In about November of 6th grade, I realized my grandmother was actually dying. Our town’s tiny community hospital only housed about 20 patient rooms, lined up neatly along one hallway. The other corridor of the L-shaped facility had a small lobby with brightly colored vinyl seats in shades of turquoise, orange and yellow, a glass-doored reception window, and a row of wide-doored rooms. The ambulance bay, home to our town’s single ambulance, faced out toward Chestnut Street, and more specifically my best friend Shana’s house. She and I used to make up outlandish stories about the tragedy and gore we could see arriving at the hospital from our vantage point on her front porch. We imagined that we could view all manner of carnage on display, so we spun wild tales to each other about the wreckage we witnessed. We of course saw no such carnage whatsoever, but that did not prevent us from telling barbaric tales of gore to one another just for our own entertainment.
I vividly recall one of the exam rooms in this second corridor. It housed the x-ray machine hovering over a steel slab of a table, topped with a duller shade of the same vinyl as the lobby chairs. It was upholstered in army-green, and in fact it is not altogether unlikely that this little hamlet hospital purchased both table and x-ray equipment from a military surplus vendor.
I remember this room so clearly because it was the only one I had any experience with before my grandmother was a patient in this place. In there, I earned a set of stitches in my head from leaning so far back in my chair that I toppled backward, dragging my scalp across a protruding nail.
When I asked Dr. Niles if the stitches would hurt, he flatly replied in his monotonous, unforgiving tone, “No. They’re all done,” and then he gave my mother whatever wound-cleansing instructions were necessary and the date and time we were to return to have the stitches snipped and removed. Dr. Niles was a good doctor, but he was no pediatrician, and his bedside manner left no room for childhood shenanigans. He tended to every person in Port Allegany, from the youngest to the oldest, and that left him little time to soothe my worry while he stitched my scalp.
I was in the same room the time we met Dr. Niles there, my having just broken my ankle while sledding. I asked if the x-ray would hurt and the nurse laughed at me, saying, “It’s just a picture, honey,” leaving me to wonder what that heavy lead drape was for, then.
By the time I broke my ankle, my grandmother was already dead. Her belongings and her body were no longer in that hospital in a room around the corner and down the hall from the x-ray machine. My ankle was hideously swollen and mangled, but did not require surgery. Dr. Niles ordered a few days’ bed rest and elevation which bought me a week off of school where my dad, when he was home, would carry me from the living room couch to the kitchen or to my 2nd floor bedroom. He would change ice packs and deliver chocolate milks. I was too young to appreciate how similar this must have been to caring for his mother, dying of cancer, just weeks before. Or maybe it was altogether different and yet it cleansed him of caring for the dying by letting him care for the knitting and mending.
In going for this x-ray, I had no real sense of the familiarity the place would bear, having hosted a family death not long prior. Although I was certainly aware of my grandmother’s death, the place seemed disconnected, like they were two separate facilities. For me, they were. I had gone there for a fix-up. My grandmother had gone there for an ending. For my parents, though, and especially my dad, they were not two separate places at all, but one aluminum-sided spectacle of unpleasantness.
When I broke this ankle, had it examined and later encased in fiberglass, I could not have recognized this similarity of place.
Throughout that winter, I had gone to the hospital after school or on weekends to visit my grandmother. Though her room had 2 beds, she was the only occupant. Her bed by the window had a bedside table littered with a box of Kleenex, the standard dusty pink plastic hospital-issue cup, some pieces of ceramic nick-knack she had made, and an assortment of family photos. I doubt she had word puzzles or magazines or even a novel. These would not suit her. The windowsill was peppered with get-well cards propped open and standing for display. Get well cards for a dying woman now seem to me to be purposeless things, selfish of the sender.
She kept a multicolored afghan on her bed, either spread to keep her warm or neatly folded to drape the foot of the bed. She no doubt had crocheted it herself, long before the cancer took away her ability to make this and the other pretty, but useless, adornments of her life, like the matching his and hers Chopper Hopper denture keepers she had painted according to a photo pattern in ceramics class. Back when she still canned every vegetable from her garden without the real intention to use it, just so she could put them on the dining room table for Sunday dinner, bragging that she had canned them. Back when she baked spice cakes from a box while still claiming the praise for a from-scratch confection.
I liked to sit on the afghan when it was folded at the end of her bed, but if it was pulled all the way up, I just stood. I don’t know if I was afraid to sit on her bed without that afghan-delineated safe zone or if I just didn’t feel welcome. Perhaps, even though I didn’t realize what cancer was, or that it was killing her, I knew sitting on her bed was not a safe space.
