How to Drop Your Body
My mother’s death was a multi-media experience.
Anyone who knew Riva would have expected nothing less.
The program for her last weekend on earth featured a jewelry trunk show, standup comedy provided by my brother, the assistance of a psychic cat, and the kindness of strangers, demented and fully present.
On more than one occasion, I found myself quoting my mother’s mantra for decades: “It’s All Happening!”
From the moment she started attending past life regression workshops in the 1960’s, Riva used to refer to her inevitable death as “the day I drop my body.” But while she often declared herself psychic (mortifying me in front of my friends) she did not predict that she would drop her mind first, in a grueling, thirteen-year struggle with Alzheimer’s. Finally, however, on a cold, snowy day in January, I received a cell phone message from Riva’s nursing home reporting that she’d choked on her lunch and slipped into a coma.
And a strange kind of exhilaration came over me.
Because an end was in sight.
When I arrived at my mother’s bedside after a long drive from New York to Rhode Island, Riva was fast asleep, with her white hair splayed across her pillow, her cheeks flushed with fever. Opening her eyes a crack she focused on me intently as I bent down to kiss her. “It’s Priscilla,” I said. “I love you, Mom. And I’m not going to leave you.”
My mother recognized me in that instant. I will always feel sure of that.
And I recognized something in myself – strength I had not possessed when my father had been dying in another nursing home twenty-five years earlier and I’d fled the scene, heartbroken and scared.
This time I wasn’t going anywhere.
I watched Riva drift back to sleep, recalling another thing she’d once told me: “You’ll be murdering me if you put me in a nursing home.”
I’d “murdered” my mother three times.
Riva had suffered two small strokes in the spring of 2001. She’d been diagnosed with Alzheimer’s and vascular dementia, but I’d never once mentioned to her what I called “The A word.” Alzheimer’s was dreaded. It was what ordinary old people got.
My fiery, independent mother had been able to remain in her own house for five years. I hired a compassionate caregiver to sleep there at night and look after her for long stretches during the day. But when she fell one afternoon and fractured her pelvis, she was hospitalized and then transferred to a rehab facility. It took two people at a time to lift her, so my mother never returned to her house. We both entered the sad, spare world of institutional eldercare.
After experiencing stints in two other places – where she was left in wet diapers for hours, and stuck in a wheelchair when she was actually capable of walking – I’d moved Riva to Steere House on the recommendation of our elder care lawyer. In a surprising burst of lucidity, my mother had tried her best to fit it, rebel, and rail against me, all at the same time.
“How could a daughter ever do this to someone?” she’d asked an aide.
I’d wondered the same, on and off, for years.
I tried to assuage my guilt by telling myself that the people at Steere House were kind and competent. They communicated to me professionally. The place was clean. They served cake often. Enthusiastic music therapists led groups in nursery rhyme recitation and sing-alongs. An aromatherapy person spritzed residents with sweet scents. Kind professionals tried their best to encourage residents to dance, sing, reminisce and rejoice.
But I had been somewhat miserable every time I visited my mother.
I hoped this final visit was going to be different, however. I wanted to usher Riva through her death with dignity and a strong dose of new-age mysticism befitting a woman who’d held dream analysis workshops in our basement every Friday night when we were growing up. Who’d attended mind-control classes as regularly as other mothers went grocery shopping.
I pulled out some jewelry I’d brought with me – colorful necklaces and earrings I’d made – and placed everything on the empty bed across the room from Riva. Whenever nurses and aides came by, I’d urge them to try on whatever appealed to them and take that as a gift from me, as an expression of gratitude for the way they’d cared for my mother. We smiled and hugged over and over again as the women did that.
But after a few hours, whatever joy I took in knowing that Riva’s suffering would come to an end was tempered by the hard reality that it wasn’t so easy to die. She had a fever of 105, which was being reduced with Tylenol. The lunch she’d choked on had settled into her lungs and led to a severe infection. Riva lay flushed and in a deep sleep.
I hoped that she was at peace.
