I stand outside the tall building with its many additions and renovations. I don’t want to go inside. But I can’t turn around now. I won’t turn around now. This is a thing I need to do, like I need to breathe, I need to eat.

The entrance wing of Riverside Community Hospital is over six stories high, extensions and expansions stretching across most of the city block, except where it bends around an old, gothic church. The church is lovely, and bells are ringing behind me.

I need to go inside.

On any given day, both the church and the hospital block the purplish-brownish mountains that surround and guard this city like sentries. Today, though, it’s rainclouds that hide them. Riverside, California is a busy city, and this is an enormous hospital filled with so many patients that I have to wear a wristband to identify me as a guest. The twenty-something security guard eyes my leather jacket and boots. But he doesn’t say anything.

My hand pauses over the clipboard where I have to sign my name. I can’t breathe. The need to cry and guilt and anger and worry slam against my chest, stick in my throat. I pretend my phone is vibrating and leave the lobby, back into the damp outside.

I need to be here.

Denise’s mother, Patricia, is in the ICU alone. But this is the hospital where my mother died. I’ve never been able to go near it without a sense of that loss coming over me, and lingering. Sometimes lingering for days. No one inside remembers my sixty-eight-year-old mother, who died on a bright and warm day in September, back in 2001. I don’t know if anyone inside was even here, then.

I need to see that Patricia is all right.

Today, it is a grey day in April, 2019. I put my phone away and go back inside. There are two more checkpoints before I can get into her little glass room filled with medical equipment. Her nurses are friendly and kind, moving around efficiently, as they do in such places. I’m asked who I am and have a moment where I don’t know what to say. I call Patricia “Mom” and she calls me “Daughter” and we laugh about that. “My best friend’s mother”, though technically correct, feels like a lie. “Friend” doesn’t seem like enough. I’ve known her since I was nineteen, and in many ways, she has been a mother. She has loved me and accepted me unconditionally. The words feel weighty, important in ways that have shadows and turns I can’t fully see.

I tell the nurse I’m her almost-daughter and that seems good enough for this moment. The nurse pulls a table over for me to put my bag on, angles it next to a chair.

But I’ve been a bad almost-daughter, not visiting Patricia much over the years. I am lousy at remembering birthdays, Mother’s Day, even Christmas. And in the past when Denise has flown home for visits, we’ve become wrapped up in our own conversations, excluded Patricia. Despite that, Patricia still loves me.

I need to sit with her.

Today isn’t the day to be a bad daughter of any kind. And I’ve done this kind of visit before. Twice, now. Four years ago, when my father was dying—not here, at a different hospital—and then before that when it was my mother, here.

But Patricia isn’t dying. She was short of breath and then nearly stopped breathing; her vision blurred; she was lightheaded, and her body ached everywhere. But she isn’t dying. She has some kind of bacterial infection that is making her very sick. I keep reminding myself of this as I watch the staff. She won’t die today, I say to myself, and a shiver runs along my arms. She can’t, I think.

These ICU rooms look like stages, with the patient, Patricia, lying on a raised bed in the center, the lights trained on her like this is some kind of performance. After about twenty minutes, she’s still not coming out of the sedation, and her heart rate is elevated. But when I hold her hand she stirs. The nurse says to keep trying, it’s bringing her out, and I stroke her cheek.

“Mom? I’m here. Kat is here, Mom.”

Her heart rate shoots higher and her face twists with pain. But she opens her eyes, and I am elated.

“Hello there,” I say, inanely. I never know what to say. “Mom, I’m here.”

She blinks in slow motion, her eyes adjusting slowly. And then she sees me. She mouths my name.

Tears flow freely down my face and I can’t speak for a second. She struggles to talk to me, holding me tightly, almost as if she’s afraid I’ll leave her alone, again.

Her heart rate continues to rise, the machine alarming, warning. The nurse is worried, keeps looking at me, at Patricia, at the machine. She leaves and comes back, her face more worried. She moves around me, adjusting things, punching numbers into the mobile unit, her motions more frantic.

I only see this out of the side of my eye. I am focused on Patricia. She opens her mouth and closes it, needing to say something. She reaches for me and holds my face tight in her hand, her mouth opening and closing.

The nurse gently suggests I might want to step out. Before I go, she tells me to write my name on the whiteboard so I can be called when Patricia isn’t in such jeopardy. I do. “Katherine (Almost-Daughter),” I write, and my number.