Aunt Carol sat on her bed all the time. I would see her, close up to my grandmother’s head, stroking her head or fixing her hair, maybe spooning halfway melted vanilla ice cream into her mouth from one of those tiny single-serving cardboard containers. Her hair was matted and flat from the pillow, but there Carol would sit, fussing over every little thing, seeing to it that her mother was presentable to any and all visitors, straightening the sheets, rearranging the cards, primping the flowers, generally keeping up appearances. Carol kept with her a copy of Elisabeth Kubler-Ross’ “On Death and Dying.” I didn’t make the connection. My mother made it for me.
As a matter of adequate preparation, my mother made some reference to “after grandma dies.” I was taken aback. Hospitals, to my young brain, were places of healing. Everyone I had ever known had come out of the hospital better than they had gone in. In that single phrase, my mother schooled me about the reality of death for the very first time. Soon,, I arrived at the solution.
“If grandma dies, I want to die too,” I claimed.
“Don’t be silly,” she said. “It will be sad, but it’s just her time.”
I don’t think that I was saddened so much by the thought of this old woman dying as I was inexperienced and confused by the thought of death itself. I knew it was inalterable. This would be my first real loss, although not my greatest.
I continued to visit her, keeping this fatal knowledge to myself but now understanding my aunt’s book.
I wasn’t allowed to visit alone. That didn’t surprise me, even though the hospital was an easy two-block walk from my house. I had never gone there by myself, because the only times I’d been inside were for the few minor childhood accidents I’d had.
I’m told my mother carried me the full two blocks, piggyback, when I was five and I managed to wedge an enormous splinter in my heel, deeply enough that good Dr. Niles was summoned to remove it. Although he was the only doctor in town, a general practitioner caring for everything from birthing to splinter removal to cardiac arrests, I don’t think he was my grandma’s doctor. Except maybe he ordered the increases in morphine as she slid toward her end.
Port Allegany Community Hospital was, I’m sure, chosen for her not because of any medical expertise in advanced cancers, but because it was close. Piggyback-carrying distance. And my grandmother’s own house, where my grandfather still lived and that was Carol’s and my dad’s childhood home was over the hill in Smethport. Just tem short miles away.
Carol spent her nights in Smethport tending to my grandfather, but she spent her lunches and other breaks in our house. She botched up the system and got in the way sometimes, but that’s just what visitors do. That’s all I thought it was, anyway. She could drop by in the evenings to give updates and then head back over the hill for the night.
I didn’t pay much attention to the times she and my father would bicker because it seemed, too, that they had soft talks. My own brother and I rarely spoke kindly to each other, so I accepted their differences as the sort of thing that siblings do. When your mother is in the hospital down the street, you’re allowed to be tense.
We had Thanksgiving at our house and my cousins came in from New Jersey. They hadn’t been able visit because they had to stay in school. I felt like I had an advantage, being able to be with her more often. They brought her two kittens to visit. To cheer her up, they said. But I really knew they had just talked their dad into buying them a kitten apiece since their mother was away. Dads will do that kind of thing for their daughters. That much I knew.
I was not to visit when the girls were with grandma because Aunt Carol said that the room would be too crowded. I figured as soon as they left, I could go back.
On Friday, the day after Thanksgiving, my brother was allowed to visit at the same time as my cousins. I was too young to understand the rules were different for him than they were for me. The kittens went home with them. I was right about that much.
Everyone seemed tired. Lots more people driving in to see us and my grandma than usual. Plus, the holiday season always got busy for my dad, who ran a State Liquor store about 45 minutes from home, past Smethport even. In the winter months, driving across the steep section of the Allegheny Mountains sometimes took more than an hour. Dad took great pride in making the trip five days a week, season after season, and having never gotten a speeding ticket or hit a deer, smashing up the car the way so many people in that area did. It meant he was responsible.
Because he worked in retail and because his commute was far and the length of time varied, he was sometimes be home at six and sometimes as late as eleven. So, my mother and I visited grandma sometimes without him, although I think my mother did it out of duty more than out of a daughter-in-law’s affection for her husband’s mother.
We’d bundle up against the snow and head, my mittened hand in her gloved hand, walking to the hospital. Winters in Port Allegany are bitter, thanks to chilled Lake Erie winds and the surrounding mountains. The town often became a snow-blanketed wonderland barely accessible without four-wheel drive trucks and tire chains. Braving the cold, we’d walk the short distance briskly, welcoming the warm rush of air guaranteed in the hospital lobby. Though it was twilight outdoors not long after 4 o’clock, the lobby’s fluorescent overhead bulbs made it seem almost cheery.
