Wednesday, June 25, 2008


Last Thursday morning I had a significant coughing fit in front of Marie. It quickly became apparent that this fit was going to be of the half-hour variety. Before long I was on my hands and knees against the hardwood floors of my kitchen. Marie laid a towel on the floor and wiped my mouth with tissues. Inside I felt embarrassed by her need to care for me in this way, but she showed not even the slightest revulsion. Sweat beaded along my brow and the back of my neck. My chest heaved with every breath, every cough. My efforts to calm the physical storm through deep breathing and relaxation fell flat. I fell victim once again to my body’s malfunctions and could merely endure until the episode reached its natural end.

My body spent and my hair soaked, I rolled over onto my side on the kitchen floor. I felt each bony prominence against the wood. Marie lay next to me. Soon I felt the plink, plink of her tears against my right ear and cheek, “How often does this happen when you are alone?” she asked. “Once or twice a day,” I replied. “Oh, baby,” she cooed sympathetically and stroked my damp hair.

I have been coughing for 8 years, but the severity has increased exponentially over the last 18 months. We have tried every cough medicine – narcotic and non-narcotic – under the sun to no avail. In fact, it was efforts to control the cough that resulted in the first 10 lb weight loss when I went on Reglan last May. I started biofeedback in hopes of gaining some control over the cough, which I can manage to do at times. I even named my cough at the suggestion of my biofeedback therapist. When she asked me for a name, “Chester” immediately came to mind because I thought of “Chester the Molester.” That’s what the cough, and the constant urge to cough, feels like: a chronic violation. It didn’t dawn on me until later that “Chester” was also an anatomically appropriate name. So sometimes I talk to my cough, “Chester, not now” or “Chester, what’s wrong? What are you trying to tell me?” I try to think of Chester as a friend – an inner physician -- a part of me that is trying to tell me something is amiss. But Chester either is not getting his message across or just doesn’t know when to give up because he can be really relentless.

For the members of my immediate family, the cough has become a “normal” part of our lives. The children preface most sentences with “Can you talk?” because they know I often cannot. They often sing their own lullabies while I stroke their backs. Everyone is well versed in assembling the arsenal needed to deal with Chester’s full-on attack: towels, tissues, an ice-cold washcloth, and water.

In high school Marie never cried. Given that she is a fellow Italian-American I found this perplexing. Crying was my job and one at which I excelled. During those teen years I listened to Lionel Richie songs just to have a good cry, even when I wasn’t sad about anything. It’s the Italian genes; we are a people with an inexplicable and profound need to emote. Marie was the comforter; she still is. Experiencing Marie’s reaction to my cough made me realize how awful it really is. I always tell myself that I am not in pain so I should be able to cope with it. But Chester is always there in full-force or lurking beneath the surface, a constant irritation in my throat threatening to interrupt a sentence, a meal, a cuddle, an outing. Yesterday I spent 20 minutes in the parking lot at REI, where I went to buy some of Aidan’s future birthday gifts, coughing uncontrollably and praying not to vomit all over. When Chester brings me to my knees, retching and perspiring, I sometimes wish it would just end and be done: once and for all. And other times I tell myself, “It’s only really horrible for a half-hour or two a day. You can do that. You can keep doing that.”

Feeling Marie’s tears against my face and her body cradling mine in the wake of my coughing fit, I knew the depth of her sadness. I didn’t need her words to tell me how she felt; I could feel her grief. “When I see you suffer like this I can let you go,” she whispered, giving me a little of the permission I will ultimately need when I decide to let go.

Over the last several weeks several people, and most especially fellow mothers of young children, have given me permission to go. Perhaps it sounds strange to need this from others at this point. After all, only I can decide if my joys outweigh my sorrows enough to bear my suffering, but I crave the permission to go when the scales tip irrevocably in favor of sorrow. And, over the past few months, several friends have come forward to tell me that I have done my job and that I can go with a clear conscience. My devoutly Catholic friend Jennifer, herself a mother of four, wrote to me that God will greet me with “Well done, my good and faithful servant” whenever I chose to stop my battle. Her words made me smile and cry simultaneously because I consider her a mother who would endure anything for her children, and if she can give me permission then it must be warranted.

When you really love someone, you cannot bear to see their endless suffering. As my friend Amy said, “I love you too much to watch you suffer this way. And if you being free of your suffering makes me a little sad, I am happy to carry that pain for you.”

For Bill, Amelia and Aidan giving such permission comes at high personal cost. It will not be an even trade for their permission for me to go leaves them with a lifetime of suffering of their own. Bill will give me permission when he knows we gave it everything we had. Perhaps this is the greatest of marital disputes and we continue to struggle with it. Amelia and Aidan may never be able to give me permission. They are too young to truly appreciate my suffering. They still see Mommy sitting on the bed “dancing” with her arms while they and their Daddy dance across the floor. Their current Mommy seems to be enough for them. And, for now, she is enough for me. From them permission may come in the form of hindsight, decades later when they finally understand how hard I fought to remain with them. In the end I hope they will come to understand and believe that when I chose to go, I did so because I felt that it was the most loving thing I could do: to set them, their father, and myself free.

On Monday morning, the day Marie and Sue left, I lay on the sofa with my head in Sue’s lap. As I cried, she rubbed my back. I thought about the “gateway theory of pain” that postures that the signal from the site of the pain can be interrupted before it reaches the central nervous system and, consequently, prevent the perception of the pain. As Sue rubbed my back, over the ribs and shoulder blades encasing my heart and lungs, my emotional pain eased a little. Perhaps this is why mothers so naturally rub their children’s boo-boos away. “When your mother died,” I asked wary of raising sad memories, “was she peaceful?” Without the slightest pause Sue responded, “Yes, very.” I didn’t ask if she and her father had given her mother, Anne, permission to go. Of course, Anne was quite a character and never really needed anyone’s permission to do anything. But I wonder if she too needed her family to let her go so that she could depart this world just as Sue said, very peacefully.

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