by Amy Chua
Even after Katrin started feeling the effects of the chemo, she never complained, not about the Hickman line inserted into her chest that carried chemical toxins straight from a drip to her major veins (“Not bad, but I still can’t look at it”); or the shivering fevers she’d suddenly get; or the hundreds of injections, pills, and needle pricks she had to endure. All the while, Katrin sent me funny e-mails that sometimes made me laugh aloud. “Yay!” she wrote once. “Starting to feel SICK. Chemo is working . . . all according to plan.” And another time: “I am looking forward to the phlebotomist visiting me this a.m. This is what I am reduced to.” The phlebotomist was the person who drew her blood and told her what her blood counts were. And: “Able to drink clear fluids again. Going to try chicken broth.Yum.”
I came to realize that when I didn’t hear back from Katrin—when she didn’t answer my calls or return my e-mails—she was either violently ill, swollen up with hives because of an allergic reaction to a platelet transfusion (something that happened regularly), or sedated with painkillers to blunt some horrible new affliction. Her updates, though, were always light-hearted. To my daily “How was last night?” e-mails, she’d respond, “You don’t want to know,” “Not too bad but not great at all,” or “Alas, another fever.”
I also realized something else: Katrin was determined to live for the sake of her children. Growing up, she’d always been the most focused of the four sisters, the one with the most concentration. Now she devoted every bit of her intellect and creativity to the task of battling her leukemia. Trained as a doctor, she was completely on top of her own disease, double-checking dosages, reviewing her cytogenetic reports, researching clinical trials on the Internet. She loved her doctors—she was medically sophisticated enough to appreciate their experience, acuity, and good judgment—and they loved her. So did all the nurses and young interns. Once, an M.D./Ph.D. student doing a rotation recognized her name—Dr. Katrin Chua of Stanford, author of two papers published in the prestigious scientific journal Nature!—and asked her in awe for some professional advice. Meanwhile, to stay in shape, Katrin forced herself to walk around for twenty minutes twice a day, wheeling around the IV stand she was hooked up to.
I was in Boston a lot during the fall and winter of 2008. Every weekend, our whole family would go up—sometimes we’d make the two-hour drive to Boston immediately after Lulu and I got back from our four-hour trip to Miss Tanaka. Katrin didn’t care at all about having visitors herself—and after the chemo killed off her immune system, visitors were discouraged—but she was worried about Jake and Ella, and it made her happy when we spent time with them. Sophia adored her baby cousin Ella, and Lulu and Jake were best friends. They had similar personalities and looked so much alike, people often thought they were siblings.
Of course, we were all holding our breath for one thing: to see whether Katrin made it into remission. On Day 20, they took the critical biopsy. Another week passed before we got the results. They weren’t good—not at all. Katrin had lost her hair, her skin was peeling, and she had every conceivable gastroenterological complication, but she was not in remission. Her doctor told her she’d need another round of chemo. “It’s not the end of the world,” he said, trying to sound upbeat. But we’d done our research, and we all knew that if the next round didn’t work, the odds of Katrin having a successful transplant were effectively zero. It was her last chance.
28
The Sack of Rice
Sophia, age sixteen
I came home from work one evening to find a carpet of raw rice on the kitchen floor. I was tired and tense. I’d just taught, then met with students for four hours, and I was thinking about driving to Boston after dinner. A big burlap sack lay in shreds, there were rags and plastic bags all over, and Coco and Pushkin were barking up a storm outside. I knew exactly what had happened.
At that moment Sophia came into the kitchen with a broom, a distraught look on her face.
I exploded at her. “Sophia, you did it again! You left the pantry door open, didn’t you? How many times have I told you the dogs would get into the rice? The entire fifty-pound bag is gone—the dogs are probably going to die now.You never listen. You always say, ‘Oh I’m so sorry, I’ll never do that again—I’m so terrible—kill me now,’ but you never change. The only thing you care about is staying out of trouble. You have no concern for anyone else. I’m sick of you not listening—sick of it!”
