Homeless

My mother, Ida, died a few years ago. By itself, her death could hardly be seen as a remarkable event. But the way she died was another matter altogether, because in the week before her death she was quite convinced she was already dead. Here's what happened.

Well along in her 97th year, her body was failing in every way imaginable. The problem list? A virtual textbook of geriatric medicine: cataracts; hearing loss; a small lacunar brainstem stroke (vertigo, diplopia), which had knocked her walking, already shaky, down a notch. Third- degree heart block, pacemaker duly implanted; atrial fibrillation; left ventricular hypertrophy from long-standing hypertension; vasospastic angina. Ischemic colitis, following the block-related bradycardia, which had mercifully resolved; a bleeding prepyloric ulcer, the antibiotic treatment for which was, in her view, decidedly worse than the disease. Urinary incontinence (pads, wet sheets, the inevitable recalcitrant bladder infections); osteoarthritis of the knees; impressive leg varicosities; and more than a little dependent edema.

As though this weren't enough, there was the mucous membrane pemphigus that had appeared some 25 years earlier; even on low every-other-day doses the consequent chronic glucocorticoid therapy had slowly melted away her muscle mass, to the point where she was barely able to walk with a walker, or lift a glass to her lips even with both hands. The skin on her legs had become tissue paper: tearing, bleeding, ulcerating—not a pretty sight. Come to think of it, the relevant text here may not be a book on geriatrics; it may be the Book of Job.

But mind and spirit? That was something else entirely. For, as she frequently put it (she was inordinately fond of aphorisms), “The chassis is dented, but the engine is running fine.” A marriage and family therapist during the last half of her life, she …