Life Itself: A Memoir

by Roger Ebert

  47 GOOD NEWS AND BAD NEWS

  AFTER A MOVIE at the Lake Street Screening Room, there was a note for me to call Bob Havey. “I have good news and bad news,” my doctor said.

  “What’s the bad news?”

  “The tests came back. You have thyroid cancer.”

  “What’s the good news?”

  “You have the kind you want to have. It’s one of the rare cancers with a ninety-nine percent cure rate.”

  He explained that I would have thyroid surgery, a common operation. After I recovered, I would check into a hospital room for two days and drink a shot glass of radioactive iodine. The Achilles’ heel of my particular cancer was that it finds iodine delicious. It soaks it in and the radiation kills it, no matter where those cells may have spread to.

  Bob Havey has stayed in general practice in an age when many physicians specialize. He is a great and brilliant man whose knowledge is wide and whose mind is open. Many sick people search the Internet and bring their findings (usually loony) to their doctors. Havey searched the specialist sites and found the latest developments for me. He discusses my condition with me thoroughly and honestly. Some patients probably prefer to be lied to. I find the truth a great comfort. If I’m going to die, I’d rather know.

  I’ve had a conviction of invulnerability through all of my illnesses, never mind how misplaced it may have turned out to be. I don’t have a lot of fear. Like many people, I fear pain more than death. I’ve had doctors I trust, and if I should die during surgery it will be no more an event than falling asleep. Now I know something I didn’t know before, which is that after my surgeries failed, I could live a perfectly happy life.

  The thyroid surgery was successful. The radiation treatment was bizarre. I was shown into a hospital room where surfaces were covered with white paper. I drank the tasteless cocktail. For two days no one was permitted to enter my room, and my meal trays were pushed through the door. I wore clothes I could throw away and resurrected an old laptop that would have to be mothballed for radioactivity. At the end of the time a nurse came in wearing protective gear and checked me with a Geiger counter, and I was sent home with instructions to not sleep in the same bed with Chaz for two weeks, or sit next to a pregnant woman on an airplane. The radioactivity in the iodine, I was told, was about 5 percent as powerful as the monthly radiation treatments I, and thousands of children, had been given in the 1950s for ear infections and acne. Those treatments paid off half a century later in a boom for the formerly rare thyroid cancer. Now all I had to do was figure out the correct dosage of Synthroid to take every day for the rest of my life. I discovered Synthroid is the most commonly prescribed prescription medication in the world.

  A few years later, I went in for a routine scan to check for any new problems. This time the news was not good. Bob Havey sent me to Harold Pelzer, a specialist, who explained cancer had been seen in my right lower jawbone. It wasn’t the same cancer as affected my thyroid, and I guessed exactly what it was. In 1988, a cancer had been found in my right salivary gland. There was a lump there clearly visible in a photograph of Siskel and me. When Christopher Hitchens fell ill, people wondered why he hadn’t noticed a lump on his clavicle that even they could see in his photos. Maybe it was because you don’t want to notice such things. I had been shaving over the lump for some months in the 1980s before Doc Schlichter palpated it and sent me to George Sisson, who was impressed; this cancer was so rare he’d never seen one in thirty-five years of practice. He was like a hunter bagging a unicorn and told me with some pride that a color slide from my tumor had made the cover of the Walter Reed military hospital’s research magazine. It was the kind of publicity difficult to turn into Nielsen ratings. My tumor grew less rare in the years to come. The childhood radiation had probably caused it. Because I was born four or five years earlier than most of the boomers, I was the canary in their coal mine.

  “He is a good surgeon,” Doc Schlichter told me. “I was in the OR every minute. He took his time and got everything, and a little bit more around it. You have no more tumor.” Yes, but Dr. Sisson warned me, “It is very, very slow growing, but the odds are it may return after some years.” It did. It had probably hidden in my mandible. Pelzer took one of those plastic models you always see in medical offices and measured a length of mandible a few inches long. This, he explained, would be removed and replaced with a bone graft taken from the fibula in my calf—one of the bones we don’t need. Dr. Neil Fine, an expert plastic surgeon, would do this and patch me up so that after healing there was every reason to expect I’d be back on the television show.

