“Anyway, the man should never have been brought to trial.”
My father was sixty-one years old at the time DeSalvo wrote that letter to him. He continued with his work for the mental health department and the state judiciary until he was seventy, but he kept on with his practice of psychiatry into his early eighties and never really gave up on the writings he was trying to complete, no matter how chaotic those writings had become, until the year he went into the nursing home.
Twelve more years had passed since then. It was now 2008. My father was 102 years old. In terms of sheer longevity, he had nearly caught up with my mother. But the signs and symptoms of his terminal fragility—“the indications,” as he might have worded it—were clear. The final hours of his life, I knew, were near at hand.
CHAPTER TWELVE
The Future in Our Memories
This is how I learned that it was time for me to give up my resistance to finality.
I was in Chicago on a day in August when my father became ill again. He had developed a recurrence of the old infection in his urinary tract and, when Julia notified his doctor, she said she would phone a new prescription to the pharmacy across the street from the apartment. Julia later told me that she felt “a funny kind of hesitation” when she got the medicine and gave the dosage written on the bottle to my father.
“I wasn’t sure why I was hesitant at first. Then I spoke to Silvia and I told her what the medicine was called and she said the doctor had prescribed it once about a year before and your father had reacted badly to it.” Silvia had been convinced he was allergic to that medicine and, after she had told this to the doctor, she had been instructed not to give him any more.
“I must have had some memory of that under the surface of my mind, but it was too late by then. I’d given him the medicine.”
By the end of the afternoon, she said, he was very nauseous and began to vomit. “I didn’t wait to call the doctor back. I took him to the hospital.”
My plane got into Boston sometime after midnight and, because I had forgotten to turn on my cell phone when the plane had landed, it was not until I walked into my house, an hour north of Boston, that I found a message there from Julia on my answering machine. She had included the name and beeper number of a doctor at the hospital.
The doctor, who responded quickly, reassured me that my father’s pulse, although it had been “very low” when he was admitted, was “regular” now and that his temperature was normal. His blood pressure had been high, the doctor said, but had since been stabilized. “I’m confident he’ll be okay tonight. If I were you, I’d get some sleep and wait until we have some test results to give you in the afternoon tomorrow.”
When I spoke with Julia, who was with my father still and said she would remain there with him at the hospital, she sounded less alarmed than in the message she had left me earlier. “I don’t think you should drive all the way back into Boston at this hour. Try to sleep. I’ll wake you if there’s any change in his condition.” The relief in Julia’s voice reassured me temporarily. At the same time, I had the premonition that the information I was to be given the next day would not be optimistic.
My father’s status remained stable in the morning but, by the early afternoon, I was told he was deteriorating quickly. It was now believed he’d undergone a cardiac arrest before the ambulance had brought him to the hospital. “Blood and oxygen cessation from a cardiac arrest,” the senior resident informed me, “does neurological damage. Some of the damage is immediate and some is delayed.” Using a term I’d often heard my father use in speaking of brain injury, he explained, “We know that he already underwent a major insult to his brain because of his Alzheimer’s. Now he’s had a second insult. If he doesn’t have another cardiac arrest today, the neurology team will examine him tomorrow to assess his brain-stem functions.”
In the “worst-case scenario,” he said, “the part of the brain that triggers breathing would no longer function. That’s the last thing that the brain gives up. I wish I could tell you…,” but I interrupted then to ask how soon my father’s life would end if I should determine to take him off his life supports that evening or the next.
“Once we begin the morphine drip, given his condition, it would likely be no more than a few hours.”
I told him I would be there before evening.
Efficiency is a convenient anesthetic. I gave myself some time to compile a list of people who would have to be alerted. I sent the list to my assistant. Then I asked her to begin to make “arrangements,” which I knew I did not need to specify, because she was prepared for this, but I did it anyway. I tried to reach my sister. I called her several times and left a message on her phone. She traveled often, so I wondered if she was away. I gave my assistant the numbers for my nieces, who, I thought, might reach her before evening. I don’t believe she got the message until late at night or early the next morning.
Then I made another list: writings published by my father, dates and markers in his medical career, the years when he began his studies at the MGH and Boston Psychopathic, then at Dr. Meyer’s clinic at Johns Hopkins, then when he began his practice in neurology….I did this obsessively. Now I wonder why I wasted time like this instead of simply getting in my car and heading for the hospital. It’s possible that making myself very busy in this manner helped me to pretend somehow that things were still as they had been, maybe as they would continue being, even while I knew beyond the slightest doubt that the end of Daddy’s life was now at hand.
Possibly, too, I was afraid that if I spent the hours of the afternoon sitting at his bedside, imagining (as I would surely try to do) that he was giving indications of responsiveness to me or thinking that I could divine some other indications of resilience and vitality, I’d lose the feeling of resolve at which I had arrived. I didn’t want to walk into the hospital until I was prepared to let my father die.
