by Amy Boesky
I waited for my mother to give Sherry the toxic smile for which she was famous and call it a day. But that didn’t seem to be happening. Instead, she and my father were going back to look again into the other rooms, taking measurements, consulting, putting their heads together, talking about coming back later with an architect. Sherry was beaming, and Julie and I looked at each other in disbelief.
“You really like it?” I asked my mother as we moved downstairs to confront the “carport” for the second time.
My mother had her back to me. Maybe she was trying to catch a glimpse of the river through the carport’s smudged window. A bird had soiled it, a white Rorschach stain. I couldn’t help recoiling at the sense of all the effort needed here, and my mother looked so frail on her cane, months of treatment ahead, years, if we were lucky. Was this the time to be taking on something so enormous?
When she turned back to face me, my mother looked defiant. “It’s got a lot to offer,” she said. “Three blocks to the library. We could walk there every day!”
All day Saturday, instead of talking about Megace or what to do about the clot, which was getting worse, we sat at the kitchen table and my mother drew blueprints, converting the gym back into a living room, imaginatively expanding the kitchen, reconceptualizing the back deck to “allow for a greater sense of the river,” as Sherry put it when she dropped by with various packets of drawings and photographs for her to consult. My father was out running errands, Sacha was trying to pull herself up on the legs of the kitchen chairs, and my mother’s own leg was propped up on another chair, the ice in constant use but not working. Julie made delicate and delicious things for dinner, using a great number of pans. When my father came home, bringing fresh prescriptions from the drugstore, all he wanted to talk about was the house.
They were in love with it, excited as newlyweds. Then the architect came over to meet with them to “go over a few numbers” and afterward they were subdued. It seemed the kind of reconfigurations my mother had in mind would cost almost as much as buying the house in the first place. They’d have to take almost every penny they had in savings to make it work, and suddenly the light went out of my mother’s face, the excitement gone, nothing left but pain, the cancer tightening its clutch around her spine.
She seemed to be remembering herself. Remembering the amount of effort involved in selling their house, enlisting the architect to work his magic, the months or years spent trying to get A River Runs Through It to work.
Isn’t that what we’d wanted, Julie and I?
The house on the ravine seemed like nothing but trouble—the wrong layout, way too expensive. So why weren’t we happy she’d finally seen what we saw, that this was impossible, that it was much better just to stay put and rest her leg and wait for Dr. Brenner to suggest what to do about that clot?
My mother was like a balloon with all its air let out. She lay back on the couch, her face ashen, as if the dream of A River Runs Through It had been more potent than Megace, and now that the dream was evaporating she was back in her own space, shrunken, with only the real to look at.
BY SATURDAY NIGHT WE HAD a serious problem: The clot wasn’t resolving. My father called Dr. Brenner on Sunday morning. It was after hours, so my father had to page him. As soon as he hung up, my father started pacing back and forth in the living room, waiting for Dr. Brenner to call back. Twenty minutes. An hour. Everything was on hold while we waited. My father, pacing, grew increasingly irate.
Waiting was a big part of Cancer Calendar. We were always waiting now, it seemed. For a doctor to call back. For someone to schedule something. For a prescription to be filled at the pharmacy. For a clot to resolve, for the pain to diminish. Something. Finally, the phone rang, and my father sprang for it like a fireman answering an alarm.
DR. BRENNER WASN’T HAPPY TO hear about the clot. This was a “significant” side effect, he told my father. Given that the clot hadn’t resolved on its own, they were going to have to stop the Megace. It was too dangerous to risk letting a clot form in a deep vein—it could end up in one of her lungs, and that could kill her.
“It’s disappointing,” he told my father. That was the frustrating thing about these treatments. They caused side effects, some of them more dangerous than the cancer itself. They’d have to try something else.
He wanted my mother to come in the next morning to “reassess.”
“I can take you,” I told her, glad to finally be able to do something useful.
That was another thing about Cancer Calendar. Things changed all the time. You made a plan, you unmade a plan. You thought one thing would work, then you gave it up. Appointments in Etch A Sketch.
