My mother’s death

Those who are left are different people trying to live the same lives — Winston Graham speaking as Demelza, Warleggan

Give sorrow words — Shakespeare, Much Ado About Nothing

William John Garbus (1944? age 23), my father

Evelyn Garbus (1943? age 21?), my mother

Dear friends and readers,

My mother died this past Friday afternoon, between 4 and 5 in the afternoon in a room in what was once called Booth Memorial Hospital, now New York hospital, located in eastern Queens county, NYC. My mother’s younger sister, my Aunt Barbara (77); me (65) & Jim (63); Barbara’s two sons (my mother’s nephews), Paul and Mark (in their early 50s); Paul’s wife, Kathy (straight from the airport by cab); and my mother’s paid home-companion-attendant, Neli, were in the room. The nurse came in and said “We are unable to find a heartbeat.” I asked, “Does that mean she’s dead?” The nurse replied that we must wait for the doctor to come in and see and he was on his way. He came in and said yes (the exact wording escapes me) and proceeded to direct a set of questions to me as the “next of kin.” My mother would have been 91 this November.

More than a month before (mid-July), six of us, this time my aunt, her husband, Erwin (78), Paul & Mark, Jim & me had met in my mother’s apartment to discuss whether she would like to go into assisted living. The next Saturday Paul had driven my mother to a place called Bear Creek to see the buildings, living quarters, costs, activities. My mother had appeared to be delighted with the place. We all made plans to help her re-settle, expecting her to live for several more years. Paul thought she might begin to thrive in a place with a social life with people like herself. In the event, about a week and a half before (August 8th?), when I called to ask my mother when she was going (so as to figure out when Jim and I could go see the place, which was not far from my aunt), my mother asserted that she did not know what was happening (something she had said before), and then when I pressed, that she did not want to change her arrangement of living in a largish rent-stabilized apartment with Neli to care for and companion her 24/7. She was unwilling to explain further (I should call my aunt), but appeared determined, & was going with Neli to sign a lease for another year in her apartment (!). They had reached a new understanding. They had not been getting along: my mother hated paying the large sum 24/7 care cost, Neli had been paying someone else to work for the weekend in order to keep a secondary job as back-up, but now my mother agreed to be pleasanter and Neli to stay all 7 days & nights. So I called my aunt, told her what my mother had said, and we left it I would now be the one to phone my mother and cope. My aunt would send me the paperwork I needed.

Then sometime this past Thursday (the afternoon of the 18th), I phoned my mother thinking to be on the phone briefly and be told all was fine. But no, she was breathless, bewildered and said she had been in pain for two weeks. She could not keep in her mind who I was. I asked if she had phoned my aunt and she asserted they phone every day. I asked for Neli to get on the phone, and Neli said, this was not so, but the pain only started the day before and was the result of diarrhea, and (as usual) my mother would not eat, this time not even rice which would help. (Neli later said my mother had stopped taking her vitamins since the last time I called — on grounds of expense.) I stayed on the phone with my mother for a while and felt something was profoundly wrong, but didn’t know what to conclude was happening as her stories didn’t make sense. I began to think I would phone my aunt the next morning after 11 am after all.

I get up early and at 7 my aunt phoned me. It seemed Neli had become badly frightened around 3 am (my mother often had bad nights) and phoned my aunt (as Neli often did), and both my aunt and uncle said “Call an ambulance.” My mother was taken to the hospital, and the people there said she’d die within the hour if they did not put a tube down her to make her breath and perform other resuscitation measures. My mother had signed a Do Not Resuscitate order long ago, but they needed someone to confirm. My aunt and uncle both were unwilling to confirm the DNR alone so they phoned me. I have spent literally years teaching a course called Advanced Composition in the Natural Sciences & Technology and devoted 1/3 of it to the practice of medicine today, read many books & essays about what happens to a person when the breathing tube is put in (it’s very painful and they must be under continual heavy sedation to endure it), the violence of real resuscitation. I know what happened to my father who endured this as the climax of his dying at 68 (his heart wall’s crumbled), remembered Wiseman’s Near Death, Mike Nichols & Emma Thompson’s Wit, and they were telling me about how frail she was, and her various systems shutting down. I confirmed.

