from No Vital Signs

by Laurie Tollman

January 25, 2004

It’s a brisk winter day as I pull my Subaru station wagon into a visitor space in the parking lot of the nursing home. Despite the cold, I open the door and let the air blast inside, airing it out before I make my exit. I’ve been chain smoking since I left my brother Larry’s house just outside Atlanta. My brother is kind enough to play host when I drive from North Carolina for my monthly visits with my mother, a promise I made to her and to myself as she withered away in a stark hospital bed in Carrollton, Georgia. For forty-five minutes I’ve been driving west on the interstate toward the Alabama line, toward my mother, smoking cigarette after cigarette and blowing the gray cloud out my window, hoping that none of the smell gets inside my car.

Smoking cigarettes is a secret I’ve been keeping from most people for almost two years. I had quit smoking for seventeen years but started back after my kids moved to California to live with their Dad and my second marriage ended in divorce. After an especially bad day, a friend suggested a Marlboro to calm my nerves, and instead of declining, I took it as if it was nothing unusual. After reading an article that proved lower risk for “five or less” I tried to control the number, but as with all my efforts to control addictive substances, I had better success some days than others. Ironically, the vacuous smoke was holding me together.

I keep telling myself I’m not supposed to have any faults. I am a professional woman, executive director of a halfway house for men. But extra effort is needed to prove that I’ve pulled myself together for my monthly visit with Mom. I’m wearing casual, comfortable clothing, hair perfectly combed, minimal makeup, nothing obviously out of place. But I know the truth—the cigarettes are my compulsory addiction that breaks the veneer of perfection. I have allowed myself this seemingly innocent obsession with tobacco to cope with the stress of watching my mother wither away, her body matching the image I held of her for years; a vapor, a wisp of a human, hovering as a nearly invisible ghost.

Breaking out of the warm car, I feel the cold air crash into my face, taking my breath away worse than the cigarettes. Walking quickly into the nursing home, I’m eager to get into the warm building. Hastily approaching the nurses’ station, I sign my name in the green three-ringed binder placed on the counter for visitors. I put on a fake smile for the attendant and turn to walk down the hallway toward my mother’s room. The stench of urine and pine disinfectant pries its way into my nostrils.

As I approach Mom’s room, her television blares generic voices that are her constant companion. Since her decision not to get out of bed, she keeps this entertaining black box on day and night. At the threshold of the room, I peer inside and see my mother lying in her bed, clothed in a pale nightgown matching her sallow skin. Her body makes a crescent, curled into itself facing the door. Her eyes are closed, like she’s asleep. This scene is replayed every time I’ve visited her in the past six months with only slight variations. She is slowly closing herself off from the world.

Mom has been lying in bed for almost two years. She has come to terms with her life and our once broken relationship has healed. As her body has slowly deteriorated, her mind and soul have inversely grown more whole. As her life ends, I am finally seeing her as the woman I knew she was: kind, gentle, and strong. What strength it has taken for her to continue to will her body to live after her suicide attempt has practically destroyed her brain. The after-effects of her overdose are a body paralyzed and in pain, and a mind that rides an emotional roller coaster of anxiety and depression. Despite the damage, I believe that she willed herself to live to heal her spirit and her relationship with my sister and me.

Mom’s hospice worker has been to see her, and they don’t know how much time she has left, but I assume not much. She remains very still, with her eyes shut almost all the time. The nurses say she doesn’t eat much at all. The last time I asked to look at her chart, they showed me a page on which was written, “weight 85.” I gasped, seeing in black and white the evidence that she is slowly evaporating. Her skin covers protruding bones, the muscles almost completely absorbed by her body for fuel to live. I’m afraid to touch her, but I need to feel her skin, to know she is alive. I don’t even know if she’s aware that I’m here. She doesn’t move when I pull up a chair to sit next to her bed.

I carefully reach out and place my hand on her arm. “Mom, I’m here. It’s Laurie.” Watching her breathe, I wait for a minute.

“Mom, are you awake?”

She makes a small groan and then in slow motion her left arm rises off the bed. With gnarled fingers she pries open one eye and looks at me. Hoarsely, barely above a whisper, she utters, “Laurie, you’re here.”

“Yes, I’m here Mom. To visit. I’ve missed you.”

“I’ve missed you too, Laurie.”

Wow! I think. She’s talking today. Over the past few months she has been very quiet. Sometimes I have made the drive, only to sit at her bedside and watch her sleep, wondering if she’s “playing dead like an opossum,” as she used to say.

She holds her eye open while we speak.

“Mom, I used your fried chicken recipe this week to cook for my friend Mike. I put it in a paper bag filled with flour, salt, and pepper and shook it just like you taught me. Then I fried it in the hot oil in my iron skillet. It turned out so good.”

