by Debi Goodwin
The blueberry tarts had disappeared quickly at the wedding before Peter had been able to get one, and he expressed regret that he hadn’t tasted them. So, I decided to make more for him, hoping to find something he could enjoy. The kitchen counter was covered with unrolled pastry and flour that Monday morning, the twenty-second of August, when Peter’s cellphone rang. After the CT the week before, he had phoned Dr. F’s office pushing for an early follow-up appointment. He wanted to get a referral to the best gastroenterologist in Hamilton to tackle his digestive issues. He wanted to be well for Rome in November. As he’d sat on the deck that morning, he’d cried, exhausted by the constant pain in his gut or his back.
It was Dr. F’s assistant on the phone, who said the only clinic that week was that day and asked if he could be there by three. I nodded that we could and hurried to finish my baking.
Even so, I got us there a few minutes late, and by the time I’d parked the car, Peter was in the waiting area. A resident, Dr. P, called us into a room soon after. I didn’t really listen to him at first when he asked Peter questions; residents are just the set-up for the doctor, after all.
“Call me Jon or Jonathan, whichever you prefer,” he said, before taking a list of Peter’s symptoms. He didn’t seem to want to hear them, though. I found that frustrating until I realized he was preparing himself for what he had to say. “Unfortunately,” he said, “the tumour is back. And it’s pressing against your heart and your spine.”
Neither Peter nor I visibly reacted, our minds still ready to fight for action on the gut issues.
“You were all right at first after the surgery,” the resident said, and I didn’t listen after that. He left us then, saying Dr. F would be in. We held hands, with tears in our eyes and few words on our lips as we waited.
“Well, at least we have an explanation for my back pain,” Peter finally said.
“Yes,” I answered. “But not the one we wanted to hear.”
“Hey, buddy,” Dr. F said when he came in the room. His usual greeting. He repeated the news and said that what had been a spot that had worried him on the first scan was now an eight-centimetre mass that had grown fast. He’d never mentioned the spot before; we’d never completely understood the nature of his worry. Nor had the oncologists Dr. S or Dr. D, who seemed to think everything looked fine based on the first scan and the pathologist’s report. But I was too stunned to query Dr. F.
He stayed with us only for a few moments. “I’m sorry,” he said, and I was grateful he didn’t blather on about his own regrets. He couldn’t operate on the tumour because of its location between the heart and spine. All he could do was send us back to the Juravinski Cancer Centre for more radiation and chemo.
“But Dr. S said he can’t have more radiation,” I said.
“This is different,” he answered.
“So it’s metasti—?” I didn’t get the full word out because I wasn’t sure I would say it correctly.
“Yes,” he said.
Just as I’d had to learn how to spell esophagus without hesitating in the winter, I now had to learn to write and say metastasize. Words that had seemed like vocabulary I could ignore became intimates in a moment.
“How long do I have?” Peter asked. My gut involuntarily shuddered at the question.
“Could be weeks, could be months, could be a year or two,” Dr. F answered. “There are those who live for several years. It’s hard to say.”
Even though Peter’s shock must have been more intense than mine, he transitioned smoothly into his helpful mode, offering to send Dr. F a link to a clinical study that showed how bad doctors were at predicting the length of life remaining for terminally ill patients. The two discussed the methodology of the study while I shook my head.
“How was your summer?” Peter asked. “Did you get some time off?”
Dr. F nodded. “You’re a gracious man,” he said.
We left the office with a prescription for an opioid to ease Peter’s back pain and a reminder to call if we needed anything from Dr. F.
As I walked to get the car, the sunny summer day and the normalness of the city streets jarred with my emotions. I wanted to cry but had to hold it together to get us home safely. Being strong, being a caregiver, comes at the cost of pushing down emotions. But I couldn’t push everything down. There was the real probability that I would lose Peter, that I would be alone. It was unthinkable that such a bright, kind human so full of ideas and plans could vanish. That there could be a day as beautiful as this one without Peter there to witness it.
