Synopsis: A mother’s life.
Category: Original Fiction
Word Count: 9,185
In 1973, eight days after her 20th birthday, Annie McCammon gave birth to a child she wasn’t expecting. Oh, she knew she was pregnant; don’t misunderstand. But the baby she delivered at 4:30 a.m., three weeks early, weighing four pounds, twelve ounces, and measuring 19 inches long, was NOT what she had imagined. They told Annie it was a girl – it hadn’t occurred to her to ask – before they whisked the baby off to the neonatal intensive care nursery (merely a precaution, they said). Annie didn’t even get to see her before she was gone.
Once in her hospital room – curiously a single – Annie tried to relax into the idea of motherhood. It would certainly be a different life from the one she’d had twelve hours earlier. That life had been careless and imponderable, designed for – if anything – a complete lack of purpose. Now, she understood that there would be Responsibilities, something she’d never really considered.
As Annie began to drift off to sleep, a nurse popped her head in and asked, “How are you doing, Annie?”
The assumed intimacy rankled Annie; she glanced at the name badge adorning the nurse’s chest. “Just swell, Louise, how about yourself?”
The nurse’s expression never changed – the wide, white smile that resembled nothing more than a cheerful, required façade, stretched a bit wider. “That’s good. The doctor will be in to talk to you in a little while.” She disappeared, and the door closed slowly upon her absence.
A thin filament of anxiety crept up Annie’s neck – doctor…talk…what the hell was that all about? Sounded ominous, but…Annie shook herself gently. Foolishness. She refused to grant entry to the fear that hid itself in space in the back of her mind.
A six o’clock, the rattling and crashing of food carts woke Annie from a dreamless sleep. The door opened and a brisk candy striper backed in carrying a tray with several plastic covers on it. The smell of coffee was strong and bitter. Setting the tray on the bed table, the volunteer, a young, homely woman in a ridiculous pink and white striped uniform, rolled the table across Annie’s bed and positioned it in front of her. “Want me to roll up the head of your bed?” she chirped in an unlikely voice.
“Yes, please.” Annie slid herself into an upright position, wincing at the discomfort of sitting.
The candy striper turned the crank at the end of the bed. “Say when.”
“That’s fine; thanks. Could you get me another pillow?”
The girl hesitated on her way to the door, and a furrow of concern creased her brow. “I…uh…I’ll see if I can get one of the nurses or aides to bring you one. I just do trays.”
Annie nodded, lifting the covers off the tray and stacking them to one side of the table, revealing a bowl of cream of wheat, curiously grey, a plate of runny scrambled eggs, toast soaking in too much butter, two strips of virtually uncooked bacon, and small dish of red Jell-O, and a mug of coffee. Sugar, artificial sweetener, creamer, and stir straws bristled from a plastic cup.
Sprinkling a tiny bit of creamer into the mug, she covered everything else and pushed the tray away. The coffee steamed into her face as she sipped it, and Annie closed her eyes in pleasure. “Nectar of the gods,” she murmured, enjoying it.
Minutes passed; Annie could hear the bustle of the carts up and down the hall, the cheery voices of volunteers and aides in and out of other rooms. After a while, she also began to hear crying, tiny voices rose in infant protest, and doors opening and closing. Placing the coffee mug back on the table and pushing it away, Annie waited in terrified anticipation for someone to bring her the baby.
Finally, confused and beginning to be concerned, Annie gingerly eased to one side of the bed and slid her feet into thin terry slippers someone had placed at her disposal. She stood up, wavered for a moment as her dizzy head adjusted itself to her position, and scooted her feet toward the door of her room. Suddenly, it opened, and a man with a white lab coat and a stethoscope stepped in. “Hey, wait a second there, young lady, just where do you think you’re going?”
“I was going to go find out….” She stopped talking.
The man smiled, though it never reached his eyes, and pointed to her bed. “Why don’t you get back in bed and let me talk to you for a minute?” He nodded and pointed, nodded and pointed.
She started back toward the bed. “Is something wrong?”
“Well, first of all, let me just tell you that your baby is very healthy for a preemie. She is a little underweight, but I suspect she’ll catch up fairly quickly. She does have a slight case of jaundice, but we’re treating that in the neonatal intensive care nursery with phototherapy, and it should clear up within a few days. I wanted to tell you about this because when you see her, she will have bandages over her eyes to protect them from the strong lights, and I didn’t want that to scare you.” As Annie slid back into bed, the doctor pulled up a chair next to her. “Secondly, I wanted to let you know that she has a case of cradle cap – very common in newborns, especially premature babies.”
“What is that? I’ve never heard of that!” Annie’s heart began to thump a little louder and faster.
“It’s just a form of dermatitis, or eczema, and it’s very common. It can be treated with a little baby oil and a soft brush; nothing to be concerned about really. Again, I just wanted to warn you about it so you wouldn’t be alarmed when you saw her scalp.” He shifted in the chair and rubbed his right index finger across his upper lip. “She is also about 4 ounces lighter than we like to see in a baby when they leave the hospital, so we’re going to keep her a few days longer than usual so we can try to fatten her up a little before you take her home. It probably won’t take more than ten days…”
“Ten days?” Annie shook her head. “But I’m supposed to go home tomorrow!”
“Well, yes, of course, we can’t allow you to stay as a patient after you’re discharged. You can certainly spend all the time you want to here, and if you like, you can even put on a gown and mask and gloves and hold her in the NICU from time to time if you want to. Just let one of the nurses know when you come up to see her. Have you chosen a name for her yet?” He smiled thinly, unconvincingly.
