by Susan Duncan
As I recall, he fudged that answer. Instead, he said, ‘If we don’t operate, she’ll die.’ Or perhaps that was the upshot. She’d definitely die in the short term, not long term. Surgery may not ensure a pretty survival; statistically it probably wouldn’t be pretty, but she’d still be breathing. The cynic in me wondered if my mother’s private medical insurance, which I’d been paying for decades, was a contributing factor to his attitude.
As if he’d heard me thinking, he added, ‘Your mother lives independently, she’s bright and aware. If she failed on any of those levels, I wouldn’t recommend the surgery.’ He turned to Esther, a slightly evangelical look in his glittery blue eyes, and asked, ‘So, shall we operate or not?’
‘Go for it!’ Esther said, sounding almost excited, as though she was about to embark on a holiday of a lifetime. ‘Your brother and dad will just have to wait.’
And I will have to pick up the pieces if it all goes awry, I thought. Then I asked myself what I would have done in the same situation. Grab the lifeline. Of course, grab the lifeline. Even a saline drip would have to taste like nectar if you knew that when it ran out you faded forever. She may have believed in God but not enough to trust Him on the big issues.
That afternoon she was transferred by ambulance to North Shore Private Hospital. Nobody told me. When I returned the following morning to see her, she’d been erased from the system. I thought she’d died. For the two minutes it took to sort out details, I was afraid I might sink quietly through a great maw in the floor.
On Christmas Eve, the bay foamed white. Mutts – well-bred, under-bred, in-bred, broad-shouldered, chicken-chested, long-legged, stumpy, brindle, red, blue, brown, black and white – their heads straining to stay above the water, battled for honours in the annual, completely shambolic, Scotland Island to Church Point Dog Race. Entry fee a longneck of beer and a can of dog food – any size. Hundreds of people lined the ragged shore, cheering, shouting, barracking. An armada of boats hung off, out of the way, loaded with people cheering wildly. During the years I’d lived offshore, the race had changed from a quirky little tribute to an offshorer’s best mate to an event that attracted dogs and crowds from all over. I resisted the temptation to mourn the loss of the intimacy of community. Times changed. As I joined in seeking out friends and neighbours to wish them health and happiness, a surgeon I’d never met sliced open my mother’s chest, plunged his hands into the cavity where her purple heart throbbed amidst ropy veins and arteries, and held the balance of life or death in his hands. Not a vegetable, I thought. Please don’t let her come out utterly ruined.
I rose very early on Christmas Day and drove along almost-deserted highways to the hospital. The emptiness was eerie, as though someone had sounded an alarm. No one walked city sidewalks. Shopfronts stared blankly. Even the cardiac ward, when I found it, seemed deathly still.
‘Only a few patients and a skeleton staff over Christmas,’ a pleasant nurse told me, leading the way to a waiting room with kitchen facilities. It looked like the small, private space where I knew from experience grieving families gathered to be told terrible news.
‘She’s ok, right?’ I heard the note of panic in my voice.
‘Yes, of course she is. I’ll just check on her before you go in.’
My mother lay in bed. Wires like strands of spaghetti rested on her dry, papery skin. A corrugated tube was thrust down her throat. Winking green and red lights flashed and occasionally emitted a high-pitched squeal. The room was bathed in a sombre yellow light. Her eyes were closed, her breathing wet and ragged through that awful tube. I stood and wept. Glad I was there and wanting desperately to be elsewhere. Happy to see her alive, terrified for her future.
I placed a small ornament of a Christmas fairy with golden wings on her bedside table to acknowledge her enduring passion for the festive season. I’m not sure whether it was a clumsy gesture meant to prove – more to me than to her – that I cared deeply. Or perhaps it was a distraction from the distressing truth that, even now, I could not bear to touch her. Unable to identify whether it was her oldness I struggled to love or forgive, or the woman I knew her to be.
Her eyelids never flickered. Not even a finger twitched. I vaguely heard the nurse tell me Esther had had a triple bypass as well as the scheduled heart valve replacement. I was devastated. She’d been perched on a fatal edge – days, perhaps only hours, from death – and I’d missed all the cues, too busy nagging her about small white lies. I sat for a short while, struggling to remember our good times. All I felt, though, was the endless burden of her. Since my brother died, hadn’t she always told me, ‘You’re all I’ve got.’ It was a noose that grew tighter every time I tried to pull away.
