A year ago I could say that. A year ago if I’d discovered a small lump in my armpit I would have thought it’s probably nothing and forgotten about it. I’ve had lumps before. They went away. I’m pretty sure they were nothing. The body is a quirky machine. Sometimes little things go wrong, get discombobulated, then fix themselves. Besides I never get sick. Or at least that’s what I used to be able to say. Now I find a small lump in my armpit and it doesn’t matter how small it is. My mind immediately starts flashing red neon signs that say LUMP! ARMPIT! LYMPH NODES! CANCER!!! My wife was there to reassure me it was a skin tag, a little bit of flesh that got lost on its way to replace an old layer of epidermis. Or maybe it’s just a small collection of cells that said, “Let’s get wacky!” This is benign. It’s like the cells having a little too much to drink at aparty and ending up on the roof screaming “I can see the Islets of Langerhans from here!” Cancer, on the other hand, is when cells have a psychotic break and decide they’re going to climb into the aorta with enough weaponry to arm the entire pancreatic military and take out everyone they can, but that’s another story. The skin tag is annoying even though it’s small, so small, in fact, that I only notice it in the shower when I’m washing my armpits. It’s so small you wouldn’t notice it if I waved to you while wearing a tank top, and not just because I’ll never wear a tank top. On the one hand I’m relieved. On the other hand I’m annoyed that something this minor would choose now to pop up. I would be a lot less happy if it were something major, but really I just want to call a truce with my physiology. I want a break. It hasn’t yet been a full year since I was first diagnosed with cancer. It hasn’t even been a year since the leg pain that was the first sign started. And it hasn’t even been three months since my last major surgery, which I sincerely hope really will be my last major surgery. It’s just too soon. I know cells have to burn off some steam once in a while, but, as their supervisor, I’m not inclined to grant even a short vacation right now. If some of them want to get drunk and go crazy right now they need to go find another body to live in. I’ll never be aslaid back as I once was, but in a year or so I’ll be a little more relaxed. Things are just still a little tender at the moment, and my body, of all things, should understand that. You’ve got a pot of spaghetti boiling over on the stove so it looks like an octopus trying to escape. The sauce is smoking, and you’re pretty sure it’s burned to the bottom of the pan, and it’s thrown little red flecks all over your white shirt so you now look like you’ve stabbed someone in the jugular, and you’re kicking yourself for not putting on an apron because tomato sauce is magnetically attracted to white fabric. The mail you casually threw on the hall table just slid off and catalogs skidded everywhere, the refrigerator is running, and the dog, who’s been barking nonstop for the past hour, is now peeing on your shoes. And he’s giving you that look that says, “I TOLD you I needed to go out!” In a sudden frenzy you get the spaghetti and the sauce off the heat, put the dog outside, wipe up the floor, catch the runaway refrigerator, and pick up the mail. Your heart is racing, you’re breathing heavily, and your pulse is pounding in your ears. Then the phone rings. Still frazzled you answer with “WHAT DO YOU WANT? WHO IS THIS? ANSWER ME BEFORE I RIP YOUR KIDNEYS OUT THROUGH YOUR NOSTRILS!” And your mother-in-law who called just to ask how you were doing is barely able to break through her catatonic shock and say, “Nothing!” It was a similar feeling that had me yelling at my armpits in the shower. I can’t see into the future, but I know that, in spite of my generally positive prognosis, there’s a chance my cancer will come back. The doctors may have used the word “cured”, but it’s never something that really goes away. My body could turn on me at any time. I just hope that if it does it’ll be in five years or ten. With enough breathing room I hope I’ll be able to respond calmly and rationally instead of having a total, even if temporary, meltdown that left me lying naked on the bathroom floor wondering if it’s time to cash in my retirement account and start the farewell tour. It was just a little too much too soon. Yes, there is a part of me that wishes that instead of a skin tag it was really cancer, not cured but steaming right ahead, and that I just yelled it into submission. A feeling of lost control is part of the life-threatening illness package. I want to feel like I’m back in charge and that this time around I didn’t need no stinkin’ chemo. This time, I want to believe, I showed that cancer who’s really boss around here, but realistically I know it was really nothing.
January 30, 2015
I was cured all right.
