Love and Laughter in the Time of Chemotherapy Read online

  One of the science teachers spoke passionately about how, unlike the Jack of Jack and the Beanstock fame (who killed the giant), they wanted to help free our children’s inner giants, unleashing their full potential, letting their true selves burst forth and conquer the world. I just ate that up. One parent I spoke to was dismissive about how the school didn’t provide stats on how many of their students got into Harvard compared to students at other high schools. But I didn’t care. I don’t want statistics. I want coyotes bringing good luck, and children becoming giants.

  Metaphors are transformative, changing something into something else, something better. For me, the best way to understand something is to think of it in terms of something else. But cancer eludes me. It is cells in my body. It is stars in the sky. It’s a crab. It’s a killer. You can have it. You can be it. It has metaphors. It is a metaphor. Homer, you told me cells don’t have motivations, but I give you Exhibit A, the Canadian Oxford Dictionary. How many other diseases have “evil” in their definition?

  cancer n. 1 a any malignant growth or tumour from an abnormal and uncontrolled division of body cells. b a disease characterized by this. 2 an evil influence or corruption spreading uncontrollably. 3 (Cancer) a constellation between Gemini and Leo, traditionally regarded as contained in the figure of a crab.

  4 (Cancer) a the fourth sign of the zodiac. b a person born when the sun is in this sign, usu. between 21 June and 22 July.

  The metaphor for cancer as a war comes in for a lot of flak (but clearly it’s an irresistible one, as I can’t even criticize it without using it). The criticism is mainly that battles have winners and losers, and it’s not fair to say someone lost their battle with cancer, because it implies that they were deficient in some way…that they were to blame. If they had been stronger, tougher, more positive, they would have been a winner and not a loser. Obviously this is not fair. It is not your fault if you die of cancer.

  If you dare put I “battled” cancer in my obituary, one letter-to-the-editor writer expounds, I will come back to haunt you.

  I read attempts to come up with other metaphors. A psychiatrist suggests it is a conversation, an attempt to communicate, to mediate, with cancer cells, to calm them and slow them down. A science writer suggests it is a dance where no one’s winning or losing, we’re in this together. But I’m not fighting, or talking, or dancing (despite my first idea that my chromosomes were changing places like square dance partners). I’m enduring.

  Homer’s description of it as a marathon is the one I find most apt. When he first said it, I didn’t like it because I was feeling upbeat and didn’t want to think about how far I still had to go. But later, he uses it more encouragingly.

  “It’s a marathon, but you’ll get through it,” he says.

  “A marathon in hell,” I grumble. Because normally you’re not forced to run a marathon, you choose to run it. But there is a choice here as well, albeit not a very palatable one. You could not engage, you could sit it out, but then you’d never make it to the finish line. You may not make it if you try either, but you definitely won’t if you don’t try. And unlike a war, you’re not fighting, you’re enduring. You’re putting your head down and concentrating on dragging one foot forward at a time.

  After the stem cell transplant, I figured I was almost at the finish line, but instead of feeling good, I was feeling worse than ever. “The closer you get to the end, the worse you feel,” Homer explained consolingly. “That’s when it’s the hardest, that’s when you want to die.” And it is. Even though you can see the end, instead of inspiring you, it seems to taunt you. Ha ha, still not there, still feel like crap. You could come this far and still not make it. I was filled with optimism at the beginning but it was really ignorance. I was hopeful only because I had no idea how hopeless it would feel.

  The poets were wrong, or at least partly wrong. It is Time you always hear at your back, but Time is not gliding along on a winged chariot, which I picture as all golden and borne along by the wind. Time is clutching a walker, shuffle-scraping behind you along an endless hospital corridor, reminding you that worse than the fear of death is the fear of the stretched-out dying that comes before, the smell of the stacked trays of leftover hospital meals in the hallway, the nausea, the pain, the weariness, the ugliness.

  I go back to the idea of a battle, or more than a battle, an all-out unconventional war, where no option is too extreme.

