The Seattle skies were grey, which was pretty typical for March, but at least it wasn’t raining. That was a relief since my parents had flown in from Denver to visit Brent and me. The year was 2008.
My mother loved Pike Place Market, so I met them at their hotel near the market on the last day of their stay for one last stroll past the flower stalls, fishmongers, and buskers.
But as we headed back to their hotel so they could pack, my sixty-two year old mother sank down onto a bench and said, “Give me a second. I need to rest.”
Mom was a short woman, with hair now dyed dark brown. She styled it in a way that hid a lot of her face, and large glasses with thick frames covered much of the rest. My entire life, she hated having her picture taken.
“Go ahead and rest,” I said, working to keep the annoyance from voice. It had been like this all weekend. She could only go two blocks without needing to stop.
This is what a lifetime of smoking gets you, I thought.
As we sat there, I wondered if I should try yet again to get her to see a doctor. Both my parents were lifelong smokers, and I’d battled with them over their pack-a-day habits for most of my life.
Growing up, our house was choked with cigarette smoke. Shady back rooms where political deals used to be cut had less smoke than our house.
Which, for a kid like me with asthma and terrible allergies, was a special kind of hell. My brother and I both harbored a longstanding grudge against our parents for raising us in a constant cloud of toxic smoke. Refusing to consider our feelings — or our health — felt like a terrible thing to do to their own children.
Now in my forties, I mostly worried about what all that smoke had done to my mother. A pack a day equaled thirty thousand cigarettes over the course of her life up to that point. As always, I feared she had cancer eating away at her lungs. But in addition to refusing to have her picture taken, she also always refused to see a doctor.
“Mom,” I said, wary. “I really wish you’d get a checkup.”
She instantly struggled to her feet. “I’m fine,” she said. “Let’s keep going.”
“But Mom, you can’t even—”
“I’m fine,” she repeated. “Please don’t nag me. I only need to rest because of my back. It’s hurting from so much walking. That’s all.”
My mom’s back had always bothered her, but she hadn’t always seemed so weary. I debated pushing the issue, but I knew it would only end up in an argument.
It always did.
Like a lot of people, I had a complicated relationship with my mother. My parents’ marriage was very dysfunctional, with constant accusations of infidelity, fights over money, some thrown dishes, and quite a bit worse.
But my mom and I had finally reconciled a year earlier. My brother and I had long believed all that dysfunction was my mother’s fault; that she was the villain in the story of our lives. But the narrative was flipped when we learned family secrets that revealed my father was the real villain — and he’d been gaslighting all three of us our entire lives.
Okay, maybe my relationship with my mom was a bit more complicated than most people’s. But that’s a story for another time.
By the time we reached my parents’ hotel, I was more than ready for them to return to Denver. But I went up to their room to say a final goodbye.
“Thanks again for paying for all of this,” my mother said, gesturing around her. “It really is so beautiful.”
The room was decent, nothing spectacular, but I was glad it made her happy. My parents were far from rich. The thirty thousand cigarettes they’d each bought over the decades had eaten through their savings like a different kind of cancer.
“You’re welcome,” I said. “I’m really glad you came.” And I was. Over the past year, my mom and I had talked on the phone every single week — something I couldn’t imagine doing before learning the truth about my father.
Mom pulled me into a fierce hug. It had always been hard for her to express her feelings, and I knew that hug said what she couldn’t bring herself to say: I love you.
I hugged her back just as tightly, grateful for the lost time we were starting to make up for, hoping there would be more time to come.
But there wouldn’t be.
Less than two months later, I sat in the ICU of a Denver hospital on a Friday evening, waiting for the results of my mom’s brain scan. It was two days before Mother’s Day.
Earlier that day, my mother was feeling anxious and had left her workplace to go out to the parking garage to smoke a cigarette. At some point, she’d suffered a coronary so massive she’d dropped dead right where she stood. She’d been alone, and by the time someone found her, her heart had likely been stopped for ten minutes.
Nonetheless, paramedics had managed to get her heart restarted. Here in the hospital, she was now being kept alive by life support.
The heart attack had been so swift and brutal that she’d fallen face-first onto the concrete floor. She’d broken several teeth, badly cut her lips, and scraped up the rest of her face.
When I first saw her, I was shocked.
