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Chast reflects that her mother was highly intelligent; she had a higher IQ than both Chast and her father. Elizabeth loved being in charge and had a temper. In the past, she admitted to Chast that she had once hit her for running away in a store. Chast concluded that must have been why she had always been afraid of her mother. In the months after George’s death, Chast came to realize that all the things that had bothered her about her father were trivial: “The only emotion that remained was one of deep affection and gratitude” (167). Elizabeth slowly started to adjust to being a widow, and Chast began to adapt to managing just her mother’s care. The first few months were particularly tough, especially because Elizabeth blamed the hospice nurses for George’s death.
During the year after George’s death, from the fall of 2007 to the fall of 2008, Elizabeth’s health gradually declined as the chronic diverticulitis worsened, and Chast took her to a gastroenterologist, who strongly recommended a colostomy, warning that she might die of sepsis without it. Chast worried that her mother wouldn’t survive the surgery. Elizabeth decided against it and confided in Chast that she felt she was losing her mental activity. They consulted a neurologist, who diagnosed depression and prescribed Lexapro, but the insurance didn’t cover it. By November 2008, Elizabeth had stopped going to the dining room, had fallen several times (once even cracking a rib), and lost weight. Her doctor initiated hospice care. She required around-the-clock care, so Chast hired two nurses from an outside agency. Chast’s financial concerns increased: In addition to the cost of rent at the Place, she faced the costs of the two nurses, medications, and all the necessary supplies. Chast sensed that her mother was finally giving up, so she said her goodbyes, told her she loved her and assured her it was okay to let go.
However, one day Chast found her mother sitting on the couch eating a tuna sandwich with her nurse, Goodie. This surprised Chast: “I had sort of adjusted to the idea that she was dying, and this was throwing me off” (176). She acknowledges that she and her mother were not close, which might explain why she was not particularly excited to see her getting better. Growing up, Chast was often left with an elderly neighbor (and later with various sitters) while both her parents worked. Her mother insisted that the sitters take Chast home for lunch and cook a hot meal, which prevented her from making friends at school. Her father remained uninvolved. Chast promised herself she would be a better mother.
In less than two months, Elizabeth regained the weight she had lost. Although she no longer qualified for hospice, she still needed around-the-clock care, unable to feed, wash, or dress herself. Goodie, one of the two nurses, offered to cover both day and night shifts to save Chast some money. Elizabeth and Goodie quickly bonded: “My mother had surrendered control to a lovely stranger” (183). Goodie, being smart and strong-willed, was a good match for Elizabeth. Chast felt guilty for not doing all the caregiving herself but was simultaneously relieved and grateful.
As Elizabeth’s dementia progressed, she started making up stories, such as claiming that her husband had died when she was pregnant. Goodie, familiar with dementia, was unfazed by these tales. Chast, however, found them fascinating and began to write them down. Many of Elizabeth’s stories involved George’s mother, Katie, with whom she did not have a good relationship. Katie, a Russian widow who adored her only son, George, never forgave him or Elizabeth after their marriage. Elizabeth invented dramatic narratives in which Katie tried to kill her: “Katie paid a young man to push my wheelchair into TRAFFIC!” (190). Other tales involved her deceased older brother visiting her and telling her that he would guide her through Hell when she arrived.
A friend sent Chast a quote from Swann’s Way, which describes the preparation for death as the chrysalis stage of life. In April 2009, Elizabeth celebrated her 97th birthday. Goodie helped her out of bed and dressed her. Chast’s daughter and some relatives and friends joined the celebration. In the following months, Elizabeth began to wither away. She stopped telling stories and was always tired, though she didn’t look frail. On Page 198, an illustration depicts Elizabeth telling the Grim Reaper, “Back off, mister” (198). Chast wondered how long this would last: Elizabeth wasn’t dying, but she wasn’t fully living either. Chast worried about the financial toll: “Every month she stays alive, the Place and Goodie get $$$$ richer… which means that I get $$$$ poorer” (200).
In June, Chast attempted a final conversation with her mother about the past. She wished they could have been friends, but Elizabeth dismissively said it didn’t worry her. Chast asked if she should stay, and Elizabeth replied that it didn’t matter. Chast left and sat in her car, crying and angry about her mother’s behavior, but realized it was too late to improve their relationship. On Page 202 is a black-and-white photograph of Chast as a child with Elizabeth.
In mid-July, Elizabeth’s doctor decided it was time for her to return to hospice care, alongside Goodie’s 24-hour care. Elizabeth mostly slept, occasionally sipping Ensure or ginger ale. Chast often asked the hospice volunteers how long they thought her mother would hold on. One of them joked, “The Devil doesn’t want her, and God’s not ready” (205). Hospice arranged for a Reiki therapist to visit Chast’s house to help with her stress. The Reiki sessions were relaxing, but Chast remained anxious.
