Category Archives: Mom stories

Nina

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Sometimes you just get lucky. When I was pregnant with my first child, during my radiation oncology residency, we had a guy living in the apartment over our garage, which we liked to refer to as “the carriage house.” He was a dog trainer by trade, and in his spare time he played softball in a local adult league. When we told him he had to move out, because we wanted the apartment for a live in childcare provider, he had a different idea. He wanted us to hire a woman he knew—the mother of one of his softball teammates. He told us about this woman in detail—that she was the mother of six children and that she had also raised her nieces and nephews when their parents were killed in a car crash, and that she was currently doing foster care for the state but had grown tired of that and disillusioned with “the system. “ He pronounced, without a shadow of doubt, “She will be PERFECT for you.”

 

Nina came to interview on a hot summer day, and she never left. At least not until we left HER to move to San Diego almost nine years later. We never checked another reference and we never interviewed another person. There was just something about her that seemed so, well, “motherly. “ That was it. She was uneducated, grew up in a poor family in Newfoundland Canada, and we only learned later that she could barely spell when she began to write down phone messages while we were at work during the day, after my maternity leave was over. It mattered not a whit. My only hesitation in hiring her was that she was fifty-six years old at the time. Since I was only thirty, I thought that was old. I think differently now.

 

About a month into Nina’s tenure with our family, my father called to ask how things were going with our new babysitter. I told him, “She’s fine, but she has one annoying habit. She shows up at work early every day. It cuts into my bonding time with my baby.” Really, I said that. My father, having relied on my mother to raise HIS three children, retorted, “And this is a PROBLEM? Do you realize how LUCKY you are?” That may have been the smartest thing my father ever said to me.

 

A year after we left Boston, Nina suffered a massive heart attack while watching the Boston Marathon. She was rushed to Brigham and Women’s Hospital, and had emergency bypass surgery and survived. A few years after that, she was diagnosed with inoperable esophageal cancer, and underwent chemotherapy and radiation therapy and again, she survived. Last year, she lost Charlie, her beloved husband of more than sixty years, and still, she survived. And two months ago she fell, hit her head and had a subdural hematoma. At eighty-five years old, she is the definition of “survivor.”

 

On our way to Boston, my daughter said, “I think we should go see Nina on Sunday.” The last time she saw Nina was nearly ten years ago, when she was in college. So Sunday we drove out to Framingham, where her old babysitter lives in a senior housing project, attended to by her daughters who live close by. On the way there, we passed the Sunshine Dairy, where Nina used to take her for ice cream as a child. Alex said, “We have to get some for Nina. She loves their maple walnut. “ She was right. We were greeted at the door by Nina, a very diminished and frail Nina wearing a single strand of pearls I bought her for her sixtieth birthday. She smiled at us, and congratulated my daughter on her medical school graduation. I burst into tears. This woman more than anyone else, had made it all possible.

 

Young woman doctors—residents, fellows and medical students—sometimes ask me how to choose a “nanny”, as they are called now. I have no idea. Mine seemed to fall into my lap and stayed forever in my heart. I hope fervently for these young mothers that they get as lucky as I was.

Happy Mother’s Day

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They lied to us, they did–Betty Friedan and Gloria Steinem and all the others who told us back in the 60’s and 70’s that we could have it all. Or maybe they weren’t exactly lying to the impressionable girls graduating from high school and like me, beginning their college and subsequent careers as professionals in schools and fields once exclusively reserved for men.  Maybe they truly didn’t know the physical and emotional tolls our lofty goals would exact on ourselves, our marriages and our children.  We have come of age now, and we are tired.

To the stay at home moms, who ran the carpools, acted as room mothers, cheered at every Little League game and had a healthy dinner on the table at six pm, I salute you.  I was secretly envious of the time you were able to spend with your children.  You didn’t miss a thing in their lives, and if you were secretly envious of me—my financial independence, my ability to walk out the door in the morning and leave the chaos behind to enter the adult world where you could actually reason with people most of the time—I never knew it.

To my fellow female doctors, lawyers, business women, veterinarians and leaders in industry, I salute you also.  No matter how tired you were at the end of the day, you made time for your children—you rushed out of work to get to the ballet recital, you helped with their homework, you got down on the floor and you played games when your back hurt and your eyelids were closing as you read “Goodnight Moon” one more time.  You were consumed by guilt most of the time—at work when you felt you could not give it your all after a sleepless night, at home when your child called you by your caregiver’s name.

