Walking my dogs by the creek near my house in Sydney, Australia, early on Christmas morning, I meet a woman with a giant poodle named Miles. I know his name is Miles because I have asked the woman on no fewer than twenty occasions. She has probably told me her own name at least as many times, but I don’t remember it. Miles chases after a tennis ball, and Lucinda, the eldest of my three dogs, looks on, bemused. My other two dogs disappear into the bushes where they once discovered the remains of a barbecued chicken. The woman and I talk of our plans for the day. I say I will spend Christmas with my elderly mother, who has dementia. She nods and tells me about the time that she and her five sisters went to visit their mother in a nursing home, soon after she had been diagnosed with Alzheimer’s:
“Your daughters have come to see you!” a nurse announced, leading the six women into their mother’s bedroom.
“Don’t be ridiculous!” their mother replied. “I don’t have any daughters! And if I did, they would look a lot better than them!”
I don’t usually laugh at stories about people with dementia. I picture myself inside the story, and suddenly it doesn’t seem funny anymore. But this one makes me laugh.
My mother and I have been at war for as long as I can remember. We have little in common besides a love of dogs, a terrible temper, and an atrophying brain.
At eighty-two my mother has vascular dementia: a series of small strokes over the past three years cut off the blood supply to parts of her brain, depriving the cells of oxygen. Her symptoms mimic those of Alzheimer’s disease.
The atrophy in my brain is the result of an injury I suffered at the age of thirty, when I was thrown from a horse. I’d barely had a chance to settle into the saddle when the horse bolted, leaping fences and racing down a steep hill. It stopped suddenly, tucking its head between its front legs, and I somersaulted forward, striking the back of my head on a rock. I wasn’t wearing a helmet. My speech and movement were not affected, but psychometric tests showed that my IQ had dropped to around 80. The neurologist told me I would never finish the PhD I was a third of the way through. The only work he saw me doing in the future was raking leaves or planting trees — and even that wouldn’t be happening anytime soon. A social worker called and offered me a job cutting up fabric to make stuffed toys.
I spent a year at home alone on a disability pension, lying on my sofa, staring into space with dribble running down the sides of my mouth. My mother didn’t believe there was anything wrong with me, and I heard almost nothing from her during that time.
At some point it dawned on me that I could not spend the rest of my life on my sofa. I needed to finish my PhD, to prove that my brain was healing. Slowly I taught myself how to read and write again. I copied blocks of text, stopping at each word I didn’t recognize and searching for it in a dictionary, then writing the word and its meaning in a notebook. Sometimes frustration overwhelmed me, and I burst into tears and thumped my fists on my desk, but I forced myself to keep going. I had no choice if I wanted to return to a vaguely normal life.
With time, reading became easier. Gradually my brain began to repair itself.
Three years after my accident I spent nearly a year at Harvard on a scholarship. I returned to Sydney, finished my PhD, and found a job in human resources. That led to another job in Singapore, and then one in Hong Kong.
Now, twenty-two years after the accident, my neurologist tells me that my brain trauma was “severe” and my recovery was “extraordinary.” He is less inclined to talk about my future. Each new MRI shows the atrophy spreading like spilled ink. People with past head injuries are at a significantly increased risk for dementia.
Last year my neurologist suggested that, after more than a decade in Singapore and Hong Kong, I should move back to Australia. He wanted me to be closer to him and other doctors who understood my history. I had stopped working by then, wanting to use whatever time I had left to write. I had also just had my heart broken by the demise of a seven-year relationship, and rather than clinging to my ex-girlfriend like a barnacle to a ship, I decided he might be right. Sydney didn’t feel like home anymore, but I had moved around so much I wasn’t sure I had a home.
I started seeing a psychiatrist once a month in Sydney — another of my neurologist’s ideas. My psychiatrist has kind, dark eyes, an engaging smile, and a fondness for perfectly pressed striped shirts. We talk of my mother’s memory troubles and my own terror of developing early-onset dementia. It is one thing for my mother, I say. She is eighty-two. I am exactly thirty years behind her in age, but probably only a couple of years or so behind her in terms of decline.