At Lovett Bay, I tied the boat and climbed the sandstone steps, instinctively dodging one or two splatters of wallaby poo, a spider’s web, taking care not to brush the foliage on either side to avoid ticks. Where the pathway turns left and the steps are steep and uneven from time, I paused. Remembering. When she was much more mobile and before she became constrained by walkers and untrustworthy legs, my mother tackled the steps but looked up to say something at a crucial moment.
‘Watch out. Focus!’ I yelled, too late. Her eyes widened in surprise as she fell forward, her legs failing to catch up with the rest of her. She came down on a mossy boulder. Flat on her face. ‘Jesus, Esther, I told you to focus,’ I said in the angry tone that partners with dread and fear, one that I have used many times to stave off grief. She lay there speechless. Unmoving.
‘Esther?’ I bent over her. She twisted her head to face me.
‘First time I’ve ever been grateful for my water wings,’ she said, laughing, probably because she was still alive, though definitely in shock. ‘Cushioned the landing,’ she added.
I sat next to her on the rock and we laughed and laughed. Congratulated her foresight in arranging a forty-eight-inch bust to be useful on an occasion such as this. Then she held out her hand. ‘Tore a fingernail. Ruined my manicure. Now I’ll have to cut them all short. Damn.’
‘I’ll leave you for a minute. Get Bob. You ok?’
‘’Course I am,’ she said dismissively. Not for the first time, I wondered at my mother’s ability to rise above catastrophe. She’d faced major heart surgery as though she was off on a cruise or booked in to a flash resort for a few days. Nearly broken her neck but mourned a broken fingernail. It’s the child in her, I thought, the child who cannot see beyond the moment. That’s how she gets through dire straits. She refuses to look beyond the instant. I see all the angles, good and bad. Always have. Is that why we had an uncanny ability to step off on the wrong foot? Her Pollyanna optimism in the face of life or death decisions clashed violently with my instinct to focus on threatening issues and ways to solve them? And yet, hasn’t she always told me, ‘Laugh in the face of adversity.’ And hasn’t that single anthem saved me more times than I care to remember? But isn’t it also the same anthem that drives me to despair when her world is crashing and she’s headed for ruin, and all she does is wave a hand as though it’s of no great import and some angel of mercy will step in at the last minute to avert disaster? And yet, here she is, aged eighty-nine and a survivor against all odds.
Inside the house, I rolled up my sleeves and began to prepare Christmas dinner. My mother was absent for the first time since I’d returned to live in Australia nearly thirty years ago. The day felt less lustrous, as though constant traditions had been spuriously waived and left us all poorer. I could never have predicted the loss.
The following morning, she opened her eyes when I entered her room. There was a faint glimmer of the old shine that flooded just before she aimed the point of a knife at you. The tube had been removed from her throat.
‘They’ve guaranteed me ten years,’ she croaked. I pulled up short. I must have looked shocked. She stretched her dry, cracked lips in a victory smile. ‘But I reckon I’ll be able to push it to fifteen.’
I counted the years on my fingers. ‘So I’ll be
looking after you until I’m seventy-five,’ I said with a mock groan.
She managed a real grin. ‘I win,’ she said hoarsely. And we laughed together.
After two weeks in rehabilitation at a private hospital high on a hill in Dee Why, with views of red-gold beaches and crashing surf, my mother was ready to return to civilian life. I booked her into respite care at the Village to ease the transition, expecting her flashy, witty, acerbic self to re-emerge, reinvigorated by a strongly beating heart and blood fizzing with oxygen. A fantasy, as it turned out.
Heart surgery did not magically transform Esther into the fit, healthy femme fatale of her youth that I believe she’d envisaged. It saved her life but it did not restore her to even half the level of fitness she’d enjoyed pre-surgery. It made her vulnerable. It made her weak. Worst of all, it made her fearful. Now she worried: Would a single reach too far for the television remote control trigger a rip in her flesh that might dislodge her new valves and end her life? Would negotiating a high gutter with her walker push her physical limits too far and result in another heart attack? Would a stroll of more than ten feet without resting every few steps send her spiralling into the final void? She switched from a woman carrying her age well, into a fearful, grey-faced old woman too afraid to spend a week, a day or even an hour without help available at the push of a button.