This Mother’s Day is my first without a mother—she passed away in January, having lived her life as the wife of a busy plastic surgeon—the endless nights of caring for three children while he was on call, the arguments over promised wealth as a private practitioner versus the academic life he chose, the pampered later years when she could and did have anything she wanted.  But when I was a sophomore in college, majoring in English, she took me aside and said, “You have to DO something!  Don’t be like me. You must choose a career where you never have to depend on anyone but yourself.”  I listened and went to medical school.  Forty years later, it was the right choice for me.

When I was a junior medical resident at Beth Israel Hospital, Betty Friedan’s daughter Emily was one of my medical students.  In a week, my own daughter graduates from medical school.  As my children grew up, I had only one bit of advice for them that I remember repeating like a mantra:  Whatever you do, wherever you go, at the end of the day, every day, be able to look in the mirror and feel good about yourself.

And don’t think it’s going to be easy.  Motherhood never is.  Happy Mother’s Day everyone!

Empty Nest

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My sister was here recently to help me out while my father was in the hospital.  She is much kinder and more patient than I am, so I was very grateful for her help. She is leaving to go home to New Jersey tomorrow.   Tonight before dinner we took the deerhounds for a walk.  In my better days, I could walk four at a time.  Last weekend, I tried three on three leashes and it did not work out too well.  They spotted a man they did not know walking up our street.  Perhaps they found him threatening.   With three hundred pounds of dog lunging and barking, it took all my strength to maintain control.  It turned out to be a very short walk.  Today, my little sister took Magic, who outweighs her by at least 20 pounds, while I took the two Q’s, Queen and Quicksilver.  We had a pleasant time.

As we ended our walk this evening by coming through the back gate, near the barn, Norman the Lipizzaner stuck his head out the stall door and nickered softly.  I said to my sister, “Let’s go visit the horses before we cook dinner.”  Into the barn we went, where the two old geldings called to us with some degree of impatience.  We loaded their mangers with Purina Equine Senior and horse treats and prepared to close up.  As we walked by the closed door of the tack room, I stopped.  I said to my sister, “Do you want to see the saddest thing?”  She looked at me, her eyes questioning, then said yes.

I pulled open the door to the tack room.  In that room there were five closed tack trunks, each stamped with the initials of a family member.  Saddles were cleaned and covered and neatly perched on their racks, ranging in size from a small child’s Western saddle with full Quarter Horse bars, to my husband’s beautiful dressage saddle.  Blankets were washed and wrapped in plastic.  Shipping wraps were bleached white and stacked in place.  Bridles were oiled and ready and bits were gleaming and polished.  But there was no one home—just old framed photographs on the walls.  I said to my sister, “Enjoy your children while you may.  This room is the ghost of childhood past.”

I hope that my children appreciate and look back with fond memories on the years when we would saddle up and ride out together.  It was a special time to me.  Lucky and Harmony and Veronica are gone now, but Dash and Norman and the memories remain.  To me, it was time and love and money well spent, and I hope that my kids, now grown, feel the same.

Closing up Shop

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They say that as we age, time accelerates.  Those endless waits for summer vacations, Christmas and our birthdays that we experienced at age six, become a mere blink of an eye at age sixty.  And if you’re approaching sixty, you will remember, like I do, those old Kodak commercials:  “Turn around, turn around, turn around and they’re gone.”  Indeed they are.

 

A few weeks ago I visited a good friend in Arizona.  We were talking about her horse, a beautiful and rare Fell pony that she bought as a two year old stud colt, mahogany bay and full of promise.  She has had very little time to train or ride him, and now gelded, he lives on her small ranch, solitary and unworked.  I asked her, “What are you going to do with Scooby?  He’s six and a half now, and he’s being wasted.  Surely there are people who would love to have him as a riding or driving pony!”  She protested, “There is NO way he could be six years old already!”  I replied, “Oh yes, he most certainly is—I remember driving with my daughter from California to Texas four years ago when she started medical school.  We stopped in to see your new horse. You had just gotten him—he was two and a half. You know she is graduating in two months.”  She was completely taken aback.  How is it possible that four years have gone by this quickly?

