“Days? Weeks?” I asked, incredulous. “Months?”
“Yes,” she whispered, “a long time.”
A CAT scan revealed that there was a “mass” that the radiologist said looked like an enlarged uterus.
“I haven’t had a uterus since 1946,” my mother said.
The nice doctor gave her the name of another doctor he wanted her to see. A gynecologic oncologist, she said once, and then we dropped the second half of his title. A gynecologist was as scary to my mother as an oncologist was to most people. The two words together were too much to bear.
“My doctor is going away,” she told me for the fourth time. She was worried that the nice doctor wouldn’t be around to care for her.
She had an appointment with the unnamed-type-of-gynecologist on Wednesday.
I told her I would go with her. “No,” she said. “You don’t have to do that.”
“I want to do that.”
“I need to save you,” she said. Save me from the bad stuff, I wondered? No, save me for the bad stuff. “I’ll need you later on.” She had this all planned out. There wasn’t even a diagnosis yet, but she had envisioned the tragedy that would follow, and my character wasn’t onstage yet. I was being saved for the big scene in the last act, a small role, but key.
I made a pathetic attempt at optimism.
“Mom, why don’t you try not to assume this is something horrible? It could end up being not such a big deal.”
She didn’t even hesitate. “I know what this is—I just know.” My mother has always “just known” about everything: what boys really wanted, why drugs and liquor were bad, why goyim don’t make good husbands, why Jews are smarter, why Israel is good and Arabs are bad, why her family is superior to other families, why margarine is better than butter, and why so many college graduates are “educated idiots.”
She stared out the window as the afternoon grew darker. “I told the doctor I won’t do chemo. Surgery, maybe; I might do radiation.” She said this calmly, as if she were picking from a list of possible spa treatments. Though there hadn’t even been a diagnosis yet, she already knew what she had, and how she would treat it.
As my husband and I got up to leave, my father watched from the top of the stairs, waving a big hand gently. He had taken to saying “I love you” a lot, which made me feel like a little girl. My mother waved from the dark room behind her. All I could see was a small silhouette against the big picture window.
In the last two days before her appointment, my mother did not get out of bed. A week earlier, she took Aleve for the pain. Now she was taking codeine, and it did nothing to alleviate her pain. It seemed incredible that something could progress from manageable with over-the-counter medication to invulnerable to prescription codeine in a mere two weeks.
The doctor’s office was on Fifth Avenue, a very posh address. My mother had to lean against the wall to walk, slowly, with my father on the other side holding her up. She was pale, and her eyes were flat and dull.
In the small examining room I helped her to undress. I had never seen my mother naked. Folding her white panties, hanging up her pants, easing off her shoes, I was nauseated by the intimacy of this act.
I helped her into the thin cotton gown and onto the table. Her skin was icy and she was shaking. I was shaking, too. When the nurse came in to take her blood pressure and ask a few questions, we were both relieved to have another person in the room. I turned away to move to the far end of the little room, out of their way.
“No,” she said. “Stay here by me.”
I moved up near her head as the doctor entered, brisk but warm, introducing himself and making friendly chitchat before moving on to the serious business.
The standard questions elicited less-than-standard responses.
“When was your last Pap smear?” he asked.
“I’ve never had one,” my mother said.
“When was your last mammogram?”
“I’ve never had that, either.”
“Your last pelvic exam?”
“1950,” my mother replied.
He looked up from his clipboard. “1950?”
“Yes,” my mother said. “I had to get a physical when we went to the adoption agency to adopt my daughter.” She looked at me. “They made me.” Her voice was flat. “They have to make sure you’re telling the truth about why you can’t get pregnant.”
“And you were telling the truth,” he said, to confirm.
“I wasn’t telling anything. I didn’t know why I couldn’t get pregnant.”
He was confused.
“I had surgery when I was seventeen,” she explained, “because I had very heavy periods, very painful. When the doctor from the adoption agency examined me, he told me I didn’t have a uterus or a left ovary.”