One cold night, kicking and shuffling the wet snow from our boots, we swept through the doors and turned left down the hall. My mother gave a friendly, obligatory wave to the nurse at the front desk. The nurse probably merely nodded in return, a Harlequin Romance or patient chart deserving more attention than a regular visitor. There were only three or four patients in the hospital, a key reason for its closure a handful of years later.
We walked down the hall, brushing the remaining flakes from our coats and loosening our scarves, tucking my mittens into my pockets since I was so good at losing them one at a time. They were handmade by my mother who knit instead of crocheted. As we tentatively approached my grandmother’s room, we could hear murmuring voices. My mother was always careful to check before allowing me in, just in case my grandmother had, just moments before, expired and was surrounded by the fever pitch and cleanup of death.
She wasn’t dead. She had visitors. Old friends from out of town, just passing through perhaps, were coming by to pay their respects in advance. Snowbirds, saying goodbye one last time before they flew off to enjoy their winter in Florida, aware they would not bother to make the trip back for her funeral. Casual friends. My grandmother had oodles of those, having been a hairdresser for years she had in some way served countless people and moderately befriended them, the way bartenders do. I knew they were not close, lifelong kinds of friends because Aunt Carol was chatting on and boasting about events of the past few years. Besides, I hadn’t seen them here before and I had been around enough to know all of the regulars.
My mother motioned to me to wait here, in the corridor, rather than going inside. She stayed outside, too; presumably she could tell that they were winding things up in there and didn’t want to intrude.
I wandered down the hall, trailing my fingers along the banister meant for those who needed it as a steadying guide. It was thick, molded plastic with a curve inward toward each door opening. My boots dripped melting snow onto the pathworn carpet. I had reached roughly the halfway point; I had curved along with that railing, leaping across each door’s opening, for 3 or 4 doorways.
I heard my mother’s coat rustling, her footfalls coming behind me, and she scooped up my mittenless hand in her warm, dry one. She was walking fast.
“Come on, sis. We have to go now.” She said. Her voice was clipped, quick.
“But –“ I protested, confused but obedient.
“We’ll come back some other time.”
She didn’t slow her pace. She maintained a good clip, but not a run. It wasn’t panicked, but it was determined, that pace of hers. It made me nervous.
She wrestled my mittens on in the lobby, and re-wrapped my scarf before we slipped through the glass double doors and back out into the dark, cold, and snow.
We didn’t speak on the way home, which was unusual, but dashing out of a hospital was pretty unusual, too.
At home, we unbundled and my mother routinely set about making dinner. While she chopped and stirred, I rearranged record albums in my room or contemplated the Andy Gibb poster on my bedroom wall, or any of a dozen other mindless pre-teen pursuits. I had simply dismissed the odd exit and return home. It no longer seemed important. One of the gifts of being an eleven year old is that things that don’t matter to you simply don’t matter.
Dinner was still on the stove when my dad got home. I heard his heavy work boots scraping on the wooden porch. Pictured his reliable entrance. He kept to a routine that I could follow by sound. The jangling of his keys as he looped them onto the crisscrossed key rack by the door, the extra push to be sure the heavy wooden door was secured, another scraping of his boots on the mat. He wouldn’t unlace them standing up. Instead he would sit in the black, plaid-cushioned rocking chair as he untied each one and dropped them onto the rag rug for dripping. He would slide on his leather moccasins and complete the pattern by hanging up his coat on his way to the kitchen.
Dinner preparations came to an immediate halt as I could hear my parents’ voices. My bedroom was directly above the kitchen, so I had the distinct advantage of being able to hear them, although I could rarely make out the words. I could gather, from tone and volume and tempo what kind of discussions they were having any time I wanted to listen in, which I did often. My parents were a great composite, and had frequent, fruitful discussions. Coming from a generation where still most households were divided into one spouse acting as the benevolent dictator of another, my parents were far ahead of their time. They held equal footing. They valued one another’s insights and opinions. One never overruled the other. In matters of importance, they negotiated like allied nations until a fair and respectful decision was reached. All parties left the table satisfied. In parenting, there was not a single occasion when one undermined or contradicted the other. That was the strength of the two, and I did not know how often that strength had been tested or how much weight it would someday bear.
The tempo in the kitchen rose. The water in the faucet ran and then stopped. A brief silence followed, but was soon broken by sharper sounds, muffled frustrations. I eased my bedroom door open slightly, hoping to hear threads of this rising pitch. I may as well have taken the door off its hinges because I heard, clear as day,
“That woman is never to set foot in this house, Jim! Not EVER. Not in my house. I can’t do it!”
