Posts Tagged ‘cancer’

5 August, 2009

The End

butterfly2The words, “The End” apparently only exist for the purposes of lulling very small and, presumably, unimaginative children, into believing that stories should only be entertained so long as an author has control over the words. There is no other place that I have found which can lay claim to those words.

We may die, but, as pointed out so eloquently by James Ellroy in an article that appears in this week’s issue of Newsweek about the death of a girl, Lily Burk, he barely knew, we live in our words, our work, and the thoughts and memories and commitments and photographs and circumstances of the people who have known us. There is, in death, often more life than the dead could have dreamed possible.

We may come to the end of a story and know, as writers, that the unknown sometimes leads us to pause at that particular moment, allowing the characters to carry on and leave us voyeurs behind. Readers reach the last page and look away, taking fragments and associations with them, using them as advice or warning, handing bits and pieces away in reference, praise or blame.

I have been preoccupied with endings afresh, or the lack of them, as I came to the end of my treatment. I realized that this new “free” time was defined, for me, not by the ceasing of treatments, but rather the loss of a series of rituals I had come to enjoy:

My morning bike rides where I have to decide whether to take the low or the high road, the way I braced for – and twice misjudged – the approaching pavement, the preparation for the last stretches of uphill paved roads in both directions as well a the anticipation of the downhill runs, the way I had to think up some new way to announce my arrival to people who shared the sidewalk with me (to whistle? to talk over their iPods? to yell? to creep along near their ankles? to hope for psychic awareness on their part?), the exhilaration of making it each day and the inward thank god when I come across the bar blocking the escape of cars in the parking garage which was perpetually untended in those early morning hours.

img_9657The way I glanced at the clock by the empty reception desk to see how I had done in terms of speed and the daily contemplation and religious avoidance of the stack of new cookies in the waiting room (yes, they are out by 6.15 am!) and the way I experienced network news on TV, something I have never done at home.

Most of all, my curiosity about the nurse who looked after me as well as tended to the application of treatments. She works two jobs, coming in to this one early, by 6 am, and leaving by 3 to sometimes do a shift at the second. She has a home she just bought, a family of parents and siblings that gather together on occasion, a father to help her with installing a window in her garage, a dog who can no longer see her working in the garden over the raised fence she had installed, a couple of weeks back, to keep him in. She has flown in a plane just once, to go to a beach with friends after school. She doesn’t quite like NYC, but she likes the Jersey Shore. She is good at what she does, but she is terrified of my physician, Dr. Weiss, and of not having me set up to her perfect specifications before she comes in to check on me. She clips up her blond hair in a sort of casual up-do, and walks with a slight side to side step, like a skater might do out of habit, which makes her seem tentative and child-like. She bought a bike for $20 at a garage sale and they told her she only had to get the tires some air, but she hasn’t done it yet though she hopes to. She “has someone” but she never said more than that.

I wonder what her relationships are like, what she does when she goes home, whether she feels the same antipathy I did toward the resident who came in to help during the last ten days of my treatment. She seemed genuinely sorry to see me go when she said she would miss seeing me early morning. She always had a question for me, and she never sounded like it was just standard OP. She moved my hair away like it belonged to a person she knew, she averted her eyes when I drew back the covers, she smiled and in ways I cannot quite describe, made it something we were experiencing together. I miss her.

Which is how and why, I suppose, the end is not quite here. A specific time period during which I had to undergo a certain form of death, of a part of me if not my whole, came and went. And yet I remain, she remains, and we go on in each others’ lives. That period came and went and because of it I am a little less quick to own the road as it were. A little quicker to remember what blessings still exist. And even more than before, interested in ordinary stories, the ones that tell of people going about ordinary days, where nationality and culture and personal history simply illuminate interactions and imbue them with a truth that points to the ultimate insignificance of those broad-brushed colors in the scheme of human life and death whose own hues are both feather light and brilliant.

