Summer 2011 /Birth & Death/


The wonderful life and untimely death of Mariah King Steinwinter Kochavi '02.

On June 15, 2008, the day that everything changes completely and irrevocably for Mariah King Steinwinter Kochavi, the 28-year-old Army veterinarian is at a remote mountain inn in the Andean highlands. It is Sunday, her third full day in Peru where she has been trekking from lodge to lodge along an ancient Incan stone-paved path. The hikes are beautiful and demanding, up and down steep slopes that will ultimately lead her group to the legendary city of Machu Picchu. Along the way, she is likely to see more mountains than people. It is a true getaway, marred only by the migraine that has nagged her since her arrival in Lima late Thursday night. Migraines are something Mariah has grappled with since childhood. This one is relentless, but she isn’t about to let it hold her back.

Besides, everyone seems to think it is probably a reaction to the changes in altitude that will go away once her body adjusts to the thinner air. Mariah had flown in from Washington, D.C.(altitude 25 ft.) to Lima (5,079 ft.), then traveled the next day to the smaller town of Cusco (11,200 ft.) where the group she was with cooled their heels for a day to get acclimated. That Sunday, their hike takes them to 14,000 ft. Despite the powerful headaches, Mariah is out in front of her group. The evening before, she did take some Tylenol, but had shaken off the offer of altitude sickness tablets. She wants to tough it out. Part of the allure of the trip, you see, is seeing how her body performs in extreme conditions.

Mariah has been pushing her body to extremes since she put on her first pair of toe shoes in ballet class. After a dancing injury sidelined her, she took up taekwondo where she worked her way up the nine grades to a black belt, suffering through at least one broken nose. At Pomona, she hooked up with students who were in ROTC and took 5 a.m. boot-camp-style workouts with them. She was so sure of her physical prowess that when she applied for a highly competitive Army Vet Corps scholarship to pay for her last three years of veterinary school, she fantasized about the military awarding the scholarship based on the number of push-ups an applicant could do in two minutes.

This trip is a breather for Mariah at a stressful, but thrilling, time in her life. She has just completed her first army veterinarian post at Fort Meade in Maryland, about 30 miles from Bethesda where she had grown up. A few months earlier, she had separated from Ramon Kochavi, her husband of eight years, whom she met and married while she was still a student at Pomona and he was finishing up at Claremont McKenna College. Leaving Ramon was not an easy decision. “I feel like I just left my best friend,” she confided to her mother, Mary-O King. But the compulsion to be free was too great. Says King: “She wanted to soar like an eagle.”

The Army had turned out to be an unexpectedly good fit for the young woman raised as a Quaker. She thrived on its discipline and loved the family environment of the military. She set her ultimate career sights on being head veterinarian at the Armed Forces Institute of Pathology on the Walter Reed campus. In the meantime, she was about to be deployed to Egypt’s Sinai Peninsula, where there are two multinational base camps and 30 observation posts. “My job will be to take care of some fifty to sixty ‘mascots.’ These are ‘dogs’ adopted by soldiers and ‘trained’ to ‘guard’ the observation posts,” she wrote in an email shortly before her trip to Peru. “For all I know they are actually rabid foxes or rogue camel spiders—go ahead and google it—the soldiers trap for entertainment value.”

Her responsibilities were to include serving as camp veterinarian for public health issues (“i.e. rabid mascots and camel spiders,” she wrote) as well as approving the farms and factories throughout Egypt and Israel that supplied food to the troops. The new job would be a challenge. That was the point.

When she left for her vacation in Peru, she was doing what we all do—fussing with the stubborn details of life that seem to matter so much at the moment. She had to figure out what to do with her Subaru, make arrangements for someone to take care of her dog Chai, get everything packed up and shipped to Egypt. Everything is about to change for Mariah. But it isn’t the change she has in mind.