“Not really. I have some things in mind; when do I have to decide?” The back of Annie’s neck began to feel hot. Something didn’t jive here. Why was this doctor taking so much time to tell her all these things that a nurse could have told her? “Is there something else?”
“Well, yes, Mrs. McCammon, there is.” The doctor stood. As he pushed the chair back toward the corner of the room, he cleared his throat. “Your baby is a Mongoloid. Do you know what that means?”
Dumbstruck, Annie shook her head, her body suddenly feeling heavy and weak.
“It means your baby will be retarded. Likely she will never walk or talk; she may not be able to care for herself in any way. My advice to you would be to place her immediately in an institution and get on with your life.” He rubbed his hands together, straightened his lab coat, and turned to go.
“Wait a minute!” Annie reached out her hand. “What are you telling me? What caused this? Can’t it be fixed? How did this happen?”
The doctor held his palms up and shook his head. “Many times there is no explanation for this condition. Babies like this are usually born to mothers who are much older than you or to mothers who have other babies who are retarded, but another young mom came in last week and gave birth to a mongoloid baby. She was only sixteen…the mom. She didn’t take her baby home; I told her the same thing I’m telling you. The best thing for you to do would be to…”
“Don’t say it again!” Annie cried, clapping her hands over her ears. “Just get out.”
The sympathetic expression drained away from his face, something like relief replacing it, and he turned and left quickly, easing the door closed behind him.
The room was very quiet when Annie let her hands fall to the bed at her sides. She couldn’t hear anything from the hallway; there was an uncomfortable roaring in her ears, like the white noise of a fan set at high speed. She felt sure she should cry, but she was too stunned. The tears were there, but they were dammed up behind her outrage, her fear, and her confusion. Moving slowly and carefully, she slid off the bed and into the slippers again, walked to the door and opened it. Turning to her right, she started down the hall.
The window looking in at the infants was crowded with beaming moms and dads, exhausted but proud, snapping photos and shooting videotape to send to grandparents and friends.
The NICU was further down the hall, and before that window no one stood. Annie straightened her spine and scooted up to see in. There were several plastic bassinets in that room; each of them cradled a tiny infant, naked, red and wrinkled, every one hooked up to a frightening array of machines that breathed for them or fed them or measured their heartbeats or kept them warm. None of these babies was crying. Three gowned, gloved, masked nurses moved calmly among the babies, touching them, stroking their cheeks, holding their tiny fingers gently. Annie tapped very softly on the glass, and a nurse nearest her looked up. Annie pointed to the babies and pressed the name band on her wrist up to the window. The nurse read the name, without expression, and moved toward the back of the small room. She opened a narrow door and disappeared. Seconds later, a door to Annie’s left opened with a whoosh of conditioned air, and a voice said, “Come on in, then.”
As Annie stepped through the door and closed it carefully behind her, a nurse approached her. “Hi, Mrs. McCammon.”
“Miss,” Annie interrupted. “Miss…I’m not…not married.”
Without missing a beat, the nurse corrected herself. “Miss McCammon. You’ll need to scrub and put those on.” She gestured toward a sink near the table on which lay a green hospital gown, latex gloves, a white mask, and green paper booties. Her expression behind her mask was unreadable, but Annie was certain she read pity in the blue eyes that met her own. Briskly, Annie washed her hands in the disinfectant soap, blinking back tears caused by its strong chemical smell. She struggled into the gown, slipped on the booties, and tied the paper mask over her nose and mouth. The nurse nodded and gestured for Annie to follow her through another door. Stepping into the NICU was like entering the lair of a sleeping giant. The wheezing of the machines unsettled her, and she suddenly wanted more than anything to escape this room, this wing, this hospital, this moment in her life.
Muffled by her mask, the nurse said, “Your baby is in the back here in the incubator. While we’re giving her phototherapy, she has to stay in the warmest environment possible. You won’t be able to hold her today, but you can reach in through the portholes and touch her if you want to. By tomorrow, you should be able to hold her for a little while in here.” She gestured to a rocking chair against the back wall. “It will be good for her to be held and rocked.” She walked back toward a plastic bubble surrounded by machines that beeped softly, displayed uneven green lines on a dark screen, and measured liquid dripping through a tiny needle taped to the infant’s scalp. Most of the baby’s face was covered with bandages, and she lay on a blue pad lined with soft cotton gauze. Her thin arms and legs waved and jerked spasmodically, and her chin quivered, but her mouth was shaped in a perfect rosy circle.
Annie spotted a small band-aid on the baby’s left heel, and for a moment, she thought she might faint. How curious that this was the thing she couldn’t bear. She touched the incubator and felt the warmth of the lights through the unforgiving plastic.
“Miss. McCammon? Do you want to touch her?” The nurse gestured to two portholes in the side of the bubble.
Annie nodded, unable to speak.
The nurse turned the covers and dropped them beside the openings where they hung on their thin plastic hinges. She stepped back and made a gesture of encouragement toward Annie. Annie moved forward and reached one hand tentatively through the opening. She stopped just short of touching the baby, her hand quivering uncertainly above the infant’s belly.
“Go ahead,” the nurse urged her. “It’s okay. Just touch her gently. She’ll know you’re there; it’s good for her to be touched.”
Annie withdrew the hand, clasped it in the other, and pressed them together hard. “It’s cold. My hand. It’s cold.”
The nurse chuckled. “That’s okay. It’ll warm up in a sec in there. Go ahead. Will the father be coming in to visit?”
Annie ducked her head, blushing. “No. I mean, there is no father. That is…” Annie returned her hand through the opening and touched the baby’s arm, drawing a finger down the tiny limb to the hand. It opened like a flower, and five miniature fingers closed around her finger. Annie suddenly realized that she was crying, soundlessly, surprisingly.
