No matter how they indulged her, she wore a constant look of demented misery. “Some people take a year to settle in,” Mrs. Kiyokawa said consolingly to the ashen-faced sisters.
When they came into her room bearing sashimi, cakes, and cookies, the first thing they saw was her slight figure slumped over in the wheelchair. She had become a mass of sorrows and frustrations barely comprehensible to herself. If only she would become an empty shell, how much easier life would be for her! They began to long for her to become completely senile. Once she was completely out of her mind and no longer able to tell the two of them apart, happiness and sadness alike might fade away.
But visualizing the long road ahead and the continuing exhaustion they must endure on the way, they felt as if they were being dragged into a bottomless swamp.
Never did they imagine that her days at Golden would terminate so quickly.
At nine-thirty one midsummer night, Mrs. Kiyokawa called from inside an ambulance. The siren could be heard over the telephone line. “Your mother has a fever. The first two emergency rooms we went to were full and turned us away. We’ve contacted a third one, and they are willing to admit her, but I need your permission.” She added apologetically, “This one has almost entirely private rooms.”
“Please go ahead,” Mitsuki said quickly.
There was no longer any reason to fret if her mother went into a private room. She telephoned Natsuki right away and told her the news, adding that since it was already late, she would go over alone to check on things. She looked up the hospital on the Internet, put on some lipstick, slung her purse—heavy with the items she always carried as protection from air-conditioning—over her shoulder, and went out to hail a taxi. Once settled into the back seat, she put on a hat, wrapped herself in a cardigan and scarf, and laid a lap robe across her knees.
She had rushed off like this just recently, when her mother had fallen from her wheelchair and was taken to the hospital. Here we go again, she thought. How many more times would there be? Outside her window was the meandering night scenery along Ring Road 7, which she usually looked down on from a bus window. The night scene was Asian to the core, motley buildings jumbled together. For all she could tell this might as easily be Seoul or Taipei. Before her there was only barrenness and bleakness—a scene totally without identity.
Mrs. Kiyokawa was waiting when she emerged from the elevator. Her usually youthful face looked drawn and old.
Mitsuki found her mother lying faceup in bed wearing an oxygen mask, her large-pupiled eyes wide open. It had been a while since she’d seen her lying down instead of sitting in a wheelchair. All those snacks hadn’t put any meat on her bones; her frame, stretched out under a thin blanket, was now flat as a board.
The oxygen mask made her large pupils stand out even more. Her eyes stared at the ceiling, not glinting as usual but seemingly covered with a thin film. Her lips were purplish. Her breathing was labored, her mouth ajar, and for some reason her tongue was twisted to one side. Phlegm stuck somewhere in her bronchial tubes made a strange gurgling noise.
But she was conscious. When she saw Mitsuki, she held out her left hand. Mitsuki clasped it gently, and her mother returned her grip with astonishing force.
Her bony fingertips were hot to the touch.
Then the night shift doctor came in. Since he was a gastroenterologist he couldn’t be sure, but he suspected aspiration pneumonia, caused by dysphagia—difficulty swallowing. Even if the antibiotics helped, she faced a long uphill battle.
“Considering her age,” he concluded gravely, “the outlook isn’t necessarily good. You and the other family members need to prepare yourselves.”
Prepare themselves? She looked at him in surprise, but his expression was bland, as though he had said the most ordinary thing in the world. Mrs. Kiyokawa’s face was still drawn but showed no surprise. Mitsuki thanked the doctor and walked Mrs. Kiyokawa to the elevator.
She was in a daze. When her father came down with pneumonia, she couldn’t remember ever having been advised to prepare herself. Use of cell phones was not allowed in the hospital, so she asked at the nurses’ station and found that there was a telephone room downstairs. She descended the dark stairs, still in a daze.
She reported what the doctor had said, and Natsuki replied, “This may very well be the end then.” For once there was not a trace of irony in her voice. She sounded quietly moved. Her sister’s calm allowed Mitsuki to slowly grasp the situation.
