IF WE LIVE LONG ENOUGH, GRIEF BECOMES A RESURGENT SCAR on the landscape. Death erases parents, friends, and spouses from our maps of the world, desertifying and shrinking the terrain. Even deaths of people we did not particularly like provoke a queasy feeling that our own extinction is rushing toward us, unthinkable and certain.
We don’t expect to lose our children. That is outside the natural order of things, an affronting foreclosure of possibilities. “To forget the wonder, the terror, the utter finality of this fact, even for a moment, is to experience it again as if for the first time,” Rudolph Wurlitzer writes in Hard Travel to Sacred Places, a book about the death of his wife’s, Lynn Davis’s, twenty-one-year-old son Ayrev. We hear the same numbed shock in Joan Didion’s new memoir, Blue Nights: “This was never supposed to happen to her.” “Her” is Didion’s adopted daughter, Quintana, who died in 2005 after a brutal illness that began with flu, developed into pneumonia, and then became excruciatingly complicated by septic shock and “whole-body infection.”
“There was a time when I played and replayed these scenes and others like them, composed them as if for the camera, trying to find some order, a pattern,” Maria Wyeth’s ex-husband, Carter, tells us at the outset of Didion’s novel Play It as It Lays. Blue Nights is this kind of restive montage, examining moments of Quintana’s life like puzzle pieces jumbled in a box. It is an elegy, not only for the lost daughter, but also for friends who’ve died, her forty-year marriage to the late John Gregory Dunne, and a bygone manner of living when life seemed to make sense. Didion laments “how inadequately I appreciated the moment when it was here.”
In this mosaic portrait, Quintana is a strikingly adult child who, having been raised in Hollywood by parents who were screenwriters as well as novelists, “knew what agents did” by age four, and at roughly the same age fashioned a dollhouse that included space for a projection room “and whatever I’ll need for Dolby Sound.” At times, the reader might infer that precocious exposure to movie sets and other often-reshuffled elements of show business produced a certain cognitive dissonance: “Dick Moore was the cinematographer on The Life and Times of Judge Roy Bean but she seemed to make no connection between this Dick Moore she encountered at the Hilton Inn in Tucson and the Dick Moore she encountered on our beach.”
Didion describes a person of drastic changeability—diagnosed, after what we’re given to assume were many psychiatric consultations, with “borderline personality disorder.” This had much to do with an adoptee’s natural fear of abandonment, something Didion was slow to discover. Fear of abandonment had not figured in the prevailing wisdom about adoption when Quintana was born. Didion had, she tells us, imagined the adopted one was “terra incognita,” and had assumed that “terra incognita” meant “free of complications,” a blank slate.
Didion’s technique of sifting memories in nonsequential order, then revisiting them to amplify the telling, overlooked detail, reflects a distinct wish for memories to “add up,” to provide the kind of methodically completed pictures that typically conclude her novels. Echoes of earlier writings are woven in: “Let me just be in the ground and go to sleep,” quoted here from Quintana, appears, I think, in Democracy, while the refrain that unhelpful information “doesn’t apply” belongs to Maria Wyeth in Play It as It Lays. Several episodes in this book already appeared in The Year of Magical Thinking, differently rendered, like movie scenes reprised through an alternative lens. Events have changed the narrator since the period of the earlier book, altered her perspective, shifted her focus.
Blue Nights discloses a great deal about Didion’s writing methods, which resemble screenwriting to an unusual extent. Characters noticeably have “arcs”; the episodic structure hits strategically placed “plot points.” Scenes are recalled, like movie flashbacks, with the aid of old photographs, wedding announcements and Mass cards, items of Quintana’s clothing.
A forensic attention to detail summons elaborate images with a stringent economy of language—often forensic in the strict medical sense, the naming of symptoms, procedures, instruments, the nominal arcana of human innards (“the Circle of Willis,” “cerebral bleed,” “epidural hematoma”) that the author learns and deploys, like runic drums or rosary beads, to gain at least a verbal purchase on uncontrollable happenings. Didion frames the dissonance between subjective distress and impersonal medical lingo to great effect, as she did in Democracy’s hospital scenes. The difference in Blue Nights, as in The Year of Magical Thinking, is that Didion isn’t inventing the script—she has no control over the events she recounts, as they really did happen—but rearranging the continuity, highlighting key details, paring away superfluous dialogue.
