Alejandro told me he’d been thinking for a while now about the possibility that I’d discussed with Silvia. But he also said he’d asked himself a question not unlike the one that I had posed.
“Does he yearn for something,” Alejandro asked, “that may turn out, in the limits of his recognition and his consciousness, to be no longer ‘there’?” He also said he had to wonder whether we could ever know for sure if this apartment, this specific place in Boston, was, in fact, the home that he was thinking of. “Your father has spoken to me many times about his mother and the building in South Boston where he lived when he was a boy,” and it had been only a couple years before that my father had imagined he was having conversations with his mother on the phone. Which home, which place, which potential destination, Alejandro asked, was my father yearning for?
“Then too,” he said after a bit of hesitation, “ ‘going home’ might have another, very different meaning for him. Something different altogether….”
It was April when I had this talk with Alejandro. Soon after that, I had a longer talk about this with Lucinda. In answer to the question I’d discussed with Alejandro, she said she found it very hard to guess the way it might affect my father to return to his apartment. But, because she’d come to be a close friend to my mother in the visits she had made to the apartment, she introduced a wholly separate question that I hadn’t really thought about before.
She told me she recognized, from her conversations with my mother, that beneath the sense of loss and sadness she had undergone when my father moved into the nursing home, there were also complicating factors in my mother’s state of mind that led her to find his absence from their home—“awful as it sounds!” Lucinda said—“a great relief to her.” One of those factors, which may come as no surprise to people who have lived with family members who were going through the early stages of dementia, had been a periodic series of events in which his growing restlessness would suddenly erupt into a loss of emotional control that had alarmed her greatly.
More than once, my father had flailed out at her after something none too sensitive that she had said about his growing loss of competence in dealing with financial matters—tearing up bills, for instance, that he incorrectly thought he had already paid and writing intemperate letters to the companies that sent them.
My mother had a sharp tongue when she grew impatient with my father, and she didn’t seem to recognize how easily her comments could reduce him to humiliation. At one of those times he pushed her away from him abruptly and she lost her balance and landed on the hardwood floor next to the bedroom door.
As soon as he saw what he had done, my father got down on the floor, put his arms around my mother’s body, and apologized abjectly. Later, in the nursing home, he wrote her some remorseful letters making clear that he had not forgotten this or, if not this actual event, that he at least retained a memory of having done some things that had been harmful to her.
“Dear Ruth,” he said in one of these letters, which was written soon after he had gone into the nursing home, “I hope you will discard any unpleasant memories that you may have and will shortly feel much better. I look forward to a most agreeable resolution of misunderstandings that have come between us. Looking forward to uniting with you promptly….”
A second letter, written a year later: “This is by Harry L. Kozol M.D. as a giant apology to my beloved wife Ruth M. Kozol. I can never stop loving you and never shall. I shall try to make up for whatever harm I may have done you….”
The last of several letters that he sent my mother, this one also written in the second year after he had moved from the apartment, did not express apologies for “whatever harm” he’d done, which it’s likely he no longer could recall, but simply conveyed a longing for my mother and a sense of urgency about returning to their home. “My dearest beloved wife residing at 780 Boylston Street, Boston, Mass. Today is Wednesday. I hope to return to the loving companionship of my desperately needed wife. I BEG OF YOU. PLEASE HELP ME!”
I don’t think I’d seen these letters when my father wrote them. As best I can recall, Lucinda had not shown them to me. They were my father’s letters to my mother, not to me, and it may be that, in her sensitivity, she was trying to respect this small degree of privacy between them.
My mother, according to Lucinda, who brought the letters with her when she went to the apartment, was obviously moved and spoke with kindness and compassion of my father. But her recollection of his turbulent behavior and, as she told Lucinda, other moments when she’d had the feeling he was on the verge of reaching out and striking her, had left her, understandably, with a degree of fear that may not have wholly dissipated with the years.
Once he was in the nursing home, those episodes of physical unruliness came under reasonable, if incomplete, control, in part because of anti-anxiety medication he received. Still, his restlessness resurfaced periodically and, once his injured hip had healed and he could stand and walk without assistance, it became self-evident that he needed careful supervision on the part of his attendants or, late at night when they weren’t there, the regular staff workers. There was the ever-present risk that he might do himself real harm if he should awaken in the middle of the night, manage to get out of bed, and walk into a door or wander out into the hall.
Misadventures of this sort had taken place a number of times when staff members were distracted by emergencies or, as happened more often than it should, were caught up in their purely social conversations at a distance from his room. Once he walked into a rack of medication trays that was directly in his path. Another time, he walked into a female patient’s room, which eventuated in no harm to her, or to himself, but elicited her outraged squeals. (I admit I was amused by Lucinda’s characteristically irreverent observation: “I think she was delighted by the scandalous idea that a man your father’s age might find her irresistible!”)
