Appearances

by Sondra Helene

  The wigs on display are only samples, it turns out. Terry opens several drawers to show us the retail stock, all neatly organized. She explains that some are made from genuine hair and some are synthetic. The synthetic wigs are easier to wash and dry, but the hair doesn’t look as real. “Whatever you want, I have,” she assures us. “And what I don’t have, I can order.”

  “I like the first one you tried,” I say to Elizabeth. “It looks natural.”

  “I don’t want to look any different,” she says.

  My mother rubs the back of Elizabeth’s neck. “You’re going to beat this.”

  “This one?” I plop on a curly red wig to lighten the mood, peeking in the mirror. “Think I could pass for Barbra Streisand? If only I could sing,” I say, and laugh. Elizabeth doesn’t smile.

  We leave Terry’s with two human-hair wigs, each nestled in its own white box like a cake from a bakery. In the car Elizabeth says, “I’m going to bring these to Megan and ask her to style and highlight them so they’re as good as my own hair.”

  “Great idea. I’ll go with you,” I say.

  “It was a perfect place to go. Private. Thank you,” Elizabeth says, and bows her head. “If I just knew I had a chance to beat it . . .” She starts crying. “I’m sorry. It’d be so much easier to deal.”

  “The doctor says you’re still young,” my mother says from the backseat. “Don’t forget, you have that on your side!” I can tell from her deliberate manner that this is the same mantra she repeats to relatives and friends.

  As we drive, Elizabeth opens one of the boxes and fingers her new wig. “God, I hope it won’t frizz. That would make it all worth it.” For a brief moment, the three of us laugh, a small relief.

  “We’ll get through this,” my mother says, wiping her face.

  Elizabeth closes her eyes, and we ride in silence. The only voice is the newscaster’s at the top of the hour, and the only noise the sounds of cars swishing by.

  THE NEXT MORNING, Elizabeth has her first radiation appointment, scheduled before her regular chemo at Beth Israel. First she’ll burn, and then she’ll be poisoned.

  At 8:30 a.m., the radiation room is bright. Light, windows, upholstery, and plants—the semblance of vitality and life. Still I fixate on a display of pamphlets in the corner detailing various cancers: lung, breast, ovary, pancreas, kidney, colon. What a world apart from the pamphlets I scanned through just last month at the dermatologist’s, reading about Botox, Restylane, and Fraxel treatments, back when I had the luxury of frivolity.

  We sign in with the receptionist and wait. Elizabeth drinks green tea that she brewed at home and carries in a thermos. Regis and Kelly are on TV, with their perky smiles. Kelly wears pink Spandex that shows off her sculpted body. She’s lifting a leg, crunching her abs, and flexing her arms. I steal a glance at Elizabeth, who smiled that same way a few weeks ago when we took an exercise class, upbeat and youthful, her whole life ahead of her. I survey the room. It seems as if everyone but us has gray hair and wrinkled skin.

  “Everyone here is old,” Elizabeth whispers, confirming my own observation. Gone is my sparkly-eyed, chatty sister. She seems irritated, and I don’t blame her. “Samantha, if something happens to me, I know Jake will get married again. He’s young. He’ll need someone to take care of him.”

  “Where is this coming from?” I ask. “Not now.” I repeat my own mantra: “Dr. Gold said we could be cautiously optimistic.”

  “I’m up all night thinking about what’s going to happen to Brooke and Lauren.”

  “You’re just starting treatments. Try to relax. Let’s see how things go.”

  “What if you’re still married to Richard? Can my kids even be with you then?” Elizabeth asks worriedly.

  “No matter what,” I assure her. I know Richard doesn’t accept my relationship with Elizabeth and Jake, but he’s not evil. I wish she didn’t have to mention it.

  “Mrs. Gordon,” calls the nurse at the perfect moment.

  “Good luck,” I say, and kiss my sister on the cheek. Time to burn. She leaves the waiting room to have the treatment, alone.

  Although it’s not my own life at stake, I, too, feel alone, unable to share these day-to-day struggles with my husband. He’s not there to hold me and tell me how strong I am being for Elizabeth. Lately, I can’t lean on anyone but myself. But my alone life began long before Elizabeth got sick. Tiny words and gestures of caring have all but disappeared between Richard and me.