Didion is perfectly aware that the reiterative backward glance, cast over real life instead of an invented backstory, can’t solve the mystery of Quintana’s character. While memory is inexhaustible, it is also a closed circuit, an immutable field of rumination, promoting, at best, speculative answers. Quintana’s illness had nothing to do with the puzzling contradictions of her personality; it arrived unwilled and unanticipated. An account of her life before she fell ill yields no improving or cautionary lessons germane to what finally happened to her. She was interesting. She was lovable. She was intelligent and funny. She was troubled. What she was not, in any fore-ordained way, was doomed.
The fact that some things, sometimes the worst things, “just happen” is unassimilable, particularly for a writer such as Didion, whose specialty is figuring out why things happen. The only answerable “Why?” in this story has to do with the stark details of infections, septicemia, breathing tubes, and ICU monitors. Didion doesn’t truly expect a revision of sequential events or selective memory to produce an alternative outcome, though she can’t avoid the fantasy that they could. Memory serves instead to keep Quintana present and alive in her mind, as a strategy for delaying the completion of grief. Didion returns to her at age twenty, at four, at thirty-seven, as curious child, uniformed student, bride, independent adult, continually morphing into different shapes and sizes, an implacable and fiercely cherished ghost.
The remembered past gradually alternates with scenes in present time, when Didion’s own mortality sharply presses into her awareness. She notices that she is aging. This catches her unprepared, a trap sprung by vexing physical events that burgeon into symptoms of irreversible decline. Grief and time confirm a lifelong fear of the rattlesnake in the playpen, the smiling stranger with a knife. Here, as elsewhere, Didion collects all the “objective” information she can to comprehend what is happening to her.
“I had lived my entire life to date,” she tells us, “without seriously believing I would age.” (She is seventy-six.) If this sounds improbable, consider that no one in the modern world “adjusts” to the aging process until it begins to pull them under. Even then, “adjustment” hardly applies. One degree of debility is followed by even worse. Artists are especially reluctant to acknowledge the onset of old age, convinced not only that their work will live on after them but that working is a lucky charm against decline and death. There is some small validity to this belief—meaningful work keeps people more “alive” than inertia. But the physical truth is that everyone who sticks around long enough experiences the slow crumble into dust signaled by neuropathies and embolisms and thinning bones and corporeal shrinkage, the fear of collapsing in the street or getting knocked over by a bicyclist, an overall diminishment evidenced in failing eyesight, free-ranging pain, and cognitive slippage.
Didion clocks her growing infirmity. A serious fall in her apartment leads to a cardiac unit she doesn’t belong in, to MRIs and PET scans. A neurologist sends her to a sports-medicine clinic where, encouraged by the fit appearance of the other patients, she has the cheering thought that “this stuff really works,” only to learn that “these particular fellow patients are in fact the New York Yankees, loosening up between games.”
Didion manages to be quite funny in Blue Nights, with something in the vicinity of gallows humor. Obliged to swallow “a little camera” in New York Presbyterian’s ICU, she informs us that the resulting images “did not demonstrate what was causing the bleed but did demonstrate that with sufficient sedation anyone could swallow a very little camera.”
On the other hand, there is the fear problem. The frailty problem. The depletion that follows any sustained effort to “maintain momentum.” The body fails to fully bounce back after injuries and illnesses. There’s the frontier-woman optimism that deliquescence can be “fixed,” followed by the realization that it can’t be. There is, finally, the inconsolable feeling that almost everything is already lost, that what remains is only the prospect of more loss. This is a brave book to have written; it takes considerable fortitude to read it, as it depicts an intolerable reality that most of us only acknowledge when we have no other choice.
In decided contrast to Didion’s intensely personal account, Susan Jacoby’s Never Say Die: The Myth and Marketing of the New Old Age is a work of polemical journalism, like Jessica Mitford’s The American Way of Death. It is only glancingly autobiographical, but the information that Jacoby is sixty-six, and formerly wrote “optimistic screeds on the joys and advantages of the new old age” for publications such as the AARP Bulletin, gives this decidedly unoptimistic book a certain dry authority.
