Mother

Every afternoon was nap time for inmates in the nursing home, but like me, mother rarely slept during the day. She was reclining in bed holding a glossy magazine as I walked in the room. "Mama," I called out. She turned round and looked me in the face. Then for a brief moment, her eyes smiled. Mother hadn't recognized me for a few years now, but her soul still knew me. 

Oh how I desperately needed to believe her soul would always know me.......

 

Mother had Alzheimer's Disease. Like many sufferers, she had struggled alone against the gathering fog that slowly clouded her mind long before any of us realized. On one of my visits to the US, I accompanied her to her family doctor. Dr L was held in awe and high esteem by both my parents, even though he had consistently failed them. " Mother's not well, she might be depressed" I said. " Nothing untoward's happened, right? There's no reason why she should be" he shrugged away the absurd idea." You do know that my brother and his family have moved out to be nearer to my niece's school ?And old people can get depressed for so many reasons" I realized then he knew nothing about my parents, moreover, was not interested. We were swiftly ushered out by a nurse because the big doctor's busy. Depression is extremely common in early Alzheimer's.

A couple of years later, on another visit I noted drastic personality changes. My normally gentle affable mother was irritable, combative, and when questioned on misplaced items responded with uncharacteristic angry outburst and childlike pouting. Father complained about her forgetfulness and irrational ire which unfortunately I instantly brushed aside, as he's been complaining about her for exactly the same offence all my life. For sometime now father had became so frail that when they went grocery shopping, he had to walk behind mother and lean on her as a walking stick, while she relied on him for direction to the shops; but even then Dr L refused to sign the form to grant father a handicapped parking space because filling the form would take up too much of his precious time - exactly why I gave up on him and took charge myself about mother : I sent my sister-in-law a Chinese version of the Mimi-Mental State Examination(MMSE) from Hong Kong to try on mother. She failed dismally. Only armed with the test result that mother was prescribed acetylcholinesterase inhibitor, except it's too little too late.

 

Following a series of incidents at home the local authorities deemed parents unsafe to stay by themselves and they were forcibly put in a nursing home. Mother proved to be a real handful. She was constantly agitated, fought the staff and attempted escape on a daily basis, even managed to break not one but two of the fairly expensive electronic tracking devices securely clapped on her wrist ( I inspected the devise and not sure I could break them !). On one occasion the police was called and when she was found wandering aimlessly a few blocks away, she put up a fight as a matter of course. The 6 ft tall Hispanic police looked down on this 4 ft 10 skinny old lady gesticulating and shouting wildly "I know Kung FU" and burst out laughing, his laugh tickled mother who readily joined in. Thus was how the nursing home staff found them later, an odd couple bent double with laughter. 

On hindsight maybe I shouldn't be surprised by mother's antics. Alzheimer's might stripe away memory and comprehension, but it also releases the sufferer from the socially expected speech and behavior, and once free of the particular facade that we've chosen to present ourselves to the world, something of the essential quality and character trait that constitutes and defines a person sometimes shines through brighter, if we'd only care to look. Mother never talked about her past, but my 4th aunt had plenty of stories, and I learnt there's another side to the docile mother I knew. 

Mother was born into a traditional Chiu Chow family which discouraged higher education for girls, all her sisters had arranged marriages right after high school, but mother wanted to have a career of her own, so at 16 she ran away from home in Hong Kong all the way to Beijing to do nursing. It must have taken a lot of pluck and determination to break out of the mould, particularly in Old China - it's exactly this core of steel in her character which sustained her through a life filled with hardships.

 

The years in Beijing were probably among the happiest in mother's life. Mother was warm and sociable, and the large number of friends she made in the hospital was the only reason I'm alive today. I was born premature at 28 weeks, totally flat with no crying or suckling reflex. There was no neonatal ICU and medical support was primitive in those days, but a stream of nurses volunteered to tend to me round the clock in their free time, feeding me milk drop by drop using an eye dropper. Mother was the first among her peers to have a child, possibly also because of the care they took of me, a special bond formed between me and these "aunties" and I became a daughter to them all, so that later when we had to leave Beijing they were heart broken. Being from Hong Kong mother was also much admired for her fashion sense by her northern colleagues. Mother's always good with her hands, even as a teenager she was making her own clothes, including off shoulder dresses with full skirt copied from Western movie magazines. Years later she'd make dresses for me and my sister because we were too poor to buy shop clothes - you see, poverty is no excuse not to look chic ! I'm my mother's daughter, so while in England I borrowed a sewing machine from my friend Irene and made most of my dresses and skirts, and to this day I still design most of my clothes. 