  That’s not how it worked out. All by myself, with nobody to blame, I found out about the work in neutron radiation being done at a handful of hospitals. It was much more powerful and narrowly targeted than gamma radiation. The leading specialist was said to be Dr. George Laramore at the University of Washington Medical Center in Seattle. “My equipment is made for your tumor,” he told me. “Of course you should have surgery first.” Pelzer also recommended surgery first. So did Havey. But no. I became convinced there was a shortcut that would avoid plastic surgery and a healing period and have me back on the air much more quickly. I insisted. It was a great temptation. My doctors and Chaz advised the path of caution, but I cited reams of Web printouts indicating what a miracle this neutron radiation was. Eventually it was decided to give it a go.

  The Internet is said to be responsible for helping patients take control of their own diseases. Few movies are ever made about sick people courageously taking doctors’ advice. No, they get bright ideas online. I believe my infatuation with neutron radiation led directly to the failure of all three of my facial surgeries, the loss of my jaw, loss of the ability to eat, drink, and speak, and the surgical damage to my right shoulder and back as my poor body was plundered for still more reconstructive transplants. Today I look like an exhibit in the Texas Chainsaw Museum.

  I have vague memories after my first surgery of Chaz holding a pad on which I could write notes. She says they didn’t always make much sense. I was on a good deal of pain medication and my memories of that period are often hallucinations. I imagined myself in a hospital that doesn’t exist in Chicago, with a broad flight of stairs leading down to the Chicago River. I saw myself in one of a row of barber chairs, while medical personnel rotated us for obscure reasons. Gradually my mind began to clear, and my assistant Carol Iwata brought three-ring notebooks and a box of pens.

  On these I wrote out everything I wanted to say. I also began various random writing projects, including my memoirs. None of those words are included in this book; they were more like exercises in total recall from long ago events that were more clear to me than whatever had happened that day. Chaz dated and preserved every one of these dozens of notebooks. “You’ll want to look at these someday,” Chaz told me. I never have. I think I would find them depressing and would discover I was sicker and more confused than I care to remember.

  I’m sure there are long painful pages written very late at night on the subject of pain medication. I was on a form of OxyContin, an addictive drug that supplies euphoria for thirty minutes or so, relative calm for another hour, and then increasing uneasiness and anxiety until it is finally time for the next dose. The final hour became almost unbearable, and I wrote out pleas that I asked the nurses to take to the overnight residents, who would have to approve additional medication. They never did. My meds were being injected using the “push” method, by which a liquid is supplied intravenously, and this produced an instant rush that seemed to expand my consciousness to fill the entire room, and then subsided into intense energy and a feeling of well-being. I think I learned something of what heroin and morphine addicts feel. I certainly learned something of the agonies of withdrawal.

  I was put on the drugs while unconscious after surgery and regained consciousness already addicted. I told Chaz I felt I needed more pain medication, and she told me I was hooked and needed to detox. Finally I couldn’t take the withdrawals
anymore. By then I was in the Rehabilitation Institute of Chicago and wrote out a note to the doctor in charge, Dr. James Sliwa, saying I was “turning myself in.” He took charge of the withdrawal process, joined by Dr. Susan Pearlson.

  From those days I remember hallucinations that are startlingly vivid. I imagined a house in Michigan I thought was ours, which wasn’t, but I had returned there with Chaz all the same. I found myself driving down country roads outside Urbana at dusk, the earth and sky unnaturally beautiful, a mournful song filling the air. I remember repurchasing my childhood home on Washington Street, moving back to Urbana, and buying the Daily Illini so I could edit it. During the presidential primaries, Chaz tells me, I thought Hillary Clinton had rescued me in a helicopter. I would often be interrupted from these hallucinations by one of my physicians making his rounds with half a dozen interns. It was like being captured by aliens.