-A Clockwork Orange
So where do I go from here? Everyones experience is unique, but in my case beating cancer was the easy part. A few brief bouts of nausea, a temporary allergy to sunlight, anemia, and fatigue were as bad as the side effects got. Surgery wasnt fun, but it went smoothly. When all this started in June 2014 I thought things would change significantly. I wasnt sure how they would change, but I thought it would be dramatic and obvious. Instead everything went so easily its tempting to feel like nothings changed, least of all my outlook. Ive always been an optimistic guy. The doctors helped me maintain that by telling me I could look forward to being cured. People with some other forms of cancer, if theyre lucky, go into remission, which merely maintains the status quo. The cancer could come back at any time. When I heard the word cured I thought it would mean Id go back to being like Id always been. Before the cancer I could say I never get sick. It was a time when I wouldnt know my general doctor if you put him in a lineup of people who looked nothing like him. When I decided to see him about the pain in my leg that had been keeping me up at nights for a couple of months I hadnt had a checkup in three years. Id volunteer for medical experiments and the people doing the tests loved me because I was a medical blank slate: no allergies, no major medical issues, and not even any minor ones. I still have my tonsils, my appendix, and Ive never had a broken bone. If Id known then what I know now when the doctors told me Id be cured I would have asked, Like a ham? And maybe theyd say yes, because it is sort of like that. Everything has changed. Im still an optimistic guy, but Im changed. Theres a cloud that Im aware of every minute of every day. I will wear a medical bracelet listing my allergies and other issues for the rest of my life. I will have regular screenings for the rest of my life. I cant take it for granted that the headache, the stomachache, or the persistent leg pain will just go away anymore. Its a lesson Im still processing. Ive read about people in near fatal car crashes, or who just barely escaped disasters or other life-threatening events. They walked away feeling like the bravest person in the world, but a few days, or a few weeks later theyd have a complete meltdown. We dont always respond immediately to trauma. In my case I was, metaphorically, in a car wreck that went on for six months. I was able to walk away from it because I had help, especially from my wife, who, metaphorically, was out there directing traffic, but as the only one in the car I need to, metaphorically, drive more carefully from now on. Hindsight is 20/20, but its only useful if we apply whatever it was an experience taught us, and I need to be more conscious because the phrase the rest of my life has taken on greater significance.
The narrator of The Stranger by Albert Camus says, Either way youre going to get it. Hes talking about two possible paths through a town, each of which has its problems, but also metaphorically about life and death. Whatever path you take the destination is the same. When I was young I thought that very profound. Id never really confronted death, so I thought it was all that needed to be said about death, and life. Because death was distant and abstract it could be romantic. Dylan Thomas, Edgar Allan Poe, and Emily Dickinson were all special, I used to think, because they died young. I even thought of them as almost lucky. It was an attitude I eventually outgrew, long before Id outlived all of them. I realized that even if their reputations had fallen if they had lived longer that didnt make death a better alternative. Theres no shame in old age. This was a conclusion I came to even while death was still an abstraction, something Id experience through the loss of some friends and family, but that I didnt think Id have to face, or even think about, one-on-one until I was closer to the end of my allotted three score and ten. Theres physical death, which, with some exceptions, we experience only once, but theres another kind of death, the kind that comes when an experience transforms us. Its a kind of death we all experience as we age. Im not the same person I was ten years ago, although I cant put my finger on what exactly changed. Sometimes, though, its less subtle. Im not the same person I was a year ago, and I know exactly why. Im a long-time Doctor Who fan, and one of the things thats always appealed to me is the Time Lords ability to regenerate. On the point of death he survives by becoming a completely different person. I always liked that, but never realized the significance. We come through traumatic events, especially those that make us aware of our own mortality, a different person. Like the Doctor I have all my memories and everything I had before my own regeneration, and like the Doctor Im going through a settling-in period, a period of asking, Who am I? Its necessary to get to know this new me, but its also an opportunity to make changes, which is even more important. A metaphor that non-Whovians might be better able to relate to is the caterpillar that becomes a butterfly. Its a cliché, but only because its so damned accurate. The butterfly is still the caterpillar, but completely transformed. The butterfly can do things it never could before, but its also got new, and bigger, responsibilities. It has wings, which are fragile, and in flight it will be more exposed than it ever was as a caterpillar, but it will also see a bigger world. I have to accept new responsibilities, but Ive also gained a whole new perspective. If I look behind me I may even have wings.
December 5, 2014
“Oh my goodness, this one’s pregnant!”