The nurse stepped quietly away and left Annie to get acquainted with her daughter.
Shift change occurred while Annie was trying to figure out how such a tiny creature could be truly hers; several unfamiliar nurses came and went around her, ignoring her. Annie leaned forward and rested her cheek against the cool plastic of the incubator. From behind her, a voice spoke. “Are you going to take her home?”
Startled, Annie turned to see a tall, grey-haired, crisply starched nurse pulling on a pair of latex gloves. “Beg your pardon?” Annie responded, sure she had misunderstood the question.
“I said,” the nurse repeated, snapping the top of a glove against her wrist, “are you planning to take her home?”
Weary but angry, Annie drew herself up straight. “As opposed to…?”
“Putting her in an institution. The other girl who was in here last week just left hers here. We had to call Children’s Services.” She turned abruptly and walked away.
Annie reached back through the portholes in her daughter’s bubble and took the tiny hand in her own. “Well,” she whispered, “I guess it’s just you and me now, little missy.”
The brass and oak chimes hanging outside the kitchen window jingled gently in the breeze. “Good morning, Mom,” Annie murmured over her coffee, just as she did every day. She closed her eyes and settled back in the red-vinyl-covered chair and rested her elbows on the white formica dinette table. For a moment she could almost hear her mother laughing. From the other room, she heard Missy stirring; she put her blue ceramic mug down and walked to the bedroom door, opening it just a crack.
Stirring, but not yet awake, Annie thought. She slipped in quietly and stood looking at her daughter. In repose, those features that caused her to resemble other adults with Down syndrome more so than anyone in her family were far less pronounced. Apart from the dark circles under her eyes, she looked like any other young woman sleeping deeply, lips slightly parted, one hand curled under her chin. Her nose made a soft whistling sound, and Annie struggled to remember whether or not she had given Missy Benadryl at bedtime. The humidifier hissed on the nightstand, and the aroma of Vick’s VapoRub wafted up from Missy’s chest.
Annie backed out of the room and pulled the door shut behind her. Missy could sleep a few minutes longer, she decided, heading to the basement to put a load of whites in the washer. She turned on the water and measured out detergent and bleach. Once the washer had filled halfway up, she started dropping in socks, underwear, bras, sheets, towels, and washcloths. She closed the lid and set the timer on her watch. Harder to remember now, she thought, and leaving wet clothes in there in warm weather was an open invitation to mildew. Climbing back up the steps, she pulled the basement door closed and went back into the kitchen to finish her coffee.
Missy smiled up at her from a chair at the table. “Well, good morning, young lady,” Annie smiled back, planting a kiss on her daughter’s forehead. “You’re certainly up early. Birds wake you?”
Shaking her head, Missy pointed out the window. “Granma’s chimes.”
“Hmmm. Well, then. I guess I’d better feed you. How about some nice crisp bacon and a scrambled egg?” Annie opened the refrigerator door and reached in.
Surprised, Annie straightened up and looked at her daughter over the open door. “You’re turning down bacon? What’s the matter – don’t you feel good?”
Missy shook her head and rubbed a finger under her nose. “Can’t breathe.”
“Okay, then, Miss Thang, well, how about some Cream Of Wheat? That’ll open up your sinuses.”
Missy smiled and said, “Yum!”
Annie laughed. “All righty, then, CreamO’Wheat it is!” She began pulling out utensils, measuring cups and a pot. “How about a piece of toast?” Her hand hovered over the half loaf of bread on the counter.
Shaking her head, Missy said, “Nope.”
“Okay, then.” Annie turned toward the stove and began preparing the hot cereal. Once the water began to boil, she looked back at Missy. The girl was sitting very still, face very animated, staring at the chair opposite her, concentrating hard. Her lips moved, and she smiled and tilted her head, her eyes sparkling.
“Missy? What is it?”
Missy jerked and her eyes focused on Annie. The smile left her face. “Nothin’.”
“Why don’t you go ahead and get your juice and bowl and spoon? This’ll be ready in a second.” Annie took the pot off the burner, covered it, and set it on an iron trivet in the middle of the white enamel surface. Grabbing the sugar substitute, she poured herself more coffee and went back to the table.
Missy slowly gathered her breakfast things, got a napkin from the red wooden chicken napkin holder on the counter, and retrieved her vitamins from the shelf above the sink. She sat back down in her chair and organized the items in front of her in predictable order. Bowl directly in front, napkin to the right with spoon and vitamins placed exactly on the diagonal, and juice box at the twelve o’clock position above the bowl. Annie took comfort in the unchanging routine and smiled again at her daughter. Missy looked up at her mother, but she didn’t smile. “Forgot something.”
“Me or you?” Annie joked, sipping her coffee.
“You.” Missy pointed at the stove.
“Well, I guess I did!” Annie laughed. “Hard to eat cereal when it’s still in the pot, isn’t it?” Annie pulled the lid off the pot and emptied the hot cereal into Missy’s bowl. “There you go. I must be gettin’ old and decrepit, huh?”
Missy giggled. “’Crepit. Me, too.”
“Not you, kiddo, you’re still just a spring chicken.”
Missy laughed at that, her mouth open and Cream Of Wheat dribbling down her chin.
“Hey, no laughing with food in your mouth. That’s gross.” Annie reached out to wipe the glob of food off Missy’s chin – the maternal instinct to clean her child’s face never went away – but the girl jerked her head back. “I can do it.” No more laughter.