Julie had to leave Sunday afternoon to fly back to Maine—she had an appointment Monday morning with her ob-gyn. She’d be back for my mother’s birthday in a few weeks. None of us talked about the peculiarity of this, the we’re-seeing-one-another-every-second-we-can sense of visits clustered so close together.
As the dream of the house in Birmingham began to fade, the here and now got sharper, clearer. The real estate agents left their glossy brochures on our coffee table, our house photographed in full color, Ideal for a Growing Family written in a crisp black font on the cover. My mother slept most of the afternoon, the pain tightening its hold. She didn’t even hear Julie’s taxi when it showed up for her at four on the dot.
I DON’T KNOW WHAT I was expecting, but Dr. Brenner wasn’t it. I was hoping he’d be like Dr. Henneker, smiling and winking and full of surprising good news. Instead, he was young and dark-haired, with oddly little teeth. No smiles. He talked rapidly, very much to the point. “Like a guillotine,” I told Jacques later, calling to fill him in. “Quick and sharp.”
Dr. Brenner said he was sorry about the Megace. Very sorry. He didn’t waste any time letting my mother know that this was bad.
“This is a setback,” he told her. “A significant setback. If the Megace had worked, that would have bought us time.”
He looked upset, glancing back and forth between the file on his desk and my mother’s face.
My mother, the historian, always wanted reasons. “Why didn’t it work?” she asked.
He shook his head. “It’s hard to say,” he told her. “In part, because your tumor isn’t estrogen receptive, it’s harder to starve it with a synthetic progesterone.”
Sacha wriggled around, reaching for things on Dr. Brenner’s desk.
“So,” my mother said, in a small, brisk voice. “What’s next?”
He’d like to get another set of scans, he told her. Then we could go from there.
My mother didn’t say anything. Then—“What if the scans look better?”
Dr. Brenner frowned. “We didn’t get very far with the Megace,” he reminded her. Given the extent of disease progression in the initial scans, he was concerned. The way he said “concerned,” it was clear things weren’t going well. This was full disclosure, this meeting. No mincing words.
Dr. Brenner explained there were three possible responses to a treatment: complete, partial, or minor. He’d been hoping for the first or at least the second, but since she’d only been able to tolerate the Megace for ten days or so, it was unreasonable to expect much of a response at all. It looked like it was time to move on to something stronger.
You could’ve heard a pin drop.
“Elaine,” Dr. Brenner said, putting both hands on the top of his desk. He straightened her file a little. “I’m sorry.”
Dr. Brenner looked like he was no more than forty. He had a tic that made one cheek muscle jump when he lifted his hands for emphasis. On the desk in a frame turned so we could see it, there was a photograph of two young boys on a tow lift, possibly out West. The boys were dark-haired, laughing. Real life, the picture seemed to suggest, happened elsewhere.
I had a pit in my stomach.
“So . . . ,” my mother said, feeling her way. “I have more scans done. Then what?”
Dr. Brenner thought the best thing would
be for my mother to start chemotherapy right away—as soon as next week, if they could schedule it. He didn’t see any reason to wait.
My mother stared at him. Megace—nontoxic, bearable—was one thing. Chemo was another.
I remembered what she’d told us on the phone. The longer she could stay on Megace, the better. Ten days didn’t seem like a great start.
Dr. Brenner was jumping into details.
He had a combination of drugs he liked to start with if Megace didn’t work. There were three involved, but the main one was 5-fluorouracil, which was called (for short) Five F-U.
F-U? Could that really be its name?
I asked about side effects.
Dr. Brenner tapped with his pencil. Yes, there were side effects. Less from the Five F-U, though some from that, but mostly from the other two—Adriamycin and Cytoxan. He gave me a funny look—what did I think this was, a picnic?—and named a few. Hair loss, fatigue, nausea. Weight loss, depression, lowered immune function.
My mother cleared her throat. “If I stuck with the Megace—”
He shook his head, putting up one hand. He was sorry, but no. Even aside from the clot, which was dangerous, her metastases were advanced. “Elaine,” he said, like she was a student who just wasn’t getting the material. “There’s significant disease progression in your spine, ribs, and pelvis. We need to get going.”