 

Four years ago we came to Texas and looked at condominiums to buy.  Texas is very supportive of its young doctors in training—if you become a homeowner, after one year you qualify to become a state resident, and the cost of attending medical school drops by two thirds.  Texas of course, has that Texan way of thinking—if you live here for a few years, and grow to know and love the state, you won’t ever want to leave.  In many cases, it’s true, and those of us who eventually do leave feel pangs of regret and forever when asked, we say, “I’m from Texas.”  Four years ago, we looked at my parents condominium—empty and unused after they retired and left for the mountains of Aspen, Colorado.  The maintenance costs were too high, and we settled on a nice one bedroom within walking distance from the Texas Medical Center, the Museum District and the live oak shaded avenues around Rice University.  My daughter has loved living here, in this light filled place with her cat perched on the eighth floor windowsill.

 

My parents’ place is now “under agreement” and I spent the day Thursday sorting through their possessions that remain there.  Today my daughter and I will do the same for her place, and this afternoon we meet with a realtor.  Four years—still a near eternity for her, with the rigors of medical school being what they are.  For me, a mere blink of an eye.

Back to the Future

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I am in Houston, Texas today—the place where I grew up.  From the moment I got off the plane on Wednesday, I had a strong sense of déjà vu—the small town feel of Hobby Airport, the banners welcoming me to the Houston Fat Stock Show and Rodeo, the drive to the Texas Medical Center where I visited my Dad at his office as a child.  But there is no possible sense of déjà vu more powerful than I felt today, in the sunny courtyard of my former medical school, waiting for the results of “The Match” to be unveiled.  For those of my readers who are not doctors, and who do not come from medical families, the Ides of March is the day that every fourth year medical student in the country finds out where they are going to do their residency.  Earlier in the year, aspiring internists, pediatricians, surgeons and obstetricians applied for internships and residencies, interviewed and finally made a list, in order of preference, of programs they wished fervently to attend.  Residency programs did the same, for students they fervently wished to attract.  And then a computer program called the National Residency Matching Program did its thing.  Today at precisely 12 pm EST, the results were announced in a white envelope.  The tension, as they say, was palpable.

 

Exactly 34 years ago today, I stood in the same place as my daughter stood today and felt my life change.  I would be leaving my hometown, my boyfriend, and last but not least my dog, to move to a city where I knew absolutely no one, because I had been given the gift of an opportunity to do my internal medicine residency at Boston’s Beth Israel Hospital, now known as Beth Israel-Deaconess Medical Center, one of the three Harvard training programs in internal medicine.  While I was there, I learned to practice medicine from some of the finest teachers and clinicians I have ever met, people who remain friends and mentors to this day.  I met my best friends, I married my husband, I got my first Scottish deerhound and I had my three children there in that order.  I hated the cold weather, but I loved the values which were instilled in me there, and which I hold to this day—in medicine, the patient always comes first;  family and tradition are paramount, and the Red Sox must ALWAYS beat the Yankees.

 

At 11:02 today Central Standard Time, the waiting and the culmination of four hard years ended.  My daughter opened her envelope and learned that she too would be headed for Boston, to the same place her father and I met so many years ago.  I think she was very pleased.  As for me—well, I did what any proud parent would do.  I beamed, took a picture, and burst into tears.   Well done, Alex, and I hope I didn’t embarrass you too much!

The Irony of It All

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My son wants a government job. After obtaining a Masters degree in Public Policy, with an emphasis on economics, he was the envy of his classmates when he actually got a job.  He has been working for the last seven months for a giant consulting corporation.  Early every Monday morning, at the bidding of his superiors, he takes an early flight from Los Angeles to Denver.  Once he gets there, he rents a car and drives it to the company where he is consulting to remedy an old story—the company grew too big, too fast, and the folks who had the great idea, and who started their little company at the ground floor are baffled and bewildered by the demands of a grown up interstate business.   My son works from early in the morning until early in the morning—sixteen to seventeen hour days being the norm.  At the end of the week, he flies back to Los Angeles, where he actually lives.  By the end of this month, he will hear whether he won the Presidential Management Fellowship he applied for.  If he did, he will go to Washington, DC and join one of the bureaus or the State department where he will learn the intricacies of our government while making low wages and in all likelihood, being expected to work nine to five.