Ms. Swisher was leaning over my shoulder looking at the starfish I’d carefully dissected. In hindsight she was one of the better science teachers I had, although I didn’t appreciate her at the time. She was a passionate teacher and enthusiastic about science, and biology in particular, which was remarkable for someone who’d been facing rooms full of surly teenagers for decades. We were given a choice of animals to dissect in ninth grade biology, and I’d chosen the starfish because starfish are cool. Also in my career as an amateur scientist I’d dissected frogs, crickets, crawfish, clams. One thing remained consistent across the phyla: their insides didn’t look anything like the textbook illustrations. Even the ones that hadn’t been embalmed had wads of gray or yellow indistinguishable stuff where certain organ systems should be. It’s why I never became a doctor. Well, it’s one of the reasons. Another reason is that I never wanted to be a doctor, and that’s one of those professions that you should only go into if you’re really passionate about it. I’d hate to be in the middle of an operation thinking, “Man, I’d rather be selling urinal cakes to coffee shops right now,” and oblivious to my patient flatlining, but that’s another story. So it didn’t surprise me that while the textbook illustration of the starfish had everything clearly marked and different organs in different shades of blue, red, and green its real insides looked like three different brands of Dijon mustard. The distinctions were clear enough that I could at least make a good guess at what was what, but it was Ms. Swisher’s years of experience that allowed her to know at a glance that the starfish’s gonads, which, like its digestive, nervous, and other systems, were spread throughout its entire body, were swollen.
There was a model of the human body at the front of her classroom, one of those with lopped off arms and legs, as though someone had tried to turn a corpse into a broken Greek statue, and the skin of the trunk cut away to reveal everything from the lungs to the liver. All my years of experience with dissection had taught me was that if I were cut open my viscera wouldn’t be that neatly color-coded, separable, easily removable, and made of plastic. We couldn’t have played football with a real liver. Well, now that I think about it, I guess we could, but there’d be a lot more fumbling.
When I started my journey with cancer I was told there was a fifty-fifty chance the chemotherapy would take care of everything, that there would be no need for further treatment. The coin was tossed and came up tails. Now theres one more bridge to cross. I hope its the last one. The surgery is called a retroperitoneal lymph node dissection. In laymans terms the surgeon’s going to cut me open right down the middle, shove most of my organs out of the way, and yank out my lymph nodes from my nut to my navel. When I was young I had nightmares about the thing that lived in the attic threatening to stab me in the stomach. Now it feels like that nightmare is coming true, although I’ll be asleep for the three to five hours the surgery takes. And I’ve met my surgeon, and I’m about as reassured as I can be. He’s a good guy, very smart, and passionate about what he does. He’s also done this operation several times, so he’s got plenty of experience. It’s good to know I’ll be in the hands of someone who knows that when he opens me up it won’t look anything like the textbook illustration.
November 7, 2014
One Monday morning on my way to work I started chatting with a woman in the elevator. I wish it were Friday, I said. You’re wishing your life away! she snarkily replied. That set me back a bit. Was I missing out on something, wasting my life, by looking forward to the future? The key to happiness, I’ve often heard, is living in the moment, enjoying life as it comes. It’s a philosophy that appeals to me because I like spontaneity. I’ve been known to take wrong turns just to see where they go, and to wander into places still under construction just out of curiosity, and these are decisions I’ve made with no advance planning. Most days at work I take a walk during my lunch break, and most of the time I don’t decide which way I’m going until I’ve left the building. Sometimes when I come to a fork in the road I flip a coin. And I love surprises. My wife knows that one way to make me happy is to say we’re going to a movie and not tell me which one. It’s even better when it’s one I know nothing about even when we get to the theater. So I’m very much a fan of living in the moment, but that doesn’t mean I never plan. It’s also nice to have things to look forward to. The present and future aren’t mutually exclusive; after all the future so quickly becomes the present. The more I thought about it the more I realized that woman was wrong. Looking forward to the future doesn’t preclude, or even diminish, whatever happiness we can find in the present. Multiple studies of work habits say that multi-tasking lowers productivity, that its a bad thing, but multi-tasking happiness–enjoying the present and looking forward to the future–isn’t just good. It’s essential. If it were possible to live exclusively in the moment we’d never have the satisfaction of achieving long-term goals, and if we’re always looking to the future we don’t stop and enjoy happiness when it comes along.
I thought about all this when I was first diagnosed with cancer. As I said I’m generally a spontaneous kind of guy, but part of my strategy for dealing with what was suddenly a strange and uncertain future was to promise myself things that I could look forward to. Some were small things, like a special (and expensive) microbrewed beer thats been sitting in the pantry since my first week of chemo. When I get the all-clear from the doctor, I said, drinking this will be part of my victory lap. And some are big things, like a trip to a part of east Tennessee, to Ozone Falls–a place thats special to me. I was very lucky in that I had very few side effects from chemo–fatigue, hair loss, and three five minute bouts of nausea were as bad as it got. There was no way to know it would be like that going in, though, and having things to look forward to helped me remain optimistic, even happy while toxins were being pumped into my veins on a daily basis.
