Year of Plagues

by Fred D’Aguiar

  The magical component to all this stems from my upbringing in Airy Hall, the Guyanese village where I spent my childhood years. Though it was a small place, it had one of everything: one drunk, one madman, one shoemaker, whose workshop doubled as a preschool taught by his wife, one corner shop for dry goods, one bakery, and a midwife who handed out homeopathic remedies for all manner of illnesses. As a child in that place, I grew to believe in things unseen as forces that shape life. I say the word magic not to belittle but to keep invention at my fingertips and bring laughter on board. I could call it by its other name (it has many names) obeah, as well, and the scene of levity turns deadly serious. I could label it all as superstition in the absence of hard scientific fact as a way to put that childhood period in its proper place. If I did that I would be a fool. Not the good fool of play and mischief for the sake of invention but the fooled, the hypnotized and duped.

  Airy Hall seemed to promote the spirit world in part to inform and safeguard the material world. Our days outside ended at nightfall and our days began early at the crack of dawn. The diurnal cycle was accompanied by the cycle of the spirit world. Spirits good and not so good ruled at night, they patrolled the dark and frolicked in it. Material things ruled the daylight. During the day our behavior was informed by that nighttime lesson of obedience to guidelines of the spirits. If a crow landed on the house, that was a bad omen of imminent news about a death or dying relative or friend. If a black cat crossed your path, that foretold a not-so-good outcome to your journey, and made you guarded for the rest of your day.

  The list, though long, is by no means exhaustive. At night we gathered around a gas-lit lamp with its soft sphere of a wick under a glass shade, to talk about the workings of spirits. Our eyes widened and jaws dropped to tales of children taken in the night by supernatural forces. We knew that to venture out into the thick dark that made the trunks of trees and their limbs join hands to form a wall would be inviting death. We also looked up for long periods at the night sky to marvel at the patterns of light as we waited for a star to pitch so that we could make a wish by it. Each childhood mishap was credited to the machinations of the spirits. But so was all our fortune. All our attention and concentration grew out of this focus on spirits and talk and thought about them. They figured in our dreams as well.

  Cancer has nothing like this world in its arsenal. Cancer’s mechanism relies on chemistry and time-locked genealogies, marvelous building blocks for sure, and vulnerable as a result to uncertainty, the numinous as magic. If cancer exhibits lockstep progression, I may be able to alter that course with inducements of magic, fable, myth, and the story component of his/her/their story. I redouble my effort to build alternatives to cancer’s march to an early end to my life. Cancer’s direct assault calls on me to absorb its energies and divert them into more creative ends (beginnings) for me. As cancer drives forward in my body, so I twist and shout to evade it.

  * * *

  There is a reggae song to go with the other tunes of my resistance to my cancer. Just as there is an epidemiology for my disease, there a matching epidemiology for my resistance to it. In 1976, Tapper Zukie, a Jamaican DJ, recorded an album in London titled MPLA (the Mozambique People’s Liberation Army). That title track, “Dub MPLA,” an exemplar of incantatory deep dub, easily works with PSMA substituted into it, along with some words about my condition and my struggle with it. After I say “PSMA,” you have to hear a heavy bass line, six beats that are 1, 2, 1, 2, 1-2, slow, slow, slow, slow, quick-quick, or boom, boom, boom, boom, boom-boom. It is hexameter if we hear every sound as a stress (’cause you feel every pound of the bass). It can be construed as pentameter if we take each of the first four numbers as stressed monosyllables, and assume that the last two numbers concede a stress on the second number, rather than counting them as two unstressed syllables delivered in rapid succession, or as two stressed ones of equal weight. So much for the grammar of my resistance in exact countermeasure to the grammar of cancer in my Black body.

