Rhythms

By Francine R. Kaufman

The story of a woman and the last three days of her mother's life and secrets

• Language: English
• Publisher: BookBaby
• Release date: Mar 1, 2015
• ISBN: 9781889467443

Francine R. Kaufman

Francine R. Kaufman, MD, is a distinguished professor emerita of pediatrics and communications at the Keck School of Medicine and the Annenberg School of Communications at the University of Southern California.In 2003, she was the president of the American Diabetes Association.

Book preview

2004

DAY ONE

2003, Monday, 3:20 AM

Rebecca was not sure what finally jolted her awake, the deafening ring or her husband’s calloused foot pushing on her calf and inching her closer to the noise. As if in a stupor, Rebecca reached for the receiver of the phone, and while she fumbled to get it to her ear, she heard her mother’s voice, Come down. The voice was raspy, but the meaning was clear.

Rebecca responded automatically, I’m coming.

She hung up the phone and dragged her thin, fifty-two year old body out from under the hand-quilted Americana comforter. Her legs were wobbly at first, but within seconds she started to take semi-coordinated steps to the bathroom. Hanging on the bathroom door hook was her navy blue terry cloth robe. She wrapped it around her naked body and cinched it closed by tying the belt in a tight surgical knot. Momentarily, she caught a glimpse of herself in the mirror dimly lit by the bathroom night-light. There were concentric circles under her eyes. Her bangs were listing to one side, and the pony tail attempting to contain her long red hair had migrated to the top of her head. Her reflection appeared disorganized and she didn’t want to believe it was hers. She shook her head and left the bathroom.

Holding onto the bleached-wood banister, Rebecca stumbled down the flight of stairs that was illuminated by the moon through the high vaulted skylight of the stairwell. Her feet landed on the steel-grey carpet of the first-floor dining room of her house. She wobbled and her left leg bumped against the polished edge of the credenza built into the wall adjacent to the staircase. In its hollows were a service for twelve of gold-rimmed Wedgewood china; a polished silver set with forks, spoons, and knives of diverse sizes and functions; crystal glasses and stemware; and brass candlesticks from England. Although these items were all housed in Rebecca’s credenza, she didn’t own them. They were still her mother’s possessions.

Feeling pain, Rebecca involuntarily ran her index finger over her left shin and felt a raised bruise materializing. Progressing more gingerly, she saw her golden retriever, Bouncer, staring at her from the pink-pillowed dog bed. Bouncer’s tail was wagging and the tags on her collar jangled from the tremor of her sixty pounds of excitement. Hi, girl, Rebecca whispered. The jangling became louder, so Rebecca made a shhh sound.

Rebecca continued to traverse the first floor and stepped down from the dining room’s landing onto the oak wood floor of the living room. She smelled the woodruff hedge surrounding her house through a small opening in the front bay windows. The airways of her lungs reacted to the scented night air and Rebecca worried she might start to wheeze. Always vigilant about her life-long asthma, Rebecca knew it could impede her if she didn’t act preemptively with an asthma inhaler. Inhalers were scattered in cabinets throughout her house, in every one of her purses, and tucked into almost all of her pockets.

She edged past Mollie’s and Ben’s bedrooms and peeked in. The rooms were overflowing with knick-knacks, trophies, awards, and posters collected through the years of her children’s hectic lives. Rebecca missed the noise her children had once created that filled the nooks and crannies of her house and she abhorred that they only ventured home for what seemed like seconds at a time between semesters, during summer breaks, and on holidays from college and graduate school. She imagined Mollie sitting in the library at school surrounded by friends and suitors, tossing her long blond hair from side-to-side, her beautiful blue eyes staring seductively, and her full lips chattering a mile-a-minute. No one could meet Mollie, she thought, and not fall in love with her. Mollie had the perfect personality, face, and all the talent required to succeed in what she had always wanted to do, fashion design. Rebecca was thrilled Mollie had a job to start as soon as she graduated from college at the end of the year. Ben, Rebecca envisioned, was hard at work somewhere; she worried he was so engrossed in devising mathematical models and in getting his Ph.D. that the world was going to pass him by. Although he was often too serious, she knew he was also capable of having fun when he allowed himself that luxury. Ben was handsome even when his thick red hair was uncombed and his face unshaven. He had light blue eyes and a strong jaw, and once the right girl came along, Rebecca was convinced she would grab him up just like she had snatched up his father. Frozen between her two children’s bedrooms, Rebecca still marveled at the fact these bedrooms had been crafted from the old master bedroom, after the second-story new master bedroom, where she and Douglas slept, was added on to her house.

