Family Meeting — Anna DeForest

When you set a thing aside, for safekeeping, for emergencies, it can be hard sometimes to know when the time at last has come. This is how it was with the bottle I kept up with the spice jars and the extracts, a commonplace whiskey I often felt good just knowing would be there, or would take down on a bad day, turn it in my hands, watch the surface tension tilt level to the floor whichever way I held it. Holding my liquor. I called it a diet—anti-inflammatory, an apt aspiration in a life that was always burning down. I cut out legumes, too, simple and complex carbohydrates, and any food in any other shape than it originally was. My mother, I recall, had done this too when she went dry, set some aside, and how nervous it had made me, how often I climbed up to that top shelf to check the seal, up in the closet an ancient bottle of gin. Gin does not, I can’t imagine, expire. 

For this reason among others, when the call came, I considered not exactly rushing to her side. I considered keeping a safe distance. My oldest brother placed the call, of course, having been there when it happened, as he always was when things went wrong, when the back of the house went up in flames, when our mother lost her license nearly running down a pedestrian. She just stood up, he said, looked around the room like an animal, made a weird low moan, and fell to the floor in front of the chair where she more and more spent her waking days. He took several stabs at the story, in fact, revising the lines. In one take, she was a scared child, in another, a glass-eyed doll. The moan inhuman, then ecstatic. Come right away, he ended at last. There may not be much time.

Dead mother, near-dead mother. I said this to myself on gentle repeat, began to introduce it into what was true about my life. I called our other brother, who was more reliable when it came to reflecting emotion back at you, smoothing it out, ridding it of extraneous or problematic aspects. But he was in the clouds from the start. Am I supposed to feel anything? he asked, and, I can’t be sure I am having my own experience. He was on a retreat and, he confessed, slightly high on a low-dose hallucinogen. Not yet, I told him, though I didn’t know the first thing about it. But I did catch a train, with or without a drink to get me started.

Any disaster is all about the telling. I wanted next to tell my husband: that my mother was in the hospital, that she was bleeding into her head. But I no longer had a husband, another fresh fact I was working to accept. Until recently I seemed to have one, but he was now definitively gone, having erased himself, having decided he didn’t even exist in the first place. That is a bit dramatic, I could imagine the therapist saying, the one we hired to help us amicably dissolve the relationship. What had happened at first was that dresses kept appearing in the closet or drawer, tennis sets in spandex, sundresses in linen stripe, things I never would have bought and never would have hung how they were hanging, haphazard, inside out. Another serious partner, a boyfriend, years before, had come out as a cocaine addict in a similar surprising fashion—coming out, meaning hiding less and less, getting sloppy. I had a tendency to be inattentive and subsequently easily surprised, then would try to catch up late by becoming unboundaried, commital, overly aligned. So I went teetotaler myself for him, even went with him to a few church basements and shyly confessed what it was that I was powerless over. The dry drunks congratulated me on how quickly I had recognized rock bottom.

So no Paul. On the train home, a toilet-smelling Amtrak thinly populated with middle-aged men in paper masks, men who look like they did nothing else for their whole lives but pull back and forth on this awful line, I stared out the window as the topography went flat. There was no sign in my body of what I was hoping for. Once it was night the window turned opaque, reflective—I only saw what had to be my own face, looking more like my mother’s as I aged, though just in the way all aging white women look more or less the same. I used to go through her things when she was out of the house, a stand-in for other intimacies she could not make available. Off her room was a large walk-in closet, always disarrayed, clothes in mounds and mountains, drawers pulled out, a chair lying sideways draped in dress-belts and scarves and other articles she’d never wear in any real life I could imagine: a tube top printed with hibiscus blooms, orange suede roller skates tied cinched with knotted laces, boating hats, fishnet hose. The closet smelled like dust and vague musk and stale beer—half-crushed cans of Milwaukee’s Best hidden behind the row of dresses, empty, dry, of unclear chronicity. This was in the house where she collapsed, the house where my older brother lived now, where we had all grown up. His trouble had not been a failure to launch, but an early descent at low altitude, a crash landing. I would go through the brothers’ things as well, drawers under unmade beds full of lotto tickets and well-worn pornographic magazines, girls or women with their legs spread wide that I ran for every time I found myself alone in the house.

