The yellow clapboard house where Jennifer Vasquez grew up is immaculate. Her mother, Linda, can’t work anymore, so she passes some of the empty hours vacuuming the Silver Spring home she once shared with her husband and four daughters. On a well-dusted end table in the living room is a photo of Jen’s sister Kathleen, beaming proudly, her reddish curls tucked into a junior ROTC cap. Nearby is a picture of Sonya, Jen’s eldest sister, in her college graduation gown. There’s no clutter; the kitchen table is polished to a high shine. “I clean the house a lot,” Linda says.
Jen, 23, was still in high school when she began to notice that her mother was forgetting stuff. It was little things at first, like where she’d left her glasses or keys. She’d put washed dishes in the refrigerator. Linda was an urgent-care nurse, and she’d always been organized and unflappable. Now, minor setbacks were causing her to burst into tears like a child. Jen tried to tell people that something was wrong, but nobody believed her. It must be stress, they said. The past several years had been stressful for the Vasquez family, especially Linda, but Jen kept pushing her mom to call a doctor. Linda insisted she was fine. The diagnosis came a few years later: early-onset Alzheimer’s disease. She was 54 years old.
Often, when Jen is on her shift as a student nurse in the pediatric oncology department at Children’s Hospital in D.C., Linda will call, wondering where her daughter is. And Jen will tell her, as she has countless times before, that she’s at the hospital, that she’ll be back in time to make dinner. She doesn’t want her mother to cook anymore because it’s too easy to turn on a burner and forget about it. That’s one of the reasons she moved back home—to keep her mother safe. Linda’s illness was yet another test of strength for Jen, who had already endured tragedies most people can’t imagine, and already decided how they would shape her.
In some ways, Jen isn’t any different from her high school friends. She’s living at home and finishing school. She watches true crime shows with her mom and they scoff at the Kardashians. Jen runs, works out at the gym and takes her dogs to the park. She wishes she had more privacy and hopes she’ll find a good job soon. On weekends, she and her girlfriends like to go to bars such as Union Jack’s in Bethesda, but unlike her friends, Jen can’t just take off for a few days. Her mother can’t manage without her.
Jen’s childhood friends are particularly important to her—they all know her story, so she doesn’t have to explain it. They remember that night in April 2004, when Jen’s 15-year-old sister, Kathleen, took her own life. They know that’s when everything changed.
Jen was only 13 at the time of Kathleen’s suicide; her parents’ marriage ended soon after. Two years later, her accomplished and glamorous sister, Sonya, 25, also took her own life.
Both sisters had been diagnosed with depression, but the treatment wasn’t enough to save them. The tragedies shattered the Vasquez family. Child Protective Services visited Jen at home and at school. “But there was nothing wrong with us except depression,” she says. “I had a great family and a happy childhood.”
Much of that happiness came to an end as Jen dealt with the loss of her sisters. She was still in her teens when she decided that she wanted to follow her mother into nursing and devote her life to helping others. She’s gone on three medical missions to Peru, volunteering in remote clinics in the Andes Mountains and the Amazon jungle. With her surviving sister,
Laura, she’s founded Viva Vasquez, a group dedicated to raising money for the American Foundation for Suicide Prevention. “I wasn’t the type of kid who took care of dolls or fallen baby birds—everyone else took care of me,” she says. “Later I realized that I was a caretaker—that I wanted to help people, to stand up for the underdog.”
Jen has wonderful memories of being the adored baby in a family of four sisters. Her father, Carlos, an internist from Lima, Peru, met her mother while both were working at Suburban Hospital in Bethesda. Dinner table conversation in the Vasquez household often veered toward interesting diseases and medical mysteries. The four sisters were good students; musical, athletic, pretty and well-liked. Younger kids at the neighborhood pool looked up to them. “You never heard of them being unkind,” says neighbor Pamela Lawrence. “That family was the last one you would have expected to have such tragedy. But depression is vicious. All it wants is to get you alone in a room and kill you.”
Jen and Kathleen, known to friends and family as “the little girls,” alternately pestered and worshipped “the big girls,” Laura and Sonya. There were vacations in Rehoboth Beach, where they’d cram into a small condo for a week; trips to meet relatives in the Peruvian highlands.