The door to a third small bedroom, Cherise’s, was shut. Rebecca thought about the now mid-thirty year old Cherise and her flawless black skin, her big toothy smile, and long lanky body. It had been complete serendipity that brought Cherise into Rebecca and her family’s life, and Rebecca was thankful for the twists and turns that had enabled Cherise to be almost as much her child as Mollie and Ben.

At the apex of these reconfigured rooms was her mother, Olivia’s, bedroom. With the door wide open, Rebecca’s eyes were drawn to the intense light radiating from the antique multi-armed brass lamp attached to the wall, next to the satin-covered headboard of the bed. The ornate winding brass arms cast a shadow of what looked like a ballet dancer on the wall and across Olivia’s face as she sat propped up against her pillow. The dancing image of the light magnified each crevice on Olivia’s face, and made the deep folds emanating from the base of her nose to her outer lips look like dark chasms. Olivia was scrambling to put on her thick glasses and had a blood pressure cuff inflated on her left upper arm over the cotton and lace sleeve of her favorite blue nightgown. Bowing her head, Olivia inched closer so she could intently watch the numbers as they appeared on the sphygmomanometer’s screen. Olivia blurted out in a low-pitched raspy voice, 179, 65, 144.

Rebecca repeated the numbers to herself. Mom, your blood pressure is 179 over 65, and your pulse is 144? she queried out loud. Contemplating the import of these numbers, she whispered shit under her breath.

What’s your rhythm like? Rebecca posed as she sat down on the edge of her mother’s bed.

Bad, bloody bad, Olivia’s voiced scratched, reminding Rebecca that her mother’s vocal cords were lax with age, and that Olivia still had an English accent and used British epithets five decades after departing from her birthplace.

Are you having chest pain? Rebecca tried to ask in a matter-of-fact manner. She palpated her mother’s pulse herself, and had trouble counting the beats and assessing the degree of her mother’s arrhythmia, her heart rhythm disturbance. Pressure, do you feel pressure? Rebecca continued to probe, attempting to remain objective.

Mind you, I don’t think I have pain, it just feels uncomfortable. Olivia was rubbing her chest with her right hand and the blood pressure cuff was still drooping off her left arm. Rebecca squinted as she stared at her mother. Magnified by her glasses, cavernous circles circumscribed Olivia’s eyes and her white conjunctivae appeared blush-stained. Her image was that of fatigue, infirmity, and old age.

Don’t worry, Rebecca’s voice cracked. Her own vocal cords felt heavy. She coughed and brought up a small amount of mucous forming not only from the night air, but also from the stale perfumed scent wafting through her mother’s room.

Rebecca persisted in taking her mother’s pulse, which was wild, uncoordinated, and jumpy. Olivia was in atrial fibrillation as the top chambers of her heart beat erratically. Atrial fibrillation could lead to a stroke, fatal heart attack, or stop her heart altogether.

What do you want to do?

Nothing, Olivia responded.

Do you think we should go to the hospital?

No, she snapped. Becka, I want to stay here.

