Mother and Daughter and Caring

One True Thing

By Anna Quindlen

Published 1994

Ellen Gulden is 24 and a Harvard graduate employed by a magazine in New York City when, during a visit home to see her brothers before they left for their next years in college, her father informs her that her mother has advanced cancer and will need her.  Ellen resists and suggests they hire a nurse.  But she leaves her NYC life behind and comes home to care for her mother.  She tells us this is not because she loves her mother, but because she felt she had no choice.  Kate Gulden was the mother who made everything from scratch, was on a first name basis with the hardware store employees, was on many community committees, and always designed and executed the best decorations for her assigned tree in the town square.  Kate Gulden’s life as wife of English Professor George Gulden of Langhorne College, a small liberal arts school in the small town of Langhorne, was one Ellen knew would never be hers.  But she agrees reluctantly to take care of Kate Gulden, in large part because it was another case of trying to achieve something her father demanded.

Quindlen tells the story of the months Ellen spends with her mother as the cancer slowly destroys her body, but not her spirit.  The descriptions of cancer’s impact are quite vivid although not in a way that causes recoil but rather draws you closer to Kate Gulden, her daughter, and all who suffer from cancer and all who take care of cancer victims.  The hospice nurse is carefully drawn and the compassion she brings to Kate, and indirectly Ellen, is clear whether or not Ellen can accept it.

Also during this period, Ellen learns much about and from her mother.  In the early stage of the caregiving, Ellen has “the childhood I might have had, had I been a different sort of girl, my mother a different sort of woman, and both our needs to woo my father less overwhelming”.   They start the Gulden Girls Book and Cook Club with only two members—mother and daughter.  They read Pride and Prejudice, Great Expectations, and Anna Karenina, all books Ellen has, of course, read.  Ellen learns eventually her mother had already read them too.

Eventually the disease begins to take a huge toll on Kate including losing strength so that Ellen needs to help her with more and more movements and activities.  The relationship between Kate and Ellen starts to shift more towards Kate as the child needing care and Ellen as the mother to provide it.  Pain becomes an overwhelming aspect of Kate’s life and her need for and use of morphine increases.

During this time Ellen’s relationship with her father also takes a shift and she becomes less all-adoring and more critical of him.  The biggest shift, however, occurs after her mother passes and it is determined that Kate’s death was due to a bolus of morphine well above and beyond what her morphine dispenser would allow.  Ellen is arrested for murder of her mother, although she hadn’t given her the overdose, and her father doesn’t even post bail for her.

The second half of the book deals with Ellen’s life immediately after Kate’s death and how it is impacted by the murder investigation and court proceedings.  I won’t spoil your reading by detailing how this goes.   There is some discussion about the ethics of supporting and/or hastening the end of life in this kind of case but fortunately the author doesn’t peach a line on this.

One review of this book suggests the epilogue makes the ending too tidy.  I somewhat agree with this view for the reason given—the author knows life, especially family relationships, grief, and loss, is untidy so a tidy ending is somewhat inconsistent with the rest of the book.

I very much appreciated the intelligent language of the book, its exploration of care giving and receiving care for such as devastating disease, and it exploration of the untidy nature of mother-daughter, father-daughter, mother-father, and mother-daughter-father relationships and how none of these relationships are static over time whether we want them to be or not. These aspects will enable the book to remain relevant for many decades (it’s already 23 years since publication).  Only one scene would definitely be different if occurring in the day of cell phones vs telephone land lines but by clearly stating the story occurs in 1985, this isn’t an issue.    I put this book on my “recommendation to others” list although not immediately for others whose life situation involves cancer and/or recent loss as a result of cancer.