Is She Family? : How That Question Has Become So Very Complicated.

We were stopped at the entrance to the Intensive Care Unit.

“How are you related to the patient?” a nurse barked, as if we had shown up at 10:30 at night just to cause trouble.

The challenge in her voice made us hesitate. We’d called a friend, left our sleeping children and rushed over to UCLA Medical Center the moment we heard that our housekeeper, Maria Alcivar, was “extremely critical” after the birth of a baby--so gravely ill that her mother was being sent for from Ecuador. We hadn’t stopped to ask sociological questions. We wanted to see Maria.

“We are her employer,” my husband said.

The nurse fired back the standard, “Only immediate family allowed in the ICU,” and would say nothing further except that the patient was, in fact, critical. If we had permission from the family, a doctor might talk to us. Come back in an hour.

We found the father of the baby propped up in the waiting room, arms stiffly crossed over a brown leather jacket. He looked like he’d been there for hours. His eyes were red.

“She is very sick,” he whispered. “We are so sorry,” we replied. And that was the extent of our communication. He speaks limited English.

Impossible. Surreal. Just two days ago we had celebrated the arrival of their baby girl, Denise Alejandra, who had weighed only 3 pounds but was doing fine. The doctors had been worried about Maria’s high blood pressure, but how could it be that 24 hours later she was rushed to a specialized, high-tech Westwood facility with massive liver failure? That, one by one, the systems of her body were shutting down, and suddenly the death of a 35-year-old mother of three seemed imminent?

We stared numbly at ABC Eyewitness News: “updates” on the Academy Award nominations, a feature on spousal abuse called “Hollywood’s Secret Shame.” The top story seemed to be that soma-glitz and mindless celebrity worship still dominate Los Angeles. But the real story, the breaking news we all live every day, is the clash of cultures that continues to shake this city like tectonic plates at play--and sometimes, at unexpected moments (say, on the seventh floor of a hospital on a Tuesday night), we find ourselves strangely isolated from both, crushed between them.

There was another couple in the waiting room, a put-together Westside lady in blue blazer, jeans and gold jewelry, and her exhausted-looking husband in sweats. Her brother-in-law had just been brought up from surgery. They had removed a brain tumor that turned out to be malignant. Dry-eyed and in shock, she asked why we were there.

“My housekeeper gave birth to a baby prematurely and now apparently has massive liver failure,” I said, still incredulous. “It’s so sudden. So crazy. She’s been with our family 10 years.”

She nodded sympathetically but I read judgment in her eyes--she was here out of “legitimate” concern for a relative. Why was I so upset about hired domestic help? A harsh voice inside me, echoing the nurse, said, “You really don’t belong here.”

How was I related to the patient?

Recently, the New York Times reported the plight of “immigrant maids” who live in servitude in upper-class suburbs from Long Island to Los Angeles, working 15-hour shifts, six days a week, for $2 per hour. I haven’t seen that kind of exploitation in my little enclave of Santa Monica, north of Montana Avenue. Here, a housekeeper who speaks moderate English gets $9 per hour, and it is not unusual for the bounds between family/outsider to blur and disappear. How to define what emerges is often just as unclear. Many housekeepers and employers, geographically separated from primary families, seem to create ad hoc family-type units, complete with dependencies, deep emotional ties, often a hybrid culture and even a patois language.

None of us have role models. The cultural mosaic of Los Angles reconfigures itself daily, and not without tension, both in our neighborhoods and in our kitchens. I wrote a novel in which a female FBI agent investigates the relationship between a housekeeper and a Santa Monica doctor’s wife in order to penetrate the heart of a betrayal that led to the housekeeper’s death. That fictional housekeeper was inspired by immigrant women like Maria, hired to care for our two children--Ben, now 10, and Emma, 4--weekdays from 9 a.m. to 5 p.m.

Maria took pride in keeping her personal life separate from her job, although she was not always able to prevent the needs of other family members from intruding into our home. It took her five years to free herself from an abusive marriage. She joined a support group. She got a restraining order and, ultimately, a divorce. There were times the ex-husband’s behavior was so paranoid and violent we feared for the safety of our own family, but we stood by Maria. We so admired her spirit.

And her commitment to us was clear, even heroic--two years ago, Douglas and I went away for a romantic weekend and L.A. was rocked by the 6.7 Northridge earthquake. Maria ran into the baby’s room, where she grabbed Emma out of the crib seconds before a changing table came crashing down, then comforted our children during the aftershocks--alone in a wrecked house for three hours in the dark. My kids nicknamed her “Monde” (pronounced Monday) because when they called, she’d say, “Monde!” a Spanish idiom that means “What is it? I’m here.”

A year ago, Maria decided to enroll in nursing school. She wanted to move beyond housekeeping. We cheered her on. We thought she would become a gifted nurse. Then, at the end of last summer, she told us she was pregnant--by the man in the waiting room, younger than she, sweet and respectful to her, with a good job. But it was as if a switch clicked off inside. Although we immediately agreed that she would return to work after the birth of the baby, I knew something that had been lasting and strong and central to my life was over. Looking back, I realized it was a unique intimacy, a gift of our cultural merging.

We spent 10 years in the kitchen together making quesadillas and fruit salad for our kids. We took pleasure in watching them grow up as close as cousins, speaking each other’s language. We shared folding laundry and gossip and advice and easy smiles and the ability to hand off children one to the other with absolute trust. With her decision to have this new baby, I felt a loss. I was angered that she had strayed from the path I had approved--nursing school and liberation--and, on a primal level, that she had chosen to begin a second family instead of remaining unconditionally devoted to ours.

Sometime after midnight, we were finally admitted to the supercharged crisis world of the ICU, and a helpful resident explained Maria’s condition to her companion and us. She had been admitted with fulminant hepatic failure due to a rare syndrome called HELLP--the liver had stopped functioning as a result of stress on it during childbirth. The syndrome can be caused by high blood pressure but the doctor was not concerned with hows or whys. Maria’s only hope was a liver transplant and, miraculously, she was in the best liver transplant unit in the world. She was listed as “Emergency Status One,” meaning that if a matching organ became available anywhere in the United States, this female working-class resident immigrant on MediCal would be among the first in line to receive it.

In the following week, I had many calls from shocked and worried moms whose children played with mine, whose housekeepers were close with Maria. An unlikely community of Anglos and Latinas was weeping and praying for her survival, all of us grieved by the deep sadness of a sick mother separated from her newborn. Maria’s condition improved, then worsened. Specialists met and agreed she was now in need of a liver and kidney transplant. Meanwhile they kept her alive on machines.

I soon hit an information impasse. The nurses refused to communicate without written permission from the family. I was intensely frustrated although I understood that the hard-pressed staff had to protect Maria’s privacy--and the ways in which we were related had not been defined by hospital protocol. By working the mom/housekeeper network, I learned some good news: Denise Alejandra was thriving and her father was rooming in every night with her. A social worker was on the case. A niece was coming from Ecuador to help. And Maria’s older children, Miguel and Cristina, had taken on some very grown-up responsibilities. Their mother would be proud.

In the meantime, I am locked out of the loop, forced to accept standard responses in a situation that may not fit anyone’s notion of “standard” but is fast becoming the norm in our city. As Maria waits day by day for a donor, my children ask when Monde is coming back. I tell them what I know, which isn’t much. As Maria floats in a nether-consciousness of artificially prolonged life, I drift in a state of nagging guilt and dread, apparently as disembodied as she. “I can’t give you any information,” a nurse informs me. “I don’t really know who you are.”