The results of the scan showed no sign of brain activity. The doctor explained they would wait a day, then run the tests again. But it was clear he was preparing my brother and me for the worst.
Later, one of the nurses gently confirmed my suspicions.
“Even a young, healthy person would have a hard time coming back from such a massive coronary,” she said. “Your mother was neither young nor healthy.”
“I get that,” I said. “What I don’t understand is why there were no warning signs. Her coworkers said she seemed perfectly normal, except maybe a little more anxious than usual.”
“Anxiety is one sign of a heart attack,” said the nurse. “For women.” Her voice had acquired an edge.
“I thought the signs were chest and arm pain, and shortness of breath, and being sweaty and clammy,” I said.
“Those are classic symptoms for men,” the nurse said. “And many women do experience those. But women are more likely to suffer a silent heart attack, where there are fewer obvious signs. In fact, 43% of women who have a coronary event never experience any pain or pressure in the chest at all.”
I had no idea. I hadn’t even learned this in my training as a flight attendant, which took inflight heart attacks very seriously.
“Women are also more likely to show signs of fatigue, as well as backaches,” the nurse went on. “And unlike men, symptoms often show up in women a month or more before the heart attack.”
A dark pit opened in my stomach. I flashed back to my parents’ Seattle visit — my mother so tired she could barely walk a block while she complained about her back.
Was she having a silent heart attack that day? Could I have prevented this?
Had I let my own lingering anger blind me to my mother’s distress? Had my impatience to go home kept me from doing more?
“It never occurred to me that those things meant she might be having a heart attack,” I said to the nurse.
“Why would it?” she said. “The medical community does a shitty job of telling people. The health of women has never been as important as that of men.” She must have caught the look of guilt on my face, because she quickly added, “You did notice your mother wasn’t well. You just didn’t know what that information meant.”
I looked over to my mother propped up in that hospital bed, at her ravaged face. The heart monitor beeped steadily, but I knew it was a lie. I knew she was already gone.
The next day, another brain scan showed no activity in my mother’s brain. The results were the same on Sunday — Mother’s Day. The doctor was as kind as he could be, but he made it crystal clear that she was gone.
He gave us our choices: remove her from life support and let her die, or move her to a long-term care facility where she might linger for months but where she would still die in the end.
In a way, the choice was hard, but in another way, it wasn’t hard at all. Keeping her body alive seemed pointless and cruel.
However, removing my mom from life support on Mother’s Day felt wrong.
So, after checking with the doctor one final time that there was truly no hope, it fell to me that Monday morning to tell the medical staff to take out the tube and turn off the machines that kept my mom alive.
I took her hand — into which my brother and I had frequently rubbed lotion during the past two days — and held it as tight as I could. My brother held the other, both of us sobbing like we hadn’t since we were children.
As her breathing slowed, I studied her battered face. It was as if all of the damage she’d suffered on the inside during her troubled life was now visible on the outside.
Standing there, the tragedy of my mother’s life hit me like an avalanche, smothering me in sadness and regret.
I wish I’d done more that day in Seattle — insisted she’d seen a doctor. But in the end, my mother was an adult, responsible for her own choices.
Anyway, what’s done was done.
All I could do now was kiss her forehead, tell her how glad I was that we’d had the past year’s worth of phone calls and visits; how sorry I was I hadn’t been a better, more patient son; and how terrible I felt that I’d simply accepted my father’s lies.
That despite everything, I was glad to be her son, and, finally, that I loved her.
None of that felt like enough then, and it doesn’t feel like enough now. But it was all I had, so it would have to suffice.
A week after my mom died, I realized there was something else I could do: I could tell women what my mother and I had not known — that the signs of a heart attack are often different in females.
I started telling everyone, especially women over fifty-five who were most at risk. I also told the training department at the airline where I worked, and they soon incorporated it into the flight attendant training.
Was I sometimes a little annoying? Maybe. I didn’t care.
A few weeks ago, I realized I could also reach thousands of people through my newsletter — on Mother’s Day, no less.
In America, the medical community now does a better job of educating people about the symptoms of heart attacks in women, but it never hurts to say it once more.
I also think it makes my mom’s early death a little less pointless.
Happy Mother’s Day, Mom, wherever you are. I still miss you.
Michael Jensen is an author, editor, and one half of Brent and Michael Are Going Places, a couple of traveling gay digital nomads. Subscribe to their free travel newsletter here.