  ACT ONE

  The curtain rises on a classic Hollywood-esque Situation Room. A dozen people sit around a long table, crowded with computers. Screens line the walls.

  CHIEF OF DEFENSE: Commander, we have a situation.

  SECURITY ANALYST #1: Good thing we’re in the Situation Room then, isn’t it?

  SECURITY ANALYST #2: (Snorts.)

  CHIEF OF DEFENSE (continuing, as if no one has spoken): Terrorist cells have been identified.

  (A murmur passes around the table.)

  COMMANDER: How many?

  CHIEF OF DEFENSE (pauses, and murmuring trails off): Thousands. No, more like millions.

  COMMANDER: Millions? Millions?? How could that many get past us? Why wasn’t I notified earlier?

  CHIEF OF DEFENSE: We just found out. It—

  COMMANDER: Just found out? How could—

  CHIEF OF DEFeNSE: Commander, please, one moment. You’ll see. We just found out because they didn’t get past us. They are us. Troops gone rogue, homegrown terrorism, whatever the hell you want to call it.

  COMMANDER (without hesitating): You know the drill. Fire away.

  (Everyone exits quickly. Cut to the next scene, in the same Situation Room, but it is dark. Only the computer screens glow. The COMMANDER and CHIEF OF DEFENSE are the only ones in the room.)

  COMMANDER: Well?

  CHIEF OF DEFENSE (wearily): Firepower was great. Damage was greater. And…

  COMMANDER: And?

  CHIEF OF DEFENSE: It was not successful.

  COMMANDER: So, our nuclear option is the only one remaining?

  CHIEF OF DEFENSE: Unfortunately, yes. But—

  COMMANDER: But what?

  CHIEF OF DEFENSE: You are sure troops from outside will come in? To rebuild? After? Will they? Otherwise, it’s pointless. Isn’t it?

  COMMANDER (shrugging): It might be pointless if we act. But it’s definitely pointless if we don’t. They’ve confirmed. That’s all I can say. It’s not like we’ll be around to follow up.

  CHIEF OF DEFENSE: Some of our troops could show them.

  COMMANDER: You know none of our troops will sur—

  “I don’t think this ‘cancer cells as terrorists’ thing works,” Simon objects. “Plus, it’s full of clichés.”

  “What do you mean?” I ask. “I thought it was perfect. Cancer cells are powerful, they’re destructive. They’re immune to reason, even to save themselves. Get it? And the clichés are there on purpose, because I’m trying to mimic—”

  “Wait a minute,” Simon protests, “I never criticized it.” He’s objecting to his first objection, which, I have to admit, I did sort of make up.

  “Are you sure?” I ask, not willing to concede that I made it up. “When I told you about it that time we were walking? Didn’t you say it was a stretch?”

  “I did not.” He is adamant.

  “But I can’t just float a whole huge metaphor like that without an accompanying critique!”

  “Well, critique it yourself.” He is refusing to play along, demonstrating what I think is a rather literal adherence to the notion that a memoir is completely true.

  “But the critique would be so much better if it was in the form of a dialogue,” I argue. “I can’t have a conversation with myself.”

  “Most of your conversations are with yourself,” he points out, accurately enough.

  I run the metaphor by Homer since he was a colonel in the Canadian Forc
es Health Services. He is skeptical.

  “No one would ever, ever authorize a nuclear attack on their own troops,” he informs me.

  “Even if it was absolutely the only way to defeat the enemy forces?”

  “No way. They would never purposely bomb everyone and risk destroying the whole country so new troops could come in and rebuild.”

  (“Or at least they would never say that’s what they were doing” is Simon’s contribution, on the record).

  “But that’s what they did to me, isn’t it? With the chemo and radiation and transplant? Wasn’t that the nuclear option? Kill every single one of my white blood cells, good and bad, even though there was a pretty high chance it could kill me? And then send in someone else’s blood cells to rebuild from scratch?”

  Homer pauses, and then admits that this is, indeed, what they did to me.