Silvia was at his bedside when I came into the room. Julia, who had had no sleep the night before, had finally gone home to rest when Silvia arrived. Silvia had been the most ferocious champion and partisan defender of my father’s life as long as any of those satisfactions she religiously detected in him still remained—good appetite, small sparks of humor, spirited resistance to demands she made, or simply that endearing smile, which I sometimes thought was all she asked for in exchange for serving him so faithfully. A single look at Silvia’s eyes said everything: acceptance.
The doctor told me that my father’s kidneys had shut down. “Most of his other organs have shut down as well. Blood coagulation is no longer functioning.” His cerebral condition was now “comatose,” the doctor said.
I signed the DNR when it was handed to me. It had no meaning now. An intravenous line was already in his wrist. His face was pale. His eyes were closed. When I bent to kiss him on his cheek, he made not the slightest stir.
The morphine drip began a little after seven. It was intensified by increments over the next hour and a half. I did not ask Silvia to leave me. Around eight-forty-five, the doctor came back to raise the level slightly. Silvia stepped away from the bed and went to stand beside the window.
From that time on until he died, I held my ear against my father’s chest and listened to his breathing as it came at longer, then much longer intervals. At four minutes before nine o’clock, his breathing stopped. The doctor came into the room again, took out his stethoscope, and listened to my father’s heart. When he looked up at me, there was nothing that he had to tell me.
My father’s doctor showed up in the corridor soon after I had left his room. She came with me and Silvia into a kind of living room at the far end of the floor. Neither Silvia nor I asked her any questions about the medication she’d prescribed to which my father had experienced a bad reaction in the past, but the doctor introduced the subject on her own. “I had no memory,” she said, “that your father was allergic to that medicine….” I remember wondering: Didn’t doctors take a look at a patient’s records when they wro
te prescriptions? But I wasn’t in a state of mind to pursue the matter.
A few moments later, as I came out to the corridor, where a nurse was waiting to confirm that I had made arrangements for the disposition of my father’s body, the young physician with whom I’d developed a close friendship after meeting at my father’s bedside when he was in the hospital about three years before came racing from a doorway and, without a single word at first, she put her arms around me and just held me close to her. She told me she had been on duty on another floor but had learned—I didn’t ask her how she knew this—that my father had just died. This wonderful, kindhearted doctor, the daughter and granddaughter of physicians as she’d told me, held my hand as she walked me to the elevator bank. When the elevator came, she squeezed my fingers very hard and promised she would call me the next morning.
I got down to the lobby and walked across to the garage and, for the longest time, I couldn’t seem to figure out where I’d left my car. Then I walked around one of those concrete posts, up another level, and finally found where I had parked it, and got in and sat there for a while before I turned the engine on. I don’t know why I couldn’t cry.
—
Nearly ten years before my father died, while he was in the nursing home, he wrote a memo that contains these words: “We expect more than the common descriptions in popular mockings of penetrating studies. ADVISE: The future remains something in our memories. We are curious, but our patients upon review may benefit….I look forward to seeing more of you once I am returned to this hemisphere.”
In a second memo, he wrote this: “I have recently been received of a physician who is well spoken of. Materials should be a great help to students—i.e., to totalize and orient the most helpful comments. Soon I may begin to work on these areas of memory of the most serious.”
I have had the opportunity to think a great deal since my father’s death about the truthfulness of memory. Neuroscience, which has undergone extraordinary breakthroughs over recent years, tells us there are reasons to distrust what we are certain we remember. This is, obviously, not a wholly new idea. Freud, among others in the psychoanalytic schools of the early 1900s, recognized that memory is subject to distortion by unconscious forces that may help us to suppress the pain of past events and allow us to create convincing but fictitious explanations for sufferings we undergo at later stages of our lives. But modern neuroscience carries these ideas considerably further by questioning the very notion that memories exist like so many fixed and hardened entities, “memory deposits” as it were, in some portion of the brain, and that our only challenge, when we remember something, is to extract it, like a bank withdrawal, from the account in which it is contained.
Neuroscientists today would argue that there isn’t any bank account, or storage box, in which our memories are waiting for us to retrieve them—to “reach in and pull them out”—but that there is, instead, only the act of remembering itself, in which electrochemical activity between the neurons of the brain re-create portions of a memory that may be accurate reflections of a previous experience but frequently are not.
“Memory is not a literal reproduction of the past,” writes Daniel Schacter, the chair of the Department of Psychology at Harvard University and a widely respected scholar of the workings of our memory. It is, instead, “a constructive process” by means of which “bits and pieces of information” that may come from a variety of sources are reassembled, as it were, into a new reality. And that act of reconstruction, he observes, may be affected by a number of distorting factors. One of them, for instance, is the attribution to a past experience of information we possess today but did not have available at the time of the occurrence or the conversation we believe we are remembering. The results of these and other sins of memory, to use Schacter’s words, may give us “a skewed rendering of a specific incident”—or, indeed, of more extended episodes of our experience.