Annie sipped coffee and watched her daughter doggedly concentrating on getting every morsel of food out of the bowl. For a moment, she thought back to Missy’s childhood, to what a struggle it had been to teach her to feed herself, how eventually she had learned to put a plastic drop cloth down in the floor under the high chair before the meal began; it was easier than trying to scrape loose the drops of rice cereal from the tile floor.
“What do you want to do today?”
Missy looked up, firmly clamped her lips together, and gestured toward her mouth with her finger, shaking her head.
“Sorry. I forgot. How about we go for a walk down at River Park? It’s really nice out today.”
“Drop-In Center?” Missy asked eagerly.
“No, not today, honey, don’t you remember? It’s closed on Mondays. How about a walk? It’ll be good for you to get out of the house. You’ve been cooped up in your room too much.”
“I don’t know…” Missy swallowed and replied, drawing out the last word.
Annie translated that from Missy-speak to ‘I definitely don’t want to do that; no thank you very much,’ and she laughed. “Oh, come on, it’ll be good for you to get outside and enjoy some sunshine and fresh air.
Missy forced a small cough and held the back of one hand up to her forehead.
Overcome now with impatience, Annie snapped, “Oh, for heaven’s sake, you’re not sick; it’s just a sniffle. You’re such a drama queen. We’re going for a walk. You need the exercise.” She dumped the rest of her coffee into the sink and headed toward the basement door. “Rinse your things and put them in the dishwasher when you’re done, please. I’m going downstairs to check on the laundry.” As she closed the door behind her, she could hear Missy muttering angrily.
The basement was steamy and warm, and the sheets were nearly too hot to touch when Annie took them out of the dryer. Folding them, she sank into a memory of her mother – taking sheets off the clothesline in their back yard. The summer was soft and fragrant around her as she scooted the wicker basket along the ground with her sneaker-clad foot. Annie leaned back in the window seat, watching her mother, finger holding her place in a paperback book. Her mother’s arms lifted and lowered, lifted and lowered, as she tucked sheets under her chin and halved them, then tucked and halved them again until they lay in neat stacks in the basket. She dropped the clothespins into the pocket of her print housedress, and swiped fair hair back from her forehead with the side of one careworn hand.
Annie lowered her eyes to her book, but movement in the corner of her eye pulled her gaze back up to the window. The scene baffled her: her mother had reached the end of the clothesline, and now she was taking sheets out of the basket, shaking out the folds, and pinning them back onto the line, moving back toward the house as she worked. Watching her mother in reverse motion made Annie slightly dizzy; was this a joke? Did her practical, no-nonsense mother see Annie watching, and was she trying to trick Annie? It seemed that Annie should laugh at this, but she couldn’t. She felt something wrong with the scene before her, but she didn’t understand what it was.
Shaking her head, Annie came back to the present with a heavy feeling of dread in her chest. Too soon to be thinking about that now. Surely I have more time. With great force, she pushed the memories away and started slowly up the steps, laundry basket balanced on one hip, hand on the railing.
Approaching Missy’s room, Annie heard music playing…only a few notes…then the station was changed, and a new song played. Another few notes…another change…again…again…Annie tapped on the door and counted to three before she opened it. Missy pressed the Mute button on the remote she held in her hand and looked up from her magazine. “What are you listening to?” Annie asked, setting the basket on the floor by the bed.
“Don’t know.” Missy eyed the basket suspiciously.
“Fold the towels and put them away, please? No rush.”
Missy nodded, eyes drawn back to the color perfume ad on the glossy page. She reached out with the remote, but waited to release the Mute until Annie left and closed the door. Music again drifted through the door…only a few seconds…changed…another song…changed. Annie rubbed her forehead and walked slowly toward the living room.
The furniture was simple, comfortable, worn but not frayed. A light blue sofa with a recliner at each end hugged one wall of the small room, and a darker blue glider with an ottoman paralleled it on the other side. A white wood bookcase filled with cookbooks stood under the picture window, and a small television rested on a wheeled cart in the corner. Pictures lined the wall behind the sofa, capturing moments of Missy’s life. Annie let her eyes follow the years, remembering some of the moments, puzzling over other scenes. “I took these, and now I can’t even remember where we were in part of them,” she muttered to herself.
She walked along in front of the sofa, trying to bring forward the memories connected with each photograph. One taken of a very young Missy, on a beach somewhere – a city Annie had fallen in love with immediately and had visited many times since – a city whose name would not come. She tried to focus on the photo, recognizing the scene as one she knew, but failing to remember the name. Frustrated, she moved on to another picture – this one a shot of Missy on horseback, helmet fastened securely on her head, too-big cowboy boots just touching the stirrups, hands tightly gripping the saddlehorn. Special Olympics, obviously, but when? It occurred to Annie that the dates might be marked on the back of each shot, but it seemed like too much trouble to take the picture down, pull the back off and look at the printing.
The next photograph showed Missy waving cheerfully in front of a log cabin set back among a stand of cedar trees. The young blonde girl beside her laughed, her head thrown back, and her t-shirt said, ‘CAMP SUMMER OLYMPICS’. Annie knew the summer camp, located in the western part of the state, was coordinated by volunteers from area colleges and universities; this one, she could identify.
Sitting down heavily on the couch, Annie wondered how many more memories would be gone in the next month, the next six months, the next year. How long would it be until, like her mother, she forgot the people around her, where she lived, how to drive, dress herself, and eventually how to talk, eat, breathe? ‘This cannot happen,’ she said to herself. ‘It simply can’t. I have to take care of Missy.’
