When it all began, my mother, Rose Kagan, 94, a great beauty, a performer, a dancer, a director, a choreographer, a star and an all-around drama queen was in failing health and living in an independent residence in Plantation, Florida.
For almost 70 years, I have been her audience. And although I live in Vermont, since my brother died I have been her sole caretaker.
I think Mom imagined that her death would be like the last act of “La Boheme”: lots of stage makeup, theatrical coughs, an emotional aria about love, a sinking to the floor in a purple velvet skirt and then a quick death in the arms of a handsome yet grieving lover. Flowers, applause, curtain.
It didn’t play out that way.
It came on fast. Wednesday, Nov. 16, I talked to my mother in the early afternoon. She had just come from the doctor — she had to see a lot of doctors — and everything was fine. So I went for a swim without a care in the world. I came back to find several frantic phone messages from the Westside Regional Medical Center’s emergency room.
They wanted to know if they should resuscitate my mother.
A sharp pain in her chest had made Mom call an ambulance. She was blue when they brought her to the hospital. Her lung had collapsed. She had no breath at all.
Now, Mom and I had “the conversation” in 2005. I knew she didn’t want to be kept alive on machines.
When I reached the ER doctor, I told him not to resuscitate her if it meant intubation, but instead they did it by using some kind of Darth Vader mask that forced air into her lungs. By then I was calling every hour, and the ER nurses told me that my mother hated and fought against the mask with all her strength.
By midnight she was in the ICU and I was frantic. I finished a week’s work in two days and flew down to Florida.
Mom and I spent three days in the ICU, her fighting every treatment — the IVs, the oxygen masks, the respiratory treatments, even the food. Mostly, though, she was fighting with me.
“Kill me now,” she demanded. “Push the button and kill me.”
“There is no button, Mom.”
“I want this to end. Kill me now.”
“I won’t go to jail for you,” I said.
“That’s what the ICU nurses said.”
So I wasn’t the only one who had been asked to kill her.
An ICU nurse told me, “There are no Dr. Kevorkians in this ICU.”
The next morning, the phone rang at 7:40 am. It was my mother’s trusted doctor, the man who had cared for her for almost 35 years, the man who had told me just a month before that “Rose is indestructible.”
“I’ve had a long talk with your mother and she is adamant,” he said. “She wants this to be over. She wants to die. What are your thoughts?”
“What is happening to her?”
“Her kidneys have been failing for years, and they can’t pump enough liquid out of her body,” he said. “She has fluid pressing on her lungs, which we’re removing with Lasix, but then we have to find the right balance between too much liquid leaving her body and too little. And because her heart is working too hard, it’s becoming compromised.”
I said, “If you agree with Mom that this is the end, I will go along with your wishes. And thank you. I can’t handle the guilt that comes with making this decision by myself.”
“There’s no need for you to feel guilty,” he said. “I’ll arrange for hospice.”
Mom was too frail to be moved to a different location, so the hospice agency — hospice is a for-profit business in Florida — rented a room for her in the cancer ward. She seemed satisfied there. “I’ll die here,” she told me, nodding her head and looking around. “I just want to die holding your hand.”
The room was bare, so I brought in the photos on Mom’s dresser, the ones she saw every night before she fell asleep: a picture of her beautiful mother — “Everyone asks if it’s me,” Mom said, her elegant, handsome father before he lost both legs to a rare disease, her beloved brother who died in the Battle of the Bulge, husband number one, who was my father, husband number two, his daughter and her husband, my late brother and his two daughters. I lined them up on a table so Mom could look at them. I also brought a picture of Mom at her second wedding, so the nurses could see her as she had been for most of her life: vital, alive, lovely.
The painful IV lines were taken out of my mother’s fragile veins. The oxygen mask was gone. Only the Foley catheter remained.
Mom was unbearably weak but fully conscious.
From then on, my time became meaningless, just an endless string of days with certain knots in them: the knot where I swam laps in the morning; the knot where I searched for parking at the hospital; the knot where I sat in the room all day, telling my mother that she was safe and nothing bad could happen to her — a bald-faced lie, since she was beginning to look like one of those Peruvian mummies they dig out of glaciers in the Andes, and she was dying, and I couldn’t think of anything worse than that; the knot where I went begging the nurses for more Ativan and morphine to calm her down; and the one where I staggered back to my mother’s apartment at night to lie in bed, eat cheesecake for comfort and watch TV until it was time to take a sleeping pill and start the whole process again.
People called every day. She could no longer speak loudly enough to be heard over the phone, but I could hold it to her ear. My brother’s best friend. My ex-husband, whom she still loved. Her cousin Ruth, whom she had known for 90 years. My husband. My cousins. Her friends at Lauderdale West. Her friends in the residence.
“To be connected through so many years,” she whispered with a big smile. “I’m happy,” she said, “I’m very happy.”
After about a week of being loved, Mom decided she wanted to live again. I consulted with her doctor and made the difficult decision that if I took her out of hospice, she would be an invalid for the rest of her life. I refused to do it. So in the end, her life really was in my hands.
Ruth told me, “Rose lived such a large, full life. She was so ‘out there.’ Some people live boring, conventional lives, but not Rose. She would hate to be an invalid.”
