My parents moved to Los Angeles from Toronto in their thirties and greeted the sunny lifestyle there like a long lost friend. Both fair and blue eyed, neither of them started using sunscreen until well into their fifties, and even then it was sporadic. In my household growing up, one of the biggest compliments to get or give was to say, “you caught the sun,” meaning you were tan or even working on a sunburn.
So it came as absolutely no surprise to me a few months ago when, at my mom’s latest appointment with her internist he showed me an almost nickel sized spot on her cheek and said, “you need to get that checked.” And no further surprise when my dermatologist called me a few weeks later to say, “yeah, it’s a basal cell cancer, the easiest to treat, but it needs to come off.” I asked her if it could wait,why put my mother through this if it was unnecessary? But she reminded me that this cancer, while rarely life threatening, would eat away at her face and it wouldn’t be pretty.It had to happen.
The standard treatment for this kind of cancer is to use the Mohs surgical technique. It is simple, the surgeon takes away a thin layer of tissue and it is then examined under a microscope while the patient waits. If cancer cells are still present, the surgeon goes back in and removes another layer. Then that tissue goes to the pathologist who looks at it again. If there are still cancerous cells present, the surgeon takes another layer, and so on. Once the pathologist sees margins that are cancer free, the procedure is over. Simple but not easy for an 86 year old patient, especially one with dementia, as it can take several hours.My dermatologist says this is what we need and two weeks later I take my mother in for the procedure.
The beginning isn’t so bad. She winces at the anesthesia shot but otherwise is calm during the initial surgery. Because they use just local anesthesia we are in the dermatologist’s office, and have been spared a trip to the hospital. I stay with her of course, but I make the mistake of accidentally glimpsing the wound while the doctor is working and it takes all of my acting skills to look back at my mom, and smile. Yes,it is 2016, but to someone not used to it, any kind of surgery still looks bloody and just a bit barbaric. I remember when my younger daughter, Lily, split her chin open when she was four and had to have it stitched.My husband Mitchell, less squeamish than me about these kinds of things, held her gently while the doctor worked. Mitchell laid down flat on the examination table and Lily right on top of him,her back on his chest. It felt to him,he later told me, as if he was the one being stitched up, because his vantage point was almost the same as hers. She was a brave little soul, only coming out with the occasional, almost matter of fact, “that hurts…ow…just a bit…yes, that hurts.” Standing nearby, not really watching but likely a bit shell shocked from the drama and the copious amounts of blood of the injury itself, I thought I was doing fine until the doctor caught a look at me and somewhat sternly said, “You need to leave, you are pale and I can’t have you fainting in here.” So, feeling a bit like a bad mother but knowing that things were under control, I walked out.
This time, of course, I don’t have that option. We go back and forth a bit, as the doctor had warned us is common, waiting for the pathologist report. The two of us do okay in this small room, me making small talk, pointing things out the window, telling her, in fact, the story of Lily’s accident, which for her in her present state of mind, is a new one.Her sympathy for four year old Lily touches me. “Oh my, poor little dear, ” she sweetly says. I am not sure she understands how long ago this all happened but it doesn’t really matter. During the waiting periods she looks at magazines without any comprehension, her normal confusion made so much worse by exhaustion and stress.
Three hours later the doctor walks in,says, “We got it all, now we just need to stitch you up.” My mom, misinterpreting partly because of the doctor’s we’re done now tone, starts to get impatient only minutes into the procedure. The doctor has draped a paper sheet over her, a hole cut open for her to work on the stitching and my mom is turned to the side and looking at me.She is not in pain, but she starts to go mad with impatience. I try what has worked all afternoon, chatting away, asking her questions, cracking jokes.But she is having none of it.
“Okay, I want to leave now, why can’t I leave?”
“Because the doctor is stitching you up, you can’t leave in the middle, mom. It won’t be that much longer.”
THIRTY SECONDS LATER
“Okay, I want to leave now, why can’t I leave?”
“Because the doctor is stitching up, you can’t…” (I think you get the idea)
We do this at least five times, the doctor herself, starting to get nervous, chiming in, trying to sound breezy. Just a bit more time,Jill, you’re doing so great. Of course it reminds me of the false cheeriness I would use with my children when they were about to get a shot or needed a bone set.We’re all great here, nothing to worry about, what a fun afternoon we are having!
And then she starts to pull herself up while the doctor is stitching.The doctor pulls away before damage is done but she looks at me in alarm and I realize this could be a real problem.
“Mom you have to lie down.”
And I tell her why. We go forty more seconds, then she asks again. A change of tactics is needed.
“Mom how about if I lie down with you?”
“What? You can’t lie down, there isn’t enough room.”
Sometimes it’s funny how she can still make a total fool out of me. She is absolutely right, of course, but I say,
“How about this?”
I move my chair very close to hers, I put my hand on her shoulder and on the tiny bit of room I lay my face right in front of hers,my body awkwardly twisted and perched on the chair.Under the sheet I could whisper her my deepest secret, we are like two little girls at a sleepover, barely an inch apart.I can smell her anxious breath.She looks so old and sunken, and yet, in her eyes there is a terrified child.
“This is funny, it’s like when I was a child and Chris and I would build a fort under the dining room, do you remember that?”
“Sort of,” she says warily. She senses there is a trick here.
“We would get blankets or towels and drape them over the dining table and anchor them with the legs of the chairs.It would feel like a different world.Sometimes I would read in there alone but other times he and I would bring snacks in there or play games.”
“I think I remember.”
“And sometimes you would join us.”
“Really?” (Ok, I am not a hundred percent sure this last part is true, but she is now intrigued.)
“Or you would bring us tea with milk and lots of sugar.”(That part might be true.)
“You liked a lot of sugar in your tea when you were….children.”
I stroke her forehead, a gesture I so clearly remember her doing for me when I needed comfort that I automatically did it with my own children. She gives me a sad, slightly fearful look and I realize, she is the child now.It’s not that she still isn’t my mother, and it’s not that when I am with her I take care of her quite the way you do with a child, and I make a conscious effort not to infantilize or patronize her because I don’t think that does either of us any good. But no question, right now, there is a total flip. She is the child and I am the mother and that’s just the way it is.And getting irritated or annoyed about it,as much as I have in the past, is just useless.
She closes her eyes for a moment and I send up a brief thank you! to the universe. But it was premature because suddenly she starts to sit up again. Fortunately at this moment the doctor isn’t actively stitching, but she still gives me an eyebrow raise.
“Mom, please, you have to lie down, come join me, please.”
Sighing, truly annoyed at this point, she puts her face back down.
“I don’t remember ever being this close to your face,” I say. And she smiles and gives out a small laugh.
She still tries to get up three more times but somehow we get through it. The doctor hugs me when it’s over, looking herself more relieved than I would have imagined. I leave feeling triumphant, like I have just climbed up a mountain. When I say good-bye to her later in her condo my mother takes both my hands and looks seriously and directly into my eyes, with total clarity.
“Laurie, I am so lucky to have you, I know this isn’t easy for you.”
And suddenly she is my mother again.