Mother Daughter Me (31 page)

Vivienne has finally, at age eighty-four, stopped dyeing her hair blond and has let it turn not gray exactly but an odd straw color. She has applied her eye makeup but apparently with a trembling hand, as the lines she has drawn with her brow pencil are coarse and jagged. Her two-bedroom apartment is roomy, the bookshelves stacked with books she has kept with her through the decades. The kitchen is small but fully functional, a far cry from the sorry little food-preparation spaces my mother and I saw in San Francisco. And Vivienne has equipped it with dishes and cookware still familiar to me from our years in Amherst.

After a quick look around, I tell Vivienne we have to leave in order to get to her doctor’s appointment on time. Pride prevents her from taking her cane, and we make our way slowly to the car, where Zoë is waiting. Zoë and Vivienne have always enjoyed each other’s company. When Zoë was small, she called her Grand-Vivienne, and Vivienne, for her part, has always made a point of asking Zoë questions that will engage her. But I can see that the slow-moving, elderly Vivienne is making Zoë uncomfortable, and on the drive to Northampton, Zoë remains silent in the back while Vivienne talks about how isolated she feels living in the country, especially since a small stroke stripped her of her driving privileges and forced her to rely on the facility’s shuttle vans. She’s taking the driving ban very hard. She feels imprisoned, she says, especially on weekends.

Vivienne asks how my mother is getting on in San Francisco. I’ve already told my stepmother about our failed attempt at living together, which my mother so diplomatically refers to as our “transition period.” Given Vivienne’s lonely circumstances, I’m careful not to say too much about how well my mother has adapted to living there, but she can tell from even the little I say that my mother is thriving. “She’s so fortunate
to be in such a wonderful city and to have you so close by,” she says, her voice tinged with envy.

Soon after we arrive at the clinic, we are shown to an examining room to wait for Vivienne’s longtime physician, Henry Simkin. When Henry enters the room, he practically bows to my stepmother, as if greeting the Queen Mother. “It is a pleasure, Vivienne!” Henry, a tall and courteous man who was also my father’s doctor, greets me just as enthusiastically.

Vivienne has an entire list of things she’d like to talk to Henry about, mostly her dissatisfaction with where she is living, which involves everything from the cost of the place to the limited transportation options. And she feels abandoned by her three children. Not only do they live in different states but they aren’t especially attentive. Henry listens carefully, playing the role of therapist as well as doctor, something so few doctors are willing to take the time to do these days.

Vivienne is eager to hear the results of a neuropsychological test she’d taken recently. “The bottom line is very gradual decline,” Henry says. “You have what’s called pseudodementia.”

Vivienne hears “dementia” and reaches for my hand.

“It’s not as bad as you think,” Henry says, and explains that it’s a scary term for “spotty cognitive problems.” Pseudodementia, I learn later from Bob, is depression in the elderly that manifests itself with memory loss and is often mistaken for Alzheimer’s disease.

Then Henry rolls his stool close to his patient and leans in, not five inches from Vivienne’s anxious face. “You’re not your usual vivacious self, the Vivienne Hafner I’ve known for twenty years, but you still have a lot of health left in you,” he says. “But here’s what I’m seeing: excellent blood pressure and a brighter countenance than the last time I saw you.”
Wow
, I think,
she must have been pretty down before, if this is a brighter countenance
. I’m also impressed with Henry’s use of the word “countenance,” formal enough to appeal to Vivienne’s British sensibilities. After the appointment, Zoë and I take Vivienne to lunch at a small café near Henry’s office, then, pressed for time, we drive her back to her place so that we can race to South Hadley for the Mount Holyoke tour.

Two days and two more campuses later, we board the plane to head home to San Francisco. I open my computer and spring for the $12.99 in-flight Wi-Fi. An email drifts in from my mother. I assume it’s her daily update, but the subject line puts me on guard: “The Steinway.” The email is brief, and she informs me that she put the piano on Craigslist and “it is gone.” The piano, my mother writes, became a nasty source of friction between us (no argument there), and she has done what she considers right “on many levels.”

Zoë is immersed in a movie. I tap her on the shoulder to show her the email.