I spoke with a hospice nurse and a social worker, anxious to do what was best for my mother as I agreed with their advice to forgo giving her any fluids, which might only increase her discomfort.
After her strokes more than a decade earlier, my mother had assigned me, her eldest child, durable power of attorney for both her finances and healthcare. I’d signed a DNR order (Do Not Resuscitate) every six months for thirteen years, from the moment she’d officially asked me to be her advocate. “Do whatever you think is right,” Riva had told me, vaguely, trusting me.
Leaving me with doubts.
By the end of my mother’s life I’d added directives that she not be fed intravenously, and that no heroic measures – including hospitalization (except for extreme trauma) and IV antibiotics – were to be administered. Kind social workers and doctors had walked me through the paperwork over and over again. I’d cried on the phone with them, and in person, repeatedly.
These people were experts at ushering residents to the other side. They even had a mascot with his own best-selling book about the topic.
Oscar was a large calico cat who lived on my mother’s ward, and starred in a book called Making Rounds with Oscar – The Extraordinary Story of an Ordinary Cat. He and I had both battled our way onto the New York Times Bestseller list at the same time. My book barely made it; Oscar’s sailed onto it comfortably.
If you Google Oscar cat nursing home, dozens of links come up, including Oscar’s own Wikipedia and Facebook pages, along with several YouTube videos, and a London newspaper’s profile about “the cat who knows too much.” A Rhode Island hospice agency awarded him a commendation for his work helping the elderly residents of Steere House depart the planet peacefully. The New England Journal of Medicine published an excerpt from Oscar’s book, written by a geriatrician named Dr. Dosa, about Oscar’s ability to sense when more than twenty-five residents of Steere House were nearing their deaths. “No one dies on the third floor unless Oscar pays a visit and stays awhile,” Dr. Sosa wrote.
I used to chuckle about Oscar’s relationship with Riva, viewing it as a power struggle between two outsized egos. Riva had never been particularly fond of the celebrity cat. I think they’d both wanted center stage.
But now I wasn’t looking for any feline help either.
I was appreciating the compassionate professionalism of the people around me.
The staff at Steere House was thoughtful and efficient. One young aide, who’d been off duty when Riva took her turn for the worst, rushed into Riva’s room and knelt by her bed crying, begging my mother to open her eyes one last time, so that she could say goodbye. She called Riva “Mama.”
I’d been so guilt ridden whenever I visited my mother that I was a bit shy around the people who cared for her. But clearly Riva had received good care.
And even love.
My brother arrived on the scene and as we recalled all the years our mother had spent talking to shamans, Jungian therapists, Buddhist teachers and psychics, we felt sure that Riva had some kind of a plan up her sleeve.
So we sat by her bed, stroking her cheek, holding her hand, and kissing her warm forehead. We told Riva how much we loved her, what a good mother she’d been, and about all the fun we’d had.
We were both writers, experienced in editing and shaping the truth.
Riva’s long illness had been challenging for us. And life with her before Alzheimer’s had been confusing, to say the least. “You had a mother,” a therapist once told me. “She just wasn’t very maternal.”
“I’ve been your mother for eighteen years,” my mother asserted when I left home for college. “Now will you be mine?”
Still, whatever had transpired during my life with Riva, whether I had felt put upon or leaned upon too much – more like a mother than a daughter on many occasions – I was putting that all aside now, as my mother lay asleep in her bed, wearing only a thin blue hospital nightgown to protect her from what lay ahead.
I left Riva’s bedside occasionally on that last weekend of her life, to spend time with the wonderful head nurse Chris, who did her best to respond to my questions while I stood by her desk, in a daze.
Was Riva in pain? We thought she was well medicated.
When would she die? That was really up to her.
How long could my mother hang on? Patients had been known to survive as long as two weeks in Riva’s condition…
I’d spent the night in a hotel room with stiff sheets and a lackluster cleaning crew. The health bars I’d brought were running low, and so were my spirits.
