A Second Farewell
Two years ago, I'd just begun my new post as clinical supervisor at the caregiver-support center at a large medical institution. The center offers emotional and practical support to families of patients who are dealing with serious illnesses and hospitalizations.
In my short time there, I'd already encountered many memorable clients, but somehow I felt a special connection with one woman, Maria. A small, intense woman with piercing dark eyes, she often came to see us between her visits to her husband, Felipe, who lay gravely ill in the hospital's cardiac intensive-care unit.
Always with Maria on her visits to Felipe were their three twentysomething daughters, Rosa, Alicia and Blanca. The family's closeness touched me--especially when it became clear that Felipe's health was going downhill.
As the days passed, Maria looked more drawn, the girls more somber--until, one day, they arrived at the center weeping.
"He's gone," Maria said.
I was struck by how quiet and calm they seemed. They weren't sobbing wildly or tearing their clothes as if the Apocalypse had descended; they simply cried and held each other.
Then Rosa said something that startled me.
"He's at peace," she said. "He was ready at the end. He's with God, and that's where he would want to be."
Her voice sounded almost ecstatic. Her sisters nodded and wiped away their tears, and I saw the center volunteers nodding as well.
As one part of me moved to comfort Maria and the girls, another part turned inward, flooded by memories of losing my own mother, who'd died nineteen years earlier after two successive battles with cancer.
My mother's first diagnosis, for breast cancer, came when she was sixty years old and in full bloom professionally and personally--a vibrant, energetic world traveler, a devoted grandmother to my baby son (her only grandchild) and deeply in love with her second husband, sixteen years her junior.
Throughout her treatment--the chemo, the baldness and the stylish wig--my mother remained her usual self. Expressing gratitude that her illness wasn't worse, she kept up a diligent exercise and beauty regimen and became a guide and mentor to other newly diagnosed women. Always a fighter against adversity and social injustice, she now battled her disease in every way possible. For several years, it seemed that she'd won.
Then Stage IV ovarian cancer invaded like a poisonous snake.
It was the worst cancer you could get, some said–-a death sentence--but, as before, Mom fought it hard. After completing the conventional treatments and surgeries in Los Angeles, where she lived, she pursued more therapy at MD Anderson Cancer Center in Houston, then at an experimental program in Greece, and she took any supplement or alternative medicine anyone offered. Finally, after surgery for an intestinal blockage, she suffered the cruelest blow: an ileostomy bag. Irreversible.
Having to wear the bag, and needing her husband's help to manage it, robbed my mother of any sense of control over her health, her body and her future. Her natural optimism melted into angry despair. As her condition worsened, she began to lash out.
"Why are you looking at me with such pity?" she asked me harshly, when I visited her in the hospital, about six months before her death. Later, she and her husband moved to New York to be closer to my sister and me. Lamenting her dwindling mobility, she said, "It's like going one step further down into Dante's inferno, every single day."
As terrible as it was to witness her suffering, it was especially painful to feel her anger where, before, there had always been unconditional love.
I felt cast out and confused. My mother and I had always been deeply connected, especially because she'd been a single parent throughout my childhood. This connection was now ruptured; I couldn't help her, and I couldn't join her. The loss felt unbearable, and on a deep emotional level, without quite knowing why, I shut down.
Now, as I worked day by day to help the center's families handle their grief at losing loved ones, I often found myself running on a parallel inner track, reexperiencing my own pain whenever someone said or did something that reopened the old wounds.
Once, for instance, a woman begged us to bring in a rabbi to pray for her husband, who was hovering between life and death following heart surgery. Once the rabbi had recited the prayers, she was calmer, comforted on her husband's behalf.
Nearly in tears, I had to leave the room. My mother, who was Jewish, had had no spiritual guide nor any blessings on her journey away from us. Now I saw clearly that she might have found some peace by talking with someone who could have understood her fury at dying and tried to give her comfort.
We denied her that, I thought, weeping with grief and regret. She never found peace; she never accepted her fate.
At the center, witnessing a family's last moments with their loved one, I would remember my own mother's final days.
"Why are you keeping me here?" she'd angrily hissed at my stepfather, the day before she died.
On what became the last day, she lay still in her bed, without her wig. She'd had a manicure at home just the week before, and her nails were glistening red. She had stopped asking for ice chips. The glasses she always wore were folded on the night table. Her expression was clear and calm; the morphine was working.
I leaned over and kissed her goodbye. It was the saddest moment of my life.
I promised to take care of my younger sister. Then I said, "It's all right to let go, Mom."
A tear ran down the side of her face, and I knew that she'd heard me. She died within the hour.
For years, I felt tremendous sadness and confusion over how my mother had acted towards us in those last few months. But now, as my work with the center's families went on, I developed a broader understanding of my mother's anger--and I realized that it wasn't directed towards me.
In one of our last conversations, when we had to ask Mom where she wanted us to scatter her ashes, she said only, "In a beautiful place."
So we did as she asked: We found many places that she had loved on both coasts, on water and on land, and, over time, we scattered her ashes and sent her free spirit soaring.
Although the Apocalypse did come for me, nineteen years ago, I've recently begun to feel that I can go on without my mother. And now I see that working at the center has brought an unexpected blessing: In helping and caring for other families, I've also made some peace with my own.
About the author:
Julie List, a licensed clinical social worker, is clinical supervisor of the Caregiver Support Center at Weiler Hospital, Montefiore Medical Center, in the Bronx. In the early 1980s her memoir The Day the Loving Stopped: A Daughter's View of Her Parents' Divorce was made into a television movie. Since then, she has published first-person articles about working with AIDS patients in the 1990s and about running a large Bronx mental-health clinic prior to coming to Montefiore. "My mother was a professional writer and strongly encouraged me to pursue it from a very early age. I have been writing about working in the healthcare and mental-health fields as a way to make sense out of the difficult stories I hear, day after day. This piece is inspired by my mother's lifelong voice in my ear, encouraging me to write in order to reflect on each experience."