Jacoby’s subject is how most of us age, as opposed to those rare, genetically blessed, and otherwise lucky souls who skydive at eighty or practice medicine, write books, and compose music into their nineties. Armed with credible statistics and the least comforting but most plausible wisdom from gerontologists and other expert witnesses, Jacoby attacks fantasies about the aging process currently in vogue among graying baby boomers—“sixty is the new forty,” “age is just a number,” the belief that fitness regimens and dietary vigilance can reverse the ravages of time, claims of “life-extension” gurus that we will soon live to 140, predictions that a “cure” for aging itself will be discovered by medical science.
Jacoby allows that “old” people today—by which she means people in their sixties and seventies—“if they are in sound financial shape, if they are in reasonably good health, and if they possess functioning brains”—can enjoy a better quality of life than earlier generations did. Those are a lot of “ifs,” however, and even people they apply to are likely to hit the wall upon reaching “old old” age at eighty and upward.
The concern here is for how society treats old people, and what might be done to alleviate misery rather than “cure” the enfeeblement that overtakes most of us, especially those of us who aren’t rich, don’t have viable support systems, and don’t imagine that “the best years of our lives” are ahead of us. Jacoby refutes the notion that “the elderly” used to be more highly valued in America than they are today; historical evidence indicates that “youth culture” has been in ascendancy since the foundation of the Republic.
Family life after the American Revolution, except among the well-to-do, did not generally encompass care for elderly members, who were expected to fend for themselves. In the absence of assistance programs, “some townships actually auctioned off impoverished old residents to farm owners in need of workers.”
Matters didn’t much improve during the nineteenth century, when Emerson, reflecting a widespread sentiment, wrote that “nature abhors the old,” and industrialization after the Civil War rendered the skills and knowledge of older people obsolete. In the twentieth century, better standards of living extended longevity, creating a vastly enlarged population of people surviving into their seventies, eighties, and nineties who lacked adequate resources to participate in the life of society.
Things are scarcely better now, and the overall population is aging. As the ranks of the elderly grow, so do demands for sophisticated medical care, and the punitive costs that go with it. Moreover, medical conditions requiring care become more varied and numerous as more people live longer.
Perhaps the harshest among these conditions is Alzheimer’s, which is not a blissfully oblivious state of gaga, as some imagine, but a gruesomely protracted illness in which the patient’s mind is progressively erased, until he or she ultimately forgets how to breathe. It is by no means “rare.” In fact it is terrifyingly common, impervious to the magic pills advertised on television, and strikes old people regardless of their history of self-care. The chances of getting it double every five years after age sixty-five.
Jacoby considers the ethical questions around euthanasia; the expensive, sometimes insensibly protracted deaths underwritten by Medicare in the absence of “living wills”; the special problems of elderly women, who are most often burdened with caring for elderly men and tend to outlive them by many years. She deplores the ubiquitous propaganda for “positive thinking” that exhorts old people to “actively seek solutions” to the problems of loss, depression, and physical diminishment. Jacoby recommends that we face things squarely, rather than find refuge in cant about “successful aging.” “People have a right to their grief, anger, and, yes, depression. . . . The assertion of this right seems to me to afford far better preparation for suffering and loss than donning a fanciful coat of emotional armor based on the notion that something good always comes out of something bad.”
This eminently sensible book ponders the most egregious difficulties encountered by old people, in horrific detail, with particular emphasis on the plight of the extremely old who feel they’re no longer of any use to anybody, including themselves. I’m not entirely comfortable with Jacoby’s conclusions, for example in the matter of whether or not people can generally accept dependence on medical technology; some of us—more of us, I think, than Jacoby assumes—would like to stay alive as long as possible, even with a drastically diminished “quality of life.” Still, it’s important that she raises the issue and gives it something like a full airing.
Jacoby’s prescriptive notions of how to improve things occasionally sound dubious—she extols New York City as “the greatest place to grow old in the United States,” citing “amenities” such as free drugstore delivery that have long disappeared from most neighborhoods—but her argument for better, more humanely informed thinking about the last years of life deserves close attention right now, as the country goes broke and its baby-boom generation, kicking and screaming, enters the home stretch.
Gary Indiana is the author of seven novels and six books of nonfiction.