  Despite myself, once Elizabeth is in radiation, I am drawn back to those cancer pamphlets like a moth. In the lung cancer brochure, I stare at blackened lungs. I scan the medical jargon: non-small-cell adenocarcinoma, clinical trials, Stage IV, incurable. Most people die within a year of Elizabeth’s particular diagnosis, but this isn’t news to me; I read it on the Internet. But these clinical papers here in my hands sadden me more, even though Elizabeth’s lungs are not blackened. Dizzy, I head back to my chair and hear a robotic voice, the sound of a man with no vocal cords.

  I reach my seat and place my head between my legs, taking slow, deep breaths, forcing myself steady. Elizabeth needs to come here for radiation five days a week. I will be here with her every time.

  Fifteen minutes later, she reappears.

  “How was it?” I ask, and put my arm around her.

  “I didn’t feel a thing.”

  I look closely and can now see the dark splotches under her eyes, the tight clench of her jaw. I imagine her lying on the table, obsessing about the future she might not have.

  “Jake should be upstairs already,” I say. “Let’s go. I need a cup of coffee.”

  After leaving the café down the hall, we board the elevator, and in a moment the doors open onto the ninth floor: Shapiro Cancer Center, where Elizabeth gets chemo. As if drawn by something beautiful, we bypass the waiting area and rest on a cushioned bench near a ten-foot fish tank, or what have become our good-luck seats. The water filter hums soothingly. Watching red and yellow fish weave lazily through the coral, indifferent and oblivious to the anxiety in the room, is a kind of therapy. For a moment, I allow myself the whimsy of shrinking down to a swimming fish, making my slow figureeights around miniature castles and treasure chests.

  Jake finds us. He’s already checked Elizabeth in. I admire their symbiosis.

  Elizabeth continues sipping her green tea from her steel travel mug. She read an article about the powers of antioxidants last week, so that’s her new thing: green tea. I’m doublefisting Starbucks coffee, one for me and one for Jake. I set Jake’s on the table, pushing back old issues of tabloid magazines. We sip and gaze through a glass partition into the hallway, expecting Dr. Varghas. We always see Elizabeth’s beloved oncologist before chemo. His warmth relieves some of the sting.

  In solidarity with my sister, when chemo started I stopped taking pleasure in what I wear. For the past few weeks, I have applied very little makeup and for coming to the hospital rarely choose my leather pants, designer jackets, or any jewelry, except for a watch. Dr. Varghas has seen me mostly in the same clothes as Elizabeth. Craving comfort, we reach for fleece jackets, workout pants, and exercise tops.

  Today, though, I have dressed in a new outfit: gray cashmere sweater, black jeans, and black ankle boots. This morning I took care applying my cognac lip liner and Beige de Chanel lipstick. I want Dr. Varghas to see that we haven’t always been worried and subdued, that Elizabeth and I are women who take pride in appearances, that we value how we look because it shapes the way we feel. I feel naked without mascara and bronzer; I think a little polish makes me look like myself. When Elizabeth and I were teenagers, our mother always said, “Don’t leave the house without your lipstick.” We were raised to indulge our vanity, and we had the privilege to do so. I can still see Elizabeth sitting on her bedroom floor as a teen, applying eye shadow with a beauty magazine to guide her, how she loved a smoky eye. Soon she will approach the mirror with a very different goal: fixing her wig to appear like the woman she used to be.r />
  Elizabeth has also dressed well, if comfortably, for her appointment with Dr. Varghas: in a beige cashmere sweat suit. The sleeves roll up easily now, for her blood test and, soon, for chemotherapy.

  “Thanks for the coffee,” Jake says, kissing me hello. His stubble stings my cheek, unusual for Jake, who is usually meticulous about a clean shave.

  “Drop off the kids okay? How’d it go at the school?” Elizabeth asks.

  “I went in to speak to the headmistress and told her,” he says.

  “And?”

  “She thanked me for letting her know the kids will be having some tough days.”

  Elizabeth’s eyes fill. “Poor babies,” she says. I reach out and squeeze her hand.

  When the phlebotomist calls Elizabeth’s name, I follow her in and Jake stays at the fish tank.

  “Have a seat and roll up your sleeve, my dear.” Our phle- botomist is a Jamaican woman with a lilting voice and a face full of compassion.

