(photo by Ellie Conant)

 

In some patients who had turned away from their mother in dislike or hate, or used some other mechanism to get away from her, I have found that there existed in their minds nevertheless a beautiful picture of the mother, but one which was felt be a picture of her only, not her real self. The real object was felt to be unattractive – really an injured incurable, and therefore dreaded person. The beautiful picture had been dissociated from the real object but had never been given up and played a great part in the specific ways of their sublimations. ~ Melanie Klien, A Contribution to the Psychogenesis of Manic Depressive States,

 

May 2013

We’d tempted fate.

We hadn’t meant to. Just feeling our oats, enjoying our lives, our home, our neighborhood, our careers, and our children. We were pleased with our bank accounts – our retirement looked reasonable enough for self-employed late bloomers, and the college funds were starting to accrue. The children were thriving, our marriage was in a good place. We had beloved friends, my mother had moved nearby to help with childcare and take on the tasks of an everyday grandmother.

We were healthy and fit – we were walking vigorously together in fact, in laps around the park before splitting off into our personal daily workout: I would practice bagua tai chi, and meditate, David would go run a few miles. It was spring, still wearing light sweat shirts, and the ground was damp and spongey.

We loved our work: both of us psychotherapists – we shared an office and had full and thriving practices. We were desirable. Effective. Non-traditional – maybe even a little renegade and rebellious. Our clients found our style direct, demystifying, refreshing.

Our kids amazed us: insightful, thoughtful, bright, beautiful. One diligent and orderly. The other creative and chaotic.

They were newly enrolled at a private school with an arts based curriculum – which seemed instantly to take enormous pressures off them and respond more to their individual gifts and deficits – and the kids seemed engaged, creative, cared for in their new environment. It was one of the cheapest private schools available, and it was going to be a challenge, maybe even a strain to pay for it – but we tried to run the numbers and if we took on a few more full fee clients a week it wouldn’t be impossible.

Psychotherapeutic work was challenging, invigorating, hard sometimes – but not in anyway a drain. We could always take on more. We enjoyed our competency, tried to be useful when other parents or the schools asked us for a little clinical guidance or our two cents on some socio-emotional problem. Our professions also offered us a role in our communities, and we felt capable and valued.

Our lives were stuffed with meaningful over-activity. Maybe even to the point of gluttony.

We were adoptive parents and active and connected throughout the adoption community – which felt like “our tribe”, our “people.” We presented at conferences, wrote articles with and for adult adoptees, lead parenting workshops, wrote a monthly column for an online magazine for adult adoptees. We had founded a non-profit organization for adoptive families that was now standing on its own without our labors. We volunteered our time and expertise to causes and organizations that were vital to our values, and did so with efficacy, and passion.

Adoption had also forged our relationship to the Korean American community – and a close circle of defacto aunties and uncles – who offered themselves as role models, who fed us all Korean food, who taught us to cook and how to shop in Korean markets. Who taught us songs and curse-words and how to write our American names in hangul. And Korea school, on Saturdays.

After chaotic and unformed twenties spent flailing around New York City as desperate actors, in miserable underpaid day gigs, after negotiating graduate school and loans in the decade after that, we had arrived somewhere, we had built something. We had spent years wondering if we’d ever have a life that felt real to us. A home. A family. A community. A career.

Life felt solid, in a good way. Secure under our feet. Satisfying. Mapped out.

And then one of us dared to say so.

I can’t remember which one of us said it, but it could very well have been me because I was certainly thinking it so I’ll accept responsibility:

“So, we are pretty much set from here. We’ve got everything in place and if we just hold here – we are cool, set up for life. We are gonna be O.K. Isn’t that nice? We spent our whole twenties and thirties wondering if our lives would ever come together, and it did, and we have, and we are going to be O.K.”

I’m sure that was the moment that our hubris drew the attention of the gods.

We wouldn’t notice the cracks opening up underneath us for several months, maybe even more than a year later. The first hairline fractures were imperceptible. But then the ground opened up wide – wide enough to twist your ankle in, and then knock your steering column out of alignment. Eventually the sinkholes would open up large enough to swallow us all whole, giving us breathtaking, staggering glimpses of the underworld. All of us would be changed forever. Some of us would never be seen again.

And I would end up with an entirely new life assignment, a mission that I did not choose but was trained for and then drafted into:

 

To live for the rest of my days in the crack between the worlds.