So when a stooped, skinny old woman with short, scruffy white hair and scant teeth shuffled down the corridor toward the nursing station my feelings shifted yet again, and I became overwhelmed.
Because she stopped, looked me in the eye, and asked, “How do I go to Jesus?”
I glanced over at Chris, who was busy doing paperwork.
The old woman repeated her question. “How do I go to Jesus?” She asked. Her eyes didn’t leave mine. “Or his mother, Mary? Where is she?”
My brain tried to wrap itself around the concept of Jesus possibly being in residence (or Mary, mother of God) when an alert social worker touched the woman’s arm gently and led her away from the nurses’ station down the hall to her roommate.
Twenty-four hours later, I was standing outside Riva’s room while her lovely aides attended to her. The same scrawny resident came walking toward me again, shuffling down the hall slowly, clutching a railing. She looked at me with piercing blue eyes.
“Hello!” she said brightly.
“Hello,” I answered, with a smile.
“Are you Jesus?” the woman asked.
I felt a stab of true, pure compassion.
“Yes,” I decided to say.
“You are?” The woman beamed at me, delighted. “That’s wonderful!”
I smiled brightly (as I thought Jesus might do.)
The woman laughed excitedly. “I love you!” she said.
“And I love you too,” I responded.
Time had slowed down. Reality had shifted. Riva was speaking through me (along with Jesus.)
“Give the people what they want,” she used to joke while hanging her work on the walls of a gallery.
While Peter and I sat vigil, Oscar the cat left Riva alone. But he did send a feline friend named Mya down the hall in his place. The white cat sat on my mother’s bed briefly, then hopped onto my lap, where she stayed for several minutes, leaning up against me and purring.
I needed the cats more than Riva did; I was starting to become exhausted.
However, it was lovely to feel so connected to my brother. He surprised me by pulling out a DVD of a comedy act he’d done twenty years earlier, and we sat by Riva’s bed, watching it and laughing. Chris left her station to join us for a few minutes.
The staff caring for Riva continued doing their jobs with enormous compassion. One aide called Riva “Hollywood” because she knew that’s where my mother had grown up. All of Riva’s family had been in the film business, and she’d graduated from Hollywood High School. No doubt Riva had shared with her caregivers some of the anecdotes familiar to me, about trick or treating at W.C. Field’s house and being cast as an extra in a Bing Crosby movie as a child.
Several nurses told me that my mother had read their palms. “She really was psychic!” one woman said. “She took the time to get to know us,” another nurse told me.
Now Chris handed us a Jewish prayer book, which she’d borrowed from a resident on another floor. One prayer stood out, and we read it aloud to Riva:
Oh God, the soul you gave me is clean. You made and created it; You breathed life into me and keep me alive. I know that some day You will take life from me, but only to continue it in another world…Blessed are You, O Lord, who can return life even to the dead.
Wait a minute.
Was there a Jewish God who could return life to the dead?
Peter and I had both received a Jewish education, but we’d never heard about the possibility of a Jewish afterlife.
Riva, however, had not stopped teaching us new tricks. And we were comforted by the idea that her soul might know where it was going.
A childhood friend called and reminded me that Riva used to say wonderful things were going to happen when she “dropped her body.” It comforted me to think that while lying flushed and still in her bed, Riva was fastening her seatbelt, ready to take off to somewhere she’d been thinking about for decades. Somewhere peaceful. And/or exciting.
In some ways, Peter and I were driving her to the airport.
Sitting by her side, watching her breathe, felt like a sacrament, we kept saying.
Riva’s aides and nurses addressed her sweetly, even though she gave no response. They stroked her stiff limbs lovingly, as they took her vital signs, adjusted her sheets, or refreshed the cool washcloth that lay across her forehead.
What I’d struggled to do all my life came so naturally to them; I’d been uncomfortable playing the role of my mother’s caregiver from the time I was a small (unqualified) child.
Now, however, they inspired me to see her in a new light.
