I looked at the carpet in her small living room. This is where she had fallen and lay for twenty-four hours before her younger sister, Auntie Tanya, had found her. According to Auntie Tanya, the first thing my grandmother mumbled was that she had been holding in going to the bathroom for hours, but she couldn’t get up. ‘Go, Irochka, just pee on the floor; it doesn’t matter,’ Auntie Tanya had cried out. And my grandmother, a neat freak by nature, went on the carpet. The paramedics had cut off her clothes, and it took six men, summoned in panic from neighbouring apartments, to carry her from the second floor down to the ambulance.

Babushka. Baba Ira. Babulya. I stared at the multi-coloured, standard Soviet issue carpet familiar to me since childhood, looking for stains despite myself. Her ancient white cat Eden, who had herself suffered two strokes and lost half of her weight, lay in the middle of the carpet (on the spot where Babulya fell?) and mewed, staring at us questioningly with her yellow eyes. A fluffy cotton ball when Babulya had taken her from our family cat’s litter sixteen years ago, Eden now resembled one of those animal rugs with a head and paws.

Outside the window, theatrically fat snowflakes were blowing about. I sat down on the couch. It was rigid. Mama and I had been up for two nights travelling from Alaska to Stavropol, Babulya’s hometown in the south of Russia. This was my first return to Russia after emigrating thirteen years prior. My eyes prickled, my head buzzed, my heart broke at how uncomfortable Babulya’s couch was – a place where, I’d imagined, she spent the majority of her time in the recent years.

As a favour, Uncle Misha – the ex-husband of Mama’s cousin and also a doctor – took us to Babulya’s hospital that first day in his car, navigating at warp speed the chaotic, narrow roads. Once there, he put on his white coat, although he didn’t work at this particular hospital, went through the glass doors of the Intensive Care Unit and down the hallway to talk to someone while we waited in an empty room. We put on the paper booties, scrubs, hats and face masks Auntie Tanya had bought for us – all a very bright American bubblegum colour. Finally, Uncle Misha summoned Mama and she disappeared into a room off the hallway.

Like a reflex that kicks in at the most inopportune of times, a familiar feeling of guilty excitement flooded over me. Let me clarify: I used to have a love affair with medicine, in large part thanks to Babulya’s long-time position as the head of a small multi-specialty clinic. As a child, I had spent many summers at her clinic ‘helping out’ the doctors (I particularly enjoyed pointing at the letters on the eye chart during vision exams); I even accompanied the doctors in the ambulance on home visits, mostly to home-bound elderly folk – not any kind of exciting bloody emergency I secretly craved. I passionately loved all the shiny scalpels and scissors, the jars full of cotton balls and gauze strips, the white coats, the rubber gloves, the beeping machines. My first summer job at fourteen was at Babulya’s clinic, in the reception room where I answered phones, filed patient histories and mopped the floors. I also spent a lot of time listening to the gossip in the lunchroom and discussing my future medical career with various doctors. As a child, I was prone to sickness, with several bouts of hospitalization, and I was nothing short of a model patient, swallowing bitter medications with abandon and stoically enduring various diagnostic procedures, more uncomfortable than painful. Babulya and Mama were in awe of my bravery and showered me with praise.

In college, I had oscillated between pre-medical and artistic tracks (like any good immigrant, I didn’t dare view mere writing as a career). Years after graduation and forays into film production, PR, law and real estate, I resumed pre-med classes and volunteered in the ER at a Brooklyn hospital. Even after I had finally resolved to not become a doctor, a nurse or even a chiropractor, I still got excited about going to the hospital. I enjoyed taking Mama in for small procedures and sitting in the curtained cubicle by her bed, checking out the equipment, which was so much more colourful and sophisticated than in Russia of my childhood, with so many more cords and buttons and packaged sterile things. There had been sickness and death in our family, of course, but it happened off-screen, in another town, and when I was very young. Therefore, I am embarrassed to admit that until the ripe age of twenty-eight, hospitals remained fascinating places to me – living exhibits at a science museum – almost entirely removed from pain and suffering.

