A woman is sitting on the edge of a bed, loose photographs in her hands. She lays them out on the flowered quilt, studies them as a gambler would, or a tarot reader preparing to interpret the flow of a life.
But there’s no revelation here and no lucky streak. The faces in the photos mean nothing to the woman. She wouldn’t know rummy from a full flush, and she couldn’t write a story about the faces if she wanted to, which she does not.
The woman is not a writer. I am the writer, and I’m watching the woman from the doorway to her room. The woman is my mother, who is 81 and losing her memory, the past dissolving each day like so many tablets dropped into water and turning to fizz.
Do you know who they are? she says, speaking to me, because she realizes I’m there in the doorway. I’m visiting for a week from out of town. She knows me, though often now she forgets my name or the terms that define our bond: mother and daughter. What she continues to know about us is beyond the grasp of language—its orderly grammar, its definitive sounds. When they fail I still exist for her now in a wordless, bone-deep familiarity, an instinctive recognition that carries with it safety and hope. Do you know who they are? She gathers up the photographs of the dead and the living—her parents, her daughters and sons-in-law, her grandchildren, her sister, her husband, her aunts and cousins and nephews, her girlhood friends—and hands them to me. Remind me.
Remind me. Re-mind. Give me back my mind. In the same tone she used when I was a child and she’d ask me to zip up her dress.
She wants to pretend that this is an ordinary lapse, a minor forgetting—Remind me—in which memory stalls for a moment and needs a jump-start, a jolt, a push, a little tinkering at most, and the information will flow again like fuel; the engine will turn over, and the names will roll off her tongue like the songs we used to sing in the car when I was a little girl and we went for Sunday drives out to the suburbs to look at model homes. This old man/He played one/He played knick-knack on his drum.
I sit down beside her. And this is your sister, Tillie, in Boston. Do you remember her? My mother touches her sister’s face. Sure, she says. Of course. She is pretending, like a child fudging the answer on a math drill or a spelling quiz, but anyone can see that she is dissembling, saving face. Sister, Tillie, Boston. I could be speaking Sanskrit, for all those words mean to my mother now.
She loses her keys. She hides her purse and spends hours searching for it. It’s deep under her bed—how did she manage to push it so far from the edge?—or buried behind the towels in the hall closet. Two weeks before my visit, she left the toaster-oven on for hours and phoned my sister, who lives nearby, complaining how hot it was in the air-conditioned apartment. Independent Living, the glossy brochures proclaim. Meaning an evening meal served in the communal dining hall and a knock on the door each morning to make sure we’re still alive, my mother says. For a moment she is once again the knowing one and I the child to whom she dispenses her hard-won wisdom. That look in the eyes: This is how it is; this is the truth; this is something you must accept.
In the supermarket my mother picks up a melon and puts it down. Then a peach. She holds a bunch of bananas in her hand, and I think she’s going to put it in the cart, but she lays it back, too. Then the peach again. A bunch of grapes, lifted and returned. She has been trying to choose some fruit for five minutes now. She has always been a leisurely shopper, but now the process stymies her. I watch her stare, bewildered, at the array of produce. What do you think, Mom? She says, I don’t know. You tell me. And so I do: two peaches, a few bananas, a small bunch of grapes. And on to the dairy aisle.
My mother’s kitchen has always been immaculate. She would not drink a glass of water without wiping out the wet sink with a paper towel. Now I open the refrigerator and food is rotting in uncovered dishes. A head of lettuce turns to slime. The milks sour. Five small Styrofoam containers: Inside I find two cookies, half a baked yam, a partially eaten apple and a bagel so stale it’s like a piece of kiln-fired pottery. These are leftovers she’s brought up from the dining hall, where she has her evening meal. In the drawer where she keeps her silverware, crumbs in every section of the Rubbermaid tray.
She loses words; a mouth opened to speak gapes like a fish. For a while she tries to finesse, begins a sentence she cannot finish and substitutes a catchall phrase: and so on and so forth. I begin ending the sentences for her, anticipating her meaning, deducing the vanished information. No, no! she’ll say, angry at me for getting it wrong, for not being able to bail her out of her plight. In the morning we were going to… and so on and so forth.
Back home I phone her every other day. Sometimes I have to wait for several minutes while she figures out which end of the receiver is the mouthpiece, which end belongs against her ear. Are you there? she yells. Hello? I try to coach her, projecting my voice across the miles that divide us, across the neurological terrain that’s more and more a desert for her, a harsh and difficult landscape. Finally there’s connection: Mom, can you hear me now? I repeat, and suddenly she says, Sure I can, as if there had never been a problem at all. Today we…then it…so I walked…and so on and so forth. I learn to pretend that she’s making sense, that we’re having a conversation. Tell me more, Mom. I’m listening. A sentence is a dream. Some you remember; some you forget.