*****

 

October 2013

 

My mother sat down next to me on a bench at the playground, over looking the Brooklyn Promenade and the New York Harbor. The children raced and screamed and flung themselves headlong down the twisty double decker slide.

I brought us box lunches, and as my mother and I ate she said:

“Last week I woke up in the morning and I had an inverted nipple.”

“Huh? What…”

“I said I have an inverted nipple. Since last week. There is a lump about the size of a quarter.”

“Have you felt anything before? When was your last mammogram?”

“About three months ago. They found nothing.”

“So that seems like something grew super fast – I don’t think most breast cancers grow that quickly? Probably just an infection or maybe some kind of cyst or something. Did you go to the doctor?”

“Not yet.”

“Well, go! Make an appointment as soon as possible. See if you can get in tomorrow even – because then they’ll have to set up another mammogram, and that will take time, and a biopsy… So call today, call soon.”

“I will when we leave here.”

“Okay. I’m surprised you didn’t already call?”

“Well, I wanted to wait, I didn’t want to make a big deal out of it if it was nothing.”

“Well, its something enough to get to a doctor ASAP.”

She saw a doctor, and they scheduled a mammogram, and a biopsy for a few weeks ahead and then I forgot about it for a bit.

The next week, David and the kids and I walked along 32nd Street, Manhattan’s Koreatown, headed over to the seasonal launch of a Korean Adoptee mentorship program that the kids had been attending for several years. We stopped first in the Korean book store, as we always did, picking out stickers and pencils with Korean cartoon characters or the Korean flag on them, looking at the books, and cookbooks, gazing at the golden statues of armored “turtle boats” and war ships that sold for thousands of dollars.

We wandered in the crisp, sunny day down the street toward the hole in the wall kimbap shop to get take home for dinner. Eli, eleven years old, graceful and handsome, funny and rambunctious, ran around us in circles, raced ahead bent over from the waist with his arms behind him for aerodynamic effect, as fast as a small human bullet train. He hopped up onto “a siamese pipe” – a flat topped pipe about two feet high, next to the entrance of a building, with two openings for attaching firehoses if necessary. They were plugged against buildings all over the city, painted in bright colors – welcome spots to sit on briefly if you need to tie your shoe. Kids all over the city loved to hop on top of them to pose briefly and victoriously before leaping back down to the concrete.

But something happened. I’m still not sure what it was. I blinked. And my boy seemed to crumple. From standing triumphantly on top of the pipe, he buckled and went down in segments, his knees, belly, chin and head struck the concrete. Hard. I ran to him.

He stood up and caught his breath.

“I’m okay” he said and took my hand. We walked a few steps together with his hand in mine when he crumpled again, hitting the pavement, unconscious. I screamed. David was ahead of us and came racing back, gathering him up. Eli was seizing, convulsing in his arms. I screamed for help, for someone to call 911. Korean grandmas and grandpas came swarming around us, popped out of the shops and began to intervene in their own way. One put ice on his head, another rubbed some stinky ointment below his ears. No one seemed to be calling an ambulance so I let David hold him, now limp and stunned and I called 911.

In a few minutes an FDNY ambulance pulled up. Eli was disoriented, but awake. Not sure what had happened to him, his response time seem slow and strange. Altered. The doctors at the ER suspected a contact seizure, but when we went to our pediatrician the next day, he wondered, as did I, if the seizure had started before he fell, if it had caused him to fall – rather than being the result of the fall. It could be epilepsy, or it could be, god forbid, a brain tumor.

My boy. My wild-peculiar-fascinating-beautiful boy.

I could barely breathe. It was probably nothing. Probably just a contact seizure – but he does also have migraines, and those vision issues… Stop. I can’t deal with that. He’s fine. Look at him. We’ll just take it a step at a time.

We would need a neurological evaluation and an MRI.

David and I were traumatized and terrified- our beautiful boy could suddenly have an entirely different life than the one we had been watching him grow into. Or, fine, nothing. Good. He’s safe. We get to hang onto our basically stable reality.

We would not know the final answer for many months.

Mom got her mammogram which revealed a growth, as we expected, and I went with her to the surgeon to arrange a biopsy.

It would take some time for the results. I imagined it would be fine. A cyst. People don’t get huge tumors out of the blue in just a few months. She’d be fine. Her mother lived to 83. We didn’t have any cancer in our family.

The weeks of waiting. I had no idea if our lives were about to be turned completely upside down forever or if we would be allowed to go back, if it would even be possible to go back, to the way we were before we foolishly displayed our hubris before the gods.