I heard this, followed by sobs. A desperate, heaving sobbing that came deep from within her chest. I pictured them, now near the dining room doorway, unable to imagine who this evil woman could be. I’d never heard these sounds coming from my mother. I’d never known a time when my father had to console her this way. She was a remarkably stoic and measured woman, now hefting sobs of anger onto this man.
It couldn’t be about my grandmother, because, as it had been made clear to me, she wasn’t leaving the hospital again, let alone coming to our house. Maybe some nurse had insulted my mother. Maybe I was totally off base and this had something to do with work or neighbors. It was a puzzle.
Things quieted back down so that I could no longer hear anything of their conversation, if there was any. I nudged my door closed again and made myself think of something else. I knew I had math homework to do, so I found ways to avoid doing it. I pushed the brief explosion away from my brain.
Mother came up the stairs, and I expected she would tap on my door to call me to dinner. Instead, she retreated to her room and closed the door behind her.
Dad rang the bell at the bottom of the stairs. He had tired of bellowing for my brother and me, so he had installed a replica of a ship’s bell at the base of the stairs. My brother could hear it even when he was blasting heavy metal through his oversized headphones. That was the point. We’d hear the dinner bell, no vocal disruptions from downstairs, and scramble into the kitchen. My father especially did not tolerate lateness to meals. He often told us about his Air Force days, when showing up late could mean not getting a meal at all.
My brother and I gathered in the kitchen to eat the meal my mother had prepared but would not get to enjoy. She stayed in her room through dinner; she did not emerge to negotiate the inevitable argument my brother and I would have about whose turn it was to wash and whose it was to dry. My brother hadn’t heard the outburst. Those headphones had swallowed his head and protected him from knowing.
Long after the dinner, the dishes, and the dishwashing argument, Aunt Carol came in the house. I was again in my room, but I knew it must be her since no one else would enter without knocking. She went toward the kitchen, where my dad would be sitting, smoking his cigarette or pipe and savoring his last coffee of the day. After-dinner coffee was a given in our house, usually brewed while Brian and I fumed over our clean-up duties. Black coffee, not decaf, always present in the evening hours and all the more pungent when the windows were closed and the house warm and soft-lit.
Again I heard the undulating voices in the kitchen below me. I’d already put on my warm pajamas and dug in under the multiple layers of blankets. Aunt Carol was probably getting her own cup of coffee and updating my dad on his mother’s condition.
This time the tone was low. My father’s voice seemed to have dropped an octave and his speech was measured, slow. I couldn’t make out Aunt Carol’s end of things, but then there was a sharp, jarring slam. A kitchen cupboard slapped closed in anger, shock, or both.
I heard the coffee cup clink against the porcelain of the kitchen sink, but not shattered or thrown. The scurrying of feet that could only have been my aunt’s. The rustling of her coat as she fluttered from the kitchen through the house. The doorknob turning, door opening, and closing resolutely but without great force.
I drifted off to sleep with a tattered, doll-sized version of my grandmother’s afghan folded at the foot of my bed. I imagined grandma crocheting it for me as a baby. Pink and white, zig-zag stripes so similar to the one on her own bed.
On December thirteenth, a Saturday or Sunday morning, when I padded down the stairs in my footed pajamas, my dad was waiting for me in his plush brown recliner. His small array of pipes rested neatly in their oak holder on the end table beside him. He motioned to me with a sweep of his arm, his usual gesture to get me to come and sit on his abundant lap. I did so with ease, knowing his big arms would provide a perfect nestling spot. A spot where I could plan a snow adventure while staying warm and cozy.
He hugged me a bit more tightly as he gently said, “We lost grandma last night, sis.”
I cried. Heat washed over me, and I caught the familiar smell of my mother’s winter-morning coffee cake, the one reserved for Sundays and snow days. The house was warm and dry. My face was hot and wet. The snow outside now looked repulsive now. I had a hundred questions and I didn’t know how to ask any of them.
There were blurry days of swift preparation, my cousins coming back from New Jersey – this time without kittens – phone calls and plants arriving at the house, clothes being laid out for my brother and me, and three full days off of school with no sledding or snowman building. We stayed indoors. We fetched things when asked. We made polite small talk with people bringing casseroles or muffins. I thought maybe I would be asked to sleep over this time, but then I realized that they were staying at grandpa’s house and grandpa’s wife had just died and this was no time for a sleepover.