After about ten minutes of admiring my sharp blue scrubs get-up, I was called in to see Babulya.

She lay in a bed in the room with four other patients, hooked to a respirator and a feeding tube. Mama was kneading her hand and whispering something into her ear. Babulya was pink and huge, even bigger than I’d remembered. There wasn’t a single wrinkle on her peachy skin. Her eyes, when she would crack them open with effort – one seeing, one blind from retinal detachment years ago – were the same rare dark blue I’d always been jealous of. The left side of her body was completely paralyzed. She squeezed my hand forcefully with her good hand. That pillowy, hot, strong hand had always been my anchor to primal, limitless comfort. Her short thick hair – winter hat, we’d called it – was grey. When did it turn grey? It had been blonde, then orange, then blonde again, and the last time, when I’d seen her five years ago in Czech Republic-purple. Irina Nikolaevna Horosheva, 71, read the tablet above her bed. If one were to ignore the plastic tube that stuck out of the gurgling hole in her neck or the feeding tube going into her dry mouth, which provoked wild bouts of coughing every few minutes, one could almost pretend she was taking a nap. She looked so much healthier than the others: the skeletal, ash-skinned woman with a black-hole mouth across the room (Evdokia Borisovna Popova, 95); or the boy with uncomprehending eyes to Babulya’s right (Vladimir Glebovich Burenkov, 24), who was throwing up yellow bile, choking on his feeding tube and crying soundlessly. One of the nurses, a young Armenian guy, came to change Vladimir’s diapers, and I looked away when he exposed his young, white thigh.

‘Mamochka, mamochka, it’s us. And, look, Ksusha is here, too,’ Mama said, as she massaged Babulya’s stocky legs. ‘We’ll work together and get you out of here, yes? We are here now, don’t worry. We are here. Do you understand? Will you work hard to get better?’

Babulya nodded her head yes. She was unable to talk.

Uncle Misha and a short, skinny doctor in white scrubs talked over Babulya.

She had suffered an ischemic stroke – not a shocking occurrence for someone with such high blood pressure, hypothyroidism, diabetes and heart arrhythmia.

‘But she was just in the hospital for her heart. She said they cured it,’ Mama told the doctor. Her grey eyes glowed a beautiful blue between her bright hat and face mask.

The doctor laughed, flirting a little. ‘Cured it? You can’t cure it. This stroke was just waiting to happen. At any moment.’

‘We didn’t know,’ Mama said in a trembling voice. ‘No one told her.’

Babulya was always so upbeat over the phone, her voice and spirit so young. She never complained. She had always been bigger than Mama, stronger physically, emotionally and financially. Like common fools, we didn’t think to worry about her too much. Over the long distance, her illness and old age were unreal.

The doctor shrugged his shoulders. ‘It could happen again.’

‘Her mother, my grandmother, was bedridden for five years after her stroke. She could sit and talk.’

The doctor shrugged again. ‘Some of the damage is reversible if treated within four hours of the stroke.’ He looked at us reproachfully.

‘There is a chance she’ll get better,’ he added in a more upbeat tone. ‘She just needs to lose weight and start breathing by herself. It’s especially hard for the morbidly obese. The longer she’s on the respirator, the harder it is to get off, and the higher chance of pneumonia. On the other hand, she’s probably losing a kilo a day now. You can stay for fifteen minutes today. Tomorrow, you can come at five and help the nurses wash and turn her.’

We were instructed to bring blended food in glass containers every day and two packs of diapers and diaper cloths (which looked like puppy toilet training pads) every other day. Then we consulted Uncle Misha regarding the appropriate amounts of bribes for the resident doctor, the night doctor, the head of the ICU department and the nurses.

When the doctor left, Mama shoved some money to the Armenian nurse with big black eyes. ‘Bozhe-moi, put it away, please,’ he said, offended. ‘I’ll take care of her.’