The nurse’s aide my sister and I have hired to help our mother take her medicines each day says, When she opened the door for me, she was naked. I told her, “Honey, we’ve got to get some clothes on you. “And she giggled like a little girl.
In the bathroom, boxes of Depends, and plastic-backed absorbent pads on her bed at night.
One day, my sister says, she arrives for a visit with our mother and finds her on her hands and knees, trying to scrub the carpet clean from an accident the night before. In the lobby of the building, neighbors of my mother confide concern. She’s going downhill so fast, they say, as if she’s on a bicycle with failed brakes or a sled gaining speed on its steep descent, one cold, winter night after an unexpected snowfall.
Her gait grows unsteady. I sway, my mother says, as if she’s talking about a new dance she’s learned at one of the exercise classes in her building. But she never goes to those classes, though my sister and I both urge her to.
Outside, just steps from the building’s front door, she falls. A broken pelvis. Weeks in the hospital, weeks more in the rehabilitation unit, months after that using a walker and then a cane.
Like me at the university, where I teach in a city hundreds of miles from my mother, she spends her life now on a campus—this is what it’s called, the complex of bright, modern buildings in a Cleveland suburb, where hundreds like her have come to age and die. There’s a new Olympic-size swimming pool for water aerobics and hydrotherapy. Buses with hydraulic lifts take residents shopping and on excursions, even those in wheelchairs offered outings to the world they can no longer navigate on their own. There’s a greenhouse and an aviary and a library with big-print books. A synagogue. An auditorium. A day-care center for the children of staff, where she liked to visit when she was able, but now that’s off-limits to her. She’s given up her Independent Living apartment and moved next door to the nursing home. Her dementia is progressive, which means she’s declining. She lives in a pavilion, which is actually a locked ward. On her ankle a sensor bracelet, so you don’t get lost, I tell her when she asks me to get this stupid thing off my leg. She sees I’m not her ally in this and drops her eyes, defeated.
She says, I don’t belong here; they’re not my kind. Unpredictably she’ll have a minute or an hour when she speaks coherently, the words gathered up out of her usual confusion and strung together in order, like glass beads on a carefully made necklace. This fleeting lucidity: Soon enough the strand will snap and the syllables scatter again across the ward’s tiled floors. She says, I used to live over there, where it was nicer and points through the day room’s window to the Independent Living building. I ask her if she remembers when she moved. My mother smiles a small, sad smile, a smile of subtle irony. My mother, with progressive dementia. Of course I remember, she says. I walked all the way myself. She could have been recalling a trek across the Russian steppes rather than the 40-foot journey she made, my sister holding her arm and a nurse wheeling her belongings piled on her hospital bed, from one building to the next, from one life to another, from where it was nicer to where she is now. Of course I remember.
I thought this piece about my mother would be more philosophical, a kind of narrative essay on meaning and loss. I thought the anecdotes to ground the speculation would arise, like photographs spread throughout a metaphysical text. That was my initial intention when I sat down to write. But vignettes arrived in a batch, and I arranged them on the screen just as my mother used to lay her pictures out on the bed. I stare and stare at what I’ve recorded. Remind me. Who was my mother, who was I, and who are we now without a language we can share like good food at a family dinner? The questions seem moot, a banquet prepared for guests who will never arrive. Beyond these fragments of our current life—hers in the nursing home, mine as her grieving observer—nothing relevant announces itself. Here are the snapshots, and so on and so forth.
My mother is forgetting how to eat. Sometimes she stares at her fork as if it were a strange tool from a vanished culture. It goes in your mouth, Mom, I whisper, hoping the verbal cue will suffice. I do not want the aides to see me put my hand on hers and guide the fork for her. In this pavilion skills are evaluated every day, her cognitive and motor abilities measured as if she were a student at a posh private school intent on maintaining its academic standards. The aides are kind; they make their notes discreetly. But we have been warned: When my mother’s scores fall below a certain level, she will be moved to the next pavilion, and it will be no promotion. The social workers speak kindly, firmly, about changing care needs. I say, Mom, like this, and mimic feeding myself. She tries. The piece of meatloaf falls from her fork; the implement grazes her shoulder and clinks on the tiled floor. She smiles at me and shrugs. Her eyes meet mine: I was a never a great student, my dear. I never did well on tests.