I don’t get it, as much as I admire public service.  Perhaps it is because I actually HAVE a government job, but only in the sense that I am paid through the University of California. My benefits and retirement plan are top notch.  My mentality however, if not my salary, is still back in the private practice customer service mode.  In my little satellite department, we start early and we work late and we get the job of treating cancer patients done, no matter how long it takes.  When I took this job five and a half years ago, I was at the “mother ship” cancer center for a year, while the satellite was being built.  This gave me the opportunity, for the first time in my career, to observe folks who actually treat the business—no, the “calling”—of caring for cancer patients as a government job.  Each role, whether it be receptionist, billing specialist, or medical assistant is fragmented down to its smallest components, and each person is judged by whether they can manage their own limited but particular task.  Never have the words “not in my job description” been adhered to so strictly.

When I hired my staff for the new satellite in 2008, my prime objective was to get people who shared my vision of service to patients, and who I knew would go above and beyond their job descriptions if necessary.  People who could cross cover other department members, and who were eager to learn new skills were at the top of my list.  I did not want to hire anyone who used an answering machine to screen calls.  I wanted one thing—plain and simple—commitment to the best care for our mutual patients.  No matter what the job description or who pays the salary and the rent, caring for cancer patients cannot be just another “government job.”

I know my son well enough to know that wherever he lands, he will be a leader, and he will strive for excellence and demand that others do so as well.  Give him a little time, and the government may never be the same!

This Be The Verse

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 “Children begin by loving their parents; as they grow older they judge them; sometimes they forgive them.”   Oscar Wilde

 

I buried my mother on January tenth.  After a long struggle with dementia, she passed away in her sleep.  In the end, my father was too ill to attend a funeral service, so my sister and I had a small graveside ceremony in Aspen, Colorado where they have lived, loved, laughed and played for the last twenty five years.  She was buried according to the Orthodox Jewish tradition in which she grew up– wrapped in a burial shroud in a plain pine box.  This is the way that it is done—there are no fancy garments, no treasured jewelry, no viewing of the body and no silk lined coffin reinforced with steel.  Ashes to ashes, dust to dust, according to the Old Testament.   There is no headstone placed at the time of the funeral; that comes a year later, after God has had plenty of time to judge the deceased, to decide which way they should go.  Sadly, I had passed judgment long ago.  And yet, the sight of my mother’s tiny coffin (always a tiny woman, no more than ninety pounds when she died) being lowered into the grave next to my dead brother was almost more than I could bear.

I don’t do funerals well and I never will.  Despite the fact that I am very good at writing eulogies, I cannot and do not deliver them.  I told my younger sister this ahead of time:  “I don’t do funerals. You will have to speak.”  She asked me why.  I explained to the best of my ability that it has to do with the work I do in my everyday life as a radiation oncologist.  Most of the time, I am able to submerge those feelings of grief and sadness at what my patients and their families are going through and my rage at the unfairness of it all.  I shove it right under, bury it deep, don’t think about it and don’t dwell on it.  But going to a funeral, and generally speaking, I do not attend patients’ funerals for this reason, all of the emotions like oxygen starved divers push their way right to the surface, gasp for air, take a deep breath and come pouring out in an uncontrollable torrent.  The ghosts of every patient that I ever cared for and cared about surround me—they grasp for my hands and my legs, they perch on my shoulders and they whisper in my ear, “Let it go.  Let it all out.”  And I do.

I never got along with my mother.  I can say it now.  As an adult, I began to understand who she was, and why she was the way she was, and that in her own way, she loved me and I of course loved her.  I can even laugh about it, in my better moments—in the last lucid phone message she left me, she threatened to disown me and write me and my three children out of her will.  Actually, it was only two of my three children—there was one who was spared her wrath.  I saved that message on my cell phone for two years, and sometimes I would replay it just to hear her voice again, after she had become mute. Then one day I accidentally erased the message.  It’s just as well.  There are better memories of better days.

As my mother was lowered into her grave, I whispered, “I forgive you.” Rest in peace, Mom.

RITA SILVER SPIRA, September 11, 1931–January 7, 2013

You Can’t Go Home Again

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“Look homeward Angel, now and melt with ruth,

And O, ye Dolphins’ waft the hapless youth”

 

In the fall of 1971, I entered Yale University as one of 250 freshman women, the third class of women to be admitted to a college still dedicated to the concept of graduating “1000 male leaders” a year.  I was seventeen and thrilled to be away from Texas and my parents. I wasted no time actually going to most of my classes, especially the 8 am conversational French class and the entirely uninteresting inorganic chemistry class which required a one mile trek up Science Hill.  When the weather turned cold, so did my dedication to chemistry and so ended my first premedical career.  By the end of the first semester, I had partied my way to earning barely passing grades in the classes I did go to, and a big “F” in the detested inorganic chemistry, which I ameliorated by groveling before the teaching assistant and swearing never to take another science class.  He passed me.  My parents’ response to my less than stellar performance was a typical Southern “You better straighten up and fly right or we will bring you right back home to the University of Houston!” And so I did.