  I say this about the two grammars (for cancer and resistance to it) and their respective epidemiology since my ear may pick up not hexameter or even pentameter but iambic trimeter, with the third pair delivered faster than the previous two pairs. Whatever you settle on for its metrical beat, the rhythm pans out as roughly similar in its buckling effects on the spine, hip, knees, and other bones, in its acceleration of the heart and blood circulation and in its exhilaration of the spirit. You have to imagine my close-cropped hair and receding hairline as magically recovered into copious swirling dreads, possibly red ones. I perform a Bob Marley skank (in those days skank referred to a reggae dance) of hips dipped and each leg bent in turn as I hop from one foot to the other, and shake my head, and as I chant “PSMA,” to bring down the Babylonian growth of my cancer.

  A pom-pom is insufficient as a prop. I need maracas and a tambourine. I need the many strings of multicolored beads of a New Orleans Mardi Gras, and a shirt from Trinidad’s carnival and the headgear of Brazil’s. Add to all that bacchanal paraphernalia those voluminous sound systems of London’s Notting Hill Carnival. Let’s party and let the games begin. Both. Dear cancer, may I have the privilege of our first dance? Hey, cancer, want to come out and play? I have this feeling that today will go my way. One of those good days that the rapper Ice Cube dreams about in his track “It Was a Good Day,” ironic, braggadocio, and ponderous in turn about life in South Central LA, where all the life-threatening things that routinely happen magically do not, until the close of day bursts the bubble of that dreamtime with the same old, same old helicopter (ghetto bird) overhead, and multiple squawking squad cars with militarized cops.

  So it is that we hit Washington in Mid-City and find nothing on the streets, a clean sweep of asphalt heading west and shining with the rain as if the sea began at my door right here in Mid-City. Debbie wonders how we will go back to jammed streets after this loving emptiness. The left onto Crenshaw yields the same grace: few cars, little foot traffic, someone selling face masks where they once sold flowers. The right onto the I-5 and it is the same, no turnstile of lights to feed cars onto the near gridlock, just an easy slide down the ramp and ease out left into sparse traffic. We sail to my appointment. We tack lanes of the sea. I do not drive. The car conveys me.

  With the air so clean and washed now by rain these last two days, there is a lightness to the already well-lit place, less resistance offered to my car, more invitations sent to my lungs to trust and draw deep. Even the lights hold us for shorter periods, their green with a polished look, their red looking more apologetic. There are spaces galore in the hospital parking lot. We don masks in our seats and emerge from the car disguised in broad daylight as if about to execute a bank raid.

  A nurse at the door points to a newly added sign that lists COVID-19 symptoms and she wants to know if we have anything on the list, coughing, runny nose, fever, difficulty breathing, we shake our heads from side to side for each, and speak loudly with our mouths comprehensively covered, and we smile with our eyes or beam goodwill with them. The nurse holds a temporal artery thermometer close to our foreheads and waves us into the hospital. We march on, less a march, more a saunter. We are early and I say to Debbie that if I move faster I might pass out from lack of air thanks to my constricting mask.

  I use a ballpoint pen to summon the elevator to the basement that houses nuclear medicine. Debbie remarks that the isolation in the basement is perfect in case of a Chernobyl-like accident. Funny you should say that. I was thinking the same thing and how I was about to introduce that feared chemical compound into my body voluntarily. Debbie has to leave, new policy, only patients who need help can have someone with them, and since the whole thing should take three hours it makes no sense for her to wait in the car for me. She wishes me luck and heads for home. I promise to keep her updated.

  There is just one other person, besides the male receptionist, in the waiting room. Alternate chairs are labeled as not for use to enforce the safe distance between patien
ts. The other person is a young woman with short hair and baggy black clothes who does not look up from her phone, which she addresses with two hands. She has a walking stick next to her seat. The fluorescent lights bleed my brown skin to resemble her whiteness, and my old middle age seems less distanced from her twentysomething youthfulness in this blanched light. It is as if the waiting room is lit by the nuclear particles that both of us need to send around our body to highlight our disease. The introductory exterior light means to lull us into making the transition to imminent interior bombardment.