Let’s see what happens. If things don’t get better, then I really think we should go. They can tell us what’s going on with your heart and maybe change some of your medications, Rebecca tried to bargain with her mother as she progressed onto her bed, and Olivia finally nodded in acquiescence. Reclining, Rebecca straightened her robe to cover her legs, and her fingers bounced over the egg-shaped bruise on her shin. It stung, but that noxious signal had to compete with aches and pains originating from what seemed like every muscle and bone in her body. Rebecca and her husband Douglas had been up with Olivia at least three times a week for the past month, and nightly for the last week. Rebecca had taken her to the hospital three times in the middle of the night, to Douglas’s emergency room in the outskirts of San Diego, and each time Olivia and Rebecca languished there for hours. Even though Rebecca knew everyone in the emergency room, Olivia was still required to fill out paperwork, get assessed by nurses and doctors, have an intravenous drip started, an oxygen cannula placed in her nose, and blood extracted to see if the cells deep inside her heart were dying. Unable to leave her mother’s side as they waited to discover Olivia’s fate, they were finally told things were stable enough to go home after four to five hours.

Landing home after dawn, all Rebecca could do was rest in Olivia’s bed for a few minutes before she had to figure out a way to resuscitate her own body. She was required to go to work so she could care for other people’s children, no matter how fatigued she was or what had transpired the night before. This routine made Rebecca wish Olivia wasn’t living in her house and that she wasn’t responsible for her mother. Not when she had so many other things to do in her clinic, in her research laboratory, and in her own life. But, Rebecca was clearly ambivalent. Her stalwart nighttime duty assured her that she mattered to her mother, that her mother needed her. After all, Rebecca reminded herself, I’m the one keeping her alive.

I had a bad dream, Olivia whispered. Olivia always whispered when she had a bad dream. Whispering made her English accent more pronounced.

Do you think that’s what started it, your heart? Rebecca probed. Olivia bit her upper lip and didn’t respond. Olivia had an escalating number of nights with bad dreams, and Rebecca watched her mother wake up from many of them with her arms flailing, her face covered in sweat, and her heart beating wildly. A bad dream, Rebecca thought. How could she not have bad dreams? She was aged, survived the Battle of Britain, and suffered unimaginable losses. Even though Olivia informed Rebecca every time she had a bad dream, Olivia never intended to divulge its details, and Rebecca didn’t want to hear a blow-by-blow rendition, especially at night, when she needed to sleep.

The rhythm and cadence of Olivia’s pulse seemed no better to Rebecca, but Olivia was more at ease. Having Rebecca in her bed calmed her. Assessing her mother’s pulse and blood pressure allowed Rebecca to play doctor and daughter. She examined her mother again, and there were no signs of impending disaster. She listened to her breathing; it was sonorous, and occasionally shallow, then gasping. Rebecca believed there might not be much time. There was no way to know if it was weeks, days, or minutes; it was impossible to imagine it was months. If Olivia stopped breathing right next to her, Rebecca knew she would follow the Advance Directive her mother had signed and buried in her nightstand drawer. This document instructed her daughter to let her go quietly, without drama, and without invasion. But then Rebecca remembered how her mother clung to life every time they went to the emergency room after an episode of suspected cardiac catastrophe. Olivia put up with poking, prodding, and dry oxygen invading her nose. In the emergency room, Olivia didn’t seem to want to let go.

With her eyes closed, Rebecca hoped they could just wait this one out. It was only an hour or two before daylight and things were always better in the daylight. In daylight, there were no dreams.

1960

Becka, please be quiet, Miss Christopherson said with such animation that her grey bun bobbed at the side of her head. She peered directly at Rebecca and told her what she must have told her a million times: Becka, just sit still. I need your hands on your desk, I need you facing forward, and I need your mouth closed.

Rebecca repositioned herself in her desk and tried to be still. It was difficult for her to keep her legs from moving under usual circumstances, but today it was impossible. She was just too eager and excited, and as she flipped around to look at the clock mounted on the brick wall at the back of her classroom, she prayed the hands on the clock would move faster. Next to the clock was a picture of President Eisenhower. This upcoming election was going to be her mother’s first chance to vote as an American citizen, and Olivia had made it clear she intended to vote however her husband Nate instructed. Staring at the clock, Rebecca was sure the big hand must have been stuck.