On the way home, we both cried as we moved through traffic on the Queen Elizabeth Way. “I have so much I want to do,” Peter said. There could still be some time, we both said. Maybe he’d never be an eighty-year-old man, but maybe he’d be a sixty-five- or a sixty-seven-year-old one. Maybe he’d have to decide which book he wanted to write most. By the time we got close to home, we had the lifespan bumped up to seventy and the books down to two thrillers that had been rattling around in his brain.
“Now, this doesn’t stop your Victory Garden project,” Peter said sternly. It was a generous thing to say, but I couldn’t read the subtext. Was he saying there would be another victory for him or that, if the cancer defeated him, I would have to find my own victory? I didn’t ask. Perhaps I didn’t want the answer.
When we got home, I had no wish to tell anyone the news, especially Jane, who had been so happy at our wedding. When Peter had received his first diagnosis, he’d immediately taken to his blog and I’d had to hurry to get emails and calls to the people I felt shouldn’t find out that way.
“Please don’t blog about this tonight,” I said. I didn’t have the energy to get ahead of any news he’d post. But it seemed he had no appetite for sharing the news either. We both needed to sit with it first.
We wanted this story to have ended. We’d gone through terrifying uncertainty in the winter and after Peter’s frightening surgery. We were in a period of slow recovery. The end. Peter and Debi get on with their lives. Peter’s a hit as the moderator at three local author events in a series called Wine and Words. Peter produces a six-part series for CBC Ideas. (Wow, isn’t he productive!) Peter and Debi write books. Peter and Debi go to Rome. Peter and Debi stay in their home and watch their trees grow over the years. The end. The end. The end we’d told ourselves and shared with others. How could we tell Jane, how could we tell anyone, the story had taken a different turn?
We sat on our deck, staring at our gorgeous garden in the soft late-afternoon light while we agonized over how to give the news to Jane. We admired our trees one moment and talked about cancer the next. Had the cancer metastasized if it wasn’t in an organ? You hear so much about it turning up in the lungs or liver. We stretched for any good news. Peter searched “metastasized” on Google and said it meant cancer cells had moved through the lymph system or the blood to another part of the body.
Restless, I got up and walked around the garden. I admired the tall purple delphiniums, the yellow saucer-sized flowers of the hibiscus tree I’d bought for next to nothing at an end-of-season sale. None of them gave my any happiness. We got nothing, they seemed to say. I stared at the rows in my Victory Garden where I’d planted seeds the day before. Were they already opening and starting to germinate, indifferent to our pain? In the squash patch, I studied the zucchini plants, needing some sign a zucchini was developing but found none.
That night I woke up thinking of the butternut squash plant I’d pulled up the day before, the one with the rotting root and the healthy vine that stretched to the end of the garden. And it made me think of metastasizing, of spreading out and settling somewhere else. Never had my garden seemed so malevolent.
The next day we both felt a little stronger. I made a soup from the butternut squash for Peter and a supper for me of rigatoni with beet greens, red onion, sliced Romas, and garlic from the garden. It had become my routine to plan my meals around the vegetables available in the garden. In the mornings, I sautéed a
chopped tomato or two with a cup of basil and threw in an egg and Parmesan to hold the mixture together. At lunch, I’d make a toasted tomato sandwich or a Greek salad. At supper I’d cook all the vegetables I could handle in various dishes. Those meals gave me moments of such pleasure. Meanwhile, Peter kept to old favourites of his own like chicken pot pie and tourtière. He seemed to crave meat more than ever.
That day, we agreed that if we had to go somewhere for treatment again, we were both pleased it would be the Juravinski Cancer Centre. The team there had always been efficient and open to questions. Cancer is a manageable disease, we told ourselves. We’d have to think in those terms. Peter got a call to go to Dr. D, the chemotherapy oncologist at the Juravinski, the following Tuesday. As we’d expected, further radiation was out of the question.