The doctor didn’t react. “And how is your health generally?” he asked.
My mother said, “Ha,” and rolled her eyes, as if this were one of the dumber questions she’d heard lately. “I’m in a lot of pain,” she said.
He looked at the CAT scan. “Yes, I’m sure,” he said. “But before this all started?”
“Okay, I guess,” my mother replied. “I don’t go to the doctor, so I don’t know. But fine.”
After I helped my mother put her naked feet into the stirrups, he said, as every gynecologist on earth says, “Okay, let’s have a look.”
My mother reached for my hand and I took her icy fingers in mine. It was the shortest pelvic exam I’d ever witnessed. The doctor briefly ran his hand across her abdomen, shrouded by the paper blanket, and said, “You can sit up,” and to me, “Why don’t you help your mom get dressed, and we’ll talk in my office.”
Silently she dressed and silently we sat and waited for him at the small round table in his cluttered office. There was a huge framed photo of the doctor crossing the finish line at the New York City Marathon. His hair was dark and he looked younger.
The doctor came in and pulled a chair up next to us.
“You have a very large abdominal mass,” he said, and my mother nodded slightly. “I’m fairly sure it’s malignant.” Her expression did not change. “It’s pressing on several organs and that’s causing the pain. I can’t tell where it started, but it needs to be removed.”
He paused. “It needs to be removed right away. I can call the hospital and get you a room for tonight and I can do the surgery tomorrow morning.”
I was stunned. My mother was staring at him, her eyes wide. She didn’t look frightened, just frozen, pulled tightly into herself. Her hands were pressed into her lap, her arms tight against her side. It looked like she was afraid she might spring apart into a thousand pieces if she relaxed at all.
“Can we wait?” I asked. “Does it have to be tomorrow?” I hadn’t even formulated questions to ask.
He looked from her to me. “It has to come out, or it’s just going to get more painful.”
“How big an operation is it, and how long is the recovery?” I asked.
“Until we’re in surgery, I won’t know exactly how many organs are affected. But maybe none are; it may be contained.” He looked at my mother. “Once you’ve healed from the surgery, we’ll talk about further treatment.”
My mother finally spoke. “I won’t do chemo,” she said.
“We can talk about that later,” he said. “Obviously, you don’t have to do anything you don’t want to. In the meantime, I need to make the arrangements with the hospital. It’ll take some doing to get you a room today.”
He looked at her, then at me. “Shall I have the staff call the hospital?” he asked.
We both looked at my mother. “I don’t know,” she said.
“Is there something you don’t understand?” he asked patiently.
She shook her head.
“Mom,” I said. “You’re in terrible pain.”
“That’s why we need to do this right away,” the doctor said.
She stared back at us, unspeaking.
T
he doctor stood up. “I’m going to leave you alone to talk about this. Take your time. If you have any questions, come find me.”
I saw no path other than the surgery: My mother couldn’t go home and lie in bed, starving and barely breathing. I wanted my mother to be in the hospital where other people—expert, responsible people, people other than me—would help.
“I’m getting Dad,” I said.
My father was so scared he could barely walk from the waiting room into the office. After he sat down next to her, and I explained what the doctor had said, he took my mother’s hand. Somehow, despite her unshaken belief that this was the end, he was still hopeful. He begged her to go to the hospital, and then started to cry.
She looked at him, and then turned to me. “All right,” she said. “Tell them I’ll go.” It sounded like she was talking about prison, or the guillotine.
If life came with a pause button, this is where I’d hit it. But that’s not how life works: You don’t know you’re at the top of the ride until you’re racing downward, and you can look back and say, “Why didn’t we stop right there?”
First, of course, there was the question of money: My parents had no credit cards, so I put the entire doctor’s fee, thousands of dollars, onto my American Express card. It was the largest item I’d ever purchased.
