When Trust Is Broken
Dr. Mary Sliwa trembled as the heavy door closed behind her with a thud. That sound, the ﬁnality of it, would remain with her for the rest of her days. What she viewed in those ﬁrst moments assaulted her memory as she looked to identify her surroundings. Her niece Jean said, “This is your new home, come this way,” as she pointed to a plain gray steel door identical to every other gray steel door leading into the patient rooms on this unit. Mary’s eyes darted from side to side. The patients here were different; there was a lack of expression on their faces, as they appeared to wander aimlessly past her. In one breathless moment Mary whispered to herself. “My God, this is an Alzheimer unit.” This was the first of many thoughts that would tighten her chest and force her pulse to race.
The halls of an Alzheimer unit are always filled with movement as patients walk without any purpose or goal, back and forth between the locked hallway doors oftentimes with the hope of escaping until a staff member redirects them or forces them to rest. Mary Sliwa looked around her and focused on the windowless doors at either end of the long hallway. She watched as people stood at those doors, touched the doorknobs and searched their memories for what to do next. The realization that the doors were locked was wasted on minds that long ago ceased to understand. That reality was not lost on Mary and she screamed inwardly. God help me, I’m in prison.
Mary redirected her focus on Jean as she turned and stepped into the tiny room assigned to her. Her brown oxford shoes offered little noise as she crossed the floor and allowed herself to sink slowly into the familiar brown lazy boy recliner. She rubbed the arms of the chair and realized that this was her chair, the one she rested on daily in her home. How did it get here? When did they move it here? She rested her hands on her knees, leaned back and methodically assessed her surroundings. The one window in the small room was covered with dated flimsy curtains. A white dresser doing double duty as a television stand was positioned beneath. Mary mused at the scratches and chipped paint on the dresser and wondered about all the previous patients that had lived in this room. How did they end up here? Like me, were they virtually kidnapped and plunked down in this place? Continuing on, Mary’s eyes settled on the single bed in the corner. There was nothing appealing about it, the cover was nondescript and the one pillow was covered with a pillowcase larger than needed with the open end laying flatly on the bed. A bathroom, awash in white tile with walls that needed a good cleaning and doors that had seen better days, housed a commode and sink. A closet now contained serviceable dark colored sweat pants and sweatshirts not the pastel, crisply ironed blouses and dress pants that hung in the mirrored closet in her home of eight years that had been designed especially for her.
As her anxiety level increased with every thought she reached for the one thing that always brought her comfort, her rosary beads. Holding them and praying the Hail Mary steadied her heart and eased her mind. Soon the quiet ticking of her alarm clock filled the silence in her room.
She thought back to this morning that had begun like any other with one exception, there was a surprise unscheduled visit by two of her nieces. They promptly extended an invitation to Mary and her sister Rita, to go out for breakfast. They went to one of the local restaurants and had a lovely time and were ready to return home when, Jean, a niece and physician, said that she needed to make a stop at a nursing home to visit one of her patients. She asked Mary to accompany her to the fourth floor. Oddly, there was only a moment when upon entering the Alzheimer unit, Mary had a feeling of impending doom. Before her mind could catch up with her new reality, Jean told her that this was her new home and that she would be safe here. Mary was perplexed. She tried to understand Jean’s statement but her brain was not cooperating. Her inability to focus was not new to her. At her last visit to her gerontologist she discussed her lack of focus and recent confusion. The doctor confirmed her suspicions that she most likely was in the early stages of Alzheimer’s.
Even with the administration of first-line Alzheimer drug therapy, Mary battled a daily fight to remain in her world. She still remembered that she was Doctor Mary Sliwa and that her friends lovingly called her Doc. She recognized her limitations but she was absolute in knowing that she did not belong in this place.
While Jean arranged Doc’s clothes in the shabby dresser, Mary summoned her courage, left the room and eased into the non-ending parade of patients walking in the hallway. As she traveled down the hallway, she noticed each doorway had a picture of a person with their first name to identify them. Some were in wedding clothes from long ago, others stood by themselves at different events in their lives. Strangers, they were all strangers to Mary. The people she passed in the hall never smiled, they just mumbled to themselves and looked totally distracted, even though their pictures all showed them smiling.