This was – if one can use such a term here – our best visit. We stayed for almost an hour without being bothered. Mama and I rubbed Babulya’s pallid thighs and meaty arms, her shoulders and all the wrinkles and rolls in the back of her wet, sweaty neck, concerned that the nurses didn’t wipe her well after washing her head or giving her water. We folded and unfolded her arms and legs for exercise, encouraged by her weak participation. We talked quietly about our life in America. When she opened her velvet blue eyes, she looked innocent and lost, a big helpless baby.

I felt hopeful when we left that night. It was probably an evolutionary reaction. We crossed the street to the shuttle stop and waited, unsure of whether it was the right stop or how late the shuttles ran. It was dark and snowing. The streets were empty, save for a lone dog walker here and there. All the terrifying snippets from stories of murders, kidnapping and rapes, which my father emailed me and my younger sister Maria every time we started talking of visiting our old Russia, came flooding in. This Russia was no longer ours. I looked at the hospital from across the street: it was encircled by a black grated fence and a grove of black, naked trees – a jail or an asylum where not only the patients but also their relatives were imprisoned.

The middle of three sisters, Irina Nikolaevna Horosheva – our Babulya – was born in Ashgabat, Turkmenistan and raised in Stavropol during the hungry post-war years. Both of her parents had been repressed by Stalin. Her mother was accused of stealing a loaf of bread from the store where she worked – that’s how she ended up exiled in Turkmenistan. Her father, a veterinarian by training, had worked as a medical researcher at the Anti-Plague Institute, developing vaccines. He was accused of foreign espionage, tortured and served time at a Siberian gulag. He came home a broken man. Babulya was jaw-droppingly beautiful: blue-eyed, ash-blonde, tall and slim, with a firecracker personality. She married an army officer at eighteen and followed him to the faraway Petropavlovsk-Kamchatsky on the Kamchatka Peninsula. That marriage fell apart quickly due to her husband’s gambling addiction. Divorced at twenty-one, Babulya returned to Stavropol with my one-year-old mother on her hip and all of their possessions packed into a single suitcase. She attended medical school and became a dentist. After a few years, she remarried and moved to the northern town of Syktyvkar. This marriage, too, was unsuccessful. Her criminal lawyer husband had many affairs, including one with the wife of his jailed client, for whom he eventually left Babulya. She concentrated on her career and rose to become the chief doctor of the clinic, a position she would hold for thirty-five years. She was awarded many honours, including Doctor Emeritus of Russia – a medal and an official diploma signed by President Vladimir Putin. After Babulya retired, she moved back to Stavropol, to be closer to her sisters.

I remember her as tall and large, all-powerful, flying around Syktyvkar in her white coat in a car driven by her personal chauffeur. She knew in minute detail the home situations of her entire staff at the clinic from the janitor and the head cardiologist: the names of their children and spouses, who was sick, who had problems with relatives, in what conditions they lived. She took them all under her wing, paying no attention to titles. During the Soviet years, when the economy was largely based on connections, she never hesitated to use hers to procure better equipment for her clinic, a much-needed medicine for the wife of the brother of one of her nurses, or to bump her newly married dermatologist up the waiting list for a one-bedroom apartment. Her heart went ahead of the rules and regulations. She made friends with her charm, her beauty and her belief that kind treatment of people will always bring out their best. She was brave enough to go to Palermo, Italy and Israel and Hawaii by herself, speaking no language other than Russian. Within a day, she’d make friends there, too.

A stern and unsentimental parent to Mama, she spoiled Maria and me rotten with gifts and attention. And she was oh so fun. She let us try the delicious, sweet Malibu rum with copious amounts of milk when I was no older than ten. She let us stay up late, watch grown-up movies and she read our fortunes. Even though she largely viewed men (except for my father) as ‘greedy cheaters’, she was my best and most understanding confidant when it came to sharing the woes of first shy and tragic loves.