Then we went to the hospital—my mother and me. My father was dismissed. “You go to work.” He was happy to do so. “We’ll call you later,” my mother said to him as I helped her out of the car at the Madison Avenue entrance to Mount Sinai. This set the tone for what was to follow: My father went to work, and I entered the darkness with my mother.
It took hours and hours, and by the time I left the hospital, it was dark outside. I had to remind myself that the doctor’s appointment, which already felt like weeks ago, had only been early that morning.
In the vast waiting area the next day, the oncologist found me. The surgery took longer than expected because the tumor, which was huge, was pressing on every major abdominal organ.
“This has been growing for a long time—years, probably.”
“So if she had gone to the gynecologist this would have been discovered?”
He lifted his palms to the air. “If she had gone for any kind of checkup, this would have been discovered by any doctor, just by palpating her abdomen.” He sounded frustrated.
“Can you tell what kind of cancer it is?” I asked hesitantly.
“Ovarian.”
“Ovarian? She only had one ovary left.” It seemed like some sort of cosmic joke: After tearing everything out of her and leaving her barren, the one thing she had left caused this?
“Yes,” he said. “I’m not even sure why they left it behind. Nowadays they might do that to keep some hormonal supply. But back then a hysterectomy was almost always total. But I don’t understand why she had that surgery in the first place.”
“No one does,” I muttered. “So what happens next?”
He explained that the preliminary tests done in the operating room were good: The portion of the tumor that had been examined looked to be a slow-growing type, and her cancer might respond well to treatment. “If she agrees to treatment,” he added. I was impressed—he listened and remembered her statements.
But, he added, “Of course, those results are only preliminary. We need to do a lot more tests, and that takes a few days.”
I heard his warning, but I tried to focus on the fact that preliminary tests were positive. Maybe there was some light at the end of this darkness.
The next few days went well. My mother woke up, then sat up and began to eat. She was in a small room for two patients, but had no roommate, so there was plenty of space when we visited: my husband and son, even my father. I went to the hospital every day after work, and sometimes in the morning as well. I told her over and over again that the preliminary tests were positive. Her only answer was, “Wait till we get the rest of the tests.”
Other than that, she was fairly quiet. She made unpleasant remarks about the nurses, and complained about the poor care. She expected me to make things happen, to yell at nurses, to make demands, to do for her what she had done for me. But I was not her. When she snapped her fingers, people jumped; when I snapped my fingers, people chuckled. Her attitude toward hospitals, toward life, was hyperaware and confrontational. Don’t be a schmuck! was her mantra. It was a profoundly negative and primed-to-fight-stance. Things will always go wrong, she thought, people will screw up, the system will fail. You damn well better be constantly on guard, ready to fight, always maneuvering, commanding, and demanding. Now I was supposed to fill this role. But I’d never had the stomach for it; it was just another way I couldn’t be the daughter she wanted.
She asked hourly for painkillers. She’d rarely ever taken an aspirin, and now she wanted morphine. “It doesn’t matter now,” she said about reversing a lifelong stance. I didn’t ask her what she meant.
On the fourth day after surgery, Lenny and Damien left town for a long-planned trip to eastern Europe and Alex went to visit a friend in New Jersey. It was Easter week, the city was quiet. Damien and Lenny came to visit her in the hospital the morning before they left and she told them to be careful, to be safe. It’s the same thing she’d said before every trip, anywhere, even around the corner to buy a carton of milk. But her energy wasn’t in it. Her own danger had distracted her.
The day after they left, things started to go wrong. There was an infection in her system that couldn’t be identified. She refused to take antibiotics. Her lung function was poor. Her legs were swelling too much. There was a steady flow of doctors in and out of her room: A pulmonary specialist was brought in, two different oncologists, an infectious-disease specialist, another gynecologist, an endocrinologist. My father visited for a few minutes, all that he could stand of the hospital. As he was leaving, he leaned over to kiss her. She patted his hand. “You’ve been a good husband,” she said. It sounded like good-bye.