My psychiatrist has studied my brain scans and talked to my neurologist, so he knows my situation. Still, he maintains he cannot detect any sign of cognitive decline from talking to me. He says he has patients who are judges and surgeons and scientists and that I could hold my own among them.
I raise my eyebrows and tell him I cannot remember what I did yesterday. “I’ve spent more than twenty years learning how to disguise my cognitive shortcomings,” I say. “I’m pretty good at fooling people.”
“You’ve fooled me,” he replies.
I tell him that rage and depression have stalked me since my accident. That two long-term partners left me on account of my inability to control my temper. That one moment I’ll be perfectly calm, and the next I’ll be in the grip of an apoplectic fury. I tell him that I abhor violence and have never hit anyone, but that I once charged at an ex-girlfriend, brandishing the wishbone from a chicken. I tell him I have no doubt I am a nightmare to live with — unless you are a dog. For some reason dogs seem to like me a lot. I tell him that relief from my rage comes in the form of prolonged bouts of depression in which I feel as if I am trapped in a narrow, airless tunnel that stretches for miles and miles, and the exits on both ends are blocked. I tell him I have experimented with six different types of antidepressants, and each has left me either zombie-like or suicidal. He nods and pays me a compliment I won’t remember.
My psychiatrist asks about my relationship with my mother. I tell him that in the twelve years I was living in Asia, we barely spoke. That since my childhood we have been united by our dislike for one another. That the only happy memory I can conjure of my mother is of a birthday cake she made me when I was seven, with two plastic horses grazing inside a paddock made from desiccated coconut she had dyed green. When I was thirteen, I showed her a short story I had written. She was an English teacher, and I trusted her opinion. She read it quickly, passed it back to me, and said, “Well, I don’t think you’re going to make much of a writer.” She delighted in telling me that I was stupid, that I would never be as clever as my father or my brother. She seemed to relish my disappointments. After a career day at school when I was fifteen, she took me aside and told me I should forget about becoming a journalist.
“Why is she like that?” my psychiatrist asks.
“I honestly don’t know.”
I tell him that my mother thrives upon conflict. That she has had no contact with her only sibling for nearly three decades. That she adores my brother and has always enjoyed pitting him against me. That even my brother admits she finds comfort in knowing we do not get along.
“I come from a long line of difficult people,” I say. “We are all difficult. But she is divisive.”
My psychiatrist unfolds his hands and asks, “Would you like to make peace with her?”
“I’m not sure it’s possible. But, yes, I suppose I would.”
I once went four years without seeing my mother. She either was “busy” when I traveled home or didn’t “feel up to” seeing me. She sent me an e-mail each year on my birthday, always with the same message: “Happy Birthday, Cheers, Diane.”
I sent her one for hers, telling her about the places I had visited, hoping she was fine. I signed mine, “Love, Sophie.” I’m not sure why.
After I first moved back to Sydney, I put off visiting my mother for ten weeks. I was settling into a house in the turmoil of renovation and waiting for my dogs to arrive from Hong Kong. Her condition was getting worse, and I felt conflicted. I could not remember when we hadn’t fought. The last time I had seen her was three years earlier: I had been to Sydney to visit my neurologist and repeat my scans. I told my mother then that I had been having problems with my memory, and it was getting worse.
“Don’t be ridiculous,” she said. “Everyone has problems with their memory.”
“My brain looks like a wasteland,” I said. “I have the scans to prove it.”
She shrugged. Then she told me how well my brother was doing.
I said I was happy for him, and reminded her that she had never even asked what job I’d been doing or where I worked.
“What more do I need to know?” she asked. “You live in Hong Kong, and you work in human resources — whatever that means.”
Now that I was back, I decided to call her each week to see how she was. It would spare us both the grief of a visit. Each time we spoke, she seemed fine and said she was in no hurry to see me. I told her to call if she needed anything.
