When her temperature crept up to 103, Rachel carried a pan of ice-cold water to her bedside and wiped down her face, hands, and arms. After the cool bath her temperature dropped to 101, but Rachel feared it was a temporary measure.
“Please,” she begged, “let me take you to the hospital.”
Mama Dixon stubbornly refused, claiming she’d be fine waiting to see Dr. Levine.
On Sunday morning, Mama Dixon’s temperature skyrocketed to 104, and she was too weak to continue her protest. Without offering an option, George called for an ambulance. When the paramedics loaded Mama Dixon into it, Rachel climbed in and sat beside her just as she had before.
“Once we get you to the hospital, you’ll be all right,” she whispered, but even as she spoke the words she was fearful of being wrong. After so many years of drawing strength from Mama Dixon, it was now time to give back some of what she’d taken.
It was Sunday, and the hospital was short-staffed on weekends. Once Mama Dixon was wheeled into an examination room, each small step forward was preceded and followed by long minutes of waiting.
Rachel stood beside the bed holding on to Mama Dixon’s hand as she listened to the sound of labored breathing and violent spurts of coughing. After each coughing spell, Mama Dixon would fall back against the pillow, her breath coming in wispy thin gasps. The small room, a sickly green color, was icy cold and devoid of any decoration whatsoever. When the nurse came to draw blood, Rachel left Mama Dixon’s side just long enough to hurry down the hall, find an orderly, and secure two heated blankets. She carried them back, covered the bed, and tucked Mama Dixon’s bony hands beneath the warm covers.
George arrived two hours later, his face drawn and his brows pinched tight.
“How’s Mama doing?” he asked.
Rachel gave a disheartened shrug. “Don’t know yet. She was terribly dehydrated, so they’ve started an IV, but we’re still waiting for results from the blood tests and X-rays.”
They stood silent for a moment, then she turned and asked who was with the children.
“I called Sadie, and she came over. She said not to worry about time; she’ll stay overnight if need be.”
Rachel gave a nod, indicating the solution was okay with her. The twins were ten years old now; they understood right from wrong; they knew never to walk away with a stranger and to scream if they were in danger. Those were the things she’d taught them, and now when Mama Dixon needed her more than they did, she had to trust that they’d learned their lessons well.
She and George stood silently beside the bed, the same fearful look etched onto their faces. Over the years they had weathered many a storm together and seldom been at a loss for words, but now there seemed to be little either of them could say.
It was after seven when the doctor came in with a report.
“It looks like your mother is going to be with us for a while,” he said. “She has a substantial amount of fluid in both lungs. We’re treating her with some heavy-duty antibiotics, and we’ll be starting her on oxygen. So far her temperature has remained steady at 104, but if it goes any higher we may have to put her on a ventilator.”
After the doctor left, there were more hours of waiting. Each time a nurse or attendant stepped into the room to check a machine or change the IV bag, either George or Rachel asked how she was doing. The answers were generally “Stable” or “Holding her own.”
After a while it became impossible to tell the nurses from the orderlies and the technicians. They came and went with little more than a nod or a stiff smile, leaving more unanswered questions and greater fear in their wake. At ten o’clock an orderly came and told them Mama Dixon was going to a room on the third floor.
“We’ll be moving her shortly,” he said.
Realizing that “shortly” could be a very long time in the emergency room, Rachel suggested George go home and get some sleep.
“I can stay here with Mama,” she said, “at least until she’s settled in a room.”
George bent and kissed his mama’s cheek. “Are you all right with that, Mama?”
She dipped her head ever so slightly and gave a frail smile.
“Would you rather I stay?” he asked.
She closed her eyes and wobbled her head side to side.
It was almost midnight when the orderly came and wheeled the gurney down the long hallway and into the elevator. Even after Mama Dixon was settled in her room and covered with three warm blankets, Rachel could see the way she was shivering.
“Are you still cold?” she asked.
Mama Dixon started to answer, but the moment she opened her mouth, a coughing fit took hold, and she struggled to catch her breath. When the coughing finally slowed, rivulets of perspiration dripped from her face, and the question went unanswered. In time, she was given a sedative that would allow her to get some rest.
Rachel stood by the bed and held her hand for a long while. Once Mama Dixon was sleeping somewhat peacefully, she whispered, “I’ll be back in the morning,” and left the room. In the lobby of the hospital, she called a taxi to come and take her home.
For the next nine days, Mama Dixon swayed back and forth. One day it would seem that she was improving, and the next she’d be worse than before. She slept when she could, but when she was awake the coughing fits came one right after another. They were so forceful they left her red-faced and wheezing for breath. From time to time she cried out because the pain in her chest was more than she could bear.
Rachel arrived at the hospital early in the morning, and she stayed until George closed the store and came to take her place. Mama Dixon spoke sometimes, but with the oxygen mask covering the lower portion of her face it came out muffled and hard to understand. Rachel sat by her side and watched as the machine counted heartbeats, rapid spikes one moment, then slowing to a near stop the next. She added blankets when Mama Dixon shivered and took them away when her face grew moist with perspiration.