Silence in the room.
Significant disease progression. I had a notebook with me—my father and my sisters had asked me to take notes, in case my mother and I forgot anything Dr. Brenner said, and I wrote that phrase down, right underneath F-U. Significant. I knew that meant bad.
“But F-U,” Dr. Brenner told us, “can have promising results.” He had statistics for us. Fifty to 75 percent of patients responded to the first course of chemotherapy. Even patients with “minor or no response” to Megace, like my mother, sometimes saw noticeable benefits.
My mother’s voice was tiny. I wondered if she’d heard “sometimes,” the way I had. “What would those benefits be?”
Dr. Brenner was quiet for a minute. “We’re looking for reduction of symptoms,” he said. “And improved quality of life.”
“And cure—?” my mother managed. Straight to the core, unflinching.
He shook his head. One short, brief shake. “Prevention of tumor progression,” he said, as if this was the best he could offer.
My mother nodded. As in, OK. I’ll take it.
That was it. Like they’d made a deal.
He looked at his watch. He didn’t have much time to go over the rest of our questions. He could probably tell we were the types who would ask and ask and ask. His waiting room was full (“This is a growth industry,” my mother said later to me, wryly. “Business is booming.”). He was pushing his chair back, getting to his feet. He was shorter than I’d imagined. I don’t know why this bothered me, but it added to my unease: my mother’s greatest ally, and my faith in him shrunk with his stature.
“We can talk more next week, at the clinic. Don’t worry,” he said, more to Sacha than to my mother or me. He leaned forward, as if he were actually about to wriggle his fingers at Sacha, then changed his mind. “We can get excellent results with Five F-U. Some of my patients—”
I noticed we’d been downgraded from “many” to “some.” But if my mother had heard, she didn’t let on.
WE WALKED SLOWLY TO THE elevator, more slowly out to Central Parking. We were an odd threesome: My mother, aged a generation in a matter of weeks, struggling with her cane. Sacha, bigger and more buoyant with every passing minute, wriggling in my arms, dying to be released to her new mobility. And me, between them, searching for my mother’s keys in my diaper bag.
In the parking garage I worked on getting Sacha into her car seat in the back, then helped my mother into the passenger’s seat. I wasn’t used to driving her car, the steering wheel felt stiff, it took me a few minutes to get out of the tight space. By accident I turned the audio system on, and my mother’s Learn Italian tape blasted out full force: “Mi chiamo Marisa! ” My parents had been planning a trip to Siena next spring.
My mother leaned forward and snapped it off.
So much for Siena, I thought.
I’ve never been there, though I’ve always wanted to go. The oldest-known representation of an hourglass, by Ambrogio Lorenzetti, is painted on a fresco on the wall of the Palazzo Pubblico in Siena’s main square. It dates from the early fourteenth century, part of a mural called The Allegory of Good Government. Temperentia, or Temperance, stands in the middle of the mural, gazing contemplatively down at the hourglass in her hands. I’ve seen slides of the fresco, but never the real thing.
I imagined her now, Temperentia, holding her hourglass. Frozen in soft ochres, browns, and burnt reds in Siena’s main courtyard, time stopped in her hands.
“I LIKED THAT HOUSE,” MY mother said suddenly.
Past tense, I noticed. Liked.
I nodded, trying to look supportive. “It needs work,” I said in what I hoped was a neutral tone.
She was looking out the window, not used to being a passenger in her own car. “Your father could walk into Birmingham . . .”, she said musingly. She wasn’t wearing her glasses, and she squinted a little, as if she were trying to see something off in the distance.
Her face suddenly folded in on itself. “I just hoped,” she said, half to herself, “that I could get him moved. You know what I mean, Mellie?”
In that one wish, so much was betrayed. The desire to help out. The sense of a timeline she couldn’t control. The acknowledgment that the move was not, in the end, for her—her interest in Birmingham, with its restaurants and shops, was not some longed-for, last-ditch return to city living, but instead an attempt to protect my father, imagining him left alone in our house—Perfect for a Growing Family. Moving with him, she could have helped him get ready. But it wasn’t going to happen.