Tellingly my aunt called back, saying the hospital was asking us to re-confirm. Were we sure? We were told that an oxygen mask was on her, she was now in an ordinary ward (not ICU), and sleeping. I reconfirmed. Then my aunt said that Paul, who lived the closest, was going to the hospital to see what’s happening. She began to make funeral arrangements and we began to call back and forth, with me talking on the phone to a cousin of mine, Carol, my father’s niece. My mother had made plans to be buried next to my father and Carole had the name of the funeral home, and cemetery. A little while later, my aunt Barbara called again, and Paul’s news was my mother had rallied soon after she arrived in the hospital and when he first saw her. Blood tests had turned up nothing, no reason for all this, and they were doing more tests. I asked Barbara would she re-open her talks with the woman at Assisted Living, and she replied she had beat me to this idea. She’d phoned the AL lady about 10 minutes ago.

I got off the phone and remembered this was a group of people who probably never saw my mother before in their lives, and thought to myself, maybe she’ll end up going home with Neli at the end of the day. Too many times I’ve seen and read of medical people wanting to do something now and proposing all sorts of technical solutions (injections whose power lasts a year) to someone they’d talked to for 10 minutes. (I recently met a psychologist of the new socially coercive pill-administering school who after 20 minutes talked absurdly to me in knee-jerk textbook fashion.) But I phoned again (I forget why) and then asked my aunt if I should come, and she thought I should this weekend, so after securing a room at the Princeton for one night, Jim and I set out for a 6 hour drive. Perhaps if I saw her, I could withstand the panicked nagging with a calmer conscience.

In the event when I got there, my aunt and Mark and Paul’s wife were there (something I didn’t expect) and my mother looked unconscious. She was also every bad color (discolored, yellow, all shrivelled), and Paul began to talk the way I’d heard people in Wiseman’s Near Death talk. I can’t remember the spiel, but it seemed her lactic acid was up very high, her kidneys shutting down, criteria about her breathing alarming (he has a degree which makes him partly a physician, an MD and Ph.D. in psychology too) and after he finished his technical talk, he looked at me and said awkwardly style, “She’s not doing so well.”

I walked over to her and tried to make contact but all I could see what one eye looked a bit open, slit, I told her I was there, who I was, tried to hug her a bit, but no response. I got closer but no response. I went over to the other side of the (small) room area where my aunt and the others were. Jim told me to notice the machine was breathing for her and making her chest move up and down. Her neck was not moving. So I asked Paul some more questions and got the same kind of response, and then I asked, “Are we watching her dying?” Well, he wasn’t sure, he couldn’t say, but then he said, “yes, probably.”

And so it was.

A nurse had come in to ask us questions as if she was going to take care of my mother. She asked me if she should take the catheter out. I didn’t know. She asked again, and after she said maybe my mother would be more comfortable, I said yes, but then Paul said he thought that was a bad idea since she could soil herself. So I agreed with him. I asked the nurse if my mother was dying. The nurse said she was not God. I replied I knew that but from her expertise in natural happenings, what were the probabilities. She said something to the effect it could turn around. She couldn’t say. She asked me what should she do. I said I had no idea. She was the nurse. She said it was up to me. I repeated I didn’t know what she should do. Meanwhile other nurses and technicians appeared to come and go and do things with the IV and machine and listen. At one point Paul’s wife left and we began to talk about how long we would stay that night and when we’d return tomorrow. I asked if the oxygen mask was prolonging this. Paul said, no, it made no difference. It just made it easier for her to breathe when she tried. (So it was a comfort measure.)

