This Is Running for Your Life

by Michelle Orange

  * * *

  I’ve been telling the tale of the ticket stubs to willing listeners since it began. “What a great story,” they always say, and I agree. “You should write about it,” they add, at which point I feel compelled to fill in the rest.

  * * *

  Illness has a concentrating effect on memory, whether it sets a life into sudden relief or slides the better part of that life to a far side of the scale. “I want to remember him at his best,” we say. “Don’t think of me this way,” they say. As if we might choose. And perhaps we can, to an extent; perhaps we should. But memory has its own mind. Like a soothsayer it reveals and explains our true experience of the world to us as we age, shuffling and redealing the moments of our lives into strangely proportioned patterns. The things we thought mattered—even made us who we are—recede into the background. The things we didn’t even know we knew—or have denied knowing or refused to know—stubbornly present themselves for scrutiny. Memory doesn’t recognize our received ideas of what’s memorable—the performed or grandiose; the picture-friendly—or of whom we are at our best. It might reflect the distortions of ego, but has no ego of its own. It’s one of the more startling rewards of both being human and human being.

  Is it possible to defy or control—or, in the modern argot of self-maintenance, manage—such a process? Is it advisable? Every day we seek signs of death by another name. We call it a failure to be beautiful, to be successful, to be relevant, to be remembered, to be our best. In an anti–memento mori culture, illness is the penultimate failure, and we forget its pain of death on a kind of principle. But something would seem to be missing from an idea of what it means to live a full life that refuses to acknowledge the necessary conditions. It erodes the larger sense of what it means not just to be fulfilled but to be human, so that illness is always a source of shame, and death a complete surprise. The cult of longevity is building a paradox made of protein shakes and hormone patches: we obsess over our bodies even as we fail to imagine their decay; we extend an idea of ourselves into an ideal future without fully accepting that our bodies have to follow us there, or acknowledging the inhospitable terrain that awaits those who “win” and make it to old age. The value of the elderly extends beyond their testimony to the world as it was. We need them perhaps even more to remind us of what it is to get old, and to show us how to die. It has gone unspoken between us that, although it is painful on both sides, for many reasons the only thing worse than my seeing Rita in her deteriorated condition is not seeing her at all.

  About a year before Rita fell ill, a reporting errand led me to Weill Cornell medical school. On a damp January evening I attended one of the recruiting sessions students are invited to throughout their first year, as they decide on a specialty. I was told they tend to be informal and involve student-oriented incentives like pizza and pop, which makes a pretty competitive lobbying process sound more cool and casual than it actually is. I imagined the dentistry department holding a screening of Marathon Man with complimentary hits of nitrous, or the surgery team unveiling a booby-trapped corpse in lieu of postmeeting snacks. But how might you sell a bunch of twenty-two-year-olds on adult-diaper duty and managing dementia?

  The geriatrics department was well aware that they rank only slightly above psychiatry on the sex-appeal scale. In a bold move, the recruiting committee focused its pitch on basic human decency. Only the truly compassionate choose to be geriatricians, a sun-starved young woman informed a group of about two dozen students, which means a higher level of care and fewer assholes on the job. Yes, the pace is slower and the stakes smaller, she went on, but a rapidly aging population makes a compelling (and also compassionate) business case, with geriatrics poised at the top of a supply-and-demand cycle. What she didn’t tell them is that geriatricians are currently the worst paid of all doctors, and those who opt to treat the elderly get none of the debt and tuition incentives offered to other specialties.

  Most of the students were tractor-beamed directly back to their textbooks as the meeting broke up. One who lingered told me that the social element of these meetings has as much to do with specialty crunching as anything else. Geriatrics, he had decided, was good people. I looked him up recently; he went with oncology.