A young Mariah—she’s 6—is hiking in Rock Creek Park in Washington, D.C., with her mother and younger brother Clay. It’s a damp Saturday in March. Clay, who is not quite 4, is dragging his feet. Bunny—the nickname Clay gave Mariah before he could say her name—is way ahead. She has found a new walking stick and is holding a white balloon she had fished out of the creek. Eight riders on horseback suddenly appear in front of her, but Bunny isn’t daunted in the least. She is determined to be the first one back. That’s all that matters to her. Her mother remembers this particular day from 25 years ago. “Being way out in front is exactly what she was doing on Machu Picchu,” King says. “It strikes me we were all always trying to keep pace with Mariah.”

The great themes of Mariah Steinwinter Kochavi’s life surfaced— and merged—in childhood. This is no small point. Many of us follow along one path in life and eventually find that it leads to another, unforeseen one. We encounter moments where we make choices that change us, for better or worse, into a person we didn’t exactly expect. Mariah, on the other hand, was like an acorn—always destined to become an oak tree. Looking back at her childhood, you can see present all of the elements that define her in adulthood. She had an acute intellect, which was matched by great physical ability. She was inordinately proud of both of these traits and subjected both brain and body to strenuous workouts.

“Once Mariah chose a path, she finished—and with gold stars,” says her father, Mark Steinwinter. “Her M.O. her whole life was to be the best that anyone was in an area. Achieving things was huge for her.” Paradoxically, achieving them quietly was equally important. After her parents divorced, her mother moved the family several times. If there was a basement room, she’d claim it for herself, says Clay. Even in childhood she was a deeply private person, disappearing for hours at a time into her little nest where she would read, or sketch, or paintshe was always working on something. She kept what she was working on to herself until she had perfected it. Not for show was the messy process of learning, of practicing something over and over until you get it right. “She would decide she was going to do something and develop it in private and in secret,” Steinwinter says. “Then, when it was a fait accompli, she would expose it with a flourish.”

Mariah’s fascination with animals, particularly birds, goes all the way back to when she was in a playpen looking out into the back yard. Every time she saw a bird, she would bounce up and down and clap her hands. She would grow to observe nature keenly, drawing and painting birds and flowers in exquisite detail, and when she was only 8, her watercolor of a ruby-throated hummingbird landed on the cover of the Massachusetts Audubon Society’s magazine.

She began rescuing animals at an early age, starting with two baby robins whose nest was blown out of a tree during a storm. With the help of her mother, Mariah fed them almost round the clock, keeping them safe while they developed their pinfeathers. There were many more rescues—like the sparrow she saw fly into a moving car one day on Wisconsin Avenue in Bethesda. She begged her mother to step into the street to retrieve it after it lay limp on the ground, then Mariah sat under a tree holding it. Back home, she made a cage out of a box and some netting, poked sticks through a small hole for perches, suspended a piece of lettuce from a string, and named it “Survivor”—a testament as much to her own resolve as to the tiny bird’s life force. She didn’t give up on it. She never gave up on anything.

The idea of going to vet school didn’t occur to Mariah until her final semester at Pomona, where she graduated with a degree in German studies and a minor in art. Actually, vet school was the brainstorm of Ramon, who believed Mariah would eventually become bored with her original career goal of becoming a scientific illustrator. Besides, being a veterinarian had been his own youthful dream. It’s kind of funny the idea hadn’t come up earlier, if only to spare the couple the vet bills for caring for the menagerie that shared the one-bedroom apartment with them— love birds, sugar gliders, ferrets, an iguana, a bunny and an umbrella cockatoo.

