When I was a little girl, I used to sit on my parents’ double bed and watch my mother get ready to go out. Propped up against the pillows, the bumpy chenille bedspread making little dents on the backs of my thighs, I would observe my mother at her dressing table. Her back was to me, but I could see her face reflected in the big mahogany-framed mirror.
My normally fastidious mother seemed to release her inhibitions in this corner of her bedroom. Her dressing table’s glass top was littered with hairpins and clips, combs and brushes, jewel-toned bottles of nail polish and seductively shaped containers of nail-polish remover, perfume bottles and atomizers, nail files and clippers, and several tubes of bright red lipstick, their tops worn down to perfectly flat circles. The center drawer of her table was even messier. Here were wadded-up hairnets, cuticle remover, vials of deodorant, lipstick-smudged tissues, tweezers, boxes of loose face powder, and several slightly grimy powder puffs. Spilled powder piled up in the corners of the drawer like mildew on grout in the bathroom.
This was the essence of my mother: makeup. She was never more real to me than when she was “putting on her face.”
From my vantage point on the bed, I also saw her back: the soft curves of her hips as they sank into the fabric-covered stool; the loose flesh of her upper arms; the wisps of hair that escaped down her neck; the indentations her bra straps made in her shoulders.
And the moles, large and funny-shaped, like dark continents on the ocean of my mother’s back. I didn’t like them, even then. It took her fifty more years to realize how dangerous they were, and by then it was too late.
Mother is extremely frail. I have come to West Virginia to help. In her bedroom she has a portable oxygen tank to help her breathe at night. Last night it came on with an earsplitting shriek that woke me in the downstairs bedroom. I couldn’t decide whether to feel anger or pity; whether to go up and check on her, or ignore it and allow her her privacy. I chose to ignore it and spent the rest of the night feeling guilty.
Today I make doctors’ appointments, talk to hospital social workers, and try to find someone who will take over Mother’s care when I go home to Missouri. In the evening I help Mother take a shower. She has so much pain in her hip that she can’t lift her leg over the edge of the tub. I practically have to pick her up to get her in. She says she weighs less than ninety pounds. She does not seem to mind my looking at her naked body, and I am shocked by what I see: hipbones straining against pale flesh, thighs sagging over kneecaps, withered breasts, and a strange bluish lump just under her jutting collarbone.
The surgeon who removed the malignant melanoma from Mother’s back last December has agreed to see her this morning. She insists on dressing up for the appointment. Seeing her struggle with the pantyhose, I suggest she go without them, but she is adamant that her legs look “too awful” without hose.
At the office, the doctor says the pain in her hip and leg may be the result of a hip fracture. “Have you fallen?” he asks. Mother hesitates. “Yes,” she says quietly, as if ashamed to admit it. She has said nothing to me about a fall. When the doctor sends us to get an X-ray, I confront her in the elevator. “Why didn’t you tell me you fell?” I ask.
She is silent for a minute, and then says defiantly, “I just didn’t.”
The X-ray shows no fracture. Mother, at eighty-eight, maintains her record of never having broken a bone.
We have an appointment with Mother’s internist of more than ten years. “How are you doing?” he asks. “I’m dying,” she replies. He does not disagree, and proceeds to listen to her heart and lungs, the stethoscope pressed against her sapphire blue blouse. He schedules a bone scan for the day after tomorrow.
Back at home, I ask Mother why she didn’t put on an examining gown. “I’ve never had to take off my clothes in his office,” she says proudly. I’m beginning to understand how the big black mole in the center of her back went unchecked for so many years.
Mother’s pain is so severe she doesn’t even leave her bed except to hobble to the bathroom. The internist authorizes an ambulance to get her to the hospital for the bone scan. The attendants have difficulty negotiating her steep, curving stairway with a stretcher, and end up carrying her down swaddled in a flower-patterned sheet. I suspect this is the last time she will ever see her bedroom. I wonder if she realizes it.
I follow the ambulance to the hospital. When I get to the unit where she has been taken, I see written above the double doors in large black letters: ONCOLOGY. My God, it’s true, I think. Mother is dying of cancer.
The bone scan is completed. Mother must be feeling better, because she’s complaining, as usual. She finds fault with the temperature of the hospital room (too cold), the food (dreadful), the sink (dripping), and the bathroom (she has to share it with a man). She is not in a good mood when I tell her the Presbyterian minister has come for a visit.
Mother is an atheist, but she sends a hundred dollars a year to the local Presbyterian church to ensure that it will conduct her funeral service when the time comes. At her request, I specified “no clergy visits” on her admitting form, so I was taken aback when I ran into the minister, Dr. Harding, in the hall looking for her room.
