One True Thing

by Anna Quindlen

  “Sometimes I think about how I first saw her at Columbia, and how eager she was,” he said. “But you know that because you know how she is. So eager, as though she wanted to see and understand and know everything, but not in that way the students had, to catalogue and dissect and then eventually dismiss or internalize it. But in the way she had of seeming to want—” he stopped sawing at the food, searching for a word in the still and murky air above our table—“wanting just to soak it up. There was a kind of life there, as though if you felt her cheek she would be warm. And she was. Still is. She’s never changed much, all these years. There’s still that, that—avidity. And I wonder sometimes where it will all go. It seems impossible that it will simply go out, like a light. All fiction takes as its great central mystery death, mortality, but it seems to me now that all of it misses the point.”

  He looked up at me, his empty fork poised in the air, like a small weapon or a signal of surrender. “I can’t imagine the light going out,” he said.

  “You’re talking about her as if she was already dead,” I said.

  “I’ve known her all my life,” he said, and his eyes were puzzled, dull, like the eyes of a sick animal.

  “Me too.”

  “Yes,” my father said. “I suppose it’s even truer of you children. But you’ll go on. I have a difficulty imagining a life without your mother.”

  He ate then, slowly but with gusto, as though he’d completed some exhausting task. When he was finished he looked up again, his eyebrows sardonically lifted, his everyday self. “So much for the soliloquy,” he said. “It’s merely that I can’t bear the thought that she’s in so much pain. Sometimes at night she’s awake for hours with it.”

  I sighed, and said what he wanted to hear. “I can take care of that,” I said.

  “I will try to give her more of an opportunity to ventilate,” he said.

  “Papa, we’re not talking about an opportunity to ventilate. If she needed to ventilate, I’d send her to this shrink Dr. Cohn recommended. She needs you to talk to her, to listen to her, to let her know that it’s all right to talk back to you, to confide, to unload. Tell her some of the things you’ve just told me.”

  “But she knows all that.”

  “Sometimes people need to hear things said out loud before they become real,” I said.

  Coffee arrived, bitter and tepid. A secretary from the English department bent over the table and told me that I was a very lucky person to have such wonderful parents. She twinkled at my father and waved over her shoulder as she disappeared into a dim corner of the restaurant, and I wondered if she had slept with him. The cheesecake tasted like heavily sugared spackle. I remembered I had to pick up strings of white lights to loop around the azalea bushes by the porch. I remembered we needed milk and toilet-bowl cleaner. I spilled coffee on the front of my sweater but luckily my mother had taught me the month before how to get coffee stains out with baking soda.

  “I think we need to begin discussing funeral arrangements,” my father said.

  “Papa,” I said. “You ask too much. You always have.” I went to the bathroom and when I came back he was finishing his coffee and talking to the brother of the board member again. “Gotta go,” I said, and I left for the mall and the supermarket.

  When I got home my mother was asleep on the living-room couch, her mouth open, her lids fluttering as though someone was chasing her in her dreams. In the kitchen I sat at the table, littered with little notes—the one that said “lights for bushes” I threw away—and some stencil patterns of rocking horses and flowers. I telephoned Dr. Cohn’s office and her nurse said she would call another prescription in to Sellinger’s. But five minutes later, as I was still going through the notes—“shop for Xmas presents for J. and B.,” one said, and I wondered how we would manage that—the phone rang.

  “Ellen,” said Dr. Cohn, without preamble, “how are we doing on that dosage? When does she get breakthrough pain?”

  “First hour the stuff doesn’t help, second and third hours she feels great,” I said. “Fourth and fifth she dozes. About the sixth hour her back starts to hurt. Sometimes I cheat a little and give her something then.”

  “Good. You go ahead and do that. I think if we play around with this a little bit we can keep her comfortable and maybe lessen the sedation some, although that may be the disease and not the medication. Make sure she keeps taking it with the laxative. How are her spirits?”

  “Depends. Quiet and thoughtful now, a lot of the time.”

  “Cogent?”

  “Yes.” I picked up the rocking horses. “Giving stencil advice on the phone.”