Obviously, the notion that we re-create and, in the process, reinvent some portions of our memories runs directly counter to the longing for a sense of certitude that most of us naturally feel about our recollections of people that we loved. Nonetheless, the compelling nature of that argument leads me to reexamine, with perhaps more diligence than otherwise, some of my own memories of my father’s life, especially the ones that depend, in turn, on memories that he himself conveyed to me, as well as those my mother has recalled.
Fortunately, many of my memories, and theirs, are corroborated by that plenitude of documents stored here in my home ever since my father shipped them to me, as well as by the others I had found in the apartment that he hadn’t had the time to organize.
Among the most delightful of these documents, one that I discovered only recently, is a letter from a woman named Aurélia Thiérrée, the daughter of Victoria Chaplin and a great-granddaughter of Eugene O’Neill, who at the time was living in New York and was soon to embark on what would be a remarkable stage career. According to her letter, she was about to go to work with the film director Milos Forman but was meanwhile working as a volunteer with children in a neighborhood of Harlem. She spoke about the joy she took in tutoring the children but also of her “sense of uselessness” and feelings of “frustration” at how little she could do to alter the conditions of their lives.
Aurélia, as I realized now, had been more than passingly acquainted with my parents. She had come to know them when she had accompanied her mother at some of those times when they entertained Victoria in Boston. “Our dinners together remain,” she wrote, “some of the most agreeable and fascinating memories I keep. Hearing from you about my great-grandfather was priceless in its depth of meaning to me. Thank you!”
I had sometimes wondered if the intimacy of my parents’ friendship with the Chaplins and their children had been overstated in my mother’s recollections. Now I was happy to discover, in Aurélia’s beautifully handwritten letter, that the many stories my mother had told Julia about her closeness to Aurélia’s family had not merely been the sweet concoctions of the years when she began to entertain herself with fantasies.
Letters from Oona, of which I have read several—affectionate and impulsive letters and, until her husband’s death, generally cheerful, filled with news about her children—have a similar effect in countering whatever doubts I may have had about my mother’s memory. (“Geraldine just had a baby boy,” she wrote in 1974, “and is on top of the world….The rest of the family [is] keeping out of jail, so life is very pleasant….”)
Other letters that I’ve read from relatives of people Daddy treated represent a different kind of affirmation—reinforcing, for example, memories that I’d retained about his methods of examination and the way that he negotiated complicated family situations. Then, too, there is the information I have now and then received in person as the consequence of a chance encounter with a man or woman who was once in treatment with him.
Two months after Daddy’s death, I was at a university in Pennsylvania to make a presentation to the undergraduates. At the end of my talk, a woman who appeared to be in her early fifties, or maybe slightly older, introduced herself to me and, after telling me about her work with troubled and disabled children, said, “I knew your father. He was my doctor when I was a teenage girl. I’d love to talk with you someday and share some of my memories.”
The two of us soon began a correspondence. The story she told me of the treatment she was given by my father reminded me of several of his other cases in that she was not the only member of her family he had treated. “You see,” she said, “before I knew your father, he had helped my father when he underwent a serious depression. At the same time, he was giving counsel to my mother because she had to bear the burden of my father’s illness. So he was seeing both of them at once, helping my father to emerge from his depression while giving my mother emotional support to keep her on an even keel while she was coping with my father.”
Her father, she said, had been an active man, but, when he was nearly fifty, he h
ad had an orthopedic problem that temporarily prevented him from walking, and it had been handled badly by an orthopedic specialist, who told him that the problem in all likelihood was irreversible and that he would probably be in a wheelchair soon. “That was when he fell into this terrible depression. He couldn’t continue with his work. Before long, he’d withdrawn from almost everything outside our home, until it occurred to him or to my mother to reach out to your father, who had been a friend of his in college….
“I don’t know exactly what your father did, but my mother said he was incensed by the behavior of the orthopedic specialist. I think he brought him to another doctor, another specialist, somebody he trusted. His own treatment of my father was purely psychiatric, to get him out of that depression, and it was amazingly successful. My father was walking normally again within another year. Thanks to God, there was never any wheelchair!”
About ten years had passed, she said, before she had to face a crisis of her own. “I was eighteen at the time and I wanted to drop out of college. That’s not so unusual these days but, when I was growing up, ‘good girls’ didn’t do that. And I had been a ‘good girl’ and had always tried to do exactly what my parents had expected. But suddenly I realized I wasn’t ready yet to be in college. I didn’t want to be there. I was feeling panicky and underwent anxiety attacks. I worried how my parents would react to this….
“When I told the college that I wanted to take off a year, they said I’d need to get a medical excuse for leaving if I ever wanted to return. The college sent me to its own psychiatrist, some doctor that the college had retained, I guess, to deal with problems like this. I hated him! I refused to talk with him.
The Theft of Memory Page 17