“No!” Mother says when I tell her he is here. “I don’t want anyone praying over me. I’m not dead yet!”
But Dr. Harding is persistent. He promises to stay just two minutes, and to say no prayers. Finally Mother relents and he sweeps into the room, confident that he is doing the work of the Lord. Mother, ever conscious of appearances, is surprisingly gracious.
The nurse leads me into the family waiting room, sits down on the couch beside me, and opens Mother’s chart. She says that Mother has congestive heart failure, a leaky valve in her heart, chronic lung disease, and osteoarthritis. In addition to this, the bone scan shows that the malignant melanoma on her back has metastasized into her pelvis, spine, and skull.
I am not surprised by the diagnosis. I am not angry, or sad. I have a curious feeling of disembodiment, as if my real self is somewhere up on the ceiling watching the scenario unfolding below.
When the internist comes by on his morning rounds, Mother is awake and propped up in bed with a quilted pink bed jacket over her scrawny shoulders.
It must be hard to tell people they’re dying. The internist leans over the bed, Mother’s chart in hand, stethoscope dangling from his neck. “You remember the mole we took off your back last year?” he asks. “You know it was cancer? Well, that cancer has spread and that’s what’s causing all the pain in your hips and thighs. I’m sorry, but there’s nothing we can do about it. We can’t operate, and chemotherapy won’t help. . . . We’ll make you as comfortable as we can.”
Mother’s only immediate reaction is a slight grimace and a pulling back into her pillows. After the doctor has left the room, she finds her voice. “Call Dr. Kevorkian,” she commands.
I sit on her bed and hold her bony hands, feeling more compassion for her now than ever in my life. I talk about hospice; she calls for sleeping pills, a plastic bag, and the Hemlock Society. Neither of us mentions a nursing home.
Then she does something she has never done before: she asks my advice. “What do you think I should do?” she says. It is more of a plea for help than a question.
I’ve given this a lot of consideration in the past twenty-four hours, and I know what I think, but do I dare suggest it? Will she think it’s cruel? If she agrees to it, will I feel guilty? And is it possible that I have my convenience, more than her comfort, in mind? Then I think about the kind of woman my mother is: Proud. Determined. Unemotional. Certainly able to make her own choices.
“I know only one way to make it quicker for you,” I whisper.
I take a deep breath. “You could,” I say quietly, “stop eating.”
She understands instantly. With a slight smile she relaxes against the pillows and says, “Give me the morning paper. I want to read the headlines.”
The doctors are anxious to get Mother out of the hospital. We reject the idea of a nursing home and enroll her in the hospice program. She will go home with a catheter in place, plenty of painkillers, and a fierce determination to “get this over with as soon as possible.” As I sign the papers agreeing to accept responsibility as her primary care-giver, I realize this will mean weeks of living at her house, a place I’ve generally avoided for years. I wonder if I’ll actually be able to carry this off. I have a brief vision of a tabloid headline: “Deadbeat Daughter Leaves Mom To Die.”
I start calling nursing agencies to find someone to help; the hospice nurses can’t be with me round-the-clock. After several hours with no luck, I begin to panic. I’m five hundred miles from home, and my dying mother is being kicked out of the hospital with only me to care for her.
For the first time since this all began, I cry. I lie on mother’s sofa and sob, feeling resentment toward her for getting sick, terror at the thought of caring for her all by myself, and anger at being an only child.
Then I think of Sarah, my daughter. She’s not working, has time on her hands. A calm sense of purpose comes over me as I call her and, voice trembling, outline my plan. She will fly here, and the two of us will take care of Mother until she dies: three generations of women together in one little house in the sweltering West Virginia summer.
When the hospital breakfast and lunch trays arrive, Mother takes a few sips of juice and leaves the rest. No one mentions the fact that she’s not eating. Seeking reassurance, I talk to several of the nurses about her decision. One tells me that, if Mother ate, she would just be “feeding the cancer.” Another says, “If I were in her situation, I’d do the exact same thing . . . unless, of course, I had a stockpile of sleeping pills.”
The oncologist starts Mother on morphine, a small blue tablet to be given every twelve hours. If the pill isn’t enough, we can put a few drops of Roxanol, a liquid morphine concentrate, under her tongue.
In the afternoon, Rat comes to visit. “Rat” stands for Robert Allen Todd. He is Mother’s special friend, a ninety-year-old former athlete with a full head of white hair, severe hearing loss, and a bad back. Mother and Rat knew each other in high school, and met again in the produce section of the supermarket four years ago. Both eager for friendship and in need of an escort to social events, they began seeing each other. On their first date they dragged out their 1924 high-school yearbook and wrote “dec.” by the picture of every classmate who had died.
