“You manipulate staff to discharge him every twenty days, just before his Medicare coverage runs out. Then you re-register him to start a new cycle. But that’s only slightly fraudulent. You invent illnesses, so Medicare will extend his stay.” “Those are real illnesses.” “That he doesn’t have.”
Winner of The Letter Review Prize for Books
Murder and Other Family Obligations
1
At a park in Osaka, Japan, a pale, fissured man sat on a pale, fissured rock waiting for the sun to rise and illuminate the life around him. Yukichi Kimura was only 116 years and 231 days old. This made him a child compared to the ancient mountain, cryptomeria trees, and stones of the park, which also watched the sunrise every morning.
The daylight over the horizon birthed vivid colors. Purples from the wisteria, reds and yellows from the camellias, and pinks and blues from the hydrangeas all exploded into existence. Small animals and insects scurried about as if their lives sprang from the new light. Yukichi breathed in the perfume and pungency. Then fell over, dead.
News outlets worldwide heralded Yukichi’s soft, muffled thump onto the grass because it made him the former “world’s oldest living person.” With his passing, the title now belonged to Dolores Ossa, who lived in a nursing home in Louisville, Kentucky. Her pallid, crumpled face appeared on every screen. Slumped forward in her wheelchair, mouth open, her fleshy, clouded eyes locked on some distant place only she could see. She wore a faded nightgown, and atop the few white threads of hair that clung to her head sat a glossy red, yellow, and blue party hat.
An entourage of cheerful people who worked at the nursing home surrounded Dolores and hailed her as their new celebrity. A reporter thrust a microphone at her. “Dolores, what’s the secret to a long life?” She groaned. The nursing home staff cheered and blew on squawking paper horns.
Dolores was born when the human lifespan was about fifty years and before the invention of zippers. Though she lacked zipper technology as a child, as of this day, she would have Instagram and Facebook pages and millions of followers on TikTok, courtesy of the people promoting her nursing home. These turned out to be a mistake, however, because while most people delight in stories like Dolores’ and are rational human beings, other people live in Florida.
2
Marta García waited in the coldest office at Miami Gardens Eldercare Community. The office belonged to the assistant service supervisor, Ian Ender, who was thirty minutes late.
Her V-neck floral-print blouse splashed with daisies, mums, and dahlias gave the sterile room its only vibrancy. She paced around, looking for something to straighten, clean, or obsess over in some way, but the office was impeccable.
“For excellence in care, compassion, and innovation,” she read on the polished plaques and spotless framed honors that hung on the walls. Her finger ran over the disappointingly dustless wooden shelves that showcased awards aligned in perfect symmetry—trophies shaped like a caring hand, a heart, and one like a star with a sharp top resembling a spear.
Marta complained, “¡Carajo! Where is this comemierda?” which means, “Damn it, where is this shit eater.” Bilingualism gave Marta a broader palette of insults, and like many Cubans, she painted with bold, vivid strokes.
After more pacing, she finally sat on an unusually tall chair that she initially thought was a piece of art. Its narrow, smooth seat and uneven distressed top rail were hand-crafted from purpleheart wood. It was a splendor to behold, but not to sit on.
Marta was 5’ 2”, and her legs were twenty-eight inches long. The chair’s seat height was thirty-two inches. So, her feet dangled above the floor.
She clenched her meaty buttocks to grip the chair, but her jeans slid slowly off the slick surface. She pulled her feet onto the seat to keep from sliding and looked as if she were preparing for a gynecological exam. Grumbling, she scooted to the front of what she was now referring to as “this fucking chair” and sat on the edge in a half-sit.
Checking her news feed on the cracked screen of her phone, she saw a clip of Dolores. The camera zoomed in. Marta paused the video on a close-up of Dolores’ drooping face and distant stare and thought, Pobrecita. They’re keeping her alive, and she doesn’t even know where she is.
Ian glided in at last, lean and stiff like his designer chair and just as hairless and compassionate. “Ah, Ms. García, here we are again.”