The hospital, like the whole town, appeared neglected, unclearly even clean it was so dingy in its details. Because of the virus they screened visitors at the door, shot us in the head with handheld touchless thermometers. Everyone does that, the woman said, closes their eyes. In the rundown ICU, I found my mother behind a curtain, her body, anyway, looking so small, looking like nothing compared to the machines all around her. To the scene overall she did not seem particularly vital. You can touch her, the nurse said, but I found I did not want to. Her hands I noticed looked smaller than I had ever seen them. The nails were long, uneven. There were black bruises in the nail beds. An alarm sounded, and the nurse pulled at a line, pulling it straight, unkinking a place where it had twisted. This was not right, I didn't know how to be in a place like this. The room smelled like wet skin and ointments. 

You know he hasn't gone to see her at all, the older brother said. The younger had flown in the day before. The older brother had been at the bedside daily since it happened. He knew the names of all the medications, the propofol, the fentanyl. She didn't wake up when they turned them off, he said, but they keep them on anyway. Who knows what she might be feeling. He had a thick spittiness in his speech from the dissolvable strips he ate constantly. The boxes scattered around the house told me that this was buprenorphine, a modern sort of methadone to keep him off the hard stuff. Our younger brother was staying at a hotel, he told me. He both sounded resentful and said it wouldn’t matter if I did the same. The house is a dump, he admitted, it got away from us. It was hard to imagine how he spent his days. In contrast to the trash strewn almost everywhere, the living room did feature a very large and new-appearing television. He had a kind of ownership of the place I guess, a grantedness or authenticity, at home in this disaster that to me felt awfully new. We're good though, I mean, we had been, he said. We have our routines. The house was filled with an array of our childhood artifacts, terrible paintings, baby teeth, unidentifiable ceramic figurines, which all would have been touching if presented with any distinction from the takeout containers, fish tanks, reflective neon vests, boxes of fabric swatches and pallets of canned goods lined and stacked up everywhere. 

When the other brother finally came to the house we sat out on the stone patio. It was uneven from the start, laid wrong, the method cost-cutting or lazy. Stray grass shot up around each piece, each panel of stone carved to look like smaller, more intricate stonework. How is Sedona, I asked him. He couldn’t complain. He said he was working on self-actualizing, maximizing his wellbeing by considering at all times each choice’s longterm utility. I suddenly remembered a time when we were children, and he told me he discovered a cure for the hiccups. You just stop, he told me, that was the big trick. Just think about your diaphragm, he said, placing a hand on his stomach. And then, like, stop. 

Oh hell. I had a small vial of emulsified marijuana, which I dropped with an eye dropper under my tongue, and passed to him. All it ever did was take the edge off, I mean, soften the edges of things, make the mind a little slow, a little narrow. It kept me from being overwhelmed. California sober was the name of this approach, a detox, a cleanse, more fun of course than a disease or steep genetic problem. I wished I were at least half-drunk every moment since I had arrived home. My brother took the tincture and started talking about his partner, a trust-funded woman he had been following around the American west, and these shamans she knew, near them, in the desert, who did guided ayahuasca. Are you going to try it, I asked him. I want to, he said. It's just, those people, and she sure knows a lot of them, I don’t really trust them at all. We had a joke about people like that, those white fake Tibetians—tuh-beesh-ins, we called them—rich old hippies with singing bowls and prayer flags and no sense of stakes in the real world at all. 

Do you ever think about it, though? The past, is what I somehow meant. I remember things in a way he doesn't. I remember always being afraid of her, never getting what I wanted—which was what, exactly? She used to say: I'm sorry I'm not the mother you were hoping for. I try not to, my brother said. But he thought I meant dying, being dead. The backyard was suddenly alight with fireflies. The brothers used to crush them between their fingers and smear the glow under their eyes. But he couldn't even think about death, he said, or the body now at all. Someone at a party had been talking about a bad break in their arm, a skiing accident, the kind of fracture where the bone shard pushes through the skin, and he stood up abrupt as hell, had to walk straight out of the room. I’m wiped out, he said. I'm going back to the hotel. I had reserved a room, too, but I didn't want to go with him. 

In the yard when he was gone I stared at the stump of a tree we used to climb. It had leaned toward the house, with one of the branches wide and low, wrapped around the trunk like a little settee. We used to sit there and—do what? All of these unattended childhood moments escaped me. What had we always been doing? No parents, no screens. The world of the past washed over me, and I realized I was finally stoned. I did not feel sad, and I did not feel happy. In the rubber-tubing cradle of the beach chaise where I sat, I sunk and imagined that I was in a coma. Can she hear anything, I heard my brother ask the bedside nurse. It's hard to know, she told us, I think they can, but maybe that is wishful thinking. Is that how to live with all the things we cannot know—wishfully? 