By then she had missed the application deadline for all the vet schools but the Cummings School of Veterinary Medicine at Tufts. She sent off her application, considering it a practice run for the following fall. With only 28 vet schools in the United States, getting accepted is even harder than getting into medical school. But on the very day of her graduation from Pomona, she received an acceptance letter from Tufts, giving Mariah and her family, who had gathered for the occasion, a double reason to celebrate. Vet school offered Mariah the perfect combination of intellectual challenge and immersion in all things animal. She took to it like a fish to water. “My favorite new muscle (who has a ‘favorite new muscle’?) is the buccinator,” she wrote in an email at the end of her first semester “You say it ‘buxinator.’ Just for comparison,my favorite muscle used to be the calf. I like doing calf raises while I brush my teeth. Now I’ve learned the muscle I thought all along was the calf is the gastrocnemius and the superficial digital flexor along with it, if you’re a cat but not a dog, the soleus. I can’t summon the will to do gastrocnemius/superficial digital flexor/soleus raises while I brush my teeth.” Who could?

The hands-on part of her veterinary education involved rotations in a variety of places—at the Bronx Zoo, in the Florida Keys, on a kibbutz in Israel, not too far from where Ramon’s parents live. Her favorite, says her father, was working at Tufts’ Wildlife Center where people would bring in wild animals from the hills of central Massachusetts. “There wasn’t really a protocol,” Steinwinter says. “Mariah especially loved working on those beasts because there was nothing to go on. She had to use all of her intuition and sensitivity and her scientific background to figure out what’s the right thing to do for this crow or this raccoon.”

Mariah never grew out of the impulse to rescue animals. But she did come to understand the fine distinction between giving up on something and letting go of it. Her mother called one day to tell her that Guy, a pet cockatiel she had since she was 9, was not perching. He was just sitting in the bottom of the cage, which is not natural, and King could feel a tumor under his wing. After a long-distance consult with the vet about the possibility of doing surgery, Mariah told her mother she should put the bird down. “She said to me, ‘He had a good life, Mom. Let him go,’” remembers King. It’s a conversation King will have reason to recall frequently.

That Sunday in Peru, after the morning’s strenuous hike, everyone in her group settles down at the lodge for an afternoon nap. Mariah can’t sleep, though. She gets up, goes out for a walk, takes some pictures. Later, when her friend Molly Harrington comes back to the room to check on her, she is relieved to see Mariah in bed, having apparently finally fallen asleep. She hadn’t slept well the entire trip so far. When Harrington tries to rouse her to ask about dinner, Mariah, who never drinks, sounds drunk and confused. Thinking she is showing signs of serious altitude sickness, Harrington races off to get their guide. When the two try to help Mariah stand up, she slumps down as if she’s fainted. The guide gives her oxygen to stabilize her and make plans to take her back to lower altitude in Cusco.

What follows is a long, jarring, winding journey over rough terrain. Harrington has to hold Mariah up because she isn’t able to do it herself. Mariah jokes about her tongue being numb, and covers her eyes because everything is blurry. It takes two hours just to get to an exchange point where they are met by the closest thing they have to an ambulance. The ride to Cusco, where there is a traveler’s clinic, is another hour-and-a-half. Mariah asks Harrington if she has had a stroke. Indeed, this will turn out to be the case. But at the moment it is unthinkable to everyone but Mariah. It will be more than another 24 hours before doctors make the shocking diagnosis that this vibrant young woman who was hardly sick a day in her life has suffered a brain stem stroke. One of the arteries feeding her brain was narrowed—probably a congenital condition. But for whatever reason—the altitude, birth control pills, nobody will ever know with certainty—it became blocked, cutting off oxygen to her brain and causing grievous damage.

It is not until Tuesday night that her family gets the news. Her father jumps on the next plane to Lima. By the time he arrives, Mariah has deteriorated even further. She is now in intensive care, breathing with the help of a ventilator. She is virtually paralyzed, wracked with vicious muscle spasms, but able to talk .She asks her father to take her home. Later, he is floored when she tells him to kill her if she is not better in four days. This is not the tenacious person he has always known. He asks her to be patient, to see how things are in six months. The next morning, when he comes back to the hospital, she has been robbed even of her speech. Cruelly, the only thing left intact is the cognitive part of her brain—the part where she can see clearly what she has lost.

