It starts with blood. It starts with breasts and ovaries and uteri and lumps and cramps and seemingly innocuous constipation. It starts with dead grandmothers and sickly aunts, with women I don’t know in black-and-white photographs. But mostly it starts with a feeding: a leech placed on my mother’s chest.
“Where once she offered me milk, she offers him blood” was how I began my poem. That was decades ago, when I believed in poetic license.
The women in my family share diseases like recipes: Here’s how to make chicken soup. Here’s how to make salmon croquettes. Here’s how to get the morphine going before the big pain comes.
When my aunt Gloria was dying, she called and asked me how my mom had done it. How did she get out of here? she said in a weak voice. I told her she’d insisted on morphine before the pain came.
Where does it hurt? I’d asked my mom.
Nowhere, she’d said. Get me more, she’d said.
And I had.
My mom and I lived together for five years—the breast cancer years—until she died from the disease. I was out of graduate school and working on my first book, and I’d fly off and leave for a couple of months at a time, going from art colony to art colony, writing a novel she wouldn’t live to read, but always returning to her. I could never get enough.
The New York Times once published an article about a museum exhibit on bloodsuckers. “Leeches are beautiful,” a curator claims. If you find yourself in a shallow body of water with one attached to your leg, he understands the instinct to snatch it from your skin, but he encourages nonchalance. An interrupted leech, he warns, might vomit into your wound and cause an infection. Better to let it finish its meal. The curator hopes you’ll watch while it feeds and appreciate the orange polka dots on its back.
We were two and a half years in when my mom started planning for a complicated reconstructive surgery that involved grafting tissue from her stomach onto her chest. This was in the early nineties, prior to advances that would offer hope for many breast-cancer patients, and her prognosis was bleak—large tumor with lymph node involvement. The chance that her cancer would return before she recovered from the reconstruction was high, and I worried she’d suffer through a lengthy convalescence only to be struck down again. I begged her to wait a year.
Wait for what? she said, irritated. Her hair had grown back in thick curls, and her stamina had returned. She had a natural breast on one side and a concave, leathery remnant on the other. She wanted to forget having been sick, while I was in the next room, sobbing like she was already gone. Just a few months later we’d discover that the cancer had metastasized to her hip.
In Woman: An Intimate Geography, Natalie Angier writes, “It is because the breast must be poised to alter its contours throughout adulthood, swelling and shrinking with each new mouth to feed, that it is prone to turning cancerous. The genetic controls that keep cell growth in check elsewhere in the corpus are relaxed in the breast, giving malignancy an easy foothold.”
With each new mouth to feed.
In the weeks prior to the reconstructive surgery she and I had a series of dramatic arguments in which I dug up her worst parenting mistakes, and she reminded me I’d been a difficult and unpleasant child. We didn’t speak for hours, until we missed each other enough to change the subject.
She was on the bike path in front of her apartment building and had been walking at a good clip—further evidence that the nasty cancer stuff was behind us. She stood in her spandex exercise gear and talked about feeling broken, lopsided. It was about balance, she said. Perhaps her hip didn’t feel quite right. Maybe there was a twinge deep in the bone. But whatever it was didn’t yet affect her gait, and she was able to ignore it.
Later, after the reconstruction, after she’d recovered enough to use her arms again and laugh without pain, the limp appeared.
We called it arthritis.
We called it a pulled muscle.
We both know exactly what it was.
When I was little, she left my father in Philadelphia and brought her two toddlers to California to escape a life she thought was small and myopic: endless Friday-night dinners with the in-laws, so much fried fish and tedium that she had to pack our bags and run.
At dusk in California she would prepare to go on dates: silky dresses and lipstick, blushed cheeks. I would miss her before she’d even left. I would scream at the window when she finally made it out the door and broke free.
She’d been searching for a different way to be in the world, and she leaned into each new boyfriend’s lifestyle, adopting his interests and beliefs. Her first boyfriend was a Bahá’í, so she quickly converted, claiming my brother and I were now Bahá’í too. She was all in.
As a Bahá’í she attended fireside chats, visited a temple, and, one Saturday, dropped my brother and me off at Bahá’í school. On a turntable in our den she played records by Cat Stevens, or by Bahá’í musicians like Seals & Crofts: my restless young mom, twirling in a circle and singing along.
She told me Bahá’ís were peaceful, loving, open-minded people who believed in all religions—a generalization that explained the ease with which she shrugged off whatever bit of Judaism she had left from her own childhood.
