Motherless Daughters (39 page)

I once read in a magazine that a woman feels the first pinch of mortality when she looks over her shoulder into a mirror and sees her mother’s ass. What is the sensation then—a slap? a kick?—for the woman who turns around and sees much more than that? In the mirror, I find my mother’s hips and hands and eyes. When I speak, I hear her voice, occasionally shaping itself around the same sentences I swore I’d never utter as an adult. And from there it seems only a short journey to the afternoon in an examining room when a doctor accidentally touches my armpit, feels a swollen lymph node, and asks, with sudden concern, “What’s this?” Such things can happen. I know.

Genetic roulette awarded me my own face, but I inherited my mother’s shape—small breasts, high waist, wide hips, slim ankles, big feet. She pointed out the similarities long before I understood that a body could feel like anything but my own. When I was five and sitting at the piano bench, she took my right hand and turned it over between both of hers. “You have piano hands, just like mine,” she said, and she showed me how her long, thin fingers could span an octave on the ivory keys.

When I reached five feet, four inches in the sixth grade and my legs showed no sign of slowing their growth, my mother became determined to deliver me from the adolescent shame she’d once felt as the tallest girl in her class. In her walk-in closet she taught me the tricks of illusion she relied on to mask her body’s perceived flaws:
cinch dresses at the waist to keep them from clinging at the hips. Use shoulder pads to offset small breasts. Avoid white shoes.

I wonder how it made her feel, to watch a first daughter’s body unfold to produce a paper-doll image of her own. Was it a personal triumph for her, a chance to relive thirteen with a mother who knew modern fashion tips? Did it spawn a barely suppressed envy, reminding her of years spent in awkward adolescent solitude as she watched me flee the house each afternoon to join my small tribe of close-knit friends? Or, in the months after the diagnosis of cancer in her left breast, did she ever look at mine and wonder whether a lump could grow inside me, too—if an ability to cultivate malevolent cells would be her final gift to me?

Perhaps this thought plagued her, or perhaps she kept it forcefully at bay. I don’t know. Although cancer runs like toxic sap up and down both sides of my family tree, we never discussed the possibility that it might show up in me. My mother didn’t speculate about its future plans. Her father had survived colon cancer in his forties and had lived for another twenty years. This was our paradigm for serious illness; she may have trusted that the same sequence would repeat for her.

In the medical records from her mastectomy, I can see her trying to deny that cancer could interrupt her life. Or was she just replacing fear with the same blind hope she tried to encourage in me? Three days before the pathology report confirmed that all of her twenty-six extracted lymph nodes had tested positive for cancer, a female social worker visited my mother’s hospital room. From the notes she left behind, this counselor apparently already knew how serious the pending diagnosis would be: “The patient is an emotionally resourceful woman who needs at this point to be very optimistic about her disease and its implications,” she wrote. “Wishing to resume her previous functioning as soon as possible. Patient feels that the two weeks of preparations she had prior to surgery gave her time to think about her priorities—‘getting back to life’—and to reduce some of the disorganizing effects of waking up to a mastectomy. Her hope-fulness is what appears to be sustaining her at this time. Her sister, on the other hand, upset about MD’s report that there was much more cancer than anticipated and patient will need chemotherapy. Talked
with her at length so as to allow her then to support patient’s defenses, i.e., a denial of its long-range implications.”

I don’t know whether my mother ever understood how far gone her cancer was, or that it would eventually win. But surely, the thought must have taunted her—how could it have not? From the pathologist’s report, the likelihood of her survival was slim. Twenty-six positive lymph nodes is about the poorest diagnosis a woman can get. But I remember what she told me after her mastectomy, as I sat at the foot of her hospital bed: “The cancer was in some of my lymph nodes but not in others, which means the doctors removed it all.” I believed her at the time—I had no reason not to—but twelve years later, I learned it wasn’t true. Which means, as I see it, either that my mother never heard the pathologist’s report or that, because she wanted to protect me from a truth too inconceivable for her to bear, she lied.

