Mr. Halpern’s Puzzle

   “Mr. Halpern, let go of the table.” Nessa said, trying to pull him back in his wheelchair.

    “My puzzle.” Pieces began to slide off as the table tipped under his grip.

    “Mr. Halpern, it is time for your lunch.” As more pieces slid off, Nessa stopped pulling on the wheelchair to pick them up off the floor. As she put the pieces on the table again, Mr. Halpern turned the ones over that were showing their cardboard side so they all showed their picture sides again.

   Nessa returned to the back of his wheelchair. “It’s time for lunch. You have to have your lunch. You want to kept your strength up.” She checked his IV to see he was still getting a steady flow of painkiller. Mr. Halpern carefully snapped another puzzle piece into place. He almost had completed half of the top edge and part of the left edge going down.

   “Okay, put that down now.” Nessa said, reaching for his hands. He clamped them down to hold onto the puzzle table. “Mr. Halpern. Mr. Halpern.”

   He would not let go. Nessa left him and interrupted Jack in his office and demanded he come to the Common Room.

  Jack approached Mr. Halpern. “Hey, Mr. Halpern, it’s lunch time. Would you like something to eat? I think Its fish and chips today. You like fish and chips. I know you do.”

   Mr. Halpern had returned to doing the puzzle. Jack took a breath to think.

   “He has to have his lunch.” Nessa said.

   “Does he? We could take this that he is voluntarily declining to eat.”

   “He has Alzheimer’s. He can’t even remember to eat.”

   “Yes, and he has cancer. Maybe he doesn’t want to eat. Maybe he just wants his puzzle.”

    “We’re required to feed him.” Nessa pulled back on his wheelchair.

   “No!” Mr. Halpern slammed his hand s on the table. Pieces flew. Then he started slapping his hands on the puzzle. “No, no, no!”

   “Alright, alright.” Jack spoke calmly, picking up the puzzle pieces and handing them to Mr. Halpern. “We’re not going to take it away. See? Here they are. All your pieces. Do you know what it looks like when it done?”

   Mr. Halpern shook his head.

   “It’s a mountain. A beautiful sky. There’s a stream in front of it. It’s very beautiful.” Jack looked at Nessa. “Okay, why don’t we put his food on a cart and put it here by his side and then it’s up to him if he eats.”

    “No. You can’t have food in the Common Room. He needs to eat in the Dining Area.”

   “He can eat in his room.” Jack said.

   “Yes. He can eat in his room, but it is better for him if he eats in the Dining Room with the others, so he maintains social contact.”

   “Yea, he’s not doing that.”

   “Fine.” Nessa placed her hands on the wheelchair again. “Come on, Mr. Halpern, you have to go to your room so you can have your lunch.”

    Mr. Halpern grabbed the table. “No.” Nessa pulled the wheelchair resulting in the puzzle table shaking as Mr. Halpern held firm.

   “Would you stop?” Jack said to Nessa.

   “If he’s not going to eat then we have to do intravenous.”

   Jack brought in Chuck and Faheem from the third floor.

   Nessa took exception. “They’re supposed to be handling aggressive patients. If they’re here who is covering upstairs?”

   “Chuck, Faheem, if you can lift Mr. Halpern in his chair, I’ll carry the table and we’ll all move together. We’re going to room two fourteen. Okay, one, two – “

   They lifted together and despite the shakiness Mr. Halpern took no notice beyond pulling a few pieces from the edges of the table towards the middle before they slid off. They passed the Dining Area and no one took notice.

   Nessa followed, looking wildly about for support in recognizing what an outrageous act was being carried out in front of her.  

   “If you could get his food, please.” Jack called back to Nessa.

   Inside Mr. Halpern’s room they set him as he was with the puzzle in the Common Room. Nessa joined them, making a show of her efficiency in meal providing.

   Chuck and Faheem left.

   “Are you diagnosing Mr. Halpern as an aggressive patient now? Because then he should be transferred upstairs.”

   “He’s not aggressive.”

   “Well, then, I don’t know why you’re calling staff from the third floor. That’s an improper assignment of duty.”

   “Okay, Nessa, I’ve never seen that on the management web site, or your union site.”

   “He’s not eating. I believe he should be on intravenous. I want it on record.”

   “I have other responsibilities today, so, I’m going to go back to my office, and I’ll make a record, and if you could come to my office at four o’clock we’ll review this.”

   “I want to discuss it now.”

   “Yes, I’ll make a record of that too, but I won’t be available until four o’clock. And I want you to leave Mr. Halpern. I’ll have Sara look in on him. Thank you.”

   At four Nessa made a show of knocking on the doorframe to Jack’s office, though the door was fully open.

   “Please.” He indicated a chair in front of his desk and took up one beside it. “So, this is because Mr. Halpern wouldn’t let go of his puzzle?”

   “I am this close to filing a grievance.”

   “No, Nessa, a grievance is for unfair working conditions. I wasn’t telling you what to do, you were telling me what to do. You’re thinking of an employee complaint where you feel you are harassed or undervalued. Anyway, I leave that up to you.

   “Now, I know that nobody cares more about patients here than you do. And I know this because nobody knows better the procedures and rules and regulations of this facility than yourself. The only reason you don’t have my job is because you can’t let go of things, can you?

   “Now, Mr. Halpern. When Mr. Halpern came to us he was a breath of fresh air, wasn’t he? I remember him telling everyone he has a nephew with a big boat. And he was filled with compliments for everyone here. He’s a very nice man. And I remember days of him saying, ‘Where’s my Nessa? Where’s my Nessa? She looks after me. Isn’t she wonderful.’

   “Mr. Halpern’s medical conditions are catching up with him now. Even with the medication he’s only able to suffer his pain because he can no longer remember how long he has been hurting, and he can’t anticipate he will keep hurting. It’s not that he won’t let go of his puzzle, it’s that it’s all he has now to hold onto. You don’t want him labelled an aggressive patient.”

   “Don’t.” Nessa said.

   Jack stopped and went behind his desk. He sat, and then spoke slowly. “You do good work, Nessa. Is there anything we should discuss? Anything you think I haven’t covered? Anything I should be made aware of?    

   Nessa rose and shook her head. “Can I look in on him?”

  “Of course, he’s in your section. He’s your responsibility.”