She went back to her mother’s room. Nothing had changed. Her mother was still breathing with difficulty, eyes wide open. Mitsuki bent over her and stroked her upper arm, mere skin and bones. Speaking slowly, she explained in a voice loud enough for her mother to hear: “Mom, you’ve got pneumonia. Your fever is high, so until the antibiotics start to do their job and you get better, you’ll have to stay here in the hospital a little while.”
Her mother nodded and said “Mkay.” She sounded like a child.
With a cardigan around her shoulders, Mitsuki continued to stroke her mother’s arm while her mother, struggling to breathe, did nothing but open and close her eyes. Mitsuki was fighting exhaustion, yet was caught up in excitement at the same time.
Then her mother spoke. “You have things to do. Go on home.”
The voice was phlegmy and hard to make out, but that was definitely what she had said. Though taken aback by this unexpected display of consideration, Mitsuki decided to follow the suggestion. “I’ll come again tomorrow,” she said, gripping her mother’s hot hand, and stood up.
After leaving the room, she stood just outside the open door and looked back in. Still lying motionless with her eyes closed. Maybe she’d gone to sleep.
The buses had long since stopped running. She got in another taxi, slipped her arms back into the sleeves of her cardigan, put on her hat and scarf, wrapped her knees in the lap robe. Thus bundled up, she watched the night scenery run backward this time out the car window and thought about last night’s sashimi.
Yesterday she had taken a different route and so had dropped by a different supermarket. A package of flounder sashimi, a favorite of her mother’s, contained five slices so exquisitely thin they were translucent and cost just over a thousand yen. The package next to it contained a generous assortment of scallops, salmon, and amberjack sashimi and was only six hundred yen. She used her mother’s money for such shopping, and as her mother was presently comfortably off, she should have gone ahead and bought the flounder, but she had formed the habit of being careful with her mother’s money. Her instincts told her that a thousand yen for five extra-thin slices of sashimi was too much.
In her mother’s room, she’d cut up the sashimi into tiny pieces as usual, using a pair of kitchen shears, but there was so much that she ended up doing it in rather slapdash style. She should have watched as her mother ate, but instead she stood diagonally behind her, sorting little cookies into plastic bags for the staff to keep and only glancing now and then at her mother’s back as she hunched over the food.
Her mother ate ravenously, like a hungry ghost of Buddhist lore. Her bent back told the shameful way she was eating—so shameful it was hard to believe this could be her mother—and Mitsuki couldn’t help wanting to avert her eyes. Her mother had always taken care to eat gracefully during meals, but those self-conscious manners were pitiably gone.
Around the time she finished off the sashimi, she started choking. Mitsuki had rushed to her side and found a sticky, semitransparent substance pouring from her mouth, more than she could wipe away no matter how many tissues she used. Where could it all be coming from? Ashamed, her mother regained a sense of what was happening and wiped her mouth, apologizing. After ten minutes or so the coughing fit had passed.
Today she had choked on her food again at lunchtime. Golden called and said they would keep an eye on her, but at night she’d developed a fever.
The doctor’s words rang in Mitsuki’s ears, but no. Her mother would never die so easily—the idea was pr
eposterous. But just supposing she did die, then by buying the less expensive sashimi and failing to cut it up properly, would she, Mitsuki, have committed matricide?
Before she knew it, the taxi was near Myohoji temple.
When it pulled up at her building, she got out, raced indoors, slipped off her shoes, and went straight to the computer on her desk in the bedroom. She turned it on and did a search for “aspiration pneumonia,” which turned out to be a common cause of death in the elderly. It did not happen out of the blue. Rather, it was related to problems in swallowing and was common in cases of dementia, occurring when improperly ingested food entered the airway and eventually the lungs. Another contributing factor was the inability to cough when lying down. “Aspiration pneumonia occurs at night,” one article said.
Even if her mother now died, she, Mitsuki, wouldn’t be a murderer. But she would definitely have shortened her mother’s life all the same.