By the time this was revealed to me, however, I’d already spent more than a decade constructing lovely, complex metaphors about beautiful, brave women who died without dignity because their fate lay in the hands of manipulative men. On alternate days my mother was either a queen removed from her kingdom without warning or a soldier pushed into battle with neither sufficient training nor adequate arms. These fantasies sustained me, justifying and multiplying my anger toward her doctors and my father, and I’d organized most of my opinions about the medical profession, illness, and death around their romantic poles. Before I saw the severity of her medical condition spelled out in type, I’d never considered the idea that my mother, alone inside her body, might have known the truth all along.

And could she have suspected it even earlier? I remember the reason she gave me for avoiding the biopsy that would have diagnosed her cancer a year before the biopsy that finally did. “Operations are expensive,” she said, “and money is tight this year.” I accepted her explanation then, but I know better now. The whole family had major-medical coverage, which would have paid 80 percent or more of the bill. Lack of money wasn’t a legitimate reason to put the surgery off.

After that conversation, we didn’t speak about the lump again, until the evening of the mammogram that showed what she described
as a “suspicious shadow,” and we never discussed death. The only time I heard her mention her mortality was during a three-minute episode one afternoon about four months before she died. I was walking into the bathroom as she was walking out. Her eyes were red and her lips tight, the mask she wore between the toilet and her bed after a chemotherapy treatment earlier in the day. As she carefully lay down, I asked her, exasperated and confused, “Why, Mom? Why do you put yourself through this hell?”

She looked at me as if I’d said I’d just had a delightful tea with God. “Hope,” she said. “I do it because I want to live.”

Which, of course, is not what happened, not at all, because four months later she was dead at forty-two. And twenty-four years later, I am forty-one, the age she was when her cancer was found. The thirty minutes I spend sitting in the radiologist’s waiting room every February while my mammogram screens are scrutinized for shadows or spots are the longest thirty minutes of my year. While I wait in a mauve armchair, I run through the mental list of differences between my mother and me. She was a stay-at-home mother; I work. She had her third and last child at thirty-two; that’s about how old I was when I had my first. She spent her entire life in New York; I landed in California after fifteen years of jumping around. It’s my personal form of prayer, as if the recitation will somehow convince God to grant me just one more difference, the big one, the one my family needs the most. And then the radiologist returns with a smile and good news for one more year. Blessed evidence, again, that my mother and I are not the same.

Then, as I exit the lobby onto Wilshire Boulevard, I catch a sideways glance of myself in the building’s mirrored panels. It is my chin that juts out, my hair flapping against my back. But it is her chest pressing forward, her ass that protrudes. Her ass. And despite the morning’s news, it is still so easy to imagine, with each thought gliding smoothly and silently into the next: Her ass, her breasts, her fate.

 

Breast cancer, heart attacks, aneurysms, depression—the specifics don’t matter all that much. More than three-quarters of the motherless daughters interviewed said they’re afraid they’ll repeat their mothers’ fates, even when the cause of death has no proven relationship
to heredity or genes. Ninety-two percent of the women whose mothers died of cancer said they feared the same demise either “somewhat” or “a lot.” The same was true for 90 percent of those whose mothers committed suicide, 87 percent whose mothers died of heart-related illnesses, 86 percent whose mothers died of cerebral hemorrhages, and 50 percent who lost mothers to accidental death.

Like many of these women, my alarm grows not only from watching a mother die but also from the shadow of an ominous family tree. Cancer afflicted both my parents, all four of my grandparents, and my maternal great-grandmother as well. One of my mother’s younger sisters was diagnosed with breast cancer six years after my mother died, and despite what little certainty we have about the disease, we know it can hitch a ride on genes. I’ve lived for more than a decade now with the knowledge that I’m considered high-risk, that my lifetime chance of developing breast cancer, according to the medical geneticist who reviewed my family’s history, is as high as one in three. My challenge is to find a way to live that allows me a realistic amount of concern yet frees me from the certainty that, any day now, I will find the lump that is already programming me to die. It’s a delicate balance, and I haven’t quite achieved it yet. On good days, I figure my chance of getting breast cancer is so slim that I need not think about it at all. On bad days, I reassess my risk as inevitable. One hundred and one percent: That’s me.

