Apropos of Nothing

1100 Bucks a Month

Just from the outset, let me say that poor 70-year-old Mr. Neely was definitely being neglected and possibly being abused by his son. The first thing they told me was that his hair was so dirty and unkempt that it was like one single dreadlock. The nurses had to cut off the worst of it to wash his hair, possibly for the first time in ten years. His nails were filthy and three inches long. Other than his obvious expressive aphasia and severe peripheral vascular disease, he had no medical history that his son could recall and had not been seen by a doctor (or anyone else, possibly) for the entire twelve years he had lived with him. His right leg has been amputated below the knee at some unknown time and the remaining foot was so swollen that the tissue ballooned out from around the elastic of his feces-encrusted sock. His shin was covered with black, gangrenous eschar and his toes were rotting off.

The son displayed a strange lack of concern about his father’s deplorable state and his medical problems, especially his expressive aphasia which is a symptom of a stroke in the speech centers in the dominant hemisphere of the brain (usually the left). All Mr. Neely could say was, “Wonderful…no…no…wonderful,” which he repeated continuously whenever he was alert.

“When did you first notice his speech change?” I asked, which is a reasonable and an important question when treating victims of strokes.

“About four years ago.” A complete lack of concern from the son.


“Didn’t you think about taking him to the doctor when it happened?”

“Well, it didn’t get any worse so I figured it would get better.” He might have been talking about what he had for lunch.

“When can he come home?” was his next question.

“I think he needs to be in a nursing home. You’re obviously not taking very good care of him,” I said, not trying to be non-judgmental, “What on earth is going through your head when you see him like this?”

Poor Mr. Neely. Trapped in his own private hell surrounded by neighbors who probably didn’t even know he existed. His son had probably gotten used to living off of his social security check in a house whose mortgage had been paid since the time when his parents still had hopes that he would amount to something. He might have died like that except the fear of losing the social security check had finally made his son risk bringing him to the Emergency Department.

What does this have to do with anything? Nothing really. No big lessons or morals to be teased out here except that maybe there aren’t two sides to every problem. Some things are obvious. Mr. Neely’s son was obviously a scumbag and was obviously neglecting his father. Evil obviously moves in the shadows of our world even if it is sometimes understated and bent on nothing more than a pitifully small government check.

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