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Twelve years ago my husband had an accident that left him a C-4 quadriplegic, paralyzed below the shoulders. After two nights in Highland Hospital he was transferred to the Neurology Department at the Kaiser Permanente in Redwood City. While there, nurses from India, Sumatra and Sunnyvale cared for him. Ten days later he was sent to the Kaiser rehab center in Vallejo. He came under the supervision of a Pakistani doctor. The therapists who moved his arms and legs and taught me how to get him in and out of his new wheelchair were students enrolled in a nearby physical therapy school. They were from Holland, Belgium, Germany, and Switzerland. Filipino nurses gave Ralph his pills, took his temperature, and recorded his vital signs. The assistants who bathed Ralph, emptied his urine bag, and shifted him from his left side onto his right were African-Americans. 

Ralph returned home a month later and four friends helped me carry him up our back steps and place him into a hospital bed in our living room. Then we were left alone. 

It didn’t take us long to realize we needed additional help. Teams of people had watched over Ralph in the hospital. It was a full-time, demanding job, and I was in no shape mentally or physically to do it alone. 

The organizations I sought advice from on how to hire live-in attendants had unrealistic goals. They expected me to know what we could afford to pay for tasks that appeared endless. Should anyone from a foreign country apply, I was told to check their immigration status. I should, under no circumstances, hire someone with a criminal record. I could ask applicants for this information, but chances were good they wouldn’t tell me the truth. Finding out if they had been incarcerated was complicated. It would take time and money—luxuries I didn’t have. 

Like other people in our situation, I posted ads for attendant care in a local newspaper. The responses were consistent: people with thick accents called and we struggled to communicate before eventually hanging up on one another; the relatives and friends of potential employees who were “too busy,” or whose English was “a little hard to understand” contacted me on their behalf and requested interviews. Face to face with potential candidates I’d demand to see green cards, student visas, and the likes, but everyone arrived empty-handed. No one I interviewed had a criminal record. When asked if they did drugs or had a drinking problem, everyone denied it. Yes, they smoked cigarettes, but they would go outside to do so. 

None of this worked out the way it was supposed to. I gave up looking for people who were U.S. citizens. I stopped searching for persons with green cards, temporary visas, or paperwork that had theirs or someone else’s name on it. I didn’t bother asking about past illegal behavior. I allowed people to smoke indoors, requesting only that they open a window before lighting up. 

I interviewed people from Ethiopia and Eritrea, Ecuador and East Oakland. I hired a woman from Brazil and when she left to become a nanny, I hired a man from England. I fired him for excessive drinking and replaced him with a guy from down the street. We learned that he had a penchant for borrowing money without asking first, but he possessed a strong back, a sense of humor, and he had nowhere else to go. Later, I hired a second man sight unseen who was still residing in his country of origin. Friends helped him navigate the red tape so that he could enter the United States. After his visa ran out, he stayed with us for several more years. 

Currently a woman lives with us who was born and raised in the United States. We don’t talk much about what she did before she became a member of our workforce. Another person sleeps on our downstairs couch and helps with Ralph’s care as needed. He’s from Central America. I’ve never seen his immigration papers, but he has shown me his rap sheet. I’m not sure if an illegal alien can have a criminal record and stay in this country, but I’m not asking. Until the health care system changes, Ralph and I will always have a need for “creative” labor tactics. 

I’m proud to say that in many ways we are equal opportunity employers. Give us your tired, your poor, your huddled masses and we will try to work it 

out.