We prepared Eli for the MRI as best as we could – and prayed that they would find nothing – no tumors, no cancer. On the day of the test, he bravely hopped up on the table, laid his head in the vice that would secure it, and we reminded him that he would have to hold perfectly still for 90 minutes in a loud machine with out moving at all. David sat in the room, draped in lead aprons, near Eli’s feet. It seemed impossible that a boy who never stopped moving, would be able to withstand this level of restraint. But he did it. Like a little atman. Just laid down, and when to some inside happy place which allowed him to sit in that machine without even a single wriggle. I stared at the readout slice by slice, cross segment by cross segment – looking for any large, horrifying anomaly.

The phone rang. It was school.

“This isn’t an emergency call. We wanted to let you know that we had a lice check today and Lucy was identified as needing to be sent home until you have remediated the problem. Eli isn’t here today, but you will need to get him checked and we recommend you and David as well. We have a packet that lists the lice busters and nit-pickers who can work with you, and can certify that the children are louse and nit free and ready to return to school. Will you be able to come and get Lucy shortly?”

“Well, Eli is in the middle of an MRI right now, we can come as soon as he is done? Can you give me the numbers of a couple of the delousing services that you have? I’ll try to call so we can all go straight there after picking her up.”

This wasn’t stopping. It was escalating.

By the time Eli was released from the restraints in the big loud x-ray can, I had already called all the nitpickers – and secured an appointment with a lady in Crown Heights two hours later. We would have just enough time whisk our son out of the imaging center, hop the subway to pick up Lucy at school, grab lunch, and then hop on back on the train to the delouser’s kitchen.

My husband congratulated our son, remaining as anxious as I was about what the imaging might have revealed, or relieved us of.

“You were amazing in there E.! Like a little Buddha – totally still!” Eli was at that time, very into doing things “the Buddha way” so this was experienced as the highest compliment. They walked slowly toward the parking elevator. David wondered if we should go grab a bite….

“But um, we can’t – because Lucy has lice, so we have to go straight to school right now – grab her, get some food, and then get on the train to Crown Heights to get to the nitpickers in time for our appointment.” He stared at me not comprehending. “Come on! we’ve gotta move, we don’t have time for this -”

“WHAT are you talking about! Stop talking in that tone – there is no reason for you to be talking to me like that.”

“Listen: Lucy has LICE. We have to GO and pick her up at SCHOOL. And then ALL of us, Eli, you, me – have to go to the nitpickers house and have her check all of us. She does it in her kitchen, its a whole operation. And then we have to go home and we are going to have to wash all of our sheets and towels in hot hot water like three times – and we are going to have to bag up all of the kids stuffed animals, anything that we can’t wash and dry in high temperatures, we are going to have to BAG all that stuff, we are going to have to bag the slip covers on our couches and our throw pillows that the kids lay on to watch TV. And vacuum everything else down – the furniture, the mattresses. Its like a whole THING and we’ve gotta go!”

“OKAY. Okay.  But you still don’t have to just dump that on me.”

“But how else am I supposed to dump it?”

On the train to the nitpicker, Lucy said: “Well now I know what it means when the lice check lady said ‘This one is just a princess.’ Its code for this one is gonna get sent home”

We would have to stop by a dollar store and get clean shirts for everyone as everything we were wearing would have to be washed after we had our heads checked or picked clean. When the train went above ground and we had a signal I called Ellie:

Ellie was one of our family’s oldest and dearest. She had come into our lives as the partner of one of David’s cousins: Half-Korean, with a white dad and a Korean mom – Ellie instantly identified with the kids – who were 3 and 4 at the time they met – they fell madly in love with each other, and forged some bond of recognition that David and I knew was essential. The kids having time alone with Ellie – to live in their own world of horseplay and Korean food and pretend – was as natural and necessary as time alone with their Grandma.

Three years from this point both Ellie and my mother would both be dead. And after they were both gone I would be diagnosed with a slow, unique and likely incurable cancer that I would live with, at least for a time, but would destroy any hope of going back to the way life was before.

But we couldn’t know any of that yet.

“Ellie, we are totally screwed today – are you around? We are on our way to the nitpickers because Lucy is a Lice Princess, and Eli just had his MRI all morning, and after all four of us are checked and deloused David and I need to debug the entire house! If you are around – and free it would be great if you could grab the kids and get them out of the house? We are so screwed right now.”

