18: Bearing Fruit
CHAPTER 19: Full
Epilogue
ACKNOWLEDGMENTS
In training to be a doctor, you learn that without the wisdom, teaching, and support of others, you will fail, and your patients will suffer. This book exists thanks to so many people who have taught and helped me over the years.
First, I thank my husband Martin, who encouraged me throughout the development of this book, edited several versions, and said “it’s great” every time. He has guided me on a route through life with meaningful destinations, exhilarating vistas, exciting side trips, and safe landings. I thank also our two beautiful daughters, Rachel and Cassandra, and their wonderful families for tolerating my life-baring narrative. They keep me grounded in the present when I stray into agonizing about the past or worrying about the future.
I am so grateful to my wise agent, Anne Devlin, for her encouragement and support. I give special thanks to Janet Ottenweller at Central Recovery Press for shaping and improving the book. Thanks also to Eliza Tutellier, Nancy Schenck, Valerie Killeen, and Patrick Hughes for believing in the book and including me in the Central Recovery Press family. And thanks to Marisa Jackson for the beautiful and meaningful cover and interior designs.
“See one, do one, teach one” is a half serious pun on learning to perform medical procedures. In contrast, writing creative nonfiction takes years of education and practice. This book would not have been possible without the outstanding teaching of Theo Nestor, from whom I learned the art and science of memoir. As she helped me with overall book design, Claire Dederer taught me to think first about the reader, which is eerily similar to another medical education truism, “the patient comes first.” Jennifer D. Munro taught me how to see the patterns and content of a manuscript. She saw what I was saying before I realized it and used brilliant surgical technique as she performed her editing operation. Jennifer Worick and Kerry Colburn taught me critical nuts and bolts of the writing business.
The women in my writing group—Rosemary Gregory, Margot Page, Joyce Tomlinson—are all expert writers who generously shared their knowledge and experience with me. They honored me by accepting me into their group; I was the straggler to their strides.
I thank the many family members, friends, and colleagues who have asked at some regularity about the progress of this memoir and were mollified with my meager responses. Finally, I am grateful to Deborah, Frank, Jack, and Marcia for restoring my sanity of sorts, without which I could not have written about my difficult beginnings.
AUTHOR’S NOTE
Four and a half decades have passed since I left home. I married early and well, and my husband and I have two daughters and several grandchildren. Along the way, I collected several academic degrees—too many probably—which led me to my career as a medical doctor and researcher. Throughout my career, my personal experiences have shaped my passion for research.
This book is a memoir, and as such, reflects my recollection of events during my life. I reconstructed conversations from my memory, which may differ from other people’s memories. In some cases, especially when recounting scenes from my early childhood, I created dialogue to support the narrative. The names and characteristics of my immediate family are real, but I changed the names and physical characteristics of many other people in the book to preserve their privacy.
The Obesity Society, whose mission is to advance the science-based understanding of the causes, consequences, prevention, and treatment of obesity, recommends that physicians and researchers use “people first” language. That is, they recommend that we refer to “persons with obesity” rather than “obese persons.” This helps create positive, productive discussions about weight and health, reduces chance of bias against persons with obesity, and underscores the medical community’s classification of obesity as a disease rather than as a failing.
As a child and early teenager, I was labeled as “fat” and other derogatory terms. I thought of myself as a fat kid, and that made me inherently ugly, undesirable, and a failure. In this memoir, I have chosen to use those terms to show my own experience with weight bias. However, I fully support the Obesity Society’s position on working to reduce the use of pejorative words to describe individuals with weight issues or obesity.
I answered the phone, expecting the usual telemarketing call telling me not to hang up. Instead, a woman’s voice asked if I was Dr. Anne McTiernan. Most people calling my home don’t know I’m a doctor, unless they are friends or relatives.
“Yes,” I said, looking out at Lake Washington’s steel gray water under an equally drab sky, a typical Northwest November sunset. Any minute now, I’d hear my husband open the garage door to bring in his bike after pedaling home from teaching his last university class of the day.
“Hi, Doctor, my name is Joan McGinn. I’m the social worker at your mom’s nursing home in Plymouth.”
“Hello,” I said. I didn’t want to deal with this tonight. I had returned late the previous night from giving a talk on obesity, exercise, and breast cancer at an American Association for Cancer Research conference in Washington, DC. Today, I’d risen as usual at 5:00 A.M. for my morning workout followed by a full day of meetings.
“Your mother asked me to call you.”
My stomach twisted into an imitation of sausage links. This was not the first person to phone me on my mother’s behalf. Over the years I’d been called by neighbors, doctors, nurses, and lawyers. I took a cleansing breath, trying to decide how much to tell this stranger about my relationship with my eighty-seven-year-old mother, how I had discontinued my visits with her ten years before and had stopped taking her calls five years ago. And I did that because every contact with my mother brought up painful memories I was unable to handle. Before I said anything, the social worker continued.
“You mom has decided to go off dialysis,” she said.
The sausage links burst. I knew what this meant. My mother had end-stage kidney disease. Without dialysis, she’d be dead within days.
“Oh, God,” I said.
“Your mom told me she’s suffered enough. She is ready to let go.”
I stayed quiet, thinking then not thinking.
“Would you like to speak with your mom? I know the two of you have been estranged.”
“No,” I said quietly. I didn’t want the last words I heard from her to be the usual accusation that I was a horrible daughter. “But please tell her that we talked,” I added.
“Okay, I’ll do that. The nurses will make sure your mom is comfortable.”
“Thanks.”
“Do you want me to let you know how she’s doing?” she asked.
“Yes, please, that would be nice.”
“Okay, I’ll be in touch.”
“Tell her I’m thinking of her.”
“I will.”
And indeed, I was thinking of her. I thought of her most days.
The social worker called as promised, two days later. “I’m sorry to tell you that your mom just died,” she said.
I decided to go to her funeral. I wanted to see for myself. I needed to make sure she was dead.