My one mistake was being a little too optimistic. I was unrealistic. Six weeks after finishing chemotherapy I was supposed to have a few tests done and then meet with my oncologist. And I expected her to look at the results and say, “You’re completely healthy. Get out of her and never darken my door again!” Admittedly I knew there’d be regular checkups, which is fine because my oncologist has been fantastic, and going back once in a while wouldn’t be a bad thing. The problem–and if I hadn’t been so blindly optimistic I would have been more aware of the facts–is that theres been a slight bump in the road to recovery. I was hoping the orchiectomy and the chemo would be the end, but I have one enlarged lymph node. It could be dead tissue, it could be a teratoma, or it could be the embryo of the Loch Ness monster. We wont know until I have surgery to take it out, and to be on the safe side the doctors are taking out the neighboring lymph nodes as well. Such is the joy of having a cancer thats metastatic, a term which comes from the Greek words meta, meaning after and static, meaning shock your friend after rubbing your feet on the carpet. So I’ve got one more step to go, and hopefully I can get it done soon. I dont want to be split open and have my guts pulled apart, but its not a step I want to skip either, because it could mean complications in the future. And it’s a reminder that even a surprise that I didn’t want and plans for something that scares me can still make me happy. Surgery isn’t fun, but I can look forward to the future that comes after.
September 26, 2014
Things you don’t want to hear from a doctor, nurse, or other health care professional:
Less is more.
I’m going to be flying before I even get out of here.
I am so non-compliant.
I’m sure it’s just allergies.
Worst case scenario : you die.
I’m not a doctor but I play one on TV. I’m just kidding. I don’t play one on TV.
It’ll get better before gets worse.
Which one are you?
What are you here for again?
You haven’t seen a kidney, have you?
I should’ve had something different for lunch.
Oh, I’ve seen a lot of this. But only in books.
Where’s my pen? I can’t write with a rectal thermometer!
I wish I could say this was an educated guess.
That’s probably an allergy I’ve never seen.
My malpractice insurance just went up…again!
Hello. I’m Dr. Giggles.
August 29, 2014
I notice the looks, the glances, the double-takes. And they don’t surprise me. Even though approximately half of all men and a third of all women will have cancer it’s not that often that you see someone out and about who obviously has it. And not everyone who gets chemo goes bald, and not all those who do cover it up by wearing doo-rags. That’s been my response to losing my hair – I have several great ones made by my mother-in-law. They’re just the thing for keeping my head warm when its cool and preventing a burn where the sun used to not shine. I just wish there was a term for them other than doo-rag, which sounds more like a term for a diaper, but thats another story.
I don’t mind people looking. It’s understandable that people should be curious, although they usually turn away as soon as I turn in their direction, which makes me think theyre uncomfortable rather than admiring of my head couture. Sometimes I think I should wear a t-shirt or maybe even a button that says, ”Its cool. It’s just cancer”. And there have been exceptions. One night when I was at a baseball game there was a guy a few seats in front of me wearing a doo-rag. The hair protruding from his made it clear that he was wearing it as a fashion statement rather than a matter of comfort. Not that there’s anything wrong with that. If it looks good wear it has always been my philosophy, although that may come as a surprise to fashion mavens who’ve seen me out and about. As the guy at the baseball game walked by me on his way to get some nachos our eyes met. We smiled and nodded at each other. I was looking at his head and thinking, Cool flames. I think he was thinking, Cool spider web.
Then there was the time at the grocery store. The man in the checkout line ahead of me said, ”Excuse me, um, chemo?” I smiled and said yes. He took off his olive-green Marines cap, revealing a head of close-cropped silver hair. “Don’t worry. It’ll grow back.” If my white cell count hadn’t been so low I would have loved to shake his hand, but maybe at least I can learn from his example and offer the same comfort to others in the future. In the meantime I’ll take the peeps, peeks, peers, ganders, glimpses, gawks, and even the occasional rubbernecking. Heck, I don’t even mind the guy at the library desk who gives me the stinkeye every time I come in. He’s an older guy, bald, except for a fringe around the sides, and I finally realized that might be his problem. He’s looking at me and thinking, Hey buddy, for me its a lifetime commitment. If I can leave my cranium uncovered you can too. Dare to bare. If the dome is chrome go glabrous or go home. Let the knob do its job and the belfry blaze. And maybe I should take him up on that. Maybe I should strip the egg of its eclipse and enter the bibliotheque in the buff. I’ll turn to him. Our eyes will meet. I’ll be thinking, Cool crown. He’ll be thinking, I have more hair than you.