  Dr. Cohn laughed, a surprisingly deep and throaty sound. “I find your mother amazing,” she said.

  “Me too,” I said, and I held my hand tight over my mouth so no noise would come out, no sobs.

  “Ellen?”

  “Fine, fine, I’m fine.”

  “I want to send you a nurse. Once a week. Blood pressure, heart sounds, that kind of thing. And to keep a watch on the catheter so that if we need it later for morphine it’s in good shape. She can give you a break, let you get out, maybe help your mother bathe or dress.”

  “She can bathe and dress herself.”

  “Whatever.”

  “No nurse,” I said.

  “I insist.”

  “No.”

  “She’ll come Monday.”

  “Ellie?” my mother called from the living room.

  “I’ve got to go,” I said. “I’ll get the prescription later. Thanks for your help.”

  I sat at the table and looked down at a sheet of paper. Morphine, morphine, I’d written over and over. The phone rang again.

  “El?” Jonathan said. “Guess what? I got the job.”

  Jonathan had applied to the district attorney’s office in Manhattan for a summer internship. Sleek and full of himself in a gray double-breasted suit and red tie, he’d interviewed the Wednesday before Thanksgiving. He sounded more surprised than I was at his good fortune.

  “We’ll get a sublet downtown, near your old place. It’ll be perfect for me and from there you can look around for something permanent. One of the women in my Con law class says she knows an NYU instructor with a one-bedroom on MacDougal who may be going on sabbatical. Maybe I can even get a magazine piece out of this.” From time to time Jonathan threatened to write something to prove that he was at least as good as I was, a fact about which I had no doubt.

  “Can you ask Jules whether she knows of anything or if she can ask around? She’s got to know someone who’s going off for the summer and wants to rent out their apartment or have someone house-sit their cat or something,” Jonathan went on. “I am so psyched about this. The money is for shit but the contacts and the résumé value are great. And naturally the living arrangements will be superb even if the apartment’s a pit.”

  “It’s great, Jon.”

  “We’ll celebrate at Christmas. My father is going to love this. Love it. It’s the closest a lawyer ever gets to being part of the NYPD.”

  “It’s great.”

  Silence. “Are you okay?” he finally asked.

  “Just working on my morphine dosages here. I had lunch with my father and he wanted to discuss funeral arrangements, but before he could get to burial versus cremation I left to pick up toilet-bowl cleaner. And I’m reading Anna Karenina. I have this sneaking suspicion that this time around, she’s going to stay with her husband and have a miserable life.” More silence. “I’m pleased for you, Jon.”

  “And we’ll get a place.”

  “I can’t leave here.”

  “Yeah, but by June, El …” Silence again, longer this time.

  “Jonathan, I’m not going to look for an apartment on the assumption that I can get rid of my mother in time to spend the summer in bed with you.”

  “I didn’t mean that,” he said.

  “Yes you did. You thought to yourself, well, Mrs. Gulden will be dead by summer and then I can split
the rent with Ellen and get laid in the process.”

  “Look—bottom line? Next time I have good news to share I’ll call somebody else.”

  “Bottom line? That’s a good idea. Because good news does not compute for me right now.” I don’t know which of us hung up first. I was the one who cried afterward. I’d been with Jonathan for nearly a third of my life and it ended over a summer sublet. Or at least that was what I would say when I made it flippant and amusing for Jules. I should have felt angry or bereft or heartbroken. But those emotions seemed luxurious to me, like a long hot shower or a bubble bath. I could not afford them.

  I heard a shuffling sound and looked up to see my mother leaning on the doorjamb. She was wearing a pair of my old leggings and a shirt of my father’s, its lower buttons pulling slightly over her distended belly. And for just a moment I thought to myself: you have ruined my life. You have ruined my life with your damn selflessness, your damn accommodations, your damn illusions, your damn husband, and now your damn death. Perhaps a shadow of all that passed over my face, for her voice was plaintive, almost childlike, when she spoke.

  “I need a pill, Ellen,” she said, the trace of a whine in the ebb and flow of her inflection.