Riva been living at Steere House with enormous dignity, I realized. She lay dying in diapers, unable to speak, but I felt her courageous composure and tried to emulate that. She’d accepted the last years of her life with courage, humor and class. Surely I could help her cross the finish line.
Or begin the next chapter!
“Lots of people with dementia lose their inhibitions,” Chris, the head nurse, told me now. “I’ve been called racist names by lots of little old ladies, and been treated terribly.” She looked over at Riva. “But I have never once heard your mother raise her voice. To me or to anyone else. She has been nothing but kind and appreciative for the four years she’s been in my care.”
I felt proud of my mother.
Life at Steere House had been reduced to small acts of grace. A nurse held Riva’s hand one extra beat after taking her pulse. An aide who worked on another unit – who I saw only once – smiled at me in the hallway. A demented old woman held a baby doll in her arms in the communal lounge, cooing as she described the wonderful day they were going to have together. And I didn’t look away, or flinch.
I felt present.
The stage was set.
The supporting actors – consummate professionals – knew all their lines.
The lead actress – perhaps best of all – knew the role she needed to play.
Riva had been unresponsive all weekend, and now her breathing became labored. So my brother and I decided to spend the night in her room. Chris arranged for a cot to be set up while we sat in the lounge and talked about what might happen.
I became frightened of what had once been described to me as “the death rattle.”
“What will it sound like?” I asked Chris. “How will I know when my mother’s actually dying?”
Chris described how Riva’s breathing would become more labored and erratic, how periods of apnea would increase.
I took a Klonopin.
“I don’t know if I can do this,” I said.
Chris told us about the first time she’d experienced the death of a patient. She had to dress the body afterwards and was afraid. A veteran nurse told her to speak to the body as though it was alive, and that worked. Chris has done that ever since.
So I took a leap of faith.
Peter and I spoke to Riva constantly. We kissed her and held her hand. We told her how much we loved her, and complimented her on the great job she was doing, reminding her that she could let go at any point.
We talked about her two best friends, long departed, Mary and Norma. “They’re waiting for you,” I said.
“And so is Dad,” Peter added.
A tall, handsome man named Israel was Riva’s nurse for that last night. He explained that he’d be coming in every hour, to give Riva some morphine drops, under her tongue.
I gave Peter the cot to sleep on, and rolled out a bright blue yoga mat I’d brought, to sleep on the floor.
And then Oscar the psychic cat appeared.
He sat on Riva’s bed quietly, then moved to a nearby folding chair, glancing down at me occasionally, on the floor. “You got this?” I imagined him saying.
“I’ve got this,” I thought. “Kind of.”
I lay on the floor, covered in my heavy black down coat, listening to piano music on my headphones, and then to my mother’s breathing.
I’d been so afraid.
Maybe it was Oscar’s presence in the room. Maybe it was the Klonopin I took. Or how handsome Israel was. Or my brother’s beautiful rendition of Lou Reed’s bittersweet song, A Perfect Day, which he sang on and off to Riva all night, strumming on the guitar he’d brought…
But I found my dying mother’s breathing to be beautiful. Primordial. It sounded like the music of humpback whales. Fierce and determined, powerful and poignant.
It was awe-inspiring.
We didn’t sleep very much. Oscar left the room while I dozed off.
And then Israel came by one last time, just before dawn, appearing like an angel in the darkness.
Peter and I shook his hand and thanked him for taking such good care of Riva. He told us that it was nice to see family members present. “Sometimes a person dies all alone,” he said, “And all we do is call a lawyer.”
I brushed my teeth in Riva’s bathroom, and then sipped orange juice and picked at some cold scrambled eggs from the courtesy cart that had been provided for us.
Riva’s breathing grew more labored. The periods in between each breath became frighteningly long. I sat by her bed holding her hand, stroking it, telling her that she was doing a great job, and who was waiting for her on the other side.
My brother continued playing his guitar for Riva. Over and over again he sang Lou Reed’s lyrics: It’s a perfect day. I’m glad I spent it with you.