When we did go over the hill to Smethport and pulled up in front of the house it seemed eerie to me. I hadn’t been here since grandma went to the hospital. Everyone had come to our house instead, at least until the day of the hospital-leaving and mother-shouting.
I didn’t like wearing the chunky boots with my fancy dress, but the snow was knee-deep. The lining of the boots pulled and tugged at my pantyhose and made me feel awkward and askew. The funeral process took three days and each of those days we had to drive to Smethport. Most of the time, my family went straight from our house to the funeral home and back again. There was no church service because grandma didn’t go to church. But there was a minister at the funeral home service and he rode in the car way up ahead of us on the hour-long trip to the cemetery. My brother rode in the car with my cousins, and they played tic-tac-toe all the way, or so he told me. To get to the cemetery, we had to drive right back through Port Allegany, and past it through several other tiny towns. It was a very long ride to be all alone in the back seat of my parents’ silent car.
After she was buried, I imagined snow filling up the grave hole. I thought they would have to dig it all back up to fill it in with dirt. I was tired, and so was my mother, so dad took us home before going back to Smethport again. I don’t remember if my brother was tired, too, or if he rode the whole way back with my cousins, but he probably did. He was older, and that arrangement would make sense to me. Plus, I don’t think the cousins-car stopped to drop him off with us.
A day later my uncle and his girls drove back to Jersey. Drove back to see their kittens and left their mother to finish up whatever adults finish up when their parent dies. I heard that Aunt Carol would spend some weeks going back and forth between New Jersey and Smethport, making some sort of plan for my grandfather because he simply shouldn’t be left alone.
The tension rose and fell all winter at our house. Grandpa spent Christmas in New Jersey. We had record snowfall in Port Allegany. Aunt Carol made a couple of trips, but each was brief and involved no visiting. I only even knew she was there because my father would go, too, and my mother would be quiet and reserved and stayed home with us.
By late January, when winter is at its harshest in that part of the country, Aunt Carol stopped making the trips. We had several days of school closures due to harsh snows and impassable roads. Perfect days for sledding unless you’re about to break your ankle barreling down an icy hill heading straight for a crooked tree. Perfect days unless you’re going to wind up back at that hospital, with a nurse assuring you that x-rays don’t hurt and your father is going to have to carry you around everywhere. And perfect, until you discover years later, that your rapid exit from the hospital with your mother was just as much about someone else as it was about you.
All of that tension, all of that outburst that night in the kitchen while you were trying so hard to listen - that was about you. And Aunt Carol, Aunt Carol was the source and your dying grandmother was just the vehicle. Really, that day was as sure to crash as your sled was destined to smack against pine bark.
While you were tracing your way down the hall, your aunt was inside that card-and-afghan-clad room pointing out the people in the photos to those unfamiliar visitors:
Aunt Carol was showing off some family photos on the bedside table...
“Yes, this one is me and my husband and our two daughters Melissa and Melinda. No, they’re not twins. They’re a year apart. Oh, thank you. They are lovely, aren’t they? And that’s my brother Jim and his wife, Bettie. That’s their son, Brian, and the little girl they adopted.”
Your sixth-grade self has just been introduced, nameless, as a distinctly separate entity from the rest of the family. “The little girl they adopted.” It must ring in your mother’s ears like a close-range shotgun blast. The little girl they adopted eleven years ago, who looks strikingly like her father despite not sharing a shred of DNA, who climbs on her daddy’s lap every chance she gets, who has never been referred to by them as anything but their daughter the same way that they’ve always called their son their son.
The little girl who, not long from now, will rely on her dad, not her adopted dad, but the only dad she knows, to forget mourning the loss of his own mother long enough to tend to his daughter’s broken ankle and her every need. The dad who will choose, not despite this venom, but because of it, to quietly ask his sister not to return to his house even as their mother is dying. He will tell her that the bond to his wife and daughter, both enacted on legal documents and not bloodlines, has far more tensile strength than the tie of lineage.
The hospital, and the ties to it as a place of hospice, will melt away. The swelling around the ankle will go down. The wounds of the heart will sting less severely with distance. But the brokenness of a sister who will not name her niece - that is the cruelest tie, the sharpest knife.
When your mother lies, dying, and your wife stands, pleading, there is only one choice you have as a man. To choose your girl. My father chose me, Susan, never to be his Nameless Girl.
*The Port Allegany Community Hospital closed years ago. It’s now a Community Fitness center, housing an aerobics and jazzercise room for overweight women and a nautilus weights and treadmill room for aging men. I spent countless evenings on Shana’s porch trying to catch a glimpse of some mangled body, being moved from ambulance to ER and had nothing but fiction and speculation to tell about it.