The right side of her lips turns up into a half smile. “Good, Laurie.”

I hear a sound behind me and turn to see a young nurse’s aide, wearing salmon-colored hospital scrubs, holding a pale green institutional tray. On it is a dome covering the mysterious lunch that awaits Mom. Beside the dome stands a glass of iced tea covered with a lid and a straw. “Mom, they’ve brought in your lunch. Are you hungry today?”

“Yes.”

I look at the aide and see her name “Christy” written on a plastic tag pinned to her shirt.
“Christy, I’ll do it today. You don’t need to stay.”

She carefully sits the tray on the bedside table, looks at my mother, then at me, and smiles. “Thank you. Enjoy your visit.” She quietly exits the room.

When I remove the covering, a compartmented plate displays three colors of pureed food—one is beige with a hint of pink, one is forest green, the other a creamy ivory. Off to the side is a small round paper container with “vanilla ice cream” written on the side.

“Mom, lunch looks good today. Hope you like it.”

I pick up a spoon and begin to feed her, just like I have done so many times. She opens her mouth like a baby bird, eyes closed tight. When the food slips from her lips and drips down her chin, I gently clean the area with a paper napkin.

“Mom, what is this one?” I ask as I place the beige food in her mouth.

She chews slowly and with effort she swallows. “Chicken,” she whispers.

Next, I place a spoonful of green pudding in her mouth. “Mom, what does this taste like?”

She swallows this one easily. “Green beans.”

I take the final spoonful of white mystery food and place it at the opening of her mouth. “What’s this one?”

She slowly swallows. “Potatoes.”

In between bites, she takes sips of the southern sweet tea, chasing the chicken, green beans and potatoes down her throat. Sometimes the tea goes down the wrong pipe, causing her to choke and cough. Nevertheless, she keeps on eating until she has consumed every bite of this pureed lunch, the most she’s consumed in months. Suddenly, I feel hopeful. Maybe she’s doing better.

“Mom, you want the ice cream for dessert?”

One side of her mouth slowly creeps into a half smile. Since half her body is paralyzed, that’s all she can do. Almost eagerly she responds, “Yes, Laurie.”

I open the half-melted ice cream in the institutional paper cup and scoop it out into her mouth.

“Mmmm.” The sound of pleasure erupts from my dear mama. She has a sweet tooth, especially for ice cream. I know she would prefer butter pecan, but today her joy comes from vanilla.

After the last bite is finished I look at her, feeling like a proud mother. I reflect to a time when I spoon-fed my young children sitting in a high chair, having that same feeling of relief of providing sustenance that will keep a loved one alive and growing.

“Look, Mom, you ate your entire lunch!”

A half smile appears on her face and then slowly fades away. I sit next to her bed feeling content, knowing that she has a belly full of food. Soon her body relaxes into slumber.

“Mom, I’ll let you take a nap now. See you next time. I love you.”

Surprisingly, I hear her whisper, “Love you too.”

Rising out of the chair, I lean toward her frail body and hug her gently, as if she is a delicate baby bird. I walk toward the door and as I enter the threshold, something in my gut tells me to stop. I turn around in the doorway and gaze at her in bed sleeping, looking so peaceful. For what seems like several minutes I watch her sleep.

As I walk down the hallway and exit the building I imagine what the next visit will be like. Strolling down the sidewalk toward my car, the sun is shining in a clear blue sky, warming the air that was bitterly cold only a few hours ago. I make the drive back home to the mountains with the belief that I will see her again next month.

February 6, 2004

It’s about 7:00 and I’ve just finished dinner. Sitting on my overstuffed blue sofa, I’m relaxing, enjoying solitude while watching something mindless on the television after a long week at work. There’s a knock at my door. That’s weird; I’m not expecting anyone. Reluctantly, I push myself off the sofa and shuffle to the door. Peering out the peephole I see Mike, my Boomerang Boyfriend. Once again, he’s shown up unexpected and uninvited. I broke up with him right after my last visit with my mother. This has become a pattern over the past few months; I tell him goodbye, but he keeps coming back, hence the name “Boomerang.”

For the past year I’ve been seeing Mike off and on. He lives in another county, far enough away to help me keep emotional and physical distance. Rarely does he come to my home, as it is my haven. Mike pursued me in the rooms of my recovery support groups until I finally relented. He was handsome, witty, charming, and arrogant. He is also a heavy smoker and self-proclaimed gambling and sex addict. Being with him was fun and exciting for a little while. When I noticed that he never had any money when we went out to dinner, I begrudgingly pulled out my plastic card to pay for our food. After our “date” we went back to his house for a night of wild and crazy sex. Eventually I wanted more than that, but he couldn’t get his gambling habit under control, nor could he quit chain smoking. I’d rather be alone than babysit another man. Tonight, he’s made the drive from Maggie Valley, and I feel sorry for him, so I open the door.