Jed has always accused me of a tendency to use disproportionate force, attaching huge moral opprobrium to the smallest of oversights. But Sophia’s strategy was usually just to take it and wait for the tempest to pass.
This time, however, Sophia exploded back. “Mommy! I’ll clean it up, okay? You’re acting like I just robbed a bank. Do you know what a good daughter I am? Everyone else I know parties all the time, and they drink and do drugs. And do you know what I do? Every day I run straight home from school. I run. Do you know how weird that is? I suddenly thought the other day, ‘Why am I doing this? Why am I running home?’ To practice more piano! You’re always talking about gratitude, but you should be grateful to me. Don’t take out your frustrations on me just because you can’t control Lulu.”
Sophia was completely right. She’d made me proud and my life so easy for sixteen years. But sometimes when I know I’m wrong and dislike myself, something inside me hardens and pushes me to go even further. So I said, “I never asked you to run home—that’s stupid. You must look ridiculous. And if you want to do drugs, go ahead. Maybe you can meet a nice guy in Rehab.”
“The dynamic in this household is ridiculous,” Sophia protested. “I do all the work, and I do everything you say, and I make one mistake and you scream at me. Lulu doesn’t do anything you say. She talks back to you and throws things.You bribe her with presents. What kind of ‘Chinese mother’ are you?”
Sophia really nailed that one. This might be a good time to raise an important point about Chinese parenting and birth order. Or maybe just birth order. I have a student named Stephanie, who recently told me a funny story. An eldest child and the daughter of Korean immigrants, Stephanie told me that when she was in high school (straight As, math whiz, concert pianist), her mother used to threaten her, “If you don’t do X, I won’t take you to school.” And this prospect would strike terror in Stephanie’s heart—miss school! So she would do whatever her mother asked, desperately hoping she wasn’t too late. By contrast, when her mother threatened Stephanie’s younger sister with the same thing, her sister responded, “Awesome. I’d love to stay home. I hate school.”
There are lots of exceptions of course, but this pattern—model first kid, rebellious second—is definitely one I’ve noticed in many families, especially immigrant families. I just thought I could beat it in Lulu’s case through sheer will and hard work.
“As you know, Sophia, I’m having trouble with Lulu,” I conceded. “What worked with you isn’t working with her. It’s a mess.”
“Oh . . . don’t worry, Ma,” Sophia said, her voice suddenly kind. “It’s just a stage. It’s awful to be thirteen—I was miserable. But things will get better.”
I hadn’t even known that Sophia was miserable at thirteen. Come to think of it, my mother hadn’t known I was miserable at thirteen either. Like most Asian immigrant households, we didn’t have heart-to-heart “talks” in my family. My mother never told me about adolescence and especially not about the gross seven-letter word that starts with p-u and ends withy and is what happens to adolescents. We absolutely never talked about the Facts of Life—just trying to imagine that conversation retroactively sends shivers up my spine.
“Sophia,” I said, “you’re just like I was in my family: the oldest, the one that everyone counts on and no one has to worry about. It’s an honor to play that role. The problem is that Western culture doesn’t see it that way. In Disney movies, the ‘good daughter’ always has to have a breakdown and realize that life is not all about following rules and winning prizes, and then take off her clo
thes and run into the ocean or something like that. But that’s just Disney’s way of appealing to all the people who never win any prizes. Winning prizes gives you opportunities, and that’s freedom—not running into the ocean.”
I was deeply moved by my oration. All the same, I felt a pang. An image of Sophia racing home from school, arms full of books, flashed into my head, and I almost couldn’t take it. “Give me the broom,” I said. “You need time to practice piano. I’ll clean this up.”