Everyone in Rebecca’s third grade class stood up, placed their right hands over their hearts, and recited the Pledge of Allegiance. Then they all sat down. Miss Christopherson took a huge book of poems from the upper left corner of her desk, opened it to a page she had marked with an index card, and began reading a poem. Rebecca barely listened. She heard her teacher say something like, The woman was old, and ragged and gray, and bent with the chill of the winter day.

What a ridiculous poem, Rebecca thought. She was eight, almost nine, years old and couldn’t imagine why Miss Christopherson would want her class to memorize a poem called Somebody’s Mother written something like a hundred years ago about a bent up, old lady for the class poem of the week. It wasn’t that she was worried she couldn’t memorize the poem; she knew she could memorize almost anything within a few minutes if she recited it or saw it on a piece of paper. In fact, if Randy Fazio hadn’t thrown a wad of paper at her after she tossed a spit ball on top of his desk, she would have memorized Miss Christopherson’s Old Lady poem already.

Rebecca stared at Miss Christopherson trying to remember all the maneuvers her mother told her to do to help her stay focused. Stare at the person talking to her, concentrate on her own breathing, interlock her fingers, or cross her legs not just once, but twice by swinging the top leg behind the calf of the bottom leg. That tied her legs in a knot so it was impossible for them to wiggle. Rebecca ran through all the maneuvers so she wouldn’t infuriate Miss Christopherson. When the teacher got angry, her wrinkled face became even more crossed with lines. Rebecca didn’t want to get banished to the principal’s office or to the school nurse, like she had been five times so far this year. Not today. All she desired was for it to be 11:30 a.m., because that’s when her mother was going to arrive in her new white and aqua Fairlane 500, with her bulldog Mack in the backseat. Having her mother demonstrate the retractable hardtop of the new car was her Show and Tell reward for not being relegated to the principal’s office for the last month. More importantly, it was her opportunity to have her mother do something really special and extraordinary, just for her.

Miss Christopherson read Somebody’s Mother one more time, handed out a mimeographed copy of the poem, and deposited her big book of poems back on her desk. It was time for math period. While the rest of her class was doing two- and three-column addition and two-column subtraction with carryover, Rebecca was allowed to do multiplication and division on her own. Her sister, Sharon, had taught her the multiplication tables and how to do long division when she started second grade. But towards the end of second grade, Sharon didn’t want to teach Rebecca anything anymore. Sharon wanted to be left alone, and all she talked about was going to college in the fall and getting out of their house. Standing at Sharon’s bedroom door, Rebecca would start to cry when Sharon bellowed, Becka, get out of here. I can’t cope with you. You’re a pest.

Rebecca asked her mother what she had done wrong. Sharon’s going through a phase, high-school girls often do, her mother tried to reassure her. You didn’t do anything wrong, darling. This has nothing to do with you. Rebecca wondered what it had to do with, as she noticed her mother’s moist eyes under her glasses. Her mother’s shoulder slumped, her mouth pursed, and her lips tugged down when she mentioned Sharon’s name.

Mr. Butterfield, the principal of the Roosevelt Elementary School in St. Louis, Missouri, confronted Rebecca with the same question each time she was sent to his office. "Rebecca, you are really a smart girl, but you can’t sit still or pay attention. Why? What is your problem?"

How was Rebecca supposed to know why she couldn’t sit still? After that first reprimand, Mr. Butterfield sent her to Miss McDonald, the school nurse, to see what her impression of Rebecca’s problem was. Miss McDonald wore a white uniform, white stockings, white shoes, and pinned a stiff white hat with a blue star at the top of her head. When she went outside, she wore a navy blue cape draped across her shoulders. Miss McDonald assumed Rebecca’s problem was due to her asthma, but fretted she might have something more serious, so she asked Olivia to take her to the doctor. When Olivia revealed to her husband what Miss McDonald said, they had a fight. After all, Nate was a respected doctor and he was sure his daughter was fine. He believed she was bored at school and that if they challenged her more, she would be able to sit still and stay out of trouble.