August 1, 2014
It started on a Sunday. I’d lathered, rinsed, and was about to repeat when I noticed about two dozen strands of hair in my hand. Well, I thought, this is it. This is the beginning of the hair loss I’ve been expecting. In fact I’d been hoping for it. So far I’ve been lucky. I haven’t had most of the side-effects associated with chemo. I haven’t had loss of appetite, mouth sores, diarrhea, constipation, spontaneous decapitation, or confusion. Although if I had confusion I dont know how I’d know. Although if I had confusion I dont know how I’d know. I did have a single bout of nausea, at around one a.m. the Friday of my first full week of chemo. Normally I dont believe in signs and omens, but the Thursday afternoon before I’d been in an office supply store where I wrote FUCK CANCER on a pad with a display pen. In my weirdly neurotic way I connected these two events. I took it to mean that I shouldn’t wallow in negativity. I’m fighting the cancer, but I also have to accept that its part of me. It’s the result of a biological miscommunication in my cells, and not the spawn of something external that can simply be expelled.
I thought the hair loss I’d experienced Sunday would be typical–that it would be a slow, gradual process that would take a while to be visible, and would, in three weeks or a month, leave me looking like a scrofulous Victorian street urchin. On Monday I was surprised to find whole handfuls of hair coming out. Each day that followed was an adventure. I began to look forward to taking a shower more than I ever had before. How much can I clog up the drain today? And I was shedding. I had to wear bandanas to bed to keep from leaving hairs all over my pillow and the rest of the bed. I had enough trouble with leaving hair everywhere else. I haven’t quite mastered the art of tying a bandana so it fits snugly to my head yet, though. If I tie it myself I look like Vermeer’s Girl With The Pearl Earring, minus the earring. It’s surprising that I have so much trouble tying a bandana. I was pretty good at knots as a Boy Scout, and give me a bottle of good Scotch and I have no problem tying one on.
The reason I looked forward to the hair loss is it’s the most obvious sign of cancer. I realize its not really the result of the cancer itself–if I’d never started treatment I’d still have a full, lush head of thin hair–but rather the chemo’s effect on fast-growing cells. And chemo is very nonjudgmental in what it attacks. Hair follicles are just one type of cell that may or may not be collateral damage. I’d heard stories of people who didn’t lose their hair, and my wife told me about one man who lost hair only from his neck down. I was hoping for baldness because, well, in my weirdly neurotic way I worried, unnecessarily, if others with worse forms of cancer looked down on me. I’m not complaining about the lack of side effects, and I’m happy about my incredibly positive prognosis. Before I was diagnosed I’d never heard anyone talk about being cured of cancer, but “cured” is exactly the word several of my doctors have used to describe the probable outcome of my treatment. But it all led me to wonder if there are other cancer sufferers who look down on me and my upbeat outlook. So far I haven’t encountered any kind of one-upmanship–nobody’s ever said “My cancer’s better than yours because it’s worse” or anything even close to that. All I’ve gotten from anyone–particularly others with cancer, regardless of the type–is sympathy and support. Still it seems like every group of people, no matter what brings them together, has a few jerks. Maybe they keep to themselves. Somewhere out there might be a support group of grizzled guys who gather around a campfire and mutter. “Doc says I got six months to live.” “Shut up, Bill. You know my doc said I got three days to live, and that was two and a half days ago.” Yeah. I kind of wanna hang with those guys.
As abruptly as it started the hair loss slowed to a crawl. It happened the following Sunday. Saturday hair was coming out in fistfuls. I could see my scalp, and was surprised to find that it had never gotten tanned, so there’s a pale patch above where my hairline used to be extending all the way back to my neck. On Sunday morning, though, I only lost a dozen hairs or so. This was in part because I didn’t have that much hair to lose, but I’ve still got some left. I’d been saying I looked like Gollum, but the truth is that I’ve got lingering sideburns, so I feel more like Gerald Ford with mange. It’s a little depressing looking at the last hairs clinging to my head. Sometimes in the shower I can hear them. “Auntie Em, Auntie Em, theres no place like home!” I want to encourage them to join the others, pulled from the drain trap and tossed to the trash. Some people, when chemo starts to take their hair, will shave their heads as a way of exercising control. My way of taking control is to let nature, or at least medicine, take its natural course. I want to watch it happen, to document it. And I am still losing hair. There’s just not that much more left. I’ve been assured that the rest of my hair will go, and probably soon as I start another cycle of chemotherapy. Although if I had confusion I don’t know how I’d know.