  I handed her the vial. “What would I do without this stuff?” she said, and she took one, her head tilted back and her throat working like a bird drinking from a puddle. “I’m so tired,” she said after it had gone down. “I’d like some tea.”

  “I’ll make it,” I said.

  “Please,” she said as she went back to the living room. I put the kettle on to boil, and then, as though by rote, I put bread in the toaster and mixed sugar and cinnamon together in a small bowl and took the butter dish out of the refrigerator. It was almost like waking up from a dream when I finally looked down and saw, on the pretty lacquer tray, the mug of tea and the plate with two slices of cinnamon toast cut in triangles. It was the snack my mother always made us when we came in from sledding, playing in the snow, skating down at the pond behind the public library.

  I carried it carefully into the living room and put the tray on the coffee table. The room was dim, and my mother was asleep on the couch, her breathing raspy, her eyes sunk into the concavities of her skull. One hand was held to the side of her face, as though to shield it from view.

  “Mama,” I said softly, but the only answering sound was the rattle of her breathing. I sat down on the ottoman and drank the tea and ate the toast and it was as though the house was breathing, too, all three of us breathing in tandem, dying in tandem, trying to keep body and soul together as the wind shook the storm windows in their metal frames. A leaf blew down the chimney and lay shivering on the stone hearth, and in a few minutes I took the tray into the kitchen and then came back into the living room to sit with her and watch her sleep.

  By Monday morning I had forgotten everything about my call from Dr. Cohn except what she’d said about the morphine. Three or four hours after she took the medication my mother was groaning with pain, sometimes keening as though she was chief mourner at her own wake. More morphine given more often helped that, although it meant she slept more and sometimes she talked to herself in a monotone I could hear from her bedroom. Maybe there were things she needed to speak aloud that she could not say to anyone else.

  So when the front door bell rang, the carillon of my childhood, bing-BING, bing, as it had not done for so long—“they all think cancer’s contagious,” my mother had said wearily one afternoon of her friends—I was unprepared for the slender dark woman who stood on the steps in a bright red jacket with a big canvas bag slung over her shoulder.

  “Ms. Gulden?” she said, careful to use the more modern honorific, the dissonant sound of bees buzzing. She had a slight accent and her teeth were very white against her dark face and hair. Above the V of her coat a white tunic jumped out like a surprise.

  “Yes,” I said, pushing at my hair, which I had not yet found time to brush or barrette back.

  She put out her hand. “I am Teresa Guerrero. I will be helping you and your mother.”

  It was so deft, the way she said it, and I wondered if they taught them etiquette in some hospice training class: do not say you are there to take care, to treat. Say that you are there for both the patient and the family. Make yourself an assistant; do not try to run the show until later.

  “Oh, Ms …”

  “Guerrero. I am Ecuadoran originally, although for quite some time I have been an American citizen.”

  “Ms. Guerrero, I told Dr. Cohn I didn’t really need any help. I’m caring for my mother myself.”

  “I appreciate that, Ms. Gulden. For today I will do nothing but meet your mother and monitor her vital signs, her heart rate, her respiration, her blood pressure. Later you can decide whether and in what ways you wish to use me.”

  I looked at Teresa Guerrero for a long time, but unlike most people she did not attempt to fill the silence that grew between us.

  “I don’t know about this, Ms. Guerrero,” I said.

  “We will find out.”

  “I am Ellen,” I said, unconsciously adopting her speech patterns.

  “I am Teresa.” I stepped aside and let her in.

  In the living room my mother was working on her needlepoint pillow, the background half finished. Her clothes hung loosely from her shoulders, and I had been able to tell for several days that she wore no bra, although I was not sure whether it was because she could not put one on or because she felt, with her poor deflated breasts, that it was superfluous.

  Teresa put down her bag, which made a clinking sound. “Mrs. Gulden,” she said, “my name is Teresa Guerrero and I am the nurse sent by Dr. Cohn to monitor your vital signs.” Vital signs, I thought, she keeps saying vital signs. Perhaps it is to make the patient feel vital. Will she ever say she is here to monitor dying signs? I watched my mother smile up at her, her bright company smile, and wondered whether she would offer refreshment.

