Decision Tree

My mother likes anything that allows her to see inside herself—mammograms, x-rays, ultrasounds. She collects the results of these procedures and files them according to year and body part. “This is my brain,” she says, pulling out an x-ray. “This is my liver, my heart, my spine.” The tests are her proof of good health, proof that she is years away from illness or death.

My brothers and I find amusement in our mother’s obsession because we don’t want to face the reality of her problem. Last Thanksgiving, the boys drove up from their homes in Boston and D.C, and for almost the entire dinner mom spoke of her recent visit to a renowned gastroenterologist.

“You wouldn’t believe what they can diagnose from a simple MRI,” Mom said.

“Can they diagnose crazy?” Brian asked.

“Exactly,” Jay said. “Did you ask this hotshot to test your sanity?”

“Please,” my mom said. “My sanity’s tested every day – I have to put up with you three, don’t I?”

But my mother is serious about these tests. She lectures me often about the need to keep on top of illness. She uses words like safeguarding, patrolling, proactive. “Good health is the result of watchfulness,” she says. “Almost everything has a cure, but only if you catch it early enough.” I have heard her arguments so frequently that the conversations are white noise – just the mention of a medical term can send me into a deep slumber.

“Oh my god” I said while driving her around during one of her tirades. “I’m going to fall asleep at the wheel and kill us both if you don’t stop talking.”

“Fine – go ahead and make jokes, but you’re going to want this information one day,” she said. “You’re young and you take your health for granted. But just wait. When you’re older you’re going to be arthritic or hypertensive or worse! And when that happens, you’re going to be begging me to talk about this stuff. You’ll see.”

My mother has absolute faith in the ability of doctors. I tell her that she’s being taken advantage of, that her doctor should be sued for malpractice for all the things he’s allowed, and even advised her to do. “You have no idea what you’re talking about,” she tells me. “Carl’s a dear friend and he knows what’s best. He’s a doctor.” She says this as if doctors are not born into the world, but burst forth from the earth, fully formed, stethoscope in hand, crying out, “This is a brain tumor. That is meningitis. Bring me the sick and I shall cure them.”

Two years ago, I moved out of my mother’s house to get away from her. I mistakenly believed that separate living quarters would distance me from her. Instead, she seems more insistent than ever that we stay close. Not only does she guilt me into visiting on the weekends, but she also calls every day. Most of our conversations involve something medical – a recent doctor’s visit or a test result she just received. Sometimes she phones just to tell me of all the cancer that exists in the family – breast, colon, lung. Or she reads me articles on the benefits of the flu shot and on advancements being made on the artificial lung. Since moving out, I have become more adamant in my dislike of doctors and hospitals. I am distrustful not only of my mother’s care, but of everything medical – of all those white pills with names that no one can pronounce, of blips on computer screens measuring all the blood being pumped to and from a heart.

I have my own accumulating pile of articles, which includes clippings on the placebo effect, psychosomatic disorders, doctors leaving instruments inside patients or carving their initials into women’s newly enlarged breasts.

“These are absolutely ridiculous,” my mother said when I first showed them to her. “Where on earth are you getting these? Are you reading the Enquirer?”

As evidence, I brought her Scientific American, Newsweek, The New Yorker. “These are credible publications,” I told her.

“Nonsense,” she said. “The things people will believe these days.”

My brothers are generally left to themselves, left to drink themselves to liver failure or smoke their way to emphysema. I think my mother sees me as an easy target, or maybe she thinks that my brothers, older and more immersed in their bad habits, are already too far gone. My brothers take after our father who we never saw without a drink, cigar or fork in his hand. “We’re all gonna die someday,” he used to say. “Why not enjoy ourselves while we’re here?” It’s a mystery to me how my mother and father ended up together. I can only imagine that once, years before there was a family to worry about, children to keep alive, Mom was a somewhat lighthearted person – someone prone to bouts of recklessness and spontaneity, someone who saw in my father a sense of abandonment and was drawn to it. How many cases of colic, ear infections and ruptured appendixes did it take to steal all of that away from her? Was it gradual – boards softening and weakening over the years, the foundation slowly rotting out beneath her? Or was it sudden – the crash of a wrecking ball and then all that dust where once a building stood?

My father was not exactly careless with us, but he believed in letting kids be independent. Nothing was off limits – knives and matches were left in plain sight, electrical outlets were exposed and doors kept unlocked. For my father, childproofing the house meant locking up the cigars and liquor so we wouldn’t exhaust his supply. “Buy your own,” he said when my brother, at twelve, asked for a sip of beer. When I was eleven and my brothers were grown, or at least pretending to be grown in order to be out of the house, our father finally left. He left us for someone who was more appreciative of his lifestyle, and less prone to harping on him for all his bad habits that, god forbid, he pass on to his children.

My father was never sick, at least that I can remember. In my mind he was a hulking, robust man, too large to be felled by things as feeble as illness and injury. When my mother speaks of our father – which she rarely does – she says taking care of him was worse, by far, than caring for all three of us, even when were young and oblivious and always an inch away from some tragic, gruesome death.

“That man,” she says. “The way he ran himself down. It surprised me each and every morning to wake up and find him still alive.”

I still think of him as indestructible, despite my mother’s descriptions and my own distant memories of the drinking and smoking and napping with a cigarette still burning between his fingers. I think of myself as somewhat invincible as well, some imaginary inheritance from my father. So it surprises me to find myself sick with something that I cannot name or dismiss. Illness in my family has always existed as a threat and nothing more, and I know only how to handle this illness, the one that merely promises to emerge and tear our world apart.

