time.

For her ‘recovery,’ Aunt Joyce had been placed in a nice facility. The building was new, the staff mostly new. I noticed a spring in the nurses’ steps—one almost jogged between rooms. ‘Do they work out together?’ I wondered. Two clearly had the build of regular exercisers. Having been in homes where workers often seemed tired, overworked, and as poorly nourished as the patients, this stood out. New building, new people, new equipment, large windows, high ceilings, abundant light. Very different from Aunt Joyce’s small brick home. I’m sure she would have preferred home, but as far as Medicare-funded extended-stay facilities go, this was a good one.

I’d visited such places for other aunts and daily during my dad’s final month. This was the kind of facility I knew Medicare could sustain for two, maybe three months. This was nearing the end of Aunt Joyce’s third month, and the other aunts had mentioned an upcoming care-team meeting. I suspected it would involve ‘the talk’ about money and next steps. In a place like this, next steps usually mean going home with ‘home care’ or staying if the family can cover the Medicare gap—about three thousand a month. I know because I’ve been there before.

As we approached the complex, I learned the sisters hadn’t called ahead. A surprise, given how long ago we’d planned the trip. Vivian, the oldest, had called during the holidays several weeks prior. She wanted to visit and neither she nor Brenda could drive. I’d been the backup for such family transport before, so we worked around my planned two-week trips in December and January. The aunts weren’t in a hurry, so we settled on a mid-week visit right after my January return. In the final minutes of the drive, the aunts began talking between themselves, expressing surprise about their sister’s condition—much as they had about my father’s after he died. “I didn’t know Joyce couldn’t walk,” the oldest said. Joyce’s ability to walk had been on the decline for years, I thought. Listening, I asked if they’d sent an update about our arrival time. The eldest then let me know her sister didn’t know we were coming. My “oh my” must have carried a texture of concern. She promptly called her sister, saying she and Brenda were coming. To the question, “Who’s driving?” the answer was, “It’s a surprise.” Being one of the few who Aunt Joyce knew would make the drive and one of her favorites, I assumed she could guess it was me.

I thought about both sisters being surprised about Joyce’s inability to walk and then considered they were normal, like so much family in America. Siblings who stop seeing, stop being with the person as they age, fall apart, become broken, and then die. I’ve seen so many ‘surprise’ deaths that, in retrospect, should have been obvious.

I think I understand the reluctance to call, to say they were coming. We delay things, become embarrassed by the delay, and then delay further to avoid the embarrassment. They hadn’t called ahead because doing so would mean acknowledging the many months they hadn’t come. It’s an ego thing.

We put on our best faces at family gatherings; we meet in nice clothes. One recently deceased cousin was a specimen of peak health and vitality at such events. Yet, after he died and we visited his home, it was clear he’d been anything but … for how many years? We often don’t see people as they are. We carry an image in our heads that moves forward in time. When we ‘see’ family, it’s often that internal image we perceive. Then, when the actual person says or does something out of sync, we get upset. Stress arises from both sides. The visitor, clinging to an internal hallucination, struggles to reconcile it with the brief glimpse of reality seated in the chair. The dissonance causes strife. The visited, dressed up for the occasion, also harbors a hallucination—a version of themselves from a better time, or a time that never existed. Their stories recount the exploits of this ghost. They, too, feel strife, aware in the back of their minds of the falseness of their performance. This is what makes family gatherings so difficult. Unreal expectations meet unreal presentations.

That’s why, when I’m invited to other families’ events, I often make sure to catch up with the ‘runt’—the one both uncomfortable at the gathering, yet comfortable in their station, less concerned with changing perceptions that cement status. Those of us accepting of being seen as we are, rather than as we wish to be, tend to offer the best conversations.

My aunts hadn’t visited as often as they felt they should, hadn’t kept up with their sister’s health. Yet each was health-oriented; I reserved the first five to fifteen minutes of any conversation with them for simply listening to their comprehensive health update. I’ve learned not to mention that I remember 90% of the status … the update must be given. Still, they had not kept up with the health status of their sister. They were comfortable sharing their own status but uncomfortable processing the decline of family. As a result, with the care facility now visible, they were only now calling ahead.

The call was made, and it was a pleasant visit. Surprised, Aunt Joyce needed time to get ready. She’d been in therapy when we called fifteen minutes out. I unloaded the aunts, grabbed an egg sandwich at the corner Roy Rogers, parked, and met them after sign-in. Aunt Joyce needed to make herself and her large room presentable. I knew this instinctively—it’s what she always did before a visit at her home. That to get ready, she needed assistence from her family, given her nurse was now displaced … the sisters seemed oblivious. I knew this lack of understanding would surface soon, and I’d need to leave the room so they could help her bathe, dress, and tidy up without a man around. So I began organizing the room, placed a few things in the bin, helped adjust the blanket bed, and said, “I’ll step out,” signaling non-verbally to the others: “… so you can help your sister.”