Olivia argued, They ring me up at least twice a week. I think Butterfield wants her to advance a grade so they can get her out of there faster. But she’s quite the immature one. She can’t sit still, she is all over the place, and she drives Sharon bloody crazy. If it wasn’t for Rose, I don’t know what I would do with her. Your mother keeps her occupied. You’re never here. You don’t see it. When Olivia said can’t, her A’s sounded like they were formed high up in her throat, not down on her tongue like when everyone else said A.

I have faith in Rebecca’s intellect and her abilities, Nate remarked, ending the conversation. He then made it clear that his wife and his mother were supposed to raise and discipline Rebecca and Sharon while he went to work to put food on the table and a roof over our heads. He was there to intercede if required, if the situation became totally egregious, or when there was an outside threat, like from Miss McDonald. And he was there to believe in his daughters.

*****

Rebecca heard Miss Christopherson repeating, Onehundred and thirty-two minus eleven is one-hundred twenty-one. It startled her, and she immediately stopped her mind from wandering. She riveted in her chair one more time to quickly glance at the clock. It was 11:15 a.m. When she boomeranged back to face forward, she realized Miss Christopherson was staring at the clock, too. Their eyes met. A faint smile descended on Miss Christopherson’s face; when it did, her wrinkles almost dissolved. She too must have thought the clock was moving slowly, because she announced, It’s almost time for Becka’s mom and dog to come. Why don’t we all get our sweaters and coats and go outside to wait for Mrs. Sheridan. You have all been so good this morning and Becka especially, so we can have a little treat. Later today, we’ll have our air raid drill and we can practice climbing under our desks and covering our heads.

A grin flew across Rebecca’s face and she jumped out of her seat. She started to run to the closet at the back of her classroom, pushing Jimmy Polk out of her way, when she felt a bony hand on her shoulder. Miss Christopherson had accelerated to catch her. Don’t ruin it now, Becka.

Coming to a screeching halt, Rebecca blurted out, I’m sorry. Miss Christopherson released her shoulder, and Rebecca fell in line behind her classmates, snatched her sweater, and walked outside. While everyone else was jutting this way and that on the green, well-manicured grass, Rebecca went straight to the edge of the teacher’s parking lot to wait for her mother. The black asphalt covering the parking lot was flawless; the white lines were perfectly parallel, and the entire parameter was outlined by azalea bushes and shaded by weeping willow trees. Rebecca peered in the direction of her house and shuffled from one foot to the other. Then she saw her. It was exactly 11:25 a.m. on the outside clock attached to the main entrance of the school. As the Fairlane 500 rounded the corner, its highly polished chrome glistened in the sunlight. A white chiffon scarf draped across her mother’s blonde bouffant hair and circled her neck. She had on dark pointy sunglasses with rhinestones around the rim. Her mother was beautiful and nothing on her body was ever out of place. Sharon was just like their mother; her blonde hair flipped up around her shoulders, her clothes were impeccable, and she hid behind sunglasses whenever she could.

Mack’s face was hanging out of the back window. He was panting, like all bulldogs, with his tongue extended far out of his mouth, flapping up and down. He was a mess, and Rebecca thought, he’s just like me. Rebecca’s skirt was off center and twisted around her waist, her red hair escaped from her pigtails, and her sweater dragged off her shoulders. Everyone told her how pretty she was, and how one day she would be beautiful when she grew up and wasn’t so disheveled. But, she doubted it. Her mother waved; it was a slight wave but a definite recognition of her daughter’s presence. Rebecca jumped up and down, waved back, and screamed, Mom. Her wave was huge and deliberate like a windmill.