Mama confessed that, as a child, she thought that Babulya – who couldn’t wait for Monday mornings – loved her work more than her. As an adult, Mama realized that Babulya was of the post-war generation of women who were raised to be strong, courageous and hard-working, to rely on themselves only, because men too often drank, betrayed and abandoned. Babulya didn’t smother or over-promise; she showed her love with deeds. She was as wildly generous as she was stubborn, ruthlessly practical in some matters and childishly gullible in others. I’d seen her orchestrate the construction of the house and lose a stack of money to a street swindler in a rigged card game. She loved beautiful things and never skimped on little pleasures. Along with work, food was another one of her great passions. She could never exorcize the ghost of starvation from her blood – she couldn’t say no to an unhealthy diet even as it was slowly killing her. Despite her medical knowledge, she seemed utterly unable to apply it to herself. Over the years, we had begged her to change her lifestyle, to eat healthier and walk more, but, ultimately, there was little we could do from more than seven thousand miles away. Or so we said to ourselves.

We visited Babulya in the hospital the next two days. We brought diapers and puréed food; we bribed the new doctors and nurses. We held Babulya’s hand. On the third morning, when we called to check on her condition, we were told that she’d been transferred to City Hospital #4. I had a horror vision of naked Babulya being pulled on a stretcher through the snowstorm, her respirator dragging on the ground behind her.

It took us an hour on two speeding, cramped shuttle buses to get to the City Hospital #4, which had a huge campus of clinics, branches, and departments. It even had its own orange-brick Orthodox Church and stray cats sitting on the porches. We checked our coats with a cranky coat check clerk and received metal tokens – just like at a fancy theatre. Then we went up several flights of stairs, down a corridor and found ourselves in front of a locked door that said ‘ICU’. High up on the door frame perched a small doorbell with a sign: ‘ring for doctor’. We changed into our blue garbs, put on the hats and the face masks and rang the doorbell. After about twenty minutes, a young nurse popped out.

‘We are here to visit Irina Horosheva,’ Mama said tenderly.

‘The doctor will come out to talk to you when she can. Wait here. Brought the diapers?’

‘Yes, yes, and food. We brought everything.’

‘I’ll put it on her shelf.’ The nurse grabbed our plastic bags.

‘It’s for Horosheva, Irina Horosheva!’ Mama yelled as the nurse disappeared behind the doors painted in institutional beige.

We sat down on a bench by the window and waited. Doctors and nurses went in and out of the magical portal where Babulya lay, banging the door. An endless stream of people went up and down the big flight of stairs: patients in their mohair robes, pyjamas and slippers and visitors in winter hats (for some reason, no one in Russia checked in their hats). The visitors lugged big bags of supplies the hospital didn’t provide. No one was allowed to use the one elevator because it was just for freight, or you had to be accompanied by a doctor, or – according to hallway chatter – the elevator attendant was passed out drunk in the break room. Out the window was a wintery scene, which, under different circumstances, I would’ve found pleasantly nostalgic – a snowy courtyard with spruce trees and naked willows, their long thin brunches spreading out from the thicker trunks like spider leg fireworks. A bench, a trash bin. On the opposite side of the courtyard stood another wing of the hospital: some of its windows were lit up and some were dark, signifying something.

Mama rang the doorbell again. After about forty minutes, Babulya’s attending doctor, Galina Ivanovna, finally appeared. She was a thin, young woman in her thirties, rather good-looking, with blonde hair gathered in a classy bun, nice jewellery but no wedding band. Her blue eyes were cold and strict. She appraised us, the Russian-Americans.

‘How is she?’ Mama asked.

‘What can I tell you?’ Galina Ivanovna said, twisting her rings. ‘She has to start breathing on her own. As long as she’s on the respirator, she’ll get a chest infection sooner or later, and that’s almost incurable in her condition. She needs to drop weight. We are monitoring her condition. Any questions?’

‘At the other hospital, they told us we could help wash and turn her.’