  I sit beside Elizabeth with my folder full of medical notes. “I’m her sister,” I say, to explain why I’m here. The technician acknowledges my statement with a smile.

  “Date of birth?” she asks Elizabeth.

  “November first, 1959.”

  “Make a fist, dear,” she says. She gets the vein easily—I can tell because Elizabeth doesn’t jump but I do—then draws four vials to ensure that Elizabeth’s white blood cell count is high enough, her body strong enough, to withstand chemo’s shock.

  Watching Elizabeth, I wince. No matter how often I let hope rise in my heart, I don’t actually believe that Elizabeth will beat this cancer. There is no Stage V.

  After the blood draw, the nurse deposits us in the doctor’s office. Elizabeth and Jake sit next to each other in armchairs. I take my seat on a swivel stool.

  “How’s your appetite?” the nurse asks.

  “Not bad,” Elizabeth says, though she’s been eating less than she used to.

  “On the scale, please.”

  At five foot five, Elizabeth weighs 125, the same she has for years. The nurse measures her oxygen level by clipping a clothespin-type device on her finger. “Ninety-eight percent,” she reads. “Very good.”

  Dr. Varghas walks in, and it’s like the lights have come on. We all snap to attention, including the nurse. “Good morning, everyone,” he says. I take out my pen and hold it poised.

  “And how are you feeling, Elizabeth?” he asks, with legitimate concern.

  “Still some lower-back pain, and I’ve been pretty tired,” she says. Elizabeth loses the irritation that has generally accompanied her diagnosis. Dr. Varghas nods and listens.

  Elizabeth continues, reporting on her pain. “I have stinging in my shoulder socket. It seems like the left side is stiffer, more swollen, than my right.” She rolls up her sleeve and displays her arm. “Some numbness in my feet, too.”

  “The PET scan you had last week specifically looked at the shoulders. There’s no cancer there,” Dr. Varghas says reassuringly.

  He always anticipates what we want to hear, which in this case is that the cancer has not spread to other bones.

  “It seems like the new symptoms you’re experiencing are side effects from the steroids and medications,” the doctor speculates.

  Elizabeth sighs with relief. “Do you think I’m getting better?”

  Dr. Varghas now turns his attention to the computer. He doesn’t answer right away, scanning the screen to consult today’s blood tests. “Everything looks good,” he says, without gazing up. “Your body is strong enough for chemo.”

  “Will I ever get better?” Elizabeth asks again.

  I lift my head from my note taking. I, too, want to know if she’ll get better.

  “Your age and relative health are a definite advantage,” Dr. Varghas repeats, as if for the first time. I scan the oncologist’s eyes for any sadness or pain that may belie his words but find nothing conclusive. I want to believe that for Elizabeth, he would feel pain.

  Elizabeth persists, “But do you think I’ll—”

  “We’ll know much more after the chemo.”

  Dr. Varghas stands. I feel bad Elizabeth keeps asking if she’s going to get better, as if the foggy shock of her diagnosis were still brand new.

  “Thank you, Doctor,” I say. “We always feel stronger after speaking with you.”

  “My pleasure,” he says, and shakes my hand.

  THE INFUSION ROOM is bright and smells strongly of antiseptic. Every chair is occupied by a patient in treatment. Some are bald, some wear wigs, and others, like Elizabeth, are at the very beginning. You can tell by their unsure steps and nervous eyes.

  We keep the curtain closed halfway around Elizabeth’s chair, enough for privacy, short of feeling claustrophobic. Jake and I flank Elizabeth, alternately sitting and hovering. Sounds of chatting patients reach us—it is clear that some of these families have become friends—but we keep to ourselves, at least for now. Elizabeth wants to quarantine cancer from the rest of her life.

  The IV nurse inserts a thin needle into a pumped-up vein on Elizabeth’s right hand, securing it with white adhesive. A clear liquid begins dripping down the narrow tube and into Elizabeth’s body. She winces. “It’s burning,” she says, opening and closing her fist.

  “Only for a few minutes,” the nurse says, soothing the port with a warm, damp cloth. Elizabeth shivers. The nurse adds a heated blanket to her shoulders and dispenses an Ativan. “Take it with some water.” Then she adds, “I’ve seen patients live a long time on this chemo.”

  “I don’t want to die,” Elizabeth says.