We knew we had to tell Jane soon, but didn’t want to call her when there was only fear and no plan. We thought it might be easier to tell her face to face, so Peter texted her to say we had to go to Toronto and to ask whether she be available for dinner on Wednesday or Thursday. She wasn’t free either evening. We didn’t want to keep suggesting days and raise suspicions, so we decided to wait until after our appointment when we could say, “Here’s what’s going to happen.”
Sitting on the deck that evening, I thought of a meme I’d seen on Facebook that has Charlie Brown saying, “Some day we will all die,” and Snoopy answering, “True, but on all the other days we live.”
The next morning, with the pink roses from D and D fading, I went out to pick fresh flowers for the house. I sent Jane a picture of the mix of hydrangeas, delphiniums, butterfly bush flowers, and hostas, and she texted back that hydrangeas would always remind her of our wedding. I hoped that would be true, that our wedding would be her most important memory of that summer. When I walked past the vegetable bed, I noticed something red peeking out from between the tomatoes and the chard. I thought at first it was a tomato stretching into the row of pepper plants, but no, it was a gorgeous, plump red pepper. The Redstart peppers I’d started from seed in the spring were doing their job. There were four of them hidden under leaves, and as I pulled them from the plants a pang of joy jolted me. Others before me had successfully grown red peppers, but I never had. New things were still possible.
Peter was still upstairs in the bedroom. I went up to him with an idea. Let’s use our wedding date as a goal, get to six months, then a year, and each time have our own quiet celebration. He said he liked the idea, and we decided to first set a modest goal of three months: get to November sixth — to garlic-planting time in garden terms. I pictured us raising our glasses once the cloves were ensconced underground.
In bed that night, I rubbed his back and threw my arm around him. “I don’t want to lose you,” I said. Was I trying to give him encouragement to go on or was I just being selfish? I don’t know. I know I needed him to understand how essential he was to my existence.
I moved through the rest of the week in a mix of tears, anxiety, and imagining. Although I wanted to stop myself, I couldn’t help but wonder what I’d do if I were alone. I’d stay in this house, I decided, for at least another garden season. Perhaps I’d end up as the crazy old lady down the street with the beautiful garden. But I hated myself for those thoughts.
In the cool mornings, I rearranged flower beds or weeded the vegetable garden, losing myself in the work. I have always hated the arrival of the dark days and the cold weather, and as the sun finally grew in strength by midmorning, I realized how tough the next winter would be. The trip to Rome was meant to ease us over the hump, to keep my November depression over the coming of the dark days at bay. We had decided to wait until after our meeting with Dr. D to cancel the trip, but I think we both knew we were kidding ourselves.
The hydromorphone Peter was now taking made his digestive problems even worse. He felt bloated and constipated all the time. And it seemed to take all motivation away from him. He didn’t want to go to the gym, which frightened me. Before Peter had his orthopedic surgery in 2012, he’d known he had to keep up his walking before the long period of his recovery. And he walked even though each step he took sent excruciating pain up his leg. By then, the silver plate from his operation as a boy, a plate that held his leg to his hip, was causing striations in his pelvis. Nonetheless, each day we’d drive to the park that ran along the Humber River near our Toronto home and he’d walk, marking how far he had to go by walking to an old willow tree that he loved and back to the parked car. After his surgery, in the year he’d learned to walk again, he’d stubbornly worked on his walking once the nerves in his leg had settled down and he could get off his crutches.
He’d shown that same determination in his first round of cancer treatment. We’d go to the gym near our new home, and after some exercises to keep up his muscle mass, he’d walk on the indoor track that circled the areas for weights and machines and the elevator shaft. As I did weights, I’d hear the click of his cane getting closer and closer before seeing him come around the corner at a hearty clip.
But in the time since his cancer surgery, he’d lost much of the muscle in his arms and legs; his once-strong thighs were like sticks. I fretted over how he’d get through another round of treatments. One day, I persuaded him to go to the gym, and while I worked with weights he started the circle. When I no longer could hear his cane, I wondered what had happened. I found him sitting by a window at the other end of the gym.
