The image above is of a cigarette butt I found in the pocket of one of my Mom’s coats. The last time she wore it was 10 years ago, just before she quit smoking.
In early July, my sister’s two-week visit with her yielded the impression that Mom could continue to live independently in her condominium for at least another year, as long as we took over her banking and bill payments. Near the end of August, a younger friend of our mother’s emailed us because Mom was having trouble handling arrangements for home repairs. Near the end of October, she was driven home by the police twice: once after they were alerted about a confused little old lady wandering around downtown Berkley, and a few days later after just walking out of a Kroger grocery store, forgetting to stop at a register on the way.
This is why I came home to Michigan. Over the course of just a few months, our mother’s level of cognitive function had taken a dive. Phone calls had become stressful. Her hearing aids weren’t working properly, and even when she could hear what I was saying, she seemed to be having trouble with comprehension and retention. She would chase words, replacing those she couldn’t find with ones that weren’t related in any sense of meaning, and then say, “I was just kidding,” or, “I don’t know why I said that.” Syntax went out the door. It was like learning a new language, trying to guess at what she was attempting to communicate. With every call, it seemed that something else in the house wasn’t working and was causing her stress. The washer and dryer, oven, garbage disposer, television, her cell phone…all of it would undergo temporary losses of function. We would arrange for family friends or service professionals to come check something out, only to find out that nothing was broken. Mom was forgetting how to use things.
In situ, it’s much easier to trace her decline. More than 20 notebooks filled with “scripts” for phone calls, documentation of things she wanted to remember, and even her own phone numbers, lay around the house. The notes start in October of last year, and become noticeably less sensible over time. This is how she was able to hide her failing memory from us, up to a point. She would write down what she wanted to say in conversation, and if we brought up a subject she wasn’t prepared for, she would say, “Okay, well, I should let you go…”
Every surface in the house had mail, much of it unopened, stacked a foot high. Every corner of every room was taken up by boxes of more paperwork and plastic shopping bags (some with her purchases still in them). I found a block of cheddar cheese wrapped in tin foil in the cabinet under the kitchen sink, and a foil-wrapped shoehorn in the refrigerator. Mom demanded to know who had put them there. There were 12 toothbrushes on the bathroom counter, 33 light bulbs, 27 bags of cough drops, 7 new shower curtain liners with curtain rings, 13 curling irons, a closet full of toilet paper. Most of these items were also on the current shopping lists that sat atop the mail piles on the kitchen table.
In the week before I arrived, the gas stove wasn’t working because she’d inexplicably unplugged it, disabling the electric ignition. I’d had a friend turn the gas off, and I’d been calling in food delivery for her dinners. The washing machine had “stopped” mid-cycle, and there was a load of laundry marinating in a full tub of water. She had pulled the control knob out, halting the machine, and didn’t remember having done so or why she would have.
My sister, Katie, lives in Oregon, with a boyfriend of 22 years and a job. My life with Charlie happens mostly in mountains and canyons, which Michigan lacks severely. We started looking for a senior community. The conversation about it was a relief. Mom said she was looking forward to never needing to worry about appliance repairs, housekeeping, or meals, and playing cards and watching TV with people closer to her own age who have things in common to talk about. And she would have medical care and general support available 24/7.
Two weeks into our search, Mom woke up in the middle of the night with a pain in either her chest or back, she couldn’t decide which. In the morning we went to see her doctor, who sent her directly to the Imaging Center at Beaumont Hospital. The x-ray report reads, in part:
“Interval development of suspicious mass like opacity within the anterior right infrahilar lung with suspected right hilar and mediastinal adenopathy. Findings are of concern for primary bronchogenic carcinoma. CT of the thorax is recommended for further evaluation.”
Lung cancer. The CT scan confirmed it. A needle biopsy identified it.
It is possible to experience shock even if you are not surprised. Becoming a smoker today is generally an informed decision, but my mother became addicted in 1954, long before the truth was revealed to the public. She was 16 years old. Now, at 81, she has a land mine growing in her right lung.
Somehow she thought she had escaped from lung cancer, as though if she was going to have it, it would’ve happened by now. The evening of the day her doctor called to tell me that Mom had it, but advised that we wait to tell her until after the CT scan, Mom was watching a news story about the dangers of vaping and said, “I am so lucky. When I think about all those years that I smoked…” Her words made me nauseous. When told that she needed to have another test to follow up the x-rays she’d had taken, she said, “Can’t we just forget about it?”
I thought the Alzheimer’s would take her mind from her before her body was ready, but it appears that’s not the case. On some level, I almost wonder if it isn’t better this way. Physical pain can be treated. Brainfuck cannot.
My dad had a stroke in 2007. He also suffered from non-Alzheimer dementia. My sister likes to remember him as always having a smile on his face, all the way up to the end. She says, “At least Dad was happy. He had no idea what was going on, but he was always smiling.” Where she saw a smile, I saw strain. I saw a grimace etched by chronic back pain, hearing loss, and a constant state of confusion and fear. I’ve always hoped I was wrong and Katie was right, but it still haunts me.
I’ve been taking Mom to church on Sundays. I don’t go in, and not once has she asked me if I will. Even with dementia, she remembers better. Just pulling up to the building, the old animosity slithers into my psyche. In the abstract I can distance myself now, but up close and personal, it’s not as easy. My gut reaction is to resent that this myth, this placebo, is the thing she will turn to even more than her self-source as her life comes to a close, but I know it’s a comfort to her, and for that I’m grateful.
Her handwriting, her voice…these are the things I’ve always thought I’ll remember most after she’s gone. Now that list includes the expression on her face as she heard her doctor say, “Joanie, you have lung cancer.” I’m sad, and pissed as hell, but our family is not special or unique or more unlucky than other families. Cancer doesn’t care who you are or who you love.
My sister got here as quickly as she could. She made it in time for the three of us to celebrate my birthday together. We don’t yet know what Mom’s course of treatment will be, or whether she’ll undergo treatment at all. Her life could go on for six more months, or 6 more years. Everyone…she herself, Katie, the doctors, and I…agrees that if treatment compromises her quality of life, it will not be pursued. Some of our bodies leave us quietly; others make some noise. Our mother is a kind, gracious woman, and her body should be allowed to leave as kindly and graciously as possible.
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