When Olivia reached the parking lot, she came out of the car holding Mack by his leash. Olivia extended her hand to Miss Christopherson as she rushed to greet her, and their bodies jiggled up and down when their hands shook. Their faces were illuminated by beams of sunlight streaking through the branches of the trees as they spoke. Olivia turned and waved nonchalantly to her daughter’s classmates who had gathered around her, and smiled at her daughter. A chorus of kids surrounded Rebecca and shouted, Hi, Mrs. Sheridan. Hi, Mack. Mack barked and deposited a puddle of drool between his front paws onto the black asphalt, and then darted to jump up onto Rebecca’s legs, until he was abruptly tugged back.

Cheers, Olivia said softly. This is the first model of a retractable hard-top convertible. With one push of a button, the entire hard top goes into the trunk, and Becka and I can drive around town with the top down.

She glided to the car, pulling Mack behind her into the back seat. She opened the front door, gracefully floated onto the seat, turned on the motor, and pushed the magic button. First, the roof ascended towards the sky. As it did, Mack barked frantically. The higher it went, the louder and more ferociously he barked. Then the trunk sprang up in one rapid, smooth motion; it rose from the rear window and remained attached at the taillights. With the trunk opened to the fullest and the roof pointing directly to the sun, everything started to move again. The roof descended into the trunk with an undulating motion, and once in, the door of the trunk shimmied shut. A convertible was revealed, sleek and futuristic, with a barking bulldog in the backseat. Olivia signaled to no one in particular, shut her car door, and drove off. Everyone stood at the edge of the teacher’s parking lot, waving. Rebecca felt her heart beating fast and her lips curled up in a huge smile. She was so happy Miss Christopherson let her mother be part of Show and Tell, and that her mother had agreed to come to school. Rebecca was pretty sure her mother didn’t really care about showing off her car, and she hoped with all her might the reason she came was to spend time with her. It hadn’t been easy to get her mother’s attention since starting third grade. She missed her mother’s hugs and she struggled to understand where they went. Rebecca nodded and thought, today is really special.

Miss Christopherson’s hand once again touched Rebecca’s shoulder, but this time it didn’t feel bony. When Rebecca turned around to stare into her teacher’s face, she thought Miss Christopherson was almost wrinkle-free.

2003, Monday, 5:45 AM

Rebecca awoke to the crackling noise of the blood pressure cuff as it inflated around her mother’s arm. As the sphygmomanometer deflated, she asked, You okay?

I’m a little better, but my pulse is still wild. Olivia waited a few minutes and announced, 160, 70, 126. The numbers had minimally rallied. Rebecca reached for her mother’s wrist to take her pulse, and her head bobbed like an erratic metronome as she tried to simulate the rhythm of her mother’s cardiac contractions.

Better, your pulse is better, Rebecca attempted to reassure them both. Let’s try to rest a little longer. I’ll stay with you until I have to get ready for work.

Becka, you can’t rest much longer, it’s already morning, Olivia insisted as she softly shook her daughter. You’d better get up and go to work.

What? Rebecca responded, only semi-cognizant of reality. She’d hoped for a longer respite, but now resigned herself to the fact she wasn’t going to get it. Advancing closer to her mother to try to assess her status, Rebecca was comforted that she was a physician and knew about disease processes, how to do a physical examination, and detect the signs and symptoms of an impending disaster. After inspecting her mother’s skin, determining her color, the status of the veins in her neck, and the way she breathed, Rebecca knew her mother was stable.

What time is it? Rebecca asked, trying to focus on the ancient wind-up alarm clock on her mother’s nightstand.

Almost six, Olivia quietly responded. Bolting out of bed, Rebecca pulled her robe around her body. As she crossed through the downstairs of the house, she realized it wasn’t as neat and clean as it had been when her mother first moved in. When Olivia first migrated to San Diego and into the room that was transformed into a bedroom next to her grandchildren, the house became almost as immaculate as the house Olivia commanded when Rebecca was growing up. Before her mother went to bed every night, she rummaged around to make sure there