Peaceful and loving as a people, perhaps, but her boyfriend Ray was impatient and constantly annoyed. At dinner I bit my nails, and Ray fumed. He said stop, and I did, but moments later my fingers found my mouth. He said stop again, louder, and again I stopped. When Ray caught me a final time, he threw his plate across the table. The spaghetti landed in front of me, and red sauce splattered my pajamas. I was five, maybe six.
There was a time when my left foot was as serviceable and as aesthetically uninteresting as my right, when my calves matched, and when I walked like anyone else: freely, without awareness or struggle. When I see pictures from back then, my eyes move to my matching legs before taking in the image of a whole girl.
It was an early morning in March, in Manhattan Beach, California, on a street without sidewalks. I wore black patent Mary Janes—the last shoes I’d wear with ease.
When the car hit me, a world of blood opened up.
My hospital stay was long and complicated—a ruptured spleen had to be removed, the fractured femur set in traction. Three weeks in, my liver abscessed. My injured calf and foot, though, seemed to confuse the doctors, and they mostly ignored them. Ray disappeared around that time.
After returning home, I started the ordeal that continued until my mid-teens. I’d be in a cast; or a chunky, unfashionable shoe with a thick pair of silver braces shooting from my foot to under my knee, which I hated the most; or a walking cast, which I hated the least because people assumed I’d just broken my leg and therefore treated me like anyone else. My fourth-grade teacher held the door open for me as I trailed behind a group of classmates. Hurry up, peg leg, he said, which he never would have said if I’d been wearing the brace.
It was nerve damage, I’d learn later. There were atrophied muscles and disfigurement, which I’d learn to hide, feeling hot shame about what my body had become.
My mom’s limp looked like my limp, but whereas we’d been living with mine for decades, hers was new. She now struggled to walk the way I’d struggled for years.
We were an odd pair, living in that apartment on the beach, limping down the building’s long hallways—my mom, despite all of it, cheerful and smiling at neighbors, pushing a wire dolly full of groceries with her sullen, black-clad daughter at her side.
Early evening, in the tiny kitchen, I stir-fried broccoli and peanuts while the rice cooker bubbled and wheezed. After dinner we played Scrabble, and each time she returned to the game after going to the bathroom, her limp surprised me.
Does it hurt? I asked.
Nothing hurts, she said. When is it supposed to hurt?
Leeches assuage the pain they’re about to inflict by applying an anesthetic before you even know they’re there. They also inject anticoagulant to keep your blood flowing. It can flow for up to ten hours, long after the leech has dropped off and scooted away.
Some leeches have two jaws. Others have three. Some have teeth on their tongues. There are protective leeches who hover over their eggs, and leeches who carry their newborns in pouches like tiny kangaroos.
I wasn’t a good baby, my mom wanted me to know. My brother slept through the night and woke up bright-eyed with a smile on his face. He was wonderful, she said. The sweetest boy.
Hmm, I said.
It’s true, she continued. I put him to bed before dark, pulled the curtains, closed the blinds, and he fell for it. She looked at me hard. You were a bad baby, she said.
No, I said. He was just gullible.
He’d sleep and sleep, she said wistfully.
I was a baby who was concerned about time, who saw the sliver of light coming in through the parted curtain as evidence of having been deceived.
Some days my mom brought my lunch to a little windowless office I rented downstairs from the apartment so I could write. I taught in the Writers’ Program at UCLA Extension, but the pay wasn’t enough to live on. One minute she claimed devotion and vowed to support me through my first book; the next she felt frustrated with her educated daughter who had a fancy degree from a fancy school she couldn’t afford. Still, she was my biggest fan. She’d read one of my short stories and lean back, amazed, saying, Genius, under her breath. Later she’d tell me to get a new job, to grow up, to stop depending on her. Cut the cord, she’d say.
She was right, of course. I was nearly thirty. But I’d never let go. She’d have to die to get away.
A year after the car hit me, my mom moved us away from that street without sidewalks and into a house in Long Beach. On campus bulletin boards all over the university, where I’m now an English professor, she stapled flyers advertising her need for childcare, eventually finding a college student to live in the guesthouse. In exchange for free rent, all he had to do was drive me to school.
Aram majored in psychology with an emphasis in human sexuality. His enthusiasm for his studies was obvious, and from the beginning he didn’t spend much time in the guesthouse. He was always making baked spaghetti in our kitchen or bringing us falafel sandwiches from a stand on Alondra Boulevard or talking to my mom on the couch. Lots of talking to my mom on the couch.
Within months he’d moved into her bedroom. Within a year they’d gotten married, my mom following him into another dramatic lifestyle shift, this time centered on becoming a nudist and joining a camp in Topanga Canyon called the Elysium. They talked openly at breakfast about having seen the porno movie Deep Throat. Books appeared on the coffee table: Anatomy of an Orgasm, Erica Jong’s Fear of Flying (which I devoured and loved at twelve), and, an outlier, James Kavanaugh’s book of poems There Are Men Too Gentle to Live Among Wolves.
