AThe many lighted windows of the front cars flash past us like decades, the brakes on the wheels screech to a halt, the doors slide open; here is the train come to take us home.

January 3, 2012, Tuesday:  Emma, my mother, 97, residing in the hospital bed in our living room, has arrived at the final stages of dementia. For a decade, I have been her sole caregiver, unpaid.

Early this morning, before the sun rises, I am awakened. I hear Emma: “How do I get to the subway?” she wants to know. I go downstairs to her. The room is dark but for the weak glow of the night light at the surbase in the adjoining hall.

My imagination shivering in fear at what I will find, I gather around myself my cloak of strength, threadbare now, enter the room and switch on the light.

Emma has thrown off her covers and skewed herself around in bed so that her head is between the rails on one side and her legs through the rails on the other. She is a tiny thing, five feet tall, weighing under 80 pounds. She looks like a holocaust victim. Yet, I have difficulty shifting her. I succeed in dislodging her, finally, straighten her body, pull her down in bed. I cover her up.  I climb the stairs and crawl back into bed. Quiet. Then, “Where is the subway? How do I get home from here? How do I get home from here?” I descend the stairs. She is sitting up, uncovered. “Here: take a drug” is not my normal way out. What should I do? Emma has become agitated again.

Emma grew up in Philadelphia, Pennsylvania, living in her West Philadelphia childhood home until she married in 1939 and lived in the western Philadelphia suburbs. Regularly she donned hat and gloves and rode the elevated train and subway into town where she worked as a secretary, or to shop or meet with friends.

The Atavan waits on the sill between the living room and hallway, waits for me to transport it to her. I have already measured the proper dose into the dropper. All I need to do is administer it. Our healthcare aides have told me that in nursing facilities they tie down agitated patients with duct tape or bungee cords. Scenes from movies of confined, supposedly insane people – mostly women – flash through my mind – old scenes captured in documentaries of patients being given lobotomies suddenly light up, black and white, like a gargoyle on a subway wall when the headlight of the fleeting train flashes on it.

What does Emma see? Where does she think she is? Lost in Philadelphia this time, trying to find her way home. Lately, she has been calling for her mother. It is sad; maybe it is scary for her. She has almost reached the end of the line. What triggers her images? What makes her brain run these thoughts? They must run like a movie trailer.

I pick up the bottle. I unscrew the top holding the dropper. I approach my mother in her bed. I remove the dropper and aim it at her, moving closer. “No,” she says. “No!” She tries to push me away. I gather her wrists in my free hand so she won’t pummel me. She breaks free. “No,” she says. “I don’t want anything to eat.” She compresses her lips. “All you have to do is stick the dropper inside her cheek,” our medical team has said. “The medication is designed to be absorbed into the gums.” O.K., I’ll try again. I collect her wrists. She breaks free. I stand back. I look at her mouth.  I’ve administered medicine from a dropper to dogs and  cats. Surely, administering it to Emma should be easier, especially easier than to cats. I am so bumbling at this; imagine me as your nurse.  I touch her cheek, her mouth, trying to open it. I aim the loaded dropper at it. I get it open. Quick. I get the dropper in and squeeze the bulb. Click! Emma clamps down her teeth on the dropper. I pull out the dropper. I hope it’s made of reinforced material. She does not break it. I place the dropper back into the bottle. Mission accomplished.

Emma continues talking for a while, about an hour. Born in 1914, do you think she would have believed it if someone had told her she would live into 2012? “Can you tell me where the subway is? How do I get home from here? How do I get home?” Now she is quiet.

Samantha Mozart