Her eyes widen. “Mom, aren’t you furious?!” I’m not really sure what I’m feeling. I’m definitely impressed by my mother’s cloak-and-dagger work. All week she’s been sending me chatty check-ins without one mention of her plans, all while taking snapshots of the piano and uploading them onto Craigslist.

Seeing Zoë’s reaction, I realize that she is holding not just her anger at my mother but my anger at my mother as well. “Mom,” she says. “Grow a pair of tiny little testicles and send her an email right this minute.”

I take a deep breath and compose an email to my mother. It takes all of sixty seconds to write:

I hit “send.”

Zoë has been watching over my shoulder while I type. “Good,” she says, and turns back to her movie.

We get home and head straight into the living room. Where the piano once stood is a large empty space.

“Well, that does it,” Zoë says. “I never want to see her or speak to her again.”

When I tell Bob about the stealth sale, his reaction is typically laid back. “I’ll miss that piano—it was awfully nice,” he says. “But such is life.” He’d invoke a relevant
Seinfeld
episode, he adds, but none comes to mind.

But I brood. I continue to puzzle through my mother’s reasons for her unilateral action. No doubt her decision was wrapped up in the feeling that I had brought her to San Francisco only for her money. So the piano had to go. And in a maneuver executed while I was out of town, she took our negotiations about it off the table.

My email to her goes unanswered.

———

N
OT LONG AFTER WE RETURN, ZOË GOES OUT ON A SATURDAY NIGHT
with her friend Gwen, with plans for Gwen to spend the night.

Zoë is sufficiently sketchy with me about their agenda for the night that I conclude that whatever they do will involve drinking. The girls return at around midnight, and Zoë comes into my room to say good night. To my relief, she appears stone sober.

It’s Gwen I should have worried about. Zoë might have been the model of abstemiousness, but Gwen made up for it. Thirty minutes after saying good night, Zoë bursts into my room to tell me that Gwen is throwing up, spreading the contents of her gut across Zoë’s bedroom. While Zoë is telling me this, I hear Gwen, who has since managed to get to the bathroom, still retching. The house is beginning to feel like a regular vomitorium.

Zoë wants me to help clean up. Absolutely not, I tell her. I’m not going anywhere near that mess. She argues with me. “But Laurel Hackett’s mom does that when drunk kids throw up at parties at their house,” she says. “I’ve seen her do it.” This is pretty unbelievable news
on many levels, especially since the Hacketts are mega-millionaires and I can’t imagine Sue Hackett cleaning up after someone else’s child. I stand my ground. She and Gwen are to take responsibility for this, and they are to scrub the room until no trace of Gwen’s debauchery remains.

I hear Zoë go downstairs for cleaning supplies. Then she’s outside my door in the hallway, putting soiled objects into plastic bags. I hear her speak soothingly to her friend, who is in no position to help. Zoë tells her she thinks they should go sleep downstairs, because her bed is now unusable.

The next morning I see that Zoë has done a remarkably thorough cleanup of her room. Both girls are asleep in my mother’s former quarters, in beds conveniently supplied by the real estate agent’s stagers in anticipation of our planned move to a smaller place. I go downstairs and seat myself quietly at the edge of Gwen’s bed. She wakes up and tells me she’s feeling better. I know she isn’t my daughter, but I can’t resist the temptation to tell her that excessive drinking at any age is just a really bad idea. Then I raise the question of what I am going to say to her parents. At this, she looks stricken. “Oh, Katie, please don’t. That will be the end of me.” I know about her terrible home life in a blended family, and I’m fairly certain she’s not exaggerating.

All of this leads me to remember my eternal gratitude to Vicky White’s parents for not informing my father and Vivienne about my shoplifting. Their decision was a gift. Now the least I can do is pay that gift forward. I assure Gwen that I won’t say a word.

As I sit there, I am silently rejoicing that it isn’t Zoë who made herself sick drinking. I don’t know what lies in store for my daughter at college, where the pressure to drink is still greater, where she will be without the tempering influence—and presence—of a mother to issue reminders of her family history of alcoholism. But for now she doesn’t seem interested in drinking, even for the sake of experimentation, and is genuinely grossed out by last night’s events.