The flow of patients that engulfed her led to a fenced in area with artificial trees, park benches and a streetlight, which in its totality gave the appearance of a small park. As Mary got closer to the park area, she passed a room with a window open to the hallway that she quickly identified as the nurse’s station. A phone sat on the desk below the window. Mary moved on and sat down on one of the park benches and blended into the surroundings as just another patient while she waited quietly until the nurse’s station was empty. Taking advantage of that opportunity, she quickly returned to the window, reached in and picked up the phone. She was familiar with dialing an outside line so she dialed nine and then her friend Stella’s number. She was leaning against the wall holding the phone when a nurse approached her and gently took the phone out of her hand as she asked, “Whom are you trying to call?” “My friend,” Mary replied with a tremor in her voice. The nurse observed her frightened newly admitted patient and spoke into the phone. She identified herself and the facility and asked, “Who is this?” “This is Stella, Mary’s friend,” “I’ve been very concerned about her. Is she being evaluated at the hospital?”
There was a slight pause as the nurse made a critical decision that would remove the cloak of secrecy surrounding Mary’s admission. Her eyes fell gently upon Mary and she said, “No, she is a patient in our Alzheimer’s unit.” Stella’s heart skipped a beat a she felt her breath literally freeze in her throat. Wanting to scream at the top of her lungs was her first instinct but she controlled herself, straining to hear everything the nurse was saying. Her mind was racing as she listened, and pieced together, “Mary’s niece brought her to the unit. Mary appears a little confused now but all of this is very new to her.” Stella’s hand was shaking as she gripped the phone tightly to avoid dropping it. The nurse informed Stella that according to the laws governing patient confidentiality, she could not give her any more information or she would be in trouble.
Stella, a registered nurse assured her that she would never get a fellow nurse in trouble and asked to speak with her friend. When she handed the phone back to Mary the nurse heard her new patient say, “Stella, help me, please. They’ve put me in prison.” Those words and the fear in her patient’s voice would haunt the nurse for months to come. She directed Mary back to her room talking to her in soft tones and telling her that everything was going to be ok, but Mary knew better, things would never be the same again.
Back in her room Mary sat amidst Jean’s persistent chatter wanting only to be alone and in a quiet space. She willed herself to be calm, closed her eyes and engulfed the memories of her life. Family and friends traversed her mind like the characters on a movie screen. Events that impacted her life for good or bad were drawn together piece by piece. And so she dreamed.
Summer in the bustling garment industry neighborhood in New York was an explosion of noise, with rolling garment racks that careened down the street, and scores of uniformed workers who rushed from one designer house to another. The Sliwa family lived amongst this hustle and bustle. This neighborhood was, for some immigrant families, the first stop on journeys across the country. It was a working-class neighborhood, nothing fancy, just a lot of families struggling to put bread on the table. The Sliwa apartment was nestled on a side street with similar buildings, all with thirteen steps to walk up and front window ledges that supported women of all shapes and sizes who leaned out to shout for their children to come home to dinner.
“Mary, take this lunch pail to your papa please.” Anne Sliwa shouted from the apartment stoop. Still in her midwife attire, Anne held the pail out to her youngest child. “ All right Mama,” replied Mary as she grabbed the pail and started down her street.
This was the best part of Mary’s summer days for she relished the time spent with her father. Walking quickly she avoided the cracks in the sidewalk where hundreds of clothes racks had left their mark and made her way to her father’s work place. He worked at the Kayser Department Store on Twenty-Second Street and Fifth Avenue, where he was responsible for accepting the delivery of clothing products from textile factories in the Bronx. At this time of the day he was taking his break and young Mary usually delivered her mother’s hearty meal to eat.
It was a quick walk and Mary soon stood in front of the side door where the name Kayser appeared in large gold letters. She gave three solid knocks and within a moment the door was opened and her father’s face came into focus. “I was beginning to wonder if I would eat today,” he said with laughter as he motioned for Mary to step inside.” Mary loved seeing her father, his round face, bushy eyebrows and twinkling blue eyes always made her smile.
“I hurried as fast as I could papa.” Mary replied, following her father down a small hallway to the back room. She set the pail on a lunchroom table opening it up to let the delicious smells of polish sausage, sauerkraut and freshly baked rye bread escape. He began to eat with gusto and then lifted his eyes looking directly at Mary and asked, “So, what is on the mind of my daughter today?”
He never told Mary how he looked forward to his talks with her, always coming away with a growing respect for her mind. He also held a secret pride in knowing that he was the first one with whom Mary shared her dreams. Looking at her he thought that although she wasn’t the most beautiful of his children she was without a doubt the brightest. They conversed in a mixture of Polish, their native tongue, and English. He corrected her Polish and she taught him English and they both laughed at this new language they had somehow developed.
“I was thinking that you and I are very similar when it comes to having a job papa. It seems so logical to me, if we want something or need something, we get a job.” The last part she emphasized and her father chuckled. “Yes, I have had many jobs since coming to America. Once I was a barber, another time I worked on the line in a soap factory in the Bronx, and now I work in inventory management for this good store.” Mary’s eyes settled with pride upon her father. “Papa, did you like all of those jobs?”
