The Long Goodbye (10 page)

“Let's try to get her up,” Dad said.

“Let's just wait and see if she starts to feel better in a few minutes,” Eamon said, patting her head.

“I think we should call the ER,” I said, pacing. “I don't think this is getting better. I think something is really wrong.”

“Then call the fucking ER,” someone snapped.

I felt my inky heart spilling open everywhere. How could my father have allowed this to happen? I went down and called 911. The operator said the paramedics would be there in twenty minutes. And they were and so it began all over—the maneuvering of her body, the gurney, the screaming, the rolling of eyes. I got in my car and Eamon came with me. Liam went in the ambulance and my dad drove his car. We drove through the pouring rain; at the hospital—it was a different hospital this time—we were all bleary-eyed; it was extremely bright. The orderly on duty said only two of us could go back into the ER with her.

“Look,” I said to him, “what's your name?”

He told me.

“Look, you can understand, maybe—our mother has terminal cancer, and we don't know what's going on. We're really worried about her. If it's quiet back there, can we all be with her? We want to be with her together, in case . . .” I let the thought dangle.

“What kind of cancer does she have?”

“Colorectal,” I said.

“Oh, that's tough,” he said. “My mother died last year from that, it was rough, man. Yeah, OK, but I may need you to not all be there later.”

“OK,” I said. “We'll do whatever if you just help us out when you can.”

At three a.m., the nurses got her settled and sedated and stabilized, and we finally left. Eamon and I drove back together. I was wondering if she'd still be alive in the morning. If she started to die, would the nurses know? Could they call us? How long would dying take, anyway? Eamon put in
Pet Sounds
, and as I drove slowly through the fog and pouring rain we sang along to “Sloop John B,” belting out,
“Well, I feel so broke up, I want to go home.”

 

 

E
XHAUSTED, we took shifts. My dad went in the morning, then came home to take Liam and Eamon to lunch. Isabel was there when I arrived. Her eyes were blurred with tears and sorrow. But she and my mother had actually had a real conversation.

“I got in the bed with her,” Isabel said. “She told me how much she loved me. She asked me to crawl into bed with her. She was funny, and clear. We lay together there, like sisters,” she said, wiping her eyes. I was cravenly envious. All night I'd dreamed that my mother had died hating us and wondered if I had become the emblem of what was killing her: the daughter taking over the mother's life. Off you go, Mom! Off to the hospital! I'll take over now! But I knew I should be happy for Isabel. And maybe my mother was back.

I went in.

“Hi, Mom,” I said.

She looked at me indifferently. As I stood there, the nurse brought her a child-size ice cream cup. “Here,” I said, “I'll give you some.” And I opened it and pulled off the tiny wooden spoon and offered her a bite. She took one, her mouth opening like a child's; inside, her tongue and cheeks were coated with a white film. I wiped my eyes, holding the ice cream awkwardly.

“Sweetie, I can do that,” Isabel said, leaning forward. “Give me the ice cream.”

I clutched it to my chest. “It's OK, I want to feed her,” I said.

My mother was eyeing us. Scoldingly she told me, “Let Bel do it if she wants to.”

A bolt of shame and anger went through me, as it does when you're a child. My mother was dying and she had not, for one moment in the last twenty-four hours, acted like my mother; she'd acted like someone who disliked me. In all my various imaginings of the awful end I knew was to come, I had never pictured an estrangement such as this. Handing Isabel the ice cream, I left the room in tears and went outside to the parking lot, where I leaned against a chill concrete wall and wept. Then I wiped my face and went back inside. I was still here and so was she.

Those were strange, delirious days. They'd give her morphine for the pain, but the moment they got it under control, it would intensify, and she'd begin moaning again. When she did wake, she was irritable. We made a point of all crowding into the room at one point, and Eamon was trying, in his brave way, to joke with her, and she said something like “That's not funny” (could this really be what she said?) and I watched his face fall. I kept asking the nurses to give her more morphine.

“OK,” the nurse said, “but she might just drift away.” And then she said: “You have to decide what kind of care you want her on. If she's in hospice, they'll give her more drugs, they'll minimize her pain, but she might die.”

I was all for more medicine, more comfort. My brothers and fatherwere not. “What if she gets better?” they kept saying.

Eamon said, “She's confused because of the drugs, we shouldn't give her more.”

“It's not because of the drugs that she's confused,” I said, insistent, rigid in my certainty. “It's because of her liver.”

My father wiped tears from his eyes. “I guess you're right,” he said. “But let's just think about it. We don't have to decide right now.”

 

 

Alone in the room with her while she was sleeping, I slowly pulled her shirt up and looked at her liver, or what they kept saying was her liver, somewhere under the skin. The belly was distended. I put my hand on it lightly but was too nervous to press—though for some reason I needed to feel it, the liver that was failing, hard as stone.

 

 

The strangest thing was that the whole time she was impeccably polite and charming to the nurses. I was proud of her but also jealous of the attention she gave them. As soon as a nurse walked into the room she opened her eyes and smiled. Late Thursday, they moved her to the cancer floor, wheeling her bed through the hallways as we trotted to keep up. She had a suite with a pullout couch and a potted plastic plant and a Zenith TV that looked like it was from 1962. She went straight to sleep; Liam stayed with her, and the rest of us went home to sleep.