The small mantel clock chimed softly from the top of the bookcase, and Annie looked up from her reading – eleven o’clock. Not a sound in the house; Missy had been in bed for half an hour, and Annie knew she was asleep. She often envied Missy her ability to drop off to sleep so easily, no matter what happened in her day. Annie rested her hand on top of the book in her lap and considered. Tomorrow is bowling, she thought, and Friday is…what is it? Squinting her eyes shut, she fumbled through the dark corners of her mind for …ah, yes…there it is, Friday is library day. Nothing going on Saturday that she could remember – she got up and checked the desk calendar on top of the bookcase. Handwritten notes and reminders covered it. Saturday? Nothing written. She went into the kitchen and glanced at the side of the refrigerator. No sticky notes, no appointment cards, no ‘to-do’ list. Relieved, Annie went back into the living room and sat down in the recliner, closing her eyes. Unwanted memories flooded her mind.
A Sunday morning in May a few days after her mother’s 70th birthday. Annie went by the house to pick her up for church, barging in as usual with only a cursory knock.
“Mom! Are you ready?” Annie crossed the rag rug in the living room and started down the hall toward the back bedroom. The door was standing open, and as she approached, she saw her mother standing in front of her mirror, dressed, a full-length slip in one hand. Annie laughed, “What’re you doing, folding laundry? Come on, we’ll be late for…” Her words trailed off as she saw a crystal-bright tear slide slowly down her mother’s cheek. “What…Mom?”
“I don’t know what I’m supposed to do with this. Can you help me?” Her mother sat down suddenly on the side of the bed. Her arm still outstretched, the slip slid perilously close to the tips of her fingers.
Annie took the slip and sat down beside her. “What’s wrong?”
Her mother shook her head. “I don’t know. I got dressed, and that was on the end of the bed, and I know I’m supposed to put it on, but…I can’t figure out where it goes.” She let loose a laugh that turned into a sob.
Annie put her arm around her mother. “Mom, that’s your slip. You wear it under your dress, over your panties and bra. You know that.” Panic left her dry-mouthed; she licked her lips. “What’s going on?”
“Well, you know I’ve been getting forgetful lately. It seems to be getting worse. I….I’m afraid, I guess. You know what happened to your papaw.” Her mother’s shoulders slumped, her back rounded, and she smoothed the skirt of her yellow print dress down over her knees. It was clear she had no hose on, and on her feet she wore her yellow bedroom slippers.
“Look, Mom,” Annie said, reaching out and turning her mother’s face toward her. “I’ll call Dr. Macoy next week and get an appointment for you, and I’ll go with you. She’ll check you out. It’s probably just….” Annie couldn’t even imagine what she could call this thing happening to her mother that wouldn’t terrify them both. “Is that okay?”
“Okay.” Her mother nodded. “I don’t think I want to go to church today.”
“Sure,” Annie nodded, “we’ll just stay here and drink coffee and talk if you want to.”
“I think I’ll lay down for a bit. You don’t mind, do you?”
“Of course not,” Annie assured her. “I’ll get out of your way…”
“Will you stay here a while and sit with me? I’m so tired.” Her mother lay back on the bed, turned toward the wall, and sighed deeply.
Annie, shaken, sat down on a creaky, cane-bottomed chair under the window and watched her mother’s back as her breath rose and fell. Shadows filled the room, the curtains still pulled across the windows, but Annie could see an uncharacteristic fine layer of dust across the headboard of the bed, on the nightstand, the chest of drawers, and the family pictures on the walls. It’s impossible, she thought angrily; this cannot happen. Not again. Papaw was bad enough, but then Aunt Louise, Aunt Verna, and now…No! It is just stress, lack of exercise, bad diet, too much caffeine, too little sleep, worry… She leaned back in the chair and cried, softly, so she wouldn’t wake her mother.
“This is more than just forgetfulness, Dr. Samuels. It’s forgetting what I’m doing in the middle of doing it; it’s not being able to retrieve a word I know as well as I know my own name; it’s having to write down absolutely everything so that I don’t miss appointments, forget to pick Missy up at the Drop-In Center, or take my medicine at night before I go to bed – the same medicine I’ve been taking at the same time for six or seven years. I’m scared to death. You know what happened to mom…and the rest of her family, except for my grandmother.”
The doctor pushed his black-rimmed glasses up his forehead and rubbed his chin thoughtfully. “Well, you know, Annie, Alzheimer’s is not uncommon in women your age. Or men either, for that matter. Also, with your family history…”
“I know, I know,” Annie interrupted. “Why do you think I’m here? What am I going to do?”
He patted her hand. “That doesn’t necessarily mean that you have A.D. It simply means that you may develop it at some time. Before we jump to conclusions as to what is going on with you, why don’t we run some tests to be sure it’s not something else?”
“Like what?” Annie asked, stubbornly hopeful.
“Well, stress, poor thyroid, bad diet, lack of exercise, anxiety, of course, but also there are also other things that can mimic the symptoms of A.D. Like a stroke. I’m not saying it’s not A.D. I’m just saying you shouldn’t panic and imagine that you are about to become completely disabled. Let’s see what is going on. I want to do a complete physical on you, order some lab work to be sure you don’t need to have your blood pressure or thyroid medicine adjusted, get an MRI of your brain, and also I’d like you to talk to a psychologist friend of mine.”
Annie jerked her head up. “What on earth for? Do you think I’m imagining all this?”
“Now don’t get all huffy with me. I just want to see if she thinks you’re clinically depressed. Depression is often the culprit behind lack of focus, forgetfulness, and so on, especially in the aging population. It is the most under-diagnosed illness older people have, in my opinion. I’ll forward an order for the blood work-up and stress test to St. Cecilia’s, and I’ll have my nurse call the hospital and schedule a carotid ultrasound to be sure your arteries are nice and clear.” He scribbled on a piece of paper and handed it to Annie. “That’s the name and phone number of the psychologist I mentioned. Call her as soon as you can. She’s very good, and she does a lot of work with our aging population. Also, even if you don’t think you’re depressed, your anxiety over the question of A.D. could be causing you to exhibit exactly the symptoms you fear.”
