Ya’ know that old trees just grow stronger,
And old rivers grow wilder ev’ry day.
Old people just grow lonesome
Waiting for someone to say, “Hello in there, hello. (from “Hello in There” by John Prine)
Aging is a mystery to be prayerfully pondered and carefully approached, not a puzzle to be solved. In Entering the Blue Stone, Molly Best Tinsley describes in sometimes agonizing detail what happens as her parents age and become increasingly dependent on others for the basics of living.
Molly’s father, Bill Best, was a retired Brigadier General from the Air Force. He was the former mayor of Lebanon, Illinois. He was a man used to caring for himself and being in charge of others. Molly illustrates this well early in the book as she describes his driving philosophy –
Dad pulled into traffic with something to prove… The world would have to rearrange itself if he wanted to change lanes.
Molly’s mother, Evelyn, once an aspiring author full of captivating dreams, had succumbed to debilitating depression from which no treatment seemed to relieve. Molly’s Dad reveals to her the extent of the problem –
“You know, Mommy sleeps a lot.”I said maybe she needed to.“She slept thirty-seven hours last week.”I pointed out that was less than six hours a night.“In a row.”
More than just getting older, diagnostically, Bill struggles with Parkinson’s disease. Evelyn display Alzheimer’s-like symptoms. It soon becomes clear that they need more on-going care and must move out of their home. Molly and her siblings find a modern assisted living facility that seems to offer the latest and best approach.
Tinsley depicts the heart-wrenching process of sorting through the household items, deciding what to keep and what to do away with, attempting to fashion her parents’ new confined living space in a functional, yet meaningful way. Her father, an avid amateur photographer, had documented the family well. Tinsley writes –
We had to throw most of the pictures away, the loose ones stuffed into boxes, the albums whose pages crumbled to the touch. What else could we do? Time was running out.
What else could they do? This theme of limited options and having to make quick decisions based on the best information available at the time carries over to Molly’s parents care as they lose more functioning and need greater assistance. At first, they move to an mostly independent apartment with available services. For a while, they Bill particularly took advantage of various therapies and activites.
But before long, Evelyn’s condition grows worse and they must move to assisted living, then to the nursing home section. Tinsley describes with poignant detail how decisions framed as for optimum care were often influenced by bureaucratic concerns. Often, the administration reminds them they could go elsewhere, but where else could they go?
While both Molly’s parents decline, Bill is the first to slide. Clearly, the rapid rate he loses his independence causes his condition to worsen. Tinsley is critical of quick decisions to prescribe potent psychotropics (like Haldol) to “manage” what could well have been simple frustration over his loss of freedom. In spite of family protests, the prescribing doctor insisted he be in charge of medical decisions and only informed them after a shot was administered.
Soon, according to staff, Bill was having “episodes” that required further restrictions in a newly opening wing, isolated and locked down. Aggressive medication and treatment measures were attempted, which only made matters worse. Bill resisted, but his body could no longer control his destiny. Tinsley describes it in hauntingly beautiful detail –
Think of it as assisted suicide, we told each other, squinting against that whirling wind. Our father had stumbled into the sort of no-win situation he’d always warned us to avoid. The nutritionist who kept sending down the trays of inedible foods. The nurse with the Haldol, the staff doctor and his Fellow from Duke with the bright idea – all became the witless accomplices in his decision to end a life whose quality had sunk below zero. We waited for the moment that would set him free.
As the moment of death approaches, the family shares some intimate moments that bring some measure of peace. By this time, Evelyn is not with it enough to be fully cognizant of the situation, though she does appear and offers support.
In contrast to Bill’s resistance to losing his independence, Evelyn at first embracing the limits imposed on her and even tries to quiet the children’s complaints about her treatment. Tinsley conveys her mother’s chaotically poetic expressions wonderfully –
“Yesterday we glued little pictures on and sprayed them. Later we’re going to eat them.”“Pictures of what?” I asked.“A chemist, a baby, and a rubber hose. This is a hopping town,” she added, by way of summary. “One of those places with peanut shells.”
But Evelyn’s pleasant confusion was not enough to shield her from the changes happening within (medically) or around (administratively) her. As with Bill, aggressive measures are taken without family consent. Her decline was not as drastic as Bill’s, and was abbreviated by pleasant moments along the way, yet the trajectory had been set. It was just a matter of time.
Death lingered for Evelyn as the family gathered around her for encouragement and to bless her on her way. They are forced to face difficult end-0f-life decisions (should she have a feeding tube?) with little clear guidance. Patients and staff attend to her physical, emotional, and spiritual needs as she approaches death. After almost of week of dying, she breathes her last.
In my interview with Tinsley about Entering the Blue Stone, she writes –
A lot of crazy things happened to my siblings and me as we tried to shepherd our parents through a three-stage continuing care facility in their final years. Some were the product of a seriously flawed system in the facility itself; some stemmed from our ignorance of the end-of-life process; and some were actually natural parts of that process—things it would be futile to try to resist or change. I’m hoping that readers facing this process (as we all are) will take my story seriously and thus become better able to differentiate the craziness!
I believe she meets her objectives well. Entering the Blue Stone is a book that will help people who have faced, are facing, or will face aging and end-of-life issues by giving them a realistic and hopeful perspective.
More than this, as a piece of literature, Entering the Blue Stone is about as good as a memoir can get. I would rate it 4 out of 5, only because I like to keep 5s reserved for books as good as Kay Redfield Jamison’s An Unquiet Mind (which is, in my mind, unmatched). One thing I particularly appreciate about Tinsley’s work is that her language is clear, concrete, and clean. She knows how to tell an evocative story without compromising it with crude cliches. While she admitted this book was personally cathartic, she doesn’t inflict on the reader the role of her therapist. She describes her dilemma and lets the reader wrestle the mystery of the suffering in the story.
Entering the Blue Stone doesn’t try to solve the puzzle of aging with formulas that won’t work, and will likely make things worse. Instead, it is a faithful steward of the mystery of death and dying that leads us to appreciate the precious lives we are given.