When I enter Mother’s hospital room after lunch, Rat is squirming in a battered vinyl chair. “Rat always takes a nap after lunch, but he’s having a hard time getting comfortable,” Mother says.
“Would you like for Rat to lie down beside you?” I ask.
“Do you think it would be OK?” she says.
Few rules apply to eighty-eight-year-old patients on the oncology floor. “It will be fine,” I say, and scoot Mother over in bed to make room for Rat. He climbs in beside her, fully dressed in suit coat, tie, and shoes. They lie on their sides, spoon-style, and Rat puts his arm around Mother.
“Have a nice nap,” I say. “I’ll be next door in the lounge.” I close the door securely behind me.
A half-hour later, I’m sitting in the lounge doing needlepoint when I hear Rat’s voice through the wall. Even with two hearing aids, he is extremely deaf, and often shouts without realizing it. I wonder why he’s talking, but decide to give them a few more minutes of privacy.
When I finally walk into the room, I find both of them sitting up in bed, giggling.
“You missed it!” Mother crows. “The minister came in and found us in bed together. He said, ‘This is your husband, I presume?’ ”
“What did you say?” I ask.
“I just said no!”
Mother is laughing so hard, tears come to her eyes. Rat looks slightly embarrassed. I am amazed the minister had the audacity to open a closed door in a hospital.
“He even said a prayer over us!” Mother says.
I wonder where I’m going to find someone to conduct the funeral service.
“You missed it” Mother crows. “The minister came in and found us in bed together. He said, ‘This is your husband, I presume?’ ” “What did you say?” I ask. “I just said no!”
Mother is discharged from the hospital. Her internist, apparently in acute denial, instructs her to come to his office in a month.
Before we leave, I confront several nurses with the question “How long?”
Nobody will be specific. One nurse reminds me that admission to the hospice program requires a life expectancy of six months or less. Another cautions that the body can go without food for a long time. Finally, the oncologist takes pity on me.
“Your mother’s urinary catheter won’t give her any trouble for thirty days,” he says. “She is very, very frail.”
“Thirty days?” I ask.
One of the last things the nurse does is put Mother on the scale. She weighs seventy-eight pounds.
The ambulance attendants carry her carefully up the front steps and through the living room to her den, which I have transformed into a sickroom. I wonder if Mother is aware that this is the last time she will ever come home. As usual, I am being sentimental for her.
“My hair must look awful,” she says. “Call Iris and see if she can come to the house tomorrow.”
The hospital bed dominates the little yellow den. There are bed linens and towels on the couch, medicines and flowers on the side table, and a television on the bureau. I put a bell on the bedside table, next to the TV remote, so that Mother can summon me easily. I will sleep on the couch in the living room, where I can hear her during the night.
I help Mother make a list of people to contact with the news. Although she has been in pain for weeks, most of her friends don’t realize how seriously ill she is. Her list ranges from longtime friends to former cleaning ladies.
Early in the afternoon, Helen, one of her oldest friends and a member of the group she calls “the Lunch Bunch,” comes to visit. Helen is brash and irreverent, an approach to life my mother relishes.
“Did you ever think you’d see me like this?” Mother asks.
“As a matter of fact, no,” Helen replies. “You do look pretty awful.” She then tells Mother that she and her husband have purchased a new puppy because they had to put their sixteen-year-old dog to sleep last week. If Mother sees any irony in this, she doesn’t mention it.
Iris, Mother’s hairdresser, arrives later with no-rinse shampoo, a curling iron, a hair dryer, and several cans of hair spray. She is a big, blowzy woman who wears lots of pancake makeup and too-tight clothing. The sweet smell of cheap bourbon surrounds her like a cloud.
As she works on Mother’s hair, Iris talks crudely about the women who have been in the beauty shop today. She pulls a few lacquered curls over Mother’s forehead, and I ask if she can do anything about the matted hair in back.
“No, honey, that’s just gotta stay that way,” Iris says. “This is the way I do the bodies at the funeral home. I curl it up at the forehead, over the ears, and along the neck, but I can’t do nothing about the back. No one ever sees it, anyway. If you want me to do your mother at the funeral home, just call me.”
Mother seems strangely oblivious to these remarks. Then I realize, gratefully, that she has removed her hearing aid to have her hair done.
My daughter arrives, tall and beautiful, with enough luggage to stay a year. Hugging me tightly, Sarah whispers, “I’m kind of afraid to see Nana.”
“I know,” I say. “It will be OK.”
She goes into the sickroom, bends over the bed, and plants a soft kiss on Mother’s sunken cheek. “Hi, Nana,” she says. “I’ve come to help take care of you.”
