The letter is signed. And to the right of the signature are the letters R.N.
“A nurse,” I say to my grandfather.
The room he has transformed into a gallery of his daughter’s photographs is cast into deep silence. He looks at me and nods his head slowly.
Nineteen seventy-seven. Twenty-seven years after Peggy’s death, a nurse writes a letter to her mother, my grandmother, whom I only knew as a blue-eyed, beautiful woman who scattered seeds across the snow for the cardinals who flew into her yard in the winter.
My grandfather tells me that I can keep the letter as I am reading the last line again … “I would think the main cause of her death was the toxemia, and of course that was greatly due to improper care on her doctor’s part.”
“Why wait all those years to write this letter?” I ask him.
He tells me that my grandmother’s heart was failing her in 1977; there was the possibility that she might not live much longer and she was desperate to find a nurse who could tell her if Dr. Wright had been responsible for Peggy’s death. He remembers this: “When your mother came home from the hospital with you boys, she got weaker and weaker. Your grandmother called Dr. Wright every day, but he told her there was nothing more he could do for her.”
On the way back home from Pennsylvania the next day, I stop in New York City to see the Taft Hotel where Peggy and my father went on their honeymoon. Of course the hotel was knocked down years ago. In the Public Library I read old newspaper accounts of the hotel. By the time Peggy and my father stayed at the Taft, it was already famous in New York as the place where young women went to jump to their death from the rooftop dance club. A month after my mother and father checked out of the hotel at the end of their honeymoon to begin their married life together, a nineteen-year-old girl jumped into a crowd of five thousand spectators who had gathered below on Seventh Avenue.
I read this in the New York Public Library, then drive back to Maine, thinking how close the angel of death was to my mother even then, on her honeymoon.
Chapter Twenty-two
Of all the strange and unlikely possibilities, Dr. Wright is still alive. My daughter Erin looks up at me from the chair where she is reading when I cry out in my astonishment.
“He’s still alive!”
A retired nurse has seen him in Lansdale, in a supermarket. She found his telephone number and address, then called my uncle Jack.
I go upstairs to my bedroom and turn on the night-light that illuminates the altar on the table beside my bed. My hands are shaking as I pick up the telephone.
He is eighty-eight years old, he tells me.
“You’ve lived a long life, doctor,” I tell him.
He replies, “I can assure you that on most days I don’t consider it a privilege to have lived so long.”
I tell him who I am.
“Yes,” he says. “I saw the article in the newspaper.”
I tell him that I’d like to come see him to talk with him about my mother who was his patient.
He says at once that he doesn’t remember a patient by that name and that none of his mothers ever died.
“I delivered over a thousand babies and I never lost a mother,” he says.
I remind him that Peggy was only nineteen years old when she died.
“Yes,” he says calmly. “I read that in the newspaper.”
“We were your first twins,” I tell him. “My father remembers you telling him that we were your first twins. You told him you were going to mark the occasion by charging him for only one baby.”
“No,” he says, “I don’t remember any of that. I’m sorry.”
He is polite, soft-spoken, sure of himself, so sure of himself that he is completely unsurprised, as if he had been waiting for me to reach him. I am left feeling that he is withholding something from me.
This is the beginning of something I cannot stop even if I wished to. This is where the iron wheel is set rolling on a track that will lead me to the purpose for my life. I am sure of it, and two days later when I am a hundred miles from home, teaching a short story by John Cheever to a class of college freshmen, someone knocks on the classroom door and tells me there is an urgent telephone call from home.
Down the glassy corridor to the telephone, the sunlight reflecting off the snow casts a band of gold ahead of me. I feel weightless, a rush of cold air swirling in my lungs.
It is Colleen. “Something came for you in the mail this morning from the North Penn Hospital.”
I remember the woman who sat at her desk in the office of medical records. All the records from the Elm Terrace Hospital had been destroyed, she told me.
She has sent an index card that was taped to the rail of my mother’s bed. “Read it to me,” I tell my Colleen.
Peggy L. Snyder. Delivery at full term. Diagnosis: preeclampsia. Dr. Edward Wright. The doctor’s name was typed just below his signature.
What this means is, forty-seven years after my mother died, I know what killed her. And I know that no matter what he has told me, Dr. Edward Wright was my mother’s doctor.
The next week a woman named Joannie Murray called me to say that her cousin sent her the newspaper story about my mother. She told me that in 1954 she almost died of extreme toxemia during a pregnancy. A condition called preeclampsia. In 1954 she was twenty-five years old and had a two-year-old son and a four-year-old daughter. It was summer and she was in the fifth month of her pregnancy when she began to feel as if she was losing her mind. Her face had swollen to nearly twice its normal size. She was suffering excruciating headaches and for hours each day her vision was so blurred that she couldn’t see across the room. One day in the middle of making lunch for her children she dropped a can of tomato soup onto the kitchen floor and this angered her so terribly that she began to hit the wall with her hand. She was watching herself hitting the wall and telling herself to stop, but she couldn’t. Soon both children were screaming with fear. She hit the wall even harder, trying to drown out their screams. She didn’t stop until she had punched a hole in the plaster.
