By Brenda Miller

Note, this post is an example of a hermit crab essay, a format Brenda teaches in which a writer adopts an existing form to contain their writing. These forms can be a number of things including emails, recipes, to do lists, and field guides. Of this essay, Brenda says,”letters are a useful form to contain our difficult stories.”

Sunday, July 17, 2016
To: Wound Care Center
Re: Tuesday, July 19 appointment

To whom it may concern:

I am writing in regard to an appointment that was made for my father to assess and treat his pressure ulcer (aka “bedsore”) which has now, in the two weeks we’ve been waiting for an appointment, progressed to Stage 4. They tell us Stage 4 means “down to the bone.” I wouldn’t know, as I haven’t seen the wound firsthand, nor do I want to. It’s at the very end of his tailbone, the coccyx, the part of our bodies where so many nerves converge. All I see is the grimace on my father’s face as he waits for his Vicodin at the nurse’s station. Sometimes he has to wait a few hours. But that’s okay. We understand everyone is busy.

We have filled out the multiple pages of paperwork required for the appointment, paperwork that seemed amusingly archaic in this age of digitized information. The poorly mimeographed sheets, with its checkerboard of boxes and redundancies, provided us a few minutes of activity in his otherwise monotonous morning. I called out the questions and he answered them, and sometimes I surreptitiously corrected the inaccuracies. He has a hard time remembering things now, so while he may think the bedsore began in the hospital months ago, it did, in fact, begin at the first rehab center approximately three weeks ago. I tell you this so that you know the paperwork is more accurate than anything my father might tell you. (He likes to be right, so allow him to be right, if you can.) The five weeks he spent at Mt. Baker Care Center has now evaporated from his mind, leaving a blank that can’t be filled.

I know that this paperwork is a formality, that it will most likely be filed away and the doctor will ask all these questions again anyway. Still, we took it seriously and tried to remember if his own father had high blood pressure and/or a drinking problem. We tried to remember if my father had ever seen a vascular surgeon. We tried to assess his health as “good,” “fair,” or “poor” (It depends on the time of day you’re asking, he said, but there was no spot to append this information). And though you asked several times if depression was one of his symptoms (I wonder sometimes if these redundancies are meant to catch us out), and he answered “no” each time, I would like to point out his progressive withdrawal into himself, the way he sits slumped in his chair, beginning to mirror the other residents who often sit in the hallways, around the nurse’s station, staring at nothing.

He is very anxious about this appointment, eager and scared. So much so that he called me this morning Sunday, at 5 a.m. I think my body knew it before my brain, because I somehow was already reaching for my phone when it rang. His voice sounded clear, stronger than it is by 11. He asked if he had woken me, and he had, but it was all right. I said, What’s up?

I can’t find the paperwork I need for the appointment, he said. I told him my mother had brought it home with her, and why did he need it now?

Because I have to be ready to go by 6. I’ve been up since 4 a.m.

I hesitated a moment before answering. I knew that something had gone wrong in the space-time continuum that is now my father’s brain. I knew that correcting him would be upsetting, but he needed to know. He needed to know that today was Sunday and the appointment was still two days off. He needed to know that he wouldn’t need to get up at 4 in the morning on Tuesday for this appointment, that it would not take him three hours to get ready for the transport van, which would be there at 7:30, since there is really very little to do: have the aide get you up, get dressed, wash your face. An hour at the most. He is not at home, where it used to take my parents several hours to get out of the house, because breakfast, conversation, and fussing can take a long time.

I sighed and told him all this as gently as I could. I told him it would be all right. He said, with a hoarse chuckle, I must be getting old.

I tell you all this just so you know how important this appointment is to my father. While he may be just one more elderly patient in the stream of your day, we are all eager for an hour where he is getting some personalized attention, where it can feel like someone cares, that something can be done. We want to know what happens when an injury has gone to the bone, if it can ever be fully healed.

With all due respect,

His Daughter

© 2025 Brenda Miller

Brenda Miller is the author of six essay collections, and her work has received seven Pushcart prizes. She co-authored the textbook Tell it Slant: Creating, Refining, and Publishing Creative Nonfiction, and The Pen and the Bell: Mindful Writing in a Busy World. She is Professor Emerita of Creative Writing at Western Washington University. Her newest book, Love You, Bye, a hybrid collection of poetry and prose, is forthcoming in 2026 from Skinner House Books.

To read about Brenda’s writing retreat with Sheila Bender in Italy in September 2026, read this post on True Stories Well Told. I’ll be there.