In the photo my mother is a schoolgirl. A 10th-grade class picture at Boston’s Girl’s Latin High School, 1932. She sits in the front row in her blue-and-white uniform dress, her white stockings, her oxford shoes, a white bow secured like a crown to her wavy, black hair. Her feet are crossed at the ankles, her hands folded in her lap; she is the portrait of decorum, except for a small, defiant smile playing at the corners of her mouth. This is not a smile posed for the school photographer—the other faces are solemn, as was the mode in that time. This is a smile that sneaks through protocol, a glint in the eye that breaks the rules. Once when she was 12 or 13, tired of the way her mother and sister ganged up on me, she liked to recall, she carried out a small insurrection. After midnight she climbed out her second-story bedroom window onto the flat porch roof and shimmied down the post to the ground. She hid until morning in a neighbor’s backyard shed, walked home once she knew her family was awake, stunned by now at her absence, panicked, alarmed. They had already called the police when she returned, coming through the front door as if returning from an errand to the corner store. But I guess I showed them. That smile again, a rebel’s quiet delight that no punishment can subdue. Decades later the nursing supervisor says that my mother is resistant, especially in the mornings, when they go get her up. She hollers sometimes; she goes limp; brandishing her cane like a sword, she threatens an aide. They ganged up on me. But I guess I showed them.
Another story from her girlhood: how she menstruated for the first time in gym class, the blood coming in a gush through her white bloomers and puddling on the buffed wooden floor. I was so embarrassed I thought I would die. Now the aides are toiletting her every two hours around the clock, trying to get a handle on the incontinence problem. In her room I help her to the bathroom myself, but we don’t make it in time. Urine spreads across the tiles. Don’t tell! she says and raises a finger to her sealed lips. I offer the gesture in return. Schoolgirls hiding the evidence, pledging silence. Don’t tell!
My mother is moving again, from one pavilion to another, from Early-stage Dementia to Advanced Dementia. My sister and I have appealed the decision; we have fought and pleaded and begged them to please give her more time here, but the nursing supervisor and the social worker are adamant: changing care needs. She is sleeping through group activities, they tell us; she can’t answer the questions in games of Trivial Pursuit designed for early-stage dementia patients; she doesn’t respond to commands; she’s more and more unsteady on her feet; she’s fallen twice, and it’s just a lucky accident she hasn’t broken anything. Everyone here is ambulatory. Everyone here can walk on their own. We know there’s another variable in the mix: supply and demand, families pressuring them for beds when it’s clear their own parents can’t live alone any longer, just as we had pressured them for our mother to be admitted before something terrible happens.
The new pavilion looks exactly like the old one. She won’t know the difference, the social worker claims.
My sister takes our mother to visit the new pavilion. Get me out of here! my mother says. Take me home!
Here the narrative threatens to collapse, as if the photo-like episodes were in fact a house of cards swaying under the burden of that last deuce of hearts. Get me out of here! Take me home! I imagine bringing my mother here to my apartment in Washington, D.C., where I will hire a practical nurse to care for her while I’m at work. Otherwise my life will belong to my mother, as hers belonged to me when I was an infant. It seems a clear equation, a quid pro quo, a natural duty I am bound to fulfill. She needs me now as I once needed her, in a state of absolute dependency. My sister, who lives 30 minutes away from the nursing home, considers the same scenario—health-care aides to help her balance the demands of my mother’s needs with those of her teenage children, her husband, her business. I say I imagine and My sister considers, but what I mean is We agonize. We can’t eat. We sleep fitfully. We cry. We have nightmares. We have panic attacks and migraines and episodes of forgetfulness so severe we worry that we ourselves are losing our minds the way our mother has lost hers. Remind me. We come to the same conclusion separately: It’s too much. Our lives would buckle beneath the weight our mother’s illness exerts. We would all fall down and break, and who would put us together again?
After the move—She won’t know the difference—my mother cries for three days.
What is she grieving? The loss of familiar people? The diagnosis that no one speaks to her and she does not articulate herself—advanced dementia? The worse fate that still awaits her? She points to a photograph on her credenza and names a female image, Irene. It is not Irene. Irene was a cousin stricken in her 40s with multiple sclerosis, who lived out the next three decades in a nursing-home bed. For almost 20 years, my mother spent every Thursday at the Home, and part of the day was always spent with Irene—putting on her makeup for her, massaging her useless legs, feeding her lunch. She has no life, my mother used to say of Irene. She has no life.