‘I don’t know about the other hospital, but we have different regulations here. I’ve got nurses who already do all that. Your job is to bring the food and the diapers and not be in the way.’

‘We won’t be in the way. We just want to be with her.’

‘It is not allowed.’

‘How can it not be allowed?’

‘If she’s doing bad, we’ll call you. Besides, we have a flu epidemic here.’

‘Doing bad? You mean about to die?’ Mama said, her voice stitched with emotion. ‘Surely she’ll need us less then!’

‘I don’t have time for this,’ Galina Ivanovna snapped and made a move towards the door.

‘Wait! My ex-brother-in-law is also a doctor at this hospital. Mikhail Andreevich Kazakov. Do you know him? He said that you are a very good doctor. We trust my mother is getting the best care in your hands, but, you see, we live so far away and the granddaughter here’ – Mama pointed at me – ‘has to go back soon. This may be her last chance to see her grandmother. Please understand. We want her to know we’re here, that we love and care about her. We want to give her positive energy, which only relatives can give.’ Mama slipped some money into Galina Ivanovna’s pocket. ‘I understand you are busy, you don’t have much time for each patient. But we’ve got all the time.’

‘Since you travelled all the way from America, I’ll make an exception for you today. Fifteen minutes,’ she said and we followed her down the white hallway to Babulya.

From then on we were at Galina Ivanovna’s mercy. Every day we came to the hospital, rang the bell and waited for up to two hours on the bench outside the ICU door, observing the futile storming of the elevator and the change of light out the window. I felt like an alien in my blue full-body scrubs: nobody else wore them. Then Galina Ivanovna to came out and told us that we couldn’t see Babulya. When Mama slipped her some money, she let us in ‘for fifteen minutes’. We did our routine with Babulya: wipe her with wet towels, massage her with lotion and exercise her heavy limbs, retell her the plots of the soap operas we tried to catch up on the night prior. Galina Ivanovna glared at us from her desk. The teenage nurses, who looked like they could barely lift a book bag much less an obese woman, shuffled around listlessly. At some point Babulya would start to cough and try to tear out her feeding tube, cringing in pain.

‘We don’t have the resources to spoon-feed every patient the required volume of food,’ Galina Ivanovna explained when Mama asked if the feeding tube could be removed.

‘I’ll do it. I’ll spoon-feed her all day! I have the time.’

‘You can’t be here all day. You are bringing microbes.’

The argument usually died down when Mama slipped Galina Ivanovna some more money. ‘You can spoon-feed her a little bit today.’

The next day, the feeding tube would be back in.

When Babulya wiggled her hand in a writing motion, we held up a pad of paper for her. In barely recognizable letters, she scribbled: ‘the nurses are torturing me’ and ‘everything hurts’.

‘What hurts?’ Mama asked.

‘Everything, everything,’ Babulya wrote. ‘I’ll hang myself.’

So we begged Galina Ivanovna for more painkillers for Babulya.

She stared at us like she’d never heard of painkillers before in her life. ‘Painkillers would numb her brain function, which she needs to start breathing on her own,’ she explained with irritation. ‘We can’t give her too much.’

‘But she’s in excruciating pain every single second – she just can’t tell you. Can you imagine the horror?’ Mama sobbed. ‘I understand about the brain, but I think she’s just trying to pass out to escape the pain.’

‘Are you a doctor?’ Galina Ivanovna said.

‘No,’ Mama said, taken aback.

‘Exactly. You can’t make medical decisions. Ten more minutes.’

We were afraid that if we didn’t comply, we wouldn’t be let in to see Babulya the following day. We sweated under our blue garbs in the hot room, and tried to cover Babulya’s private parts from the half-mad stares of her roommates. There were no chairs for us to sit on. After a week, Babulya began to wiggle her formerly paralyzed foot, and we ran to report this to Galina Ivanovna. Don’t give up on her yet! But that didn’t seem to impress her.