The next day she was moved to what they called a “step-down room,” a unit with four patients and its own full-time nurse. “This gives her a little more attention until we can get everything straightened out,” a doctor explained.
There were so many doctors now that I wasn’t sure which one to talk to. I came every day; she wouldn’t allow anyone else to visit. My father was excused. My husband and sons were away. The one aunt and uncle she still spoke to were in Florida, and couldn’t travel. She had no friends left, having pushed them all out of her life after my brother died. I tried to get to the hospital by 7:00 a.m., to catch the doctors as they did rounds. But it seemed as if every time I managed to find one of them, and get him to hold still for a question, more often than not I was told that it was not his area; it was someone else’s department. Or he would give me a quick rundown and then launch into the list of things he wanted me to persuade my mother to do: a CAT scan of her lungs, an IV of antibiotics, blood thinners. I almost laughed at them.
I was there every day, but it wasn’t enough. I didn’t yell at the staff to clean the floor or get her more blankets. I didn’t make the painkillers arrive on time. I couldn’t get them to heat up her tea. She didn’t want to eat; but even so, why couldn’t I make sure there was only white meat turkey? I couldn’t scream at people, or throw fits and make demands. I was a failure at the most important test of my life.
I hired attendants to stay with her, so she would have someone there to look out for her, to badger the nurse or demand painkillers—to fight the fight she couldn’t fight for herself, and I couldn’t fight for her. She complained about how stupid they were, how incompetent.
The hours in the step-down unit passed slowly. I brought my knitting with me; and in just a few days I started and finished an entire baby sweater for a pregnant friend. One of the doctors, an internist, was also a knitter. We compared projects.
“Must be a fayegleh,” my mother said when he left the room.
“But Mom, he’s married.”
She
gave me a withering look.
My mother answered the doctors’ questions in monosyllables, but she managed a sentence here and there for the nurses. A new one came on duty one evening and introduced herself: “Hello, I’m Shonda.”
“That’s a lovely name,” my mother said.
The nurse smiled and thanked her. When she left the room, my mother said, “You should always pay them a compliment, butter them up a little, you get better treatment.” Then she added, “What a stupid name.”
Each day she looked worse: paler, thinner, in more pain. She’d stopped eating, and refused an IV line. She asked me for lemon ices; I brought her two each time I came. She would take a few spoonfuls before pushing them aside. One night, she told me to give her a sponge bath. She didn’t ask; maybe she was afraid I would say no. She ordered. “Don’t the nurses do that?” I asked, horrified.
“I don’t trust them,” she said. “You do it.”
I got a bowl and a sponge from the nurse and washed my mother’s pale, splotchy, scarred body. I tried to be gentle, but my hands were shaking. “Get it down there,” she said and struggled to pull her legs a few inches apart. I couldn’t look at what I was doing; it was the closest I’ve ever come to leaving my body.
When I left that night, it was after 10:00 p.m., and the city was dark. “Take a cab,” my mother said. “You shouldn’t have stayed so late.”
“I’m okay,” I said. “It’s just across the park.”
“Be safe,” she said. It was the last thing she ever said to me.
“Did the test results come in yet?”
On the phone in the dim morning light, I could hear the doctor rummaging through papers, looking for those long-awaited test results.
“They’re here, and they’re not good,” he said.
“But the preliminary test…”
“That was just one test. These are different. I’m sorry. Why don’t we talk about it when you get here?”
As the taxi spun through the dawn darkness of Central Park, I thought about how I’d crossed this park every day for almost two weeks, which felt like two months, or two years. Though the park was beautiful, my stomach tensed as we got closer to the black stone monolith of Mount Sinai. I dreaded every second of every minute in the hospital with my mother. I was there to fill the role of loving daughter; but I was not that person. I felt incredibly alone. It was Easter, and with so many friends and family out of town, I’d barely had time to tell anyone about my mother’s situation.
Jessica Lost Page 24