Exit Laughing (20 page)

Who was this God of Hosts, and what exactly was I supposed never to forget? I was convinced, as usual, that everyone in the world knew except me. I didn’t even know who “our boys” were, let alone the sacrifices they were supposed to have made. I thought they must have been vaguely related to Jesus, because I was always being told at school that He had also made sacrifices on my behalf, the significance of which also escaped me.

As soon as the two minutes of silence was announced, I’d look around surreptitiously. Everybody else’s eyes were properly downcast, their faces obedient masks of sadness and sobriety. I had no doubts they were thinking the right and proper thoughts. The only infidel in the entire assembly was me. The Jewess. I knew with sinking certainty that my doom was sealed, that I was helpless to avert my fate. I was going to laugh. It would start off as a tiny trembling bubble, until it finally burst into a huge resounding yawp. I’d be sent to the principal’s office and accused yet again of heartlessness, insensitivity, and callousness. After laughing hysterically all the way through my grandfather’s funeral, that was exactly what my family accused me of too. Nor could I stop laughing at any further reference to my grandfather’s death at family gatherings. I was a disgrace and a pariah.

Was it my grandfather’s messy and undignified death that had made me laugh? A sort of payback for my childhood disenchantment, my precipitous fall from royal grace? I didn’t know then, and I don’t know now. I do know, however, that I still laugh at inappropriate moments. I giggled my way through my marriage ceremony and guffawed when I was
sworn in as a Canadian, something that very nearly cost me my citizenship. The same thing happened when I became an American. I sometimes wonder whether I’ll have both the wit and the will to laugh at the moment of my own demise. If I do, at least I won’t be around to witness anyone else’s anger at my offensive behavior.

I have only two regrets about that unforgettable incident at my grandfather’s deathbed. One is that I wish I could have controlled myself in front of my mother; the other is that I wish I could say that to this day I can’t bear the sight, the smell, or the taste of chicken noodle soup, but I can’t.

I love it.

Six weeks before she died, my mother and I were together in her apartment, a rare January sunlight streaming across the living room carpet and warming the sofa where she was nested. Aware that her life was coming to an end, Mom was becoming increasingly agitated. An avowed atheist, she was facing the reality—her reality—that there was no God, no life after death, no heavenly place awaiting her where she would be reunited with her husband and all those friends who had died before her. This could only mean that the end, the absolute and inarguable end of her life, was fast approaching.

She had been declaring for months that she was ready, that the quality and value of her life had run their course and that, had she the courage, she would bring closure to this
nonsense
herself. But she did not have the courage, perhaps not even the inclination, to end her life. So she lived on, her body failing her, her memory slipping, as she continued to be the victim of the cruelest trick of all: death was approaching, and she was poignantly and painfully aware of its proximity.

Mom was eighty-nine, a former art teacher, a painter, Scrabble demon, and political activist. She was a loving friend to her peers, an occasionally difficult and judgmental mother
to her daughters. I recall many instances where I felt distrusted and disrespected, despite being a fairly serious girl and woman who followed the rules and rarely wavered from the path I was taught to follow.

When I was a teenager, she harped on the fact that I could get pregnant, like so many classmates, and bring shame to my life. I assured her often that I was innocent to the point of naïveté, yet she never wavered from her threats and accusations. When I was a middle-aged woman, she warned me about excessive spending, yet I was never in debt and so fiscally responsible that I too often denied myself the little luxuries I could afford. This difficult side of our relationship was heightened by my mother’s stubborn nature, and compounded even more by a sense of entitlement that resulted in her often saying whatever she wanted, no matter the consequences.

Eighteen months before her death, there were signs of physical problems: general weakness, lack of appetite, blood pressure fluctuations. “I’m old,” was her explanation whenever I pressed her to see her doctor. And then the falling, the 911 calls, my phone ringing at all hours to meet her at the hospital. Blood work, guesses, nothing firm. If I took a bath, the phone was perched on the nearby sink. If I ran downstairs to get the mail, the headset was grasped in my hand. I knew the call would come; I just didn’t know when.

For the first time in their three-decade relationship, her doctor called me. “She’s bleeding internally,” said Dr. Candell. “I’m sure of it, but she refuses to have a colonoscopy.” He asked me to help convince her, while he continued to plea
and cajole. Meanwhile, she was slipping into a state of severe anemia, and a transfusion was given that alleviated her symptoms but did not stop her decline.

After several months and more emergency trips to the hospital, my patience was nearly gone. When next she was shuttled to the ER—I got that call at three o’clock in the morning—I raced across the Bay Bridge, surrounded by the eerie emptiness of a highway normally jammed.

Mom was so pale that she was gray. After the saline bag was empty and the transfusion was complete, I blocked the door of her examination room like some linebacker daring a runner to break through and announced that she was going nowhere until the colonoscopy was performed. With a dramatic scowl and teeth grinding, she begrudgingly agreed.

Instead of the two hours it normally takes to drink the bowel-cleansing solution, Mom drank hers in forty-eight. That was my mother. Heels. Dug. In.

Finally prepped for the procedure—a euphemism for having everything cleaned out and the entire colon visible through an intestine-traveling camera—she was transferred to a gurney and wheeled into the examination room. I waited outside, concerned that this invasive but rarely dangerous procedure might be too much for her. In less than an hour, the doctor joined me.

Colon cancer.

Nearly total blockage.

Laparoscopic surgery would do the trick, probably cure it. He doubted there would be a need for radiation or chemotherapy.

I called Dr. Candell and asked him to come and talk to us. We needed his expertise, his calm nature, to guide us through what would be the most important decision of my mother’s life. Most of all, we were desperate to hear the opinion of a medic who truly cared about her well-being and, more importantly, her quality of life.