By the time she got into bed, she felt defiant. If she had shortened her mother’s life, so be it. Surely her mother would have no complaint if she could die before turning into something even less like her old self. Now perhaps all of them—her mother included—would be free of her: the thought swam in her head, along with an image of her mother’s face bearing the seal of death.
It was the middle of the night, too late to call, but she had no doubt Natsuki was lying awake too, gripped by a similar fever of excitement. As she stared into the darkness, Tetsuo’s still unsuspecting face floated up in her mind.
LOW-CALORIE INFUSION SOLUTION
The next day, Mitsuki met up with her sister, and they went to see their mother together. When they arrived, she was sleeping, but her oxygen mask had slipped out of place. Seeking oxygen, her open mouth was cavernous, a dark pit. Her tongue was still twisted to one side, and she was wheezing. Not only her lips were purple; in the light of day, purplish speckles covered her entire face.
Mitsuki readjusted the mask, touched her mother on the shoulder, and whispered, “Mom.” Her fingers encountered mere bone—artificial bone at that, since this was her right shoulder.
She hadn’t been asleep after all, it seemed, for she instantly opened her eyes wide and looked at them with recognition. “Natsuki’s here too?” Her tongue couldn’t move. Her voice was barely audible.
“Gorgeous me, in the flesh.” Natsuki pointed at herself comically.
Their mother, despite the state she was in, smiled contemptuously and said, “You’re nuts,” before turning to Mitsuki. “Where am I?”
She might be able to give a flippant response, but her powers of comprehension were clearly gone. Mitsuki bent over the bed, her mouth close by her mother’s pillow, and repeated the explanation she had given her the night before. Once again, her mother nodded and said, “Mkay,” docilely, like a child—then added, apropos of nothing, “I’m hungry.”
Lately she said this often, making it impossible to know whether she actually did feel hungry. But last night the doctor had intimated that she might soon die, and Mitsuki frankly hoped she would. Her inability to wish that her mother would get well enough to eat again gave her a pang.
Still bent over the bed, she told her mother that she couldn’t eat anything now, but that the bag overhead contained nourishment that she was getting, so not to worry. In fact the bag contained a low-calorie solution that was not enough to support life for very long.
“Can’t I have some candy?” she whispered, looking up at the IV bag.
“No candy.”
“No fun.”
Neither of them responded.
“This is no fun!” she croaked again, her tongue stiff, her voice slightly louder than before. She kept breathing with her mouth open to get oxygen, so the inside of her mouth must have been bone dry.
“You’ll have to be patient, Mom,” Mitsuki said in the gentlest voice she could muster. “That’s just how it is.”
From below the oxygen mask, her mother replied in a low, husky voice, like a man’s. It didn’t sound like her voice, but the words were definitely hers. “I’ve had it. I can’t—this is for the birds.”
“She was saying that before too,” said Natsuki behind her in a low voice, and despite the gravity of the situation Mitsuki felt laughter bubbling up, when in came the doctor.
Thanks to her mother, Mitsuki had had occasion to meet all sorts of doctors, and while knowing it was rude, she couldn’t help taking private stock: medium height and weight. Balanced features. Looked to be in his early forties. Hair shiny, expression smooth. Probably sincere but looked like a pampered son who had never known hardship.
On the outside at least, the sisters listened respectfully, like dutiful daughters, as he spoke.
“First we have to see whether the antibiotic does the job.”
They nodded.
“She’s not young anymore, so don’t get your hopes up. You need to understand that.”
This was virtually the same thing the other doctor had said the day before.
“One more thing. If she pulls out her IV at night, restraints may become necessary. Is that all right?”
They assented and saw the doctor out. No sooner was he gone than Mitsuki cried out: “Oh! We should have him take a look at that paper.”
“What paper?”
“You know. That signed statement from the Society for Dying with Dignity. It’s a copy, but she was always adamant about it. Insisted we show it to them if they ever came for her by ambulance.”