  The elder-care boom described that night did not arrive in time for Rita. Six years later, there is one geriatrician for every two thousand Americans over the age of seventy-five. Her early appointments with a geriatric psychiatrist were months in coming, unsatisfying when they arrived, and of little consequence to her condition. She was put on antidepressants that exacerbated her somatic symptoms; an eventual medication switch only put a new name to the status quo. If it was sometimes difficult even for those of us who knew better to keep in mind that she was ill—that a lack of cognitive impairment didn’t mean she was choosing not to care—for her doctors the source of her despair made little difference. Her condition was normal enough for a ninety-one-year-old with fewer friends by the week.

  She had talked of suicide before the transplant to Halifax. The move seemed to stabilize her. In the ensuing three and a half years, the terror of those months mellowed into consuming anxiety, a restlessness that cut her phone calls short and eventually confined her to Melville. She didn’t feel safe, she said, outside of her chair. Early on she had asked for help—she was desperate for relief and continued to hope we might find it for her. Over time her pleas were fewer and less forthcoming, though she was most open with my aunt. Shortly before I arrived, Rita had confessed to being a bad person. Despite doing less and less to keep herself alive, she told her youngest daughter that she was afraid to die.

  * * *

  Join your hands out in front of your chest with your arms rounded and your elbows high and you’ll have the rough shape and size of the clock hanging way up on Rita’s living-room wall. An hour passes broken only by one practiced soliloquy, delivered in response to a question about my love life. She listens with the same astonished expression as I tell her that New York is a place where the men either can’t stop competing with you or refuse to start.

  Both of her daughters divorced—a double blow to Rita, although she didn’t discuss it outside of wounded asides and coded messages on ticket stubs. Nor did she finagle me with spells or curses or other inductions to marry. My grandfather might have felt differently. On his first visit with my parents after their engagement, Latham fell to his knees and crawled to my father’s feet, thanking him for making his twenty-one-year-old daughter’s university career worthwhile. “I thought it was a scream,” my mother recalled later that evening, as she settled into my aunt’s Halifax apartment and my eyebrows explored the upper reaches of my forehead.

  Throughout my disquisition on dating in New York City, Rita stole urgent glances at the clock, which is white with huge black numbers in a kind of treble-clef font. In the absence of follow-up questions we return to silence, her head swiveling back to the clock a few times a minute. She raises an index finger to her mouth and bites the tip gently, adopting an almost comical posture of contemplative worry. When I ask her what she’s thinking about, she lifts her eyes and says, “Nothing in particular.” A few beats pass, then Rita slowly pivots her chair toward the wall, a silent forfeiture, and fixes her eyes on the clock for the remaining half hour.

  * * *

  The Melville dining room’s massive solarium windows join the sky to a thickly wooded reservoir. As we shuffle into the seating area, a woman calls out to Rita. Outside, the sky is sullen, stung by the storm and looming close to the glass like an accusation, like an aquarium whale. Her hearing has declined somewhat, but I wonder if Rita means to dust this insuperable woman, who is already dining with two others. Seating arrangements are cliquish and hotly contested.

  “Oh, Rita! Ree-tah!” After the third call I touch my grandma’s shoulder and point in the woman’s direction.

  “Oh,” Rita says. “Hello.”

  “I went to visit Marge Lowe yesterday,” the woman announces as we putter up ta
bleside. “No one’s heard from her since she left, you know, but her spirits are good.” The other women murmur. “She’s in good spirits.”

  I want us to make it through this interaction but I can feel my smile tacking, and Rita can’t pretend to give a shit when there’s a chair nearby that needs sitting in.

  “I just thought you’d want to know,” the woman concludes, with a bathetic moue that takes the remaining wind out of my goodwill. “She said to send her regards.”

  “Oh, good,” Rita says.

  The crash of a cutlery dump carries over the dining room.

  “Is that your daughter?”

  * * *

  Dinner is served every evening to fifty double-tableclothed tables, and at 5:30 the room is humming with news and reviews of the night’s menu. At precisely 5:25, Rita had reached to clip on the gold earrings she keeps in a dish by her chair and insisted we not be late. The waitstaff is a mix of scurrying high schoolers and brisk middle-aged women. They greet residents formally, meeting their cranky demands with Teflon manners. Mrs. Boyle’s requests (no ice, dressing on the side, no dessert) are made in a low, querulous voice that startles me. I wonder what they think of her here.

