by Hope Edelman
In the medical records from her mastectomy, I can see her trying to deny that cancer could interrupt her life. Or was she just replacing fear with the same blind hope she tried to encourage in me? Three days before the pathology report confirmed that all of her twenty-six extracted lymph nodes had tested positive for cancer, a female social worker visited my mother’s hospital room. From the notes she left behind, this counselor apparently already knew how serious the pending diagnosis would be: “The patient is an emotionally resourceful woman who needs at this point to be very optimistic about her disease and its implications,” she wrote. “Wishing to resume her previous functioning as soon as possible. Patient feels that the two weeks of preparations she had prior to surgery gave her time to think about her priorities—‘getting back to life’—and to reduce some of the disorganizing effects of waking up to a mastectomy. Her hope-fulness is what appears to be sustaining her at this time. Her sister, on the other hand, upset about MD’s report that there was much more cancer than anticipated and patient will need chemotherapy. Talked with her at length so as to allow her then to support patient’s defenses, i.e., a denial of its long-range implications.”
I don’t know whether my mother ever understood how far gone her cancer was, or that it would eventually win. But surely, the thought must have taunted her—how could it have not? From the pathologist’s report, the likelihood of her survival was slim. Twenty-six positive lymph nodes is about the poorest diagnosis a woman can get. But I remember what she told me after her mastectomy, as I sat at the foot of her hospital bed: “The cancer was in some of my lymph nodes but not in others, which means the doctors removed it all.” I believed her at the time—I had no reason not to—but twelve years later, I learned it wasn’t true. Which means, as I see it, either that my mother never heard the pathologist’s report or that, because she wanted to protect me from a truth too inconceivable for her to bear, she lied.
By the time this was revealed to me, however, I’d already spent more than a decade constructing lovely, complex metaphors about beautiful, brave women who died without dignity because their fate lay in the hands of manipulative men. On alternate days my mother was either a queen removed from her kingdom without warning or a soldier pushed into battle with neither sufficient training nor adequate arms. These fantasies sustained me, justifying and multiplying my anger toward her doctors and my father, and I’d organized most of my opinions about the medical profession, illness, and death around their romantic poles. Before I saw the severity of her medical condition spelled out in type, I’d never considered the idea that my mother, alone inside her body, might have known the truth all along.
And could she have suspected it even earlier? I remember the reason she gave me for avoiding the biopsy that would have diagnosed her cancer a year before the biopsy that finally did. “Operations are expensive,” she said, “and money is tight this year.” I accepted her explanation then, but I know better now. The whole family had major-medical coverage, which would have paid 80 percent or more of the bill. Lack of money wasn’t a legitimate reason to put the surgery off.
After that conversation, we didn’t speak about the lump again, until the evening of the mammogram that showed what she described as a “suspicious shadow,” and we never discussed death. The only time I heard her mention her mortality was during a three-minute episode one afternoon about four months before she died. I was walking into the bathroom as she was walking out. Her eyes were red and her lips tight, the mask she wore between the toilet and her bed after a chemotherapy treatment earlier in the day. As she carefully lay down, I asked her, exasperated and confused, “Why, Mom? Why do you put yourself through this hell?”
She looked at me as if I’d said I’d just had a delightful tea with God. “Hope,” she said. “I do it because I want to live.”
Which, of course, is not what happened, not at all, because four months later she was dead at forty-two. And twenty-four years later, I am forty-one, the age she was when her cancer was found. The thirty minutes I spend sitting in the radiologist’s waiting room every February while my mammogram screens are scrutinized for shadows or spots are the longest thirty minutes of my year. While I wait in a mauve armchair, I run through the mental list of differences between my mother and me. She was a stay-at-home mother; I work. She had her third and last child at thirty-two; that’s about how old I was when I had my first. She spent her entire life in New York; I landed in California after fifteen years of jumping around. It’s my personal form of prayer, as if the recitation will somehow convince God to grant me just one more difference, the big one, the one my family needs the most. And then the radiologist returns with a smile and good news for one more year. Blessed evidence, again, that my mother and I are not the same.