“I’ve been here for a while.” She crossed her arms and exhaled loudly to emphasize her annoyance. Subtlety was not her strength.
Ian ignored the gesture, sat, and pecked away at his computer, focused on his screen. “Oh? Did we get our times confused?”
“‘We’ is too many people for that sentence,” she said.
He snickered. “Oh, I’m not going to miss our conversations.”
“What do you mean?”
He swiveled to face her, folded his hands, and launched into what sounded like a rehearsed sales pitch. “At Miami Gardens, we insist on the highest standards…”
“I’ve read the brochure, Ian. Why am I here?”
“We’ve discussed this many times. Medicare won’t cover your grandfather’s costs. And we don’t accept Medicaid.”
Marta instantly brightened. “But that’s what makes Miami Gardens so great. You care more about people than rules.”
Ian shook his head in disbelief. “No, I care about rules. I love them, in fact.” He sat up taller, sharpening the downward angle of his gaze. “It’s you who doesn’t care about them.”
Ian turned his monitor toward her. It displayed a spreadsheet that at the top had the file name “García Infractions.” It was a long list.
“You manipulate staff to discharge him every twenty days, just before his Medicare coverage runs out. Then you re-register him to start a new cycle. But that’s only slightly fraudulent. You invent illnesses, so Medicare will extend his stay.”
“Those are real illnesses.”
“That he doesn’t have.” Ian locked eyes with her. “Medicare doesn’t cover custodial care, only medical. Time’s up.” His tone made it clear he was done speaking to her. A tone Marta ignored.
“Custodial…Do you mean he’s not sick enough? He’s 116. We can find something.”
Ian looked bored. “Being 116 isn’t a medical condition.”
His desk was positioned so that, at this time of day, shards of sunlight shot into the eyes of the person in the designer chair. Marta noticed that he scheduled his meetings with her to coincide with this solar event.
She squinted as she argued, “He has a severe medical issue.”
Ian sighed. “Go ahead.”
Marta pulled out her phone to help with her diagnosis. “Probably Meniere’s disease, I think that’s how you say that. Or vestibular migraines. Very hard to diagnose and cure.” She put her phone away. “See? Not custodial. Medical.”
“He has neither condition.”
Marta threw up her arms. “How do you know? He can’t stand up; he’s so dizzy,” she said.
“He can’t stand because he’s 116.”
“Impossible!” Marta slapped her thigh and sat up. “You just said being old isn’t a medical condition.”
Ian rubbed his eyes. “Okay. Let me try this again. Despite your…creative methods, the primary reason we’ve allowed this charade is Eric. Your nephew is our best nurse, and he enjoys having his great-grandfather here. But enough is enough. There’s a waiting list. This…” He waved his hand casually in the air. “…is the top elder care facility in the state, and we have expenses.”
“Like your thousand-dollar suit?” Marta snapped back.
Ian’s cool, detached demeanor vanished. His pale face turned scarlet. Marta knew she had poked the one thing he treasured, his image. “How dare you!” he raged. “The care we provide…and this is a Brioni Signature, custom-made! …the care we…it was seven thousand…the point is… one thousand? How dare you!”
Ian held up his hand and lowered his head as if stifling a sneeze. He breathed deeply, taking a minute to settle back into his reptilian essence. Once there, he carried on in his usual icy demeanor. “Miami Gardens is for people with means. People who’ve earned the right to be here.”
“My abuelo has earned it. He was the most revered stage actor in Cuba. There are still theaters named for him. Ask any of the older Cuban residents. They’ll tell you.”
“How nice, you’re both creative.” He spat out “creative” like he meant “infected.” “Medicaid covers adequate…or near adequate facilities, and that’s where you should go.”
“He’s made it to 116. He’s earned it.”
“Not in any way that counts.” Ian rubbed his thumb and fingers together. He then turned his attention toward his phone, making it clear, again, that she was dismissed. “Lauren has a packet ready for you. Discharge instructions. A list of Medicaid facilities, etcetera.”