15 June, 2009

Beginning Treatment

flowerI went for my first appointment today. I saw Dr. Weiss, who explained things in terms of crime-scenes and neighborhoods and light-houses emitting stay-away signals. My favorite was her description of my “unforgiving, grudge-holding nerves,” determined to exact revenge. The way I deal with them is up to me, she told me, whether I choose to ignore it, minimize it, dwell on it. Which is not that different from the way we deal with any other sort of trauma or pain. These were the words that came to mind as they prepared me for the coming weeks.

The Planning Stage

A red line
gives me two halves I can see
reflected in the overhead.
A machine that knows me in indecipherable code
accepts me into its heart.
I fling up my arms and become motionless.

The mirror is just a mirror in which I am
my body.

The therapist is a man who says he loves this job.
This job of measurement and accuracy and tattooing landing strips into
naked, named skin.
I wince and try to think of it in terms of laugh lines.

Is it boring? I ask.
Am I still a woman? I don’t ask.
He lays a warm sheet over me, reveals, shrouds, reveals,
I feel his breath on my body.
I read his name-tag in the silence.

They validate my parking ticket;
this is the perq for having to walk through
uncertain doors.

Outside there is no rain.

8 June, 2009

The language of cancer

srilanka08-1151I had wanted to write this blog post a while back. But it seems that every new day during the past several weeks has brought with it yet another layer of meaning that, in its development, mirrors the layers of skin, tissue, musculature, nerves, blood vessels and so forth that are beyond my physical reach.

I’ve always subscribed to the “there’s a reason for everything” POV. Perhaps it is the Buddhist philosophy that has guided my life, or the culture of “what is to be done, this is how it is” that underlines life in Sri Lanka. A few months ago, I was cursing because a sprained ligament put an end to my dance classes, but it was that same toe that forced me to consult with a neighbor and find a doctor to call my own in a new town, a year after I’d moved here. And it was that doctor who brushed aside the usual excuses to insist that I get a mammogram.

The world reflects, in its quirky way, the things that are tipsy within us. I had to go back three times before I could get that mammogram. The first time I was a week early. The second time I did not have my paperwork. The third time I was lucky and I had a new friend behind the radiology desk at Lankenau Hospital. I had only had one mammogram before that one, and that several years ago, but some instinct must have told me all was not well; leaving those offices, I found myself rooted to the floor in front of the hospital cafe, gazing at sweet pastries and falling apart because I couldn’t think of a single friend near enough and unemployed enough to be available to have tea and cakes with me! And I think it was on my way back home that I met with the inconsequential accident that I talked about here, in a blog post titled Character.

Through the next week, when mammograms were compared and “the sort of pattern we don’t like” was discovered in dots and dashes that appeared like Morse Code on black film lit up from behind, and a biopsy ordered, I strode through my days full of the kind of humor that I always use to keep unpleasantness at bay, “If God was going to give me breast cancer,” I said, “couldn’t I have been given the mother of all breasts first?!” combined with upbeat equanimity, “well, I figure it’s either nothing or it is very early stage and something can be done about it.” It is also a way of postponing having to face up to difficulties, so much so that it wasn’t until I was standing in a shapeless double-gown (for modesty, apparently), and a radiologist with the unlikely name of Dr. Love, was explaining the procedure to come (stereotactic core-needle biopsy), that I felt like I was going to pass out. The guidelines say that “no significant pain” should be felt. But what exactly does that mean? I have always postponed the big howls because I imagine that the “big” pain is still to come, and I might as well not engage in premature melt downs; usually this means that I never get to have the big reaction because by the time I am well and truly ready to scream, it is all over.

Visiting with my surgeon soon after, I found myself alone in a room with a stack of glossy magazines which contained information about resources for people with cancer and their families. I picked it up and put it down. Nobody had told me I had cancer, and I was not about to acquire its accoutrements until someone did. Yes, said a friend, later that day, you don’t want to own it. But perhaps it was not bravado but hubris, the kind from which most mortals suffer, living with a subconscious belief in our immortality rather than accepting our daily march toward ceasing to exist in this particular life.

