Up to Date

A Short Story

Karen sat in the car for a minute after she turned the engine off. The yellow roses were coming into their second flush along the front step. Her mother had put them in the year after Bill died — she’d wanted something bright, she said, so she’d have a reason to come out in the mornings. Karen had knelt in the dirt that July afternoon and her mother had stood behind her with the trowel in one hand and Bill’s hat in the other, saying one down from the left, then no, one down from the right. Karen had been forty-eight then, her mother sixty-nine. From the driveway now the roses looked like something someone else had planted.

The polyester of her work pants held the smell of the fryer. She had come from the six-to-ten and her lower back was in the state it had been in for eleven months, since the manager cut a hostess and put her on the floor. Second dose of Shingrix at eleven. She had read the package insert the night before on her phone in bed — she read the inserts the night before any new one, and re-read the old ones when the appointments came round. She knew what the second dose did to the seventy-five cohort. She knew what her mother would feel by that evening and again in the morning and how long it would take her to walk normally after. She had known that when she called last month to book it.

She had a figure in her head from the county assessor’s site and another from the actuarial tables at the library. The years were still too far out. Every appointment was a small correction.

She got out of the car and went to the door.

The photograph on the hall table caught the light as she passed — Bill and her mother on the porch of this house, the summer they’d paid it off. Nineteen ninety-four. Bill in a striped shirt he’d had for years, his arm around Margaret. Karen had taken the picture. She remembered the shutter and Bill saying his shoes hurt.

“In the kitchen, love.”

Her mother was at the counter, buttering toast she wouldn’t finish. The good tea was out. The calendar on the fridge had her sister’s birthday circled in red — the fourteenth, next week. Denver. Her mother had already rung twice this month to confirm the time difference.

“You didn’t need to make anything, Mum. We’ll be back by twelve.”

“I made you a slice. You never eat before work.”

Karen took the toast. Set it on a plate. Didn’t sit down. Her mother had a smear of butter on the cuff of her cardigan. Karen reached across and rubbed it away with her thumb before she’d thought about it.

“Coat’s in the hall,” her mother said.

The drive to the medical center took four minutes. Her mother talked about her sister’s grandson, who’d started at a state school in Colorado. The boy had rung her, which she said had made her whole week. Karen listened with the part of herself she used for driving. In the other part she was running the schedule. October for the flu. November for the pneumococcal follow-up, a year on from the first. The RSV had been added to the seventy-five-plus recommendation earlier that year; she’d read the notice at work on her phone and marked it for the fall of the following one — no need to rush it, and the stacking was easier to justify with something already on the books.

The receptionist looked up as they came in. “Hello, Margaret. How’s your sister doing?”

“Oh, she’s well. She’s coming out at Thanksgiving.”

“Give her my best, won’t you.” The receptionist smiled. “Just have a seat, the doctor’s running about ten minutes.”

The waiting room was mostly older people. A woman with an oxygen line. A man with his wife, both of them reading the same magazine over each other’s shoulders. A poster on the wall said Ask about shingles protection. A rack of pamphlets by the door: heart health, diabetes, dementia, flu.

Her mother sat with her handbag on her knees.

“Mary said hers was awful,” she said, not looking at Karen.

“Mary’s a worrier, Mum.”

“She said she couldn’t get out of bed for two days.”

“You’ve been fine with the others.”

Mary was in fact not a worrier. Mary had had a bad reaction to the first dose and refused the second, and had told Margaret so at bridge, and Karen had heard about it in the car in April and made a note of the language Mary had used so she could dismiss it.

The nurse called them through. Blood pressure, weight, the small ritual. Then the exam room, and the doctor coming in with his good-humored expression, shaking her mother’s hand.

“Second dose today, Margaret. How’ve we been since the first one?”

“A bit tired for a day.”

“That’s what we see. This one can be a little stronger — some people get flu-like symptoms for a day or two. Nothing to worry about.”

A day or two. Karen had read the reactogenicity data. In the seventy-five cohort the systemic reactions could run three to seven days; nearly a fifth missed activities they’d normally do. That was the published data. What her mother would go through was in her mother’s body, not in a table.

“Mary at bridge said hers —”

“Everyone’s different, Margaret. The important thing is the protection lasts for years. You’ll be glad you did it.”

Her mother looked at Karen.

“The doctor thinks it’s worth it, Mum.”

It came out the way it always came out. She’d said it about the pneumonia one, and the shingles first dose, and the boosters. Her mother offered her arm.

The nurse came in with the syringe. Her mother looked at the wall. The nurse pressed the plunger. That was the dose. That was what would be doing its work in the muscle by evening and in the blood by tomorrow and in her mother’s whole small body by Sunday. Her mother’s face did the small tightening it always did. Then it was done, and the nurse was pressing a cotton ball, and her mother was saying thank you.

At the front desk on the way out, Karen paused.

“Should we get the flu shot on the calendar? For October?”

“Of course. Any preference on time?”

“Mornings are better for her.”

The receptionist tapped at her keyboard. Karen looked back over her shoulder. Her mother was standing by the door reading the community health fair poster, her handbag in both hands.

“October twelfth at nine forty-five?”

“That works.”

Back at the house, Karen put the kettle on. Her mother sat at the kitchen table, her cardigan back on, her handbag on the chair beside her. Karen brought the tea over and turned the handle of her mother’s cup so she could pick it up without twisting her wrist. Her mother had already begun rubbing her shoulder — the arm the shot had gone into — with the palm of her other hand.

