Not Done

The hardest battles of cancer often give rise to the most resilience, wisdom and love.

BY NOAH LANE BROWNE

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YOU FEEL THE lump first.  Or maybe I do.  You have just turned forty.

“The good thing about breast cancer,” the surgeon said, “is that it’s really common.  We know a lot about it.”  The bad thing about breast cancer is that we don’t know anything about it.

We do research, book appointments, make decisions.  We do all of these things quickly because your tumor is growing quickly.  We select a hospital, mainly because it is close.  We choose an oncologist, mainly because she seems kind.  A breast surgeon, mainly because she seems competent.  A plastic surgeon, mainly because he seems funny. 

We talk about freezing your eggs, preserving the potential for life while you fight for yours.  The fertility doctor, with compassion, explains our chances of eventually conceiving.  Low.  The oncologist, with compassion, explains the risk of injecting hormones while the tumor is still inside you.  High.  That decision is easy.      

You decide that your mom, living far away, can’t handle the news.  I decide that mine, living closer, must.  Strange that love can mean either withholding your pain from someone or sharing it with them.

You get a mediport placed near your collarbone to save your veins while they administer the chemo.  When you wake up you are groggy from the drugs but smiling widely.  The nurse hands you a tired-looking laminated one-page “menu” with pictures of a salad trifecta: egg, chicken, or tuna.  You choose tuna salad and are ecstatic.  “It’s the best sandwich I’ve ever had,” you insist.  The sandwich is dry and bland but I want to share in your small joy.  “It’s delicious,” I say.

I am so proud of you.  But you are not done.

You tell your hairdresser to cut it short, and you tell her why.  She starts to cry.  You tell her not to worry, that it will all be OK.  It will be the first time of many you are asked to comfort others because of your illness.  The pixie cut sharpens your Eastern-European cheekbones.  You look beautiful.

When they shoot in the chemo the first time, you are fine and then you are not.  Your face and chest blush a deep red and your pulse races.  It happens in a second.  I fumble for the panic button.  An army of nurses rushes in.  Their expressions are hidden by surgical masks but their eyes, focused and intent, betray concern.  They quickly switch the poison for Benadryl.  Within minutes, your breath and pulse and color return to normal.  They swap in the poison again.

I am so proud of you.  But you are not done.

You lose clumps of hair.  You choose a beautiful wig of dark brown human hair that falls just past your shoulders.  The kind lady at the store guides you into a backroom and gently shaves your head.  Your pixie cut becomes a jumbled dark mess around your feet.  You cry.  Then a smile breaks over your face as you look into the mirror at your freshly shaven head. 

“I look like a baby in makeup,” you say.  The kind lady laughs.

Your dark auburn wig brings out your dark eyes.  You look beautiful.

Chemo for months, an Olympian test of human endurance.  Fatigue.  Painful sores.  Sharp headaches.  Dizzy spells.  Weak appetite.  Lost weight.  I realize I cannot carry these burdens for you and that helplessness is the worst feeling there is.

Every visit to the hospital means new medical students and interns who accompany the doctors.  The students ask politely if they can examine you, and you always say yes.  The young male ones are especially nervous, their hands trembling and fingers clammy as they touch your chest.  I look down so they don’t feel my gaze.  You put them at ease with small talk and a smile. 

We try to live normal lives.  We go for a walk on a Saturday but you have to turn back after a few blocks because it is hot and you are tired or dizzy or nauseous or all three.  I get frustrated that your cancer has stolen from us a simple pleasure.  “Let’s just walk home,” I say, trying hard not to show my irritation.  But you notice and you get quiet.

Your sense of smell becomes uncanny.  You know if the litter box needs changing long before I do.  You can tell if cheese has even a hint of aroma or if the spinach has formed a bead of sweat in the refrigerator.  “It’s my new superpower,” you say lightly.

On your last day of chemo, we take a goofy picture next to your IV stand and chemo pump.  You pout your lips and sag your shoulders in a mocking goodbye.  Then you ring the brass bell hanging near the reception desk to celebrate the end.  The nurses gather and applaud.  Some of them hug you.  Your smile is brighter than all suns. 

