Me: Not necessary.
Dr. Gregory: And what else? You asked about chemotherapy, right? The interferon therapy would only be recommended to patients as a last resort. These drugs are hugely toxic to the system, and they offer minimal benefits, in my opinion. The treatment is a whole year. And the side effects are pretty awful. Really awful, to be honest.
Me: Really awful. Really.
Dr. Gregory: And as far as the vaccine is concerned, believe it or not, we were one of the first hospitals to do vaccine trials. We have patients who first received the drugs twelve years ago. And all of our trials, up until this year, were with Stage III and IV patients. This year, for the first time ever, we’re doing a trial with stage II patients. Stage II means a melanoma depth of at least .75. Your .4 thickness puts you into the Stage I category, so—
Me: So I’m fucked, basically.
Dr. Gregory: No, it’s good you don’t qualify. And the better news is, the way things are going, the vaccine should be FDA approved within the next two years.
Me: That would be amazing.
Dr. Gregory: And something about staying out of the sun?
Me: . . . if that decreases my chances of a recurrence.
Dr. Gregory: No, not really. But let me say, your odds of a recurrence are very low—
Me: Great.
Dr. Gregory:—but you do have around a 30 percent chance of getting a new melanoma, considering your staging, age, the location of your tumor, etc.
Me: Thirty percent? If I stay out of the sun, does that go down?
Dr. Gregory: You could live underground and never see the light of day and still get another melanoma.
Me: Thirty percent—that sounds so . . . high. How can I have a three-in-ten chance of another melanoma if I’m never in the sun?
Dr. Gregory: Because you’ve already done most of your sun damage. And there is an “unknown” with melanoma. Sun damage plays a role, but it’s not the only cause. There’s more to it than that.
Me: Maybe I could be like one of those translucent creatures that live deep in the soil and slither around using their little hairy tentacles, or whatever it is they use.
Dr. Gregory: Bottom line: You need to stay out of the sun. But that doesn’t guarantee you won’t get another melanoma.
Me: Thirty percent.
Dr. Gregory: Let’s get to your last question. The answer is, I don’t know for certain.
Me: You don’t know if you got all the cancer cells.
Dr. Gregory: Correct. Not for certain.
Me: Oh.
Dr. Gregory: You’re n.e.d. No evidence of disease.
Me:
Dr. Gregory: Well, if that’s it, I’m off. I will see you in a couple of weeks. Oh, don’t forget to stop at the lab.
Me: I won’t. N.e.d., n.e.d.
“Hi, nice to meet you. I’m N. e. d., and you are?”
“N.e.d., but I’m waiting for L.e.d.”
“Never heard of him.”
“You know, lots of evidence of disease.’”
“Oh . . . shit. Hope I never run into him.”
Knock, knock.
Me: I’m getting dressed.
Other: It’s your nurse. It’s Dana. I wanted to say hi.
Me: Come on in . . . I like as many people as possible to see me naked.
Nurse Dana: How are you doing?
Me: Good. Oh my God, you’re huge! When are you due? . . . Here, walk with me to the lab.
Nurse Dana: I’m at thirty-one weeks.
Me: That’s incredible. My husband and I are actually getting really close to starting a family. I’ve been looking forward to big, voluptuous nursing breasts for a very long time.
Nurse Dana: You talked to Dr. Gregory about that?
Me: Ah, no.
Nurse Dana: About getting pregnant?
Me: Um, no. Why?
Nurse Dana: Maybe I should page him . . . I’ll page him. He didn’t say anything?
Me: About what? About me getting pregnant? No. Why?
Nurse Dana: He should talk to you about it. He’s better at explaining it—
Ring.
Nurse Dana: That’s him calling. You can pick up.
Ring.
Me:
Ring, ring.
Nurse Dana: Pick up.
Me:
Ring.
Nurse Dana: Hi. I’ve got Hillary, here. She has a question for you.