“I’m not that old; how could this be happening to me so soon?”
“Not everyone who gets Alzheimer’s disease is old. Some develop early-onset A.D. as young as 40. I’m not trying to frighten you or add to your stress, but you also need to know that the incidence of A.D. is much higher in people like Missy who have Down syndrome than in the general population.”
A cold ripple of fear ran up Annie’s back. She stared at him, speechless, for a long moment, and then asked, “Are you sure?”
He ran his hand across his forehead, smoothing back the few fine brown hairs that still crowned his head. “Of course. They age earlier, and by the time they reach 50, about half of the people with Down syndrome will be showing memory loss and other problems. The life expectancy of people with Down has increased; in the past, A.D. was virtually unknown in that population simply because they didn’t live long enough to exhibit symptoms.”
“Missy is 33; should I be worrying about this now? What should I be watching for?” Annie wrung her hands.
Casually, he shrugged. “I should never have mentioned it. Leave that alone for now, okay? You have time to consider what to do about Missy later. Right now we just need to deal with your symptoms and see what we need to do for you.” He stood and dropped his ink pen into his lab coat pocket.
Panicked, Annie spoke fast, “But what am I going to do if I am getting Alzheimer’s? Who’s going to take care of Missy? What if she gets it? You know we don’t have any family, and…”
“Whoa! Wait a minute now,” he interrupted, hand up, palm out. “Nobody is saying anybody has Alzheimer’s yet. We certainly don’t know for certain that you are developing symptoms. As for Missy…well, we’ve got some pamphlets about A.D. and Down syndrome. Ask my nurse for one as you leave. Read it and let me know if you have any questions.”
“I’ll tell you the truth, doctor; I’m scared to death. You know my mom and her sisters and her father all got it, and when she died, my mother was in diapers and didn’t even know who I was!”
“Look, we don’t know anything about either one of you for sure, as far as this goes yet. Let’s look at your tests first and see if there’s anything wrong or anything we need to do to help you before we get all excited and assume that you are developing symptoms of A.D.”
Straightening her shoulders, Annie slid off the examining table. “Of course. I’m just feeling a little overwhelmed. Next month is the anniversary of my mother’s death, and I always freak out a little when that comes around. And it worries me that Missy isn’t more active. She doesn’t want to do anything but sit in her room and work word search puzzles. She never wants to leave the house or do Special Olympics anymore or anything.”
The doctor checked his watch. “Uh huh,” he said, distracted. “If she can do those puzzles, I’d be very reluctant to diagnosis A.D. in her. I can’t do them, and as far as I know, I have NO symptoms of dementia at all!” He patted Annie’s shoulder. “Now go on home and relax. I’ll have my nurse call you about the tests. For the time being, assume you are fine.” He patted her shoulder again, then turned and left the room.
For a moment, Annie sat still, trying to pull her fear and concern back from the edge of hysteria. When she felt she was sufficiently under control, she picked up her purse and walked out to the nurse’s desk. The slim young woman looked up and smiled. “How’s Missy, Mrs. McCammon? We haven’t seen her for a while.”
“Fine,” Annie mumbled. “The doctor said something about a pamphlet about Alzheimer’s and Down’s?”
“Of course…” The nurse reached behind her and pulled a brochure from a cubbyhole in her desk. “Here you go.”
Annie went through the lobby door and stopped at the front desk. The pretty young blonde receptionist looked up. “What do I owe you?” Annie asked, scrabbling in her purse.
“Just your $25 co-pay today.”
Annie moved the contents of her purse back and forth, searching…searching….the brochure, with its big black letters lay in front of her; she tried not to look at it, but…she suddenly realized she couldn’t remember what it was she had been searching for. She looked up at the receptionist. “I’m sorry, what did you say?”
The woman smiled more brightly. “Co-pay. Twenty-five dollar co-pay?”
“Oh, yes, I’m sorry,” Annie replied, feeling a hot flush of humiliation creep up her neck. She pulled out her wallet, opened it – there was no cash in it, only a couple of receipts and her identification.
Now the woman was not smiling. “You usually write a check?”
“Yes, of course,” Annie said, putting her wallet back in her purse. “I’m so sorry. It’s just been one of those days, you know?” Her hand touched her black checkbook case, and she grasped it and pulled it from her purse. Setting her purse down, she opened the checkbook and wrote out a check for twenty-five dollars, signed it and handed it to the receptionist. “Thanks for putting up with me.”
“Not a problem. Wait a sec, and I’ll get you your receipt.” The woman stamped the back of the check “For Deposit Only”, keyed the payment information into her computer, and printed out a receipt she handed to Annie.
Embarrassed, Annie tucked the receipt into her purse and zipped it shut. “Thanks.” She started toward the office door, but the woman called after her.
“Ms. McCammon! You forgot the pamphlet!”
Annie turned slowly and walked back, shoulders slumped. Picking up the brochure, she stuffed it hurriedly into her purse, turned and nearly ran toward the exit.
“Have a good one!” the woman chirped cheerily, but Annie was already halfway through the outer office door.
Annie turned to see Missy standing at the door to the kitchen, watching her. She quickly wiped her eyes and shook her head. “What, Missy?”
Missy walked slowly over and touched Annie’s cheek with a finger. “Crying?”
“No, of course not.” Annie stood up and walked to the sink, rinsing her cup and placing it in the drain rack. “Whatcha need?”