Around then the nurse came in with her comment that they were unable to find a heart beat. (Not that it had stopped. How careful all the language was throughout.) But then when the doctor came and left, the machines were turned off, things disconnected and tossed about, and we knew. The changes in her corpse were an unnerving sight (as had my father’s embalmed remains when I had seen them 23 years ago). A dry wizened body, a frozen face, expressionless. Look down and see what death is doing.

We didn’t very much. We all went in and out of the room, discussing the funeral arrangements which my aunt said we should do on Sunday. We would have a Jewish ritual, a rabbi. She and Paul got on the phone using the numbers my cousin, Carol, gave us, and since Paul again lived nearest (he lives on Long Island and the cemetary and funeral home are in Wading River, near Riverhead, Suffolk), he would go discuss what we’d do and what would be the cost face-to-face, but keep in continual contact by phone with my husband, Jim. I phoned my older daughter, Laura, to ask for her and my younger daughter, Isobel, to come tomorrow.

Neli began to cry. She had had a hard year (though well-paid) and was in shock. On Tuesday she and my mother had gone for a walk, dressed up, all seemed well.

A doctor came in and talked and told us the body would be taken down to the morgue within an hour. I asked him “What did she die of physically?” He said the tests showed she had had a viral infection, and because of her age and weak state, the infection had overwhelmed her.

What did she die of, how did she come to this beyond age? A year ago her handbag had been grabbed from her as she stood outside her apartment house. She had (in character this) chased after the man, yelling at him, but was no match in speed or strength. When she came upstairs to her apartment, unnerved, she fell off a stool. She broke some part of her ankle but not badly. But when she was taken to a hospital and told she could go home that night with a boot on the ankle, she refused. Suddenly after 22 years of living alone (from the time my father died), apparently fearlessly, going to spas, to colleges for adult ed classes, at first traveling to see cousins, and now at least staying lively (shopping even driving), something welled up within, an intense sense of vulnerability, loneliness and she refused to go home alone. The only way she could stay was to have her leg put in a cast. Alas, she decided on that and was put into a rehabilitation home for six weeks. She began to lose a lot of weight.

When she came out, she was too weak to walk, needed physical therapy, help at night (really care 24/7 — someone to cook for her, dress her, clean for her); the cleaning lady who had come 4 times a week was dismissed (my aunt and mother did this) and Neli found, hired 24/7. She never accepted Neli as a companion (in my presence called Neli “the aid”), but sat in a corner of the room, not watching TV or listening to the radio with Neli (claiming Neli did not understand it when she did, enough at any rate). She would not turn it on. She did not like the two options (home companion or assisted living), she obsessed over her money and what things cost her, gave my aunt migraine headaches and Jim and I frantic conversations in which he’d demonstrate to her she had tons of money. Sometimes she did seem better physically but basically over the course of the year she would say she was depressed & just continually declined & deteriorated. And so the thing went on until she made the recent decision she found she couldn’t live with.

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Photo take by Laura with her ipad

The funeral. I had been to this place before, 23 years ago to be precise: when my father died (aged 68). Again the death had been unexpected if you looked at it from an immediate standpoint or long over-expected, in his case at least since he was 62 when he had experienced cardiac arrest, been advised to have open heart surgery and refused. The surprise was not that he had died, but that he had been enabled to live so long with a heart that beat irregularly since he was 47, and 20 years of gradually accumulating symptoms, each one worsening the other, and medicines that themselves caused multiple problems. I do not mean to imply he made the wrong decision when he decided against the surgery; he had too much imagination to live with the statistics which he said were near 50% death on the table or soon afterward.

Again an aunt (this time my father’s eldest sister) had taken charge. My aunt Helen had arranged for a Catholic ceremony of sorts for him. She said that if she didn’t, the relatives would not be satisfied, and as for cremation (which my mother to give her credit here brought up), it was out of the question. No one would come. Later my mother regretted the amounts of money she had been led to spend, feeling her sense of shame had been exploited for absurd things like “eternal care” and inner steel in the casket. We had discussed Jessica Mitford and she said she knew all that about the American way of death and yet could not help herself somehow. It was apparently a somewhat shorn or short one since he had not been in a church since an adolescent. He had been an atheist and so some things were lacking that were used in the ceremonies.

