In this bleak little book, psychiatrist/novelist Wheelis (The Doctor of Desire, 1987, etc.) offers a history of his dutiful but loveless relationship with his mother, an account of her death, and a pre-vision of his own life's end--which, at age 74, he feels to be imminent. Wheelis grew up in poverty in the American South, son of a doctor whose tuberculosis prevented him from working and who occupied all the attention of his wife, who chose to care for him at home. The author's childhood memories are of ugly things like sputum cups and sheets boiling in a cauldron in the backyard. When Wheelis's father died, the boy replaced him as the center of his mother's devotion, granting him a burdensome power over her. Guilt that Wheelis would feel the rest of his life arose from an incident when, as a preadolescent sleeping in bed with his mother, he explored her naked body as she slept. After that, he did his duty by her, with no joy and little love, nursed her through a spell of illness when he was in college, and invited her for long visits after he married, became a psychiatrist, and moved across the country--even though her dependency and devotion made him and his wife acutely uncomfortable. Wheelis's mother became, as he honestly but brutally says here, ``a foolish old woman'' while still in her 50s--and she remained so until her death in a nursing home nearly a half-century later. Is our dismal and often cruel existence, Wheelis wonders, unredeemed by any meaning after its end? He fantasizes returning to the dear scenes of his married life in the Pacific Northwest, and finds solace in the certainty that his survivors will love and miss him--as, to his grief, he never could manage to love his mother. A brave book, but a grim one.