The Care Coordination Call

The call came at 10:30 AM on a Thursday, which was, of course, 11:30 PM in Singapore, because Rachel had always had impeccable timing in the way a wildfire has impeccable timing, arriving exactly when you'd finally sat down with something hot and caffeinated and were harboring fragile hopes of productivity. My phone lit up with her contact photo (her at someone's wedding, mid-laugh, approximately thirteen time zones and what felt like several geological epochs ago), and I experienced that particular full-body clench that came from knowing you were about to have a conversation that would somehow be simultaneously crucial and completely fucking pointless.

"Hey," I said, which was the verbal equivalent of bracing for impact.

"So Mom fell again," Rachel said, no preamble, because we'd abandoned pleasantries somewhere around the third international move and had been operating on a framework of radical conversational efficiency ever since—which would have been admirable if it didn't make every phone call feel like being ambushed by a particularly aggressive PowerPoint deck. "She's fine. Well, she's fine fine, not actually fine. She bruised her hip. Mrs. Kowalski found her in the garden trying to deadhead the roses like nothing happened."

I was thirty-four years old. I had a master's degree. I had stood in front of conference rooms full of people who got paid more than most small nations' GDPs and convinced them to do things they didn't want to do. And yet somehow my primary role in life had become receiving updates about my mother's ongoing war of attrition against basic physical safety—a war she was losing with the kind of stubborn dignity usually reserved for doomed military campaigns and romantic comedies entering their third act.

"Did she go to the doctor?" I asked, already knowing the answer, which was how all our conversations went now: a call-and-response liturgy of reasonable questions and unreasonable parental behavior, performed across fiber-optic cables and satellite arrays like some kind of deeply depressing modern opera.

"She says she's going tomorrow. Which means she's not going."

"Right." I pulled up my calendar—a color-coded monument to the myth that organization equals control—and started looking for gaps that could accommodate a flight from Raleigh to Cleveland, which felt more exhausting every time I had to book one, as if the universe was charging an escalating tax on guilt.

"No, don't." Rachel's voice did that thing where it got very small and very tired, like it had been physically compressed by the weight of twelve time zones and three years of being the only one actually there. "It's not—I'm handling it. I just wanted you to know."

Which was, of course, a lie. Not the handling-it part (Rachel could have coordinated the Normandy invasion from a Starbucks using only a bullet journal and sheer force of will), but the just-wanting-me-to-know part. What she wanted was for me to acknowledge that she was the one doing the actual work while I was doing the emotional labor of feeling guilty about it from a distance—which was admittedly a much lighter lift, in the same way that watching someone do burpees on Instagram is much lighter than actually doing burpees.

"How's—" I stopped myself, recalibrated. "How are you holding up?"

In the background, I could hear the ambient sounds of her apartment - a TV playing something in Mandarin, the language she'd learned through immersion and determination, which felt both impressive and like a metaphor for something I was too tired to parse.

"I'm tired," she finally said, which coming from Rachel was roughly equivalent to anyone else saying they were one minor inconvenience away from faking their own death and joining a monastery. "I love my life here. I do. But every time I video call her and she's got a new bruise or she's 'fine' in that very specific way that means she's absolutely not fine, I just—"

She didn't finish. Didn't need to. We'd been having the same conversation for three years—since Dad died and Mom became a solo operation, since Rachel made partner at her firm and couldn't just fly back every month, since I got promoted and suddenly my calendar became a Jenga tower of immovable commitments. We'd been having this conversation in different time zones and different emotional registers. Still, it was always the same conversation, which was really about the impossible mathematics of care: how you divided yourself across distance, how you weighed your own life against someone else's needs, how you performed being a good daughter when "good" seemed to require being in two places at once.

"We should probably—" I started.

"Look into care options, yeah." Rachel sighed, "The in-home care agency I researched has a starting rate that's basically my monthly mortgage. Plus, Mom would hate it. She'd treat them like hostile invaders. She'd be polite about it, which would somehow be worse."

This was accurate. Our mother had a gift for gracious hostility that should have been studied by anthropologists—the ability to make someone feel simultaneously welcomed and like they were fundamentally disappointing her by existing. She'd perfected it on us; extending it to professional caregivers felt almost inevitable.

"What if—" I was scrolling through my email now, looking for that thing I'd flagged weeks ago, some article about aging in place and technology solutions, as if apps could solve the fundamental problem of human bodies deteriorating across time and space. "There's that monitoring thing. The sensors that alert you if there's been a fall or unusual inactivity?"

"You want to bug Mom's house like she's an espionage risk?"

"I want her to not die alone on the kitchen floor because neither of us is there," I said, which came out sharper than intended—but then, most honest things did. That was the problem with long-distance everything: you were constantly trying to translate emotional nuance through mediums designed for efficiency. Every conversation was a lossy compression algorithm, bits of meaning scattered across the distance like debris.

Another pause. I could hear her breathing, or maybe that was just the connection—the digital artifact of space pretending to be intimacy.

"I'll talk to her," Rachel finally said. "About the monitoring thing. And maybe getting someone to come weekly, just for the heavy stuff. Cleaning, yard work. Frame it as helping her maintain independence, which is technically true and also completely manipulative."

"Sounds perfect," I said, and meant it. This was what we'd become: two women in different hemispheres, trading strategies for managing decline, performing competence across continents. We had shared Google docs. We had a group chat with our mother that she used exclusively to send photos of her garden and confused questions about her phone. We had a system, which was what you called it when what you really had was an elaborate pretense that distance was the same as presence, that checking in was the same as being there.

"I should go," Rachel said. "Early meeting tomorrow. Client wants to discuss their growth strategy, by which I mean they want me to tell them how to fire people without calling it firing people."

"Late-stage capitalism thanks you for your service."

She laughed—actually laughed—, and for a second we were just us again, not crisis managers or amateur geriatric care coordinators, just sisters who'd once shared a bathroom and an extensive vocabulary of inside jokes. Then the laugh faded, and we were back to being adults with responsibilities and time zones and all the accumulated sediment of choices that had seemed reasonable at the time.

"Love you," she said, which in our family was both rare and weighted, carrying freight that other people spread across daily use.

"Love you too. Tell Mom I'll call her this weekend."

"She'll ask when you're visiting."

"Tell her soon," I said, which was what I always said, and we both knew what it meant: not soon enough, probably never enough, some quantity that couldn't be calculated because the formula itself was broken.

We hung up. My coffee was cold. My calendar still glowed with its optimistic color-coding, as if any of it mattered, as if I wasn't just moving pieces around a board where the rules kept changing and no one won. Outside my window, it was a perfectly nice afternoon in whatever timezone I was currently occupying. Somewhere across the world, Rachel was getting ready for bed, and somewhere in Cleveland, my mother was probably in her garden, refusing to acknowledge that her body was staging a gentle but persistent coup.

I marked my calendar: "Call Mom." And then, because I was efficient if nothing else: "Research care monitoring systems." And finally, smallest font: "Figure out how to be in two places at once."

The last one didn't have a time slot assigned. Some tasks were ongoing—less items to complete than conditions to endure.

I closed my laptop. Got more coffee. Began the elaborate pretense that I was going to get anything else done that day.

The phone stayed close, though. Just in case.

It always did.