In July my mother was admitted to a hospital with heart problems, and I went to visit her. She knows the warning signs of a stroke — the nausea, the dizziness, the headache — and has the number of an ambulance on speed dial.
I found her propped up in bed in a public ward. A frizzy-haired stranger in her seventies, dressed in a white hospital gown, was standing at the foot of my mother’s bed.
“Oh, it’s you,” my mother said when she saw me. She looked at the frizzy-haired woman, who occupied the bed opposite hers. “I’m sorry. I’ve forgotten your name.”
The woman glanced up at the ceiling. “Me, too,” she said. “I think it’s Heather.”
“Heather, this is my daughter, Sophie.” I shook Heather’s hand, and she made herself comfortable on the end of my mother’s bed. I was grateful for her presence: as long as she sat there, it was unlikely my mother would say something unpleasant. We talked about the news and the loathsome American dentist who had killed Cecil the lion in Zimbabwe.
“I never wanted children,” Heather said. “I always preferred animals.”
I said I did, too. I realized that I liked Heather more than I liked my mother, and I had only just met her.
“Not me!” my mother said, and we turned to her with interest. “Of course I wanted children,” she said. “I just never wanted girls.”
“Well, you only had one,” I said.
“One was enough!” She grinned at Heather.
When I was fourteen, my mother admitted to me that her heart had been broken by a miscarriage two years before my birth. It had been a boy, she said; she knew it. She would have named him Matthew.
“But you made your father happy!” she told me — as if to say that being a joy to one parent was better than nothing.
That same year my mother advised me never to have children. “I just don’t think you’d make much of a mother,” she said.
I have no regrets about not having children of my own. Motherhood is like yoga: it’s not for everyone. But I do wonder what provoked her to say such a thing to me when I was still a child myself.
My mother has a theory that mothers and daughters never get along, that our relationship was doomed from the start. She was not close to her own mother, who died when I was eleven. Within hours of hearing of my grandmother’s death, my mother sat me down and said, “Perhaps one day you will be able to understand this, Sophie, but all I feel is relief. I am finally free.”
This was a lot for a grief-stricken eleven-year-old to absorb: how could my mother be happy that her own mother was dead? Now, though, I think I understand what she meant.
A nurse came to take Heather’s blood pressure, and my mother and I were left alone. We talked about the hospital food, which my mother said was delicious, and the bird that peered into her window from the ledge outside.
“What do you call that bird?” she asked.
“That’s a magpie,” I said.
I, too, forget words and names. On my way to visit my mother that morning, I had met a friend for coffee. He’d told me of his plans to travel to Muscat, the capital of Oman, which I had visited three years earlier. “It’s beautiful,” I said. “You must get a driver to take you out into the desert. What do you call those things in the desert with water?” I asked, unable to remember the word. I felt my heart stop.
“Yes!” I said, doing my best to compose myself. “You must see an oasis.”
My mother was trying to solve the day’s anagram puzzle in the newspaper. We looked at the letters, and she wrote down words that started with P. Concerned she would be better at it than I was, I blurted out, “Parlatory.”
“That’s not a word,” my mother said.
I feared she was right. I reached into my bag for my cellphone and typed in, “Parlatory.”
“It is a word. It means ‘the parlor of a convent or a monastery.’ ”
Unconvinced, my mother demanded to look at my phone.
I noticed that her newspaper was from the day before. She had the current day’s paper on her bedside table, and I picked it up and flipped to the page where the puzzle solutions were given. “Portrayal,” the paper said. I felt my hands tremble.
I told my mother I was wrong, and she looked as if she wasn’t surprised.
This past September I drove across town to see my mother. She had forgotten my birthday in August and wanted us to have lunch to celebrate. I picked her up as planned, and she asked me to take her to the bank.
We drove to an ATM, and I helped her out of the car and stood behind her as she removed the leather watchband from her wrist and read the four-digit code she had written on its back.
“Don’t look!” she snapped. “I don’t want you knowing my password!”
I promised her that I wasn’t looking and that I neither wanted nor needed her money.
