Universal Table

When Monica places the baby ceremonially in my arms, Amy locks her knees like gates and quickly positions herself so she can stand up in my lap and face out. She wears a red jumper, a white blouse, long striped athletic sox in bright shades of blue and purple, and a tiny pair of sneakers the color of goldenrod. She is four months old. Her two moms and I sit down on hard dark chairs and a couch in the conference room in the hospital's radiation oncology department. It is five months since the September 11 terrorist attacks, the day before Valentine's Day. I love holding her, love her vanilla bean smell and the bald spot on the back of her head, but feel a little distracted from the careful listening I want to do.

Grace, Amy's other mom, is my patient. Today she wears an oversized t shirt with an American flag on front in the shape of a huge heart. She tells me what I already know, that she is no longer in remission. Not only is the cancer still in her lungs, it is also in her liver and her brain. She has resumed chemotherapy, a protocol less toxic than the one she endured when Monica was pregnant. Grace insists that Dr. Mannan be completely honest with her, so she knows there is only a ten per cent chance she  will be alive a year from now.

When I comment on the sadness that must permeate their lives, Grace's reply surprises me. "To tell you the truth," she says, "I have never been so happy, so much at peace."  Indeed, her face shines. Her disability application has been approved, she is building a high chair in her basement for Amy, and her mother's upcoming visit will end a long period of estrangement between them. Not only that, but they have just mailed paper work that will make Amy Grace's legally adopted child. The baby bounces on my lap with her knees still locked.

Grace is recording her reflections in three keepsake notebooks: one for her mother, one for Monica, and one for Amy. The one for Amy is composed of letters she wants Amy to read when the time is right: Starting School, Getting Your Period, Falling in Love, Figuring Out About Alcohol, Leaving Home. In braver moments, she is working on a piece called The Mom You Don't Remember, as well as her personal reflections on dying.

Monica reaches into the diaper bag and brings out a round, dark green wooden box. It is painted in tiny pink flowers curled tightly at the tips of their long, graceful stems. We go ahead with our plan to cut a ceremonial lock of Grace's hair (before any more falls out) to put in the box, another keepsake for Amy. I have come prepared with scissors. When I snip the lock from the back of Grace's neck, the scissors make a bright, crisp sound. We smile. Believe it or not, we are having a good time.

I am also prepared with a package of clay. "Is it time for this now?" I ask, and they nod. Leaving them to wait for me, I walk to the staff lunch room. There, I cut the clay in two with a plastic knife. Then I heat each half on a paper towel in the microwave for a minute, until it rises like a biscuit. Slowly, I flatten each one with my hand, patting it from the center out, as if I were rolling out a pie crust, until I have two warm, smooth spongy pancakes.

When I return, Grace presses each of her hands, one at a time, into the warm clay, while Monica and I look on, smiling and pressing our own hands against hers so the impressions will be as clear as possible. Then Monica holds the wriggling baby over the clay. I press each of her tiny hands into the clay inside Grace's prints so that the big hand will be holding the little one. She shrieks and balks as we hold her still, uncurl her fingers, and press hard. The impressions are perfect. In twenty-four hours the clay will be dry.         

During the next year, I meet with Grace often enough to feel quite close to her. Eventually, she becomes too sick to come into the hospital any more. Her care is transferred to hospice. I miss our meetings, understand how fragile she is, and decide to make a home visit. A woman with a full face and thin lips lets me in. She is Eva, an old friend who is taking care of Grace in the last weeks of her life, and she leads the way upstairs to a room where Grace lies in a hospital bed. Then she discreetly disappears. It is hot and humid in the house. Grace has no shirt on. Her pendulous breasts rest on her stomach, as if they have just been emptied. I can tell she is glad to see me again. She makes a little joke about being shirtless, says she hopes it doesn't matter since we're all women. Grace is usually very direct, so her comment does not surprise me. Still, it takes me a moment to adjust to seeing her this way. I have never made a home visit to a dying patient, and I have no idea what sort of professional boundary is appropriate.

Grace seems both herself and not herself. Much of her body has wasted away; she does her best to focus through a fog of morphine. Still, when our eyes meet the gaze holds, and when she speaks, her voice is the same - honest, funny, wise.

What do you say to someone who is dying? I feel awkward, aware how little experience with this, except for my mother's death. I ask how she is feeling and watch her face for a sign she hears me, hoping the question does not strike her under the circumstances as ridiculous. After a moment her face breaks out in a broad smile, and she says she is actually doing pretty well. There is a pause, then she says that every single face she looks into--and I especially recall her use of the word "single"--seems full of love, and she can't imagine anything better than that. I see in my mind the faces of the people she loves, at least the ones I know - the baby, of course, and Monica, who must be at once both overwhelmed and distracted by the need to make a living and take care of Alice.

Eva has come upstairs now to see if Grace needs anything. Grace says her mouth is dry. Eva reaches for a tube of gel and offers it to me with a question on her face. I understand she is offering to let me put some gel on my finger and smooth it around Grace's mouth. It is the kind of act Eva must perform a dozen times a day. I am unprepared for the gesture, confused again about the professional boundaries that usually apply in my work but don't seem to apply here. So I shrug my shoulders and shake my head as if to say I don't quite understand how all this works, which is true. Rescuing me, Eva moistens Grace's mouth with the gel, then leaves us alone again.

I am glad for the silence that envelops us as Grace drifts in and out of consciousness. Once in awhile she says something that lets me know she is aware I'm still there. Once she reassures me that she is still "there" no matter how it looks. I am struck by how gracious she is to give me this feed-back even as she lies dying. There is a lump in my throat and a bee in my belly. I have no idea how to be helpful. I only know I needed to see her this one last time to say good-bye.

After a while, as if from a great distance, Grace says she is hungry. She says this as if hunger surprises her, tickles her in some way. I tell her I will let Eva know, then go downstairs to ask if Eva if she can bring up something to eat.

When Eva returns I am surprised to see that she has brought an orange, which she hands to me. Grace has shared a lot of her writing with me, and once she wrote about oranges-- how they were God's gift and how she loved their taste almost as much as she had once loved alcohol, how she would hoard them as a child and eat them by the bagful. Holding the orange in my hand, I remind Grace of the piece she wrote, which makes her smile. She reminds me that she expects me to read it at her funeral, which makes me smile. Then I surprise myself by asking her if she knows how to peel an orange with a spoon. There is a twinkle in her eye as she shakes her head no. I ask Eva if she can bring up a spoon, which she quickly does, then raises the bed up so Grace is in a semi-sitting position.

I hold the orange up so Grace can see it clearly. I pierce the skin with the tip of the spoon and watch as oil poofs into the air as if from an atomizer, suffusing the air in the tight room with a sharp fragrance. Carefully, I probe with the spoon the space between the peel and the fruit, moving slowly in a circular fashion with an almost ratcheting motion, the way you do when peeling an apple so the skin comes off in a one long dancing spiral. Grace lets out a giggle, and a sigh of pleasure. The orange is very ripe, even a little overripe, so I am making a mess. There is juice running down my arm as I pull open the fruit and raise a piece to Grace's open mouth. Eva helps her to lean forward. With an openhearted smile, she takes a fragment of the fruit into her mouth where she savors it for a moment, then utters the one word delicious.

This effort exhausts her, and when she lies back down she seems to sink more deeply into the bed and to retreat into a sleep that carries her away to a place I cannot go. When I kiss her good-bye, she barely responds.

At her funeral service the next week I bring a large basket of oranges to share. Alice plays with them on the floor to everyone's delight, rolling them like balls.