When I graduated four years later I finally did go back to Texas for medical school, but the allure of those “bright college years” had not quite worn off—the brilliant if unappreciated professors, the gothic architecture, the endless “intellectual” conversations over cigarettes and alcohol which went late into the night and early into the morning, the snowball fights, the chess games played out on a human scale between the North and South Courts of Berkeley College, the dogwood and cherry trees blooming in the spring.  During my fourth year of medical school, I had the opportunity to do “away” rotations, the medical student’s way of testing the waters to see if a particular program might be a good place for an internship and residency.  In November of 1978, I chose to go back to Yale for my medicine “subinternship.”  During the days I roamed the wards of Yale New Haven Hospital, dutifully following my resident’s every command.  At night I huddled under an electric blanket in a spare room in the poorly heated medical student dormitory, a far cry from the hissing radiators of the undergraduate colleges.  I figured out very quickly that being an undergraduate at Yale was very different from being an intern in an inner city hospital where there was no film society or cabaret club to entertain you in the evening.  By the time applications were due, I opted out.

My own daughter graduated from Yale in 2006, and like her mother before her, entered medical school after a period of intense resistance to her life’s calling.  And like I did, so long ago, she is applying for residencies in Internal Medicine.  I told her, “Don’t bother applying to Yale, it’s not the same as being in college.”  My husband, Yale ’70, told her the same thing.  Kids don’t listen to their parents, and besides, she still has friends there.  She flew from Houston to Hartford yesterday and made her way to New Haven for interviews today.  I spoke with her tonight, and despite dinner at Mory’s, a quick stop into Atticus Bookstore Café and a mild gray cloudy day, she told me that our instincts had been confirmed.

You can sing “Boola Boola” all you want, and call yourself an “Old Blue”, but you can only be seventeen and full of dreams once.  Thomas Wolfe was right—you can’t go home again.

The Care At The End Of The Road

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Seven months ago, in Carbondale, Colorado, staff at the skilled nursing facility where my mother had resided for over a year recommended that she be placed on hospice.  My mother has severe advanced dementia and can no longer walk, speak, feed herself or recognize her family members. As much as I know about hospice care for cancer patients here in San Diego, I knew nothing about hospice care in Carbondale for severely demented patients.  Although we had declared my mother DNR (“Do Not Resuscitate”) when she entered the nursing facility in January of 2011, my concern was that this meant that once she was transferred to the care of hospice workers, albeit in the same bed in the same facility, she would be left alone in soiled diapers to die.  She could not ask for anything, did not need any medications for pain or otherwise, and did not respond to questions.  I envisioned that hospice had more pressing problems to deal with—for example, cancer patients in severe pain or with debilitating shortness of breath or inconsolable family members. My father was convinced, but I was not.  I could not have been more wrong.

On November 12, the news broke in the San Diego Union Tribune that the San Diego Hospice, a not for profit highly respected hospice in our area, was being audited by Medicare.  The hospice had stopped accepting patients November 10, and there was a threatened layoff of 200 of the 870 employees.  Two programs—one for HIV/AIDS and one for the parents of newborns with life threatening illnesses who were not expected to survive, were halted immediately.  And what crime did the San Diego Hospice commit?  The audit focused on whether the hospice had been “too liberal” in its admissions.  You see, in order to qualify for Medicare hospice benefits, you have to be expected to die within six months.  If you are terminal by this definition, Medicare pays $172 per day for your care.  The thing of it is that all of the patients admitted by the San Diego Hospice did not die on schedule.  The hospice spokeswoman was quoted as saying, “We put the concept of patients and what we were able to do for them above what the guidelines are.”  A day later, both the physician CEO and the CFO resigned.  Ironically, the reason that the hospice is being penalized is perhaps that the care was just too good—that by taking away fear, and providing excellent pain management and emotional support—the patients lived longer than the expected six months.  And there is no comparison “other side of the coin”—what would these patients have cost society if they had continued on active chemotherapy or radiation, or had expensive acute care hospitalizations for infection or pain management?