My mom was a high school teacher, but on weekends her pantyhose and heels and modest dresses disappeared. She was overly tan and small-framed, with a band of soft belly and large breasts, which I saw when she and my stepfather walked the halls of our suburban home. My brother and I were unwilling and unhappy witnesses to her swinging breasts, his uncut penis. She insisted it was natural. Aram insisted it was perfectly natural.
Researching leeches online is like researching illness: lots of contradictory information and suspect anecdotes. Experts disagree on how best to dislodge a leech: Use a credit card to pry it loose. Apply alcohol. Apply salt. Come at the feeding leech with a lit cigarette.
In Rose George’s Nine Pints I learn that not all leeches suck blood or latch on to humans, but enough do, and we need them. A cottage industry exists—half a dozen places in the world where leeches are farmed and prepped for medicinal use. I learn that the poor were once pushed into rivers to collect the bloodsuckers on their flesh.
His name was Dr. Bonecutter. It’s unbelievable, I know. I doubted it myself, but I looked him up—a Los Angeles neurologist working in the late sixties.
His office was where my exaggerated response to medical care began. This was a few months after the car had hit me. I’d been such a good girl before, so brave, an old soul: Six going on sixty, the nurses said. I’d been stoic, willingly giving my arm to every phlebotomist who came calling, and once, when my veins had failed, offering up the innermost part of my thigh without protest. But now I was becoming a new kind of girl—one who screamed when you touched her. The accident was an obvious source of trauma, but it was the continued hands on my unhappy, unwilling body that disturbed me most.
Dr. Bonecutter performed a spinal tap–like procedure on my leg, and I screamed as if he were actually cutting my bones. He didn’t know a girl could scream so long, he said. He’d never do the procedure on a child again, he told my young mom, who was solemn on the drive home.
I want to tell you she registered the screaming I’d done on his table as something to be addressed, that she found me a compassionate therapist, but this was the late 1960s. It didn’t occur to anyone that I needed to process anything.
Poor boy, my mom said when she heard that the driver who’d hit me was just seventeen and without insurance. Years later, when she was sick, I would ask her what I’d been doing, walking all alone at just six years old. She’d vomit into a bowl and shake her head. The only answer.
On the morning of my mom’s reconstruction surgery we bickered on the freeway, snapped at each other on the 405, and argued all the way down the many blocks of La Cienega Boulevard. By the time we reached the hospital, though, we were silent. I should’ve been supportive or at least neutral, but I was still seething: angry about the disease stalking my mother, yes, but also spinning around in my own body shame. She was not the only one who’d been scarred. I had come first. My leg was uglier, I believed, and I’d been living with it for decades. Couldn’t she at least make it to the five-year mark before insisting on a medical fix? Couldn’t she wait until they lied and called her cured?
The surgery itself was uneventful. The recovery was not. Around midnight the doctor called and told me my mom’s body was rejecting the flap of skin he’d attached to her chest. Necrosis was a possibility. He explained that my mom’s blood was not making its way through the transplant, and, without intervention, the new breast would have to be removed.
I told him to do whatever needed to be done. That’s when he asked my permission to apply medicinal leeches to the area.
Fine, I said. Do it, I said.
Sometimes, after being applied to a specific area where they’re needed, leeches migrate, which is just what one did during my mom’s procedure. Perhaps he was impatient or didn’t want to work too hard. Either way, he escaped from under the gauze and made his way to her neck, where a vein hummed with the promise of an easy meal.
Earlier the doctor had scooped out some of her soft belly and sculpted it into her new breast, which would remain without a nipple through the cancer’s recurrences and her eventual death. But tonight that breast was going to feed these parasites who’d been starved with just this purpose in mind.
One would fit in the palm of your open hand. He would sit across your lifeline, an interruption. Squirming with delight, he’d smell your skin. Later, when fat and full, he’d be flipped into a pile with his satiated cousins to die. Imagine his last moments. Perfect. Thick. Rich. Drunk. Body plump with mother.
The morning after the reconstruction I stood by my mom’s hospital bed and watched her sleep. In addition to the expected vest of gauze, there was a bandage on her neck. When it was later removed, a reddish hickey was exposed. I thought about that impatient leech making his way up my mother’s torso, her clavicle a bridge to what he really wanted—original skin, generous flesh; about what else would eat her, how her body would give way and give up; about how soon she’d be devoured whole.
