by Thom Jones
Okay, the Dilaudid was permanently off the menu, but morphine sulfate wasn’t half bad. No more cartoons but rather a mellow glow. Left, right, left, right. Hup, two, three, four! Even a journey of a thousand miles begins with the first step. On the morphine she was walking a quarter of an inch off the ground and everything was…softer, mercifully so. Maybe she could hack it for a thousand miles.
But those people in the hospital rooms, gray and dying, that was her. Could such a thing be possible? To die? Really? Yes, at some point she guessed you did die. But her? Now? So soon? With so little time to get used to the idea?
No, this was all a bad dream! She’d wake up. She’d wake up back in her little girl room on the farm near Battle Lake, Minnesota. There was a depression, things were a little rough, but big deal. What could beat a sun-kissed morning on Battle Lake and a robin’s song? There was an abundance of jays, larks, bluebirds, cardinals, hummingbirds, red-winged blackbirds in those days before acid rain and heavy-metal poisoning, and they came to her yard to eat from the cherry, apple, plum, and pear trees. What they really went for were the mulberries.
Ah, youth! Good looks, a clean complexion, muscle tone, a full head of lustrous hair—her best feature, although her legs were pretty good, too. Strength. Vitality. A happy kid with a bright future. Cheerleader her senior year. Pharmacy scholarship at the college in Fergus Falls. Geez, if her dad hadn’t died, she could have been a pharmacist. Her grades were good, but hard-luck stories were the order of the day. It was a Great Depression. She would have to take her chances. Gosh! It had been a great, wide, wonderful world in those days, and no matter what, an adventure lay ahead, something marvelous—a handsome prince and a life happily ever after. Luck was with her. Where had all the time gone? How had all the dreams…fallen away? Now she was in the Valley of the Shadow. The morphine sulfate was like a warm and friendly hearth in Gloom City, her one and only consolation.
He was supposed to be a good doctor, one of the best in the field, but he had absolutely no bedside manner. She really began to hate him when he took away the morphine and put her on Tylenol 3. Then it began to sink in that things might presently go downhill in a hurry.
They worked out a routine. If her brother was busy, her daughter drove her up to the clinic and then back down to the office, and the thin oncologist is…called away, or he’s…running behind, or he’s…something. Couldn’t they run a business, get their shit together? Why couldn’t they anticipate? It was one thing to wait in line at a bank when you’re well, but when you’ve got cancer and you’re this cancer patient and you wait an hour, two hours, or they tell you to come back next week…come back for something that’s worse than anything, the very worst thing in the world! Hard to get up for that. You really had to brace yourself. Cisplatin, God! Metal mouth, restlessness, pacing. Flop on the couch, but that’s no good; get up and pace, but you can’t handle that, so you flop on the couch again. Get up and pace. Is this really happening to me? I can’t believe this is really happening to me! How can such a thing be possible?
Then there were the episodes of simultaneous diarrhea and vomiting that sprayed the bathroom from floor to ceiling! Dry heaves and then dry heaves with bile and then dry heaves with blood. You could drink a quart of tequila and then a quart of rum and have some sloe gin too and eat pink birthday cakes and five pounds of licorice, Epsom salts, a pint of kerosene, some Southern Comfort—and you’re on a Sunday picnic compared to cisplatin. Only an archfiend could devise a dilemma where to maybe get well you first had to poison yourself within a whisker of death, and in fact if you didn’t die, you wished that you had.
There were visitors in droves. Flowers. Various intrusions at all hours. Go away. Leave me alone…please, God, leave me…alone.
Oh, hi, thanks for coming. Oh, what a lovely—such beautiful flowers…
There were moments when she felt that if she had one more episode of diarrhea, she’d jump out of the window. Five stories. Would that be high enough? Or would you lie there for a time and die slowly? Maybe if you took a header right onto the concrete. Maybe then you wouldn’t feel a thing. Cisplatin: she had to pace. But she had to lie down, but she was squirrelly as hell and she couldn’t lie down. TV was no good—she had double vision, and it was all just a bunch of stupid shit, anyhow. Soap operas—good grief! What absolute crap. Even her old favorites. You only live once, and to think of all the time she pissed away watching soap operas.
