From her bed in the middle of the dining room Anna stared wordlessly. Her caregiver, a taciturn Polish emigre, watched television in the adjoining room. Anna's northwest Chicago bungalow had been renovated over the past decade: exposed brick, skylights, and newly rediscovered wood encased the woman dwarfed in her hospital bed. The decor combined contemporary taste with old hippie inclination. The "Desiderata" print on the wall was a case in point:Go placidly amidst the noise and haste and remember what peace there may be in silence.

I hadn't seen that poster since I was a teenager in the early 1970s. After one of my Saturday-afternoon forays into Chicago's Old Town I returned with a copy for my bedroom wall. That furled piece of parchment promised a key to life's mysteries. Never mind that its wisdom, supposedly excavated from an unnamed and far-flung ancient church, was ubiquitous. Next to Fritz Perls's injunction that "you are you, and I am I, and if by chance, we find each other [horizontal ellipsis]" "Desiderata" was the closest we had to a generational statement of ethos. Of course I would go placidly, live in eternal peace, and avoid all the pitfalls and dumb mistakes my parents made. The prospect was quite simple, really, I thought, as I rode the bus home down Clark Street, adjusting my red bandanna over my waist-length hair, fantasizing about the impending Saturday night.

Anna stared but made no response to my queries. Pain? Breathing difficulties? Nausea? Her enormous dark brown eyes tracked my movements around her bed. There was so little flesh remaining that her face appeared unequal to the task of supporting those eyes and open mouth. She would become the fifth member of her family to die of Alzheimer disease before the age of 50. Her marriage 20 years ago was a crapshoot. She and her husband knew the odds and went for it.

On the way to the bathroom to wash my hands, I passed the wall of photos. Here we go again-that stabbing moment of recognition when nurses confront their patients transformed, a quick rewind back to the land of vitality and hope. There she was, center stage at a family reunion, laughing in the midst of a sprawling Italian clan. And there she stood beside her husband on their wedding day, dark hair falling to her shoulders. The final picture brought me to a standstill. A family photo: Anna next to her husband and two sons, one a teenager and the other perhaps 10 years old, still young enough to allow his mother's arms to encircle him. They clustered together atop a lookout tower, a place I recognized as one where I had so posed with my three children in summers past: Door County, Wisconsin, a mecca as familiar to Chicago vacationers as the kitschy Wisconsin Dells, neighbor to the west.

When I returned I raised my voice over One Life to Live, asking the caregiver about the sons. With effort, she directed her attention away from the TV. "The youngest-he's about 15 now. He still comes home from school and climbs into bed with her."

"And the older one?"

"Oh, he killed himself a few weeks ago. That's why they transferred her to the hospital."

I had heard about her recent stay in the hospice unit. Her nurse had explained how she was transferred there for a few days to allow the family a brief respite and how, when she returned home, she had two pressure ulcers gnawing at what remained of her buttocks. The hospice staff pointed the finger at the EMT crew. In a misguided gesture of compassion, they had strapped her into a sitting position for the long, bumpy ambulance ride home so she could look out the window. Whatever the cause, accusations were pointless.

It strains the imagination to anticipate the consequences of such extreme frailty. Nothing can be taken for granted; few can sustain such vigilance without faltering. This I understood. But the son's suicide-that had not been mentioned in the nursing report.

I pulled back Anna's sheet, touched the olive flesh drawn tautly across her kneecaps and wondered what treasures she had borne on her lap. About what had she mused, riding home on the bus? Counting her respirations, I imagined the summer breezes through her hair as she drew her son's sweaty back toward her and smiled into the camera.

From deep within welled the guilt endemic to survivors, we consumers of unmarked time and marriage beds, heedless in our abandon, thoughtless and insatiable. I closed my nursing bag. Outside on her porch, a half-realized prayer for Anna: may the memory of peace promised to silence reside among the cerebral plaques. May we all, aging children, go placidly.

At the curb, I looked back. Even if I never see Anna again, we remain connected. Our bony knees may have brushed years ago, as we hurried off the bus, eager, toward all that awaited us.