‘Give her time,’ Bob said. ‘She’ll get more confident as she goes along.’ At least, I thought, she had all her wits, bright, shiny and with the requisite number of points sharpened in ancient and recent skirmishes.
‘You must have done something good in a former life,’ I joked. ‘Or maybe you’ve got a direct line to God.’
‘Both!’ she quipped straight back. But her stay in assisted care stretched from weeks into months. Eventually the manager told me it was time for her to go home or arrange a permanent move. Would I have a talk to her?
In her respite room – bed, bathroom, closet and minuscule kitchenette – I carefully explained that she’d come through surgery magnificently, without any hideous side effects. I explained that her renovated heart was beating strongly. The follow-up appointment with the Rottweiler, as I called the specialist, had confirmed it. I explained she’d been given a Get Out of Jail Free card, and it was up to her to make the most of it, to vindicate the faith shown when she was slipped onto the tail end of a busy operating schedule on Christmas Eve. She was a very, very lucky woman. Then I explained it was time to return to her unit.
‘Your health is as good as it’s ever going to get. You’ll have to go home sometime,’ I said as kindly as I could. ‘Might as well make the break now.’
I stocked her pantry with cans of her favourite soups, stews and plenty of the beetroot she craved when she felt crook, in the same way I longed for canned tomato soup and buttery toast. Filled the fridge with mountainous stacks of her beloved crème caramels. Paused midstream. Should a woman who’d had a heart attack, open-heart surgery and three heart valves replaced eat creamy sweet desserts? Oh hell, I thought, she’s nearly ninety. She can have whatever she likes. So I made sure there was a restorative bottle of whisky within reach, as well as a bottle of gin for drop-ins. If you were reduced to existing instead of living, you might as well give up.
But after less than two days and just one night alone, she asked to be returned to respite. The manager called me for instructions. When I arrived at her unit to suss out the situation, Esther said, ‘I’m not well enough to manage on my own.’ She reached for a cup of tea on the coffee table with a violently shaking hand. I looked away. Losing an argument? Fake a shaky hand. Get caught in a lie? Fake a shaky hand. Make a mistake? Fake a shaky hand. See how frail I am?
‘You’re not ill,’ I said firmly. ‘Technically, you’re fitter than you’ve been for a long while.’ She put a hand to the centre of her chest, just below her neck. A single puce vein, no more than a thread, snaked and pulsed under skin, still bruised yellow and blue.
‘Look,’ she said, opening her shirtfront. A raw scar, about eight inches long, like a symbol of initiation, ran down her sternum. ‘The pain. You have no idea.’
I crumpled instantly. ‘Ok,’ I said, ‘we’ll organise more time. But one day soon, Esther, you’re going to have to face up to living alone.’
‘Where are you and Bob at the moment?’
Puzzled, I replied, ‘At Tarrangaua. Where else would we be? Why?’ She gave a little shrug, inviting me to work it out. ‘Ah, I see. You wouldn’t make it across in the boat, Esther, let alone up the track. You’d be back in hospital in a flash and I’d be accused of inflicting grievous bodily harm. Imprisoned with a life sentence for cruelty to mothers. Then you’d really be on your own.’ Hopelessly joking, trying not to sound as bad a daughter as I felt.
‘Bob would look after me, wouldn’t he?’
Was she serious? I frowned. My mother had always flirted with the boyfriends I brought home. Lunched with them when I was away on jobs or overseas. Tagged along to parties when I was a cadet journalist. Looking after me, she explained. At the time I never questioned her. From this end of my life it seemed curious at the very least.
‘Not sure about that. He’s a good man, but …’ Thank god, I thought, for the moat between us. Thank god for the difficulty of offshore living. Thank god I do not have to feel guilty for failing to move her into our home and our lives. I played the trump card: ‘If anything went wrong you’d be long dead before the paramedics made it across the water. I’ll see if I can organise a bed tonight, but you might have to wait a couple of days, ok?’