 

Parents met in Beijing quite by fate, as they were from different worlds. Father, from a rich family in Indonesia, was studying Law in Shanghai, while mother, hailing from Hong Kong, was shut away in a Beijing hospital. After 1949 in the New China, they were both assigned to work in the same commune in Beijing. After marriage father was appointed a senior post in the Chinese Embassy in India, and we were given a house in the Embassy Staff Quarters, a car, a big dog and 2 maids to take care of me and my sister. We had 3 short good years before the storm broke.

 

Father was a naiveté in politics and was made to pay heavily for speaking his mind. When he was sentenced to a labor camp in Inner Mongolia for re-education, the Authorities told mother as she's non-political she could stay on in Beijing, but she would have none of it. She's as loyal as she's stubborn, and would endure anything to be with father. ( An exact replay occurred years later when the US informed mother they'd accept her immigration application to America only if she agreed to divorce father). So began the year of exile for the whole family in a barren wilderness where temperature in winter drops to -32 °C and in summer soars to 43°C. 

A year later grandfather died in Hong Kong, and because of mother's good relationship with the officials, special permission was granted for her to go to the funeral, taking my sister and I, on the condition that we all must return after the funeral. We never went back. Life in Hong Kong was hard in the late 1950s, especially for a single parent with 2 young children. The RN (registered nurse) qualification mother had from China was not recognized in Hong Kong and she could only work as an EN ( enrolled nurse) making meagre wages, until she re-sat the exams some years later and regained RN status. Mother's immensely proud of this and even in her later stage of Alzheimer's was most happy when addressed as "Nurse Yiu" (姚姑娘). Mother was a good nurse and much appreciated by her patients. Years after retirement and immigration to America we bumped into some past patient of hers in the streets of San Francisco, who rushed up to mother to grasp her hands and would not let go.

After arriving in HK we were put up in a room at the back of one of the shops belonging to mother's family, which meant we lived under the same roof as her sharp-tongued step-mother. It didn't help that I was an unruly child, and with mother away working so much of the time, I ran wild and frequently got into trouble. Even though I didn't understand the Chiu Chow dialect, but with a child's intuition I could sense disparage, and step-grandma was super-fluent in derogatory rhetoric : how we would never amount to anything, how hopeless mother was for only having girls and for marrying father, how useless father was. Those were not happy years. I remember woken up nights to find mother weeping by the dim bedside lamp. Unsurprisingly step-grandma and I were forever at loggerheads, I was the only one in the whole extended family who dared to stand up to her and gave her as good as she dished out - if she shouted I would scream louder, drowning out her words. Poor mother, I'd never know what my hot-head must have put her through ! 

5 years later father was given special pardon by Premier Zhou Enlai personally and allowed to join us in Hong Kong. We moved away immediately. Times were tough as father couldn't fit in in capitalist Hong Kong and had tremendous difficulty keeping a job. Essentially mother's was the reliable income, all of $300 HK. I've no idea how she managed because we were never hungry, always properly dressed; she even forked out $10 each for my sister and I for piano lessons every month, until she despaired and stopped my classes (at my request) a few months later because I couldn't sit still for even the half hour session. My hyperactivity and impatience also led to my first hair-cut at age 7. My hair was thick and exuberant, and following the northern custom, my hair was never cut from birth and it grew to waist length, but the daily morning chore of braiding it and my incessant complaint of pain while untangling the mess finally got to mother and I was marched to the hair dresser's. I was excited and intrigued by the novelty of it all so I was astonished by mother's tears when the hair fell off, covering half the shop floor. I never knew what the hair meant to mother, I did know it's later sold to a wig-making factory in Diamond Hill and fetched a pretty penny. For myself I was just glad to be rid of it. From then on to save money mother cut my hair for me until I left for England, after that I took over cutting my hair myself, which I still do to this day.