Mother is comfortable, alert, and complaining. She makes no pretense of cheer. One friend tells her, “I’m so sorry you’re sick,” and she replies, “Me, too.” She wonders why she couldn’t have just dropped dead. She asks me if I’ve called the funeral home yet. I say no. (Actually, I have, just to find out what I’ll need to do when the time comes.)
More friends and neighbors come to call. Mother is concerned about her appearance. She doesn’t look bad, considering. Iris has sprayed her hair into immobility, and each morning we wash her hands and face and dress her in a fresh pastel-colored gown. Her face has the waxy sheen of artificial fruit, but is virtually unlined.
Faithful Rat comes every day at 10 A.M. and 4 P.M., and does almost all the talking. He calls Mother “Sweetie Pie,” sings to her (“Darlin’, I’ll miss you more than you’ll ever know”), and encourages her to live each day as it comes and try to enjoy what it offers. “When Gabriel wants you in heaven,” Rat says, “he’ll toot his horn — toot, toot, toot.” Sometimes Rat brings a gift for Sarah and me. One time it is an envelope containing five hundred-dollar bills. Another time it is a box of cheese crackers.
My cousin Martha, who lives three hours away, comes to visit. Martha’s mother and mine are sisters. Her mother is in good physical shape, but has senile dementia and lives in a nursing home. My mother, with all her physical ailments, is alert and competent. Martha and I wonder which is worse.
During Martha’s visit, Mother suddenly says, “Martha always had such pretty hair.”
I wait for a comment about my hair, but none is forthcoming. Mother has never complimented me on my appearance.
Martha’s mother . . . is in good physical shape, but has senile dementia and lives in a nursing home. My mother, with all her physical ailments, is alert and competent. Martha and I wonder which is worse.
Mother’s blood pressure is 80 over 50 and seems to be falling. Beth, our hospice nurse, explains that as death nears, the numbers get closer together and finally converge.
The complaining continues. “Why in hell did I buy that two-hundred-dollar dress last winter?” Mother asks. (I wonder the same thing myself, but hold my tongue.) Scanning the morning paper, she says, “I hate that they put the obituaries in the sports section.” At one point, she declares, “I must look like a cadaver. Maybe I shouldn’t let people see me.” As Sarah and I turn her and rub her body with lotion to prevent bedsores, she mutters, “A rag, a bone, a hank of hair.” We try to reassure her and offer her a mirror, but she refuses to look.
Talking to well-wishers who come to visit, I’m beginning to realize that my image of my mother — a perspective I’ve nurtured and cultivated for years — is not one everybody shares. Where I see a silly, frivolous woman, they see a person with a good sense of humor. Where I see a cold, unemotional parent, they see a strong, independent woman. Where I see cruelty, they see sardonic wit. While I think Mother puts on airs, they see her as having good manners.
Mother wakes at 5:30 A.M. and wants to read the morning paper. I get it for her, spoon some crushed frozen juice between her parched lips, and go upstairs to wake Sarah and trade places with her.
At nine, Sarah rushes upstairs, crying, “Nana is choking!”
Mother is sitting up, her face blue, the veins in her neck distended. She is coughing with a wet, gurgling sound, straining for air, gasping and wheezing, occasionally spitting out small blobs of white, frothy slime. Sarah and I support her back with pillows, wipe her face with a cool cloth, and hold tissues under her chin. The choking sounds continue.
“Call the nurse,” I whisper to Sarah over Mother’s head.
The hospice nurse tells Sarah to put one-fourth teaspoon of Roxanol under Mother’s tongue, and promises to come immediately with a special gel to dry up the fluid in her lungs. Sarah and I wonder why we weren’t given this magic gel in the first place.
The liquid morphine doesn’t work as rapidly as we would hope, although the frantic coughing and gasping do subside slightly. Sarah and I stand on either side of the bed, rubbing Mother’s arms and talking softly to her. She is so thin I can wrap my thumb and middle finger around her biceps. The skin of her forearm is dry and wrinkled, and reminds me of a chicken leg left too long in the refrigerator. Her bony shoulder is hard, cool, and smooth to the touch, like a marble statue. I’m struck by the fact that I have seen and touched more of Mother’s body in the past few days than in the previous five decades.
Finally Ruby, the on-call hospice nurse, arrives. Short, plump, and businesslike, she pulls on a pair of rubber gloves, inserts a morphine pill in Mother’s rectum, squirts another dose of morphine under her tongue, takes her vital signs — still strong — and calls the doctor to get approval for an increase in the fluid-reducing medication.
Mother slips into a comfortable, drug-induced sleep, but three hours after Ruby leaves, she wakes up, agitated and thirsty. “Why can’t they just give me a shot and get this over with?” she wants to know.
“A shot to put you to sleep, or a shot to kill you?” I ask.
“I know they won’t kill me, but I think it’s cruel to keep me awake and thirsty like this.”
