After pausing for a few seconds, the palliative care nurse turned toward me.
“Our guest in Room 5 is active, and I haven’t been able to get in touch with his children.”
Charm City Steel, the five-piece band, pick up their sticks and in rhythm tap out a fetching tune on their huge steel drums. This is the preamble to a special program to celebrate and remember my mom, who died of advanced dementia at age eighty-seven in my home. The music lifts me as people wander in.
It is Mom’s memorial service, and she asked for this. It was ten years ago out of the blue, between steel drum dance tunes while vacationing together in Maine. She pointed at me from across the village green and said, “I want a steel band at my funeral!” No matter that she never brought up death or dying before or since. At that moment the heavens opened, and she delivered her wish to me. And I said to her, to myself and my daughter Amelia: “Done.”
Her spirit left the week before, and her body lay inside her casket shrunken. She died on January 29, 2019 and her family would need to let her go. She had lived eight years with Alzheimer's and, despite a valiant effort and family support, Sue Insuk Kwak could no longer be trapped inside her body.
A week and a half before, I went to Seattle to see my mother for the last time. I tried to coax her to eat and to move, but at sixty-five pounds she was declaring herself no longer part of the living world. She was, quite deliberately, choosing to die.
"I want to do something now. What can I do?"
My mother's body and mind were restless, moving in their own patterns just like the gray, low-hanging clouds that morning in August. "Why don’t you tell me what you want me to do?"
She didn't wait for my response but shouted, "Don't you dare tell me what to do, I'm not a child!" while pounding her cane on the floor with such might that I could feel the vibrations in my stomach. Then she sank into her chair and fell silent, her eyes glazing over.
One week into a three week "staycation," I enjoyed drinking coffee on the loveseat with my husband, holding his hand and pondering life. We sat in comfortable silence, but an inner turbulence unsettled me. He tapped his foot to some inaudible percussion.
"I've got two weeks of vacation left, and I already dread going back to work," I blurted without thinking, without self-editing.
His foot stilled. "Then don't," he said.
Several decades ago, my elderly patient, Mr. Waverly, coded in the ICU. Dr. Schiller, myself, and three other nurses tried feverishly to resuscitate him. Unfortunately, without success.
I prepared to let go and wished for more time. There was nothing left but to let my youngest son be at peace. Tomorrow we would unplug the machines.
His transplanted liver was failing, and he was too sick to get another. He coded three days earlier. Now, beneath the sedatives, paralytics and seizure medications, he was convulsing continuously.
There was no hope for meaningful recovery. As a physician, I knew it was the right choice. As a mother, I was heartbroken. How could I reconcile the rightness of the decision with something that felt so wrong?
Sometimes, the answer is so small and simple it goes unnoticed at the time.
I had barely entered my twenties when my parents died, within two years of one another. Well-wishers inundated me with questions about whether I would keep the family homestead, continue my education or change jobs. Should I donate my parents’ clothing and furniture and start a new life in a smaller place? After all, the old status quo was gone, never to return.
... You were thirty years old, and your mother was also my patient? What if she said you wouldn’t speak to her? What if she said you told her your grandfather sexually abused you? What if she said, “My father was a lot of things, but he was not a sexual predator”? What if she called you “a liar”? What if she didn’t believe you because your sister denied it happened to her? What if you knew that she knew? What if I couldn’t convince her to validate you? What if you cut off all family ties and turned to drugs? What if you killed yourself?
The jolt of pain shot up my back. Oh shit! I immediately stopped rowing. But then I recommenced my “high intensity” work out, with some modifications, not saying a peep to the instructor. Within a day, I had searing pain down my right thigh, like someone was tearing apart my quad with hot tongs. Every time I tried to stand, I turned ashen white and collapsed down. Me, the marathon runner; me, the active ob/gyn; me, the one who doesn’t know how to say no. Me, brought to my knees by overwhelming pain.
Immediately, I’m texting my partner. Prescribe me some steroids please. I’m thinking it has to be a herniated disc. My daughter drives me to the pharmacy, and I can’t make the walk to the back of CVS. I stop part way then, when I’m close, collapse into a chair. My daughter looks scared. “Just ask them for my prescription,” I tell her, trying to sound calm. I don’t know how I’m going to get back to the car.
"We need to leave. Joan's father just died."
My husband, Richard, our newborn baby, Andy, and I were in Binghamton, New York, where Richard was interviewing for a postdoctoral fellowship.
I had been in our host's guest room nursing Andy when someone called Richard to the phone. As I overheard Richard's words, my consciousness split in half. One part registered the information with dismay. The other continued cooing to Andy, enchanted that he had just awarded me his first smile.
My dog was lean and strong from swimming, running and walking long distances. Her fur--thick, soft and golden--glistened in the sun. She slept half on and half off her bed near mine. At 6:30 each morning, her wet nose nuzzled me awake. Keeva loved snow and cold weather. She pounced on disappearing snowballs. She chased after balls on the icy beach or plunged after them into the frigid sea. The ocean, a lake or swimming pool all beckoned to her.
For almost forty-five years, I have been angry. While this anger never leaves me, it becomes more profound on December 11, my son’s birthday. It was on that day in 1973 that the seeds of anger were planted.