  “I know,” the nurse says. A loud beeping interrupts her. “Just an air bubble,” she explains, massaging the tube. The solution drips without disturbance for a few minutes.

  “My kids need me,” Elizabeth says, pained and exhausted.

  The nurse rubs Elizabeth’s arm. “I’ll be back to check on you.”

  Elizabeth turns her head toward me. “I hope this is worth it,” she says.

  “If not, new treatments come out all the time,” I say. “I’m researching everything.” She knows my point of view. My attitude is that her cancer can be managed with medication as a chronic illness. It’s optimistic and realistic. Elizabeth turns away because this isn’t what she wants to hear.

  “You’re doing great,” I say, scrutinizing the IV.

  Elizabeth scrunches her nose. “Jake?”

  “You’re a champ,” Jake says, and gets up to kiss her on the cheek. When he sits, he lowers his eyes to his BlackBerry, working his thumbs. He would never think of not being here, but he can’t afford to get caught in a web of sadness and despair.

  “A friend told me I should try acupuncture,” Elizabeth says.

  Jake rises again and tucks his shirt into his jeans. He’s wearing a pressed button-down shirt, size large, even though he only needs a medium, never wanting to feel constricted. He keeps his hair short, cropped close to his head every Thursday, with a little scalp showing through. Jake’s toned body is the result of his five-mile-a-day runs and four-times-per-week weight training. That’s Jake. He believes in discipline. Salmon for dinner, turkey for lunch.

  An elderly volunteer with a purple rinse walks by and glances in between the curtains. A large button on her shoulder says SURVIVOR. “Would you like any lunch today?” she asks, and her face folds into a hundred smile lines.

  Elizabeth and I order the usual: tuna on whole wheat with lettuce and tomato, a bag of chips, a bottle of water. Jake orders turkey on wheat, no mayo. We begin to flip through magazines— W, Self, Vogue—while the IV does its wicked work.

  “Look at these.” My sister points to Christian Louboutin black patent leather pumps. “I’m going to buy them,” she announces with a half-smile. I can see her in those shoes, wear ing an ivory pantsuit at an event for the Asthma and Allergy Foundation, where she fund-raises, the spring restored to her high-heeled step as she takes charge, raising awareness of peanut allergies, which affect her da
ughter, Brooke.

  Elizabeth suddenly puts the magazine down and lies back. “Never mind. I can’t do this right now.” That’s my cue to pull the curtain.

  With our privacy restored, I rub Elizabeth’s feet and begin a meditation that I learned while studying Herbert Benson’s Relaxation Response from Joan Borysenko at Beth Israel Hospital in the ’80s. I’ve used it with my speech pathology patients, and I use it on Elizabeth now to relieve her anxiety and frustration.

  “Sit back. Breathe deeply. Relax,” I say. “In, out. Relax. From the top of your head to the tips of your toes, you feel calm, comfortable, and warm. Breathe. Relax.”

  Jake raises his eyebrows. He has no use for hocus-pocus. Before she was diagnosed, Elizabeth never went for this kind of thing, either, but now she’s open to anything, desperate to heal.

  “Your whole body feels calm and strong,” I continue. “The chemo is entering, your ally. This therapy heals. Your body regenerates. All of your strength battles the cancer that has invaded your body.” I begin to improvise as I continue rubbing Elizabeth’s feet. “Breathe in all that strengthens you. Breathe out everything that weakens you. May you feel happy and healthy. May you be free from suffering. May you find peace.” The foot massage is something tangible I can do, skin to skin; it feels good for both of us. I watch Elizabeth, her eyes closed, breathing deeply. She dozes, partly from the meditation, partly from the IV bags, labeled TAXOL and CARBOPLATINUM. I think about the poison coursing through her body, hoping it hits its target and little else.

  Now that Elizabeth is asleep, I am suddenly aware of my own exhaustion. We’ve already been at the hospital for hours. I glance at Jake, his business documents scattered on the floor around his chair.

  “I have a lot going on,” he says, catching my gaze. “Hey, Don,” he says into his BlackBerry. “Yeah, I need that done yesterday.” Don is Jake’s lawyer. Jake makes demands. “Increase the offer. Keep up the pressure. We close by Friday.” I know Jake: whatever it takes, he will close that deal. It’s what my brother-in-law can’t promise that scares him, and me.