If Only . . .

by ALVIN ABRAM

This story appeared in April 2007 ARS MEDICA: A Journal of Medicine, the Arts, and Humanities - Department of Psychiatry, Mount Sinai Hospital, Toronto

I was asked in 1994 to speak to an audience of about four hundred donors at Baycrest Home for the aged in Toronto about how my mother came to be there. I told a variation of this story, leading to the fact that love was not a word spoken in our home, and with my mother in the final stages of Alzheimer's I regretted not telling her how I felt about her face-to-face. I would say the words to myself often but not have the courage to tell her. After I finished my story, I turned to my mother in the room, strapped to a wheelchair, body slumped forward, head down, and I finished by saying, "I love you, mother."

To everyone's surprise, my mother raised her head and tried to stand. A photographer ran over and began shooting photographs. My wife undid the belt and helped my mother to her feet. She bowed to the people, smiled, and fell back onto my wife's arms. She was placed in her chair and strapped. The people and I were stunned, to say the least. My mother had not voluntarily moved in over a year. A few weeks later she passed away in her sleep at the age of ninety-two.


I HAD HOPED that when I met with the doctor, the news I would hear would at least offer me some hope. But what I heard was as bad as it could be. “Is there any kind of medicine that might make a difference?” I whispered.

“No, I’m sorry, there isn’t. If there were I would have recommended it.”

“How long?”

“It varies. There’ll be a steady decline in health. You’ve already seen some of it. It will become more obvious in time.”

“And now . . . what do I do now?”

“Your mother can’t live alone anymore. She needs twenty-four-hour care. You knew this day would come.”

“I’d hoped it wouldn’t.”

“What she has is a progressive illness without any known cure. At least not as of this moment.”

My voice trembled. “I’m not ready.”

“I don’t think anyone ever is.”

“There are words that I wish I had said to her, but if I say them now . . . she can’t hear them.”

“Maybe she can,” the doctor said. “No one knows.”

I rose. “Do you think so?”

He shrugged and gave me a tired smile.

I SAT IN my car outside my mother’s apartment building, unwilling to enter, knowing what awaited me in her apartment. I knew, no matter how long I sat there, nothing would change. The inevitable awaited for me. I had made excuses for months for what I was seeing. I refused to accept the truth, but the truth refused to go away. In my eyes, my mother appeared ageless. European-born, with simple old country logic, she was my friend and protector as I grew up in a trouble home.

Public school was fraught with mediocre marks due to my lack of interest and my short attention span. I was disciplined by the principal often. I had few friends. At home I would go into my room, close the door and bury myself in a book – it became my universe. My mother sensed it was where I hid. One day she came in and asked, “What happens to you when you go to school? I know you’re not a bad boy, so something must happen that I don’t know about. Do you want to tell me?”

I struggled with the words. “I dream,” I said. “I make-believe I’m one of the people in the book I’m reading. There’s adventure. I’m their hero and there’s no pain. The teacher’s voice disappears and I can see everything in my mind. Then the teacher catches me and makes fun of me when I tell her I was dreaming. Everyone in the class laughs and she would send me to the principal’s office.”

“Do you know that dreaming is not real?” my mother asked.

“Yes, I know, but for a little while, it’s real to me. Is that wrong?”

She smiled. “No, it’s not wrong,” she said. “Just as long as you know it’s not real. It’s a gift not everyone has and those who don’t, won’t understand. To be in one place while you’re somewhere else in your mind is like magic. But you must share this gift with the present, and maybe some day you’ll be able to use your gift so that others can enjoy what you see in your mind.”

Life was hard. When I was eighteen, my father died from a heart attack. He had been my mother’s big love. She was a good mother, but she never spoke the word, ‘love’ and yet I never felt unloved.

I SIGHED. I had to go into the building. I left my car, went in the front door and rode the elevator to her floor. I loved being with my mother. There were times when I would invent reasons to come to her building, just to inhale the aroma of her cooking, to have a no-nonsense conversation with someone I admired and respected. Then I saw the changes in her. I made excuses. Her apartment took on a look of neglect and her clothes were often unwashed. Her conversation was increasingly stinted and broken.

The elevator stopped and I reluctantly walked towards her apartment. Beside her door was a mezuzah to bless those who entered, but I did not feel blessed by what would confront me. Her home always rang with laughter and all around the walls hung souvenirs of her sons childhood. To visit my mother’s apartment as an adult was to feel young again. Her home was always filled with good memories. But now I hesitated at the door. I did not want to enter.

I knocked, even though I had a key, praying she would greet me with that familiar twinkle in her eyes, but all was silent. I hesitantly placed the key in the lock and opened the door. She was sitting on the edge of the couch wearing her nightgown and housecoat, hands clasped in front of her, her head bowed. I prayed she would turn her eyes towards me, but she appeared unaware of my presence. I was late tonight and the woman I hired to be with her had gone home. “Hello, Mom, how are you?”

She did not answer.

I turned on the lamp. Still no sign that she was aware of my presence. She sat in a room surrounded by her past, a past she no longer remembered. I sat beside her and began the ritual of my visit by telling her about my day’s activities. I told her she would soon be a grand bubbi. Her other two sons would be coming tomorrow. She blinked and a tear formed in the corner of her eye. I couldn’t find the words to tell her what the doctor had said.

She looked at me and smiled. “Where’s my mother?” she asked.

She asked the same question every day. “She’s gone out for a little while,” I answered. “She’ll be back soon. Don’t worry.”

I felt the pressure of her fingers on my hands; her skin tough as leather, creased and marked by the many hours she had worked with a sewing machine. The look on her face did not change. I waited for the next question.

“Do you know my mother?” she asked.

“No, but I know a lot about her. She’s a nice person, just like you.”

Her head bobbed ever so slightly in agreement. She had not looked at me when I spoke and I wondered if she knew what I had just said.

“Who are you?”

“I’m your son.”

She stared at me. “Do we know each other?”

“Yes, very well.”

Her head slowly dropped, her eyes to the floor. The smile slipped from her face. I knew I had lost her again. I led her to her bed and removed her housecoat and covered her with the comforter. I leaned over to kiss her good night and headed for the door, but I stopped to look back at her. She lay still, lifeless. She looked so fragile. Time no longer existed for her. At least not the time I knew.

I turned off the lights and left, locking the door behind me. In the morning, the woman from the agency would come. What had just taken place would not be remembered by anyone but me. Alzheimer’s is painless for those who have the illness, but not for those who remember how things used to be.

I returned to my car and stared up at her window.

If only . . . she knew how I felt.

If only . . . I had said the words when she could have understood.

“I love you, Mother,” I said aloud. “Can you hear me?”