Desperate to Cry, Desperate Not To

By ANNA B. REISMAN
20 april 2008--I knelt down in front of the elderly woman’s wheelchair so she could see me. She wore a baby-blue sweatsuit and smelled of cigarettes and hair spray.
“My breathing,” she said in her gravelly voice, “it’s a little worse.”
An 84-year-old former hairdresser who had served in the Women’s Army Corps in World War II, she was widowed once and divorced four times. She didn’t have much in the way of local support. Most of her friends were dead, and though she was close to her two daughters, they lived halfway across the country. Despite severe emphysema and bad knees, she had managed on her own until three years ago, when she became legally blind. For the past three years, about as long as I’d been her doctor, the woman had shared her home with a middle-aged man, who helped with her medications and meals.
I asked a few questions, listened to her lungs, prescribed a new inhaler and offered to call her housemate. I’d speak with him on the telephone after every appointment to go over her treatment plan. I had never met him in person, but he was invariably friendly and gracious.
I remarked to her that she was lucky to have someone like him.
“He’s not a nice man.”
Had I heard her correctly?
“Everybody thinks he’s so nice, but he’s nasty.”
Stunned, I regarded her more closely. Her thin gray hair framed her wrinkled face like a puff of smoke, the circle of plastic tubing that ran from her oxygen tank to her nose a low-slung halo.
“He calls me lazy, yells at me for not helping out in the kitchen.”
How could she stand at the sink? How could she even see if the dishes were clean?
“My daughter’s been trying to get me to live with her for 10 years,” she said. “But I don’t want to move. I don’t know what to do.”
And she began to cry.
There you go, I thought, perversely relieved that she felt safe enough with me to let out the tears.
But something was wrong.
The woman was fumbling frantically in her large handbag. “I can’t cry!” she croaked, her voice faint. I grabbed a box of tissues and set them in front of her. She shook her head and finally extracted an inhaler from the bag. Her hand shook as she lifted it to her mouth.
I suddenly realized how quiet it was. Her shoulders and chest were heaving, but she wasn’t breathing. She was trembling, the tears streaming down her cheeks, and she couldn’t take a breath to use the inhaler. I sat still, trying to look calm, my mind racing. Should I thump her back? Call for help? Start CPR? After an interminable moment she sucked in a couple of wheezy puffs.
“If I cry,” she said, still panting, her face pale, “I can’t breathe. I can’t allow myself to cry.”
Then it struck me. Regular breathing was hard enough with her emphysema; crying — with its deep irregular inhalations — crippled her ability to draw in air.
Her life was defined by her need not to cry. So she spent most of her time alone in her room to avoid her housemate. And although she wanted to go to her friends’ funerals and wakes, she could not take the risk.
By the end of our session, I knew that I would have to ask some hard questions. I would learn that day that despite her housemate’s bad temper, she never felt threatened by him. Three months later, she would report that he was leaving because of his own health problems, and she would move soon after to be with her daughter. By late September, I would learn, the woman was dead.
But at that moment, I just sat with her, neither of us talking, waiting for her breathing to calm.