Clumsiness had aged Gertrude more quickly than she could have ever imagined. Ever since she fell out of her bed two years ago, hit her noggin on the corner of her nightstand so hard she wound up in an ambulance, memories felt like sand slipping through an hourglass. Time no longer seemed concrete, tangible. It floated around her in a bubble, popped as soon as she tried to reach out to it. She’d wake from what she thought was a nap, only to realize it was morning. She’d fall asleep, certain she slept through the night, only to realize it was the middle of the afternoon. The sun and the moon do-si-doed around her in a dizzying dance and she was always two steps behind.

Two knocks sounded on the outside of her door. It couldn’t be time for her pills yet. Those damn pills clouded Gertrude’s mind, made her see ghosts—her father, in prison, his rail-thin body starved of all nourishment; her brother Gerald, swaddled in a blanket, his body gray and still. She told Carolina, the night nurse, about the apparitions, how they appeared so real she felt she could reach out and touch them. Carolina would simply pat Gertrude’s arm, hand her a paper cup, coax her to sip water to wash the pills down.

Gertrude raised the head of her hospital bed higher, shook out the folded flannel blanket wedged in her side, covered herself up. Not that it mattered whether any of the staff saw her in her pale pink cotton nightgown, the one she wore every day, all day. These were the same people who showered her once a week, lifted the pale folds of her sagging, naked skin, scrubbed her inner creases red raw.

There was another knock. “May I come in? You have some mail today.”

Kathy, with the high-pitched, singsong voice, was the third-floor day nurse who always felt the need to talk to Gertrude and all of the other patients as if they were preschoolers during circle time. She meant well (didn’t they all), but her sunny countenance grated on Gertrude.

The door cracked opened before Gertrude could respond. She never understood why anyone here asked permission to enter her room when they did what they wanted anyway. Gertrude could answer no to every question they asked her for the rest of her life, and the staff at Pretoria Homes would still go about their business, oblivious to her objections.

Kathy slid inside, squinted at the dim light, flicked on a few switches. She wore pale blue scrubs with pink elephants, had a different set for every day of the week. Gertrude could picture Kathy at her closet every morning contemplating the decision to wear the elephants over the scrubs with the smiling frogs. The dilemmas of some people!