Then, as I exit the lobby onto Wilshire Boulevard, I catch a sideways glance of myself in the building’s mirrored panels. It is my chin that juts out, my hair flapping against my back. But it is her chest pressing forward, her ass that protrudes. Her ass. And despite the morning’s news, it is still so easy to imagine, with each thought gliding smoothly and silently into the next: Her ass, her breasts, her fate.
Breast cancer, heart attacks, aneurysms, depression—the specifics don’t matter all that much. More than three-quarters of the motherless daughters interviewed said they’re afraid they’ll repeat their mothers’ fates, even when the cause of death has no proven relationship to heredity or genes. Ninety-two percent of the women whose mothers died of cancer said they feared the same demise either “somewhat” or “a lot.” The same was true for 90 percent of those whose mothers committed suicide, 87 percent whose mothers died of heart-related illnesses, 86 percent whose mothers died of cerebral hemorrhages, and 50 percent who lost mothers to accidental death.
Like many of these women, my alarm grows not only from watching a mother die but also from the shadow of an ominous family tree. Cancer afflicted both my parents, all four of my grandparents, and my maternal great-grandmother as well. One of my mother’s younger sisters was diagnosed with breast cancer six years after my mother died, and despite what little certainty we have about the disease, we know it can hitch a ride on genes. I’ve lived for more than a decade now with the knowledge that I’m considered high-risk, that my lifetime chance of developing breast cancer, according to the medical geneticist who reviewed my family’s history, is as high as one in three. My challenge is to find a way to live that allows me a realistic amount of concern yet frees me from the certainty that, any day now, I will find the lump that is already programming me to die. It’s a delicate balance, and I haven’t quite achieved it yet. On good days, I figure my chance of getting breast cancer is so slim that I need not think about it at all. On bad days, I reassess my risk as inevitable. One hundred and one percent: That’s me.
Here’s what’s available to the high-risk daughter: Statistics. Odds. And, for heart disease and some cancers, early detection tests—which may or may not improve long-term survival, depending on which article you read. But statistics and test results don’t completely calm a woman’s fears. They appeal to her rational side, which isn’t necessarily averse to optimism but can’t squash her panic alone. My mother’s death from breast cancer left an emotional imprint on me, and that’s the part that can’t quite believe the same won’t happen to me.
When a daughter watches a mother die, especially from an illness, she becomes aware of her own physical vulnerability as a female. At some level, she already understands that the female experience is one of relinquishing complete control over the body.
Menstruation, gestation, and menopause progress at paces of their own unless deliberate medical intervention changes their course. But to see her mother’s system taken over by disease confirms one fear and encourages another: Her mother’s body failed too young, and the same can happen to hers.
This cognitive leap from the horror of a mother’s death to the fear of self-demise is a broad one, but easy for a daughter to make. The psycho-physiolog
ical connection between daughters and mothers begins the moment the physical tie is cut. With the severing of the umbilical cord, two female bodies face each other, separate, yet the same. A mother looks at a daughter’s body and sees her younger self; a daughter looks to a mother’s body for clues about her physical future. Bound by this symbiotic identification, daughters and mothers act as mirrors for each other, reflecting anachronistic versions of the self.
Alison Milburn, Ph.D., a psychologist in Iowa City, Iowa, who has counseled many motherless daughters, has observed that women with the most extreme fears of contracting their mothers’ diseases typically over-identified with their mothers during childhood. “As adults, they still see themselves as being very, very much like their mothers,” she explains, “and their mothers, most often, really reinforced that. As their daughters were growing up they said things like, ‘You look exactly like me,’ or ‘You’re exactly like me,’ or they responded strongly to events that happened to their daughters as if the events were happening to them.” When boundaries between mother and daughter are so fluid and ill defined, a daughter also can’t properly distinguish between her mother’s experience and her own. If cancer or heart failure or suicide took her mother’s life, she reacts to the illness as if it were a threat to her system, too.