Me: Hey. I don’t know what I’m supposed to be asking you. Dana and I were taking about having kids, and then she paged you . . . I don’t know. Melanoma doesn’t affect my ability to have kids, does it?
Dr. Gregory: No, no, no. You and your husband just have to wait a while, that’s all.
Me: How long?
Dr. Gregory: Well, I usually say at least two years. Between two and five.
Me:
Dr. Gregory: . . . hello?
Me: . . . yeah . . . I’m here. I can’t have kids for five years?
Dr. Gregory: You’re at the highest risk for a recurrence within the first two years.
Me: You said I’m not at high risk, though.
Dr. Gregory: You’re not, but about forty percent of melanomas have hormone receptors on them.
Me: So?
Dr. Gregory: Meaning, if you were to get pregnant, and if we didn’t get all the cancer cells with the surgery, the hormonal changes during pregnancy could stimulate those cells, causing them to multiply and spread really quickly. Also, if you have a recurrence, your treatment options are greatly reduced if you’re pregnant. I don’t want you in a situation where you have to choose between your health—your life— and the life of your child. I’ve seen too many cases where the mother postponed necessary treatment in order to carry her child to term, and the mother—
Me: I don’t understand. Why didn’t someone mention all this before?
Dr. Gregory: I assumed you and your gynecologist had discussed it.
Me: I knew I couldn’t be on birth control pills because of the hormones, but no one ever mentioned melanoma affecting pregnancy. How is that possible?
Dr. Gregory: Look, this is a very controversial topic. Some researchers say there is no connection between hormonal changes during pregnancy and an increased risk of recurrence. But you need to give your body some time.
Me: Time? Time for what? Time to see if cancer cells turn up in my lymph nodes? Time to develop a new melanoma and then wait another two years, only to have a third fucking cancerous mole and have to wait two more years, and on and on and—this doesn’t make any sense.
Dr. Gregory: Try and—
Me: I’ve gotta go. I’ll talk to you later.
Dr. Gregory: But—
Click.
Dana: Honey, it’s—
Me: You know what? I don’t want to talk about it. Howard, take my blood so I can get out of this fucking hospital.
My life is starting to feel more and more like a Lifetime (television for women) miniseries. Confessions of a Survivor, starring Tracey Gold, with Patty Duke and a Special Appearance by Meredith Baxter-Birney . . .
Tracey dashes out of the lab, trying desperately to hold back her tears. As she sprints down an endless hallway filled with children of all ages, the tears start to flow. Background music swells as we hear Tracey’s thoughts aloud. “And so I ran,” she says, her voice calm and reflective, “As hard and fast as my feet would allow.” She is sobbing as she reaches the entrance to the hospital and frantically pushes through the revolving door, stopping on the other side just long enough to reach into her purse for her sunglasses. And her hat. And some sunscreen. With music pounding, we watch in slow motion as Tracey tilts her head toward the sky and with arms outstretched screams, “Whyyyy meeee?”
Fade to white, as “To be continued” makes a slow crawl up the screen.
THE DRIVE HOME:
Me: Is Adam around?
Marci: He just stepped into a meeting with Greg. Can I have him call you back? Are you on your cell?
Me: Could you pul
l him out of the meeting, please?
Marci: He’s in with Greg, and the door’s closed.
Me: Could you get him?
Marci: Uh . . . ah . . . okay. Just a second.
Adam: Hello? What’s wrong? What happened? Are you okay?
Me: Yeah, I’m fine—
Adam: You scared me to death.
Me: I just wanted to say . . . hi.
Adam: Hi . . . What’s going on?
Me: No, I just wanted to say hi and that I love you, that’s all.
Adam: I love you too. Did you see Dr. Gregory this morning?
Me: Yeah.
Adam: I see. Are you going to tell me what happened?
Me: No.
Adam: What did he say?
Me: I don’t want to tell you . . . before I tell you, I just want you to know that I’m not convinced he’s right about any of this, and I’m going to do my own research on the subject, because I’m not going to trust every word he says just because he’s a doctor, because they don’t know everything and they can be wrong about a lot of things a lot of the time and this whole issue doesn’t really make sense to—
Adam: What did he say?