“It’s been three hours,” I say. “I’ll give you some more morphine.” I hold the teaspoon as Sarah measures out the liquid, sucks it up in a syringe, and places a few drops at a time under Mother’s tongue.
I call Ruby to ask permission for what we’ve just done. She assures me it’s OK to give morphine every three hours. I know the answer to the next question, but ask it anyway: “What’s the worst thing that could happen if we give her too much?”
“It could depress her respiration and kill her,” Ruby answers.
I tell Sarah this, and we look at each other, both wondering whether we could do it.
Later that night, when Mother is quiet and comfortable, I talk to her about dying. “I wish I could write,” she says. “I’d like to write something about dying.”
This is unexpected. In her younger days, Mother was a publicist for various civic and charitable organizations, but I’ve never known her to write anything serious.
“If you want,” I offer, “you can dictate it, and I’ll take it down for you.”
Here is what she says:
I always thought the ideal way to die was to go quickly — just drop dead — but that doesn’t usually happen. It’s nice to live long enough to be ill and receive wonderful care and affection from your family that you would probably never otherwise enjoy. It’s been interesting to think back on all the things I’ve done in my life, things I’ve enjoyed, and to get better acquainted with my family, which hasn’t been around for a while. Since I haven’t suffered, it’s been a rather nice experience, one I wish everyone could have. I’ve enjoyed a good life — better than most — and now I think, at my age, it’s time to go.
I start to encourage her to explore her feelings further, but she asks for the evening paper; she wants to read the headlines.
Lying on the couch that night in a wonderful soupy state of half sleep, I feel a shiver of energy dart through my body. That must be Mother’s spirit, I think. She has died. Slowly I get up and make my way into her room. Her small, round shoulders rise from the pillow: she is still breathing.
My earliest memories are of being sick. Severe asthma attacks punctuated my childhood, beginning when I was three. During them, I would sit hunched over on my bed, my arms propped on pillows, coughing, wheezing, and gasping for breath. Mother and Daddy would give me cough medicine, run the vaporizer, rub my back, and try to calm me. Often I would be in bed for a week. Mother would take care of me during the day. She’d let me eat anything I wanted, which was usually a dish we called “cinders”: ground beef with lots of salt, crumbled and fried to a crisp in an iron skillet. I would eat the meat with my fingers, licking off the salt and rubbing the grease on a linen napkin. She’d also fix baked custard, dusted with nutmeg and served in little glass custard cups. Sometimes I would eat nothing but cinders and custard for days. The rest of the time, I would listen to the radio, nap, color in my coloring books, and wait for Daddy to come home.
When I heard Daddy walk in the door at 5:30, I would tremble with excitement. He’d take off his hat and coat, hang them in the closet, kiss Mother on the cheek, and say, “Fix me a highball.” Then he would come upstairs to give me his undivided attention for the remainder of the evening.
Sometimes Daddy would bundle me up in bathrobe and slippers and carry me downstairs to the couch, where he would sit beside me with the day’s edition of the newspaper spread out before us. He would read the funnies to me, and help me sound out the title and author of each strip. I will never forget his glee the evening I figured out the creator of Nancy was Ernie Bushmiller.
When I had trouble sleeping, Daddy would carry me downstairs and walk the floor with me. I remember the warmth of his arms, the smell of his after-shave lotion and hair tonic and tobacco, the stubbly feel of his beard against my cheek. His creased leather slippers would slap against his heels as he walked. I’d hear the hum of the refrigerator, the tick of the clock, and the swoosh and roar of the furnace coming on. The only light would be the glow from the top of the stairs and occasionally the headlights of a passing car glancing around the living room. Finally, I would fall asleep.
Mother took good care of me when I was sick. She took me to the doctor, brought my meals upstairs, gave me my medicine on schedule. But she was not comfortable with illness, and was quick to say that nursing did not interest her.
Daddy wasn’t interested in nursing, either. But he was interested in me, and I knew it.
The flowers that arrived when Mother came home are dying. I go into the garden and cut some buds from her favorite pink rosebush and put them in a small vase next to her bed.
She sleeps more today and is lethargic when awake. She talks about eating steak and shrimp cocktail, then says, “Whoever would have thought that I would starve to death?” I remind her that this is her choice, and that she can always change her mind and eat something. She shakes her head no.
Sarah and I sit on the front steps after dinner, watching the lightning bugs do their slow dance in and out of the yew hedge. Sarah suggests that we tell Mother it’s OK for her to die. “Maybe she’s holding on to something we don’t know about, and if we tell her it’s all right to let go, it will be easier for her.”