On the tenth morning she found Mama Dixon’s bed empty, the blanket folded back and the nightstand cleared of everything.
The memory of the empty crib flashed before her eyes, and suddenly it was that morning all over again, the fear as great as ever. It swelled in her chest and slammed against her brain as she turned and ran toward the nurses’ station.
“Where’s Mama Dixon?” she shouted.
“Dixon?” the nurse repeated. “Helen Dixon?”
“Yes, she was in room 305—”
“She’s been moved to the ICU on the fifth floor.”
Panic did not bode well in the ICU. Sorrow, yes, tears even, but panic gave the staff cause for alarm. When Rachel burst through the doors looking wild-eyed and frenzied, Cecile VanTyne left her station and hurried over.
“Is there a problem?”
Rachel bobbed her head from one side to the other, trying to see past Cecile.
“I need to find Helen Dixon.”
“Ah, yes . . .” Cecile smiled. “You must be her daughter.”
Rachel nodded. “Why is she—”
Cecile reached out and touched Rachel’s arm. “Don’t worry—your mom is stable for the time being. Last night she had difficulty breathing, but she’s on a ventilator now and resting comfortably.”
“A ventilator?”
“I know it sounds scary, but it’s much easier on her. She doesn’t have to work to breathe; the machine does it for her.” Cecile turned and motioned for Rachel to follow. “I know she’ll be glad to see you. You were the last person she spoke of before they placed the intubation tube in her throat.”
When they reached the door of the room, Cecile stuck her head in and said, “Helen, dear, your daughter is here to see you.” The cheerfulness in her voice seemed strangely out of place.
Rachel remained by Mama Dixon’s side throughout the day. At first she spoke as though nothing were wrong, telling of the friends pitching in to keep an eye on the twins, of Hope studying for the school spelling bee and how Sadie had spent the night in the upsta
irs guest room.
As the sun dropped low in the sky, Rachel saw the weariness in Mama Dixon’s face, and the terrible truth curled itself around her heart in a stranglehold. Tears welled in her eyes as she lifted the limp hand and held it to her heart.
“Oh, Mama Dixon,” she said as she sobbed. “I hope you can feel how much I love you. I would have never made it through those terrible years without you. Please don’t leave us now. I understand you’re tired and hurting, but you’ve got to keep fighting. I need you, the kids need you, George needs you. You’re the one who makes our family whole. Without you . . .”
Rachel couldn’t finish the sentence, because the thought of being without Mama Dixon was too painful to even consider.
When George arrived, they both sat by his mama’s bedside. George wrapped his arm around her back when a coughing fit seized her, and Rachel held tight to her hand when she cried out in pain. It was long past suppertime when the pulmonary specialist came to talk.
“Dr. Kenneth Cornwell,” he said and offered his hand first to Rachel, then George. He listened to Mama Dixon’s chest, lifted her eyelids, and checked the intubation. After he’d made a few notations on her chart, he asked them to step outside the room for a chat.
With his eyes shifting back and forth between George’s face and the floor, he said, “I imagine you’ve already sensed this, but I need to tell you that your mother’s infection is not responding to the antibiotics. Her lungs are compromised, and she’s not able to fight this off.” He hesitated a moment, looking at George, then Rachel. “She was a smoker, wasn’t she?”
George nodded. “But she stopped more than ten years ago, when the twins were born.”
The doctor gave a regretful-sounding sigh. “The damage is sometimes irreversible. Right now, she’s fighting so hard to breathe that her body doesn’t have the strength to rebuild itself. I’d like to suggest that we put her in an induced coma. Chances are it won’t change what’s happening, but if she’s able to rest easier there’s a possibility she’ll regain her strength.”
“What’s the downside of that?” George asked.
“She may not respond when we take her off the medication.”
Rachel gasped. “Do you mean she might never come out of the coma?”
The muscles in Dr. Cornwell’s face tightened. “I’m afraid so.” He shifted his focus from Rachel to George, then back to her again. “I know it sounds harsh, but you need to know so when the time comes, you’ll be able to make the decision that’s best for you and your mother.”
Tears overflowed Rachel’s eyes and began rolling down her cheeks.
“There is no best decision,” she said. “They’re all horrible.” Without saying anything more, she turned and went back inside the room to sit beside Mama Dixon.
When he finished talking with the doctor, George returned to the room and sat beside Rachel. It was a long while before he spoke. When he did, his voice was weighted with sorrow.
“I told him not to do anything yet; maybe Mama will come around. We’ll see what happens in the next day or two.”
George stayed until almost midnight, and when he left Rachel remained behind.
“I’m going to stay with Mama,” she said, “because I know it’s what she would do for me.”
Sometime during the wee hours of morning, Mama Dixon slipped into a coma, naturally and of her own accord. Two days later, her heart gave out. She passed away with George and Rachel by her side.
ANOTHER SEARCH
Fairlawn, 1985
When Lara went from middle school into high school, no birth certificate was needed. Her school transcript was sufficient. No one thought to question a girl who was on the student council and got straight A’s.