It’s a formidable road that stretches out before Mariah. She is receiving the best care in the world, first from Walter Reed Army Medical Center where she was flown to as soon as she could be moved from Lima, then at the polytrauma rehab unit at McGuire Veterans Affairs Medical Center in Richmond, Va. There she undergoes five months of intensive therapies—physical, occupational, speech, kinesiology and recreational therapies. Finally, she returns to the Walter Reed campus to live at the Mologne House, a kind of assisted living hotel, where she will continue the recovery process as an outpatient.

The prognosis is not terrific. At first she can only communicate by wiggling her feet—she wears one sock that says “yes,” the other “no.” After a few months she regains her ability to speak. She calls it a “Mariah-cle.” But the production of sounds is labored; the old musicality to her voice gone. She has to relearn how to walk, how to reach for things, how to brush her hair, how to swallow. She has always been a voracious reader. Now she not only has trouble holding a book up to read, but she has double vision. The most doctors can do for that is suggest an eye patch. Damage to her vestibular system, which contributes not only to her balance but her sense of where her body is in space, is profound. She is afraid of walking on her own, terrified that she is going to fall and hurt her head. Still, everyone who knows Mariah holds the same thought: If anyone can beat the odds and astound the medical experts, it will be Mariah.

But it’s not like that at all. She is profoundly depressed, even suicidal, from the first. She does make slow, but marked, progress, meeting one milestone after another—sitting up, holding a fork, walking with assistance, maneuvering her wheelchair. In her old life, she would often throw her kayak on top of her car at the crack of dawn and head out for a solitary morning of paddling and birdwatching. As part of her therapy, she gets back in a kayak, courtesy of a volunteer program run out of Walter Reed. Kayaking is an excellent way to rebuild core muscle strength and confidence, Mariah starts out in an indoor pool with a specially outfitted kayak, but eventually kayaks in the C&O Canal and the Potomac River. She also participates in equine therapy at Fort Meyer, which puts her back among the familiar smells and sounds of a stable. She works her way up to a point where she is able to ride solo—a stunning achievement.

But all of this progress seems lost on her. In fact, she continually rejects the notion that she has made any progress at all, denies taking steps on her own or kayaking on the canal—perplexing everyone who has worked with her and witnessed her achievements. “I don’t know if it was because she was holding out for being back where she was and even better—which was never going to be in the cards,” says her father Mark Steinwinter. “Or if the stroke itself had robbed her of the rational ability to see what was and measure it against where she had been.”

Truly, her losses are staggering. Yes, she can talk—quite intelligibly if she talks slowly and if the listener pays good attention. “It was miles from the articulate, witty, brilliant Mariah that she liked to project,” says Steinwinter. Her occupational therapist brags about the snowman Mariah drew one day during a session— a noteworthy accomplishment in her recovery. Still, can Mariah have heard that praise without grieving for the lost pleasure of sitting cross-legged on the grass with a sketchbook in her lap while she captured the fine details of a rose about to bloom?

There are collateral losses as well—the privacy she so prized, for one, and, too often, her dignity. One afternoon her mother took her out for lunch at her favorite delicatessen. Afterwards, they decided to get manicures at the nearby salon. “Such a good girl,” the nail technician cooed to this brilliant, sophisticated woman as though she were a child.

A few months after the stroke, doctors tested her cognitive functions. “I’m still the smartest girl in the world,” she told Steinwinter when she was wheeled back into her room. “She had memory that scored her in the 99th percentile of people who have not had strokes,” he says. It was on her intellect, finally, that she pinned her hopes. She wanted to get back on track with her veterinary pathology career. One of the giant roadblocks to this goal was that she didn’t have the fine motor coordination to write; in fact, even using a keyboard was a challenge for her. She suggested trying speech recognition software, and when she first tried it out she was able to compose a nice message to her brother.