A woman living in the upstairs apartment came to see what the noise was all about, and then called Joannie’s physician.
She was hospitalized, first for three days during which time the preeclampsia was diagnosed, and then after another month at home, for six weeks. It was a Catholic hospital. Joannie was Catholic and so were her husband and her doctor. During her second hospitalization she began to suspect that she wasn’t being told everything by the medical staff. She had made friends by then with a red-haired nurse, an Irish girl who eventually confided in her that she was in grave danger. The only cure for preeclampsia was delivery of the baby. If she carried the baby to full term she would most likely die. In fact, she was in great danger if she didn’t have the baby delivered prematurely before the seventh month.
Because preeclampsia is a condition where the fetus is poisoning the mother, the only cure is to take the baby. But the Irish nurse told her that the Catholic Church held a clear and unwavering moral position in such cases: the mother was always to be sacrificed in order to allow the baby the greatest possible chance to survive.
In Joannie’s case, her husband and physician had agreed to keep from her the full account of her condition. The doctor instructed the nurses on the floor not to tell her that her life was threatened by the baby. They were to keep her as calm and as comfortable as possible.
After the Irish nurse broke the silence, Joannie had her mother arrange for her to be transferred to another hospital where, before she told her husband that she was going to give up the baby, she found a sympathetic doctor who did an emergency cesarean. Her four-months-premature baby boy did not live, but Joannie survived. “I had two children at home who I had to live for,” she told me. “At least this is what I have made myself believe all these years.”
That night I sat in the kitchen with the index card that had once been taped to the rail of my mother’s bed. I wanted to believe that she had touched this
card, had brushed her fingers across it.
I brought the card up to my bedroom and placed it on the altar with the photographs and the baby rattle and as I stared at the words—Peggy L. Snyder. Delivery at full term. Diagnosis: preeclampsia. Dr. Edward Wright, and the doctor’s signature just above his typed name—I began to wonder if it was possible that my mother had carried my brother and me to full term without the knowledge of what this would do to her. If she had died in the name of some religious code. My grandfather had been a fervent churchman, he had practically started the Lutheran church in Hatfield. Was it possible that Dr. Wright had explained the preeclampsia to him and he had spoken with his minister and they had made a decision without consulting my mother? This might explain my grandfather’s tears whenever he spoke about Peggy, and the gallery of photographs he lived with in the nursing home.
I already know that this sort of thing could have happened. After my mother died I went to live with my father’s mother—a woman I called Nana, who became the center of my world. She died when I was fourteen of a horrible stomach cancer which filled the little house where she lived on Towamencin Avenue with a smell so rancid that it clawed at my eyeballs. The doctor and my father’s father had made the decision that it was better for her if she wasn’t told what was wrong with her. They told her she just had the stomach flu. She had to know that people with the flu don’t smell the way she smelled. But no one ever told her the truth.
Not even my father, her only son. He must have believed it would be better for her. He must have kept his silence out of love for her.
My father. My mother’s husband, a man who believed that God had chosen him for a special purpose. A man who saw the goodness in all things and whose faith in the divine order of things was childlike and unyielding. He believed that Peggy was a gift from God. Could he also have believed then that her life was in God’s hands?
What if my father knew? My father who, in his grief over losing Peggy, declared himself to blame for her death. My father who, ten years after her death, decided to go to the seminary to become a minister and devote himself to God. Could this have been an act of penance?
Was it possible that my grandfather and my father had placed my mother in God’s hands, telling themselves that because they were doing the right thing by the Church, God would protect her from harm, and them from losing her?
That night I lay in bed listening to the branches of a tree rattle against the window. After a while it began to sound like someone was trying to get in from outside. It went on for hours and then I went out into the backyard and snapped the branch off with both hands. I threw the pieces as far as I could into the dark night.
On the altar was the index card that had changed everything. It was in writing: my mother didn’t die because Dr. Wright had failed to make the proper diagnosis of her condition. He had known of her condition from the first time she visited him in January of 1950. He had done the urine test then and found the presence of protein. He had noted her high blood pressure and with these two things in mind he had told her that she would have to have her baby in the Sacred Heart Hospital in Norristown. She then told her husband and her mother and father. They all went to talk with the pastor of the Grace Lutheran Church. The law was laid down, and my mother was sentenced to death.
. . .
This is a new reason not to sleep at night. I sit in bed staring at Colleen asleep beside me. Should I tell her how little I thought of my dead mother across the years of my life? In 1985 when we were living in Iowa City expecting our first child I thought of Peggy because I thought that I might lose Colleen like my father had lost her. Then another five years passed before I thought of her again. Maybe it had been ten years since I had last thought of her.
Finally I get out of bed and call my brother who is a Lutheran minister. I ask him to find out for me what the Lutheran Church’s position would have been in 1950.
“I already know,” he says. “I’ve been thinking the same thing, so I checked. The Lutheran Church held the same position as the Catholic Church.”
I feel a slow burning anger rise inside me. I imagine my mother growing sicker and sicker and no one telling her why.
