Death/In Place, pt 3

We were scheduled to see a pulmonary oncologist at M.D. Anderson in two weeks. The morning after the night during which my mother accused me of trying to poison her, I called the hospital and asked for an emergency appointment. I was shocked when I got one for the following day, the day when the home helpers were due for their first visit, the day, perhaps, finally, of my mother’s long-awaited bath. Crossing off the helpers’ names on my calendar and replacing them with “MDA” felt unclean, a betrayal of her desires.

At intervals during the long day before our appointment, my mother would be quite lucid: she understood, or seemed to understand, that we would be soon be visiting the hospital. In the afternoon she made the connection between the original plan and this new exigency. “I don’t want to be dirty for the doctor,” she said. After weeks of trying, I finally persuaded her to take a “pezzi” bath, a term from our Italian days meaning a bath of parts or pieces. My mother had me take pezzi baths when I was sick so I wouldn’t make my cold or fever worse. Pezzi baths meant a special soap from the commissary with what I now know is a German name: Badedas. It was yellow and smelled like health. Later, or perhaps only in the States, it was eventually dyed green and renamed “Vitabath.” Its power to heal disappeared. I did not have bubble bath under any name in any of my drawers or cabinets, but I did find an unused natural sponge, flat and dry in its sealed package. Together, like children performing a simple science experiment, my mother and I dipped the sponge in warm water and watched it grow large and soft. When the sponge had blossomed, I left my mother to “pezzi” herself. 

I have, I think, repressed the short journey to M.D. Anderson and what it took to transport my mother one more time to a place she did not want to be. My memory awakens in a bright, white room—no view this time—and a doctor is talking to me. He has a clipboard, and the biopsy from NYU. “You know,” he said, “that your mother has large-cell lung cancer? “Yes,” I said. “You know,” he said, “that the kind of cancer she has does not respond to chemotherapy?” “I didn’t know that,” I said, thinking of my mother’s expedition from New York, of the blue babies she had seen choking in the recirculated air of the plane, and of her fear of being poisoned once we got to my house. “So, you mean there was no point coming to Houston?’” I asked.  The doctor was gentle. “This is your chance to be with your mother,” he said. “That’s the point.” I thought about the doctors at NYU who had encouraged me to take my mother to Houston, and of how I could have taken dependent care leave. There was not much time to think about anything else before the doctor became brisk: “I would recommend a hospice,” he said. 

I broke the news to my mother that she was dying as I would break similar news to different people several times in the following years, downstream of what I have called the river of related deaths. I am sure I am better at it now. My mother caught at the word “hospice.” “What’s that?” she asked. I told her all I had learned in five minutes of reading brochures in the hallway. I told her it was a place where she would be made comfortable, where they would feed and bathe her and not let her feel pain. I did not tell her, in part because I did not know this yet, that when writing my book on Victorian honeymoons, the word “uncomfortable,” which occurred frequently, would make me cry. I told her that in a hospice there were never any set visiting hours and that I could be there all the time. I hoped I was telling the truth.

For a moment—and I think it might have been the last one-- the mother I had known for a lifetime returned. “Which is the best one?” she said. “Can you get me into the best one?” The question sums up for me so much about my mother: her desire for the best thing, whether it was heavy cream or tiny tea sandwiches, a triple-ply secondhand cashmere sweater, or an Ivy League college for her daughter. Her odd mixture of canniness and bewilderment as she surveyed a world of institutions she knew only little about. Her characteristic assertion of privilege that was not quite entitlement because, underneath it all, as I knew from the time I was a child, my mother did not value herself as she valued the objects with which she insisted on living.  “I can get you in,” I said. In my denial of my mother’s condition and in a sense I seemed to have shared with her that a hospice was like a highly selective college, I was actually worried that she would not qualify. Hadn’t the brochure—as shiny and desire-producing as the college admissions pamphlets my mother and I had poured over when I was in high school—said that patients had to be “in the last weeks of life” to be admitted? Perhaps, I thought, with dread and hope, they would realize that my mother had far too long to live. Perhaps they would reject her. 

Getting in was easy. Scott and I packed my mother’s few things and walked them over to the hospice in the same medical complex. It was housed in a small stone building stuck between gleaming hospital towers. Hospices are of course the prototypical—and indeed final—instance of institutions in the shape of homes about which I wrote in a past entry. They are the last stop in a life cycle of home substitutes, from schools, to birthing suites to nursing homes. LINK I did not get to the hospice in that entry, and now I have to cross that threshold—to close my eyes and imagine the upholstered armchairs scaled to fit real people, the vases filled not with the rigid arrangements of gladioli so ubiquitous in hospital lobbies, but with more intimate grocery store bouquets, complete with curling and browning leaves.