Then the older brother emerged from the back door. He sat in the chair the other brother left vacant and stared at the back of the house. This was the part that was rebuilt after the fire. The details were all a little off: the trim too wide, the paint too bright. He said nothing for a long time. Then he sort of muttered to himself or to the sky. He said, I only know that John is the one to help today. I wanted to ignore him, but he didn’t notice. They had done a test, he said, last year. For cognitive decline. Draw a clock, draw a cube, repeat after me: I only know that John is the one to help today. How did she do? Not great, he said. She was right on the line. They called it pseudo-dementia. Said maybe she was just depressed. 

I thought of her ten years ago, the morning of my wedding. She wanted me to help with her makeup. She had only drugstore stuff, Wet ’n’ Wild, no brushes. The woman I had paid to do mine was gone. I touched something shining to her eyelids with an index finger. Where had she thought I would have learned to apply make up? She left the reception just after it started. She said: This isn’t about me at all. Now I imagined her dead, imagined telling someone about her posthumously, telling the wedding story, saying, She was like that. So caught in herself, never able to see anyone else, not really; what a trap to be alone in. It makes me think of dreams I have of being buried in the rubbled of a building collapse. When I dream this it is just like it has really happened. I feel I have experienced what I experience in dreams.

The meeting was held the next day in a conference room with rolling chairs and a large table and a whiteboard scrawled over in three colors of marker, a series of waving lines, unclearly tubes or pathways, arrows pointing in and out at right angles, labeled in abbreviations like on the periodic table of elements. While we waited the oldest brother reached into his pocket, then set a slip of medication under his tongue. What does it feel like, I wondered. More than just relief? The doctor was a young woman with brown skin and brown hair. Her youth in a way gave me confidence; it was easy to imagine her with her own troubled mother. There is another doctor beside her, a white man with white hair, looking down, thumbing at a cell phone. She described the bleeding, how the blood and subsequent swelling were blocking the path where the signals try to travel from her brain to everywhere else. Do you want to see it? she asked. The brothers were staring at the walls, the whiteboard. Okay, I tell her. On a rolling screen she pulled up the scan. A white rose blooming from the thin trunk the young doctor called her brainstem. But why, the oldest brother asked, is what I wonder, why is any of this happening at all? This kind of catastrophe happens, she said, at a certain age, unprovoked. Or high blood pressure, smoking, anything can lead to this sort of injury. I saw her wanting to steer away from blaming our mother for anything. How strange that she could only see an old woman in a gown on a breathing machine. 

The ICU was a long hall with only curtains between the beds, not at all what you’d expect from seeing ICUs on television. In the next bed over an elderly woman was watched by a younger one who introduced herself as the home aid. But I’ve been with the family for years, she said. When her husband died, they even counted me among the primary bereaved. He had pancreatic cancer, she said, and at the end he looked dead for weeks. She had come one afternoon and found the other aid, the morning aid, sitting attentively beside the husband, now plainly and actually deceased. The other aid was trying to take his blood pressure. The cuff wasn’t reading anything. She didn’t even know it, the aid told me. I had to bring it to her attention. I said, Has he looked like that all day? A consummate professional, this aid did not call what her employer had done dying. She called it transitioning, becoming imminent, passing on.

I don’t want to learn to make increasingly confident abstract statements. I want to bring into presence the real things all around me. Whenever I tried to explain an idea I had to anyone, I had to describe where I had been the first time I ever thought of it. Why do you do that? Paul would always ask. Say where you were when you thought a thing. I didn’t know, so I had to guess: If you were there too, maybe you would have thought it with me. Could I understand it at all, being born into the wrong body? What I understood, though only at times, was the despair of being born into any body at all. And if I hated to be a woman, I had always casually blamed this on my mother, who cut her own hair, who joylessly raised her children alone, who condemned the women at the public pool who untied the backs of their swimsuit tops while they sunbathed on their stomachs as pathetic. But all this was some sort of storytelling. So when my spouse came home in culottes and blouses, I tried wrongheadedly to relate. I taped my breasts down with drugstore sports tape that tore off layers of the skin under my arms, only achieving an irregular approximation of a B-cup. I let the dark hairs that grow around the corner of my mouth proliferate. Excited by my outward support, she, my husband, got an estrogen prescription and began spending hours a day in the bathtub, waiting for her body to arrive. She didn’t seem to see me at all. 

But I am a lesbian, she finally told me. This was at night, at a bar I like, where the martinis are served in collins glasses, tall cold cups of gin. I told her I was not. This was a lie, a little—in truth I was in love with someone else. But where was he, the man I married? A dead man with a dead man’s name. If only we got to keep people, or parts of them, at least the parts we make up for ourselves. This was not a story I wanted to be on the wrong side of, yet here I was. All through the funeral I would have to answer the question: How is Paul?