A nurse named Suzette started her shift. She checked on Riva and then turned to me, with a concerned look on her face.
“Go light,” Suzette said kindly.
I looked at her.
“I lost my mother three years ago,” Suzette told me. “I know what you’re going through. But go light.”
I glanced at my mother, breathing long, hard breaths.
She was not going light.
But I had to.
I decided to leave Riva’s room and listen to a powerful guided meditation my friend Belleruth Naparstek, a gifted therapist, had recorded. It was hard-core. The stuff I listened to when the going got tough. When I needed to cry.
I thought that watching my mother die qualified as tough going.
“I love you, Mom,” I said, bending down to kiss Riva’s ruddy cheek. “I’m going outside to meditate for a little bit.”
I lingered over my mother’s bed for a moment, watching her labored breathing, her closed eyes fluttering with each exhale. Then I walked out of the locked doors of her unit, and found a comfortable wing chair in the hallway. I sat down and put on my headphones, closing my eyes as music started playing, nudging me into a meditative state.
Belleruth’s guided imagery downloads had seen me through many turbulent plane rides, battles with insomnia, and other stressful situations.
Now I needed her more than ever.
I settled into my chair, trying to tune out the people walking past me. I imagined the warm energy of my breath healing sore, tense parts of my body. I noted thoughts coming and going, and emotions rocking around inside of me.
Belleruth’s words led me to imagined spaces I conjured up deep inside of me. A path in the woods opened up to an enormous valley, high up in the mountains. I imagined myself staring up at a brilliant blue sky. Wildflowers swayed in a cooling breeze; I could feel the warm sunshine on my skin. The setting was breathtaking, and I felt held in Belleruth’s loving embrace.
A large group of people emerged into my imagined landscape. There must have been two hundred of them, filling the entire valley, standing by the wildflowers, quietly watching me.
And then my mother appeared, skipping into the crowd with a lightness of spirit that moved and delighted me. She looked like she did when she was about my age, her hair just turning grey, clad in one of her distinctive flowing skirts, giddy at the prospect of what seemed like a party.
Suddenly I recognized two women in the front of the crowd – her old friends Mary and Norma, long departed. They linked their arms through Riva’s and tried to lead her away, toward the mountains.
But my mother kept glancing back at me, laughing and smiling, shaking her head, as if to say “I don’t want to leave you, Priscilla.”
Belleruth’s voice began urging me to leave the scene as well.
I didn’t want to leave my mother, however. We kept glancing back at each other.
Over and over again, we tried to part ways.
But we couldn’t.
And then a strong male presence stepped out from the back of the crowd and approached Riva. He put his arm around her, turned, and led her away.
I could sense that this person was my father. I felt that Riva belonged with him.
And so did she.
She looked back at me one last time, with her sweet little smile, and walked away.
I turned and left the scene as well, retracing the imaginary steps and path I’d taken on my way to the mountains and meadow.
Breathing deeply, I reemerged into my surroundings slowly, opening my eyes.
I sat still for a minute and then the doors to Riva’s locked unit flew open and my brother appeared.
“I think Mom’s gone!” he cried out.
We raced back to Riva’s room and found her lifeless.
I bent down to kiss her cheek one last time, held her still face in my hands, and burst into tears.
Then I noticed two other women in the room – a physician assistant who’d been caring for Riva for years, and a hospice nurse, new to the case.
My brother had been shaving in a rest room down the hall when these women arrived at Steere House, rode up in the elevator together, and walked into Riva’s room.
“I told your mother that I was going to take her vital signs,” the physician assistant reported. “When I put my stethoscope to her chest, I heard three flutters. And then she was gone.”
Riva had orchestrated her departure to a T.
The two women left, and I hugged my brother, as we both cried.
Suddenly I remembered something that a nurse had instructed me to do.
I ran over to the nearest window and opened it, so that Riva’s soul could fly out.
Then I returned to Riva’s bedside one last time and smiled at Peter.
“We rocked this death!” I said to my brother, high-fiving him over our mother’s dead body.