On the way to the cafe, a man dashed out in front of my car, and my mother shrieked, “You drive like a lunatic! You could have killed him!”
I explained that at twenty kilometers an hour, it was unlikely I could have killed anyone. She screamed at me again, and I stomped on the brake, did a U-turn, and drove her straight back to her apartment, stopping outside her front door.
“Let’s never see each other again,” I said, as I removed her walker from the car.
“Fine by me,” she replied.
By the time I’d left, tears were streaming down my face. What kind of person fights with her demented mother and then suggests they never see one another again? I sank into the same well of gloom and failure I seemed always to inhabit after seeing her.
As soon as I got home, I rang my mother and apologized.
“Thank you for apologizing,” she said and then hung up.
I saw my psychiatrist a fortnight before Christmas, and we talked about my mother. I would be her only company on Christmas Day; my brother and his wife had planned an overseas trip. Just fourteen days separated me from her, and I was starting to panic.
“If it gets to be too much, just leave,” my psychiatrist said.
I told him I wanted to make damned sure I was able to end my own life before I started exhibiting obvious signs of dementia. He knew that I did not say this lightly. I am, for the most part, a rational person who views suicide as the dignified response to a progressive brain condition. For now, my three dogs form the foundation of my suicide-prevention strategy: I will not even contemplate killing myself without making arrangements to find them a new home — one that is at least as good as the home they currently have.
My psychiatrist told me that, when the time came, he would write me a script for a box of fifty tricyclic antidepressants that I could keep at home and take when I was ready.
Euthanasia is against the law in Australia, and I had always wondered how hard it would be to find a doctor who was prepared to help.
I asked if I could get drunk before I took the pills.
“No. You might vomit, and then they will have no effect.”
“I rarely vomit,” I said. “And never from alcohol.”
“Well, you might if you wash down fifty of these tablets with alcohol.”
I sighed. “There’s no pleasure even in death.”
He gave me a wry smile.
I struggled to embrace the idea of swallowing fifty pills in a single sitting and dying shortly thereafter.
“If it was me,” he said, “I’d just wait till evening, go to bed, take them all, and fall asleep.”
There was a knock at the door, and his secretary announced that the next patient was waiting. My psychiatrist had already explained that I would not see him the following month; he was leaving soon to go to New York for five weeks.
“Enjoy your trip!” I said, and tried to mean it.
This man gave me hope, and though I might not have liked the thought of him spending five weeks on the other side of the world from me while I was alone with my mother, I understood that the poor man needed a holiday.
I take Lucinda, the most responsible, best-behaved of my three dogs, to my mother’s place on Christmas Day. The other two are wild dogs I rescued in Hong Kong, and their behavior can be unpredictable. Lucinda will be our Switzerland, the neutral territory between my mother and me. She will distract us from each other. Lucinda is boundlessly amiable — which makes one of us.
I alight from the elevator on the fourteenth floor of my mother’s apartment building with Lucinda by my side, my shopping bags stuffed with groceries. My mother is outside her front door, leaning on her walker. She looks older and frailer than when I last saw her.
“What’s his name?” she asks, beckoning my dog.
“What a pretty name.”
As soon as we are inside, my mother asks Lucinda’s name again. She eases herself onto the sofa, and I coax Lucinda up beside her. My mother reaches into her pocket for a treat called a Schmacko, snaps it in half, and offers both pieces to Lucinda.
“What a lovely dog,” she says, stroking Lucinda’s chest. She inspects the name on the tag hanging from Lucinda’s collar. “Lucinda,” she says before digging into her pocket for another Schmacko.
Lucinda eats the second Schmacko and starts to pant. I say she needs a drink, and my mother tells me there’s a water bowl in the kitchen for the neighbor’s dog, who occasionally comes to visit. “She’s not stupid; she’ll find it,” she adds.
“Don’t bet on it,” I say, and I call Lucinda to the water bowl.
“Did you say she’s stupid?” my mother asks.
“I did not. But she is not the smartest of my dogs.”
