NOT IN VAIN, A PROMISE KEPT

A family copes with a cancer diagnosis and the unforeseen challenges of the U.S. health care system in this debut memoir.

Mullamphys’ mother, Constance E. Burns, was “a fighter from the very beginning,” according to the author. She was born in New York state in 1942, weighing only two pounds, but managed to survive. She was the sole daughter in a family with four brothers; the author characterizes her as a giving woman and a well-liked restaurant server who worked very hard, but who also had an aversion to going to the doctor. When she finally did, after falling ill in 2010, physicians discovered that she had a 15-pound tumor on her ovary; she was soon diagnosed with ovarian cancer, along with other ailments, including a hiatal hernia, gastritis, and hemorrhoids. Mullamphy documents her mother’s numerous appointments over the course of eight months, which included chemotherapy sessions and surgeries before she died in December 2010. At the end of each chapter is a “Things We Learned” recap, which includes such insights as “Get to know the nurses on the floor,” which the family learned in May, and that “having a better schedule and consistency in staff would have made [hospice] easier,” which they discovered in the final month of Constance’s life.

Over the course of this book, the descriptions of the author’s mother’s worsening symptoms are chilling, but the most disturbing parts are those that recount the family’s struggles with the health care system. In one case, for instance, Mullamphy writes that she suspected that her mother, who suffered from constant, severe nausea, had been poisoned by excessive chemotherapy, which an oncologist later confirmed. What sets the author’s work apart from other memoirs of grief, however, are her expressions of anger a decade since her mother’s passing, and how accessible she makes these emotions to the reader. She tells of doggedly pursuing answers while dealing with seemingly apathetic doctors, and her layman’s translations of medical jargon even offer occasional lighter moments: “What the hell is platelet apheresis? It is a big machine similar to dialysis…like a rinse cycle, but it removes extra junk that can kill you instead of cleaning clothes.” The author writes that she worked on this book for a decade as a promise to her mother, expressed in the title. In it, she’s candid about the ugly parts of her own grieving process, including accounts of her worsening performance at a corporate reinsurance company, and the seizures she endured, in part, as the result of stress; she was eventually diagnosed with a neurocognitive disorder in 2013. Mullamphy’s impressions of her mother’s medical care oscillate throughout the work, but may be summed up with the dictum that one shouldn’t blindly trust medical staff “because human error happens.” She also effectively stresses how important it is “to watch over your loved ones and advocate for them when they cannot or won’t.”

An unflinching chronicle of loss that takes a hard look at the state of medical care in the United States.