When the pain first began, I thought it was indigestion, some heartburn. I took antacids, drank milk and slept most of the night sitting up, propped against pillows, but the pain continued and then worsened. Although I’m scared, I refuse to tell my mother because I can’t bear to hear her diagnoses and suggestions. I’ve been turning down her dinner invitations for three weeks thinking the pain will subside, so when the phone rings this afternoon I’m hesitant to answer.

“Are you avoiding me?” my mother asks when I pick up the phone.

“I’ve been busy.”

“Have you purposely been busy so that you can avoid me? It’s been weeks. Look, if you don’t come over tonight, I’m coming over there. Is something wrong?”

“There’s nothing wrong.”

“Good. Then are you coming over here or are you going to make me drive on the highway at night – you know how bad my eyes are.”

When I arrive at the house, I can see the shock in my mother’s face. I have lost more than ten pounds since I last saw her and my skin has turned some terrible shade of gray?

“You’re sick,” my mom says, and I can’t tell if it’s fear or excitement that I hear in her voice.

“It’s just a bug,” I say.

“How long has this been going on?”

“Not long. A couple weeks maybe? It’s probably nothing.”

“Oh, it’s something, alright,” she says. “I’m calling Carl.”

“It’s seven o’clock on a Saturday.”

“It’s fine. I have his home number.”

Mom calls Carl, and I overhear her making plans for me, recommending an MRI, blood tests, upper and lower GI’s. I have only a vague understanding of what these procedures entail, gleaned from the stories my mother has told me about her own experiences. I know that all of the tests are frightening in their own way. Each one will tell me something dark and foreboding about my body, something that is best left unknown. But what does my mom know about truths best left alone?

“Though I didn’t schedule one,” she says to me after hanging up the phone with Carl, “I think you should really consider an endoscopy. They’re very informative.”

“I think we’re getting ahead of ourselves,” I say. “I’m not sure I even need all these tests.”

“Well, it’s best to be on the safe side,” Mom says.

At the doctor’s office the next morning, Carl is cheerful and full of questions about my body.

“There are lots of things we can do for you,” he says.

He has a list of questions for me concerning my symptoms, and we quickly fall into a pattern of Carl asking, me answering and Mom elaborating.

“You don’t even know what I’m feeling,” I say to her after the fourth or fifth question.

“Well, you’re being too brief,” she says. “How can you expect Carl to help you when you won’t even answer his questions in any detail?”

“Actually, I think this is a good start,” Carl says, interrupting us both. “I’m going to have a nurse take you to get some x-rays, and your mother and I will see you back here in a few minutes.”

Through the office window I can see Carl studying my x-rays with what I consider to be unusual seriousness. It is a look that I imagine passes over the faces of a flight crew when they first realize the plane is going down.

“It’s something terrible,” I say to my mother.

“It’s fine.”

“He looks worried.”

“All doctors look that way – pensive and in charge – it’s calming for the patients.”

“It is?”

“It gives the impression that everything is under control.”

“Is everything under control?”

“Now, I don’t want you to be alarmed,” Carl says when he enters the room and holds the x-ray up to the light. “It’s a very small mass, nothing to be worried about. Most likely it’s completely benign.”

My mother moves in closer to inspect the x-ray.

“It’s here,” Carl says to her. “Do you see it?”

“Oh yes,” Mom says taking the x-ray from him and turning it around in front of the light. “It’s very obvious, isn’t it?”

They point and nod and say things like minor surgery and biopsy. They throw those words around as if I were not even in the room, as if it were not my body, but somebody else’s, that was going to be split wide open and stripped of essential parts and pieces.

“It’s nothing to be worried about.” Carl says, turning to me.

“Yes, don’t be worried,” Mom says. “It’s practically nothing at all.”

“Your mom is right – it’s almost nothing,” Carl says. “Would you like to see what we’re discussing?” He takes the x-ray from my mother and motions for me to look closer. “It really is so small, hardly noticeable I would say. Can you see the mass we’re talking about? It’s here.”

Carl holds up the x-ray but I see only black and white and shades of gray. There is no mass. There is not even a body for the mass to have grown in. It looks nothing like my liver, my stomach. I want to tell them that they’ve made a mistake, that we’re looking at someone else’s x-rays, the insides of a stranger who, by the look of it, needs to get a hold of herself and decide just what exactly is going on in there.

“Are you having some difficulty seeing it?” Carl asks. “It’s here. Do you see?”

Slowly, as I look more closely, things begin to take form. Lines and shapes become more distinct, and even the color is changing and looking a little more blue than it did just minutes before, or is it more of a green? I look at it now, and I am surprised that I didn’t notice this before – it looks not unlike Lousiana. Or no, maybe more like an ocean liner cruising the Pacific.

“Can you see it?” Carl asks again.

Of course I see it. It’s an old man on a porch, smoking a pipe. A figure skater landing a triple salchow. Zebras running roaming the savannah.

“This is your liver,” he says and he points to Senegal. “And this is the malformation,” he says pointing to the bomber taking flight.

“”Do you see it?” my mother asks.

“Of course,” I say. “Of course I see it.” And I do. Everything is becoming clearer to me.

Melanie Roeder is a graduate of the University of Arizona and the School of the Art Institute of Chicago. She currently lives in Chicago where she is an occasional writer and a more frequent hypochondriac.