I pull up the house at 4:30 pm. I’m always early for work, but I am anxious anytime I am running even a minute behind. Today is going to be a good day. We are celebrating Bailey's 14th birthday. It’s not my first time being at these, but it is my first time working with this kind of situation: I’m dating their oldest daughter and I’m the home health aid of their middle daughter.

Walking up the steps to the door, I can already hear the younger kids running around and playing, feeling the buzz of joy in the air as the whole family gets ready for the celebration. For the family, this day is a little more important than other birthdays as Bailey has an unknown number left. She has a genetic disease called skeletal muscular atrophy. It affects her whole body. She can’t walk. She can’t move on her own, or even breath on her own. She depends on machines and the care of others.

As I walk in, everyone greets me. First Early, Bailey's mother. Then Bailey's stepdad and her younger siblings. I greet them all, placing the gift I got for Bailey on the table where I see some others are placed. I walk in to see Bailey.

“Hey crazy,” I say to her.

“You’re crazy,” is the response I get back.

“No, you’re crazy.”

“No, you are crazy!”

We do this often, an inside joke. I ask her how she’s been, losing the battle of crazies.

We talk for a bit about her day, and about who all is coming. A lot of her family plan to come today: grandparents, aunts, uncles, and even her real dad that I’ve only ever met one other time.

As we talk, I start and end her feeding. It was her 3pm “snack” as we called it. I turn the machine off, undo the port that goes into her stomach, making sure to close it off quickly so no acid comes out. After that, I open the machine, take the bag of nutrients out and unwind it from the pump. It looks a lot like milk, but it smells stronger. I tell her I’m going to talk to her mom for a bit and make sure the show she’s watching has plenty of time left before needing a new episode.

I go to the door and open it, pulling my black and mild out of my pocket followed by my lighter, and out comes Early. I hand her my lighter as she often forgets hers inside, especially on busy days like today.

“Thank you,” she says as she lights her Marlboro red.

“No problem. It’s been a busy day huh?”

She agrees and asks me about how school has been. I lie, saying that it is going well, knowing full well I haven’t been in weeks. I try to change the subject.

“It’s not very cool of the hospital to schedule her check ups the day after her birthday.”

“When she was five, I had to take her up ON her birthday. She had to get a couple different shots and you know how she feels about shots. I still hear about that a few times a year.”

I ask her if there’s anything else I need to know about taking her tomorrow.

She goes over the schedule again. I feel my shoulders relax and my jaw unclench, something I never notice that I’m doing until I’m sore from the tightness of my muscles. I think she notices because she says, “I’m not worried about you taking her.”

We go inside and she asks me to finish decorating for the party.

I move to the living room to blow balloons. About an hour later the rest of the family and friends show up. I pause decorating to go help Bailey with the TV, and to help translate what she’s saying to her uncles and aunts. Bailey has her own kind of English, like a different dialect, one where you don’t move your tongue, jaw, or lips. It took me awhile to learn it, but I can now understand everything she says. The family look at her when they talk to her but look at me for a response which I never really got used to.

Later in the evening, after we have all eaten and had our normal “how have you been” conversation, it’s time to bring out the cake. I get Bailey into the recliner, having to unhook her from her oxygen machine, and carry her quickly over, plugging it back in. She tells me how much she hates not being able to breath for those few moments. I understand, and feel bad for a moment, but tell her she’s crazy, starting the “crazies” up again until her mom comes carrying the cake. We all sing happy birthday. As we are singing, I look around and realize how much these people mean to me. I feel like a member of the family. Everyone cares about me and I care about them. I remember when I first thought about taking this job.

 I let my self go into those memories, trying to remember all the details.

It was about a week after Bailey's grandpa had quit working for her that Early first sold me on it: “you’ll get to stay here and see your girlfriend more, and we pay better than sonic, and you get to relax on the couch in A/C most of the time!” Being freshly out of high school, it sounded like a golden opportunity. We talked about what I would need to do, her saying the only thing I needed was a first aid and CPR class. I never had stopped to think that I did not know Bailey well, only ever really saying hi a few times.

Within a week I had already signed the paperwork to start, finished my training, and would be starting work. I remember that I had a really challenging time understanding her, needing to have her mom translate for me. Me and Bailey quickly grew to be friends, something that comes pretty easy, spending 45 hours a week together. We talked a lot about what she thought about life, her siblings, and her adventures to the hospital. We shared future plans about growing up, getting married, kids, and even tattoos. She had a lot of plans. Saying she wants to be a criminal investigator because of Criminal Minds, a show we watched everyday, hours on end, even to the point she could say every single word in the show.

We spent months talking everyday, complaining about our days, telling her about little adventures I had, and of course picking on each other, calling each other crazy an uncountable number of times, sometimes going on for minutes back and forth. I even remember the first time I brought my dog to come see her. I would sit the dog on the bed with her, careful not to get the hair near her booth or tracheotomy. The puppy would lick her hands and feet, Bailey yelling that it tickled and that she wanted to pet the dog, I would help her, grabbing her hand and moving it on the dogs head and down its back. She had always enjoyed when I brought animals. Later: a ferret, and a pig. She loved them.

Bailey says she is ready to get back into the bed. I unplug her and pick her up, quickly carrying her back to the bed because she needs a cough assist. I have to lay her down and put the machine on her. Then I attach a small tube that sucks up the mucus down the tracheotomy. She needs this often when she’s off the machine by her bed. We finish the night out, having to put up her “tent” I got her for her birthday. She says “it might rain and I don’t want to get wet.” I laugh and put it up.