As we prepare Mother for sleep, we tell her that we love her, that we’ll miss her, but that it’s OK for her to die; we’ll be all right without her. Sarah thanks her for the privilege of taking care of her. I tell Mother that we know she is anxious to go, and wish we could help her more, but we can’t.
“I wish you could, too, but your name would be mud if you did,” she says.
I’m caught off guard by that familiar saying of hers, one I haven’t thought of in years. I used to hear it almost every day when I was little, and always wondered what it would be like to be named Mud.
Mother wakes at 3 A.M., complaining of pain in her side. I turn her and give her more juice and another dose of morphine. Suddenly she says, “She came in July, and she left in July.” She is referring to her birthday, nineteen days away.
After her morning medications, Mother informs us that she won’t live through the day. I sit on the stool beside her bed, rubbing her forehead and stroking her milky, blue-veined arms. Suddenly she opens her eyes and says, “Rat.” I ask if she wants him to come, and she says yes.
When Rat walks in the door, she says, “It’s time for you to kiss me goodbye.” He doesn’t linger at her bedside today, but rather seems anxious to get out of the house. He has already lost a wife and a previous female companion to cancer.
Suddenly, Mother says, rather loudly, “Are they here yet?” “Who?” I ask. “The people from the funeral home,” she says. Sarah and I look at each other and laugh. “No, Mother,” I say. “You have to die first.” She smiles and says, “Well, at least I’ll go out with my sense of humor.”
Mother wakes after ten hours of sleep, during which her respiration was so shallow and erratic it was hard to tell if she was breathing. Oddly, she is alert and happy.
“I dreamed it was springtime,” she says, “and I wrote a poem for that guy Jack who has a silly column in the paper.”
I ask if she can recite the poem for me.
“Slush” is all she says, a request for the crushed frozen juice that has become the focal point of her existence.
When I return from the kitchen, she tells me, “If I go, I’m thankful for such a wonderful daughter.” I hug her and tell her that I love her and will miss her. I’m still waiting for her to say that she loves me.
Then she muses, “I never told Rat that I love him. I wonder if he knew it.”
Faithful, devoted Rat: though he is almost completely deaf, I imagine he is well aware that he’s never heard these three important words from Mother.
“Do you want to tell him you love him?” I ask.
Mother thinks a minute.
“Maybe I did that yesterday,” she says.
The phone hasn’t rung all day — phone calls from Mother’s friends have almost ceased — but Rat continues to visit at his appointed times. While Mother lies quietly with her eyes closed, he recites the Twenty-Third Psalm and Tennyson’s poem “Crossing the Bar,” and reaffirms his love for her. As he walks down the front steps, placing his cane gingerly in front of him, he stops and takes a handkerchief out of his pocket to wipe his eyes and blow his nose.
That evening, Mother clutches my hand and says, “Forgive me, Barbara.”
“For what?” I ask.
“For everything I did to make you so unhappy.”
“I’ve already forgiven you,” I say, and as the words come out of my mouth I realize they’re true. “You were as good a mother as you knew how to be. I’ve turned out OK.”
“I just wish I were leaving you with better memories,” she says.
So do I. But this, at least, is a good one to go out on. I go upstairs, where Sarah is lying on the bed eating corn chips and watching the news. I lie down beside her and tell her what Mother said. She puts her arms around me, and together we determine to make good memories for each other.
The summer I was twelve, Mother decided I would take sewing lessons. It didn’t matter that I had absolutely no interest in sewing and had barely passed my junior-high sewing class, where we had to make a potholder, a tea towel, and an apron. In Mother’s view, every woman should know how to sew, so I was enrolled for a series of classes.
Mother let me pick out my dress pattern (I chose the easiest one I could find) and packed it and all the other things I would need — fabric, tape measure, pins, thimble, thread, scissors — into a navy blue Samsonite case. Then she sent me off on the bus to my first class.
I never made it there. When the bus stopped at the public library, I got off and went straight to the musty reading room, where I gathered an armful of books and magazines, propped my feet on the blue sewing case, and read for two hours. Then I went home on the twelve o’clock bus. I did this for six weeks.
After the class was over, Mother opened the case to see my dress. There was the pattern, still in its envelope, and the fabric, still folded in a neat rectangle.
“I went to the library instead,” I said.
I think she was furious, but she just looked at me and said, “Oh, Barbara.”
This morning, my cousin Martha comes for a short visit and decides that Mother needs some makeup. “A little lipstick always makes people feel better,” Martha says. It doesn’t make me feel better to see Mother with bright pink blotches of blush on her sunken cheeks and a red slash across her lips. She looks like a discarded kewpie doll.
“I don’t think it’s fair to put makeup on someone who can’t take it off,” Sarah mutters after Martha leaves. Mother doesn’t seem to care; she still refuses to look at herself.
