Novel gives doctor way of showing what it means to care for a loved one as death nears

In the early 1990s, my mother came to live with me and my husband and my then early teenage children, and she remained in my house until she died almost 14 years later. As you can imagine, there were wonderful and terrible aspects to that arrangement, and as she aged, the demands and the pressures increased almost daily.

As she became weaker and more frail, I tried to truly understand who she was, what her life experiences had been, and what secrets she might have had that made her who she was. In some ways, I could look at her and know everything about her — her pulse, her blood pressure, her cardiac condition — and in other ways, I felt I hardly knew her at all. I thought about what she had she gone through: born during World War I, living through the Great Depression, marrying in the midst of World War II, coming to a new country on her own, and being a Midwestern housewife raising three children. What secrets did she have and how did they shape her?

It was those questions that compelled me to write a fictional account of an older woman, Olivia Sherman, her relationship with her middle-aged daughter, Dr. Rebecca Brodie, and secrets. The book takes place over the last three days of Olivia’s life, and goes back and forth in time to reveal facts and experiences about Olivia, Rebecca, Rebecca’s sister Sharon, and the people around them. For those of us who have had aging, increasingly dependent parents, the key moment in my book is when Rebecca realized that she had become her mother’s mother. The raw emotions that Rebecca felt, the sense of being overwhelmed, and the depth of the responsibility sweeps over Rebecca as a paralyzing toxin. And yet at the moment of her loss, Rebecca realized that after all that had been said and done between her and Olivia, she had not arrived at closure. Maybe closure is more elusive than most of us hope it is?

I tried to bring to life through my characters the myriad emotions I have felt, the untold experiences I have had ministering to my patients and my family, and the vicissitudes of life. 

I could only write a work of fiction with the protagonist as a physician. I had tried to make her something else, but after being a physician for almost 40 years, I realized that I also wanted to write about viewing the world through a physician’s lens. So beyond family, aging, and secrets, my novel is also about how Rebecca, the quintessential clinician and researcher, navigates the world and experiences life and death in ways that are similar, yet different, from other people. The novel is also infused with the intrigues that occur in the medical world, from enigmatic patients, to jealous colleagues, to the challenges of research.

None of the characters in my novel are modeled after actual people – perhaps other than Rebecca’s husband — but the book is laced with emotional realism. I tried to bring to life through my characters the myriad emotions I have felt, the untold experiences I have had ministering to my patients and my family, and the vicissitudes of life. There is no better title than “Rhythms” for my book. There was a rhythm, a cadence, and a beat that determined how Rebecca, Sharon, Olivia, and all of my other characters spent their days and nights, and ultimately dealt with their secrets.

My goal was to illustrate how demanding caring for a loved one in the period before death can be, and how difficult it is to infuse the process with dignity. Since none of us can likely escape the aging process, it’s critical that we think about our family members and ourselves, to plan and resolve. Beyond all the science and medicine, I’ve sought to show that what drives us is often more in the emotional realm than the rational one.

[Photo by Sheena876 via Flickr.]