Working in tandem with the hospital’s obstetrics and gynecology clinic, Dr. Milburn has seen this fear taken to its extreme. She’s counseled a college student who demanded a hysterectomy at twenty-five because her mother died of uterine cancer; a corporate executive who showed up for a breast exam with a chest full of pen marks, indicating the lumps she’d been monitoring daily for several months; and several mothers who requested prophylactic mastectomies in their thirties because they believed it would reduce their cancer risk.11 Through relaxation and thought-stopping strategies, occasional medication management, and discussions of risk factors and family histories, Dr. Milburn tries to disentangle these women from the belief that a mother’s and a daughter’s destiny must be the same. “The best way these women can emerge intact from a difficult health situation with their mothers,” she says, “is to begin to become less psychologically identified with them.”
That’s not an easy task, especially when a daughter has inherited her mother’s appearance or physical shape. Because this daughter can easily imagine her body overcome by the same disease, she’s the one who identifies most strongly with a mother’s experience when the mother falls ill. “Of course, having your mother’s shape doesn’t mean anything about the reality of what’s going to happen to you, but that embodied sense of connection runs very, very deep,” Naomi Lowinsky says. “The problem for the motherless daughter is, she winds up in a horrendous catch-22. In order to fully identify with her femaleness, she’s got to be in her body. But that also means identifying with her mother’s body, and if she associates her mother’s body with a terrible illness and an early death, it feels like the last place in the world she wants to go.”
Yet it can seem, at the same time, like the only possible place for her to end up. This is the secret that motherless daughters share: We fear we will die young. And not at some unspecified point in the future—no, we fear it will happen when we reach the ages our mothers were when they died.
“The magic number,” one motherless woman called it. “Oh, the invisible line in the sand,” another daughter said. “I don’t know if any other women have said this,” about eight dozen women have confided in me over the years, “but I’m afraid I won’t live longer than thirty-nine (or forty-five or fifty-three).”
The last math class I took was in high school, and I have to use my fingers to add any single digit to a nine. But I have always been able to tell you, without pause for calculation, how many years have stood between my current age and forty-two. Now, as I fast approach that deadline I’ve started to include months as well. And it gives me a small amount of comfort to know my mother was forty-two years and ten months when she died, which is practically the same thing as being forty-three.
This is Mortality Math 101, in which a mother’s age at death is a fixed value, and the only distance worth measuring is the one between here and there. We fixate on mental additions and subtractions, anxious about approaching the dreaded age—because what if we, too, die?—joyful, yet still fearful, about leaving it behind.
Living beyond a mother’s final year is a daughter’s exquisite reminder of her separateness. She did not—and now cannot—repeat her mother’s exact fate. This realization, says Therese Rando, can evoke a reaction similar to survivor guilt. “For some women, it’s very uncomfortable to survive past the age of a mother,” she explains. “They feel like they got extra time, and got something their mothers didn’t. They feel almost as if they were bad for getting away with it, and that if the mother didn’t have those extra years, they shouldn’t have them, either.” She believes this is why some people die when they predict they will, especially when they’re convinced they’ll die at the same age a parent did.
Two-thirds of the motherless women aged fifty-five and younger surveyed for this book admitted that they fear reaching the ages their mothers were when they died either “somewhat” or “a lot.” Some are so certain they’ll die that same year, they’ve designed their lives in preparation. Take Janine, for example. She was not quite two when her thirty-three-year-old mother died in a car accident, and although she was sitting in the back seat when it happened, Janine says she has no conscious memories of the crash. Nevertheless, she spent the next thirty-one years subconsciously waiting for the same accident to happen again, this time with her in the driver’s seat. “I never thought I’d live past thirty-three, which I didn’t even realize until I turned thirty-four,” she says. “All that time, I just never planned for the future. I sort of lived thinking in the back of my mind somewhere that I’d be in a car accident at thirty-three and die, so why plan beyond that? I had no future orientation whatsoever. I dropped out of college. I got a job, but I’d work only thirty hours a week so I had time to be an activist instead of working forty hours and saving money to go back to school or to open an IRA.”
