Could Not Fall Asleep

In a crowded ward where families were moving in and out, a woman was sitting still on a narrow fold-out companion chair beside a hospital bed. Dressed in a lilac uniform, Aunt Luo seemed out of place. She wasn't really resting. Although her eyes were closed for a moment, every sound in the room seemed to pull her back awake. A nurse rolling a medication cart down the corridor. The soft beeping of an infusion pump. She opened her eyes almost immediately, instinctively checking whether her patient needed anything.

The chair was only slightly wider than her shoulders. This was where she slept. Or rather, where she waited for the next interruption.

When I introduced myself and asked whether she had time to chat outside the ward, she hesitated. Her expression tightened. For a few seconds she looked as though she was weighing every possible consequence of speaking to a stranger. Only after several minutes of ordinary conversation did her tightly hunched shoulders gradually loosen. She talked with such a kind of relief as if she had not spoken for years. Every three minutes, she was instinctively drawn to the patient’s bedside.

The patient she was caring for had pleural disease and had been bedridden for over a month. "He can't do anything by himself now." Her job, she explained, was everything that happened outside medicine: watching the IV drip, helping him wash, ordering meals, changing clothes, cleaning him, helping him use the toilet. Emptying accumulated fluid. If doctors treated disease, she cared for everything illness left behind. 

She had been with this patient for more than a month, twenty-four hours a day with no shifts. "It sounds exhausting," I said. "It is," she laughed quietly, "But what can you do?" The patient had almost no family with him. His relatives were busy and only stopped by occasionally before leaving again. Most days, the room contained only the two of them. I asked whether she could sleep through the night. She shook her head, "About once every hour." Every hour she helped clean him, reposition him, or deal with another bodily need that could no longer wait until morning. People often imagine hospital work as dramatic emergencies. Her work was repetitive, so repetitive that it became invisible. It is the kind of labor that slowly wears a person down without anyone noticing.

The responsibility, she said, was enormous. "If anything happens to the patient..." she paused, "...it's on us." Legally, medical complications were not her responsibility. But if a patient fell while she was helping him walk...If he slipped while getting out of bed...The agency expected its caregivers to bear part of the responsibility. "So you have to be careful all the time," she emphasized the last words softly. Careful all the time, as if treading on thin ice. Even accompanying a patient downstairs for fresh air required calculation. If someone was physically weak enough to fall, she simply refused, no matter how much they wanted to go outside. "The risk is too great."

I asked whether she and her patient talked much. "Not really." He spent most of the day lying in bed. When he spoke, it was usually to ask for water, food, or help. Occasionally he joked. More often, he lost his temper. "He used to be a department manager," she smiled knowingly, "He has strong opinions. Even doctors sometimes struggled to persuade him to follow medical advice. I tell him, 'If you already know medicine better than the doctors, why come to the hospital?'" 

She laughed, “He never listens." 

"So what do you do when he's angry?"

"I let him be."

There was no resentment in her voice. "To be a caregiver," she said, "you need compassion, patience, and attention to detail. You can't take everything personally. You have to treat patients like family." She said it so naturally that it sounded less like a principle than a motherly instinct.

Halfway through our conversation, a man dressed in a suit entered the ward. Aunt Luo immediately straightened up. "Our supervisor," she whispered. The atmosphere changed almost instantly. The supervisor explained that the caregiving company was a third-party agency contracted by the hospital, then politely ended the conversation. 

When he left, Aunt Luo's smile returned. She spoke more openly again. Their agency worked in two ways. Some caregivers stayed on one floor permanently. Others, like her, accepted individual assignments wherever patients needed them. "They tell us where to go." She could refuse an assignment if she wished. Most didn't. The price depended on the patient's condition. Ironically, she explained, the patient she was caring for had become much sicker after she accepted the job. When they first signed the contract, he could still move a little by himself. Now he was completely bedridden. "The workload increased. But the price couldn't," she smiled again, just as someone stating an inconvenient fact.

She had worked as a caregiver for only two years, yet had already looked after more patients than she could remember. Some stayed for two days, and some for three months. Each illness was different. Chemotherapy affected everyone differently. Some patients vomited constantly. Some became too dizzy to stand. Some simply lost all their strength. Whatever happened, someone still had to bring food, help them into bed, accompany them to examinations, or simply stay beside them. That someone was often her. 

I asked what she did after work. She answered without thinking. "I go home. And play mahjong." For the first time during the conversation, she laughed wholeheartedly. It was such an ordinary answer that I found myself laughing too. Not because mahjong was remarkable, but because it reminded me that before she became someone's twenty-four-hour caregiver, she was simply another woman who wanted to go home, relax for a while, and spend an evening with friends. When I left the ward, Aunt Luo unfolded the companion chair again and sat back beside her patient's bed. The chair creaked softly beneath her. She leaned back, but not all the way.

A caregiver, I realized, never really rests. She only waits for the next voice to call her name.