“It’s broke.” She handed a slim black remote control to Annie. “Can’t turn it.”
“Well, the batteries are probably dead. Let me see if we have any.” Annie crouched down in front of the cabinets under the sink and opened one door. Sliding out the wicker basket that held odds and ends, she scrabbled through it. Rubber bands, twist-ties, pens, matches, cork coasters, scotch tape rolls, several soft cases for glasses, a clear plastic box of finishing nails, but no batteries. “Damn!” Annie grunted as she pushed the basket back in and stood up, handing the remote back to Missy. “No batteries, sweetie. Guess you’ll just have to change the channels the old-fashioned way.”
Missy thrust the remote at her mother. “Batteries, please.”
Annie surrendered. “Okay. I’ll get them next time we go to the store. But for now, you can do this with the buttons.”
Missy folded her arms across her chest and pouted.
Annie felt a sudden urge to slap her daughter, an urge so powerful, she turned immediately and walked out of the kitchen. As she stood in front of the living room bay window, she heard Missy’s door close, and she trembled with the unexpected anger that had washed over her.
Annie sat down at her PC, took a pen out of her desk, and began her search, jotting down information as she went along. She spent some time searching under ‘Alzheimer’s Disease’ and under ‘Down syndrome’. Using both phrases, she began to find more information; however, much of the medical reporting in journals that she saw, she could not interpret. She linked to the National Down Down_Syndrome Association and saw several articles that had information related to A.D. and Down syndrome.
After a while, she realized that several phrases repeated over and over. “Occurs in 50% of adults over 50, near 100% by age 60…accelerated aging…rapid decline… problems in forming new long-term memories…difficulty communicating, walking, grooming, sleep disturbances, wandering behavior…higher rates of seizures…loss of life skills”. When her eyes began to hurt from the strain of reading, Annie sat back and rubbed them. To her surprise, she found tears on her cheeks. Her volatile emotions once again had expressed themselves outside her awareness.
Supper is over; pizza again. Annie doesn’t have the energy to cook anything; she pours every drop of her strength into worrying about Missy’s future. She stands in front of her chest of drawers, the top drawer open a few inches. Inside, neatly lined up, rest amber plastic bottles containing all the medicines she takes at night: two for high blood pressure, three for anxiety, depression, and sleeplessness, one for high cholesterol, and baby aspirin for her heart. She hesitates for a moment, trying very hard to imagine other options – she has no other family, there is no one who could care for Missy if something happens to her, she knows what the state will do. Shrugging, she opens three of the plastic bottles and pours out the tablets on top of the chest next to a small picture of Missy smiling on a beach with a huge seashell in her hand. She counts pills, recounts them, and begins breaking them in half.
“How about movie night this weekend? We’ll rent some movies Friday night, fix chili, and pig out!”
Missy nodded and smiled around a mouthful of Hamburger Helper. Swallowing, she said, “Excellent!”
“Cool,” Annie responded. “Anything in particular you’d like to see?”
Chewing, Missy pondered the question. “Scooby-Doo?”
“Again? Good grief, you’ve seen that movie twelve times!” Annie laughed.
“Yeah!” Missy put her spoon down and clapped. “Rooby-rooby-roo!” She laughed heartily.
“Scooby-Doo it is, then,” Annie agreed. “I guess if you can watch it again, so can I.”
The pre-heat light on the oven went out, and Annie slid the muffin tin in and closed the door. Checking the timer, she cleared away the mixing bowl, spoons, measuring cups, and ingredients. The crockpot burbled gently on the counter, and the breadmaker kicked into knead mode. Annie looked around the kitchen, then out the window. Dark clouds gathered to the west, and there was a very faint rumble of thunder from that direction. “Not now,” she whispered. She leaned back against the counter and removed the letter from her jeans pocket. The printing at the top of the first page was boldly outlined in red. She laughed. “Of course. What else?” She didn’t bother to read the opening paragraph; she knew it by heart now. Putting that page behind the others, she scanned down over her test results. The details weren’t important; she didn’t understand the technical language of laboratories. Only the brief conclusion at the end mattered. The words blurred as she read them again. “…assumed early onset of Alzheimer’s disease…medication recommended to reduce symptoms and prolong functioning…”
She reached for the manila folder on the kitchen table. She pulled out each page, read it carefully, and turned it face down on the open folder. When she’d finished, she turned them all over again and closed the folder. Annie reached into her pocket and pulled out a Sharpie. She uncapped it, and in careful print, wrote “In Case Of Emergency” on the front. Underneath that, she wrote a name, address, and telephone number. “I guess he’ll do at least this much for me,” she murmured to herself, capping the pen.
Annie tried to remember the last time she’d spoken with her brother, Jackson, but the memory wouldn’t come. They hadn’t been close for many years – a consequence of his careless neglect during their mother’s lengthy illness. He responded to her diagnosis of Alzheimer’s disease by refusing to watch her decline. When he showed up at the funeral home the day of the service, Annie almost didn’t recognize him. He’d lost weight, grown greyer, and had a hollow, haunted look behind his pale green eyes. A persistent smoker’s cough wracked his body as he sat dry-eyed through the eulogy. Annie had insisted on a closed casket; a spray of lavender orchids draped the top. Annie couldn’t bear the thought of seeing her mother’s thin, pale face again, remembering the horror of the days leading up to her death.
“Ms. McCammon?” the soft voice on the phone asked.
“Yes?” Annie didn’t recognize the woman’s voice, but a cold feeling of dread lay over her. She glanced at the clock above the stove – 10:30 p.m. The bad news always comes at night, she thought.
“This is Sara at the nursing home?”
Annie dropped into a chair and fisted her left hand in her lap. “Yes?”