“I’ve had enough,” he said casually, as if walking was a slight matter. He couldn’t have gone more than three times around the track. Three times around the track was not enough.
That week, two thumb-sized zucchini appeared on a vine, but within a day they both withered away. Victory seemed so unlikely.
Finally, the day for the visit to Dr. D arrived. While we were both afraid she might say there was nothing she could do, we took some comfort in knowing the driving route to the Juravinski in Hamilton by heart. During the first panicked visits in the fall, I’d driven around the neighbourhood for half an hour before settling on the cheapest street parking I could find. This time I knew exactly where to park. Even in the darkest times, the smallest things offer sparks of reassurance.
Everyone who saw Peter — the assistant, the nurse, and Dr. D herself — was alarmed at his weight loss. On their scale, he weighed in at 145, down from the 187 pounds recorded during his follow-up visit in the spring, down from slightly more than 200 when the cancer was first diagnosed. Dr. D reminded us that chemotherapy was the only option, but it could never destroy the tumour; it could only shrink it and give Peter six to eighteen months more of life. Neither of us brought up how wrong doctors could be, but I’m sure it was in the back of Peter’s mind, as it was in mine. When he’d had his blood problems, the doctor had described Peter as “a tank” for living with his low hemoglobin count. Even though Peter didn’t look like a tank now, part of me still thought of him as a survivor.
Dr. D wasn’t prepared to start the treatment she proposed — two intravenous chemo drugs and one in the form of tablets — until she knew the state of Peter’s heart because one of the drugs was hard on the heart. She ordered an echocardiogram. She also wanted a feeding tube in Peter to keep his weight steady, and that would mean waiting for a surgical bed. And she ordered blood work to make sure he didn’t have an infection. It was best to have everything in order before beginning, she said, so the negative effects of the drugs didn’t outweigh the benefits. If everything wasn’t in order, she said, Peter could end up in hospital with septic shock and they’d have to wait to start the chemotherapy again. She also warned he shouldn’t be sedentary for more than 50 percent of the time, and I fretted again about Peter’s lack of interest in exercise.
That night, we finally found the courage to call Jane. The cancer has returned, we said. They are going to try chemo. Kept it simple until we could see her in person. She told us she was coming for the Labour Day weekend and could come early since there was no work at her job in the city hall courts in
the days before the long weekend.
The next evening, I drove along the Lakeshore to pick her up at the bus stop in St. Catharines, past the fruit stands, the orchards, and the vineyards of Niagara, a region that was in my soul. I rolled down the windows for the cool breeze, rolled up the volume on the radio. The song was Justin Bieber’s hit “Sorry.” The adult in me issued instructions to turn the radio off or listen to something more intelligent, more inspiring. The teenager in me relived summer evening drives after a day of farm work with the latest hit du jour blasting out of the car and life full of possibilities. The teenager won out.
I revelled in the drive and later revelled in an evening with Jane as we ate rigatoni with red peppers, Swiss chard, and my latest batch of tomato sauce, as we drank red wine and watched the feel-good movie Chef. This was the calm I’d been seeking over the past week, but it left me feeling guilty.
Peter was in bed but awake when I went upstairs. Selfishly, I cried when he asked if we’d had a good evening and I told him we had. “Don’t,” he said. “You’re allowed to have a good time. I wouldn’t want you not to.”
After the fall of France in the Second World War, Britain’s prime minister Winston Churchill called it the “darkest hour,” referring to a line by Thomas Fuller: “It is always darkest just before the Day dawneth.” But how does one find the courage to go on, to patiently wait for doctors to try new treatments, to continue digging and planting, when victory looks unlikely, when the dawn could bring harsher news? All I knew that evening, as summer was coming to an end, was that it was all going to hurt so much.
Chapter Thirteen