An Ailing Parent and Unabashed Honesty: A Review of Mothercare: On Obligation, Love, Death, and Ambivalence

Mothercare: On Obligation, Love, Death, and Ambivalence

by Lynne Tillman

Soft Skull Press, 2022; 176 pp.; $21.39 (Hardcover)

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I was first drawn to Lynne Tillman’s Mothercare: On Obligation, Love, Death, and Ambivalence by the promise of “a cautionary tale and sympathetic guidance for anyone who suddenly becomes a caregiver.” The line spoke to my experience with my mother, who abruptly started needing care two years ago. Tillman’s memoir, an extended essay of just over 170 pages, documents and emotionally processes the complicated role reversal between parent and adult child when the former falls ill. Tillman sets the tone for her book from the beginning: caregiving is a hard job, even when you have assistance from others, and watching a parent decline is heartbreaking, no matter the situation.

The book is marked by the author’s open ambivalence toward a woman she calls simply “Mother,” a result of conflict throughout her childhood. I’m not sure I know anyone with an uncomplicated relationship to their mother, father, or the people who raised them. And even the sunniest of mother-daughter connections can be overshadowed by family history and moments of tension when the roles are reversed. Still, Tillman doesn’t hold back about how it feels to care for an ailing parent when you might not care much for them.

For me, reading Mothercare felt like springing open a pressure-loaded door that I’ve tried to hold tightly shut. Instead of denying the difficulty in caregiving situations, here is an essayist who just lets it all hang out. She exposes the truth behind the experience, offers empathy for others, and raises awareness about the shortcomings of our healthcare system, particularly at the end of life. Some may find her memoir tough to read for its barefaced honesty. Yet I believe we need more caregiver storytellers like Tillman. The number of adult children caring for an elderly parent is on the rise, including over a quarter of adults in their forties and fifties in the United States and similar numbers in other countries. Much of that care is unpaid labor and so time-consuming that it forces many to leave their jobs; too often, that caregiving falls to women.

Tillman, a novelist, short story writer, and culture critic, adeptly employs her literary craft to reveal these bitter truths. Like Mother, several of Tillman’s other characters are unnamed, for example her “Carolina sister” and “New York sister.” This device, though possibly chosen to protect privacy, allows her to develop archetypes of people involved in end-of-life care and the healthcare system. The doctors’ anonymity, for example, transforms Dr. R into an intelligent savior and Dr. Z into something of an arrogantly incompetent villain (who is now dead, we later learn, without emotion or fanfare).

Tillman gives names to her mother’s paid caregivers, humanizing them in contrast to many of the other players in Mother’s life. These women become indispensable to Tillman and her sisters. For example, Frances is described as “our last and longest running caregiver [who was] terrific with Mother. . . . We trusted her.” But for much of the book, Tillman struggles with conflicting emotions over Frances who, though highly valued, later betrays her trust. In the end, because a caregiver isn’t actually a member of the family, she is not afforded the graces of kinship. Tillman lays this out in a refreshingly honest way, accounting for the emotion as well as the inequities inherent in paid care.

The reader, in fact, learns so much about Frances that I was left wondering: as the adult children of ailing parents, how much of this tale is ours to tell? Ownership of the narrative is a critical question when writing creative nonfiction and, in particular, memoir. Brenda Miller and Suzanne Paola call this “Permission to Speak” in Tell It Slant: “Our role as writers can be that of the witness.” Tillman seems to recognize this critical role:

Still, because the caregivers are named where so many others are not, I was curious how Frances herself felt about these same difficult events. The only insight that readers receive is an account of angry phone messages she leaves for Tillman. How would she have written about what happened? Relying on the author’s perspective is, of course, a critical difference between reporting and creative nonfiction, and as Miller and Paola say, “In essay writing, it’s nearly impossible to tell the ‘whole’ truth.” Frances, like all of Mother’s paid caregivers, is a woman of color, and Tillman is white, a difference the author plainly calls out. As a renowned author, Tillman has a platform, whereas Frances does not. Deciding what to include—and what to leave out—is a true challenge for nonfiction authors, particularly when the topic is so profound.

In Mothercare, Tillman shares truths as she sees them, and the result is a sometimes-gritty read that offers advice and resonance for adult children caring for an ailing parent. Her approach is sometimes emotional, for example diving into self-reflection and guilt, and at times practical, at one point offering a straightforward list of Mother’s medications. As a writer who is also a caregiver, I find it an ever-imperfect task to describe my mother’s decline with complete honesty. I am also a former journalist and so hold myself to a high standard of truth-telling, but as a daughter and carer, I wonder if it’s possible. I’m distracted by an unpredictable array of crises and very difficult feelings. Tillman, however, is unafraid of this task. Sometimes Mothercare reads like a journal, and sometimes it reads like a family history. Regardless of her approach or its form, the author and her book hold an important lesson for writers who are also caregivers: share your truth, no matter how messy it may seem.