Later, going through Mother’s billfold, I discover two membership cards in the Hemlock Society. Sarah has already found two slim paperback books: Common-Sense Suicide and Let Me Die before I Wake. I haven’t told anyone about what I came across in the basement, on a shelf next to the washing machine: a plastic bag filled with half-full bottles of pills, all the medications prescribed for Mother over the past five years.
We show the books and membership cards (but not the pills) to Beth the nurse, who goes in to see Mother. After a few minutes of casual chatting, Beth asks, “Before you became so sick, did you ever think about committing suicide?”
Mother looks blankly at Beth for a minute, then whispers, almost glumly, “No.” Beth takes her blood pressure: 105 over 50, higher than it’s been for days.
Beth, Sarah, and I sit in the living room, eating candy brought by Rat and discussing the suicide materials. Sarah and I press Beth to tell us how much morphine it would take to bring on death. Beth thinks for a long time.
“I can’t do it,” she finally says. “I’m a hospice nurse. I’m not supposed to do anything to cause, or delay, a natural death.”
She pauses and looks down at her shoes.
“But, having said that, if you were to give her 10 cc of Roxanol, it would be a good idea to replace that amount with water in the bottle.”
The temperature outside reaches a hundred today. When I bring Mother her juice, she asks, “Is this slush or is this bread?” Yet she is lucid enough to remember the store where she bought the two-hundred-dollar dress, and the name of the clerk who sold it to her.
I’m beginning to suspect kidney failure. Mother’s urine has turned the color of strong iced tea, and very little collects in the catheter pouch. Beth explains the buildup of toxins in the blood. Mother’s blood pressure is inching downward.
Near bedtime, Sarah and I give Mother her medications, rub her with lotion, and turn her again to prevent bedsores. Like barbecuing a roast on a spit, I think. The bedsores, at least, are enemies we can fight.
I put a cool washcloth on Mother’s head and feed her slippery ice chips with my fingers.
“Good night, Mother,” I say.
“Good night,” she replies, and, for the first time in my memory, she says, “I love you.”
In the afternoon, we go through Mother’s clothes. We find more than thirty hats, some dating back to the 1950s, all carefully preserved in hatboxes from stores that closed long ago. We model them for Mother, who urges us to take them and wear them often. We sort through suits and dresses, Mother’s pride and joy, each encased in a plastic bag. All a petite size four, these are of little interest to us. Her jewelry surprises me. Most of it is costume jewelry, large and flashy. The only quality piece is a strand of cultured pearls.
I feel an almost clinical detachment going through these things that Mother treasured. In her eyes, these possessions were important. By adorning her, they defined who she was.
Beth has made arrangements for us to have eight hours of respite care tonight: an aide will sit with Mother from 11 P.M. to 7 A.M. so Sarah and I can get some uninterrupted rest. Having spent the last eighteen nights on the couch, I am almost giddy at the prospect of sleeping in a bed.
After Mother’s evening medications, Sarah and I sit quietly with her for a few minutes. Suddenly Sarah asks, “Nana, where is your belly-dancing costume?”
Mother doesn’t hesitate a second. “In that closet, in a box on the shelf, on the right-hand side.” Sarah quickly finds it: a sheer black skirt with gold fringe around the hips, and a black bra with rhinestone studs at the nipples. Unable to resist, she runs to the bathroom to try it on and returns to give an impromptu performance at the foot of Mother’s bed.
“How old were you when you took belly-dancing lessons?” I ask Mother.
“Sixty-eight,” she replies.
Today it is three weeks since Mother received the diagnosis of metastatic bone cancer; twenty-one days since she last had a bite of solid food. Two people call to inquire about her. Both refer to her as a “tough old bird.” I’ve decided she is very brave.
When Sarah and I administer Mother’s evening medications, she is exhausted, limp, and moaning slightly. Swallowing has become very difficult for her. Instead of trying to insert the twelve-hour morphine tablet rectally — a prospect we’ve been dreading — we decide to give her ten drops of Roxanol under her tongue, even though it means we’ll have to give her more in four hours.
Mother sighs loudly and closes her eyes, then rouses to ask, “What time is it?”
“It’s nine o’clock on Tuesday, July 18,” I tell her. I put my left hand on her forehead and lightly stroke her soft gray curls. It’s like petting a poodle. Mother, who was always so untouchable, so unapproachable, doesn’t seem to mind my caresses. Then I wonder if she really does, but politeness prevents her from saying so.
This morning Mother is sleeping on her back, her head and feet slightly elevated by the hospital bed, her mouth in an O shape. Her breathing is erratic — sometimes deep, with long intervals between breaths; other times shallow and rapid.
