Today begins with a muscle relaxer. It’s surprising how much this needle hurts, surprising because it’s simply the latest in a series of needles. As with bee stings, I expect each new penetration of the skin to feel like the one before it, yet there are differences, and whether they’re a result of the needle’s diameter, the nurse’s skill or the site of injection, I can’t say. Before this needle there were the needles to draw blood, inject contrast dyes, and retrieve tissue samples which were then delivered to the laboratory for testing and diagnosis.
Of all the needles, I remember the one used for the spleen biopsy most vividly; it was this needle that submerged beneath my skin like a submarine, only to swiftly resurface, bringing the mutated cells into the unwelcome light of day. The doctor performing the procedure asked me, while I was laid out on the operating table, what my own physician had suggested as the likely cause of the symptoms I had been experiencing, the discomfort and the pain.
I told him, “He said I could be recovering from an infection, or maybe my lymph nodes are simply larger than normal. He also said it could be lymphoma.”
I couldn’t tell what expression the doctor wore behind his mask, but his tone was matter-of-fact. “Oh, it’s cancer. You have lymphoma.”
They can’t anesthetize bone of course, so after the muscle relaxer has begun to do its work, they administer the minor, nimbler injections that numb skin. Marrow will be extracted from two sites on either side of the small of my back. I sense that Terry, my partner of sixteen years, is growing tense as he waits for the doctor to tell him to leave the room so they may continue. Terry asks, “Should I go now?”
This doctor says, “No, you can stay.”
I say, “Why don’t you leave? I don’t want you to see me cry like a little girl.”
The doctor and nurse laugh and Terry gets up, tells me he’ll be right outside in the waiting room.
The doctor instructs me to close my eyes and rest my head in the crook of my arm. He says, “Deep breaths. Breathe with me, in and out. In…and out.”
Needle is forced through bone. This isn’t what causes the pain, it’s the moment when the plunger is lifted and the marrow is drawn up and out. It’s for this moment that I received the muscle relaxer: there’s no medical reason for it, apart from preventing me from jumping off the table, screaming, a needle sticking out of my back like a hunter’s arrow.
The team moves on to the other side, extracts more marrow and a core sample. In a few days my oncologist will tell me that the cancer has breached the deepest recesses of my body. I will officially be in stage IV of non-Hodgkin’s Lymphoma, which, like all cancers, does not have a stage V. There will be some comparatively good news, however: My type of cancer grows very slowly, and, statistically speaking, over half of non-Hodgkin’s Lymphoma patients live for five years after diagnoses.
The doctor finishes collecting his samples and congratulates me on my courage, but really, what other option do I have? Being courageous, being afraid, neither of these things will change the facts, and truth be told, it’s easier to be courageous, easier on the people around me, easier on myself. I simply don’t have the energy to be frightened, it smacks of an effort I’m unwilling to make. I politely thank the doctor and nurse as they leave me to recover in my own way.
Days come and go, punctuated by appointments and tests and procedures. Today, for example, I have monocelluar immunotherapy, a.k.a. chemotherapy. Terry and I pass the Virginia Piper Breast Cancer Unit on our way to the chemo ward and through the windows I see the tasteful library, the coffee served on real china, the thick, terry cloth robes and fluffy slippers worn by patients. They should stick a Post-It note on the door to the Piper Unit with the words “All Other Cancers” scrawled across it, along with a crooked arrow pointing in the direction of General Oncology, my destination.
My unit more closely resembles an airport gate prior to departure. Often Terry and I can’t find seats together and there is always a line for the bathroom. At first I was horrified, but then I thought: Do you really want to walk into an oncology waiting room that’s empty? And besides, now that I’m a veteran patient, the waiting room doesn’t bother me anymore. I no longer envy the women in the Piper Unit because the hustle and bustle of general oncology has its own peculiar charms. Here we swap prognoses like recipes, we study the pamphlets and brochures that are meant to empower, inform, comfort. One booklet tells me: “Don’t blame yourself for your cancer. Some people believe they got cancer because of something they did or did not do…Remember, cancer can happen to anyone.” Just once, I want to pick up a flyer that says, “Boy, did you fuck up. If you had only been a kinder, more generous human being, this never would have happened.”
My name is called. It’s time for a new needle, for the new IV drip that will deliver the liquid Benadryl, which tempers my allergic reaction to the Retuxin, the drug that I will receive for the next four or five hours. I open a book as the vein is prepared and Terry turns on his laptop, beginning his day’s work of volunteer management. I was never much of a reader growing up – I didn’t fall in love with books until I was in my mid 20s – but now, in my 40s, I read more than I ever have. And although I have many assigned texts as a graduate student, I rarely bring these with me to chemotherapy. Instead, I revisit old favorites as I sit in a recliner, one of nearly forty that circle the nurse’s station.