July 18, 2014
High blood pressure. Insomnia. Stomach cramps. These are not side effects of chemotherapy. These are side effects of anticipating chemotherapy. As the date of my first treatment got closer the symptoms got worse. It was only after I stepped back and thought about it that the reason became clear. I was terrified of chemotherapy. I was terrified because I had no idea what to expect. Everything Id ever heard or read was either vague (I had chemotherapy) or technical (the protocol consists of three primary…) with no real practical descriptions. Would it hurt? How long would it take? What was involved? Would I have to do any heavy lifting or math? For some reason these were questions that I never thought to ask, at least partly because the name chemotherapy is so intimidating. Even shortening it to chemo doesnt help, because only people with cancer get chemo, so theres guilt by association. This is misleading. Technically taking an aspirin to get rid of a headache is chemotherapy. Why give the treatment an intimidating name? Cancer is bad enough without making the remedy sound as intimidating as the disease.
The marketing is something we can address later. For now I feel it falls to me to reveal the dirty secret of chemotherapy: its boring. I’m not talking about the side effects, which can range from annoying to horrendous. I’m talking about the actual process itself. You sit in a chair and let toxins drip into your veins for several hours. Aside from the needle sticks and remembering to unplug your IV unit so you can go to the bathroom because the power cord wont reach that far, and remembering to plug it back in when you get back to your room even though it supposedly has a battery life of several hours, but who wants to take chances, it’s sitting around with your feet up. Fortunately for me my first round of chemo did offer plenty to break up the monotony. Gilda Radner, who passed away from ovarian cancer, famously said, It’s always something. She could just as easily have been talking about my first five days in the chemo ward.
Day 1 – Blood draw. They have to determine how to mix my chemo cocktail. I tell them shaken, not stirred, on the rocks, and with a twist. Instead a nurse sticks a needle in my arm with an open tube at the end for easy access later on. This is taped down and I’m sent upstairs to the infusion center. In the center Im given a small room where I can put my feet up. A nurse brings me apple juice and a granola bar. They flush my IV with cold saline, which feels strangely pleasant, almost like peppermint being injected directly into my skin. At this point Im in full panic because I imagine things can only get worse. In fact what happens is the nurses come back with big bags of fluid which they hang from my IV stand. And that’s it. Several hours later, bags emptied, Im free to go. The worst thing that will happen to me today is they leave the needle in my arm for easy access tomorrow. And even that’s not so bad until I go to take a shower and my wife has to wrap my arm in plastic.
Day 2 – The nurses tell me theyre adding an anti-nausea drug to my cocktail. I ask them to put salt around the rim. Maybe this was a mistake. After a few minutes I feel an intense burning in my arm. The nurse explains that this is happening because they’re using the same IV from yesterday. She has to remove it and re-stick me further up. This isn’t a problem, except that I now have trouble bending my arm, which makes it difficult to do things like unzip my pants. And since my cocktail is all liquid and includes a liter of saline, not to mention the apple juice, that’s kind of important.
This is also the day I have surgery to get a chest port: a plastic tube that will allow direct and easy access to my jugular vein, and prevent the nurses from having to stick my arm every day so I won’t end up looking like a heroin addict. The doctors tell me they’re just going to use a local anesthetic, which makes me worry Ill be vaguely conscious of people in masks stabbing my chest with scalpels. Instead the local anesthetic knocks me out completely, and I amuse the surgical staff by reciting Comfortably Numb lyrics when I regain consciousness. My terror leading up to the procedure becomes increasingly anti-climactic as I wait two hours in recovery listening to a man in the bed next to me demand beer and belch fifty-two times in a row.
Day 3 – Everything goes smoothly. The nurse uses my new chest port, first flushing it with saline, so I get peppermint in my chest instead of my arm. For the first time I get a sense of how future chemo treatments will go. The only thing that breaks up the monotony is a volunteer with a guitar and harmonica who comes in to sing me songs from The Sound of Music, Oklahoma! and The Wizard of Oz. He and I worked at the same summer camp twenty years ago. Small world.
In the evening my wife notices my legs are swollen. Maybe this is cause for alarm, but I’m not sure what to be scared of anymore. She calls the doctor, who assures her this isn’t unusual.
Day 4 – My right leg is horrendously swollen and my jeans don’t fit. I wriggle into an older, larger pair, and head off to treatment. The nurses give me diuretic pills, and I entertain them by talking about elephantiasis caused by filarial worms. Then the pills kick in and I run to the bathroom every five minutes, pausing only to be yanked back because I’ve forgotten to unplug my IV unit.
The swelling isn’t unexpected, but the doctor schedules an ultrasound for the afternoon just to be sure it’s just all the fluid they’ve been giving me going straight to my hips, thighs, and calves. I’ve now become so accustomed to getting ultrasounds I fall asleep on the table. The ultrasound technician confirms that, yes, I’m merely filling up with fluid. No one thinks much of my suggestion that an application of leeches might help.