  As we’re seated, the cafeteria crier repeats her news about Marge Lowe exactly (spirits good; sends her regards; thought you’d want to know) to a second arrival. I hear it twice more before the meal is over. Rita tells me she and Marge shared a table before Marge’s recent transfer to the nursing home. After drizzling a perfect orange loop of dressing over a finger bowl full of salad, Rita raises her fork like someone with nasty but necessary work to do, and I decide to let the meal pass in silence. I’m supposed to make her eat but I learned a long time ago that I can’t make anyone do anything.

  One of the few men at Melville—tall, cardiganed, aquiline nose; prime men’s-club material—sits down to dine directly in my sight line. He adjusts his place setting, folds his newspaper, and fans out his napkin with transfixing deliberation before requesting a glass of beer—a Sunday treat—to go with his steak and baked potato. When all three arrive, I watch him crop dust the steak with salt so intently that he turns his heavy lids on me with a look that would freeze the warts off a witch’s nose. I settle on him again, like a fly, after a desultory flitting about. I tell the waitress to bring Rita’s pie anyway, and she tucks in like she was expecting it all along.

  Melville residents run from retirement age to mobile nonagenarians; walkers fender-bend between the dining-room tables and line the far wall. The building is clean and modern, collegial and dignified—hardly the moaning void often associated with old-age facilities. Yet it is distinctly a world apart, a place where things begin to move so quickly it seems there’s no movement at all; where there’s a new Marge Lowe every hour, and you rocket from your midthirties to your midsixties in the blink of an old woman’s eye.

  As if to contain the secret of this sudden acceleration, a sort of narrative vacuum forms around the residents; though not the space designated for dying, it would seem to be where the story ends. Melville is for living and convening, eating and exercising, but not for the outside world, or “independence” as it’s otherwise defined. It’s an elegant resort with no return and no postcards. I clung to Mr. Sunday Times, whose life’s attitude seemed preserved in his posture and placid self-containment, so contented with himself and his surroundings, yet so apart from them. Nearer to my right a white-haired woman sat alone, reckoning with her bacon-wrapped scallops, a human shipwreck arranged into her dinner-hour best.

  Rita refuses to use the walker her daughters bought for her, and she’s not interested in my arm either. She skims close to the wall on the walk back. Even a late interception by my mother and Frank, just arrived from Toronto, doesn’t dissuade her. She shuffles on to her door, hunches over the lock for an extended struggle, moves into the living room, and lowers herself back into her chair. Only then and there can she mobilize the energy necessary for anything else. I get the sense that her entire day is built around pulling off that walk, a contest of weakness and will that’s difficult to watch in part because it feels too familiar.

  My mother responds to her mother’s Prairie-flat affect by winding herself into a type A tornado. Laundry is triaged for washing or replacement (more than once I’ve seen Rita stripped of days-old clothes where she stood), rations are cited for replenishing (Rita has dubbed her, not incorrectly, “the food police”), and, most relentlessly, the family silver is polished before she will consider sitting down. I’m pretty sure the ideal visit would involve no sitting at all. I have watched my mother bent over the Boyle tea set, elbows wagging, for the better part of every previous visit, a scene completed by Rita’s staring into space and my watching askance with a prickling neck, prepared to fire up some old coping protocol.

  But we all react to the eighty-pound elephant in the room with a form of extremity. Frank, a congenial whistler whose own mother passed away in 2009, at age one hundred—still sharp as a mongoose and prone to the odd, unreconstructed racial slur—tends to glower over Rita’s apparent rudeness before long, making his oppression known with passive-aggressive asides. My mother is calmer this trip. After noting, prethreshold, that the wreath hanging on Rita’s door is out of season (door hangings are the Melville residents’ version of a profile photo), she casts off her parka and collapses on the couch.