ZOË AND I ARE
now in our new apartment, and Candace comes over one morning to help me unpack. Bob has spent the night, and while I make breakfast he sits down and asks Candace how her mother is doing. “Not
well,” Candace answers. Ramona is losing more weight and is down to an alarming eighty-two pounds. From the questions Bob is asking, I can tell he has been following Ramona’s case from the periphery. At a dinner we had with Candace and Ramona a couple of months earlier, he noticed her fragile condition, and his medical antennae must have gone up.

His next question: What were the results of the thoracentesis, the removal of the fluid abutting the lung, a test Candace had taken Ramona in for weeks earlier? Candace never got them, she tells him, and when she called to follow up, she was told they had been lost. When she says this, I’m horrified, but Bob, who has written extensively on the topic of medical errors, just rolls his eyes. Candace says she does have the results of a recent echocardiogram. Ramona’s “ejection fraction,” she tells him, is 15 percent. I see Bob’s expression change.

Ever so subtly, Bob transforms from someone making polite conversation at a breakfast table to a caring, concerned doctor. And that doctor quietly steers the conversation to a place he must have navigated many times before: an end-of-life discussion. First he gives Candace an explanation of what is happening with Ramona’s heart. The ejection fraction is the fraction of blood pumped out of ventricles with each heartbeat, he says, and at 15 percent Ramona’s volume is far below the normal value of around 60 percent. Such diminished volume means that Ramona’s weakened, fragile heart could stop at any moment.

As Candace absorbs what Bob has just told her, it’s clear that Ramona’s physicians have not taken the time to explain in much detail Ramona’s condition and its implications. When Bob asks Candace whether Ramona has prepared an advance health directive, she says yes, and that it contains a Do Not Resuscitate order, which is in her medical file. Candace thinks that’s fine, but Bob knows it isn’t. Again, very gently, and via a cautionary tale of a former patient of his whose DNR order was in a file but nowhere near the person himself, Bob tells Candace that when the prognosis is so grim, the situation so unpredictable, copies of Ramona’s DNR order should be everywhere: on her refrigerator, on a bracelet on her arm, in her purse.

Next he sounds Candace out to see if she has considered the possibility that her mother might eventually benefit from hospice care. She looks surprised but asks him to tell her more. Bob’s doctorly manner,
which I am witnessing for the first time, is as respectful as can be. Rather than starting every sentence with “You should,” he talks about a common misunderstanding people have when it comes to the concept of hospice. He tells her it’s something people tend to think of only in relation to advanced cancer and other diseases that can seem more obviously terminal. With advanced heart disease of the type Ramona has, people think it can be treated, that it doesn’t necessarily imply a grim prognosis. But with the numbers Candace has just given him, he says, Ramona’s prognosis is probably no better than that of a woman her age with an aggressive metastatic cancer, and he would be remiss if he didn’t bring up the topic of palliative care. Most patients who end up in hospice, he tells her, do so for only the last week or so of their lives—which is too bad, since hospice has so much to offer dying patients and their families. But many people misunderstand what hospice is about, and the instinct to fight on or even to deny reality is very powerful.

Here’s Candace, hearing for the first time that her mother’s heart could fail without notice, that Ramona has, at best, a couple of years left. Candace is taking it all in and says she’ll get right on that medical directive. Bob nods approvingly. Seeing these two people—one of whom I have loved for many years, the other I’m just coming to love—talk through an issue this difficult moves me deeply.

As I look at Bob now, I’m beginning to unlock a riddle about our relationship—and why my mother is so very wrong about him. When Bob talks to Candace about her mom, he is the very essence of the sober, compassionate physician. His academic accomplishments are remarkable, and his professional side means a lot to him. Yet it’s the other facet of Bob’s personality that I’ve come to appreciate still more. As Bob turns to his French toast, maple syrup dripping during each brief trip from plate to mouth, I recall a story in which his ex-wife remarked that she could always predict what he would order off a breakfast menu by asking herself, “What would a six-year-old choose?”