I am so proud of you.  But you are not done.

You have an MRI to image the tumor before it is removed.  I sit in the corner as they wheel you into the tube where you must lay as still as death.  They give you headphones to block out the noise and you choose classical music.  They seat me in the corner and give me cheap yellow foam earplugs.  When the scan begins, magnets clang and the coils clash.  The loud pulses of sound—unpredictable, arrhythmic, violent—rip through my body.  The earplugs are worthless.  My chest tightens, my breath quickens, my vision narrows.  The walls of the room seem to collapse.  I try to meditate, to focus my mind elsewhere.  But I am trapped.  Panic edges in, threatening to pull me under.  Then it ends.

They wheel you out and you swing your legs over the gurney.  “That wasn’t too bad, was it?” you ask. 

I am so proud of you.  But you are not done.

Your hair starts to grow back.  It’s fuzzy and soft, like a baby chick with black fur.  “I’m starting to look like my dad,” you say.  You are right and I laugh.

We meet with your plastic surgeon.  He is your only male doctor and you like him.  “You can get basically whatever size you want,” he explains.  “And insurance will pay for symmetry, even if only one is removed.”  You were not aware that this option was available, but you are not interested; your current size suits you just fine.  Instead you ask, “When I have an implant, can I start kickboxing?”  “You want to start kickboxing?” the plastic surgeon says with a grin.  “It’s just a hypothetical,” you respond, also grinning.

We arrive early to the hospital for your surgery.  They will remove a breast and give you a new one at the same time.  They draw on your chest with a dark purple pen.  “Surgical site marking,” the attending says.  You repeat your name and birthday ten times to five different people.  You look terrified.  I kiss you goodbye and they wheel you away.

I sit in the waiting room, surrounded by a half dozen people who look far calmer than I feel.  I try to read or to listen to music but cannot.  There is a monitor that is supposed to track the progress of patients and assure loved ones who are waiting.  I look at it constantly, though there has been no change: next to your number it has said “in theater” for hours.  Does the monitor even work?  Why is this taking so long?  Have there been complications?  Time crawls and I am alone with my thoughts, a dangerous place. 

After an eternity the plastic surgeon walks in and sits beside me.  “She did great,” he says.  I exhale for the first time in hours. 

You are determined to return home the same day, to sleep in your bed next to your cat.  The pain meds start to wear off as we are driving home, and every bump in the pavement is a paroxysm of pain.  I go as slowly as I can, silently cursing our old car and the potholed city streets.

You rest.

We celebrate a friend’s wedding a week later.  You wear a black cardigan, cleverly hiding your surgical drain.  Except for the bride and groom, no one knows what fresh hell you have been through.  We slow dance, holding the secret safely between us.

I am so proud of you.  But you are not done.

“We are recommending radiation,” the oncologist says. 

“It’s like trying to kill a mosquito with a firehose,” the plastic surgeon shrugs.

Five days a week you return to the hospital to lie on the table so they can fire invisible beams into your chest, neck, and armpit.  You insist you don’t need me there.  I feel guilty, but also selfishly relieved, to be distanced from the relentless grind of your treatment.  At month’s end you are exhausted, the fatigue a thousand-pound weight on your shoulders. 

I drive you to the last session.  It is the day before Christmas and the walls of the radiation suite are decorated gaudily with tinsel and lights.  They hand you a hospital certificate, signed by the doctor.  “Congratulations on the successful completion of radiotherapy,” it says. 

I am so proud of you.  But you are not done. 

“You need immunotherapy,” the oncologist says.  “It may have implications for your heart function.”

Your tumor had switched surface receptors during treatment, a fickle teenager changing clothes before a date.  Different receptors, different intervention.  Your cancer, any cancer, cannot be trusted.

We had talked about when your mediport could be removed.  About how we would not have to come to the hospital so often.  About how we would treat ourselves to a long vacation.  About how and when you would tell your mom.  Instead, your mediport will remain tucked next to your collarbone and you will have infusions for the next year.  They will watch your heart closely. 

I am so proud of you.

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