  We don’t stay long; this is a pickup mission, with a proper visit to follow. Their flight had been almost as harrowing as mine, and after trading stories—surely we had all faced death to reach this room—and condoling our mutual nausea, we leave Rita to her giant TV, deliverer of what she told me earlier, on prodding, was her one remaining pleasure: televised golf tournaments.

  * * *

  I ask if we can stop by Deadman’s Island on the way to my aunt’s apartment. Only a few blocks from Melville Heights, it’s the burial site of nearly two hundred American soldiers who died in British captivity during the War of 1812. A poor excuse for an island at high tide, when the water’s low it’s more of a thinly treed mound attached to the mainland by a muddy isthmus. As we park and climb down the hundredsome stairs leading to the shore, Frank tells me that a few years ago a developer had petitioned to build luxury condos on the grounds. The men buried there had been all but forgotten, and the prison that held over eight thousand prisoners of war on Melville Island, just across Halifax Harbour, was converted into a yacht club a decade back. But committees were formed and the dead got their due; their sinking graves were declared a heritage site in 2005.

  As we pick our way along the shoe-sucking shore and onto a brown hump the size of a softball diamond, the telltale plaques come into view. They describe the smallpox epidemic that ran through the prison and how its victims were quickly scraped into the earth, where their bones might mingle with those of Spanish and French prisoners from wars past. The names of the latter are long gone, but those of all 195 Americans, rescued from archival oblivion, are listed along with their rank, unit, and date of death. Seaman, soldier; private, prize master; boatswain, militiaman; Chesapeake, Rattlesnake; Eliza, Polly Ann; Vixen, Lizard; Friendship, Hope. I can’t tell their ages but imagine them to be a small fraction of my grandmother’s, whose life span already accommodates two world wars, the ascent of the airplane, women’s much-rumored liberation, the birth and death of Rita Hayworth, and the seemingly immortal inception of the digital age. I know it’s supposed to be funny, the image of an old person grappling with new technology, but whenever I watch my grandmother lift a cell phone to the vicinity of her ear as though it were an old shoe, I am filled with the queerest sadness.

  My elders are anxious to leave. The sun is setting and the tide, my mother the oceanographer insists, is coming in. In three weeks, upon touching down in Honolulu for a conference, I will receive an e-mail notifying me that, after continued decline, Rita was taken to the ER and diagnosed with metastatic cancer of the liver. They don’t bother to trace its source, admitting her directly to palliative care. I wil
l snap the message off when I hit the word cancer; it seems impossible to receive such news while checking my BlackBerry in a moving taxi on a tropical island.

  “Well,” Rita will say in the doctor’s office, “that’s that.”

  * * *

  Later I will listen to her breathing through that same device while facing into the Pacific. I will tell her that I love her, that I’m going to try to tell her story, and she’ll say, “Okay.”

  It’s a futile phone call, exactly like the rest. And yet, as the days go on, I will hear of a bedside transformation. Rita will say the things we wish the dying to say, and to say I suppose when we die ourselves: she is at peace; she is going home. I will wonder if the doctor, aware of the power of diagnosis as a personal storytelling device, had decided to play editorial God. Rita had cleared several complete physicals since her depression’s onset, showed no definitive symptoms, and in addition to her sudden spiritual calm reported no physical pain. Perhaps it’s a more viable ending than dying of sadness; perhaps it’s the first time cancer did anyone a favor. There is a script to follow now, and it is taken up with relief.

  Shortly after my return from Hawaii I will meet with a friend whose grandmother, also ninety-five, had died the previous week. My friend is more shaken than she had imagined she would be, as far as she had imagined this death at all. The funeral was a shock: her father wept—unthinkable—and her grandmother’s body was laid out in an open casket. My friend thought the practice macabre. “I don’t want to remember her that way,” she’ll say. By any standard it was an ideal death: sudden, and on the heels of a birthday celebrated by an entire community, the last pages of a small-town pastoral. But there is gothic history there—incest, abuse, suicide—and though my friend felt ascendant compassion for her grandmother, she never knew the woman well. Her peers have responded with a sympathetic shrug: What did you expect?