In her younger days mother loved dancing, Cha-Cha being her favorite. Right after father came to HK he hooked up with his former Shanghainese college friends, most of them millionaire textile tycoons. For the first year we were frequently invited to prestigious country clubs and fancy parties. I found a few pictures of parents in the only X'mas ball mother's ever been to, she in her simple black cheongsam ( the only nice dress she had), sitting at the same table with bejeweled tai-tais in their embroidered brocade dresses, I could sense how she must had felt totally out of place. All the talks at every table were circled around money. Father was gripped by a giant inferiority complex, and quickly we stopped going to anymore dos. So at age 10 I'd had a glimpse of High Society and I was not impressed, I was only happy it's over so I didn't have to wear itchy party dresses anymore !

Back to cold harsh reality. We moved home every year in search of cheaper lodgings, so often that one time after school I went back to the old address, clean forgotten we'd moved again. In the course of our nomadic migration, we had lived in some pretty run down shitty places, but mother could make a home under any circumstance. Observing mother, I understood subliminally early on that in adverse situations, flexibility and adaptation are the keys to survival. There was a year we lived on a balcony on the second floor of a building right by the high street. The noise and light pollution was horrendous. There were about 10 households in the same unit sharing one small kitchen, so to avoid the crowding and squabbling mother did all her cooking on a small kerosene stove in our balcony room, squatting on a low stool; and all her washing up in a bucket.

 

Mother was a simple woman and didn't ask much from life. Family and friends were everything to her. She had an easy way with people, and particularly enjoyed meeting my friends. She's happiest at family reunions and family outings. 

 

Mother was a wonderful cook but father was stingy in his praises. The years of internment and psychological torture had broken him, he's become neurotic, paranoid and distrustful. The constant worry and pressure of making ends meet had left him bitter and disillusioned. Like so many other men frustrated by life, father took to venting his disappointment and anger on mother. The verbal abuse was relentless: mother was stupid, uneducated, coarse, a peasant, none of her family members were any good, all of them looked down on us........ Mother bore it all in silence. I'd almost never heard her answer back. She'd just carry on with her sewing, knitting, cleaning or food preparation, she's always doing something- all these on top of a full time nursing job. Mother's the most hard working person I know, or maybe it's just her way to avoid confrontation. Or maybe she knew as I suspected that father was sick. Regrettably I never got to find out what she really felt. The little time we lived together each one of us was so engrossed in getting through our days we had very little meaningful conversation, then we were separated by geography. 

Back to HK for a brief holiday, in a skirt I made myself.

It's evidently not in mother's nature to bear grudges, however mean father might have treated her. In the big scheme of things maybe settling scores is at best juvenile, for in the end her loving nature won out. By the time father died, mother was in the middle stage of Alzheimer's. I didn't see any point in telling her of father's passing, so every time mother asked about father we'd say "he's gone to see Dr L" and she'd be visibly relieved "Oh, then he's all right" At long last we'd found some use for Dr L ! Then whenever we went out for a meal she'd ask to pack some food for father." Ah Old Kwok likes this "she'd say ; even in the nursing home she's been caught repeatedly taken food from the meal tray and hid it in the drawer of her bedside table for when father returned from the doctor. Interestingly, mother, who had been slighted and looked down on all her life, in her dementia world, had created for herself an uncle who's the Police Chief in LA, who cherished her and would stand up for her in all matters. And mother, who didn't do much exercise even in the days when she was well, assigned herself the role of a well respected Kung Fu expert ! She was no longer the downtrodden one running around attending to everybody else's needs, now at last she's someone important even if it's all made-believe !

 

 

Funny thing is, growing up I seldom ever saw mother with a book, reading was the prerogative of father and us the children, but in her declining years, she finally had the leisure to thumb through newspapers and magazines, though by then it's difficult to say what she could still take in. Mother might not be an intellectual, but she's not averse to learning, particularly necessary skills for survival. When we were planning immigration to Canada in the late 60s, she did a course with Mr Josiah Lau (劉家傑), the most famous teacher in conversational English in Hong Kong. Every evening she'd diligently practice writing the new words she's learnt. A few years ago when I cleared out her house after she was admitted to the nursing home I found pieces of paper with names of vegetables and food items written in her big clear handwriting, it seemed that after all these years she's been secretly practicing writing English again. Unfortunately all the papers were lost in spring cleaning in my apartment, all that remained is the envelope she used to give me my gold wedding bracelet, which I also promptly lost ! In preparing for immigration mother also did a cookery course, in both Chinese and Western cuisine. There're still Chinese recipes in her handwriting at the bottom of the drawer, and for someone who didn't write much, mother had beautiful penmanship (both English and Chinese), so much better than mine.