If only she could sleep. God, couldn’t they give her Dilaudid? No! Wait! Hold that! Somehow Dilaudid would make it even worse. Ether then. Put her out. Wake me up in five days. Just let me sleep. She had to get up to pace. She had to lie down. She had to vomit. Oh, hi, thanks for coming. Oh, what a lovely—such beautiful flowers.
The second treatment made the first treatment seem like a month in the country. The third treatment—oh, damn! The whole scenario had been underplayed. Those movie stars who got it and wrote books about it were stoics, valiant warriors compared to her. She had no idea anything could be so horrible. Starving in Bangladesh? No problem, I’ll trade. Here’s my MasterCard and the keys to the Buick—I’ll pull a rickshaw, anything! Anything but this. HIV-positive? Why, just sign right here on the dotted line and you’ve got a deal! I’ll trade with anybody! Anybody.
The thin oncologist with the Bugs Bunny voice said the CA-125 number was still up in the stratosphere. He said it was up to her if she wanted to go on with this. What was holding her up? She didn’t know, and her own voice came from a can now. She heard herself say, “Doctor, what would you do…if you were me?”
He thought it over for a long time. He pulled off his wire rims and pinched his nose, world-weary. “I’d take the next treatment.”
It was the worst by far—square root to infinity. Five days: no sleep, pacing, lying down, pacing. Puke and diarrhea. The phone. She wanted to tear it off the wall. After all these years, couldn’t they make a quiet bell?—did they have shit for brains or what? Oh, hi, well…just fine. Just dandy. Coming by on Sunday? With the kids? Well…no, I feel great. No. No. No. I’d love to see you…
And then one day the thin-timbre voice delivered good news. “Your CA 125 is almost within normal limits. It’s working!”
Hallelujah! Oh my God, let it be so! A miracle. Hurrah!
“It is a miracle,” he said. He was almost human, Dr. Kildare, Dr. Ben Casey, Marcus Welby, M.D.—take your pick. “Your CA is down to rock bottom. I think we should do one, possibly two more treatments and then go back inside for a look. If we do too few, we may not kill it all but if we do too much—you see, it’s toxic to your healthy cells as well. You can get cardiomyopathy in one session of cisplatin and you can die.”
“One more is all I can handle.”
“Gotcha, Mrs. Wilson. One more and in for a look.”
“I hate to tell you this,” he said. Was he making the cartoons go away? “I’ll be up front about it, Mrs. Wilson, we’ve still got a problem. The little Grape-Nuts—fewer than in the beginning, but the remaining cells will be resistant to cisplatin, so our options are running thin. We could try a month of an experimental form of hard chemotherapy right here in the hospital—very, very risky stuff. Or we could resume the cisplatin, not so much aiming for a cure but rather as a holding action. Or we could not do anything at all…”
Her voice was flat. She said, “What if I don’t do anything?”
“Dead in three months, maybe six.”
She said, “Dead how?”
“Lungs, liver, or bowel. Don’t worry, Mrs. Wilson, there won’t be a lot of pain. I’ll see to that.”
Bingo! He flipped the chart shut and…whiz, bang, he was outta there!
She realized that when she got right down to it, she wanted to live, more than anything, on almost any terms, so she took more cisplatin. But the oncologist was right, it couldn’t touch those resistant rogue cells; they were like roaches that could live through atomic warfare, grow and thrive. Well then, screw it! At least there wouldn’t be pain. What
more can you do? She shouldn’t have let him open her up again. That had been the worst sort of folly. She’d let him steamroll her with Doctor Knows Best. Air had hit it. No wonder it was a wildfire. A conflagration.
Her friends came by. It was an effort to make small talk. How could they know? How could they know what it was like? They loved her, they said, with liquor on their breath. They had to get juiced before they could stand to come by! They came with casseroles and cleaned for her, but she had to sweat out her nights alone. Dark nights of the soul on Tylenol 3 and Xanax. A lot of good that was. But then when she was in her loose, giddy freedom’s just another word for nothing left to lose mood, about ten days after a treatment, she realized her friends weren’t so dumb. They knew that they couldn’t really know. Bugs Bunny told her there was no point in going on with the cisplatin. He told her she was a very brave lady. He said he was sorry.