The first tragedy struck when Jen was in eighth grade at Col. E. Brooke Lee Middle School in Silver Spring. She was doing homework in her room when she heard sirens outside; ambulances were coming to a stop near her house. Soon afterward, police knocked on the door with the news that Kathleen had been hit by a car. Kat, as she was called, died four days later. From writings Kat left behind, the family realized that what looked like an accident had been a deliberate attempt to end her life.
Kat was the artistic, poetic one, good at drawing, more interested in astrology than biology. Like her sisters, she was outgoing and had a large circle of friends. Some months before her death, she was diagnosed with depression, started medication, and seemed to be doing better. But she kept a secret blog in which she wrote about being suicidal. Out of misplaced loyalty, none of Kat’s friends broke the code of silence; even Jen, the sister closest to her, hadn’t known about it.
“When Kat died, I grew up very fast,” Jen says. The drama of middle school seemed trivial. She had no patience for cliques, and couldn’t imagine being deliberately cruel or exclusive to anyone. “It was so hard after my sister died, and my family really fell apart for a while.”
Although Jen’s parents’ marriage didn’t survive Kat’s death, Carlos moved nearby and stayed closely involved with his family as another worry emerged: Sonya was also suffering from depression. In the months after Kat’s suicide, Sonya had seemed to power through the loss and aim again at setting an example for her younger sisters. She had excelled academically at the University of Maryland in College Park and eventually earned her MBA there. She was making plans to attend law school, working as a paralegal and volunteering at CASA de Maryland when it became increasingly clear that her depression was worsening.
Keenly aware this time that the illness could be fatal, the family managed to get Sonya hospitalized. But they had to fight to have health insurance cover her treatment, and as an adult, Sonya could not be kept in the hospital against her will. In March 2006, 23 months after Kat died, Sonya took her own life. Jen still has a hard time talking about it.
Nobody can tell Jen for sure whether losing two daughters is what made her mother sick, but she’s seen studies suggesting that overwhelming emotional distress is a risk factor for Alzheimer’s. Both of Linda’s elderly parents had dementia, but she was barely 50 when the symptoms started, and it was soon after Sonya’s suicide. “I kept saying that I didn’t have it,” Linda says on a Sunday afternoon in her kitchen. She and Jen have the same fair coloring, delicate features, and heavy-lidded eyes.
Soon after Sonya died, Laura, who’d been attending Montgomery College, transferred to Johns Hopkins University in Baltimore. That left Jen home alone with her mom, in a big house that once seemed brimming with people. But they both went back to work and school, determined to keep going. Throughout her years at John F. Kennedy High School in Silver Spring, Jen’s close friends were supportive. Her boyfriend’s family embraced her, even inviting her to spend a summer with them visiting relatives in Europe. But the grief seemed to have made Jen’s mother increasingly distracted and forgetful. Jen worried about Linda, but her parents urged her to forge ahead with her life, and in 2009 she went off to college at the University of Maryland, Baltimore County. Two years later, Linda lost her job due to memory lapses. Then she crashed her car. Finally, Linda agreed to see a neurologist, who diagnosed her with cognitive impairment consistent with early-onset Alzheimer’s.
After the diagnosis, Jen decided to move home and transfer to nursing school at the Universities at Shady Grove in Rockville. Although Carlos dropped by often to check on his ex-wife, it was clear that Linda needed more care. She could no longer drive, and she couldn’t remember to take her medications or pay the bills. Now Jen takes care of the things her mother used to handle.
Reversing roles with her child “is very, very strange for me,” Linda says. “That’s why I call her ‘Mom.’ ”
“We joke about it, but it’s true,” Jen says softly, as her mother steps away to open the back door for Jen’s dogs, Jessie, a rescue mixed-breed, and Louie, a Yorkie that was Sonya’s.
“She’s not a mother figure for me anymore. I can’t ask her for any kind of advice.” Over time, Jen has watched her mother’s personality change. She’s mellower now, always up for a leisurely chat with strangers in the grocery store. She reads her neighborhood book club’s book of the month, though it’s hard for her to remember the plots. “She used to be very on top of things—very sharp, rather strict,” Jen says. As Linda walks back to the kitchen table, she points out that between working full time and raising a large family, she had to be strict. But now, she says, glancing at her daughter and smiling tenderly, “I’ve shaped you into the nice girl that you are.”
