AN ESSAY ON THE SHAKY PALSY
I am working at the post office while my parents are overseas visiting my sister. I turn up with strong coffee in the dark mornings and park shoddily out the front of the sun-faded building on the corner. My paternal grandmother, Nanny, is already sorting mail when I enter yawning. We talk about Fluffy, the cat who decided it liked her house better than its house across the street and now sleeps under the covers with her every night. I tell her that our cat Pixie had to sleep in the frost last night because I fell asleep before she came back from her night-time stalk of native birds. Nanny tells me I need to look after the cat better because she is the only thing of our maternal grandmother we have left. I nod, uncomfortable with that notion.
I serve the customers who come in early to buy the local newspaper. I pick coins out of the shaking leathery hands of an aged farmer. I walk Mrs M out to her mobility scooter on the footpath, steadying her as she shuffles down the ramp. Nanny asks if I need her to do anything else before she heads home, and I say no. She is almost eighty and the mornings are tiring for her. I turn off the ABC radio as soon as she leaves. The post office is quiet. A letter appears through the slot in the post office wall. It falls softly, and I pull it from the collection bin. My siblings and I used to sit under this slot, waiting to catch a letter as it was posted – cheap thrills after school. The envelope is addressed in a spidery blue script, quivering up and down the paper. It’s almost illegible. Mail in the cities is sorted by machines now so I neatly print the address underneath, just in case, and send it on.
I spend the day leaning against the counter, my fingers black from selling newspapers. I chat about the predicted rain that doesn’t look like it’s coming. I shoo a scruffy dog from the front door where it stands barking at customers. I chase Mrs B out to her car when she leaves her purse sitting with the iced coffee she just bought on the counter. I remind Mrs T, that she came in to pay her electricity bill, buy cream and eggs and chocolate and no, she doesn’t need bacon, she bought bacon yesterday.
An overwhelming majority of my town’s population is elderly. For a town so small, an alarming percentage is affected by Parkinson’s disease. While Parkinson’s is predominantly associated with the elderly population, old age can’t be circled in red pen and labelled the sole cause of the disease when the likelihood from suffering from the shakes is higher in rural Australia. The first sign of Parkinson’s is usually a tremor in one hand. Movement becomes slow, muscles rigid. Posture changes, stoops develop. Ability to perform automatic movements decreases – smiling and swinging arms while walking and blinking become difficult. Tremors and shakes and trembling set in as nerve cells are damaged and dopamine levels in the brain drop.
My maternal grandmother had Parkinson’s for over a decade. In Mass on Sunday mornings, I used to watch one of our neighbours sitting in front of the piano, his hands clasped and trembling in his lap. Another neighbour, who bought my siblings and I souvenir T-shirts from his trip to Disneyland, just celebrated his 88th birthday in the dementia ward of an aged care facility in a town half an hour from ours. The white-haired priest who led my grandmother’s funeral the day before New Year’s Eve made the sign of the cross over her coffin. He held one hand tightly in the other. His hands were shaking.
While my siblings and I were growing up alongside our cousins in her backyard amongst the lavender and camellias, Grandma was shaking. She mended the dropped stitches in our lumpy scarves and knitted squares until Mum told us it was getting too hard for her to handle the needles. Our knitting misdemeanours remained in our unfinished scarves. Grandma waited under the tulip tree at the end of her driveway for her many grandchildren to get off the school bus. As she walked us up the gravel drive to the brick house with the chimney puffing, she would tell us of the scones with cream and jam waiting in the kitchen. As we grew older, we were trusted to make it up the driveway unsupervised. I don’t think we realised this coincided with Grandma finding it increasingly difficult to walk long distances unassisted.
I am unlikely to develop Parkinson’s. Cases of generational Parkinson’s are rare. Studies are being conducted on what is now considered to be the second most common neurodegenerative disease, and genetics are of little aid in indicating a predisposition to the disease. Genetic mutation increases risks of Parkinson’s, but it does not directly cause it. Current research narrows the cause of Parkinson’s down to environmental factors and genetic makeup, but it’s still not known what exactly causes grandparents to drop glassware while standing still, struggle to press buttons on the TV remote or suddenly be unable to balance food on a spoon.