  My pride in my metaphor is short-lived. I am sobered by the realization that the war against cancer is more vicious than a classic war would be. In this war, there are no Geneva conventions; nuclear strikes against your own citizens are the only options. And, after everything, I don’t even get to claim the victory myself. Because I wasn’t the one fighting the battle. I was only the battleground, the miles of territory won and lost, and won again. But the full debrief, the complete accounting, is still to come at some unknown time in the future. Until then, I will know neither the extent of the victory nor its price.

  Chapter Twenty-Seven

  The phone rings, jolting me out of the fast asleepness of my afternoon nap. The duvet is as heavy and warm over my head as the afternoon is chilly and gray. The phone is on Simon’s side of the bed, because that’s where the jack is, not because Simon ever wants to use it, and the message is already half over before I can even contemplate stretching out to reach it.

  “…Dr. G.’s office, please call back at…” I’ll call back later I think, about to sink back into my nap, and then something niggles at me and I am suddenly wide awake. Why is Dr. G.’s office calling me? It could only be one reason. He had sent me for a mammogram and breast ultrasound this week, part of the ongoing monitoring for secondary cancers because of all the radiation I had. He must have the test results. And it’s a quick leap from that to, if he’s calling, the results must be bad. They never call with good news. In fact, I was expecting to have to call in the next week or so, just to follow up, so sure was I that they would not call me. I grab the phone to call back, get voice mail, and leave a message; but my peaceful afternoon is shot. I call back compulsively every half hour for the rest of the afternoon, but continue to get only voice mail. I don’t leave any more messages.

  “You don’t know that it’s bad news,” says Simon.

  “What else could it be?” I wail. I have breast cancer. Tears spring to my eyes. This is so unfair. Really. I can’t have leukemia and breast cancer. Can I? It’s getting ridiculous. Like Oscar Wilde saying losing one parent is a misfortune, losing both looks like carelessness; getting cancer is a tragedy, to keep getting it is a farce. One of those times where you start losing the sympathy you initially inspired, and start feeling like this is really reflecting badly on you. What lengths am I prepared to go to for attention, to keep the spotlight trained upon me, to keep the casseroles and gifts coming that have dried up of late? At some point it’s no longer going to be sad, but unseemly.

  Simon is sanguine. “You have bigger things to worry about,” he reminds me. This does not help.

  I have an appointment with my family doctor the next day for five vaccinations. When you have a stem cell transplant it’s like you are reborn, so you have to have all the immunizations an infant would get in the first two years of life. I had been dreading it, but it now feels like a fun morning in comparison to what I fear lies ahead. I can’t do more chemo. I won’t, I won’t, I won’t. I ask my doctor if she has the ultrasound results, suddenly thinking maybe, just maybe, the clinic faxed them to her. She checks, but they weren’t sent to her since she wasn’t the doctor who requisitioned the tests.

  I have to wait an endless two weeks to get an appointment to go over the test results. Then hours more to see the specialist, because he’s late arriving at his clinic, due to an emergency at the hospital he attends. When I finally see the test results, I have to read the short paragraph several times before I understand that all it means is I have to repeat the test in six more months. The doctor does a quick manual check. “I think you just have lumpy breasts,” he concludes reassuringly, albeit unflatteringly. Six months it is, and in six months it’s fine.

  I have a similar scare with a pap smear that sends me back to Sunnybrook for further testing that reveals “pre-cancerous” cervical cells. They are scraped out by laser in a very painful procedure, the start of which leaves me so tense and tearful they suggest doing it under general anesthetic. But that scares me more, so I say to go ahead and do it with local freezing. It turns out the set-up was the worst part, and the procedure itself is not that bad. I’m offered the chance to watch it on the screen. I decline. “Breathe deeply, stop twitching your toes,” the doctor says, “because it makes your whole body move and you need to be still for the surgery.” I stop.

  I have to watch the nervous fidgeting. A while ago, a doctor, noticing my jiggling leg, got me a percussive MRI in the middle of the night to make sure I didn’t have a brain tumor. I didn’t. But it was lots of fun waiting to find out if I did.