We witnessed Babulya’s pain directly when the nurses allowed us to help them hold her on her side while they put the ointment on her bloody bed sores or changed her diaper. Or when they disconnected the breathing tube and vacuumed the phlegm out of the hole in her neck. Babulya’s face would become purple and tears would stream out of her closed eyes, and Mama would squeeze Babulya’s big, limp hands and cry.

Mostly, Babulya kept her eyes closed. Sometimes she didn’t wake up at all during our visits. I looked at her, fighting back the tears at the vulgar irony and injustice of it all. A loved and respected doctor, how could she suffer so much in the hands of medicine and its executors? How could I have adored hospitals? And, if I had become a doctor, would I, too, have become desensitized and scientific? Babulya’s body was so familiar and dear to me, like a mountain I’d climbed many times in childhood, played on, cried on, slept on. I readjusted the special pillows I’d made out of oil sheet per doctor’s instructions that kept Babulya’s limbs on the bed. What a perfect horror it would be if her heavy arm rolled off the bed and hung like that all night. I didn’t trust the night nurse to notice as Babulya lay there, feeling her arm being twisted out of her shoulder socket, unable to say anything.

Before leaving, Mama bribed the young nurses and begged them to be gentler with Babulya. They nodded absentmindedly, their blue eyes round and childlike. For a while Mama bribed the head of the ICU department as well, but then she decided that, considering our bribe budget, the money would be better spent on those who touched Babulya’s body most often.

‘I think they wash her and change her sheets right before our visit, that’s why we have to wait so long, for them to get around to it,’ Mama said as we were leaving the hospital after an especially frustrating visit. ‘Those nurses . . . Teenagers! More interested in flirting with the doctors than turning a heavy, sick woman. That’s why they won’t let the families in, to see their negligence. Not hospital rules or microbes!’

Not once had I wondered whether the doctors and the nurses were truly that indifferent, or if there was simply nothing that could be done enough to ease Babulya’s pain and ours.

Every day on our way to the shuttle stop, we walked by the orange Orthodox Church. We could hear the mournful singsong of early evening services. Hunched over, bundled-up people trickled through the open doors into the dark chamber. It was very temping to go in, to attach hope to specific, ancient motions.

The relief I felt after leaving Babulya’s room was similar to the relief one feels after finishing a difficult exam. I tore off my blue gown and hat, snapped off my face mask – my chin wet from sweat, tears and snot – and nearly skipped down the stairway, high from the anticipation of the ordered sequence of events that would complete my day and require minimum conflict and emotional involvement. We walked to the shuttle stop. We knew which number to take home and where to get off. We knew how to walk to the apartment from the stop, where the grocery store and the garbage dump were. In the kitchen, we found coffee, tea and vast supplies of sugar. Every cup, figurine and appliance was familiar to me from childhood, and everything was covered with dust, grime and food debris. Babulya couldn’t see well and she couldn’t bend, so we cleaned well into the night preparing for her return home. Finally, we climbed into Babulya’s bed, which seemed too firm and uncomfortable, like her couch. Babulya’s cat Eden curled up at our feet. Eden had a bad reputation, and I was terrified she’d bite me if I accidentally touched her in my sleep. Now, for a few fitful hours we could try to forget everything. And yet, I was already getting used to our daily commute, the daily humiliation and despair at the hospital. The Russian curse words were coming back. My life in America, to which I no longer had even an electronic connection through email or Facebook, seemed to be happening in another time and space altogether.

The next day, everything would repeat.

At home, I got a glimpse of Babulya’s life in the last few years. There were photographs of Mama, Maria and me everywhere. But they were old photographs, and not our best shots. She’d saved every birthday card Maria and I had ever made for her, but we seemed to have stopped sending them when we reached teenage years. Looking for some documents Mama needed, I stumbled upon neatly organized envelopes containing all of Babulya’s honorary diplomas, pins, medals and decals; her membership cards in the local orchard society; pet health insurance for Eden; her local assembly ID. One of her colleagues had made a scrapbook of her medical career, ending with photos of a lavish retirement party. Only then did I vaguely remember Babulya telling us that after the party – back in Syktyvkar, where she was known and loved – her apartment was so stuffed with flowers, she could hardly walk through.