“Those jobs gave us the money to survive here Mary. My jobs have been good and gave our family the money needed to live a good life in this country. You and your brothers and sisters will do better. This is why we work hard; to help all our children reach their dreams.” Mary thought about that for a moment and then said, “My dreams are always about becoming a doctor and helping people.” Her father looked intently at her and thought from where did this one come? Tall and built more like a boy than a girl with a wide smile and thick curly hair, she had a quick mind, a logical mind that was noticed by all. He knew that there would be barriers put up to deter her from her dream, but he also knew that a light burned deeply within her that one day would shine in the world.
“Identity was partly heritage, partly upbringing, but mostly the choices you make in life.”
On the way home Mary considered everything she and her father shared and laughed out loud just thinking of him. He was successful wherever he worked but totally inept at repairing anything in their home. Mary, on the other hand, could always figure out how to fix whatever was broken. Her father would begin the project and then quietly ask Mary to help him finish. He always whispered to her, don’t tell your mother. Once, he gave her what he believed was an enormous compliment saying, “You are smart enough to be a man.” This further encouraged her curious and analytical mind to tackle any project with success.
The Sliwa’s life pretty much mirrored other immigrant families. Everyone was expected to contribute to the general welfare of the family in some way. Mary learned early on that even though she was the baby of the family, there was more expectation placed on her than the others. As she matured she became very inventive when it came to making money. She held a host of jobs in her pursuit of becoming a physician. As a young child, she would do “beer runs” for the men in her neighborhood, taking their beer pails to the local tavern, purchasing beer for twenty cents a pail yet charging each man a quarter, earning five cents’ profit on each run. Mary knew the value of money and every little bit helped.
Being tall and large for her age was both good and bad. Her stature helped her land a job running a machine at a fabric factory. She had lied about her age and was able to pull it off until one of the neighborhood men saw her and asked why she was working there since she wasn’t yet eighteen. Her boss heard the question and her ability to bring much needed cash into their household came to a quick end.
During high school, she rented a concession stand at local carnivals. She purchased ice cream at the ice cream outlet and sold cones to customers. Eventually, she added cotton candy to her repertoire and boosted her sales.
One job opportunity lasted all of eight hours. She was hired by Macy’s and really looked spiffy in her uniform and white gloves. She ran the elevator up and down so many times that it upset her stomach and she threw up. That was the end of her position at Macy’s.
If you asked Mary why she became so enthralled with becoming a physician, something that by all measure should have been out of her reach as a poor woman, she would respond that her yearning to become a physician began while watching her mother practice midwifery, helping to birth babies and tend to the ill. Whenever her mother had a call, Mary would beg to go along. She watched as her mother referred to a book on midwifery and treatment of related ailments, written in her native polish language. Once, her mother found Mary looking at the book and said, “You are too young to be looking at the pictures in this book, they are not meant for young girls.” Mary’s mind already captured the gist of the images understanding that they were directions on how to help mother’s birth their babies, not bad pictures to be kept away from the eyes of a young girl.
Mary witnessed first hand the tenderness of her mother while caring for a woman with burns on her upper body, cleaning and changing the bandages, and experienced the gratitude in the woman’s eyes. These experiences combined with her strong faith in God and devotion to the Blessed Mother fueled even more her ambition to become a physician. Her mother acknowledged that desire but warned that she would have to study very hard to do this. Aware of Mary’s aspiration her mother knew there was no stopping her. She would become a physician helping others and ultimately lift her family out of poverty.
Mary’s mother was probably the greatest influence on her character. From when she was very young her mother encouraged her to study, and used whatever money was available to round out her intellect with music lessons. Mary played the piano, guitar, accordion, trumpet and violin. One instrument, in her hands, literally sang. It was the violin and within a relatively short time she was performing at the church, school functions and even for the Red Cross where her mother was a volunteer. As high school approached, Mary’s mother made a decision that would have great impact on Mary. Recognizing her intelligence and drive she decided to send Mary to a private girls school. This was not an easy task for the family, but sacrifice was not new to them. Mary attended Cathedral Catholic high school for girls in Manhattan. It was here that she totally immersed herself in studying and mastering the violin. Those early days were full of learning, working, and helping. Mary helped the family, assisting her parents and babysitting her older sisters’ children.
After graduation from high school Mary entered St. John’s University in New York City with a bright mind and a strong musical background, having mastered the violin and several other instruments. She was offered and accepted, much to the chagrin of the upper classmen, the first chair in the violin section of the university orchestra. Mary earned her way through the University as she worked two jobs, scrubbing floors at a bank at night and working as a nurse’s aide during the day whenever her class schedule allowed.