Me: He said . . . and I can’t believe it never came—
Adam: What did he say?
Me: That we have to wait to start a family.
Adam:
Adam: How long?
Me: At least two years.
Adam: What does “at least two” mean?
Me: Two to five.
Adam: And what’s the reasoning behind this?
Me: It’s the hormone issue again. Apparently, the hormonal changes during pregnancy can stimulate melanoma cells or something. If I still have some cancer cells in my body, they would multiply and spread really fast if I was pregnant—something like that. So I’m supposed to wait until I’m out of high-risk territory. The whole thing seems—
Adam: High risk for what?
Me: A recurrence, the cancer showing up in my lymphatic system . . . which doesn’t really make sense, since he said I’m not really at risk for a recurrence. Either there’s a risk or there isn’t. It can’t be both at the same time.
Adam: Then you’re not getting pregnant.
Me: What do you mean? Of course I am. I just have to wait.
Adam: I’m not going to let you do anything that puts your health at risk. There are other ways to have children—
Me: I know. I just—
Adam: We’ll figure it out.
Me: I know. I—
Adam: We’ll figure it out. We always do.
Me: I love you.
Adam: I love you.
Me: Get back to Greg. He’s probably busting a gut by now. We can talk about this later.
Adam: Don’t worry.
Me: Yeah. I’ll try.
Adam: And concentrate on the road.
Me: I’m not driving right now.
Adam: Where are you?
Me: I’m parked. I started to get a panic attack, so I pulled over.
Adam: Jesus.
Me:
Adam: Are you crying?
Me: I’m laughing.
Adam: What’s so funny?
Me: This. This whole . . . thing.
I have moments. Moments within moments when I’m able to make things stop spinning just long enough to take a close look at things—my world, the events that are unfolding—and I’m able to get some perspective. These moments are few and far between, but when they happen they are brilliant, extraordinary, awe-inspiring, because for a split second I am able to see my life the way others see it, see it from the outside looking in. And so as I sit in my car—which is parked on the side of a busy Santa Monica street, after I just had a panic attack because my surgeon said I shouldn’t get pregnant and that I have a 30 percent chance of going through all this over again—I get a peek, a glimpse, at what others see. At what my husband must see. And so I do the only thing I can think to do, the only thing that my body will allow: I laugh. I’m laughing so hard, tears are rolling down my cheeks and I’m getting a cramp in my side and my stomach is turning cartwheels and still I can’t stop laughing. All of a sudden everything seems so fucking hilarious. Like the funniest moment in the funniest scene of a John Candy classic . . . it’s hard to catch my breath . . . aw, shit, this shit is funny . . . aw, God . . . so funny . . . This is sick . . . I may . . . never . . . be able to . . . stop . . . laughing . . . except that . . . now . . . I’m pretty sure . . . I’m crying . . . there is no more laugh in these tears . . . yep . . . I am. I’m most definitely crying . . .
Knock, knock.
Cop: Miss, you can’t park here. You need to move along.
Me: Okay. I’m trying to move along. Trust me. I’m trying.
One Big Cookie
After yesterday’s festivities and an evening of nail biting and cuticle demolition, I find myself standing outside the door of my best friend’s house. I don’t know if she’s home—I don’t know if she’s due home—I just know I need to talk. And I want her to be the one who listens.
Tess and I go way back. Our friendship started, slow, in seventh grade. I knew of her because she was “the gymnast,” close to Olympic level, or so I heard. She knew of me, I’m assuming, because I was the tall new girl from Georgia. I was Big Bird, I was The Tree—names I was given lovingly by prepubescent boys who were nearly approaching half my size. I was a short five foot seven and a half. Or at least I liked to think so. I was the girl you didn’t want to be friends with. The one you never wanted to be seen with, especially not in seventh grade. Not when one’s very existence hinges on trying to be cool and popular and—if you are a girl—having boobs. I fell into none of the previously mentioned categories, and so I was on my own, destined to eat lunch by myself until something happened that made me cool or popular or develop . . . you know whats.