Medicare has been offering a hospice benefit since 1982.  In 2000, 513,000 patients took advantage of the benefit.  In 2010, 1,100,000 patients went on hospice.  The cost to Medicare was 3 billion in 2000, and 13 billion in 2010.  Do the governing bodies of Medicare truly think that this is because hospices all over America are plotting to defraud the government?  Personally, I think not.  While there is Medicare fraud in all segments of the medical and hospital businesses, I prefer to think that the increase is due to the aging of our population, the acceptance into hospice of more Alzheimer’s and other chronic disease patients, and the growing level of comfort among physicians to consider hospice when there is no chance of a reasonable recovery for their patients. Undeniably, there has been a sharp increase in the number of for profit hospices nationwide, from 34% in 2001 to 55% in 2011, causing alarms to go off and triggering Medicare audits across the country.

A week ago my father called me to say that the nursing facility in Carbondale had no other choice but to take my mother off of hospice.  The volunteers who came in to read to her, despite her lack of response, the massage therapists, the bright smiles and the occasional little gifts of lotion and a flower—are all gone. My mother, because of the excellent care she has received at the nursing home and from the local hospice, had simply failed to die on time of a bedsore, a urinary tract infection, or aspiration pneumonia.  My father is lucky—if he chooses to he can continue some of the services that hospice was providing by paying for them out of pocket.  San Diego Hospice closed the doors of its 24 bed inpatient facility yesterday.  I wonder if the patients who were being cared for by the wonderful doctors and nurses and staff there will be so lucky.

The Purple Bathing Suit

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“April is the cruelest month”  T.S. Eliot

Although I have spent my professional career battling cancer, cancer is not the cruelest disease.  Tonight I was looking through old photographs that my father had taken to a print shop to be scanned on to a disk.  He sent me a copy, but I had not had much time to look at the pictures.  When I finally did, last night, I was disappointed in the sloppy job that the print shop or camera shop had done—photos were scanned in upside down, backside forward, reversed, random and unlabeled.  There was no chronology or logic—it was just willy-nilly, get the job done.  And I am sure that they charged him a lot of money for that service.

Looking again tonight, there is joy and sadness in those old and out of order family photographs.  My sister smiles as she receives her diploma from Stanford.  My little brother, now long dead of a drug overdose, blue eyed and perfect as a three year old sitting next to my 5 year old pony-tailed self.  Me, in my favorite “car-coat” as my mother called it, felted and toggle tied and warm.  I remember that time it snowed in Houston—I was in first grade and I had pretended to be sick to stay home from school and then it snowed, beautiful white fluffy snow, and my Nana would not let me go outside to play because, of course, I was “sick”.  By the next day, the snow was gone.

Of all of those old pictures, there is one that jumps right off the screen at me.  It is a photograph of my mother, just graduated from college, in a purple skirted Jantzen bathing suit.  I know it is a Jantzen because I remember the logo from my childhood—a little diver with a swim cap covering her head, doing a swan dive into a pool, ubiquitously sewn onto every Jantzen suit of the 1950’s.  My mother is at the beach, sitting demurely on a beach towel that appears to be engulfed by a foamy wave which creeps just past her delicately crossed legs.  She is brunette, petite, beautiful and smiling.  She is 21, and her whole life is before her.  I like to think that my father, deeply in love, took that picture just before they married.

Sixty years later, my mother is a two time cancer survivor.  She was treated for breast cancer in 2001, and then for a disease of the blood, Waldenstrom’s macroglobulinemia, which involved her brain in 2005.  At that time she received chemotherapy directly into her central nervous system.  Five years later, in 2010, she began to lose her memory, and her will to walk, and to speak, and to eat.  Now, in 2012, she has advanced dementia.  She does not recognize me or my sister, and my father dutifully visits her at least every other day in her nursing home, where she receives excellent care, completely dependent on others for her survival.  Because her nurses are so attentive, she has not had a life threatening pneumonia or urinary infection or infected bed sore which would cause her demise.  And so, we wait.

I never got along very well with my mother, but despite that I wish fervently that she could be herself again, older and wiser, waiting out the tide in her purple Jantzen bathing suit. Cancer is not the cruelest disease—dementia is.   I am waiting to see which shoe will drop for me.