I didn’t know that this day, this clear crisp early fall day, was what life was going to feel like for the next three years, and then forever. The sensation of the floor about to give way out from under you – and then it does, on repeat. Thinking it can’t get worse, but it does and then hoping it won’t get worse again.

Let worm gnaw, there can be no rebirth until the skull is picked clean.                ~ Henrik Ibsen

We walked in the warm sun through Crown Heights until we reach a white clapboard house with a low white wooden fence in front of it. The mother of the household ushered us into the kitchen – which had a row of hair salon stools set up for customers to sit on. Other families waited nearby on a black leather couch, scratching their heads involuntarily, tugging on their socks. No one made eye-contact.

I tried to breathe and surrender to the moment. To the impossibility of the day.

Warm and chatty and nonjudgmental, the wives and daughters in this Orthodox family explained what they were doing step by step. First, they had us all change into the package of Haines Men’s Large White T-shirts we had picked up on the way. They sat us on the stools and massaged great handfuls of clean smelling hair conditioner into our dry hair. They then combed through our slippery scalps and follicles with metal lice combs. It was rhythmic, sweet smelling, comforting.

“This one is HUGE! Come look! This has been here a VERY long time!” the nitpicker checking the woman in the chair next to me cried out, all of them gathering around to gawk at the specimen.

And when my lady determined that I was lice free, and David was, and the kids had only a nit or two and no mature lice, and no sign of infestation – caught it early- I breathed a sigh of relief. Small blessings.

Okay. So just the house to bag up and run through the laundry. And then the MRI results three days later. And then back to our regular life, right?

We paid and thanked the women and left with our too large white t-shirts with rolled up sleeves and hair slicked back like 50’s greasers.

“Stay clean!” she called after us as we waved goodbye.

The sun was still shining. I had no idea how many hours had passed since the day had begun – the morning felt like it might have been years before.

And on the train, as we were still above ground, my phone rang.

“Bark Bark Bark!” was the ring I had set for my mother. “Bark Bark Bark!”

“Mom” I explained to David, and answered:

“We got the results back” my mother said. “Its cancer, its positive, its malignant.”

And the phone went dead as the train plunged into the tunnel. The rest of the ride would be underground.

******

“This isn’t going to end well. This is going to eat me alive. My mother is going to die in the slowest, most dependent way imaginable, and I’m not going to be able to do anything about it.”

“Oh, come on,” they both chided. “Maybe it will be okay, maybe she’ll be fine and tolerate the chemo and bounce back…”

“Not my mom.” I replied. My mom doesn’t bounce. She sinks. She prefers sinking, she chooses it.”

David and I were having dinner with our friend James, also a psychotherapist, a day or two after my mother’s diagnosis was confirmed. I’d watched her respond to a lung infection that took half of a lung, a heart attack, a diagnosis of rheumatoid arthritis. I’d paid for her dentures when she had all her teeth pulled. I’d lived with her. My mother was not bouncy.

I’d been to her initial biopsy appointment with the surgeon, listened to the mastectomy plan, taken notes about the kinds of aftercare she would need. And although her apartment was just fifteen minutes away by foot – I knew that between the kids and work, the only way I would be able to get her through post-op recovery was to move her into our apartment. She would sleep in our room, David and I would sleep on the pull out couch in the living room.

She was clearly vulnerable, scared. She hadn’t asked the surgeon a single question. She hadn’t asked about when she would meet with an oncologist or what type of breast cancer she had or how it was staged. She didn’t ask about her prognosis. She didn’t ask for a second opinion. She didn’t ask about home health care assistance.

The cancer was a triple negative breast cancer. It had been found in one lymph node.  My mother attached to the notion of  “only one” lymph node as a good sign,  and the doctor did not correct her. Neither did I.

I knew if I asked the doctor a single question, if I took the helm of her cancer care, that I would be consumed whole – that I would be able to preserve nothing of myself as a mother to my own children, or my career as a psychotherapist.

My mother had no one else. Since moving to NYC and taking up residence in a studio we paid for she had not attempted to forge a single friendship, she had not sought out a part time job. She had not volunteered or or even considered volunteering with any organization. She participated in no church or spiritual community. She took no classes, had no hobby or creative pursuits. She nervously avoided eye-contact with my husband. She had no husband, no romantic interest of any kind. Her relationships consisted entirely of near daily phone calls to her older sister in Minnesota, and once monthly check ins by phone or email with my two younger brothers.