In rural areas where instances of Parkinson’s are higher than average, the environmental factor scientists are pointing at are the large-scale use of chemicals such as organophosphate insecticides. If an insect is exposed to organophosphates it dies instantly. The insecticide attacks the insect’s nervous system, protecting the crop from insect damage. Organophosphates, despite being banned in the United States and restricted in the United Kingdom and Europe, are the most widely used insecticides in Australia. Flinders University toxicologist Associate Professor John Edwards told the ABC that organophosphates are ‘relatively safe’ for humans ‘provided exposure is limited’. However, the real danger with organophosphates is that the toxicity accumulates over repeated exposure – the effect isn’t immediate, which means prevention wasn’t either. Australia saw sweeping occupational health and safety reforms in the 1970s and 1980s after studies showed that regulations in the UK (which were similar to Australia) were fundamentally insufficient in preventing workplace accidents, illnesses, and diseases. Before these reforms took place, it was common practice in farming communities to distribute pesticides without proper protective measures, waterways were at risk of contamination from run-off and superphosphates were dropped from light aircraft to stimulate crop growth. Exposure to organophosphates was high but negative side effects were seemingly nil.
The Michael J. Fox Foundation for Parkinson’s Research has a sentence on its website which reads ‘You die with Parkinson’s disease, not from it.’ My grandmother was sick for a long time. I was living in London when she first fell and broke her hip. If an elderly person breaks their hip, they either recover or their body starts to shut down. My grandmother recovered, as best a person with Parkinson’s can recover. She fell and broke her wrist a year later and was treated for a broken shoulder for almost two weeks before the nursing staff realised their mistake. And then over a year later, she shook so much she fell out of bed and smashed her other hip on the hard floor. A hematoma developed on her head, a solid swelling of clotted blood. The nursing staff put her mattress on the ground, so she wouldn’t fall as far next time.
There are two stages of dying – active and passive. Passive dying is the pre-active part of dying – it’s the warm-up. It usually lasts for two weeks. The active phase of dying – the unresponsive, barely breathing but still breathing stage – usually lasts three days. My grandmother was actively dying for a week, her eight adult children rotating around her in the hot days leading up to Christmas. Her grandchildren were shielded from her dying, shielded from the almost impossible faintness of the woman who had shaped and coloured our childhood. A group of us went to the local pool and spent the afternoon swimming, sharing ice blocks and spending spare cash on lollies. No one mentioned Grandma fading from our lives and we didn’t discuss the fact that we had been rapidly vanishing from hers over the past few months. It wasn’t death stealing her memory of us, but Parkinson’s comorbid partner in crime – Alzheimer’s. Most people with Parkinson’s eventually suffer from Alzheimer’s because of the way that Parkinson’s changes the brain, allowing the second disease to encroach on other regions. In her last years, Grandma fluctuated between mislabelling us as our siblings or cousins, knowing who we were but not remembering our names, or knowing our names but not realising those names matched the very people sitting in her nursing home room. She started talking about my grandfather. They were married for 53 years and she had rarely mentioned him since his passing five years before.
I went to work the morning my grandmother passed. People needed their newspapers, even on Christmas Eve, even when someone has died. One of our neighbours came in and asked after Grandma. She cried against the counter when I told her that she’d passed away. I blinked. This woman was crying, and I was trying to find the words to comfort her when I didn’t have the words to comfort myself. But this woman wasn’t only crying for my Grandma. She was also crying for herself, for her husband who has had Parkinson’s for decades, a disease so cruel in its gradualness. She was crying for her friends and her family and her neighbours, for those who had already been claimed by the shakes in our small pocket of the world. I had no words of comfort for myself, but I found the ones she needed from me. I clasped her hand and took a breath and assured her I would let her know about the funeral arrangements.
Alaina Dean is a writer who never knew she needed to live by the beach until she lived by the beach.