Ruth sensed from the moment that Rachel walked through Gate 7 at San Francisco International Airport that something was—off—with her makuahine. She had never seen Rachel looking so weary after a flight to California; usually she couldn’t contain her excitement. But she was, Ruth reminded herself, eighty-three years old, and more than entitled to feel exhausted after six hours of flying.
As soon as Rachel caught sight of Ruth, her face brightened.
“Welcome back, Mother,” Ruth said, embracing her. She said the word easily now; after twenty-one years, she was able to accept the fact that she had two mothers and that loving one was not a betrayal of the other.
Ruth noted a slight puffiness in Rachel’s cheeks. “Long flight?”
Rachel gladly let her take her carry-on. “Yes, very. But how is Frank?”
The week before, Frank had been in a traffic accident coming home from work. His car was T-boned on the passenger side with enough force that it slammed the side of his head into the driver’s-side window. The glass didn’t shatter, but the impact perforated his left eardrum.
“He’s recovering, thanks,” Ruth said as they headed for baggage claim. “The doctor thinks the eardrum might heal on its own in a few weeks, so he’s keeping an eye on it for now. If not Frank might need surgery to repair it.”
“But he wasn’t otherwise hurt?”
“A few bruises on his face. He tells people I beat him.” Rachel laughed at that. “The new Pontiac fared worse, it’s in the shop.” More soberly she said, “How are you coping on your own? Without Sarah?”
“I miss her. But I’ll—what’s that word Etsuko told me?—gaman.”
At home Frank greeted her warmly, the side of his face swollen and purpled, his ear bandaged to prevent infection. “The doctors say I need to take things easy,” he said, “so it’s going to be a quiet Christmas.”
That was fine with Rachel, who was more fatigued than she tried to let on. At dinner she ate sparingly and took only a few bites of the ono, delicious, roast beef Ruth had cooked for everyone but herself. “I’m a little nauseous from the flight,” Rachel explained, though the flight had nothing to do with it.
Ruth didn’t give this another thought, but the next morning, when her makuahine awoke looking just as tired as the day before, she began to worry. “Did you not get a good night’s sleep?” Ruth asked.
“Oh, I find the older I get, the less I sleep.”
Despite her fatigue, Rachel found the holiday delightful. She spent time with Ralph and his family, with Horace and Stanley and their large broods, and most important with Don and Peggy. Peggy was now married to a fellow vet, David Tanaka, though both were too busy with their veterinary practices to start a family yet. Don—who was quick to tell his tūtū about an upcoming trip to study coral reefs in the Maldives—had married Trish, and Rachel was introduced to their seven-month-old son, Charles Kenji Harada. Rachel was immensely moved by their gesture and held the infant tenderly in her arms, tears in her eyes, thankful and amazed that she had lived long enough to be holding her great-grandson.
With Frank under orders to rest, Ruth was kept busy handling the cooking, but even in the midst of the holiday chaos she began to notice things that rekindled her concern for Rachel:
Her mother seemed never to eat very much, and had a different excuse for it each time. The puffiness in her face did not go away after the airplane flight, nor did the exhaustion Ruth glimpsed every day in her eyes. Several times Ruth caught her rubbing her back as if it pained her, but her mother had never exhibited any back problems before.
On Monday morning, as Rachel sat in the living room with Frank, watching television, Ruth went into Rachel’s bathroom with a scrub brush, sponge, and a can of Comet, intending to scrub the sink and counter—but quickly forgot both when she looked into the toilet bowl.
The toilet had been flushed but, to Ruth’s horror, she saw a spattering of blood-red droplets freckling the face of the water.
* * *
Frank went to take a nap, and once Ruth was alone with Rachel, she sat down next to her on the living room couch and said, her tone solemn as a prayer: “Mother, please be honest with me. What’s wrong with you?”
“What do you mean?”
“There’s blood in your toilet bowl.”
Rachel winced. How had she missed that? She didn’t want to admit the truth, but the fear in her daughter’s eyes shamed her into confessing.
“My … kidneys are failing. It’s a side effect of the sulfa drugs they give us to treat Hansen’s disease. I’m sorry I kept it from you, but … it didn’t seem an appropriate subject for the holidays.”
Ruth was shocked, but not yet alarmed.
“So if you stop taking the drugs,” she asked hopefully, “will it get better?”
“I’m … afraid not,” Rachel said, and saw the fear this sparked in her daughter’s eyes. “My doctor says my kidney function is down to eighteen percent. One kidney has stopped working altogether. At fifteen percent you enter what they call end-stage renal failure.”
“But—they can do something, can’t they?” Ruth asked, desperation creeping into her voice. “What about this new treatment—dialysis?”
Rachel sighed. This was just as hard as she thought it would be.
“The doctors say it’s not practical yet for end-stage kidney failure,” she told Ruth. “And frankly that’s just as well. I wouldn’t want to spend eight to ten hours a day, every other day, lying in bed, having my blood filtered through a machine.”
Ruth hadn’t felt this kind of fear and helplessness since the day her okāsan had had her heart attack. “There must be something they can do!”
Rachel shook her head. “All they can do is treat the symptoms. I take a diuretic for high blood pressure, an iron supplement for anemia. And I have to watch my diet. Even so, I … probably have only about two months before I reach the last stage.”
Ruth could barely get out the words: “And … and how long before…”
“Anywhere between two months to a year,” Rachel said stoically.
Ruth’s mind was a welter of shock, grief, denial, anger.
“How the hell can you be so calm about it?” she demanded. “You sound like you’ve given up, like you won’t even put up a fight!”
“I won’t win this fight, Ruth. I can put it off, but in the end I’ll lose.”
“No!” Ruth cried, as if through sheer force of will she could command fate, reverse time. “You’ve got to fight it!”
Rachel heard the anguish in her daughter’s voice and put a reassuring hand on her arm.
“Ruth—don’t you see?” she said softly. “The last twenty-three years have been … a miracle. In 1946 I was dying, literally dying. I’d made my peace with God. Then, suddenly, I wasn’t dying anymore. I was cured; free. The sulfa drugs gave me new life, another chance at life.
“I left Kalaupapa. I found my sister and my brother on Maui. I found you. I couldn’t be there to play with you as a child, but you allowed me to play with my grandchildren and to watch them grow up into such fine people, so pono. And on this trip I was blessed to be able to hold my great-grandson in my arms. Can’t you see how miraculous that is?”
Tears were streaming down Ruth’s cheeks.
“Yes, the sulfa drugs are killing me,” Rachel said, “but without them, I would never have known the love of my only child.”
She embraced Ruth and they sat holding each other until Ruth pulled back, wiped away her tears, and said, “All right—however long you have, we can spend it together. Ellie can pack up your things, ship them here to—”
Oh God, Rachel thought. This is hard.
“Ruth,” she said sadly, “I can’t stay here.”
“What?” Ruth was incredulous. “Of course you can. We have some of the finest doctors in California in San Jose, you’ll receive the best of care—”
Rachel just shook her head again.