 

After father died mother was transferred to a second nursing home. The first year in the new home was mainly about adjustment, mother was not eating well and lost quite a bit of weight. The nursing home doctor missed her anemia and slightly raised blood sugar, which he made amend after I pointed them out to him. I also cut down her poly-pharmacy (over a dozen drugs !) to about 3. In this nursing home, mother was roomed with a lady even more demented than she was. In her tender caring way mother automatically took upon herself to look out for her roomie, made sure she ate her meals, tucked her in at night and even made her bed some of the mornings when the nurses were busy, until both her own energy and wit dissipated.  After that we hired a Hong Kong lady, Ester, to sit with her a couple of hours every day  . Ester was a God sent, loving and patient, she quickly formed a special bond with mother. The next couple of years were good years. Mother was taking walks in the park, visited the mall, making friends with all she met, though she could remember none of them. She particularly loved children, whenever she saw them her face would lit up, and beaming happily, her eyes would follow their every move. Her kindly, cheerful disposition was on full display. There was an amusing episode : mother had a green thumb and loved plants. In the nursing home garden there was a small rose bush mother took to watering, problem was she over-watered it as she kept forgetting she's already done so, and the plant died. So the nursing staff put a plastic rose in its place, mother didn't know the difference and watered it to her heart's content !

 

 

 

 

March 2016 while Ester was on leave mother fell and fractured her right arm in the nursing home. The subsequent 2 years unfolded the horror of American medical and nursing care. The fracture was badly managed, resulting in deformity and severe hypertrophic spurring of the humeral head. From then on mother couldn't lift her right arm without pain, so she didn't. The nursing home was so fearful of another fall they insisted on keeping mother in a wheelchair, very quickly mother lost the ability to walk and the use of her legs. 

In mid 2017, mother was dropped accidentally in the home and sustained a right inter-trochanteric fracture. The nursing home tried to hide the fact but Ester noticed mother wincing everything her right hip was moved, so we requested an XR, which proved the fracture. Mother was sent to hospital in July 2017 for fixture. On discharge mother deteriorated rapidly, she became dull, off food. Incredibly no follow up XR was ever done. Five months on in Nov when mother again appeared to have pain in the right hip, we requested a check up. XR this time showed the pin was put in so badly it protruded through the head of femur into the hip joint, causing infection and damage that rendered the previously normal hip joint completely and irreparably destroyed. The reason for mother's deterioration was because she's been sitting in a pool of pus all this time, the infection resulted in anemia, lethargy, anorexia and poor mental state, not to mention pain and suffering which of course she's unable to communicate. Mother also had right lower leg edema on and off for a few months. The nursing home doctor made light of it but I impressed on him the need for a Doppler ultrasound, particularly with pending surgery. An ultrasound was finally arranged the following week and voila, there's a blood clot in the calf ! She was started on anticoagulant. In mid Dec mother developed fever and septicemia and only then was the pin removed and the pus drained. I'd no idea if the surgeon knew about her DVT (deep vein thrombosis), or what was done about the anticoagulant. There appeared to be complete communication breakdown between the nursing home doctor and hospital surgeon. She was put on IV antibiotics, and the moment the fever subsided, she was rushed back to the nursing home.

A few days after discharge mother was wheeled to the dining room at lunch time, where she vomited blood then collapsed and died. Mother had never had stomach problem before: it's possible she's been given anticoagulant and analgesics with no stomach protection medication, what's certain was INR was never checked.  Mother was certified dead at 2:10 PM, 26 Dec 2017 San Francisco time . Am I incorrect to think this is a wrongful death ? Much of what happened should never have happened. Old demented people apparently have no rights in America. There was not one word of apology from the nursing home, the hospital or the doctor responsible, in fact everyone's been double quick to shy away from mother's case. 

On the 7th day after death the soul returns to earth for a last visit, mother came to me in a dream. She said nothing , only smiled, but gave me a chance to apologize for not being the good daughter she deserved. On the 7th day over 7000 miles away in Memphis Tennessee, Emily Dai Mui, mother's favorite niece, also had a dream. She dreamed of her parents, Big Uncle and Big Aunt who passed a number of years ago, but in her dream they were both young, energetic and happy. They nodded briefly at her then turned to run towards someone she couldn't see. She woke up and wondered " Who were they running to meet ?"
" Emily," I told her "they were running to meet my mum"