  Since the procedure is experimental, I have a lot of reading matter, mostly disclaimers in case I die or become disabled, though this rarely happens, going by the stats (one in one hundred thousand), and a lot of consent to grant the experts in various branches of the medical profession access to my file. One part of the test is known and in abundant use at over twenty thousand hospitals worldwide. But the tracer is the culprit in need of research. The friendly head of nuclear medicine research, and professor and surgeon (he offers his card in one hand and his elbow for me to bump), tells me that the tracer is already approved to show cancer in the brain. This prostate application for the PSMA test, though it utilizes the same chemical imaging technique as the PSA test, is not approved. The professor says that they came upon it accidentally when a patient with both brain and prostate cancer was given the tracer for the brain and it showed cancer in the prostate as well. He thinks that approval is inevitable given the high accuracy of the look for the surgeon that the trace drug affords and because it is approved for another procedure; that is, it’s not truly experimental. They just need the numbers of patients, he tells me. I feel like I am doing some good for medicine. I hope the medicine will reciprocate.

  The approved part of the test is the conventional position emission tomography (PET) machine, which provides a magnetic resonance pictograph of the body’s interior with a chemical highlighter taken orally or intravenously to sharpen what the radiologist sees. PET maps inside the body by bouncing magnetic sound waves off the organs, which are highlighted by tracers that the machine’s waves find, just as homing coordinates might reposition a satellite remotely. The unapproved part concerns the tracer, called 68Ga-PSMA-11. The first number is the chemical chart placing of the gamma rays. 68Ga radiation has a short half-life of six hours or less. It is ordered up from the manufacturing lab the moment I pay for the test. A special delivery of a lead-clad, outsize sandwich container brings it to me. The radiation sits in its cozy stainless-steel canister in the room to attain room temperature, though the nurse tells me that it will feel cool running up the vein in my arm since my blood is warmer than the room.

  Somehow children crop up in my talk with the director-professor-surgeon. We agree, along sexist, cisgender assumptions, that his boy and my two sons cope better with being housebound than his daughter and mine, who appear more agitated with isolation and seem to need more tactile human exchanges. His boy plays games online, as do mine, and his daughter yearns to get out of the house and meet with her friends in the flesh, as does mine. A part of my consciousness wants to ingratiate itself with the surgeon to let him know I’m just like him except for my malady. It occurs to me that I’ve taken to heart those radio reports about Black people under COVID-19. Apparently, Black men are fearful in public with their masks on their faces in case it adds to an already threatening reading of their bodies. Also, an alarmingly high number of Blacks compared with Whites are dying from COVID-19.

  What troubles me is my need to feel as near a human as possible to the head of nuclear medicine research. I view my cancer as a factor that separates me from the rest of humanity. Blackness is my marker for this noted difference in a White-run system. COVID-19 for all its pandemic hoopla has not altered the fact that race plays a big role in who gets to live and who is left to die. I should twin race with poverty. The poor and homeless face the brunt of the effects of COVID-19. Add to this the fact that African American men are more likely than White men (of European descent) to contract prostate cancer and perhaps my paranoia is justified after all, is not in fact paranoia but a fair assumption.

  I wish I had fewer things to worry about. It makes sense that cancer would co-opt many things on its side to overload me with anxiety about having it and weaken my resolve to fight it. A nurse comes in and she delights in her driving time to work cut in half by COVID-19. She asks me to pick an arm for the intravenous site. I roll up my right sleeve, remembering that I gave blood last week from my left arm. I do not want my veins to look like I imagine heroin addicts’ arms to be—laddered with bruises from the assault of countless needles. I fear the collapse of a traumatized vein.

  The nurse barely makes contact with my skin. Gloveless, she wears a plain, thin gold ring on her left thumb. Her manicured, pink nails, possibly modest extensions, shine. Her hands’ butterfly touch belie the pinch she meekly warns me about before she punctures my vein. It feels more than an avuncular pinch, more like my aunt changing her mind halfway through her pincer movement on my flesh and releasing her vice to leave me with a burn that is about half the strength of her usual furious application. She pours a white powder into 1,000 mL of glucose solution that dyes the square plastic bottle ruby. She says I have forty-five minutes to drink it all. I reply that I’ll pretend it’s red wine since I’ve not had a drink in months. She raises the gurney on which I am seated so that I can put up my feet and recline, and she departs. I check my phone but cannot get a signal in the nuclear basement bunker. I imagine cement poured over days by a convoy of trucks with slowly rotating payloads lined up both sides of Wiltshire Plaza and snaking for a mile along these Westwood streets.