Today I’m reading “Family Dancing,” David Leavitt’s debut collection of short stories. I’ve included two of them in a course packet for my own students, and one of these, “Counting Months,” is about a woman named Anna who realizes that six months have passed since her cancer diagnosis, that on the day the story takes place, she was supposed to be dead. I chose this story in June, two months later, I had been diagnosed myself. We will be discussing “Counting Months” in class this week. I find myself returning over and over again to a single passage in the story, in which the oncologist congratulates Anna:
" 'I think it’s marvelous the way you’re handling this thing. I’ve had patients who’ve just given up to depression. A lot of them end up in hospitals. But you keep an active life. Still on the PTA? Still entering those cooking contests? I’ll never forget those terrific brownies you brought. The nurses were talking about them for a week.'
" 'Thank you, Doctor,' she said. He didn’t know. All these months she had been so “active,” she suddenly knew for a lie. You had to lie to live through your death, or else you die through what’s left of your life."
I used to find that passage depressing, but with this reading I find it comforting. Anna and I now have something in common. Correcting the syntax in an undergraduate’s short story, cleaning up the shit spread throughout the backyard by three dogs: Before cancer these tasks were annoying, now they’re the little lies that enable me to live through death. They keep the drama at bay; they send casual acquaintances (the ones who want the experience of befriending a Zenlike terminal man) packing.
Like Anna, I also receive praise from others: people tell me how good I look, not like a cancer patient at all, or they gasp in amazement when I tell them I’m teaching during treatment. I’ve learned to ignore the impulse to correct them, to say that I’m not fighting the tide -- rather, I’m drifting along with it. I lie because people are at their most patriotic in the war against mortality, they believe that with the proper attitude it will be the cancer cells that wither and die. I don’t tell them about my experience with the AIDS pandemic, of how it was sometimes the case that passive people lingered on while the go-getters died within weeks of their diagnoses. I don’t believe that we have control over these things. And if I don’t beat the odds, if I do go quickly, I don’t plan to lie on my deathbed convinced that it was a character flaw rather than the cancer that stole my life from me.
Time passes and chemo rush hour begins. At about ten a.m. the short-timers arrive to be hooked up for just an hour or two. There is a steady stream of them throughout the day and they generally come alone, the IV drip now as much a part of their routine as filling the car with gas or paying the bills at the end of each month. Some conduct business on cell phones, others read or listen to headphones as they watch the televisions that are suspended from the ceiling.
I have a good friend who visits every time I’m in the ward. She brings fresh muffins and cupcakes from a bakery on Franklin Avenue, along with gossip and the occasional astute observation. As Terry stretches his legs, she says, “You’ve been keeping a pretty tight lid on all this.”
Her comment surprises me since my diagnosis isn’t a secret. It’s easier to have it out in the open, I have a lousy memory and keeping people in strict camps, those who know and those who don’t, is beyond my mental capacity. I say, “No, I haven’t. People know, it’s nothing I’m ashamed of. And I’m too lazy to protect people from the truth.”
“You haven’t fallen apart,” she tells me.
“Not in front of you, no.”
“If not in front of your best friend, then who?”
I look at her. She is my closest friend; a lesbian mom by design, not by divorce. We’ve known each other for nearly thirty years. I was there when her first baby was born and I’m Uncle Brian to her children. She was there when my roommate died of AIDS, my brother of cancer. She is no tourist in my life. If she wants to know when I hit bottom, she’s entitled. “I was by myself when it happened,” I tell her.
She gives me her look. We both know I owe her more.
“After I found out I thought I had to seize the day, to live life to its fullest. But then I just sat on the couch and channel surfed. And I watched my first episode of Dawson’s Creek and of course one of the main characters dies. It was totally manipulative, they played Jewel in the background and people wept and held each other and analyzed their lives. And I completely fell for it. I just started crying because all through AIDS I’ve been the HIV negative friend, the friend that lives. I don’t want to be the friend who dies. I want to talk about the friend who dies with the other friends that live.”
“I get it,” she says.
I turn back to “Counting Months,” embarrassed. Anna is home and has decided to broil chicken for dinner. She leaves her children to set the table as she heads to the bathroom. Leavitt writes:
"Occasional moments it came back to her, and she had to hold on to keep from fainting. Such as when she was sitting on the toilet, in her green bathrobe, among the plants, her pantyhose and underwear around her knees. Suddenly the horror swept through her again…"
Hours pass, and the latest needle is removed, the site cleaned and bandaged. In 120 minutes I can remove the dressing and go about my life as if the cancer had never happened. There will still be the pain, the discomfort, but these things can be kept in their proper compartments, isolated from the rest of me, the me with a stack of papers to grade, the me still in love with a man named Terry, who drives us home. There, our three dogs wait impatiently, twitching in anticipation of our return.
Postscript: I am in remission.