She watched TV. Read detective novels. Babysat for my kids when asked. Came to my place for dinner, reluctantly, when we would try to pry her out of her isolation. She provided herself with nothing. She lived on as little as possible. She had camped out in deprivation, and could not be persuaded to pitch her tent nearer to any other human being.

I was it.

Whatever financial, logistical, spiritual, emotional, psychological support my mother would receive would come from me. And if I did not provide it for her myself, she would do without. She’d been that way for years. A stubborn and persistent refusal to actively care for herself. Being autonomous, independent meant needing nothing from anyone else. Never exposing a normative human need to another human being – other than me. “Its fine. I’m just fine.” she would insist, especially when she wasn’t.

This is the psychotherapist’s inescapable dilemma – our parents are very often our first clients, the ones unconsciously who trained us to reach through their injuries to receive intimacy. As adults, we seek our a profession that rewards us for the skill set that has been ingrained in us, the job that we can never retire from. Alice Miller, author of the famous and infamous “Drama of The Gifted Child” named this core-conflict explicitly in her earlier writing: “Prisoner’s of Childhood” in which the prisoner, is the psychotherapist – who is never able to leave their inherited position behind:

It is often said that psychoanalysts suffer from a narcissistic disturbance… deductively from the type of talent that is needed by an analyst. His sensibility, his empathy, his intense and differentiated emotional responsiveness, and his unusually powerful “antennae” seem to predestine him as a child to be used – if not misused – by people with intense narcissistic needs. ~ Prisoners Of Childhood, Alice Miller p. 22

My “antennae” were tuned to hear the unspoken, unnamed, unacknowledged hunger that lurked behind her every protest that she was “just fine” in her deprivation.

I was not fine. Not fine at all. I would have to contend with the primal archetypal drive to care for my ailing parent, a profoundly dependent parent – and also abandon her, repeatedly, to profound and painful needs that I would never be able to fulfill. To leave her in a vacuum with her own suffering while I did what I could.

I knew my mother’s quiet, shut-down, ancient wish to disappear, to be as invisible as possible meant that this would end in death. I would never be able to fill the hole that haunted her. I would have to feed my dying mother whatever I could, any and everything I had to spare – knowing that she would remain in starvation no matter what I gave.

I explained to James and David that this was it. I was officially circling my core psychological conflict – I would have to determine how to give my dying mother some proportional piece of my core while preserving my very substance. In Junginan terms: I would be fighting the She-Dragon, the Great Devouring Mother, while I also cared tenderly for my isolated, impoverished disabled mother in all her humanity, the mother who loved me more than anything, who thought I was the most beautiful creature on the planet.

I didn’t know what was ahead for any of us. But I knew it was going to be a shit show, maybe a transformative one, but a shit show none the less. There was no point in hoping otherwise.

*******

I cancelled as many work hours as I could afford to attend the crucial appointments, but I couldn’t take my single, friendless, mother to every single test, every exam, every scan, every cardiac screening, every meeting to discuss every result.   I asked: Did they have a treatment plan yet? Had she asked? When would it start?

“I don’t know” she replied testily. “How am I supposed to know?”

“Well Mom, I think a lot of people might ask. You can ask the doctor. You can ask them when you are at an appointment, or you can even call them on the phone and ask them a question.”

“What does it matter? I’ll find out when they tell me.”

I dropped it. I cleared my morning client schedule again to attend the next 9:00 am appointment with the oncologist. I kept my 12:15 appointment on the books. Chemotherapy hadn’t even begun and I was already missing so much work, losing income. Tuition payments for this too expensive school were looming.

I had no idea where they were in the process – if there would be more blood tests, more levels needed before chemotherapy started. I had no idea if chemotherapy would be pills or infusions, in hospital or outpatient, how many times a week, how much assistance with activities of daily living my mother might need. I did not know how sick, how weak, how dangerous, how dependent this would get. I did not know if she would need home care attendants. I did not know how to get assistance if she needed it. I did not know how to feed her, or how she would feed herself.

She ate like shit. Never ordered a vegetable. Loved mashed potatoes and fried foods. Fast food daily and her idea of a healthy lunch was a Subway sandwich. She never cooked. Green vegetables were represented by canned peas – which she loved. And pickles. And Swedish Fish. Once, before she moved to be with us, I asked if she was prepared for a Minnesota blizzard heading her way – and she told me she had stocked up on cigarettes, Pepsi and Ritz crackers. For decades I would tell people that tobacco counted as a vegetable on my mother’s food pyramid, until half of her lung was removed and she had to quit smoking.