I was on my way out the door to make it to an NPR event with Marty Moss-Coane (Radio Times), when my cell phone rang in my hand. It was the good news, bad news call that I both had and hadn’t expected. It was cancer, or DCIS, which is like cancer’s calling card. Or is considered as such until surgery confirms or disproves that prognosis. I got off the phone and kept on going out that door, into the car and down the road to Bryn Mawr College where I was going to meet the host of a radio show I really liked.

I had determined then and there that I was not going to become Ru The Cancer Patient. If appointments there were, those appointments would be kept. The book tour would go on. I would fly to Chicago as planned. I can and would “work around” this hurdle. But determining such things is a lot easier than living them. Although I wrote brave emails to my agent, editors and publicists, not to mention my brothers, I could not escape the fragility that imbued everything and everybody around me. And late at night it was impossible not to be furious that nothing in my life has ever come easy.

Worse, still, was the fact that I appeared to be an individual with a personality and a way of looking at the world that was only apparent to me. I kept visiting hospitals where the vulnerable corporeal me would sit feigning strength and concentration, listening to my body being described in unfamiliar terms. But Ru the writer could not help but pay greater attention to the particularly hilarious language that was being used to do so.

She is a well-developed, well-nourished woman in no apparent distress…

I am not sure why it wasn’t apparent that I was in deep distress, or that frankly, my nourishment leaves much to be desired on most days. And I would not consider myself well-developed – witness the lack of the mother of all breasts!

She presents today with a recent abnormal mammogram. She denies any palpable masses…

But I have not spoken. And I am not living in the third person. I have a name. I am not a condition, or a case.

The DCIS appears to be contained, and has not left the ducts.

I picture dapper malignant cells, with black top hats and canes, sitting on wrought iron benches, tickets tucked into lapels, waiting for the next train to take them out of those ducts and into the rest of my body. I think of titles for short stories. I realize that all of this can be safely filed under Coping. But it is also my life as a writer that allows me to put the same safe distance between my spirit and my physicians as they have created between themselves and my body, all of us using language as our first tool of choice.

The surgery I don’t recall. I do recall the misery of yet another hapless pre-op nurse attempting to pierce my too-thin veins with their low-pressured blood. I have given up apologizing for the way my body carries me through the world with its barely-there affect holding up a high tempered heart. I recall the various barbarisms that are required before being wheeled in, still trying to be humorous, to an operating room where I fixate on the eyes I can see, kind, brown, calm, the voices that, thoughtfully, call me by my name.

I like my surgeon. She is warm, accessible, beautifully pregnant, and appropriately alive. She is not overly calm, nor unnaturally optimistic. She can say the words “survival rate” without making me panic. She can’t however offer me any reassurances that aren’t based on statistics and I am not a person who does well with needles or numbers. 80% of people who go through the stereotactic biopsy come through with a clean bill of health. I, unfortunately, belonged to the 20% that did not. 70% of those who go through surgery do not require additional surgery. Given the ease with which I crept into that previous minority, it is hard to imagine that I would be that lucky. But while I wait to hear, tomorrow, if all goes well, I continue to look for a narrative that can accompany me on the journey.

It is easy to flail at the blights that come into our lives, to say this or that is unfair, from the beetles that infest our roses to the cancers that invade our insides. I have done both those things. But there’s a part of me that realizes that I have no more right to exist than those cells that found in me, a permissible space. We lay down our roads and then curse the deer. We plant our flowers and then curse the insects. We create a lifestyle, and then curse our diseases. I do not know what particular toxin I poured in, or spiritual lack I became comfortable with might have caused my body to become habitable for a type of cell that nothing in my family or medical history or good-girl living could have predicted. Which is not to say that I believe I deserve to be going through this, but only that there is a reason for everything, whether or not I know what that reason might be.

The Books:

The Books:

On Sal Mal Lane

In the tradition of In the Time of the Butterflies and The Kite Runner, a tender, evocative novel about the years leading up to the Sri Lankan civil war.

A Disobedient Girl

A Disobedient Girl is a compelling map of womanhood, its desires and loyalties, set against the backdrop of beautiful, politically turbulent, Sri Lanka.