“Are you happy to see me?” he arrogantly asks in his deep smoker’s voice.

“Sure, come on in.” I lie.

As I walk back over to the sofa and sit down, I regret opening the door.

“Can I get something to drink?” he says as he bypasses me on the sofa and walks proudly into my kitchen. I hear him open the cabinets and grab a glass. Water is running in the sink and I hear him fill the glass. The freezer door opens, and I know he’s getting ice cubes. He plops them sloppily into the glass. Eventually the faucet turns off.

Mike walks the few steps from the kitchen to where I’m sitting on the sofa and slithers next to me, pressing his body against mine. He leans across me and places the glass of water on the wooden table next to the sofa. Expectedly, his arm is around my shoulder within seconds. I begin to squirm.

“Mike, what are you doing? We’ve broken up.”

“I missed you.”

“You didn’t even let me know you were coming.”

“I knew you wouldn’t agree if I called and asked you. I’m trying to do better, Laurie. I have a lead on a job.”

“Well, good for you. What kind of job?”

“It’s at a restaurant, as a waiter.”

“You should be good at that. You’re such a people person.”

Since we began this conversation I’ve been staring at the TV, avoiding looking at him. Without thinking, I turn and look at his face, and into his eyes…his beautiful blue eyes, for a second too long.

He leans in, gently and expertly, kissing my mouth. I feel the warmth between us. We slowly begin to recline, and the passion rises. Why does this part have to feel so good?

Hands begin to explore the cloth covering the sensitive parts of our bodies.

I hear a loud ringing and our passionate foreplay is abruptly halted. It’s my cell phone. Who on earth could be calling me on a Friday night? I look at the screen and see “Kathy.”

“It’s my sister. I should answer this. Hi, Kathy. What’s up?”

“I just got a weird call from the nursing home. “

“What do you mean a weird call?”

“Well, a nurse called and said that there’s something wrong with Mom. “

“What did they say?”

“They said that she has no vital signs. Do you think they need to take her to the hospital?”

“WHAT!?”

“She has no vital signs. Laurie, do you know what that means?”

“Yes, ‘no vital signs’ means she’s dead. What else did they say?”

“The nurse said they needed to call the doctor and have him come to the nursing home to see Mom. They want me to meet them there.”

“Oh my God, Kathy. Will you please call me back when you know more?”

“Ok, I will. I love you. Bye.”

“Bye, Kathy.”

I look at Mike. “My mom is dead.”

Expressionless, he looks at me. “What can I do?”

“Can you stay here with me please?”

“Of course.”

As crazy as Mike has been, he has a good heart and he is a friend. We don’t kiss anymore. He wraps his arms around me while we lie horizontally watching TV and wait for the next call. I feel numb. But those words keeping turning over and over like a Ferris wheel inside my head—she has no vital signs.

About an hour and a half goes by when the phone rings again.

“Kathy, what’s the news?”

“Yes, she’s dead Laurie.” Her voice cracks. “Right after I hung up with you I called Larry and he drove over and met me at the nursing home. The doctor came and saw her. He’s the only one who could pronounce her dead. The nurses and other staff can’t do it. That’s the reason they couldn’t tell me over the phone when they called the first time. Laurie, she looks awful. I wish I hadn’t seen her like that.”

“I’ll get my things in order and drive down tomorrow. I’ll call Larry and see if I can stay with him. Then we can get together and work on funeral arrangements.”

After I hang up the phone I call Larry, and he sounds upset. He welcomes me to stay with him and I give him a tentative arrival time for tomorrow. I’m taking this one step at a time.

After our call, Mike and I stay up a little while longer talking and staring at the TV. Eventually, we make our way to the bedroom where, for the first time, sex is not foremost on our minds.

In shock, I barely sleep, tossing and turning all night, those words repeating again and again. She has no vital signs. Mom’s dead. I wake up early and start packing. Mike asks me again what he can do to help.

“Will you please stay here and take care of my cats? I can’t leave them alone.”

“Of course, I’ll do whatever I can to help.”

“Thanks, Mike.” I embrace him, feeling comfort in knowing that, for once, my Boomerang Boyfriend is here when I need him.

Laurie Tollman was raised and educated in suburban Atlanta, earning a BSW from Georgia State and an MSW from the University of Georgia. In 1996, she moved to North Carolina, where she raised her children. She has worked as a clinical social worker and addiction specialist for the past eighteen years and has been in recovery from addiction for over thirty years. She is currently married and working as a clinician at Vaya Health while she completes her memoir.

About No Vital Signs—This is an excerpt from a memoir I am writing about how the death of my mother transformed my life.

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