By the time we got to the hospice, my mother had appeared, as if by magic or ambulance; she was lying very still and quiet in bed under a patchwork coverlet that looked as if a real person might have made it. Minutes later, a middle-aged woman in a green wool dress arrived in the room carrying a notepad. She spoke, unusually, directly to my mother. “What do you need?” she asked her. “What would you like first?” “A bath,” said my mother, speaking to me as she had learned to do during months of hospital visits.  “Can you bathe her?” I asked the woman, hoping that if she said “no” it would seem to be directed at me. And I did expect a no. I expected that a bath would violate some rule, some protocol, that it would be seen as too much, too intimate, above or below someone’s/everyone’s pay grade, too gross, too intimate, over-indulgent, medically dangerous, a waste of somebody’s time. The woman hesitated. “It might take twenty minutes to get everything ready,” she said. 

Exactly twenty minutes later, a young woman came in carrying a plastic tub of water, a sponge, and some towels. She set these down on the table and dipped the sponge into the water. The lines in my mother’s face relaxed at the first warm touch. I felt something in my jaw, and then something different in the back of my neck, release. I wasn’t sure whether my mother would want me to be there, but I did not want to ask, did not want to interrupt the rhythm of what felt like a ritual cleansing, or the quiet sounds of warm water rippling in the bowl and moistening my mother’s parched skin. The woman pulled back the quilt to wash my mother’s stomach, and I saw that someone, at some point in the day, had put my mother in a diaper. I held my mother’s hand and listened to the slosh of the sponge in the bowl and felt my own face get wet.

The Victorians—if I may generalize in that way-- put a lot of emphasis on people’s last words, carefully recording them in journals and letters: “death sentences,” as one Victorianist scholar has called them. I do not remember other words, later words, words after “bath,” as I took no notes, scribbled no letters at her bedside that might serve as a record. If words there were, I do not remember them, and neither does my husband. We sat together and listened to the sound of my mother’s breathing, her small changes of breath, and the quiet noise she made that signaled the end.

My mother died away from her home and away from mine, in a place of whose existence she became aware only hours before dying. More bewilderingly, perhaps, this woman who had always considered New York to be her home, even when she lived for 17 years in a place that she probably liked better, died 1,639 miles away from it. When I rummage through family papers the shock of her death certificate is doubled for me: my mother is dead, and she died in Texas. I do not say this in the way that many New Yorkers and other denizens of the two favored coasts say the name of the state: I am very fond of Texas, I love Houston, and my children are Texans. My mother, surprisingly, was also very attracted to Houston and to Galveston, although deeply--and it must be said ignorantly--suspicious of other parts of the state. By invoking the strangeness of Texas, I am signaling not the scorn of a blue stater for a red state, but a sense of displacement, of homelessness—and of course of the guilt follows me as I think about how I uprooted my mother from her home when she had less than a week to live. It pains me even now to think of how my home was no substitute for hers, of how I could not in her last days make a home for her, even as I surrounded her with the rituals and some of the same objects with which she had for long surrounded me. During the first days of my mourning, I sentimentalized my childhood, forgetting my own frequent experiences of Freud’s unhominess surrounded by love in my parents’ apartment, my own desires to “go home” when, by all accounts, I was already there.

After my mother’s death, I reexperienced in real time the distance between New York and Texas. The plane flight back to New York, with my mother’s body in some secret compartment below the passenger deck, was interminable. The travel agent told us we were lucky that the plane we were on could accommodate the dead: “You’ll be on the same flight,” she said with a practiced mixture of cheer and solemnity. As the plane turned irrevocably North, I thought for a minute that we might be undoing the nightmarish journey in the other direction, that my mother was somehow going home alive, and we were going with her. 

After the funeral, when we had picked up the car we had left in Pennsylvania, we drove back to Texas, my husband, my small son, and I. We stopped in Hope, Arkansas, to eat a donut at the shop that Bill Clinton—surely not Hillary?—had patronized when he was governor. It was, I think, the day of his first presidential inaugural—or as close as makes no difference. He was in Washington, and we were in his hometown, eating his donuts and hoping—to use his own pun—for the best.

I started this long three-part entry with my mother-in-law’s death and with an image of the river that for me brings together her last days and those of my mother, my father, my uncle, my aunt, and my childhood dog. I think of Peg, a few towns and a world away from her house that was sold by the time of her death to pay for her nursing home. I think of my uncle’s partner—by courtesy and by affection, my aunt—who achieved what so many people of her generations wanted by avoiding assisted living, nursing homes, and—until the very last—hospitals. I think of my uncle himself who was so angry at my mother’s treatment that he alienated the doctors who were, I assume, trying to take good care of her. The river curves, it bends, I cannot see what happens next. The places on the river are not the same as the places where people sicken and die: the painfully literal brick and mortar of homes, hospitals, and hospices. The river runs under them all, unmoved perhaps by the drama of the where we spend our lives.