I had been traumatized by grief and unable to take in what I was seeing, but I had vivid memories of little bits. I had not been in control and at one point during the ceremonies inside the funeral home, got up and just talked plainly about how much I and others had valued my father and recited a litany of all the generous and good things he had done for others in his life and I described a little of what he was. I just could not stand the ritual which did not seem to talk about him as a person or our missing him at all.

At graveside I was much worse. It was a freezing cold day in December and the ground could not be dug up. A large crowd of people seemed to be there, but not much was said and the funeral director said (rightly enough), that it was so cold we should go back. But when I saw the others turn to leave, I lost it. I cried out, crazily, “We’re not going to leave him here, like this!” I made hysterical gestures, but the funeral director (I realized later) must have been watching me and was prepared. First he handed me this gold cross and said, my father wasn’t there. I didn’t insult the man or the other people around me, held the cross (in law silence is construed as consent) in my hand, but while I was perhaps thinking of something to say against this object and hand it back, there was Bobby, my father’s youngest sister’s youngest son, coming over, hugging me, and saying something or other, and putting his arm around me to pull me away. The funeral director had somehow found out something of my relationship with my cousin. He couldn’t know that I had slept in a crib with Bobby as a baby, and my father, fond of Bobby, helped Bobby now and again over the years, and would joke “let’s go rescue Bobby” when Bobby would arrive at the airport. But he had found out enough from someone. My uncle Erwin said something sensible too, was on the other side of me, and I did walk away.

This time I was determined to do better. I asked Laura to bring Tennyson’s poems but upon looking at “Crossing the Bar,” I decided against it: the feeling was right, but the words mushy, and it ended with religion. Stanzas from In Memoriam were too particularized. And then I thought of the poem R.L. Stevenson had engraved on his gravestone and Jim found it using his ipad, I wrote it out and practiced it and decided I’d read it before or after (or at some time during) the rabbi’s speech. I’d be careful to ask first and make sure it was understood I’d do this by the rabbi. After all I was paying for this ($8260). Unlike my mother I didn’t and don’t regret the money; I was doing it for everyone else as the daughter, providing this, sort of a minimum I could do as I knew and know there is much I couldn’t do and others had done in my stead. It was understood (or thought) I would inherit ample to cover it. Still American-like I was paying and indeed the Rabbi asked me several times what I wanted, and I kept saying, do what my aunt would want and as he seemed to be dissatisfied with this, I told him, I was an atheist and my aunt Jewish and he should do all the Jewish things regularly done, which she would want. I added that for she was central to was my prime motivation at this ceremony.

But this time I did want to say something appropriate for my father which I had not last time, and I knew, know my mother was not a practicing Jew; though she was a Jewish person in culture and shared many American Jewish attitudes, I never in all my life saw her do any ritual that could be called religious. She never claimed to pray. She told me that once when she and my father thought I was near death after giving birth to Isobel, she asked him if she should pray. He said something about the uselessness of such behaviors, and so she didn’t.

The rabbi did leave an interval for me to say the poem. I got up and said that my mother and father were buried in one grave appropriately as they had shaped one another’s existences since the time they married (in November 1945 about a year or more after the photos at the head of this blog were taken). I didn’t say for better or worse (though I meant this to be understood). I did say it was short, strong, and they would probably find lines in it familiar:

UNDER the wide and starry sky
    Dig the grave and let me lie:
Glad did I live and gladly die,
    And I laid me down with a will.

This be the verse you ‘grave for me:
    Here he lies where he long’d to be;
Home is the sailor, home from the sea,
    And the hunter home from the hill.

Continued in the comments. See also my description of our walk in High Line Park and Sondheim’s Into the Woods.

E.M.