Here’s what’s available to the high-risk daughter: Statistics. Odds. And, for heart disease and some cancers, early detection tests—which may or may not improve long-term survival, depending on which article you read. But statistics and test results don’t completely calm a woman’s fears. They appeal to her rational side, which isn’t necessarily averse to optimism but can’t squash her panic alone. My mother’s death from breast cancer left an emotional imprint on me, and that’s the part that can’t quite believe the same won’t happen to me.

When a daughter watches a mother die, especially from an illness, she becomes aware of her own physical vulnerability as a female. At some level, she already understands that the female experience is one of relinquishing complete control over the body.

Menstruation, gestation, and menopause progress at paces of their own unless deliberate medical intervention changes their course. But to see her mother’s system taken over by disease confirms one fear and encourages another: Her mother’s body failed too young, and the same can happen to hers.

This cognitive leap from the horror of a mother’s death to the fear of self-demise is a broad one, but easy for a daughter to make. The psycho-physiological connection between daughters and mothers begins the moment the physical tie is cut. With the severing of the umbilical cord, two female bodies face each other, separate, yet the same. A mother looks at a daughter’s body and sees her younger self; a daughter looks to a mother’s body for clues about her physical future. Bound by this symbiotic identification, daughters and mothers act as mirrors for each other, reflecting anachronistic versions of the self.

Alison Milburn, Ph.D., a psychologist in Iowa City, Iowa, who has counseled many motherless daughters, has observed that women with the most extreme fears of contracting their mothers’ diseases typically over-identified with their mothers during childhood. “As adults, they still see themselves as being very, very much like their mothers,” she explains, “and their mothers, most often, really reinforced that. As their daughters were growing up they said things like, ‘You look exactly like me,’ or ‘You’re exactly like me,’ or they responded strongly to events that happened to their daughters as if the events were happening to them.” When boundaries between mother and daughter are so fluid and ill defined, a daughter also can’t properly distinguish between her mother’s experience and her own. If cancer or heart failure or suicide took her mother’s life, she reacts to the illness as if it were a threat to her system, too.

Working in tandem with the hospital’s obstetrics and gynecology clinic, Dr. Milburn has seen this fear taken to its extreme. She’s counseled a college student who demanded a hysterectomy at twenty-five because her mother died of uterine cancer; a corporate executive who showed up for a breast exam with a chest full of pen marks, indicating the lumps she’d been monitoring daily for several months; and several mothers who requested prophylactic mastectomies in their thirties because they believed it would reduce their
cancer risk.
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Through relaxation and thought-stopping strategies, occasional medication management, and discussions of risk factors and family histories, Dr. Milburn tries to disentangle these women from the belief that a mother’s and a daughter’s destiny must be the same. “The best way these women can emerge intact from a difficult health situation with their mothers,” she says, “is to begin to become less psychologically identified with them.”

That’s not an easy task, especially when a daughter has inherited her mother’s appearance or physical shape. Because this daughter can easily imagine her body overcome by the same disease, she’s the one who identifies most strongly with a mother’s experience when the mother falls ill. “Of course, having your mother’s shape doesn’t mean anything about the reality of what’s going to happen to you, but that embodied sense of connection runs very, very deep,” Naomi Lowinsky says. “The problem for the motherless daughter is, she winds up in a horrendous catch-22. In order to fully identify with her femaleness, she’s got to be in her body. But that also means identifying with her mother’s body, and if she associates her mother’s body with a terrible illness and an early death, it feels like the last place in the world she wants to go.”

Yet it can seem, at the same time, like the only possible place for her to end up. This is the secret that motherless daughters share: We fear we will die young. And not at some unspecified point in the future—no, we fear it will happen when we reach the ages our mothers were when they died.