  Left alone, I pour the sweet, red water into a paper cup and drink. Room temperature below ground means cool, so that I feel this burgeoning refrigeration of my body that offers nectar to my disease, for it to sip, lose its camouflage, and reveal its encampment in me. The masking effect of the sugar does little to disguise the medicinal taste. I read the long handout about the test and stop after every paragraph to take a gulp and after several of those, stop to refill the cup. I note, without wanting to, how more plastic shows than drink and soon less drink, that makes me wonder if I have one or two more pours from the bottle for me to drain it. I am helped by the fact that six hours ago I took my last drink, early-morning coffee that I woke in the dark to enjoy, making me wonder if I faced a firing squad and they offered me a last cigarette whether I would decline it for a coffee or in addition to a coffee, since to drink deep of the air that I was about to lose makes a delight and a delicacy out of a cigarette. Or would it be a spliff and a coffee? Coffee first. No doubt.

  The nurse returns and congratulates me on finishing the drink, she says quite a few people find it impossible to get to the end. I think, Now you tell me I could have left some, when you gave me the impression forty-five minutes ago that I had to drink it all. Sneaky. She directs me to the lavatory to empty my bladder. I elbow open the bathroom door, a long lever curved at the inward-facing end, and use a napkin to turn the lock on it. I dispose of the tissue and pee. It is clear. And not as much as I expected given how much I took on board. I thought ahead to the time when the urge to go again would make me have to ask someone or other to point me to a bathroom.

  To keep me at the sink for the recommended twenty seconds with the water running and me rubbing my hands, I recite Langston Hughes’s “The Negro Speaks of Rivers,” for its bravura packed into two musical nuggets for stanzas. The poem’s trancelike opener that repeats at the poem’s close is as nimble as water. The water in the refrain matches the flow of the tap. The smatterings of soap, water, and twist and turn of flesh might be the poem’s metrics and shifts of the speaker through the emblems of ancient African civilizations to the ancient Mississippi, to link Africa with America: As I dry my hands, I think for the second and final time:

  “My soul has grown deep like the rivers.”

  I exit with the same tissue trick to unlock the door and to push d
own the door handle, and with my foot, I jam the door and widen the opening with the help of my elbow to keep the door wide for me to slide sideways through it. The nurse meets me outside and she sees my maneuver and says with a smile that everyone is doing that nowadays.

  The PET-CT scanner takes up the room: a long gurney engulfed at one end by a big white tube, the size of a tractor tire. Everything is painted white with the odd pastel tone that is so saccharine in a room but denotes sterility. She tells me to take off my pants and put on a white pajama bottom that has faded lilac-like flowers on it. The pants are big. I ask the nurse if I can keep my underpants on. She says yes, and exits smartly. I mean her moves are economical, as if edited by her before she does them. I take off my shoes, my trousers, and pull on the huge pajama bottoms. They gather at my feet. I wait for a moment and she returns. Can she see me change? I expect the room to be wired for everything, sound and image present in the walls as well as in the PET-CT scanner.

  I lie on the gurney and she makes me scoot up to rest my head on a pillow. I tell myself to relax and she offers me a warm blanket, which she spreads on me. I marvel at its warmth. She says they keep the blankets heated because the room needs to be cooler than usual to keep the machine cool. She offers me a second blanket. I say yes, keen on the cozy feel of a warm cover gently pressing on me. She takes my arm and flushes out the IV with saline. Then she adds the gamma nuclear concoction to the IV with a warning about the slow crawl of the cool liquid up my arm that spreads into my chest and up my neck.