In the dream I enter a house much like the one in which I grew up. My mother is there, frail and confused but living there on her own. She seems pleased that I’ve come. Soon after I arrive, I hear the noises of feet and furniture above us. Afraid, I ask my mother, What’s going on? We are on the top floor—what could account for the rumbling on the roof? My mother smiles at me. It’s the man upstairs, she says. I tell her, Mom, there isn’t an ‘upstairs.’ This is the last floor. There’s no attic in this house. But she’s insistent, indulgent of my doubt but not swayed in her conviction. Believe what I’m saying. It’s the man upstairs. At that moment a portal opens in the wall facing us, a doorway where there was no doorway. Beyond that a staircase and a man who descends it. He enters the room, where I stand in shocked disbelief and my mother continues to smile, though I see sadness in her face, as well, as you might welcome a doctor come to treat a sick relative. But if this man is a doctor, he’s the charlatan kind, natty and urbane and too slick to trust, a con man making a Fred Astaire entrance. He’s carrying a jar in his manicured hands. The closer he gets, the more frightened I am. In the room there’s a partition, something like a folding screen, and I beg my mother to hide with me behind it. Behind that barrier we’d be safe from the intruder: It’s not his territory there. But she won’t come with me. You go, she says in the voice she used when I was young, urging me to take the last serving of dessert. Whether she was sacrificing herself or truly not hungry, I never knew. You go. Which I do, moving out of the range of the man upstairs, who stands before my mother now, so close he could touch her. He opens the jar, and it’s smoking like dry ice. He dips his fingers into it, and they come out coated with a white foam he applies with the gentlest touch to my mother’s forehead. She’s very still, tilted toward him in a kind of bow. I am choking on panic behind the partition, but it is clear to me that I must not intercede, that I am meant to remain out of his reach, just as she is meant to receive his mysterious ministrations. What is that? she asks him, and the man upstairs says, Nuclear energy, radioactivity, working it in beyond the brow to her skull itself, her entire head covered now with the fatal salve.
She’s had a series of small strokes, a kind of rapid misfiring in the brain. Now she can’t walk at all. She can’t feed herself. Swallowing is difficult, and all her food is pureed—pureed fish, pureed salad, pureed apple turnover. The meal looks like a palette of thick paint in varying shades. What she doesn’t like she spits out. She pushes away the spoon the way a baby does when she’s had her fill or when the taste is not to her liking. But she is not a baby. She is my mother, and after a half-hour of my trying to feed her this lunch, she shudders, as if the entire effort—being at this table, allowing herself to be fed like an infant, consuming food she finds distasteful, living here among the gravely afflicted—is too much for her to bear. She has no life. My mother says, It’s enough. I’m tired. And falls into a deep sleep in her wheelchair.
At the table with my mother, another woman picks at her own lunch, solid food, with silverware she’s able to grasp. But she has no appetite, takes no pleasure in this meal. The woman has a face so lined and contorted with grief it seems as if she’s wearing a corrugated mask. I have never heard her speak a sentence, though she has sat in a chair for hours, screaming her dead husband’s name: Jack, Jack, Jack. Today she says, I had a husband a long time ago, but I forget who he was. As if she knows she’s lost one more thing—his name—she begins to weep. She is twisting the tablecloth in her hands, threatening to pull it off the table, and all the dishes with it. I walk around my sleeping mother and sit down beside this other woman. I straighten out the tablecloth and take her hands in mine. They are different from my mother’s hands. My mother’s hands are small and smooth, and her nails are well-shaped and polished a glossy pink. This woman’s hands are rugged, gnarled as tree roots, and her nails clipped short, to the quick. The weeping turns into a wail, which turns into a question she begs me to answer, in a language she retrieves from the time when speech was easy for her, commonplace, part of what it meant to be human. Now her words come out of her mouth in a gravelly rasp, as if a plumber’s snake were dredging them up, vocabulary and coherence released by a powerful implement that cuts through the blockage and again allows a flow of speech: Is this life, or is this death? I have to know. Which is it? What is the reality here? You’ve got to tell me. Is this life, or is this death? Like an oracle I answer her. Ida, this is life. She stares at me in grave disbelief, then in horror that what I’ve said is true. Do you mean to tell me this is life? This? She directs her rheumy gaze from one side of the dining room to the other. She watches my mother, awakening in her wheelchair, lifting her head, grinning at us as if we were girlfriends she had come to join for lunch in the school cafeteria. Is this what you’re telling me? That this is life?