29
Despair
My sister Michelle and I were both tested to see if either of us could be Katrin’s bone marrow donor. Siblings have the best chance of being a perfect match—about one in three—and I felt strangely hopeful that my blood would come through. But I was wrong. Neither Michelle nor I was a match for Katrin. The irony was that we were perfect matches for each other, but neither of us could help Katrin. This meant that Katrin now had to try to find a donor through the national bone marrow registries. To our dismay, we learned that once siblings had failed to match, the odds of finding a donor decreased dramatically, especially for people of Asian and African descent. The Internet is filled with appeals from dying patients desperately searching for a bone marrow match. And even if there was a match out there, the process could take months—months that Katrin might not have.
Katrin’s first round of chemo had not been a nightmare, but the second round more than made up for that. It was brutal. Now days would go by without my hearing from her. In panic I’d call Or, but often just get his voice mail; or he’d answer brusquely and say, “I can’t talk now, Amy. I’ll try to call later.”
The main source of mortality from chemotherapy is infection. Ordinary ailments like the common cold or flu can easily kill a cancer patient whose white blood cells have been destroyed. Katrin got one infection after another. To fight them, her doctors prescribed a slew of antibiotics, which caused all kinds of painful side effects, and when those antibiotics didn’t work, they tried different ones. She couldn’t eat or drink for weeks and had to be given fluids intravenously. She was always either freezing or burning up. The complications and crises kept coming, and she was often in so much agony she had to be sedated.
When the second round of chemo had been administered, we again had to hold our breath and wait. One of the ways we’d know if Katrin’s leukemia was in remission was if she starting producing healthy blood cells—in particular neutrophils, which defend against bacterial infection. I knew that Katrin’s blood was drawn first thing every morning, so I’d sit at my computer screen starting at 6:00 A.M., waiting for an e-mail from her. But Katrin no longer wrote to me. When I couldn’t stand waiting anymore and e-mailed Katrin first, I’d get terse answers like, “Counts not going up yet” or “Still nothing. Pretty disappointed.” Soon, she didn’t respond to my e-mails at all.
I’ve always wondered what’s wrong with people who don’t get the point and leave voice message after voice message (“Ca-a-ll me! Where are you? I’m worried!”) even when it’s obvious there’s a reason no one’s calling them back. Well, now I couldn’t help myself. I was too anxious to care about being annoying. The week after her second round of chemo ended, I called Katrin over and over every morning, and even though she never answered—she had caller ID, so she knew it was me—I kept leaving messages, giving her updates on useless things, imagining that I was being cheery and uplifting.
Then one morning, Katrin answered the phone. She didn’t sound like herself. Her voice was so faint I could barely hear her. I asked her how she was feeling, but she just sighed. Then she said, “It’s no use, Amy. I’m not going to make it. There’s no hope. . . . There’s just no hope,” and her voice trailed off.
“Don’t be silly, Katrin. It’s totally normal for it to take this long for counts to go up. Sometimes it can take months. Jed actually just researched all this. I can send you the numbers if you want. Also, Or tells me that the doctor is extremely optimistic. Just give it one more day.”
There was no reply, so I started up again. “Lulu is such a nightmare!” I said, and I regaled her with stories about the violin and our fights and me flipping out. Before she got sick, Katrin and I had often talked about parenting and how it was impossible for us to wield the same authority over our kids that our parents had exerted over us.
Then, to my relief, I heard Katrin laugh on the other end and say in a more normal voice, “Poor Lulu. She’s such a nice girl, Amy. You shouldn’t be so hard on her.”
On Halloween, we learned that they had located a donor, a Chinese-American who was apparently a perfect match for Katrin. Four days later, I got an e-mail from Katrin saying, “I have neutrophils! Level is 100, needs to be 500 but hopefully rising.” And they did—very slowly, but they did. In early November, Katrin was released from the hospital to regain her strength. She had exactly one month before the bone marrow transplant, which unbelievably would require yet another round of chemo—this one the mother of all chemos, administered in a special germ-free ward—to wipe out all of Katrin’s own diseased bone marrow so that the donor’s healthy marrow could replace it. Many patients never made it out of that ward.