She nodded, but it probably felt like a lifetime to her.
Half an hour later, I said, ‘You’re in luck. Let’s go. I’ll bring your stuff over when you’re settled.’ I helped her off the sofa, put both her hands firmly on her walker. ‘Follow me,’ I ordered.
We proceeded to cover a very short distance at a stop-start snail’s pace with enough theatrics to warrant an encore. Was I being mean? Cynical? To test her, I pointed at the sky: ‘Could rain any minute. Your hair will be ruined.’ She galloped. I laughed silently. But the spurt was brief. A funny white band appeared around her mouth, crept along the bridge of her nose and reached into her forehead. She looked like she could collapse. ‘Hang on. I’ll run back and get an umbrella.’ She nodded. Unable to speak.
Three months later, I asked her one last time if she was ready to return to her unit.
‘No,’ she said, pouting.
I held my hands up in surrender. Spelled out the future for her: ‘Once you’ve officially quit your old unit you can’t go back. Are you sure that’s what you want?’
‘I’m sure.’
I gestured around the small space. ‘Four closed-in walls from now on, a single room.’ She nodded. I tried again: ‘If you’re worried about coping on your own, we’ll find a way to make it work.’
In effect, the independent life she’d described to the heart specialist outside my hearing was moot. I did her shopping, a cleaner came once a week, I took care of her bills and finances. We went out to lunch regularly. If Esther didn’t feel like cooking, she called the village restaurant or the takeaway Chinese in Mona Vale and arranged to have lunch or dinner delivered. Or she met the girls in the dining room. A carer dropped by to chat with her twice a week at twenty dollars an hour; a good woman, whom my mother referred to as a real daughter. A comment I eventually let slide straight through to the keeper without reacting. Eventually.
‘I’m well looked after here,’ she said, indicating her little space. ‘It suits me.’
I gave her a long, severe look. Was she frightened? Did she crave company – staff – popping in and out all day? Was she truly incapable of doing anything at all beyond shuffling to the bathroom or making a cup of tea in the tiny kitchenette? But nobody’s health improves if they lie anchored to a bed. I gave it a final shot. ‘If you don’t use it, you lose it,’ I said, resorting to the kind of language my mother understood best.
Her eyes flashed. ‘I do my
exercises every day,’ she snapped. ‘Look!’ And from a supine position she raised first one leg and then the other. ‘See?’
I sighed. Stood up to go. ‘You have to make an effort, Esther. For your own sake.’ She threw me another dirty look. ‘Ok. I’ll get things moving,’ I said. ‘For what it’s worth, I think you’re putting yourself at even greater risk.’ She closed her eyes, locking me out. I hesitated, wondering if I should try to bully her into trying harder. Gave in and gave up. Her life. Her choice. But it’s never that simple. It was impossible to shrug off the idea that somehow, because you were younger, fitter and sharper, it was your responsibility to try to make the best choices for a vulnerable parent. Even the tough ones.
As I left, she called after me: ‘It’s like living in a hotel, you know. They wait on me hand and foot.’ And there it was. The underlying thrill and attraction. My mother found what I considered the ignobility of dependence to be a luxury. Or perhaps in a spin worthy of a crooked politician, that’s how she rationalised her situation so she could live with it. As always, it was impossible to know.
I began unravelling the legal rigmarole of her unit. Meanwhile, she was well looked after. It was a phrase that became a catchcry of self-congratulation. As if having someone zip her trousers, button her shirt, wash her, was a singular and great achievement. Years later, I read a book by Atul Gawande titled Being Mortal: Illness, Medicine and What Matters in the End. He argued: a person has a right to make her own decisions. If they end in catastrophe, so be it.
My mother had exercised that right.
5
IN BETWEEN MY MOTHER’S HEALTH ISSUES, Bob attempted an interim quick, cheap fix for the kiln that didn’t work.
‘I’m sorry,’ I said, feeling guilty, ‘I pushed you into all this.’
He grinned, slipped an arm around my waist: ‘I was ready for a challenge.’