Mitsuki ran out into the corridor and caught up with the white-coated doctor. She showed him the paper and explained politely but firmly that her mother had joined the association in her sixties and always stressed that she wanted no heroic measures.
In recent years Mitsuki had taken to carrying the statement around in her purse (along with the tag for a hard-to-find brand of underwear that her mother liked, inscribed with the product name and her size). The number of Japanese doctors antagonistic to the concept of death with dignity was decreasing, she had heard, but this doctor in his forties could be a diehard right-to-lifer for all she knew.
He glanced at the paper she held out.
She took the precaution of adding that when her mother was no longer capable of eating on her own, she didn’t want a nasogastric tube or, God forbid, a gastrostomy.
A nasogastric tube was a slender feeding tube inserted through the nose and down the esophagus into the stomach; a gastrostomy was an operation to implant a feeding tube directly into the stomach. Being your elderly mother’s caregiver meant learning words you’d never seen or heard of before—words you were better off never having to encounter. How sad, she thought.
When she was a little girl reading novels, many in translation, she’d picked up new terms naturally: “fir tree,” “windmill,” “fireplace,” “carriage and four,” “fairy.” The illustrations were pretty, but those unfamiliar words themselves had had the magical power to take her out of the shabby little house in Chitose Funabashi and into a mist-shrouded realm that was and was not of this world. The novels she’d read in adolescence had been full of words that filled her with dreams of one day becoming a grown-up woman: “silk stockings,” “black lace gloves,” “velvet cloak,” “rouge,” “satin obi.”
Back then she could hardly wait for her life to begin.
And yet at some point life had forced her to learn words utterly devoid of poetry and romance. “Femoral-neck fracture”: that term for a broken hip she had learned a dozen years ago at the time of her mother’s accident. “Dysphagia,” “nasogastric tube,” “gastrostomy”: until recently she hadn’t known any of these words, but now they rolled off her tongue. And now she could add “aspiration pneumonia” to the list.
The doctor handed the document back, nodding, and said, “Yes, of course. I understand.”
When she returned to the room, her sister asked, “How’d it go?”
“He said he understands.”
“Really?”
She sounded relieved yet vag
uely doubtful.
They took turns going to see her and always kept fresh flowers in her room. Before, whether at the hospital or at Golden, they had avoided bringing her flowers so as not to cause the staff extra work. Now they sensed that this stay might end up differently from all the rest, which meant that one or the other of them would be going to see her every day, so they could tend to the flowers themselves.
The antibiotic did not take effect.
It was uncomfortable having to frequent the hospital in midsummer, with air-conditioning at its peak, yet Mitsuki found these visits more peaceful than before; since her mother mostly slept and didn’t speak, there was no need to interact with her.
Administered only the low-calorie solution, her open mouth a dark cave, she grew even more emaciated. As instructed in the “Patient Guide,” they had brought along a toothbrush and toothpaste, but brushing her teeth was out of the question since any water going down the wrong way could be fatal. A nurse wearing plastic gloves would moisten the inside of her mouth with damp gauze, carefully remove clumps of dried black sputum, and clean her tongue. Two front teeth were so loose she was in danger of swallowing them, so they were pulled, first one and then, two days later, the other, leaving her mouth even darker than before. When she was awake, a nurse would perform suction, inserting a narrow tube down her nose to remove phlegm. This was apparently very uncomfortable, and she would try to brush the tube away with both hands. Mitsuki assisted the nurse by holding down her mother’s hands. It was distressing to see her writhe and struggle, but after suction her breathing came a bit more easily.
Another two days passed peaceably by, then three, then four. Mitsuki and her sister visited their mother on alternate days and kept in touch by telephone, discarding the withered flowers in her room and replacing them with fresh ones. Mitsuki took her laptop with her and worked on translations while she was there. Once in a while she would look up and check on the bag of milky fluid hanging over her mother’s head.
Inheritance from Mother Page 16