During her month at home, Katrin seemed so happy. She enjoyed everything: feeding Ella, taking her children for walks, and just watching them sleep. Her favorite thing was to watch Jake play tennis.
The bone marrow transplant took place on Christmas Eve. My parents and my whole family took rooms in a Boston hotel. We had takeout Chinese food and opened presents with Or, Jake, and Ella.
30
“Hebrew Melody”
A brand new year—2009. It didn’t start off too festively for us. We returned from Boston, exhausted. It had been hard work trying to bring holiday cheer to Jake and Ella while their mother lay in an intensive-care bone marrow ward. Dealing with my parents was even more excruciating. My mother insisted on torturing herself by asking why, why, why Katrin had gotten leukemia. I snapped at her cruelly a few times, then felt awful. My father kept asking me the same medical questions over and over, which I referred to Jed, who patiently explained the mechanics of the transplant process. We were all terrified of what the new year might bring.
When we got back to New Haven, we found our house dark and freezing. There had been a vicious snowstorm with record-high winds, and some of our windows were broken. Then there was an electricity blackout, which left us heatless for a while. Jed and I had a new semester starting up, and courses to prepare for. Worst of all, the violin loomed—Lulu had three concerts coming up—and so did Lulu’s Bat Mitzvah. Back into the trenches, I thought grimly.
Lulu and I were barely speaking. Her hair was a violent rebuke. Despite the hair cutter’s best efforts, it was still short and a little jagged, and it put me in a bad mood.
In late January, Katrin was released from the hospital. She was initially so frail she had trouble going up stairs. Because she was still highly vulnerable to infection, she was not permitted to go to restaurants, grocery stores, or movie theaters without a protective mask. We all crossed our fingers and prayed that her new blood wouldn’t attack her own body. We’d know within a few months whether or not she’d have the worst kind of complication—acute graft-versus-host disease—which was potentially fatal.
As the weeks passed and her Bat Mitzvah got closer, Lulu and I engaged in intensifying combat. As with Sophia, we were being unconventional and having the Bat Mitzvah in our home. Jed handled the major responsibilities, but I was the one constantly haranguing Lulu to practice her haftarah portion—I was going to be a Chinese mother even when it came to Hebrew. As always, it was over the violin that we fought most bitterly. “Didn’t you hear me? I said go upstairs and practice the ‘Hebrew Melody’ NOW!” I must have thundered a thousand times. “It’s not a difficult piece, so if it’s not incredibly moving, it’ll be a failure.” “Do you want to be mediocre?” I’d yell at other times. “Is that what you want?”
Lulu always retaliated fiercely. “Not everyone’s Bat Mitzvah has
to be special, and I don’t want to practice,” she’d shoot back. Or: “I’m not playing violin at my Bat Mitzvah! And you can’t change my mind.” Or: “I hate violin. I want to quit!” The decibel level in our house went off the charts. Right up until the morning of the Bat Mitzvah, I didn’t know if Lulu was going to play the “Hebrew Melody” or not, even though it was on the programs Jed had had printed up.
Lulu did it. She came through. She read her Torah and haftarah portions with poise and confidence, and the way she played the “Hebrew Melody”—filling the room with tones so hauntingly beautiful guests cried—it was clear to everyone that it came from deep inside her.
At the reception afterward, I saw Lulu’s face glowing as she greeted guests. “Oh my God Lulu, you are, like, scary on the violin, I mean like totally amazing,” I heard one of her friends say to her.
“She’s extraordinary,” a singer friend of mine marveled. “She clearly has a gift, something no one can teach.” When I told her how much trouble I was having getting Lulu to practice, my friend said, “You can’t let her quit. She’ll regret it for the rest of her life.”
That’s how it always was when Lulu played the violin. Listeners were gripped by her, and she seemed gripped by the music. It’s what made it so confusing and maddening when we fought and she insisted she hated the violin.