On my way home, I stop at the Riverside National Cemetery. I haven’t been here since my father’s funeral, but it feels right to stop. My parents’ graves are side by side near a tree, in the quietest part of the cemetery. You can’t hear the nearby freeway from here, you can’t even tell how close it is. It’s a Saturday, and despite the rain that’s started, families are here having picnics under bright umbrellas. I see an elderly couple across the road, the woman in a stiff black dress and the man in a dusty old suit that was never tailored to fit. Their faces mirror the flat, grey sky. They are putting violets on a grave with a carved lamb headstone and I look away, because it feels like I am invading their privacy.

My mother’s stone says “Ruth Ann Kiefer. AIC. US Air Force. Korea. Dec 31 1932 to Sep 15 2001. The Spirit is Eternal.” She was 68 when she died. The quote is from the Bhagavad Gita, but the truth is she probably would have preferred something from the New Testament.

I sit on the wet grass, rain misting my hair flat against my head, and run fingers inside the carved lines of the words. I say, “You’re not really in there.” I don’t care if someone hears me. “I miss you so much.”

The rain is coating my skin, but I’m not crying. I haven’t been able to cry for my mother. Not when she died of mesothelioma and a slew of other ailments. Not even during the years of fighting with asthma and lung cancer. My younger daughter told me one time that she hadn’t cried at the hospital, nor later at the funeral.

“Is there something wrong with me?” she asked.

If there was, it was wrong with me also, I thought. But what I said was, “When something happens that is so powerful, like losing someone we love beyond anything, our emotions hide away. They get stuck.” That seemed to comfort her. It didn’t comfort me.

In her final days in the hospital, my mother and I had a series of last conversations. I didn’t realize at the time they were the last ones.

They took place in a different room at that same hospital. More equipment, more loud electronic beeping and plinking, another bed center stage, and a different efficient staff. She struggled to catch her breath to say the things she could say, and often the words didn’t make sense. Medication ran through her, confusing her. I went every day. I would go before and after my classes; I would go after dropping my daughters off at school; I would go on my husband’s days off and stay until they kicked me out. They gave up kicking me out. I became a fixture, another wall-mounted lamp, another curtain. Even when she improved and they moved her to a shared room, and then later when her body started failing again and they moved her back to intensive care, I stayed with her.

Not just me. My sisters and father were also there. We never wanted her to be alone.

It’s always interesting to me how quickly something can become a routine. And you don’t even notice that’s happened until the routine ends. Our routine was to sit in her room, watch TV, and chat. Mostly it was me complaining about my classes, my instructors, or my kids. She listened. She would pat my hand, offer a smile, often look off into space. Talking had become painful for her, even with the oxygen. She struggled to make the most simple sentences.

Those final conversations—spread out over the final three days she would be conscious—are forever in my brain.

I came in each of those days and filled the room with empty chatter. I regret that, maybe more than anything else. I can’t cry that she’s gone, but I can hate myself for wasting time talking about minutia. I opened the drapes and talked about the sky outside, impossibly blue and cloudless. I told her stories about the girls’ school, about my husband. The morphine wasn’t working, and nothing seemed to help with her pain. I had this idea that if I could distract her, she wouldn’t feel so much pain, but the cancer was ravaging her on the inside, and every part of her hurt from it.

I want to say that the time moved too fast or too slow. It seems like that should be the case. But I wasn’t even aware of the time as I chattered on and on endless, vacuously, inanely.

Though it ached to draw breath in to speak, she did say things, things that I later realized she thought were the most important things.

She said, “You shouldn’t be here. You have your own family to look after. I’m fine with the staff.”

She said, “I’m really not worth all this trouble y’all are going to.”

She said, “Don’t let anyone bring me flowers. Flowers are for funerals.”

She said, “You need to take care of your father, Katherine. I’m counting on you.”

She said, “Don’t you bring the girls in here. I don’t want them to think of me like this.”

She said, “If you’re going to do this thing,” and by this thing she meant finish college, “then we’ll have to make sure you have enough money. If you’re really going to stick with it, we can make it happen.”

And at the end of that third day, the last time we talked, she said the worst thing a parent can say to a child.

She said, “I can’t do this anymore.” She meant go from intensive care unit to regular hospital room back to intensive care unit. She said, “I’m ’bout done with all of this.”

“That’s why,” I said, rubbing lotion into her fingernail beds, “you’ve got to get better.”

I told her about all of the plans we had for making the house easier for her during her recovery. I told her about the visiting nurse we’d arranged to come to the house, and how I was going to take a semester off to help my father around the house.

She shook her head. “No. I don’t want any of that. I can’t do this anymore, Katherine.” Her lilting voice, so soft and lovely, was filled with pain. And anger. And her Southern accent was stronger than it had been in decades. She reached for my hand. The medication tubes got in the way and she didn’t really have a hold on me. Her skin was clammy and limp, her fingers fluttered against my wrist.