So what happened, I asked, when she turned thirty-four?
“Well,” she says, “one thing was that I really started thinking about my mother. For years I could talk about her without crying. I’d just sort of tick off the facts very rationally. But when I kept living at thirty-four, I started getting very emotional about her death.” Passing her mother’s age shifted Janine’s focus away from her own mortality and allowed her to mourn her mother for the first time. She also found herself moving forward, without plans, into years she hadn’t expected to see. She recalls, almost wryly, “When I turned thirty-four, the future suddenly was here. Figuring out what to do with it, however, has been another story. It took me five years to come up with a plan. At thirty-nine, I’m just getting ready to implement it. But I worry about all those lost years. I sort of think that at sixty I’m going to be a bag lady unless I get my act together quickly.”
Janine’s fear of a foreshortened future is common among motherless women. Because a same-sex parent acts as a natural buffer zone between a child and her own mortality, as long as the mother is present, life—and not death—is the daughter’s image of her future. When that barrier is removed, death feels more imminent to her, and decidedly more real. A girl who at a young age loses a mother, also loses the ability to perceive herself growing into old age. If a mother dies or leaves at forty-six, she can represent a physical model for her daughter only until that age. Instead of envisioning herself as a matron of seventy-three, the daughter then sees early demise as a potential—or even inevitable—physical future for herself.
The psychologists Veronika Denes-Raj and Howard Ehrlichman tested this theory in 1991, when they compared a group of New York City college students who’d lost parents prematurely to a group whose parents were still alive. When they asked the students in both groups to predict how long they’d live, based on objective criteria
such as their genetic backgrounds, medical history, and past and present health behavior, those with parents still alive estimated that they’d live an average of seventy-nine years. Those who’d lost parents predicted that they’d live for only seventy-two.
Even more telling was the discrepancy between the groups when participants were asked to predict again, based on their “gut feelings,” that is, their hopes, fears, and dreams. This time, the group with parents estimated lifespans of an optimistic eighty-three years. Subjects who’d experienced early parent loss predicted that they’d live an average of fifteen years less—to sixty-eight. Once again, emotion prevailed over rationality. Even those whose parents were victims of random accidents with no potential for genetic inheritance expected to die young. That’s how powerful the parental model can be.
Most of us didn’t spend our childhoods obsessed with conscious thoughts about our mothers dying. Occasionally, we might have wondered about our own demise—Who’ll come to my funeral? Will anybody cry?—but chances are that we didn’t think about that very often either. To live in a world constantly aware and afraid of impending death would mean living in a state of perpetual fear and anxiety, a situation so intense it would ultimately consume us. From a very early age our protective mental faculties begin shielding us from the ongoing realization that life comes stamped with an expiration date. Because the concept of self-demise is too enormous, too incomprehensible for anyone to grasp fully at the conscious level, we exist instead in an ongoing tug-of-war between the fear of death, which we must have for purposes of self-preservation, and the illusion of immortality, which allows us to enjoy life.
The loss of a parent—especially a same-sex one—can drastically tip this balance. A mother’s death is as close as a daughter can get to experiencing her own, leaving her with the sudden realization of vulnerability and exposure. When my mother died, I remember feeling as if a tornado had blown through town and carried my roof away. Although I’d turned away from religion a few years before, I’d been raised in the Judeo-Christian tradition that houses its almighty God in a kingdom in the sky, and those early images never completely evaporate. The week after my mother died, I developed a bizarre, painful (and probably psychosomatic) stomach ailment, and I went to sleep each night for a week half-expecting a divine hand to reach down from the heavens and snatch me before I woke. This sounds ridiculously dramatic to me now, but I can remember how it felt then—that I was the next woman in line, that the next one to go would be me.