I assumed that this appointment would be a treatment planning meeting. The oncology office was only a few blocks away, but still we took a car service. Her knees and joints were ravaged by rheumatoid arthritis, her heart weak from a heart attack, her breath fast and shallow after having half a lung removed. Seven blocks, especially in the early winter, was simply too much.

The nurse came and joked and teased and babied my mother. Nurses loved her. All nurses. They found her adorable, and pleasant and funny. Her doctors enjoyed her too, saw her as fragile, sweet.

She had been through a lot. There was no disputing that. She had been sick, in one way or another, for a long long time.

But the truth was I resented the nurses pampering and babying her anyway. I resented that they told her she was brave and that she dared to believe that, even though she was mostly inert and avoidant. I secretly, privately, in my darkest heart, hated that they had no idea how burdensome her passive compliance could be, and hated them for rewarding her for it. “Don’t baby her, make her grow up!” I wanted to yell. But I didn’t of course.

I listened and watched and bit my tongue as my mother morphed into whatever her care taker wanted her to be.

“Are you Irish?” the nurse asked. “You look Irish.”

“Yep” my mother nodded “I am Irish all right.”

We weren’t Irish and if we were, it was news to me. We were only Irish the way millions of white people were Irish: 1/16th Irish and 1/8th German, and so on. We certainly were not Irish the way this Irish nurse was Irish. But suddenly here was my mother acting like our ancestors had been tragically impacted by the potato famine. Like she had grown up in Limerick next door to the McCourt family.

When my suddenly Irish mother finished having her blood pressure checked, we filed back into the waiting room, to be called into the doctor’s office. This oncologist was simply the doctor nearest to my mother’s home. My mother in the seven years she had lived in New York had never attempted learn the subway or bus system, had never ventured into Manhattan by herself by taxi or car service. She took cars to our apartment and back, and walked to the movie theaters and the Brooklyn promenade a few steps from her apartment. She had not asked for a second opinion, or asked us to help arrange one for her.

She seemed either to wish that I would scoop her up and take care of every single thing, or to be left, passive and inert, rolling down the path of least resistance.

The doctor was a kindly older woman, probably in her mid-sixties – who clearly identified with my seventy two year old mother as a peer. When she spoke to you she seemed to be speaking to herself, allowing you to overhear her internal dialogue, as if Alice’s White Rabbit had been trained in oncology.

“All right then, lets see, okay so today we have the results of the biopsy and what you have is called triple negative breast cancer – which means that it does require chemo therapy – now, so the first thing you need to know is that it is treatable. Okay? Treatable. So lets not be worried about that. And lots of people are able to walk around, and work and stay engaged in their regular daily activities straight through treatment, so that is good. Other people get pretty tired and need to rest and that is just fine too… ”

“Good,” my mother said. “It’s treatable.” I would hear that word “treatable” from so many cancer doctors that I would come to understand that treatable means only that. It does not mean survivable.

“Okay now, so, lets see, nausea won’t be a problem – we have medications to control that… of course you’ll find that many of the foods you like – you eat well? Lots of good fresh food? Fruits and vegetables?” she continued answering her own question -“Yes, yes yes – of course you do. You take very good care of yourself. You’ll need to do your best to keep eating a healthy balanced diet with lots of veggies and fruit- Oh and yogurt – its a good idea to eat yogurt every day. Many of your favorite foods won’t taste the same and so you’ll have to experiment to see what tastes good to you.”

My mother had consistently refused to try any unfamiliar cuisine since moving to the city. She rejected all “ethnic” cuisines. Ate none of the vegetables I ever cooked other than green beans. I knew there would be no eating experiments.

I took notes to help me bite my tongue.

“What else, what else?… Oh, yes, you’ll need to drink plenty of water. At least one of those very tall bottles of water a day. It’s important to stay hydrated and to flush the chemotherapy through and out of your system.”

My mother drank bottled green tea loaded with high fructose corn syrup and Pepsi exclusively. I’d never seen her drink a glass of water in her life.

“Let me see, what else should we cover? Oh, yes, you’ll be immunosuppressed. Which means that anyone who comes to your home will have to wash their hands, and you’ll need to avoid exposing yourself people with colds and flus. Do you have a cat?”

Yes. Two. And she rarely changed the litter, couldn’t or wouldn’t dust or clean for herself while insisting she could and would. She regularly dismissed the cleaning ladies that I sent to her apartment.