Day 5 – Nothing happens. I’m not even serenaded. The blind panic that preceded chemotherapy is rapidly receding, and I start wondering what the big deal is. I’m done for the week, and I start thinking that it would be really nice to go home and have some chemotherapy in the form of a beer.
July 11, 2014
Here’s how it was supposed to happen:
The doctor would call my wife and I into his office, which I imagined would be a wood-paneled room lined with books. He would rest his elbows on his desk and fold his hands, and, quietly and soberly, say, “Mr. Waldrop, Im afraid you have cancer.”
And I would say, Id like a second opinion.
At this point I expect hed start looking through a list and saying something about referrals, and I’d have to stop him and say, “Doc, you’re supposed to say, ‘And you need a haircut.'” And I would have to explain to him who Henny Youngman is, because they don’t teach the important things in medical school.
Here’s how it did happen:
I’d been in for an appointment about an ongoing pain in my leg. This had lasted a couple of months, and I was tired of it waking me up at night. While he was telling me to turn my head and cough my doctor noticed some other things that concerned him, so he ordered some tests, including an ultrasound and a CT scan. Some other doctors might not have taken the time or been concerned, but he didn’t see any need for delay. My wife and I were on our way home from those tests when the doctor called my wife’s cell phone. In fact we were two blocks away.
“Chris needs to be taken to the emergency room right away. He has a blood clot in his leg. Also he has testicular cancer.”
I know that if he could have had the sober wood-paneled office meeting he would have, but while cancer is slow blood clots have a tendency to cause sudden death. And my diagnosis would play a part in my treatment over the longest three days of my life.
So we turned around and went to the emergency room, where we managed to find a couple of chairs together in a corner. This was a Tuesday, and I would later be told that emergency rooms are busiest early in the week, maybe because it takes sick people a while to recover from their hangovers. After about twenty minutes I was called back by a nurse. We sat on opposite sides of a desk and I was subjected to a routine interrogation. It included taking my blood pressure, and being asked the following questions:
”Are you allergic to anything?”
“Are you taking any prescription medications or drugs?”
“Do you have any religious or cultural sensitivities we should be aware of?”
I made the mistake of thinking this was progress. Instead I was sent back to the waiting room where, after five minutes, I was prepared to offer my spot in line, or at least cash, to anyone who could figure out how to change the television to any show not set in a hospital. Ten minutes later I was called back by another nurse. Progress! She took my blood pressure and asked me some strangely familiar questions.
“Are you allergic to anything?”
“Are you taking any prescription medications or drugs?”
“Do you have any religious or cultural sensitivities we should be aware of?”
And it was back to the waiting room where a kid with green-tinted hair and bright green skin sat listening to a pair of bright red headphones. His problem seemed more urgent than mine, but he was still waiting when I was called back again. This time I was led to an oversized closet with a bed. I was given a gown to change into and a pair of socks with sticky pads on the feet. A few minutes later a nurse came in to take my blood pressure and ask a surprising series of questions.
“Are you allergic to anything?”
“Are you taking any prescription medications or drugs?”
“Just baby aspirin and PCP.”
“Do you have any religious or cultural sensitivities we should be aware of?”
“As a Mayan I believe the world ended in 2012.”
I’m pretty sure the word ”smartass” is now a permanent part of my medical records.
My chest and stomach were then covered with stickers attached to wires that went to a machine that measured my breathing, heart rate, eye color, measurements, pet peeves, favorite television station, turn-ons, turn-offs–everything, in fact, except my blood pressure, which a nurse would have to come and check every four hours.
Since I was staying in a teaching hospital I was also visited by groups of approximately twenty-seven people in lab coats, all of whom politely asked if they could examine me, which meant hiking up my gown and acting like it was our third date. I haven’t been naked in the presence of so many people since high school gym class, but I didn’t complain. Unlike dodgeball I knew I had a good chance of beating this cancer, and Dr. Coldfinger and Co. were stepping up to be part of my team. I was going to make their job as easy as possible. Maybe I got a little too comfortable. Every time the door opened I hiked up my gown, only to have one person say, ”Whoops, wrong room!”
Apparently if you’ve seen one you’ve seen ‘em all doesn’t apply for certain regions.
I was also visited by a nice young doctor who asked me if I wanted to be listed as DNR–Do Not Resuscitate. The question set me back a bit. I was certain of my answer. If it was an option I wanted to be Do Resuscitate, Please! It was just the reality settling in. I hadn’t been in a hospital as a patient in thirty-nine years, when I was treated for a condition that, ironically, was a risk factor for the cancer I now had. I’d known I was going to end up in the hospital again eventually. I just didn’t expect to be facing questions of life and death quite so soon, or so suddenly.