There was a photograph of me with my brothers, elementary-aged with the height differential of our mere year, each, apart, dressed in our mother's dresses, complete with clashing hats. And whose thought had that been? The oldest, his motivations as ever completely unclear. It was certainly not a subversion of sex or gender. In an odd way, he even now was completely without identity. No job, no will, no partner. A house pet, I thought, if your cat could need a prescription for opioid dependence. 

The meeting had ended with the doctor suggesting we think about what she would say, if she could stand beside herself and speak the words out loud. It was framed as a choice but her death was certain in any scenario. It was only a question of timing or, in a way, a question of volition, of desire for volition—whether we wanted to help move things along.

That night we were all on the patio, pretending not to be high. The oldest brother was rapidly running through contingencies. What if the doctors are wrong? What if there were a miracle, or a medical mistake, the scan was swapped, the sedation was too high, causing the appearance of comatose paralysis? The younger brother stood suddenly. I’m going inside, he said. I’m going to start boxing some of this shit up. It seemed obvious what we had to do next. To you, maybe, the older brother said. You haven’t been here. And we all know the two of you, well. He stopped himself short. 

Well, what? I didn’t hate her, I didn’t wish her harm. I never meant to discredit her of anything good she had given me. Even seeing her in the bed, with the breathing tube, the machines, all I wanted most was to grab her by both of her arms and shake her. I wanted to shout: I don’t know anything about you!

I went in. Even with a different porch, a different door, the sounds of coming into the house made me small and fearful. The younger brother was standing at the bookshelf in the hall holding a statuette, a big-eyed child cast in porcelain. We’re going to stop the machines, I told him. He didn’t say anything. I started again. Can you just fuck off a little, for a minute, he said. Jesus. 

A surprise, a confusion occurred the next day. I told the older brother what I remembered, that she didn't want to die afraid. But he said no, that wasn't right, or if not wrong, anyway, she had over time changed her priorities. He said she didn't want to die undressed. He laid it out, an anxiety she voiced constantly when watching emergencies on television, something it seems they did often, and seeing the clothes cut away with shears, the saggy bodies laid out, unshielded, for the mocking eyes of the first responders. There was no reason I could think of that this would be a lie. I went into her closet to see what I could find. It was full of trash bags now, a sea of trash bags piled halfway to the ceiling. I tore one open, found some soft blue pants, a button-up top with a faint trace of yellow flowers, and smoothed them out on the bed. It didn’t seem like anything she ever would have worn. A costume, almost, the sort of thing some other mother her age might wear. It's good, the older brother said. He grabbed a pair of shoes from by the door, soft pull-on sneakers that really didn't go, but I wasn't going to say it. We couldn’t get the younger brother to even come with us.

At the hospital the doctor told us what would happen next. We expect her to transition, uh, rather quickly, she said, once we take her off the vent. She suggested we say our goodbyes in advance. The bedside nurse, a man that day, objected entirely to our little bag of clothes. It just isn’t done, he said. She might, for instance, shit herself—soil was the word he used—and the clothing would be ruined. That doesn’t matter, why would that matter, the older brother said. I had never seen him so near tears, before or even since. The nurse at last agreed not to stop us. Hold the breathing tube, my brother said, and we pulled her forward and got the shirt around her, undid the gown. The IVs were slack enough to thread up the sleeves and out the shirt at the collar. We pulled the pants up around the urine catheter, moving her limbs like a little doll, averting our eyes from the parts of her she wouldn’t want us to look at. The job was hard and we were sweating before it was finished. The shoes were a nice touch, although we had forgotten socks. Ready to go? The nurse leaned through the curtain and asked. Our mother looked like someone, a person, at least.

I left the brothers the next day, left them to deal with the rest. The younger one woke up rearing for endless logistics, never asking about what he had missed out on. There was a funeral, poorly attended, and the estate we would liquidate or mostly dispose of. In the end I arrived back to the station where I had started to find that my luggage had not. A man at the little claims desk pulled out a form, hunched down over it, pen in hand. And what have you lost, he asked without looking up. Everything, I said. I have lost everything. When the tube came out, she didn’t breathe, didn’t even try to. I watched the blue seep up her fingers, her hands, like at sunset when you can’t see the sun, only all the light fleeing from the sky.

***

Anna DeForest is a neurologist and palliative care physician in New York City. Her writing has appeared in the Alaska Quarterly Review, the Journal of the American Medical Association, the New England Journal of Medicine, and the Paris Review. A History of Present Illness, coming in August from Little, Brown, is her first novel.