I go for a walk. The neighbors are beginning their day: heading out the door with a briefcase, turning on lawn sprinklers, letting out the dog, weeding flower beds in the cool of early morning. Starting a new day is easy, I think. Ending a life is hard.
When I return from my walk, I go in to check on Mother, and somehow I realize this is it. Frightened, I call Beth, who promises to come right over. Tresa, a hospice aide, arrives for her scheduled visit and offers to examine Mother, but I am reluctant to disturb what might be her last sleep.
When she gets here, Beth checks Mother’s vital signs, but can’t find a blood pressure. Mother’s heart is pumping furiously. She wakes, and we ask if she wants water or juice. “Not yet,” she says.
It’s been more than twelve hours since she has had any pain medication, so I measure out a dropper of Roxanol. Mother opens her mouth like a baby bird to receive it. Sarah stands beside me, her hand on my back. After the Roxanol, I clean Mother’s mouth with a sponge brush, and she sucks the moisture from the swab. She seems aware of what is happening and eager to get on with it.
She looks directly at me, then at Sarah, and mouths the words, “I love you both.”
Through tears, we tell her that we love her, too.
Suddenly, Mother says, rather loudly, “Are they here yet?”
“Who?” I ask.
“The people from the funeral home,” she says.
Sarah and I look at each other and laugh. “No, Mother,” I say. “You have to die first.”
She smiles and says, “Well, at least I’ll go out with my sense of humor.”
At six, the first of our continuous-care nurses arrives. Hospice starts continuous care when the nurse believes death is imminent. We are entitled to forty-eight hours of this service. Mother doesn’t know she has a deadline. We check on her one more time, and the nurse points out signs of approaching death: the soles of Mother’s feet are bluish and bruised-looking, her urine has ceased, her legs are beginning to feel cool to the touch, and her limbs are becoming stiff. Occasionally, Mother raises her hand, as if in a silent goodbye. Her face twitches. I wonder what, if anything, she is thinking or feeling.
When I go downstairs at eight, Mother is lying on her side, eyes open and staring, lids blinking rapidly. She has a temperature of 103.5, and the nurse inserts a Tylenol suppository. Mother coughs — a guttural, burbling sound from high in her chest — and spits out a blob of brown sputum. Her sticklike arms quiver constantly. She doesn’t respond when I stroke her cheek or squeeze her hand.
Thinking that the rapid eye blinks might be caused by dryness, the nurse suggests artificial tears. I find an unopened bottle in my contact-lens case. An hour later, when the eyelid movement hasn’t ceased, we decide it might be a reaction to pain, and the nurse administers another dose of morphine. Several hours later, Mother’s condition is unchanged, and we wonder if she might simply be afraid to close her eyes. Perhaps, in her innermost being, she is afraid of death, after all.
This tenacious holding on to life by a woman who has contemplated suicide and chosen to starve herself puzzles Beth, who has been troubled all along by Mother’s lack of spiritual commitment. Maybe, Beth suggests, it’s time to call in a minister. Sarah and I consider this, but decide it would be wrong to impose someone else’s beliefs on her now. Mother continues to blink.
In the late afternoon, the florist delivers a huge bouquet of red and white roses. The card reads: “Farewell. I will love you forever. Just as always, Rat.” I bring the roses to the bed to show Mother, and she seems to smile. I read her the card, then slip it into her cool, dry fingers. I believe she can hear me and is aware of things around her, but is able to respond only with a slight smile — not such a bad way to react on your deathbed.
Mother has had a restless night, unable to close her eyes, with periods of coughing and agitation. Rita, the nurse who arrives at 7 A.M., opens a benadryl capsule and puts the contents under Mother’s tongue in an attempt to relax her.
I am brushing my teeth when Sarah runs upstairs to say, “It’s time.”
Mother’s breathing has become deep and throaty. Her eyes are wide but unseeing. Her jaw opens and closes reflexively. Her body seems to be collapsing in on itself.
I put Mother’s hand between Sarah’s and mine and stroke her cheek with my fingers.
“It’s OK,” I say. “You’ll be OK. We’ll be OK.”
We watch as life slowly ebbs away. The room is quiet except for the ceiling fan, which sends a cool breeze over the bed. Rita stays in the background, letting Sarah and me occupy the last minute of Mother’s life.
“Close her eyes,” Sarah finally whispers. With my right thumb I gently press down on Mother’s right eyelid, then her left. They remain shut.
“The official time will be 7:57,” Rita says softly.
Holding Mother’s face in my hands, I bend down close. “Where are you?” I whisper. “Where have you gone?”
Then I am aware that it is over. The only thing left for me to do is to turn and hug my daughter.
Today, two years after my mother’s death, if I could tell her one thing, it would be this: You died without your makeup on, Mother. And to me, you were never more beautiful.