I could see now how she managed to live on her pension and still send us money. She reused every plastic bag and container; she laundered kitchen cloths made from her old underwear. We found a bucket of prickly brown soap bars that looked like they’d been made during the war. The cheap toilet paper was gray and hard, just like in so many Russian jokes. She could afford better, but she chose to save for us, in America. Yet she spoiled Eden; my Blondie, she’d called her. The freezer was stocked with beef, fish and chicken hearts, cut up and packed into separate little bags. Eden, who was named after a rich blonde heroine from the American soap opera Santa Barbara, ate beef in the morning, hearts for lunch and fish for dinner. After retiring and moving back to Stavropol, Babulya could no longer travel because no one would agree to look on Eden, claiming that she jumped at their throats the moment they walked in the door. She was a terrible cat, half feral and destructive, everyone repeated throughout the years, and advised Babulya to put her to sleep. But Babulya would never do it; to her, she’d said, betrayal was the greatest sin of all. Eden, meanwhile, could hardly walk now. Her joints locked robotically; her hind legs dragged. She mewed asking for food, then mewed again, unable to chew it. Or maybe she was already mourning her life with Babulya.

Every night we got calls from Babulya’s friends and former colleagues in Syktyvkar. They told us how much they wanted to be there for her, to sit by her side day and night, to return the kindness and understanding she’d shown them throughout the years.

One of her old orderlies from the clinic, Tamara Petrovna, recalled how when she was sick, Babulya, the chief doctor at the time, blew into her room at the hospital, large and beautiful in her coat and furs. She brought flowers, bags upon bags of food, and began spoon-feeding chicken broth to Tamara Petrovna. When Tamara Petrovna could no longer eat, Babulya slurped the rest of the broth from the jar. ‘Irina Nikolaevna, are you not squeamish?’ Tamara Petrovna had asked. ‘Ah, of course not! Why waste a good thing! And I love to eat,’ Babulya replied, throwing up her hands.

Her former driver Oleg called to say that he could be in Stavropol within twenty-four hours. What could he do to help? What should he bring? Medicine? A wheelchair? The Chechen side of his family – with whom Babulya had also been friendly, despite the historical antagonism between Chechens and Russians – swore they’d get anything for her, from under the ground or from the moon, whatever it took.

But what could they realistically do short of getting into a fist fight with Galina Ivanovna or buying her a private jet?

When we asked Babulya whether, if it were possible, she would want to go back to Syktyvkar – the whole town would take care of her! – she vigorously shook her head no. It wasn’t hard to guess why: she didn’t want all those people who adored and respected her to see her in her condition, mute and paralyzed, with her urine catheter peeking from under the sheets. And, as much as I would have wanted them to take care of her, I also wanted someone to take care of us – to feel her pain and ours, to appreciate that this was the most monumental and tragic event Mama and I were living through to date; to free us from the worry about her sheets being changed regularly and fully embody the horror that were the notes she tried to scribble with her one barely functional hand. ‘I’ll hang myself, I’ll hang myself.’ Stretched out letters, letters sliding off the page, incomprehensible knots of lines and curlicues were an excruciating contrast to the A-student handwriting in the small notebook with a list of names, birth dates and phone numbers, which still lay on her nightstand.

What if Babulya perishes?’ Mama said one night, as we were waiting for the shuttle to take us back home. Her eyes were wet, from the icy wind and tears. Perishes. Like in a battle or a war. That word pierced my heart. Unlike ‘pass’ or even ‘die’, ‘perish’ was such an active verb. To me, it signified failure. Our failure. In the battle with the doctors and nurses, with Babulya’s body, with being too late: not twenty hours, but twenty years. We fought against our mistakes and hers, against all the usual regrets and guilts – of not calling enough, of not visiting enough, of being too busy. It was all the stuff they tell you, so cliché. Yet here we were. ‘What am I going to do?’