But while most seventh graders looked through me, over me, Tess didn’t. She was different. She was nice. On the surface she seemed perfectly content hanging out with her popular buddies and watching quietly as they tormented the unsuspecting, the unassuming, but her smile spoke of other things, deeper things. But maybe that was because she was a freak, too. She had muscles. Gymnast pecs and all that. All the boys in my grade put together didn’t equal the power in her two arms. She was small, solid as a rock, and, of course, flat as a pancake.
So, like I said, our friendship started slow. Friendly hellos developed into birthday party invitations, into sleepovers, into long yearbook entries—each year, our friendship growing and changing, changing with us, in spite of us, our lives becoming more intricately intertwined, until it felt as if we’d always known each other. Until we couldn’t remember a time when we hadn’t had each other to lean on, to laugh with, to confide in. A decade later, the core of our friendship remains unchanged, a time capsule. Because I am still, in many ways, the gawky new girl, and Tess, well, she’s still solid as a rock . . . and a rock is just what I need right now.
Knock, knock.
Me: Tess? It’s me. Tess?
Knock.
Me: Tess? Hel-lo?
Knock, knock.
Me: Shit—
Tess: I’m coming . . . hold on . . . I’ve got cookie dough on my hands . . . I’m—Sabrina, get off!—The cat is pouncing on my leg . . . Hi, sorry. Come in. Sorry about the mess. It’s my turn to clean. I promised Jimmy I would have it done before he got home, but I’m not sure that’s realistic. I’ve gotta finish these cookies for one of my patients. This is my second batch. I wanted to make one big cookie, but I couldn’t get the inside cooked without burning the edges, so I had to go to the market and get more dough. In my head it seemed like a good idea. And the cat keeps trying to jump up on the counters. I’d be so embarrassed if my supervisor found a cat hair in one of the cookies. How was your doctor’s appointment yesterday?
Me: Fine. It was fine.
Tess: What’s wrong? Something’s wrong.
Me: I’m trying not to freak out about it. It was reall
y weird. I was talking to one of the nurses, and I told her I was thinking about getting pregnant—I already started taking prenatal vitamins and everything—and next thing I know, I’m on the phone with Gregory and he’s saying I have to wait to get pregnant.
Tess: Wait, why? How long?
Me: First he said two years—
Tess: Well, two years isn’t so bad, when you think about it. You and Adam can do all the traveling—
Me: No, I wouldn’t mind the two, but then he said two to five. And that’s assuming I don’t get another melanoma between now and then. I mean, what if I wait, like, a year and a half and then get melanoma again? I’ll have to wait another two years, and then . . . I don’t know.
Tess: Did he say why you have to wait?
Me: It has to do with the hormonal changes during pregnancy. They can stimulate melanoma cells or something.
Tess: So, how does all this make you feel?
Me: You are such a therapist right now.
Tess: Sorry. How do you feel?
Me: I feel . . . sad. I feel really sad. And angry. I’m pissed because . . . I don’t know.
Tess: Why do you feel—
Me: I’m pissed because—it’s not about the two years, I can wait the two years—it’s that I feel like this stupid melanoma is taking over everything. I can’t get away from it. I can’t stop thinking, worrying, checking every single little fucking mole on my body every single fucking day. I wake up, I check my moles. I shower, I look at my moles. I put on sunscreen, I look at them again. I step outside, and I am reminded. I get in my fucking car and I worry because my side windows aren’t UV tinted because if I tint them I’ll get ticketed . . . and now the whole pregnancy thing. It was something I had to look forward to. Something that seemed positive. Something that I’ve always wanted and . . . and something I had control over. I feel like I have no control over anything anymore.
Tess: I’m so sorry. I can’t even imagine what it feels like.
Me: It feels bad. It feels really bad.
Pale Girl Speaks Page 7