Lucinda drinks from the bowl, and my mother produces another Schmacko from a packet stuffed into a crevice in the sofa. She motions to Lucinda and whispers just loud enough for me to hear, “That’s why she has you. So she can feel clever.” She gives my dog a smug smile and glances up to make sure I’ve heard her.
Looking at this old woman hunched over on the sofa, trying to conspire with my dog, I don’t know what to say. I go inside the kitchen and hide.
The walls and doors of my mother’s apartment are festooned with yellow sticky notes full of commands: “Turn off the coffee machine!” “Don’t forget to put water inside the machine! You have broken it TWICE already!” “Don’t leave the house without your keys!” “Don’t forget to take your medicine! It’s next to the kitchen sink.” The more important notes — the ones that prevent her from locking herself out or leaving the stove on and burning down the apartment block — have been fastened to the wall with tape.
In the middle of her living room stands a whiteboard on an easel. Written across the top in black marker are the names and phone numbers of people my mother might need to contact in an emergency. I notice my name is missing. At the bottom are the times when Vicky or Tracey will visit. They are the nurses my brother has employed to check on my mother each morning and afternoon while he and his wife are abroad.
Vicky and Tracey do not work on Christmas Day.
Between feeding treats to my dog, my mother tells me that she plans to kill herself. When I ask how, she says, “I know people.”
I remind her that it’s illegal and say that if she wants help, she’d better make arrangements while she’s still able.
“I can do it myself,” she says.
“It’s not as easy as it seems,” I say.
I am about to tell her about the fifty tablets when it occurs to me that my mother would likely turn around and tell my brother that I offered her the pills in an attempt to kill her.
If there is a point at which my relationship with my mother fractured, it was during my father’s last weeks. I was twenty-nine and had taken unpaid leave from work to help my mother care for him at home. The prospect of my father’s death terrified me. I adored him, and he had always protected me from my mother. Without him, I’d be left alone with her and my brother.
Bowel cancer had spread into my father’s spine, and the pain had become unbearable. We were injecting him with the highest doses of morphine we could, and still he screamed and soaked his sheets in sweat. My father had an unusually high tolerance for pain and discomfort (which came in handy being married to my mother). If he struck his thumb with a hammer, he might wince, but he would never shout. When I was fifteen, he had developed a serious bout of pneumonia. A doctor visited him at home and told him that he should be in a hospital, that without proper treatment he might die. My father refused. He took the antibiotics the doctor gave him, and three days later he dragged himself back to the university where he worked as a professor.
One morning, while my mother was out, my father begged me to help end his life. He could not bear the pain any longer, he said.
Stupidly I told my mother.
“You want to murder him?” she shouted.
I explained that he was dying anyway; I didn’t see how it counted as murder. She told me I was an idiot, that of course it was murder.
That afternoon I heard her talking on the phone to an aunt. “Sophie wants to murder him!” I got the feeling that if anyone was going to turn me over to the police for helping my father die, it would be my mother.
I told my father about her reaction.
“Why on earth did you tell her?” he asked.
I tried to explain: I was terrified that something would go wrong, and I would make things worse.
My failure to help my father die is the one thing for which I will never forgive myself; the one thing for which I will never forgive my mother.
I wonder how I would react now if my mother asked me to help her die. Of course I would do what I could to help.
A decade ago, when I was in my early forties, I wrote to my mother apologizing for my part in our relationship. I had not been an easy child, I admitted, nor had she been an easy mother. I hoped we could put the past behind us and start anew. She did not respond to my letter. I waited a month before sending her an e-mail to check that the letter had reached her.
“Yes,” she replied.
“Did you plan to answer?”
“I didn’t think I needed to,” she wrote back. “Of course we are friends.”
I did not respond. I had friends already. I wanted a mother.
In preparation for our Christmas feast, my sister-in-law e-mailed me my mother’s dietary restrictions, beginning with “NO LEAFY GREENS!” As a vegetarian, I wondered what I could prepare that we both might want to eat. It would also be fair to say my culinary skills are somewhat underdeveloped.