Even in the most recent years, moreover, as the increasing weakness of his legs prevented him from walking any distance on his own, my father still was able, if by inadvertence the guardrail of his bed had not been raised, to climb out of bed and wander around a little in his room until he bumped into a chair or, in one instance, fell down on the floor.
When I brought these matters up with Alejandro in a second conversation later in the spring, he dispelled them rapidly. “Your father’s physical turbulence is not an issue anymore. He represents no danger to your mother or to anybody other than himself.” The physical precautions taken in the nursing home to guarantee his safety were, in any case, “not especially impressive,” Alejandro noted, and could easily be duplicated, and made more consistent, by attendants such as Silvia who might care for him at home.
The medical supervision by the doctor at the nursing home was, as both of us had seen, more or less a fiction. “He comes in and looks at patients’ records, maybe writes prescriptions, issues some instructions….I don’t know how frequently, if ever, he conducts examinations.” A good arrangement with a doctor I might find in Boston would, he thought, be likely to provide much better supervision. Lucinda, as he noted, was one of the few members of the staff who gave my father thoroughgoing medical attention. Perhaps, he said, there might be a way that she could keep on seeing him, maybe on a weekly basis, if in fact I did decide at last to bring him home.
There was a final question in my mind, however, which I did not share with Alejandro. Even without the slightest risk of danger to my mother’s safety, I had to wonder what effects the plan I was considering might have upon the well-established patterns of accommodation she had made to living in his absence.
Without being disrespectful to my mother, who was holding up with a good deal of courage in the face of a variety of small infirmities, including some arthritic pains, and the normal loss of energy in someone who was nearly ninety-nine years old, it is only honest to concede that she had grown increasingly tyrannical in her reliance on the constant presence of the people who looked after her. Even wit
h the slightly larger team of helpers Silvia believed that she could put together to take care of both of them at once, I didn’t have the least idea of how my mother would react to sharing their attention with my father.
It was time for me to go and have a conversation with my mother.
—
The apartment where my parents had been living since they moved into the city in the early 1970s consisted of a good-size bedroom, a second bedroom where the people caring for my mother could lie down and get some rest once she’d gone to sleep, and a large, attractive living room, at one end of which my father’s desk remained the centerpiece and at the other end of which there was a dining area and, just adjacent to the dining area, a small and narrow kitchen.
My mother still could walk into the living room, usually on her own, or with some assistance from her helpers. In good weather they would sometimes bring her downstairs to the mezzanine of the apartment building, which opened on a grassy area where she could enjoy the sun and see young people strolling by and walk along the flower beds and hedges on the far side of the lawn.
When it was too cold to go outside, her helpers walked with her along the corridors or in the lobby area every afternoon, after which she liked her daily ritual of having tea and English biscuits at the dinner table, where her helpers usually would sit and join her.
At night, during the baseball season, she liked to watch the Red Sox games. Before my father’s accident, they often used to watch the ball games on a large screen at the Harvard Club and would sometimes have dessert or dinner there. My father liked to pick up conversations with people he had never met before, graduate students, lawyers or physicians, other academic people, mostly of my generation, whom my mother said that both of them found more interesting to be with than the rapidly diminishing number of their peers.
Now, in the evenings, my mother would sit up in bed to watch the games. I had given her a Red Sox jersey as a birthday present when she was ninety-five. Her helpers said she liked to wear it, as a good luck symbol, while she cheered for players whom she recognized from long familiarity. In earlier years she had been a fan of Roger Clemens. But when Clemens ended up pitching for New York, her opinion of him quickly changed. “He’s gotten too fat. We’re better off without him.” (Before long, she replaced him in her loyalties with Pedro Martinez.) A few years later, when the Red Sox finally broke their famous curse and brought home a championship after more than eighty years, my mother was triumphant.
I asked her once if she recalled the previous time the Red Sox had brought home a victory. She could not remember exactly in what year it was but she said, “I was a teenager then. I was at Girls’ Latin School”—a highly respected secondary school that has, however, since been closed. She said she’d never seen a game until she was older, because she had to study hard to keep up with the rigorous curriculum for which her school was famous. In addition to this, three afternoons a week, she had to take the trolley train from her home in Dorchester all the way to Symphony Hall, where one of the violinists of the Boston Symphony, who was acquainted with her mother, had been giving her instruction since the age of ten on a violin that she had saved for all these years, still in the old and tattered case she carried on the trolley.
When there was no ball game or when it came on too late because the team was playing in the west, she usually stayed up long enough to watch the TV news at ten. Then the person taking care of her would lower the reclining bed and stay there in the room with her until she fell asleep.
Among her helpers at the time, the one to whom she felt the closest and who had cared for her the longest was a woman of about my age whose name is Julia Walker and whose children I had known when I was teaching in her neighborhood in the 1960s. Julia told me recently that, up until the age of ninety-nine, my mother insisted upon looking at the Boston Globe each afternoon or evening. When the gradual impairment of her reading vision made it hard for her to do this, Julia would pick out a few important stories and would read them to her, and discuss them with her—political stories for the most part, Julia said, that she knew would be of interest to my mother.