A month after she was off that poison, cisplatin, there was a little side benefit. She could see the colors of the earth again and taste food and smell flowers—it was a bittersweet pleasure, to be sure. But her friends took her to Hawaii, where they had this great friend (“You gotta meet him!”) and he…he made a play for her and brought her flowers every day, expensive roses, et cetera. She had never considered another man since John had died from can…cer ten years before. How wonderful to forget it all for a moment here and there. A moment? Qualify that—make that ten, fifteen seconds. How can you forget it? Ever since she got the news she could…not…forget…it.
Now there were stabbing pains, twinges, flutterings—maybe it was normal everyday stuff amplified by the imagination or maybe it was real. How fast would it move, this wildfire brand? Better not to ask.
Suddenly she was horrible again. Those nights alone—killers. Finally one night she broke down and called her daughter. Hated to do it, throw in the towel, but this was the fifteenth round and she didn’t have a prayer.
“Oh, hi. I’m just fine”—blah blah blah—“but I was thinking maybe I could come down and stay, just a while. I’d like to see Janey and—”
“We’ll drive up in the morning.”
At least she was with blood. And her darling granddaughter. What a delight. Playing with the little girl, she could forget. It was even better than Hawaii. After a year of sheer hell, in which all of the good stuff added up to less than an hour and four minutes total, there was a way to forget. She helped with the dishes. A little light cleaning. Watched the game shows, worked the Times crossword, but the pains grew worse. Goddamn it, it felt like nasty little yellow-tooth rodents or a horde of translucent termites—thousands of them, chewing her guts out! Tylenol 3 couldn’t touch it. The new doctor she had been passed to gave her Dilaudid. She was enormously relieved. But what she got was a vial of little pink tablets and after the first dose she realized it wasn’t much good in the pill form; you could squeeze by on it but they’d promised—no pain! She was losing steam. Grinding down.
They spent a couple of days on the Oregon coast. The son-in-law—somehow it was easy to be with him. He didn’t pretend that things were other than they were. He could be a pain in the bun, like everyone, bitching over trivialities, smoking Kool cigarettes, strong ones—jolters! A pack a day easy, although he was considerate enough to go outside and do it. She wanted to tell him, “Fool! Your health is your greatest fortune!” But she was the one who’d let six months pass after that first discharge.
The Oregon coast was lovely, although the surf was too cold for actual swimming. She sat in the hotel whirlpool and watched her granddaughter swim a whole length of the pool all on her own, a kind of dog-paddle thing but not bad for a kid going on seven. They saw a show of shooting stars one night but it was exhausting to keep up a good front and not to be morbid, losing weight big time. After a shower, standing at the mirror, scars zigzagging all over the joint like the Bride of Frankenstein, it was just awful. She was bald, scrawny, ashen, yet with a bloated belly. She couldn’t look. Sometimes she would sink to the floor and just lie there, too sick to even cry, too weak to even get dressed, yet somehow she did get dressed, slapped on that hot, goddamn wig, and showed up for dinner. It was easier to do that if you pretended that it wasn’t real, if you pretended it was all on TV.
She felt like a naughty little girl sitting before the table looking at meals her daughter was killing herself to make—old favorites that now tasted like a combination of forty-weight Texaco oil and sawdust. It was a relief to get back to the couch and work crossword puzzles. It was hell imposing on her daughter but she was frightened. Terrified! They were her blood. They had to take her. Oh, to come to this!
The son-in-law worked swing shift and he cheered her in the morning when he got up and made coffee. He was full of life. He was real. He was authentic. He even interjected little pockets of hope. Not that he pushed macrobiotics or any of that foolishness, but it was a fact—if you were happy, if you had something to live for, if you loved life, you lived. It had been a mistake for her to hole up there in the mountains after John died. The Will to Live was more important than doctors and medicines. You had to reinvigorate the Will to Live. The granddaughter was good for that. She just couldn’t go the meditation-tape route, imagining microscopic, ravenous, good-guy little sharks eating the bad cancer cells, et cetera. At least the son-in-law didn’t suggest that or come on strong with a theology trip. She noticed he read the King James Bible, though.