I spent about forty minutes outside. The first ten, I sat with my phone, researching whether I needed to make any retirement fund transactions. I was, perhaps stupidly, invested in ways to not benefit certain people and forces. As those same billionaire people are now allowed to manipulate markets, I sometimes have to move money around to avoid being crushed. So, glasses on, I read. The next thirty, I paced slowly around the large common area, reading video titles on shelves, peering through a locked door into the sunny cold courtyard. For all but a minute, I was the only visitor. Everyone else was staff scurrying about or patients in rooms with TVs. On a Wednesday morning, visitors were few. I paced to keep my blood flowing. Every once in a while I would hear, “What’s your pain level today…” as the nurse made her rounds. As I walked, I was aware the norm is to sit in such ‘sit’uations. And so I paced slowly, pausing occasionally to read titles in the video library or peruse the sole magazine available: dozens of issues of Buddhism Today—each an advertisement for a specific Buddhist-flavored religious organization. I’d read a cover, a page inside, and upon encountering something that felt misplaced given the magazine’s title, I’d put it down.

Actually, it was the same phrase that consistently made me close a magazine: “You are perfect as you are.” The entire point of each publication seemed to be informing readers of gatherings where one could travel, chant, make a payment, and make a difference in their lives as people already ‘perfect as you are.’ I would scroll several pages hoping to see words indicating the Buddha taught we suffer because we are not perfect as we are, and that he offered a path to control grasping, contain ego, and walk a more ‘right’ way. Such words were nowhere to be seen. After each slow lap, I’d pause, pick up another volume. Buddhism Today was the only reading material on every table. Fifteen laps, thirty minutes, fifteen different volumes. Not one mentioned anything related to the Buddhism I knew.

But I knew this: I was familiar with this commercialized approach. It was what first drew me to the path as a young person, through chanting with my cousins. It served a purpose then. Today, it served a purpose again, because after the fifteenth lap and the thirtieth minute, the door to my aunt’s room was ajar—the signal to return.

Soon after I entered—the room now sparkling, Aunt Joyce dressed—I received two sets of signals. The visiting aunts were ready to go; the visited aunt was ready to be visited. I responded to both, assuring the eldest, who hinted they might have taken too much of my time, that I was fine and ready whenever they were—knowing they didn’t want to admit they were ready. Aunt Joyce, fresh and dressed, wanted out of her room. She wanted to be alive for a moment with family, not just a patient. I began the routine of getting her into her wheelchair and could tell she hadn’t had many guests. Those with regular visitors know how to operate their beds. Modern beds in American facilities like this are complex, one-ton industrial lifts. Aunt Joyce hadn’t used the lift adjustment to prepare for the transfer, so I suggested steps as she pressed buttons on the remote. The key was to raise and flatten the lower section to create a stable, level launch point for the stand-and-swivel to the chair. We took a few minutes, with her operating the controls. She wanted to be in control, and she still trusted her brain to learn. In my dad’s later months, he’d stopped fighting his inability to learn and remember, graciously letting go at the right moment so I could handle the positioning. Here, I braced my feet, offering a steady hand just in case, but she managed it after only a minor adjustment.

The visit in the common area was nice. Rather than dwell on ailments, Aunt Joyce caught up briefly with her sisters, then turned to me for updates on my children. I could see behind the pleasantries she needed to handle some bookkeeping, so after a quick update, I steered the conversation back in that direction. Her sisters were browsing magazines and video shelves—something I knew could occupy one of them for a while—so I helped Aunt Joyce back to her room to find a contract she’d received a call about. We read it, located the missing information she needed, and she wrote a check. Like my father, it was a medical loan—five figures to pay off a service, likely a past hospital visit. For my dad, his big one was $20k for permanent teeth he was convinced to buy to avoid dentures. He still needed dentures.

Forty minutes later, I had a bundle of addressed envelopes in my back pocket, and we returned to the common area. It was now past noon. The sisters were ready. I finished updating Aunt Joyce on my four kids and my brothers’ families as best I could. In truth, her memory was sharp. She knew the situations of my brothers’ twins and their families as well as I did. I only knew slightly more about the timing of their second children… but only slightly.

Ten minutes later, we said our goodbyes. I retrieved the car, and we drove back to Baltimore just as uneventfully. The trip had been perfect in many respects. The sisters needed to become again the caring, attentive siblings they wanted to be—the ones they hadn’t been while living and surviving as elderly, ailing women themselves. The next visit, two days later, would involve decisions easier made when family felt like family.

I like catching up with Aunt Joyce. We always get along. Our many months apart let me recharge my capacity for elder family care. I had the skills and knowledge to make a simple, fun family visit feel smooth and effortless—like a normal get-together, not a propping up for ‘one last time.’ That’s when I usually see family at such homes in America. We don’t visit in general, just as we don’t care for our elderly at home in general. But when goaded by, “It may be your last time to see her alive,” we can get off the sofa, into a car, and attend—impatiently trying not to look at our phones the whole time. It’s then, and on holidays, that I see visiting family… and when it’s time to talk payments.

I found myself home around 4:00 p.m., realizing I hadn’t checked off most of my daily boxes. Had I done my morning exercise? Outdoor activity? Prepared my meals? Gotten out for socializing? Other than the last, the answer was no. My watch barely registered the pacing as activity. I had socialized, but now a full evening lay ahead. Where to start? A walk to Mom’s grocery? I felt spent. I considered a nap, but instead pressed the ON button on my espresso machine, just as I had at 6:30 a.m.

Let’s begin this day again.

Tags: aging, health, healthcare