Each time Lara passed such a milestone, Angela breathed a sigh of relief. She knew eventually the birth certificate issue would become a problem—if not this year, then the next or the one after that. Shortly after Lara entered her freshman year of high school, Angela realized time was closing in on her and decided to do something.
That November the car was in the shop for repairs, and it rained almost every day, but neither of those things was enough to dissuade her. She pulled on her boots, covered her head with a plastic rain cap, and trudged over to the Fairlawn Public Library. Although she had only the vaguest idea of what she was looking for, Angela settled herself at the reading table in the research section and began poring over books loaded with words like affidavit, whereas, and wherefore. She found a wealth of information on establishing a property claim, filing for citizenship, or registering a business, but there seemed to be nothing on birth certificates.
She was on the verge of giving up when she came across a weighty tome published by the Health and Human Resources Department. Halfway through the book she discovered a section titled DELAYED CERTIFICATE OF BIRTH. It was a scant three pages long but clearly spelled out what a person could do to obtain a certificate of identity if a child’s birth had previously gone unrecorded.
Previously unrecorded.
That thought stuck in Angela’s head. Since no one had ever seen a birth certificate, she could easily enough slide into the assumption that Lara’s birth had never been recorded. Which meant she could apply for one this way.
She read through the section five times; reading and then rereading each sentence to make certain she understood what had to be done. With each word, her pulse quickened. This was it, precisely what she’d been searching for all these years. A simple process for filing, a twenty-seven-dollar processing fee, and she’d never again have to worry about Lara not having a birth certificate. As she read through the pages one last time, Angela’s eyes grew teary, and her heart swelled in her chest.
Pulling the pad and pencil from her bag, she began making notes.
Full name of mother and father
Date and county of birth
Three pieces of documentary evidence
Notarized affidavit signed by one parent or legal guardian
After she’d listed everything she was going to need, Angela copied down the address for the Vital Records Registration office.
It was near dark when she left the library; the wind had picked up, and the temperature had dropped another ten degrees. When she rounded the corner of Chester Street an icy gust took her rain cap, but she ducked her head down and kept going, all the while thinking of how she’d go about getting the documents she’d need. She arrived home drenched and shivering, but none of that mattered; she’d found what she’d been searching for.
That night Angela told Kenny of her plans. “It’s not all that complicated,” she said. “We have to submit proof of Vicki’s death, a notarized statement saying we were Lara’s guardians prior to the age of seven, and three forms of proof.”
“That’s it?” he replied. “We don’t need a release from Murphy?”
She shook her head. “Nope. I’ve gone through the requirements word by word, and as far as I can tell, we’ll be able to provide everything that’s required.”
“Which is . . . ?”
Angela ran through the list again; in a few short hours she’d memorized every last detail. “First off, there’s Vicki’s death certificate. Then we prepare a statement saying Lara has been with us since her mother’s death and have it notarized. After that, we’ll need three forms of proof that Lara is physically here and living under our care.”
“What forms of proof are you—”
He wasn’t asking anything Angela hadn’t already asked herself, so she jumped in. “Her school records, her medical records, and a letter from the pastor.”
After years of working with the telephone company, Kenny knew with a government organization, things were seldom as simple as they were said to be. “Once you submit those documents, what happens?” he asked.
“My understanding is that they verify your claim and send out the child’s birth certificate.”
“That’s it?” he repeated, but there was no smile, and his jaw was rigid
as a washboard.
Angela seemed not to notice the look of concern stretched across his face as she rambled on with a tale of how she’d found this obscure bit of information in a book the size of two encyclopedias bound together.
“When we finally get Lara’s birth certificate, we should have a real family celebration,” she said happily. “Maybe take her to Paducah on a shopping spree.”
The ridges across Kenny’s forehead deepened. “You haven’t told Lara about any of this, have you?”
“Not about the birth certificate. She’s always known Vicki is her birth mom, and we’re her adoptive parents, but she doesn’t know we don’t have her birth certificate or adoption papers. Now, I was thinking that since we’re this close—”
He was already shaking his head. “I know you’re excited, but hold off mentioning anything until we actually have the document in hand. Right now she’s not questioning any of this, so why give her something to worry about when there’s no need?”
Before a week had gone by, Angela had all the documentation she needed. On Monday morning she wrote a letter explaining the situation and detailing her request, then packaged everything in a large manila envelope and mailed it off to the Vital Records Registration office.
She’d expected the birth certificate to arrive in a week or two, three at the most, but six weeks passed before the official-looking envelope appeared in their mailbox.
Angela anxiously slit the envelope open and trembled as she unfolded the single sheet of paper. Instead of Lara’s birth certificate, it was a form letter.
It stated that in the absence of a parental signature and/or guardianship documentation, the Vital Records Registration office would require an announcement ad containing the name of the birth mother and/or the name of the child’s father be placed in all applicable newspapers in the district where the birth occurred.
The second paragraph stated that once the announcement requirement had been satisfied, the court would set a date for the hearing.
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