“It aches already, love.”

“That’s normal, Mum. It means it’s working.”

Her mother nodded. Took a sip. Made a small satisfied sound at the temperature.

“He was nice, the doctor. I like him better than the old one.”

“He’s good.”

Her mother went on about the doctor, and about her sister’s grandson, and about a woman from the parish who’d had a fall. Karen listened, or listened enough. Her eyes went past her mother to the sideboard against the far wall — the good china behind the glass, the cut-crystal decanter Bill had been given when he’d retired, small blue flowers on the wallpaper Margaret and Bill had chosen the year they’d paid the house off, faded now around the window where the sun came in.

She had done the calculation three years ago at the kitchen table of her rental with a cup of tea going cold in front of her. Rent, savings, the hours left in her body. Half of what the house was worth, after her brother in Portland took his share, was enough to stop. She had begun with the ones she knew hit the seventy-plus cohort hardest and worked from there.

She looked at her watch.

“I’ve got to get back, Mum.”

“Off you go, love. I’ll ring you tomorrow.”

Karen washed her cup. Kissed her mother on the top of the head. Went out through the hall, past the photograph, past the coat rack. At the front door she stopped, her hand on the frame. Down the hall her mother was still at the kitchen table, both hands around the cup for the warmth. Karen pulled the door shut and heard the lock catch.

⁂

The roses were in poor shape when Karen pulled in.

Two and a half years of dead heads on the canes, most of them, from the summer before. Her mother had stopped pruning them the winter after the second Shingrix. Karen had watched the schedule fill after that. The pneumococcal follow-up in November as planned. Flu in October. A COVID booster in the spring when the reformulation came out. RSV in the fall as she’d scheduled it. Then the flu again. Then the new combined booster, then a repeat COVID as the strain shifted, then a second RSV that the trials hadn’t recommended but the practice was offering. She had said yes to all of it. Each one had done what she knew it would.

She didn’t knock. Let herself in with the key.

“Mum, it’s me.”

The house smelled of something that had been in the oven and forgotten. Not burned — just baked past the point anyone would eat it. Her mother was in her chair in the living room with her coat already on. The television was on low. Some daytime program with a kitchen and a laughing host.

“You’re early, love.”

“I’m on time, Mum.”

Her mother looked at the clock on the mantel, then back at Karen, and smiled. “So you are.”

Karen went into the kitchen for a moment. Force of habit — the toast, the tea. There was one cup on the drainer. On the sideboard against the far wall, one cup where there used to be two, one on Bill’s side and one on her mother’s. Her mother had stopped setting Bill’s out sometime in the last year. The calendar on the fridge was from a year and a half ago, still hanging on October, the month Karen had put it there and pinned it up. Her sister’s birthday was not circled on it because her mother hadn’t asked her to.

Karen didn’t fix any of it.

She went back to the living room. “Ready?”

“Where are we going, love?”

“Doctor’s, Mum. Just the flu shot.”

“Oh, that’s right.”

The drive to the medical center took four minutes. Half a mile in, her mother turned to her.

“Where are we going, love?”

“Doctor’s. Flu shot.”

“Oh.”

She didn’t say it with any surprise. She said it the way you accept a piece of information you’ve been given for the first time. Karen kept her eyes on the road. She had two things on the schedule today. She would agree to a third if the doctor offered one.

The receptionist was the same one. She looked up as they came in and stood — Karen had not seen her stand for a patient before — and came around the desk to help settle Margaret into a chair.

“Hello, sweetheart. How’s Denver?”

Her mother looked at her.

“Your sister, love. Did she come out for Thanksgiving?”

“Oh. Yes. She was here.”

“Good. That’s lovely.” The receptionist patted her hand. She looked at Karen and did not quite smile.

Karen filled out the form on her mother’s behalf — the address she still knew, the date of birth, the emergency contact.

The doctor this time was one of the practice’s newer ones. Young, thorough. He had her mother’s chart open on the screen.

“So we’re due for the flu today, Margaret. And I’m seeing the second RSV hasn’t been done yet — we’re doing a booster now, one year on for the seventy-five-plus. Might as well do them together while you’re here.”

Karen answered before her mother could look at her.

“That makes sense. Save her another trip.”

“Good.” He turned to her mother, warm. “Just two small ones today. Left arm and right arm. Easier than one in each cheek.”

Her mother didn’t laugh at the joke, but she smiled at him because he’d smiled at her. She offered both arms in turn. The nurse gave the flu first, then the RSV. Her mother winced twice but didn’t say anything.

At the front desk the receptionist looked at her mother and said, gently, “See you in January, Margaret.” She said it the way you say something to someone you know will not remember it.

Karen drove them home. Helped her mother out of the passenger seat and up the two low steps to the front door. Put her in her chair. Went into the kitchen and put the kettle on. When she brought the tea in her mother had one hand on each arm, palms flat, pressing.

“Everything hurts, love.”

“That’s normal, Mum. It means it’s working.”

She said it without the pitch this time. She said it the way she’d have said the time, or the weather. She set her mother’s cup on the small table by the chair and her own on the sideboard. The television was still on. The kitchen host was laughing at something.

Her mother closed her eyes. Her mother’s hand moved a little along the arm of the chair, palm up, in the small blind way of someone reaching for what she trusted would be there. Karen leaned across and took it. Her mother’s fingers were warm from where she’d been pressing them against the pain. Karen held her mother’s hand while her breathing evened, and after her breathing evened, and after the light in the room began to change. The kitchen host was still laughing.

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