“We were both elated. Maybe it wasn’t necessary for her to be able to write really well to be successful professionally,” Steinwinter says. “She could do it this way. I know that just filled her with a lot of hope.” He bought a high-end laptop for her and loaded it up with the speech recognition software and took it to her the next time he went to see her, a few weeks before Thanksgiving. “The plan was to see if she could also do some veterinarian transcription type stuff,” he says. “She was eager to have a go at it.” But this time around, for whatever reason, her speech was off just enough that the system didn’t do a good enough job transcribing what she was saying. It was frustrating, but she kept at it for hours—to the point that she was barely intelligible.

“Here was the problem,” says Steinwinter. “A few weeks earlier there had been this giant breakthrough and all the hopes that went with it. And all of a sudden she was crashing into a wall. I think that did two things to her. It robbed her of a technical solution to a problem. But it also isolated her further and just reminded her—other people have trouble understanding me and so does the computer and here I am stuck in this awful situation.”

Mariah has spent her whole life on a mountain. On the rare occasion that her smarts and strengths didn’t carry her all the way to the top, the sheer force of her will made up the difference. Now picture Mariah sitting there at that computer, trying to train it to recognize her voice—a voice she couldn’t quite control, a voice she herself didn’t even really recognize as her own. Imagine her talking into the machine over and over and not being able to make it understand. Imagine her heart breaking as this failure washes over her. Is she giving up—or is she letting go?

One afternoon, Mariah and her mother are sitting in companionable silence in Mariah’s room at Mologne House. “What are you thinking about, Mariah?” King asks. “I’m thinking I had a wonderful life before the stroke,” she answers. Her mother can’t help but remember when she has heard Mariah say something like that before.

Perhaps that wonderful life—filled as it has been with dogged ambition and grand accomplishment—has left Mariah unsuited for a decidedly imperfect body, for a life that is not of her own choosing. Whatever the reason, a few weeks later, on December 24, 2009, 18 months after the stroke, while her mother is out running some last-minute errands for the holiday, Mariah makes one final, heartbreaking choice—to end her own life.

It is her mother who finds her, as Mariah must have known it would be. That morning, she had painstakingly signed a homemade Christmas card for King, made from one of her earlier wildlife drawings. “I love you, Mom,” it said, in handwriting so quivery it looked like it had been written with an Etch-a-Sketch. Now, King opens the door to Mariah’s room at the Mologne House, anticipating the holiday evening ahead with Mariah home. Moments later, she is back into the hallway, crying for help, crying because there can be no help.

In Boston, Mark Steinwinter is following his family out the door to Christmas Eve service when the phone rings. Upon hearing the news that Mariah is gone, he takes a step backwards to sit down but misses, landing on the floor.

Clay won’t learn of his sister’s death until the next day. When his father tries to break the news to him gently, Clay screams an endless, echoing “Noooooooooooo”—perhaps equal in weight to all of the hope and love the family had put into holding Mariah up until she could find her own way.

King opened the Metro section of the Washington Post the day after Mariah’s death to see Mariah’s picture front and center. Ironically, the Post has chosen Christmas Day to run a story that has been in the works for some time on the equine therapy program for wounded warriors at Fort Meyer.

In the days and months to come, King will mourn for her daughter. She will spend sleepless nights going through all of the drawings and paintings and scraps of writing that Mariah left behind, trying to hold onto her daughter, trying to not be buried by her grief.

But on this raw Christmas morning, King is jarred, and then comforted to see her daughter’s familiar face. In the photo, Mariah is wearing the softest pink sweatshirt. She has just finished grooming a gentle white horse named Minnie, her favorite, and is hugging her, her face almost buried in Minnie’s neck. It’s a beautiful photo—a benediction of sorts. She is hanging on for dear life, it seems. And she is saying good-bye.

Mariah King Steinwinter Kochavi was buried with full honors in Arlington National Cemetery, her caisson pulled by some of the very horses that she rode at Fort Meyer, including Minnie.