That evening I was taken for a spin around the hospital by a nice orderly named Leonard. He was taking me for another ultrasound at eleven thirty at night, and I’m pretty sure he was taking me around the entire hospital just for fun.
In a strange and half-lit room I was gooped up and given another ultrasound in search of the deadly blood clot, which declined to make an appearance, then sent back to the closet for a shot of blood thinner, which the nurse assured me would be just like a mosquito bite. She meant one of those prehistoric mosquitoes, with a schnozz like an elephant. And then I managed to sleep, waking only to hike up my gown whenever the door opened, even though the nurses kept telling me they’d use my arm to take my blood pressure.
Later that evening I’d get up out of my hospital bed and go to the bathroom next door. For some reason the emergency room bathroom didn’t have a lock, so as I was sitting there trying to relieve myself the door opened. “Occupied!” I yelled. The doctor who’d opened the door was talking to someone–obviously his need wasn’t that urgent–so he didn’t hear me. He just stood there, one hand on the doorknob, with me exposed to the world. This would be the only time I’d have my gown hiked up that I felt genuinely embarrassed. Finally he turned around, said, “Oh!” and closed the door. I’ll never know who you were, doc, but thanks for the look-in.
In the morning I woke with heartburn, probably because I hadn’t eaten anything in nearly eighteen hours. I thought this meant I needed an antacid and maybe some breakfast. The staff thought it meant I needed an EKG, which meant adhering more wires to my chest. Two weeks later I’d still be washing off sticker residue.
“We dont want to alarm you, said the nurse, ”but you could be having a heart attack.”
The only thing I found alarming was that the way she put it could give me a heart attack. Fortunately it turned out that what I needed was an antacid and some breakfast. This was followed by another shot of blood thinner from a slightly smaller mosquito, and then I was told I was being scheduled for surgery. The original plan had been to perform a biopsy, but the doctors decided that since the source of the trouble was in an easily accessible spot between my legs they’d cut out the middleman–or rather the manufacturer.
Surgery meant being moved upstairs to a luxury suite the size of a double-wide trailer, complete with a private bathroom, shower, sitting area, refrigerator, and, right across the hall, a pantry stuffed with all kinds of snacks and drinks, from chocolate milk and sodas to yogurt, cheese, and crackers. And a nurse who was professional, courteous, efficient, and who, when she was done with all her tasks, sprawled at the end of my bed and told us how much she was looking forward to going home and having a beer with her country singer boyfriend. I would have loved a beer myself, but, almost as good was having someone come in and talk to me as a person rather than a patient.
Then she left. My wife left too. My wife had been the best source of comfort and stability I could have hoped for, and more. She had gone above and beyond necessity to take care of me, but I now I needed her to take care of herself. I needed her to take care of the dogs. And I needed to crank up Take The Skinheads Bowling by Camper Van Beethoven and dance around the room, which I can’t do in the presence of other people.
A week after my orchiectomy I would learn I had an embryonal some-kind-of-noma, with an excellent chance of being completely cured. And half of it was a yolk sac, which made it sound even more like an alien parasite. It was fitting. Whenever the subject of astrology came up a college friend of mine liked to say, ”I’m a Cancer, sign of the crab. I’m two diseases nobody wants.” This made me wonder what cancer had to do with crabs, so I looked it up. Ancient doctors found that tumors, when cut, spread sideways, like a crab. Cancer is of the body, but behaves like an invader.
The prognosis was in the future, though. Alone the night before my surgery I wandered down the hall to a spot the nurse had shown me earlier. My room had everything except a window to the outside. It had been twenty-four hours since Id seen the sky. I’d been wired up but disconnected from the world. At the end of the hall was a window that looks over a section of Twenty-First Avenue I knew well. I could see the bar where I knew someone was playing pool. I could see the coffee shop where I knew someone was eating red velvet cake and laughing with friends. I could just make out the indie theater where I knew someone had escaped into the silvery darkness of a movie. The avenue itself was an artery pulsing with red and white lights, people illuminating the future. I had been all of them. I was all of them. I don’t want to be the heroic survivor who inspires others. I simply want to live.
The darkness deepened over the world below, but the lights brightened. I wondered if, in the months to come, I would still be as brave as I felt, if I would keep my sense of humor. I knew things would get worse before they’d get better, but I knew they would get better. The first most crucial step was taken because my doctor had been on the ball.