Thanksgiving Day came and went; the oncology ward emptied out. People took their cancer and went home. But Mom’s grandchildren came down from New York and sat with her for a long weekend. She could no longer see or talk, but she was very aware that the girls were there.
Every day, I had to drive through the community of Lauderdale West to reach the hospital. My parents had retired there when it was still being developed. They were healthy and tan and in their 50s, and they enjoyed marvelous lives. My father made good friends. My mother wrote, choreographed, directed and performed in shows— she did her last one at 91.
Now I was driving through Lauderdale West thinking “Gert died in that house,” and “My father and my stepfather died in that one,” and “That’s where Claire had her stroke and her husband died in the garage and no one found him for two days” and “That’s where Sam had his heart attack and drove to the hospital to die.”
People say there are ghosts in old New England houses and in Southern mansions, but I started wondering if there were ghosts in ticky-tacky developments, and whether it mattered to the people who lived there now that people had died in the room where they play canasta.
The morphine put Mom in a haze, but she was still beautiful. It was almost unfair how beautiful and innocent her smile was.
Living may be hard, but dying isn’t easy. We couldn’t get a pulse-ox reading one morning and I wrongly thought it was the end. Then Mom started becoming agitated, pulling on her gown, fighting off the nurse, trying to get out of bed. Soon she was seeing people near the ceiling and waving and talking — whole sentences that didn’t make sense.
“Mommy” was the last word she said.
“She’s traveling,” said the hospice social worker. “She’s dreaming the dreams of her life.”
“Consecutively?” I asked. She seemed surprised by the question.
“So I can follow along,” I explained. “I know the plot.”
“We don’t know.”
Many of these dreams must have involved dancing, given the number of times Mom tried to get out of her bed. Keeping her down was difficult; she was very strong,
Then her hands turned into purple chicken feet — all bone. I kissed her hands and her temples; it made her smile.
Me? I was filled with loss, depression, sadness and fear. I was exhausted. At night, after I took my sleeping pills, Randy put the cat on the phone so she could purr me to sleep. When this is over, I thought, I will kick pills and learn how to sleep normally again.
Then I thought, when this is over, my mother will be dead.
I whispered in her ear my confessions — that I’ve always been jealous of her beauty and star presence, that for years I thought she didn’t love me, that I’ve been angry about so much, but that I’ve forgiven her, that she is precious to me, and that I know now how much she really loved me,
The morning of Dec. 5, Day 15 of hospice care, I was sitting close to my dying mother. She now looked even more skeletal than she had during her Peruvian mummy phase. Her breathing was rough. Her mouth and eyes were wide open. I was certain she couldn’t see, but I was just as certain that she knew I was there.
“It’s all right, Mom,” I crooned, holding and kissing her hands, one of which had turned completely blue. “Let it go, let it go, you’re safe, you’re protected, you’re loved, I’m here, nothing bad can happen to you, let it go now, let it go.”
Her blood pressure was 53 over 32. It hit me like a rock that she was really dying. Her body was curled. She was breathing out of her mouth, and her breath came in the tempo of the heartbeat I could feel through her wrists. Hurumph. Hurumph. Hurumph. Hurumph. Hard but steady, harrumph, harrumph. After about a half hour, she suddenly started skipping beats — breathing with every other heartbeat — and I knew death was coming. Then she gave a loud “harrumph,” almost but not quite a cough.
And then she was quiet.
She was gone. I took my mother in my arms and and shrieked.
I had seen death happen to the person I loved the most in the world. I was no longer afraid of death. This was a great gift. This was an honor.
I always knew that Mom was to be buried next to my father. I also knew that she wanted to be buried with her red dancing shoes — threadbare, worn, torn and cracked. I found them waiting for me in a bag on a bookshelf. The next day, the day of the funeral, I grabbed some masking tape and drove out to the cemetery. When the hearse pulled in, I jumped inside and taped the shoes to the top of the coffin.
There were about 30 people at the graveside service, people from every part of my mother’s life. From before she married my father. From when she was a young mother in Brooklyn. From when she led our Girl Scout troop in Far Rockaway. From her shows.
The rabbi said Kaddish. The head of Hadassah spoke glowingly about my mother. I explained the red shoes.
When they lowered her coffin with the red shoes still on top, everyone stood up and gave her a final round of applause. It was perfect.
The little desk, a family heirloom, went to one granddaughter. The antique mirror and the English tea sets went to the other.
I took my grandmother’s sapphire ring, hundreds of family photographs, my mother’s diaries and a stunning chandelier for which I have no use.
The leftover hospital gear went to a homeless shelter, the medicines to a veterans’ home. The sheets, pillowcases, towels, quilts and blankets went to the Humane Society, along with all the eye medicine. My mother’s elegant, finely-made clothing went to Women in Distress — 12 large garbage bags full. The furniture went to a Christian group that ended each phone call with “May you have a blessed day.”
With the help of good friends, I emptied my mother’s apartment. Then I flew home to Vermont to mourn. I imagine I will be sad for a long, long time.
She was a great and graceful beauty, a gifted performer, a cultured and remarkable woman. Her last year was lonely and difficult and she faced it bravely. She touched the lives many, many people. She and I had had our problems, but in the end, I will always be honored to be her daughter.