“Well you’ll have to have someone else change their cat litter, because it is dangerous for people who have suppressed immune systems.”

Added to my list.

“And I’m sorry to say, of course, that you will lose your hair, and some people do get mouth sores, and we have mouth rinses for that… but lets not worry about that yet”

She already had mouth sores. Her poor oral hygiene had caused her to aspirate oral bacteria deep into her respiratory system, causing a giant pus filled abscess to destroy the lower half of her left lung five years earlier. As part of her treatment plan, they had pulled all of her teeth, and I’d been the one to send her three thousand dollars to buy a set of dentures. And although she smiled openly with them in for the first time in her life – she had always been ashamed of her natural overbite – her gums had never made peace with the false teeth.

No need to ask if my mother had questions. She had none. And I, perhaps stubbornly, perhaps selfishly, refused to take control of her experience. I would follow behind her and do what I could to ameliorate her suffering, but I would not rescue her, I would not assume responsibility for her as if she were mine to care for. I had children who needed me. I had clients. I had a household to support. I had school tuition to pay for, my mother’s apartment and living expenses and a mortgage and college and retirement funds to keep supplied. And long term care insurance so that I would never be this kind of burden to my children.

“So why don’t we get started?” the doctor said, clapping her hands together.

“What? Today?” I had a new client in an hour and a half.

“Sure. Why not?” my mother said.

“We do it right here in the office,” the doctor said handing me a prescription. “You’ll need to run to the pharmacy to get her this anti-nausea medication. She’ll need to take it within the next four hours after we administer the Adriamycin.

“Oh, get me some hand sanitizer and some of those disposable hand towels too for the bathroom.”

She was going to feel like shit pretty quickly – I dashed to the pharmacy – I checked my watch: if I was lucky it would take about fifteen minutes to get to the office from mom’s place. I had about an hour and a half: If I ran to the pharmacy, I’d make it in time to see that new client. Or maybe I’d be a little late… I’d missed so much work already, lost so much income, spent so much on extra babysitting, disappointed, inconvenienced or pissed off so many clients.

So: fuck it – I’d just get through what I could. I left her with the doctor, ready for her first infusion – ran the eight blocks to the pharmacy, where they didn’t have the anti nausea medication but could have it delivered within the hour. I grabbed the supplies she would need, hand sanitizer, hand towels, and some food I knew she might be willing to eat. I raced the five blocks to her apartment, unloaded the supplies, changed the cat litter. I was hot, dressed in work clothes – and my hair smelled of the cloud of cat litter dust. Back to the pharmacy, where they still did not have the medication – but it should arrive at any moment and they would deliver it before I got her back to her apartment.

Next: Over to the doctor, to see how she was, help her get up, get her coat on, get her into a car service, get her settled at home and give her the pill. Then off ten blocks to the subway: I was going to be late – but maybe, maybe maybe if the subway was pulling into the station right as I got down the deep elevator and dashed to the platform and the Great and Mighty Subway Gods and Archangels smiled down upon me I could hop on and get to Wall Street, walk the three minutes to the office, ride the elevator up to the top floor, and let myself into the waiting room – and greet the new client only five, or maybe eight minutes late. Five minutes late didn’t even count as late in New York City, right?

And of course each step took three to five minutes longer than I had calculated, as I rushed along and apologized to everyone for my thinly-disguised-with-false-cheer-so-obvious impatience: to my mother, to the doctor, to my mother again, to the pharmacist, to the doorman, to my mother.

And I felt like shit. And I could see that my mother was utterly starved for emotional support, was overwhelmed and frightened, yearned for time and attention. But I did not have it, beyond the entire morning I had already designated and spent. And I did not feel tenderly toward my mother, and I knew just how much she wanted that tenderness from me, because there was simply no one else in her world who could offer it.

And because I was her daughter. I had been her baby. The very baby who had rescued her from a lonely disconnected marriage and who had “taught her what love meant” as she told me every year on my birthday. “This is our day!” she would say.

Yes, she loved me too much, she loved me to the exclusion of everything else, she neglected herself profoundly, she put too much upon me, and always always had. But she did love me. But mostly I behaved love for her, I enacted and verbed love at her. But I rarely felt it. It wasn’t a noun or an object I could offer up. She wanted me to feel love for her, to adore her and admire her more than she wanted anything else.