Within a few hours, he was sitting in her hospital room, holding her hand and quietly going over her options. There were two: surgery and hospice. He confirmed what we both suspected, that any surgery performed on a woman nearing ninety had its risks. And not so much the surgery itself—hers would be less invasive than many—but the damage that the anesthesia could cause to her organs and her level of strength. What frightened us was the knowledge that anesthesia can cause long-term cognitive disorder, especially in the elderly. Was it worth the chance, subjecting my sharp-minded, opinionated, and creative mother to this risk? What if she came out of the surgery cancer-free, but with short-term, and even long-term anesthesia-induced senile dementia?

“How long will I live if I choose hospice?” she asked.

The doctor’s eyes softened, his fondness for my mother evident. “Three to six weeks.”

She chose hospice.

I phoned my children and then my sister. As the firstborn, Michele had taken the brunt of our mother’s nasty tongue. This was compounded by the fact she is a gifted and recognized artist and writer, and our mother long envied her daughter’s accomplishments. That envy manifested itself as an
undercurrent of ill-treatment from a woman who had aspired to similar recognition.

Like so many women of her generation—especially highly intelligent and creative women—Mom lacked the ability to take risks. While she insisted that her life had been fulfilling, there was a bitterness that ran through her relationships with her children. When learning of our mother’s decision to choose death over surgery, Michele would have been more than justified in distancing herself. Instead, she assured me that she would fly in immediately. With our mother only days from hospice, it was a relief to know that Michele would be there to support her—and in so many ways, me—through this process of dying.

The day of the colonoscopy, shortly after Dr. Candell took his leave, a surgeon showed up in Mom’s room. The hospital had contacted him prior to her decision, so he arrived with no knowledge that she had chosen death over surgery. He was young, attractive, and friendly. I assumed that surgeons in his age group would be more supportive of life/death choices, so I was comforted by his presence.

Mom informed him that she was going into hospice. “I’m old, I’m tired, and I prefer a quiet and pain-free death,” she explained.

The surgeon nodded thoughtfully, which allowed me to think: enlightened generation, accepting and respectful of personal choice. He stood at the foot of her bed and leaned against the railing. His face radiated concern and comprehension. And then he spoke. “Your death will be anything but
quiet and painless,” he said. When I asked him to explain, he looked directly at my mother. “You’ll stop eating, but there will be times when you’ll want a little something. With this blockage, you’ll soon be vomiting your own feces.”

My mother’s eyes widened until they bulged. I had seen fear in her face many times—going back to when I was a teenager and she suffered from an autoimmune disease that had taken her near death on several occasions—but I don’t recall ever having seen that look of terror. Had I not been caught off-balance by this man’s insensitive declaration, I would have challenged him. I would have asked, With morphine helping her into a coma, why would she eat? I would have asked, And if she did eat, wouldn’t it be sips of water and juice? Instead, I sat there stunned by the vile picture he had created … and then it was too late. My mother had already visualized, with an imagination that comes from sixty years of painting, a tableau that was as inhumane as it was revolting.

The next day, she underwent surgery.

She bounced back physically, but something was amiss.

This woman whose mind had always been sharp and probing was struggling to remember the simplest things. And she knew it.

There were days when she asked me the same question four times … in a period of five minutes. There were moments when she stared at me, yet had just enough awareness not to ask who I was or what the hell I was doing in her bedroom.

The delirium of anesthesia, compounded by the extended anemia—which could have been avoided, had she allowed simple
tests to be run early in her illness—resulted in an increasing dementia that became part of her daily life.

“She’ll come out of it,” said her friends. And it was true, there were hours at a time, often days, when her mind seemed clear and she understood everything going on around her, including the political discussions on C-SPAN. On those days, my heart soared with the possibility that she was coming back.

But more than the occasional rallies were the signs that she needed increased care. The cancer was gone—and with it, the blockage—but she had little appetite and she was severely depressed. I suspected that she wasn’t taking her medications, so I kept a tally of how many there were on a given day and compared those numbers to what remained in the bottles three days later. She was missing six pills for blood pressure, when only three should have been taken. The thyroid pill count had not changed. As for the vitamins, minerals, antidepressants, pain pills, and sleeping pills, the numbers were all over the place.

Several years before her illness, Mom had sold her town house and moved into a retirement community for seniors who enjoyed independent living. Despite the number of elderly residents pushing walkers and an average age hovering near eighty, I’d never seen such comings and goings! There were poker games, movies in the leather-seated theater, Democratic club meetings and residents’ committees that, urged on by my leftie mother, might have threatened to build barricades and storm the management offices if demands were not met.
There were lectures and concerts, van rides into San Francisco for museum and gallery tours, dances, and mah-jongg games.

Fortunately for my mother, Cardinal Point was also a haven, an elegant and comfortable place that rivaled many four-star hotels, and was staffed by the kind of people anyone would choose to watch over their aging parents. One of their services was to provide daily care for residents recovering from illness. If able, they could remain in their apartments and be visited several times a day by aides. For Mom, this was a blessing. Morning and night, someone was there to be sure she was comfortable, that the correct medications were being taken, and that I had everything I needed to care for her. I continued my morning-to-night visits, but I also welcomed and appreciated the support. As someone who occasionally is tripped up by her own hubris, I found it difficult to let go of control. But as incontinence became an issue, I soon learned to ask for help.

One afternoon, we were together in her living room, Mom nested on the sofa as she attempted to concentrate on her crossword puzzle. Quietly, she put down the paper and turned to me. “I believe in the Eskimo tradition,” she said. “I’m going to die soon. Why can’t you just take me to Alaska and put me on a block of ice and float me out to sea?”

At first, I wasn’t sure how to react, but then something struck me. Taking this as one of those moments when levity might be appreciated, I said, “Well, with global warming, I’m not sure there’s much ice left.”