Mouth dry, I maneuvered her car out of the garage, and we headed home.
F-U
THE SECOND STAGE OF GRIEF, according to Kübler-Ross, is anger.
Anger has always been hard in our family. I was raised to be anything but: to accept, to apologize. Being the middle of three girls didn’t help; I was usually the one who tried to fix things, to see both sides. Being middle-class and middle-American didn’t help, either, and it didn’t help growing up in the 1960s, the daughter of parents who studied conflict but didn’t live it. I remember walking somewhere with my father when I was young and two men near us broke into a fight and my father grabbed my arm, eyes down, and told me in a low, urgent voice just to keep walking and not to look at them. I was surprised, without really understanding; surprised by the force of his need to get away from their quarrel, and to protect me from it. Anger, my parents taught us, was dangerous. Like disease—something that can destroy you, eat you up from the inside. Better to keep your distance, walk away.
When something or someone makes me angry, I almost never realize it until minutes or even hours later. Delayed reaction. By then, it’s too late to say anything. Not that I’d be likely to let it show.
But Kübler-Ross must have been on to something, because after my mother’s second set of scans came back, I was angry all the time. The news, Dr. Brenner reported, was “very disappointing.” The metastases were worse, despite her brief course of Megace. It was a good thing, he said—trying to find something positive to say, I guess—that they’d scheduled chemo for the following week. They needed to get going.
Anger for me came out at the wrong times and places. At the Northwest Airlines ticket counter. At the drugstore. Seeing ordinary people doing ordinary things. Once, in a dressing room with Sacha in Newton, trying something on, I heard a mother and daughter in the dressing room next to me. They were laughing and arguing with each other about something one of them was trying on and the whole scene was so perfectly ordinary, so much exactly what a mother and daughter should be doing on a summer afternoon, buying something to wea
r to some event they were going to—maybe together—that I could feel rage burn in my face. I had to look away so Sacha wouldn’t see. Why couldn’t we have that? Why not? OK, I knew there were worse things. Hurricanes and rape and addiction and homelessness. Horrible things happen, I got that. I knew in the scheme of things I didn’t deserve to be so infuriated about this random situation of ours, our preset half-life. But I was.
I even picked a fight with Annie when she called to check in. I had told her about my mother in June, but this was our first real talk in weeks. Right away I could tell we were in different moods—she was upbeat, filled with news and plans; I was quiet and down. She started telling me a long story about a friend of her mother’s who had cancer and was doing great, years and years later. Annie was convinced that her attitude really helped. As she put it: “She’s just the kind of person who finds the positive in everything, you know?” I found myself snapping at her. “Surviving cancer isn’t about attitude, Annie! It’s about cell type.” She was silent, and I apologized—she was just trying to be a good friend—but I couldn’t help it. I read too much into everything these days.
I was angry, Julie was angry, Sara was angry, I suppose in their way Jacques and Jon and Geoff were angry, and most of all, my father was angry. Blazing, furious, white-hot anger. We controlled ourselves and tried to pull ourselves together in front of my mother, which sometimes worked and sometimes didn’t.
My mother, instead of being angry—or at least outwardly so—was busy trying to squeeze her chemo schedule into her summer plans. There were endless logistics, shifting of schedules. Sara was flying out at the end of the week, and would stay through the Fourth of July, so she could take my mother back and forth to the hospital for the first round of F-U. I’d come back in with Sacha for round two in late July, since Julie would be too pregnant to fly by that point. My father would be on vacation in August, and he could take her to round three. My mother set it all up the same way she organized our tickets back and forth for family reunions. She was in her usual position, at the center of everything, running the show. Her biggest concern seemed to be making sure chemo wouldn’t get in the way of her top priorities: having us all together in Michigan for the Fourth of July; going out to Maine when Julie had the baby; getting all of us to Charlevoix over Labor Day weekend.