“Ma’am, Dr. Macoy asked me to get in touch with you. Your mother is failing, and she asked me to tell you that you should come down here right away.” The pity in her voice was not false, and Annie couldn’t bear it.
For just a moment, all she could feel was anger. “Again?!?” she barked, feeling the familiar tears rise. “This is the third time this week you people have…”
“Ma’am, I’m sorry, but Dr. Macoy asked me to tell you that your mother is failing. The chaplain is in with her now…”
Bitterness and fear warred in Annie’s heart. Silently, she put the phone down and headed for her bedroom to dress. Once she had her coat on and her keys in her hand, she tiptoed into Missy’s room and kissed her lightly on the forehead. “I have to go to the nursing home; I’ll be back as soon as I can. Call the cell phone if you need me.”
Eyes closed, Missy nodded sleepily.
It was cold outside, the sky dark and threatening. Annie hoped it held up. She didn’t like driving in snow, and the tires on her car didn’t have a lot of tread left on them. The motor turned over, and Annie pulled out onto the street, heading for her mother’s bedside.
Pulling into the parking lot at Mercy Services, Annie found a spot as near the door as possible, and tapped the brakes lightly. It had begun snowing just as she’d gotten to the main road into town, and she winced as she pulled her cramped hands off the steering wheel. She shut off the motor, pulled the keys out of the ignition, and stepped out of the car, stuffing her hands deep into her coat pockets. In spite of the cold, she could feel sweat breaking out on her upper lip as she neared the side door of the nursing home.
Punching in the security code that prevented patients with dementia from wandering, Annie pulled open the door and held her breath against the smell of urine and industrial strength cleaner. As usual, she breathed through her mouth as she headed to the nurse’s station on A Wing. The night nurse, Bill, wrote something in a chart, but he looked up as he heard her footsteps approaching. “Annie, I’m so sorry.” He stood, came around the desk, and hugged her.
She stiffened against the tears that threatened, but patted him on the back and murmured, “Thanks.”
He straightened, eyes shining with sadness and pity, and led the way down the hall to the door of her mother’s room. Before he opened it, he said, “We moved Mrs. Wilson out for the time being. I knew you’d want to spend some time with your mom without anyone…” He pulled open the door and started to enter the room, but she caught his arm.
“Please. I need to see her alone for a moment.”
Bill turned. “I need to check her vitals.” He patted Annie’s shoulder. “You can stay as long as you want. I won’t be a moment. The doctor says it won’t be long now.”
“When was she here?” Annie couldn’t bring herself to enter the room. She could hear her mother’s gasping, labored breathing, and the smell of sickness hung over the small bed near the window.
“Dr. Macoy checks in pretty often. She’s very good about keeping up with the patients that are dy….that are gravely ill.” Bill walked on into the room, reached out, and took Annie’s mother’s hand in his. Fingers gently pressing her wrist, he studied his watch and counted the beats of her mother’s failing heart.
Annie watched from the open doorway, postponing the inevitable sight of her mother’s colorless, thin face. Everything in the room had lost its color – the walls, the bedclothes, the curtains, and her mother. Shivering, Annie thought, ‘It’s as if it’s been snowing in here, too.’
Leaning down, Bill pressed a stethoscope against her mother’s chest and listened, eyes closed. He moved it slightly to one side, then the other, then pulled it away and hung it around his neck. Tenderly, he pulled the comforter up over her mother’s arms and tucked it under her chin. Turning to Annie, he nodded and walked back past her. Before he closed the door, he said, “Let me know if there’s anything that I can do.” He stepped into the hall and pulled the door shut.
Annie approached the bed, pulled a chair near her mother’s shrunken form, and sat down, taking her mother’s hand in her own. “Oh, Mom, I’m so sorry.” Tears began to flow down her cheeks, and she leaned forward, resting her forehead on the bed beside her mother. “For…for…just for everything.” She didn’t know if she was crying for her mother, or for herself. It occurred suddenly to her that once her mother passed, she’d be an orphan. She barely remembered her father’s passing from emphysema so many years before; that death caused her pain, but this death would be a heartbreak from which she doubted she could recover.
At the funeral home, she greeted guests with a cool poise; her calm demeanor later became the subject of much discussion. She knew the grieving would come later, in private. Several of the staff from Mercy Services attended briefly; they presented her with a gift in memory of her mother – a box containing brass and walnut wind chimes. She thanked them graciously, handed the box to a friend, and walked away, swallowing hard against the loss of her composure.
Later, at home, she opened the box, assembled the chimes, and hung them from a nail on the eave over her deck. Immediately, the chimes rang, the baritone sounds playing accompaniment to her sobbing.
Letter written, she stuff the pages into the manila envelope and printed her brother’s name on it. She tried to envision the most conspicuous place to leave it, and finally decided on the small table by the front door where she usually left her keys, mail, umbrella, and other things she’d need to find before leaving the house.
She piled the broken halves of the pills on a double-folded paper towel and wrapped it around them tightly. Reaching into a drawer, she pulled out a heavy wooden rolling pin, one she’d claimed from her grandmother’s trailer after her sudden death. Pulling on her oven mitts to protect her from the cold, she began rolling it back and forth across the lump of pills, crushing them completely into powder. She knew her grandmother would be furious that the tool was being used for something other than making food for family and friends. Annie brushed that thought away. Sure she had pulverized all the pills, she put aside the rolling pin, opened the paper towel, and looked for a long minute at the powder.
As she wiped off the countertop, Annie gazed out the kitchen window at the daffodils nodding their yellow heads in the spring breeze. The wind chimes rang softly, and the timer on the crockpot buzzed.