A nurse placed a DNR bracelet on Elizabeth, but it made her sad, so Chast taped it to her medical file. Chast told her mother it was okay to let go, that she should feel free to join her husband and deceased brothers. She also mentioned that they were running out of money. In her final days, Elizabeth called out for her father. One day, she told Chast she loved her. In September, Elizabeth developed a hole in her abdomen due to diverticulosis. On September 30, Chast received a phone call from Goodie informing her that Elizabeth had passed away. When she arrived, Chast found her mother in bed in her pajamas. Alone with her mother’s body, Chast drew her. Pages 211-22 feature drawings from July until the final one of Elizabeth after her death.
In Chast’s closet are two special boxes. One holds her father’s cremains and the other her mother’s. The funeral director asked if Chast wanted their ashes mixed, but she declined, saying that her mother “had been so dominant when they were alive” that it was best “if he had a little space of his own” (225). The ashes weigh around five pounds each and have tags on them. Chast reflects that the thought of burying her parents does not appeal to her. She likes having them in her closet, and every time she opens the door, she thinks of them. Chast remembers her dad with great affection and is working through her feelings about her mother. She still has a desire to make things right with her. Chast reflects that she never felt quite part of the family, sometimes wondering if she was adopted. Nevertheless, they were her “one and only set of parents” (228), and she feels their loss deeply. They often appear in her dreams.
George’s death affected Chast and Elizabeth in different ways. Chast realized that all the things that had bothered her about her father were trivial: “The only emotion that remained was one of deep affection and gratitude” (167). This revelation underscores the notion that, in the face of death, past conflicts and arguments fade, leaving behind only love for the departed. Elizabeth, on the other hand, responded to her husband’s death by burying her emotions as usual, exemplifying the theme of Emotional Avoidance as a Coping Mechanism. She irrationally blamed the hospice nurses for giving George too much morphine, denying that he would have suffered without it. Even on her deathbed, when Chast attempted to reconcile past conflicts, Elizabeth brushed them off, saying that they didn’t bother her and that she didn’t care whether Chast stayed or left. This is yet another example of Elizabeth’s unwillingness to address unresolved issues.
With only her mother left and her health steadily declining, Chast was thrust deeper into the role of caregiver, underscoring the theme of Caring for Aging Parents. Elizabeth required 24-hour care, entering a limbo state in which she was “not living and not dying” (199). A friend sent Chast a quote from Swann’s Way, likening this stage of preparation for death to a chrysalis. The illustration of Elizabeth telling the Grim Reaper, “Back off, mister” (198), adds an ironic tone, showing her reluctance to succumb to death. At this point, Goodie appeared: A strong-willed and capable nurse, she formed a good relationship with Elizabeth. Although the memoir does not reveal much detail about Goodie’s background, she became a positive figure, even offering to cover both day and night shifts to help Chast. With Goodie’s help, Chast experienced a mix of guilt and relief. She felt guilty for not handling all the caregiving herself, yet relieved to have assistance. This duality in Chast’s emotions—duty versus the desire to distance herself—highlights the complex feelings involved in caring for aging parents. As Elizabeth’s care became more intensive, Chast’s financial worries escalated. Expenses mounted, including rent at the Place, nurses’ salaries, medication, and supplies. These pragmatic financial concerns contrast sharply with the emotional weight of a dying parent, yet Chast portrays them, realistically, as an inseparable part of the caregiving experience: “Every month she stays alive, the Place and Goodie get $$$$ richer…which means that I get $$$$ poorer” (200).
The author delves into family dynamics too, particularly the strained relationship between Chast and her mother. Elizabeth’s strong personality often clashed with that of Chast, who always felt closer to her father: “I was my father’s daughter, not my mother’s” (177). Chast recalls being left in the care of an elderly neighbor and various babysitters, preventing her from making friends at school. She promises herself to be a better mother, aiming to be both a parent and a friend: “I knew, when I had children of my own, that I would try my hardest to be a MOTHER AND a FRIEND” (179). On her deathbed, Chast tells Elizabeth she wishes they could have been friends, but Elizabeth’s dismissive response left Chast feeling that it was too late for reconciliation. Even after Elizabeth’s death, Chast yearned to go back in time to improve their relationship. Despite their conflicts, Chast acknowledges that her parents were her “one and only set of parents” and feels their loss deeply (228). This underscores the idea that, in families, conflicts are inevitable, but the bonds are strong and enduring. Chast’s decision to keep her parents’ ashes in her closet symbolizes her complex feelings: a desire to keep them out of sight while also wanting them close to her and her possessions.
As Elizabeth approached death, The Complexities of American Healthcare and Elder Care became an increasingly central theme. Elizabeth was diagnosed with depression and prescribed Lexapro, which insurance didn’t cover, adding to the financial strain. Chast’s concerns about the cost of her mother’s care serve as a critique of the American healthcare system, highlighting its exorbitant costs. The narrative condemns a system that places such a heavy financial burden on families during difficult times.
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