In my nightmare, the same five men are standing at Peggy’s grave. The moon is bright and a narrow band of light sweeps over their heads. These are the five men who have outlived her. The doctor who delivered her babies. Her father. Her husband. Her twin sons. They are all standing on the earth in her absence. All of them are gray-haired men now. Compared to her astonishing beauty, what a sorry sight they are there at her grave.
No wonder no one ever took me to this grave or told me anything about my mother’s life. No wonder I never asked; a part of me must always have known that I was to blame.
I am thinking this in my half sleep as I watch the five men standing at my mother’s grave. None of them boys, none of them young anymore. All of them have outlived her. Her father at ninety. Her doctor at eighty-eight. Her husband at seventy-one. Her twin sons at forty-seven. We have all outlived her. Conspirators in her death, the death that claimed her at age nineteen. How can we justify our living? How can we ever sleep through the night knowing that we lived on for so long after her life was finished?
I feel blood on my hands. My part in her destruction.
I place another telephone call to Dr. Wright. “Are you sure you can’t remember her, sir?”
This time he tells me that he has checked his records and he never had a patient by her name.
Chapter Twenty-three
In the predawn light of those February mornings I felt like I was trying to pick a thread up off the dark floor. I was close to something, I knew that, but it would never stay between my fingertips long enough for me to hold it to the light. At times it felt like it was something I had once possessed, maybe some knowledge that I had always carried with me.
A neighbor of Peggy’s who lived three doors down Market Street in 1950 told me that though my mother was living there in her parents’ house, she never saw her after April and she didn’t think Peggy went outside at all the whole summer until the morning of August 9 when she saw her hobbling barefoot down the cement walkway in the backyard. She was barefoot, her feet were swollen like blocks of wood and her face was twice its normal size. The neighbor watched Peggy slide into the front seat of her father’s car and drive away. That was the day she went into Elm Terrace Hospital to be delivered.
I planned another trip to Pennsylvania at the end of the winter. My brother was going to meet me there and we were going to go see Dr. Wright. It was my idea not to tell him that we were coming; I was afraid he would find a reason not to be there. And I wrote him a long letter which I hoped would make it easier for him to open his door when we stood there knocking:
Dear Dr. Wright:
I am writing you now to apologize. For the past fifty years some people in the Snyder and Schwartz families have believed that you were negligent during the time when Peggy was your patient. Stories of your disregard for her have stood as truth and were passed on to me and my twin brother across the years. Peggy’s mother, my grandmother, went to her grave believing in her heart that you didn’t care for her daughter and that was why she died.
The story that persisted all these years was that you never should have released Peggy from Elm Terrace. And when she was home for seven days someone finally summoned Dr. Paul Moyer, Peggy’s family physician, who came over and when he saw Peggy, he remarked with anger, “This is not the Peggy I know.” He immediately summoned an ambulance and had Peggy taken to Grandview where she died less than an hour later.
But I have received something in the mail which shows that none of this is true, Dr. Wright. Though all hospital records from Elm Terrace were destroyed when the new hospital was built, I was sent an index card that apparently had marked Peggy’s chart while she was in Elm Terrace as your patient in 1950. The card reads: Peggy Snyder. Admitt. Diag. Pregnancy at term. Preeclampsia. Final Diag. Same. Service of Dr. Edward H.
Wright.
That one word, Dr. Wright, preeclampsia, is enough to make me see now that those who have blamed you for my mother’s death are wrong. That one word has compelled me to see in a different light everything else I have learned about Peggy’s life in the last year of my research and writing. It has enabled me to answer so many questions. First, why did Peggy have you instead of Dr. Moyer for her physician; Dr. Moyer had been her doctor since she was a young girl. He had been her mother’s physician less than a year before and had delivered her mother’s baby in October of 1949.
Why? Because when Dr. Moyer examined Peggy for the first time and discovered that she was pregnant, he also discovered in her urine test that there was protein present, and that her blood pressure was unusually high—both told him that she was probably going to face a difficult pregnancy with preeclampsia. So, he referred her to you, a more experienced physician with expertise in obstetrics.
Why did Peggy write to a friend as early as January 1950 that she was going to have her baby in Sacred Heart Hospital in Norristown? Because you advised her that it was a much more sophisticated hospital than Elm Terrace, one where a prematurely delivered baby would have a better chance to survive.
Why does my father remember you telling him not to let Peggy eat any salt?
Because you were right on top of the diagnosis of preeclampsia.
Why did Peggy move back home with her parents in the fourth month of her pregnancy? Because you cautioned her that she was in for a rough time. I believe it is even possible that you told her the only cure for her condition was to have the baby delivered by cesarean, before the seventh month. You told her that if her pregnancy continued any longer than this, her condition could be fatal. But when you told her that the baby might not live if it was delivered early, I believe the Schwartz and the Snyder families, because of their deep religious beliefs, either persuaded Peggy or simply acquiesced to her desire to carry the baby to full term. And if this is true, Dr. Wright, then it explains why the family was never able to face the truth across the years and why you were blamed; anything less would have meant that they were partially responsible for Peggy’s death. They had “placed her in God’s hands,” with their religious belief that the baby was meant to be spared in cases like this. And then when Peggy died, they blamed you.
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