I realized how hard it was for her to talk and almost ran out to get the nurse, but she stopped me. Her eyes held me tighter than her fingers could, and she said, “You know what you have to do.”

And I knew what she meant.

She was remembering a conversation we had on a dusty, sweaty day in Georgia years before. We’d been visiting my grandmother in a nursing home. Every day, for three weeks, we trudged into that place. My grandmother had always been a strong and intelligent woman. She had raised four children, outlived two husbands, and started nursing school in her early forties. She was fierce and resilient. But not at the end. In her final years, she sat in a wheelchair vacantly staring out the dirty window. We sat there, me crying most of the time, my mother chattering about absolutely nothing. On the last day we escaped, pausing for my mother to light a cigarette.

“I never want to get like that,” she said.

I agreed.

“If I get that way, and you let me just sit in a chair out of my mind, I will haunt you until your dying day.”

I promised I never would.

And then she said, “You do whatever you have to do. Put a pillow over my face, if that’s all you can. You hear me?”

I was twenty-two at the time. Of course, I agreed. And we laughed about it. We hugged and laughed, she put out her cigarette and we drove to the airport. We couldn’t wait to get home. I remember the last day of our trip as being so humid that the pine tar in the air stuck to my skin, and I was sweating so hard everything tasted like salt. Every piece of clothing we’d brought smelled like the nursing home, smelled like delayed death and shriveled hopes and end times. I needed to be back in the dry California sunshine.

With that California sun right outside my mother’s hospital window, her last words to me were, “You know what you have to do.”

I knew.

And I was angry. Or maybe scared. I refused, of course. My father came to visit and sat with her until she went to sleep. I had to get home to make dinner for my family, and to put my daughters to bed. I had to finish my homework. I didn’t want to go. I didn’t want to leave her.

She never woke up. They put her on full life support, something she would’ve been furious about. But my father was the one they called, and he said, “Do whatever you need to do.”

That led to a family meeting, my sisters and I overruling him. We told the doctor we wouldn’t be keeping her on the life supports. My sister Maryellen remembers that she was the one who forced him to do it. I remember that I was the one. He argued, but without any real force.

I called my husband and told him not to bring the girls to tell their grandmother goodbye. I told him she didn’t want that. But he ignored my mother’s last wish. I think I was happy he had. He probably said something profound like, “It’s not really about her, now.” He’s good about that sort of thing. Maybe I was happy he was there and my daughters were there and I could feel like the end of my mother’s life wasn’t the end of everything. Maybe no one said, “It’s not really about her, now.”

At the cemetery, almost twenty years later, a couple crosses the thin asphalt road. The man gives the woman his handkerchief and she takes it and hides her face in it. He puts his arm around her shoulders and they slowly walk back to the parking lot. The low clouds play with the sound, and I can hear her heavy shoes on the damp road. I watch them walk until they turn the corner and move out of my sight. There’s a leaf on my father’s gravestone. I brush at it, but it sticks to my finger. It’s dark from the rain, folded over like origami.

I look at my phone to see if anyone has called from the hospital about Patricia. But it’s too soon. Patricia was one of the few people who came to my mother’s funeral. She didn’t know my mother, the two women had never met, but she came for me. She held me and told me it was okay to cry. I can almost convince myself that I smell her baby powder skin as I stand there.

Denise calls me when I’m back in my car. She says her mother is not improving yet, and I comfort her. Patricia will improve, but we’ll have several scary days. Denise will fly down to be with her mother and will be followed by her sister. Patricia’s church members will visit in tight little packs of people, surround her with love and care. Patricia will recuperate and begin planning to move up to Washington and live with Denise. In a few weeks, I will go back to only occasional conversations with Patricia on social media. I’m a bad almost-daughter.

I don’t know this then.

On the phone with Denise, I make promises I will never keep. On the phone, I cry for my mother, even though I am talking about Patricia. I don’t think there’s anything wrong with me. Sometimes our emotions pour, like water. They find the way out, even after years of being trapped inside. Maybe.

Kat Kiefer-Newman is a person-who-writes, storyteller, and author. She lives in the dusty Southern California farming town of San Jacinto with way too many pets, a husband, and at least one adult daughter at any given moment. She is currently content editor for the podcast and blog site OpenIvoryTower.org, has a few graduate degrees, teaches a dizzyingly diverse amount of classes at two colleges and a university, exists on Diet Coke and 5 Hour Energy shots, and notoriously talks during movies.