My mind flew to earlier images, from the shadow next to me to the memories of the fierceness that had been my mother. Although she used to occupy endless space-or at least the 400 miles from her house to mine-she had gradually become almost skeletal. Still, I thought, she would snap out of this. The changes in medication that I had discussed with her neurologist would dissolve the fog, and she would once again remember my children's names. Certainly there had to be some remedy that would reverse her dimmed cognition and energize her slowed limbs.

Or perhaps her frailty was simply the latest of her clever ways to grab our attention. Was it possible that she could sit at a family dinner so passively when once she had dominated both food and conversation? Who was this feeble lady? What had become of my overbearing, controlling, but loving mother?

I was humbled by how much I missed the classic methods of her mothering. She had needed frequent contact and seemed to call and visit excessively. She focused on me and later on my children. This intrusion felt cloying, and I never quite got used to it. Her needs had surfaced and my defenses had rallied-thrust and parry-since I was 11. She mothered by overdoing and by ignoring boundaries. I resisted, resentfully, always troubled that my actions added pain to her unhealed childhood wounds.

I couldn't deny how difficult those dynamics had been for me. At the same time, her calls, her neediness, her overdoing were the currency of her mothering, and all of that had ended. As I gripped her brittle hand, I struggled to believe that my experience of being mothered was gone forever, despite my objections to the way she had enacted her role.

All around me, I saw stark evidence of the cycle of life: my mother's shriveled self, the weariness and vulnerability in my father's bristled face in a moment under the sun, my daughter's hungry eyes and selfless giggle, my son's certainties and missing teeth. Most of all, I saw the changes in my own face and in my husband's-deeper shadows and creases, hard-earned scars of having already lived half our lives. Shedding my familiar identity as daughter seemed to leave my wrinkles more exposed.

Although I knew that this cycle of life was right-it's in the blueprints-it was still a painful reckoning. I missed seeing my kids reveling in the bounty of their grandparents' passionate attention. I also felt deeply grateful for this time in which my parents were alive; this joy was mixed with my grief and my sense of impending greater loss. I also appreciated the gift of a few years of knowing true empathy and tenderness for my mother after decades of ambivalence.

Yet as I stood beside her, I inwardly rebelled against what she had become. The contrast between the formidable parent I had known and the meek woman next to me filled me with anger and pity. I tried to comfort myself, to will myself into acceptance. But my powerlessness as a daughter and as a physician to retrieve my mother's evaporated vitality overwhelmed me. Perhaps, as well, her decline was difficult because it foreshadowed my own future, when it will inevitably become my turn to wither- and, if I am lucky, to have my own grown children take me by the hand.