She couldn’t eat. There was a milk-shake diet she choked down. Vanilla, chocolate fudge, strawberry—your choice. Would Madame like a bottle of wine with dinner? Ha, ha, ha.
Dilaudid. It wasn’t working, there was serious pain, especially in her chest, dagger thrusts—Et tu, Brute? She watched the clock like a hawk and had her pills out and ready every four hours—and that last hour was getting to be murder, a morbid sweat began popping out of her in the last fifteen minutes. One morning she caved in and timidly asked the son-in-law, “Can I take three?”
He said, “Hell, take four. It’s a safe drug. If you have bad pain, take four.” Her eyes were popping out of her head. “Here, drink it with coffee and it will kick in faster.”
He was right. He knew more than the doctor. You just can’t do everything by the book. Maybe that had been her trouble all along—she was too compliant, one of those “cancer” personalities. She believed in the rules. She was one of those kind who wanted to leave the world a better place than she found it. She had been a good person, had always done the right thing—this just wasn’t right. It wasn’t fair. She was so…angry!
The next day, over the phone, her son-in-law bullied a prescription of methadone from the cancer doctor. She heard one side of a lengthy heated exchange while the son-in-law made a persuasive case for methadone. He came on like Clarence Darrow or F. Lee Bailey. It was a commanding performance. She’d never heard of anyone giving a doctor hell before. God bless him for not backing down! On methadone tablets a warm orange glow sprang forth and bloomed like a glorious, time-lapse rose in her abdomen and then rolled through her body in orgasmic waves. The sense of relief shattered all fear and doubt though the pain was still there to some extent. It was still there but—so what? And the methadone tablets lasted a very long time—no more of that every four hours bullshit.
Purple blotches all over her skin, swollen ankles. Pain in her hips and joints. An ambulance trip to the emergency room. “Oh,” they said, “it’s nothing…vascular purpura. Take aspirin. Who’s next?”
Who’s next? Why hadn’t she taken John’s old .38 revolver the very day she heard that voice in the can? Stuck it in the back of her mouth and pulled the trigger? She had no fear of hellfire. She was a decent, moral person but she did not believe. Neither was she the Hamlet type—what lies on the other side? It was probably the same thing that occurred before you were born—zilch. And zilch wasn’t that bad. What was wrong with zilch?
One morning she waited overlong for the son-in-law to get up, almost smashed a candy dish to get him out of bed. Was he going to sleep
forever? Actually, he got up at his usual time.
“I can’t. Get. My breath,” she told him.
“You probably have water in your lungs,” the son-in-law said. He knew she didn’t want to go to the clinic. “We’ve got some diuretic. They were Boxer’s when she had congestive heart failure—dog medicine, but it’s the same thing they give humans. Boxer weighed fifty-five pounds. Let me see…take four, no, take three. To be cautious. Do you feel like you have to cough?”
“Yes.” Kaff, kaff, kaff.
“This might draw the water out of your lungs. It’s pretty safe. Try to eat a banana or a potato skin to keep your potassium up. If it doesn’t work, we can go over to the clinic.”
How would he know something like that? But he was right. It worked like magic. She had to pee like crazy but she could breathe. The panic to end all panics was over. If she could only go…number two. Well, the methadone slows you down. “Try some Metamucil,” the son-in-law said.
It worked. Kind of, but it sure wasn’t anything to write home about.
“I can’t breathe. The diuretics aren’t working.”
The son-in-law said they could tap her lung. It would mean another drive to the clinic, but the procedure was almost painless and provided instantaneous relief. It worked but it was three days of exhaustion after that one. The waiting room. Why so long? Why couldn’t they anticipate? You didn’t have to be a genius to know which way the wildfire was spreading. Would the methadone keep that internal orange glow going or would they run out of ammo? Was methadone the ultimate or were there bigger guns? Street heroin? She’d have to put on her wig and go out and score China White.
The little girl began to tune out. Gramma wasn’t so much fun anymore; she just lay there and gave off this smell. There was no more dressing up; it was just the bathrobe. In fact, she felt the best in her old red-and-black tartan pattern, flannel, ratty-ass bathrobe, not the good one. The crosswords—forget it, too depressing. You could live the life of Cleopatra but if it came down to this, what was the point?