  Then I have a few instances when I have trouble catching my breath, and Simon marches me to emerg over my protests. I’m told I need another bronchoscopy. I won’t do it. I won’t do it. I have to do it.

  It ends up being okay. I get a drug called “twilight” this time around and don’t feel a thing. “It’s what Michael Jackson used!” the nurse tells me cheerfully, even though that didn’t work out so well for him. It turns out I don’t have a fungal infection.

  “Every time I get a cough now, I worry I’m dying,” I complain to Simon.

  “Get used to it” is all he says. “I’ve been doing that for thirty years.”

  I’m troubled that he still feels that way when his cancer was thirty years ago, but I’m reassured that he is here having this conversation thirty years later.

  “I’m not a hypochondriac,” I tell Kate on the phone, when she calls to check in on how I’m doing. “But now, after every test, I assume I’m going to die.”

  “It’s post-traumatic stress disorder,” she suggests.

  “No, no, that’s for veterans who’ve seen friends blown up beside them.”

  “No,” she keeps going, “you’re in a heightened state of anxiety. Something small happens, like having to repeat a test, and you assume the worst, because that’s what it triggers. Your life was at risk. Like when a firecracker makes a soldier assume it’s a bomb.”

  Battle metaphors, yet again. I need something better.

  I decide to ask my mother if there’s some Hindu myth that could work as a metaphor for cancer. My brother and I used to devour those luridly illustrated Amar Chitra Katha comic books as kids. There were so many heroes and heroines who cheated death, there must be something there.

  She’s not quite sure what I’m looking for.

  “Some story where someone defeats death in some way,” I explain vaguely. I decide I want a positive metaphor this time.

  My brother and I have been rolling our eyes our whole childhood at her dinnertime dissertations about how Hinduism is misunderstood in the West; how people think it’s about these hundreds of strange gods and goddesses, when really the stories represent great philosophical truths, blah blah blah. I can’t believe that now that I actually want to listen to all that, she can’t think of anything. She can’t believe it either. She starts getting stressed, and frowning, as she struggles to come up with something.

  “How about Krishna?” I ask impatiently. “Wasn’t he going to get killed and then he escaped? Or something?”r />
  “Yes!” Her eyes light up and she sits up straighter on the sofa she had slumped into as she was thinking. “Okay, so Kansa—”

  “Who?”

  “Kansa, the bad king, hears a prophecy that his sister’s eighth son will defeat him. So he locks up his sister and sister’s husband. They have no children yet, and he kills each child she has and—”

  “Wait,” I interrupt. “He kills seven babies?”

  “Yes, and Krishna is eighth and he gets out. He gets smuggled out, and—”

  “How is seven dead babies a story about defeating death?”

  “No, no, point is Krishna’s alive. When he’s born, they switch him with a baby, a, a baby just born to some woodcutter and his wife, a baby girl, and they take the baby girl back to the jail. And then she, she ascends to heaven, triumphant, and says Ha! You didn’t succeed, Krishna is still alive.”

  “Ascends to heaven? How is that triumphant? Doesn’t that mean she died?”

  “Umm yes, but see, Krishna won, that’s the victory!” My mother pumps both fists in the air, presumably to illustrate what a great victory it was, but her arms drop down to her sides again when she sees my skeptical face.

  “When we heard the story,” she says, “we just thought, Yay! Krishna won. That’s the point of it, that he tricked Kansa. But if I look at it your way, I see uh…” Her voice trails off.

  “We were just really happy Krishna won,” she repeats more strongly.

  I am not convinced. That’s not the kind of defeating death story I had in mind. Plus, Simon’s busy poking more holes in it. “Why would Kansa lock his sister and her husband up together?” he asks me. I try again.

  “Isn’t there one about a wife? A wife whose husband dies, but then she follows him, and wins him back, or something?”

  My mother nods eagerly. “Savitri and Satyavan!”

  “Satya what?” I ask. I was hoping for a catchier name, so the story would be easier to follow.