My mother, who had been an unrelenting liberal as long as I recalled, remained attuned to politics, although she grew amusingly confused when George W. Bush was elected president in November 2000. “We already had him long ago!” she said to Julia, mixing up Bush the father with the son. “What’s he doing back again?”
I don’t want to overstate my mother’s clarity of thinking. Now and then she’d make an observation about somebody in public life that had, at best, a very tenuous and whimsical connection to reality. “Hillary Clinton is sick of being married to her husband,” she announced to me and Julia one night in 2001. “She’s ready to get rid of him.”
“I wouldn’t be surprised,” said Julia, “after what he’s put her through.”
“I think she wants to marry Jonathan,” my mother said.
“Why me?” I asked.
Julia looked at me with sympathy.
But my mother kept right on. “She isn’t getting enough attention from her husband. She needs to get remarried.” That, to my relief, was her final word for now on what would come to be one of her favorite subjects of discussion.
Apart from this maternal fantasy and a couple others that she found appealing and allowed herself to entertain from time to time, my mother’s thinking had continued to be reasonably clear. The attorney who was managing my father’s trust and hers believed she was still competent to sign her income tax returns, which she did with the attorney’s pen in an only slightly shaky hand. Like my father, she had appointed me to be her healthcare proxy in anticipation of a time when she would no longer have the judgment to arrive at an informed decision in a medical emergency. That time had not yet come, however, and I had no wish to limit her autonomy in this or any other area in which she chose to exercise her will and make her own decisions.
A handful of people who had visited my mother after Daddy went into the nursing home had rather briskly written off her competence because, when they arrived at the apartment, she would pretty much ignore them and, more than once, she actually refused to speak with them. On one of these visits, after keeping silent for a while, she flatly said, “I don’t trust you. I don’t want to talk to you. Go home!”
Their natural reaction was to reaffirm the uninformed assumption they’d already made prior to their visits: a self-confirming process since my mother recognized the way they looked upon her and, I thought, was fighting justifiably in defense of her own dignity when she wouldn’t let them lead her into conversations that were obviously intended to be tests of her lucidity.
One of them said to me, “She’s crazy as a loon! She wouldn’t even talk to me!” I didn’t think that this was crazy in the least. She loved to talk at length with Julia and Lucinda, and with several of my younger friends who were very fond of her and had known her long before my father became ill. Why did she look forward to the time they spent with her and talk with them so openly? I think it was because she knew that they respected her.
Even on those evenings when she yielded to her fantasies, there was always something faintly comical about her tone of voice, which, no matter how positive or stubborn she might sound, seemed to signal that she knew she might be wandering into a region of the only semi-real. “I think your mother knows deep down when she’s ‘stretching’ something that she’d kind of like into a reality,” said Julia. “I think she knows the difference. It’s like something that she plays with for a while. If I tell her I think she’s incorrect in something that she’s said, it always seems to slow her down or bring the story to an end.” That was my experience as well. It didn’t often take more than a few no-fooling words to bring my mother back into the world of actualities.
As late as in the previous fall, she still retained sufficient rationality and independence in her thinking to make a major medical decision without asking my approval or opinion. Her physician had detected something tha
t he found irregular, and worrisome, in one of my mother’s ovaries. A biopsy revealed a cancerous growth—but small and highly localized.
The doctor, who was not a geriatrician but was widely known in Boston as an excellent practitioner, talked with me about the risks a woman of her age would inevitably face even in a fairly routine surgical procedure. The likelihood that she’d come out of this without complications was, he told me, relatively good. “She’s got a lot of spunkiness and fire in her still….If you decide you want to go ahead, I’ll make the referral and we’ll put her in the MGH. I’d like to get it done as fast as possible.”
My mother, when I spoke to her about this, said that she’d already made her own decision. “Go ahead! Get it done! I don’t want to die yet. I’ll tell you when I’m ready….”
I put her into Phillips House, a section of the MGH in which a little more than the usual attention could be given to a patient. She underwent the various preoperative procedures, went into surgery on a Monday morning, emerged from anesthesia safely, and was kept in the hospital for only three more days before they sent her home to her apartment, where she made a fairly swift recovery.
This, then, was the background for the conversation with my mother that I had put off, longer than I should, about the plan I had been contemplating for my father.
—
On an evening late in June, I sat beside my mother’s bed and told her what I had been thinking about Daddy. I summarized the medical issues I’d discussed with Alejandro. I told her of the offer Silvia had made. I also told her that I had no way to know, and nobody I’d talked with seemed to know, how it would affect my father to come back and live in the apartment.
The Theft of Memory Page 8