I just didn’t have it. Instead I had guilt. I had a karmic debt to her. I had empathy for her emptiness, but no capacity or desire to fill that emptiness, to stave that hunger.

Fuck. This wasn’t going to get better. Or, it might get better at after the next 6 months of chemotherapy only to get worse again. This was going to be long, and exhausting, and impossible – and drawn out.

All this churned in my brain as I speed walked through the crowd and the slushy streets, too hot in my sweater, a trickle of sweat rolling slowly down my middle back. I could smell myself, the smell of a frantic and stressful morning, as I played subway roulette with my office arrival time.

The Subway Gods did not smile upon me. I arrived twenty five minutes late. For an initial consultation. For a new and obviously irritated potential client. One who could pay my full fee. Who was simultaneously referred by both another client of mine, and a colleague – both of whom had recommended me as highly professional. The client waited in the elevator bay, unable to gain access to the waiting room since I was not there to buzz her in.

“I had just said to myself: ‘two more minutes and then I’m leaving.’” she said.

There is debate in the psychoanalytic psychotherapy community as to whether practitioners should apologize for such failures, or if by offering up an apology, they are binding their client’s aggression. And maybe on a good day I would have apologized like a human being, and deftly made space for her justifiable anger -– but on this day, fuck it, I could not. I would not.

Understandably the client was suspicious of me. And worse, she was an intern training to be a therapist. Who thought she knew exactly what was supposed to happen and what wasn’t and what the rules are and what they are not. But what she did not know was that I was in no mood to be held to some inhuman standard – I was not an ever-flowing teat spouting nurturance enough to soothe the masses. I sat in my chair letting her stew in her anger. After I ascertained that she was not in active crisis, I could barely listen, consumed with my morning.

Although if I had chosen a profession that was any less insane, one that truly allowed me to be a human, I would be permitted to explain that I was coming from my mother’s oncology appointment, and I was flustered and ambushed by a string of impossible logistics and I would apologize for miscalculating. If I lived in a culture that offered respite to caretakers or at least permitted an adult daughter to express feelings of exhaustion and resentment at caring for a parent who had been passive and sick in one way or another for their entire lives, the client and I wouldn’t have found ourselves trapped in this shitty unspoken situation. If I could only explain — “Listen, I’m sorry that I didn’t give you a heads up that I might be late, but you see, the last thing I want is to let my devouring mother consume any more of my time, energy, career, income, or core autonomy than is absolutely necessary. So – I was gonna be damned if I let her sabotage my work day. Clearly I made the wrong call. I’m very sorry it inconvenienced you.” — we could move on an get to work.

But instead: I had to sit and listen to this stranger’s oozing if understandable hostility. As she discussed her presenting problem and ran through a brief history it became increasingly clear to me that this woman and I would not be a good therapeutic fit even if we met on the very best day of my life.

Sweating – I took a tissue from the box on the the coffee table positioned between us, and wiped my upper-lip, tamping my forehead a little. I wanted to grab fistfuls and stuff them down the front of my shirt, into my bra which felt like a heavy sponge soaked in hot water hanging from my chest. I noticed I was squinting, my brow furrowed – the sun beat down on me through the open blinds of my south-facing office window. As she spoke, I stood up, nodding to indicate attentiveness, and crossed the room to adjust the blinds. She stopped speaking and glared at me. I noticed how intensely I hated her.

“What do you think you are doing?” she asked.

“I’ve adjusted the blinds because the sun was directly in my eyes.” I said as I walked back to the chair.

“Well, I just feel that you are all over the place and that this is all very unprofessional, and this just isn’t working for me.”

My response surprised me: “Excellent. I absolutely agree. We are in perfect agreement that you should see someone else. That I should not be your therapist. So we should probably stop right here.”

She looked stunned – shocked I hadn’t groveled. I walked to the door and opened it.

“I’d offer you a referral but I suspect that you have plenty of other, and probably better options to follow up on than anything I could provide. Take care.”

She gathered her bag and coat and left.

I stood in my empty office directly under the air vent as my damp shirt grew cold upon my skin and I understood that whatever came next would require that I learn to live more ruthlessly.

 

Death is stalking me. Therefore I have no room for doubts or remorse… You on the other hand, feel that you are immortal and the decisions of an immortal man can be canceled or regretted or doubted. In a world where death is the hunter, my friend, there is not time for regrets or doubts. There is only time for decisions.         

~ Carlos Castaneda Journey to Ixtlan: The Lessons of Don Juan,