  “I appreciate that,” said my mother. “Would you like a cup of tea?”

  “No, thank you,” Teresa said solemnly. “I never drink on duty. I don’t eat on duty either.”

  “Do you laugh on duty?” I said.

  “If something is funny,” Teresa said. Turning back to my mother she asked her to push up her sleeve and unbutton the top two buttons of her shirt. “Knock knock,” she said.

  “Who’s there?” said my mother.

  “Banana.”

  “Banana who?”

  “Knock knock.”

  “Who’s there?”

  “Banana.” Her slight accent made the word sound exotic and very beautiful, almost erotic.

  “Banana who?”

  “Knock knock.” She inflated the blood pressure cuff and consulted her watch.

  “Who’s there?”

  “Banana.”

  “Banana who?”

  “Knock knock.”

  My mother giggled. “Who’s there?” she said.

  “Orange.”

  “Ah! Orange who?”

  “Orange you glad I didn’t say banana?”

  We all laughed. “I thought these children had told me every knock-knock joke under the sun, but I’ve never heard that one,” my mother said.

  Teresa was listening to my mother’s heart. “Shhh,” she said.

  She moved the silver disc of the stethoscope from place to place, stopped to run her fingers gently over the catheter beneath my mother’s skin.

  “Is it still beating?” my mother asked.

  “Loud and clear,” said Teresa, who took a clipboard from her bag and began filling in a form.

  “Do you have children?” I said.

  “No,” said Teresa. “I have not yet married.”

  “So where’d you hear the knock-knock joke? Not from Dr. Cohn?”

  “No, not from Dr. Cohn. From the daughter of a woman I also visit. She is five and thinks that joke is very funny. I have heard it from her perhaps twenty times.”

  “What’s wrong
with her mother?” my mother said, buttoning her shirt.

  “Mama, I’m sure they’re not allowed to go from house to house talking about their patients.”

  “Her mother has breast cancer, Mrs. Gulden,” said Teresa. “I have been seeing her for three months. Her own mother cares for her some of the time but she is not able to do certain things for her.”

  “And she has a five-year-old?”

  “And a seven-year-old.”

  “Oh, Lord, that poor girl,” my mother said, her mouth trembling.

  “If the two of you were together in this room you would have a great deal to talk about,” said Teresa.

  “Yes?” said my mother.

  “We can talk more about that. In the meantime what can I do for you? Is your pain under control? Can I help with your diet? Would you like help with bathing or dressing?”

  “Oh, I’m having a terrible time getting in and out of the bathtub. But I can’t have you coming to bathe me.”

  “Mama, you didn’t tell me that,” I said.

  “Oh, there are so many things to worry about, Ellen.”

  “I can help you.”

  “No. Not with that.”

  “Oh, Mama, I’ve been in a million locker rooms.”

  “It’s different,” my mother said.

  “Let’s go upstairs,” Teresa said. “I can show you some of the ways that coming in and out of the tub can be made more comfortable. And I would like to irrigate your catheter and you should be lying comfortably for that.”

  “Will it hurt?” said my mother.

  “Compared to what I imagine you are used to, not very much.” My mother’s lips quivered again as she replied, “What I’m used to is awful.”

  “Yes,” said Teresa, and she took my mother’s hand. “It is important that you not hurt.” My mother’s head dropped, an orange daisy in a drought. Tears fell, plop, plop, on their joined hands. I felt like a voyeur, a stranger. They stood together, Teresa helping my mother to her feet.

  “Excuse me,” said my mother, pulling a tissue from her sleeve and dabbing at her face. “I’m usually better than this.”

  “Better and stoic are two different things, Mrs. Gulden. You have a right, even an obligation, to express your feelings.” She reached into her bag and brought out a folder. “You may want to read these,” she said to me. “Not all of them are suitable for all patients but Dr. Cohn seemed to think you should have them, particularly the more technical information.” Then she offered my mother her arm. Through the white bones of the banisters I watched them disappear, head, torso, knees, feet, as though they were ascending to heaven.