Alcohol is a wonderful salve at Christmastime, but neither my mother nor I is allowed to drink. I spent most of my adult life drinking to excess. Four years ago, after seeing the results of one of my brain scans, my neurologist advised me to cut back to one drink a day. Though I’d grown accustomed to a dozen or more, for the most part I managed. Earlier this year he suggested I stop drinking altogether. Eager to conserve what few healthy brain cells I had left, I decided to follow his advice. I keep a six-pack of low-alcohol beer on hand for emergencies. Half a glass makes me giddy.
My mother nudges at the food I have prepared for her, without leafy greens or the myriad other ingredients she is forbidden that might have made it more palatable. A large piece of Tasmanian salmon sits atop her noodles. She likes salmon, or so she said before I put it in front of her.
I ask if there’s anything wrong, and she says no, but I can tell she is lying. I glance out her window at the Opera House, and when she thinks I’m not looking, she breaks the salmon in half and feeds part of it to Lucinda.
“Dessert will be better,” I say. “I brought some goat cheese and poppy-seed crackers and two mangoes.”
“What’s a mango?” she asks.
I wonder if she is joking. When I was growing up, mangoes were a luxury we could not always afford, but when the price was right, my mother would buy three or four at a time, and we would share them after dinner.
She places her knife and fork together on top of her meal. I take her plate to the kitchen, toss the food out (minus the remains of the salmon), and return with a mango.
“What’s that?” she asks.
“A mango. Smell it,” I say.
She holds it up to her nose and shakes her head: nothing. Like many people with dementia, she has lost her sense of smell. She examines the mango closely. “I have never seen anything like it!” she says.
I return from the kitchen with a cutting board, a knife, and two plates. I place the mango on the board and slice it down either side of its pit. Then I take the two sides, crisscross the flesh with the knife, and turn the skin inside out, the way she taught me when I was a child.
My mother looks on in wonder.
I pass her a piece and wait for her to try it.
She holds the mango up to her mouth, juice streaming down one arm. I offer to cut the flesh away from the skin, but she refuses.
“I can feed myself,” she says, returning the mango to the plate and using a fork.
She takes a mouthful and closes her eyes.
“Oh, my,” she says. “This is the most delicious thing I have ever tasted!”
I give her the rest.
Somehow we survive lunch. Afterward my mother says she feels tired, and I emit an audible sigh of relief. I suggest she take a nap while I wash up and let myself out.
“No!” she says. “I like washing up.”
I yield to her wishes and go into the kitchen and retrieve my belongings.
“Thank you,” she says. “It was a lovely lunch.”
I smile, give her a perfunctory hug, summon my dog, and leave.
As soon as I step into the elevator, I get down on one knee and hug Lucinda. “That was all your doing,” I say. “You are the best dog in the world.”
That evening the phone rings. It’s my mother.
“I can’t find your phone number!” she says in a panic.
“Don’t worry,” I say. “You’ve found it.”
“You’re ringing me now.”
“Oh.” She laughs. “I suppose I am. I wanted to thank you for lunch.”
“My pleasure,” I say.
“And to say that I enjoyed meeting your dog . . .”
“Yes, Lucinda!” she says.
“Thank you,” I say. “Well, call me if you need anything. You have my number.”
It is the most cordial conversation I can recall us having.
I hang up the phone and position myself on the sofa around my other two dogs. Lucinda is curled up on her dog bed on the floor, sleeping off her Christmas lunch.
I wonder if my relationship with my mother will improve as her dementia progresses. It would make both our lives simpler. I also wonder how long it will be before I forget what a mango is. Before my home is festooned with post-it notes. Before all my mother’s deficiencies become mine. Seized by panic, I get up, go to the fridge, and open my emergency stash of beer. I pour two-thirds of a bottle into a glass and the rest down the sink. Then I turn on the TV and watch a blond woman in a long dress sing “Have Yourself a Merry Little Christmas.” Lucinda gets up from her bed, rests her head on my knee, and gazes into my eyes. I bend down to kiss her, and I remind her that she is the best dog in the world.