He arrives to your floor, stooped and hunched even while sitting, paper-thin skin pale in the sunlight attempting to sneak through the small hospital room windows. You worry at first that he won't be able to make it from the ER stretcher to the bed without help, but he pulls out a cherry-stained cane from beside him on the gurney, swings his legs over the side, and takes small but sure steps to the side, where he perches carefully at the edge and looks up at you, eyes bright and blue despite the 92 years his chart claims he has.
He laughs through most of your questions as you get him settled, putting a new hospital gown on, getting vital signs, making sure his request for a Do Not Resuscitate is accurate. He didn't really fall at home, of course, he just woke up and found himself sleeping on the carpet rather suddenly, because didn't it seem like the place to be in the afternoon for a nap? His wife sits in the chair across from the bed, her own cane matching his held across her lap, shaking her head at his answers, a small smile at the corner of her eyes nearly obscured behind thick glasses.
You've already called the representative for his internal defibrillator to come in and assess the small device implanted in his chest, and she walks apologetically in to hook him up while he continues to elaborate on his story about the entire event being planned, of course, to get him and his wife out of the house to socialize for their 62nd anniversary; it's quite the anniversary, he says, and that calls for some adventure.
The representative (you think her name is Jessica) prints off history from the pacemaker and pulls up the current settings. She confirms that yes, it looks like he had a shockable bad rhythm about the time he decided to take his sudden nap, but it had been set to wait to shock a little longer than it should have. She adjusts the time, then frowning, asks him if he's feeling okay. Still smiling, he tells her that her lovely personality is making him lightheaded, that's all, but what else could we expect from a sappy old soul like him? She lightly smiles, but tells him that he might want to brace himself, because he's going to end up getting a shock for the same rhythm.
The jolt takes everyone by surprise, and the smile fades from his face quickly as his entire body stiffens and jerks once with the charge from the pacer. His normal rhythm quickly returns, though when he shakes his head as if to clear it, some of the sparkle is gone from his eyes. You see him gaze behind you, and turn to see his wife attempting to hide tears quietly sneaking down the sides of her face, leaving small traces in her foundation. She shakes her head and quickly tells him off for always making her cry with worry, that in 62 years he can't go a day without doing something to scare the living daylights out of her; he grins like a schoolboy, looking ridiculously pleased with himself.
* * *
Hours later, after you've started an IV with medication to prevent further dysrhythmias and shocks from his pacer, the doctor makes rounds, discussing goals with the patient and his wife. No, he is pretty clear, he doesn't want major interventions. 92 years is a long time to have been causing the kind of trouble he has; he's met all 26 of his grandkids and can name each of them; he still has every single model of every train engine that he operated when the train station in town was booming and he first met his wife, and didn't all those models need to go somewhere good soon, anyway?
He sits quietly as he decides firmly to go home once the medication works. His eyes are still bright, though perhaps not quite as bright as that afternoon when he first arrived, hands folded in his lap with the fading sunlight illuminating the myriad of blue veins on his arthritic knuckles. His wife still sits across the room, wiping small tears and shaking her head, though perhaps more in accepting sadness now rather than simple amusement.
After the doctor leaves, you sit and listen to him tell you about the town 60 years before when he met his wife. Wasn't she pretty, working at the switchboard overnight when he drove the trains in? She always wore such lovely dresses, but she'd take her shoes off when he walked her home, and be barefoot in the grass in the summertime. That was when he fell in love, he said, seeing her under the moonlight with bare feet, when the entire rest of the world was sleeping and couldn't interrupt.
He asked her to marry him at 3am one morning when they both were off work, after he'd known her a bare six weeks, because the moon, he said, never lied. And wasn't he right of course, because 62 years later, she still walks barefoot outside under the moon with him and listens for the trains.
* * *
You send him home the next day, new medication in hand, after shaking your hand as he takes his cane and walks himself downstairs, refusing the wheelchair because that's only for really old people, after all.
Don't ever let your hands get too hard, he says, grinning once again like a schoolboy, because the world needs more nurses with soft hands to deal with the hard heads of the world like him. You watch as he shuffles out with his wife, still shaking her head behind his hunched back as they disappear around the corner.