 

 

The next morning, Liam called. “Mom is better,” he said.

I could hear relief in his voice. “She's eating some food, and she's totally clearheaded.”

Thank God we hadn't medicated her to death. I got there as soon as I could, using the proper entrance instead of the shabby ER doors, and took the elevator up to my mother's room. She was sitting up, a plate of eggs and pancakes on her tray, and Liam was next to her, on the phone. She waved. Her eyes were bright. Part of me still didn't trust her.

“I've been enjoying some pancakes,” she said. (She'd had about three bites, by the looks of it.) Then she laughed. “Did Liam tell you what I did? I was reading the hospital menu, trying to order, and I guess there are all these special menus—the low cholesterol menu, the heart-healthy menu, and when I opened it I went straight to the ‘Deathbed Menu.' And I thought:
That's grim!
” Tears of laughter ran down her cheeks. “I didn't have my glasses on. It's really a
diabetic
menu.”

Her fever had broken. The doctors conjectured that two things had caused her delirium. The doctors who had done the radiation surgery had put her on too high a dose of steroids, causing not just “irritability” (a common side effect of steroids) but actual delusion and dementia. At the same time, she had a urinary tract infection, which was exacerbating everything, and the first hospital had missed it. What the doctors also said, when I pressed them in the hall outside her room, was that her liver was probably experiencing “necrosis.” There's no ammonia building up in her brain, they said, but soon there probably will be.

While Liam and my dad went to work, I tried to organize her release from the hospital. “I just want to go home,” she kept saying. We'd arranged for hospice, and all that was needed was for the hospital to approve her discharge. But they wouldn't do it until there was a hospital bed at home, and the insurance company was dragging its feet.

“I have to warn you,” the head nurse said, standing in the doorway of my mother's suite, “I don't think this is going to happen today, which means it won't happen till Monday, because the insurance companies are closed over the weekend.”

“They're
closed
?” I hissed. If the deli could be open twenty-four hours, surely an insurance approval line could be, I thought. And I was struck by how much control over these most intimate decisions—decisions about when and where and how my mother would die—we'd given to doctors and insurance companies. I knew, of course, why this had happened, why I had put my mother in circumstances she desperately disliked. Morphine, painkillers: these are good things. When she first went back into the hospital, I had felt reassured: She was getting fluids! She was hydrated again. She would be OK. But it pained me to think that she would have to spend extra days, precious days, in the hospital because
we could not get permission to bring her home
. Whose death was this, after all?

“Meg?” my mother called from the bathroom. “I just fell.” I went in and lifted her up. She needed someone to lift her from the toilet each time she used it now; Liam had warned me. I was already getting used to doing it. It made sense. It was what she had done for us, back before we became private and civilized about our bodies. In some ways I liked it. A level of anxiety about the body had been stripped away, and we were left with the simple reality: Here it was.

I heard a lot about the idea of dying “with dignity” while my mother was sick. It was only near her very end that I gave much thought to what this idea meant. I didn't actually feel it was undignified for my mother's body to fail—that was the human condition. Having to help my mother on and off the toilet was difficult, but it was natural. The real indignity, it seemed, was dying where no one cared for you the way your family did, dying where it was hard for your whole family to be with you and where excessive measures might be taken to keep you alive past a moment that called for letting go. I didn't want that for my mother. I wanted her to be able to go home. I didn't want to pretend she wasn't going to die.

 

 

Eamon stayed with her that night. When I came the next day to spell him, she told me what a nice time they'd had. “He just needed to see me,” she said. “He needed to watch a movie and talk.” Our mother! Here she was. Surely she would never leave us again; we needed her.

“I think Eamon's hitting it off with the nurse,” she continued. “She comes in a lot more when he's visiting.”

“Which one?” I said, hitting the morphine button to give her a boost, which made me feel I wasn't useless.

“Christine—Nicole—I can't remember. They all have names like Christine or Nicole.”

My father called that afternoon to say that he and Eamon had the stomach flu and were throwing up. He wanted to know if I could stay another night.

My mother needed to see a local oncologist before the hospital would let her go home: more emergencies might occur, and she wouldn't be going to New York anymore to see Mears. It was a Saturday, and the only oncologist around was a doctor named Malefatto. After a silent double take—his name, traced to Italian roots, sounded a lot like Dr. “Wrongdoing” or Dr. “Badly Done”—I asked the nurse to send him to our room when he did rounds.

Dr. Badly Done turned out to be kind. And he did well something that is easily done badly: he told my mother she had a few days or weeks left to live, a fact she had not quite taken in. It was his job to tell her that she had to decide whether she wanted to become a “hospice patient”—to receive only pain management rather than major interventions. He said something about “what remained to be done”; my mother misunderstood him and said she didn't want any chemotherapy. He corrected her: “There's really no more chemotherapy we can do,” he said. In that moment, I saw my mother realize, anew, what she had realized earlier that fall when Mears had told her there were no remaining treatments.

“So,” she said slowly, “there is nothing left to do?”

“No,” said Dr. Malefatto.

My mother's face grew still. I could see how strange this was to her, as it was to me. Five days earlier, she'd been walking around, even going to work for an hour here and there. Now she couldn't stand without one of us lifting her. How had we gotten here so fast? Then she looked at me.

“I have to call your father and tell him,” she said. I didn't say: He already knows.