“Ian, this is his home. I can’t move him,” Marta pleaded.
She could see that he was reading a restaurant review on his phone as he muttered, “Mmm hmm.”
Marta raised her voice slightly, “Last time I moved him, he nearly died. The confusion, the break in routine…”
“Mmm hmm.”
Louder now: “We can move him to a smaller room, maybe?”
“Mmm hmm.”
She continued her appeal, projecting louder and louder with every sentence. Ian paid focused attention to his phone, repeating, “Mmm hmm,” even after she had finished speaking.
Marta sucked in as much air as would fit in her body. She imagined the sound his shiny skull would make if she hit it with one of the awards sitting on his shelf. She had her eye on the pointy one.
“¡CABRÓN! You throw an old man into the street and sit there relaxed like you’re taking a shit on a Sunday morning? ¡OYE! ¡HIJO DE PUTA! I’M TALKING TO YOU!”
Ian had a reputation for remaining cool and disinterested even when faced with enraged family members. It would have earned him five stars on any rating system for cold-hearted pricks. However, Marta projected with such ferocity that he cowered as if a grizzly had sprung from her mouth.
Her screams caused the floors to rumble and Ian’s shelves to rattle as heavy rhythmic thuds reverberated throughout the office.
Marta’s cry had alerted her nephew, Eric. He stood at six-foot-seven, with a gigantic head, an impenetrable forest of black hair, and a powerful, broad back. His big mocha-colored arms and massive legs stretched his light blue nurse uniform so that one could almost hear the individual fibers’ tiny screams of anguish. He weighed more than 300 pounds. As he charged into the room, all eyes were drawn to him, possibly by the gravitational pull.
Eric thundered, “Tía! What’s wrong?”
Ian adeptly switched from prick to placatory. “Everything is fine, Eric! We were discussing some general housekeeping aspects of your great-grandfather’s situation here. We all love him, and want what’s best…”
“He’s kicking Abuelo out,” Marta cut in.
Eric’s eyes and mouth sprang open wide. He began to breathe in quickly without exhaling, swelling bigger and bigger like a giant balloon.
Ian held up his hands, trying to diffuse what was beginning to look like an Eric bomb set to go off. “No, no, no! ‘Kicking out’ is not what I said. We want to transition him to a more suitable place.”
Ian’s attempt failed. Eric began to cry, softly at first, then in loud, bellowing moans that echoed off Ian’s reflective walls. He cried so loudly that several staff and executives peeked in with concerned looks.
A woman wearing enormous round glasses popped her head in the doorway. “Eric, what’s wrong?”
A thin, shaggy-haired man’s head appeared next to hers. “Was it a resident you were close to?”
Eric’s sad cries drew in people from every office like a Greek siren with seasonal depression. More concerned heads quickly materialized in the doorway.
Ian’s pasty face somehow blanched further as the heads multiplied. He closed his office door on them. A few shouted through the door. “I’m around if you need me, Eric!”
“See,” Marta said. “Everyone who works here, patients, all the families…they love Eric. What are you going to tell them? ‘Oh, he can’t help you because I crushed his soul?’”
Ian seemed to consider the consequences of Eric blubbering about the old man’s eviction and relented. “How about this?” He clapped his hands, likely hoping the gesture would cheer the mood. It did not. “I’m having some minor work done to the resident section where your grandfather is. He can stay for one month while we touch up. A whole month!” He spread his arms in an expression of feigned joy as if waiting for applause.
After some silence, he added, “Then once they’re done, we’ll need his room.” Turning to Eric, he said with overdone sympathy, “Eric, this is upsetting for everyone, especially me. I care deeply for your great-grandfather—”
“Pfftttt,” Marta said.
Ian continued to console a sobbing Eric, “I wish there was more that I could do…”
Marta walked over and grabbed the pointy award. It was heavier than she expected. Perfect.
Author Biography: I’ve been a professional writer for 35 years, running a creative marketing boutique specializing in healthcare.