Mama had never known her father, and had only gotten close to Babulya in a sincere, adult way in the last few years, after she’d finally written off all her childhood hurts and become the anthropologist of her early family life. She had no siblings.

And if Babulya did pull through, if she were to be bedridden for another five years like her own mother, Mama would have to stay in Stavropol with her. There was no one else she could trust here. Not Babulya’s sisters, who were also old and weak, not the nurses we could presumably hire, who would probably pocket the money and not bother with much. How could we supervise them from across the ocean? Eventually, Mama would lose her piano students, her health insurance, her house. Two lives ruined.

I had no answer for her. I was terrified that she didn’t know what to do. Babulya’s portal into the magic world of medicine had closed, and the metal door slammed into our faces.

After ten days in Russia, I went back to Alaska to work. Mama stayed on to wage our war. Babulya began to breathe on her own, and we were hopeful again. Mama wrote an open letter to Galina Ivanovna and the nurses about how as the chief doctor Babulya had always looked out for her staff in Syktyvkar, how alive she was to the pain of others. In the letter, Mama called on their sense of duty as medics, their conscience and human compassion. And if they did one thing, would they please call her by her full name to show respect for her medical accomplishments, and not, condescendingly, ‘grandma’, as though she spent her life digging potatoes in some yard and was now something decrepit, absolute, useless? Yet, Galina Ivanovna still made Mama wait for hours for a chance to stand next to Babulya’s bed and hold her hand for twenty minutes. A month and a half after her stroke, Babulya stopped opening her eyes, moving her limbs and asking to write on the pad. She stopped trying to pull out her feeding tube.

When, after reporting the latest soap opera twists and news from around the world, Mama had told Babulya about the devastating earthquake in Japan (this was March 2011) and then thousands of lives lost, Babulya began to cry.

One day she lay with her incredible dark blue eyes open wide and stared out the window. Mama got very excited. The following morning she got a call from the hospital: Babulya had died during the night. So she hadn’t been getting better; rather, she was saying goodbye to the world, that grey wintry patch of it that she could glimpse out of the window with her one seeing eye. And that was it.

I felt a guilty relief that Babulya was no longer in agonizing physical pain. Mama, however, was about to enter a long, dark tunnel of mourning, with all of its attendant ghouls: from anger and regret to complete re-examination of her life. ‘Probably no one even noticed until morning. She probably choked. When she gave up, when she stopped pulling her tube out, we should’ve just let her die in peace,’ she cried over the phone, as if it was something conceivably in our control. ‘Not change her sheets, not turn her, not touch her at all. Just drown her in morphine. Screw the brain function.’

I also felt a shameful relief that now that Mama had lost her mother, who had for two months become her baby, I had regained my mother. We would be back to our normal American lives soon enough, I thought.

Now Babulya’s sisters and niece, who had experience with planning what came after, took over. The memorial service was staged in the best traditions of Soviet slapstick. It was MC-ed by Babulya’s medical school classmate, a former Chief Dentist of Stavropol, careerist communist functionary and now the head of the Christian Doctors Organization. In a practised stage voice, he veered between stories of their student years and talking about how when his wife died, he would get himself a young second wife, completely overwhelming the speaker at the other memorial taking place in the opposite corner of the restaurant. Afterwards, there was a squabble over the leftovers. The food, after all, had already been paid for.

No one wanted to take Eden on, citing her feral menace. So, the day before Mama left Stavropol, Auntie Tanya called a veterinarian she knew to come to the apartment. Mama, who was present at Eden’s birth all those years ago – before we moved to America, before Babulya got old and sick, before Maria and I grew up – held the fluffy, yellow-eyed cat in her arms, petting and whispering words of love into her twitching ears through a deluge of tears, as Eden the Blondie passed from her happy, pampered life to catch up with Babulya.

Image courtesy of Kseniya Melnik