  So no, I don’t want to look at those notebooks. Much of what happened is confused and lost. Let it stay that way. I have, however, identified the mournful plaintive beautiful song I heard on my drive through the Illinois cornfields. It was “Calling You” from Bagdad Cafe, waiting in my memory all those years.

  48 NIL BY MOUTH

  WHEN I MENTIONED in my blog that I can no longer eat, drink, or speak, a reader wrote, “That sounds so sad. Do you miss it?” Not so much really. Not anymore. The new reality took shape slowly. Understand that I was never told that after surgery I might lose the ability to eat, drink, and speak. Eating and drinking were not mentioned, and it was said that after the first surgery I might be able to go back to work on television. Success in such surgery is not unheard of. It didn’t happen that way. The second surgery was also intended to restore my speaking ability. It seemed to hold together for a while, but then, in surgeon-speak, also “fell apart.” In both cases the idea was to rebuild my face with bone and flesh transplants from my legs to restore an acceptable appearance. Both surgeries failed because microsurgery to reattach blood vessels broke down. Dr. Neil Fine had done an exemplary job both times, but the neutron radiation was there ahead of him and the tissue could not hold. In the second, a vein was used to carry blood from a healthier area into a more threatened one. Dr. Fine instructed nurses and interns how to listen to this vein, and I listened in myself: a soft pulsing flow. One day it could not be heard. The transplanted flesh would die and had to be removed. Both of these surgeries eventually resulted in catastrophic bleeding of a carotid artery.

  I was flat on my back for long periods after the surgeries, to avoid stress on the sutured areas. Muscular degeneration took place, and I graduated from intensive care to the Rehabilitation Institute of Chicago to learn to walk again. At the start they winched me out of bed in a sling. I eventually walked well enough, but never again with the happy stride of the ten-thousand-steps-a-day period.

  Neil Fine was a human being, a caring man. He had a national reputation and was known as a perfectionist. I could tell he was disappointed that his best efforts had failed. He and Dr. Pelzer came to me with a third idea, which they felt might be safely attempted. By now there was no pretense of “restoration,” and the goal became simply to repair the opening in my chin. Both of my fibulas and both of my thighs had already been plundered. It would be necessary to transplant tissue from elsewhere. Fine proposed what he considered a very conservative approach. Chaz and I flew to Houston to get an opinion from Pierong Yu, a surgical specialist at the MD Anderson Cancer Center. He proposed moving a flap of tissue from my right shoulder and rotating it to fasten under my chin. This had the advantage of preserving its existing blood supply. We returned to Chicago and had a long, serious talk with Fine and Pelzer. Fine did me the honor of being absolutely honest. Yu’s approach would be the one he himself might attempt, he said, but after two surgeries had failed, he preferred to be very conservative on the third attempt.

  Surgery at MD Anderson worked better than we’d dare to hope. Dr. Yu was a master. In a mirror I saw myself looking familiar again. But after a little more than a week, that surgery failed, too. Radiation damage again. A fourth surgery has been proposed, but I flatly rejected the idea. To paraphrase a line from the orchid collector in Adaptation, I’m done with surgery. I should actually have stopped after the first, but then I had no idea of the troubles ahead. If I’d had no surgery, the cancer would have continued to spread, and today I might probably be dead. Since removing the cancer was the primary objective of the first surgery, it’s unfair to call it a failure. I’m very aware of what Dr. Sisson told me long ago: My cancer is very slow growing and insidious. The bastard is quite likely lurking somewhere as I write. I’m sixty-nine, but in excellent health. I’m happy and working well. I would be obscurely pleased if something else carries me off before that insidious cancer wins its waiting game.

  During the entire period of my surgeries, I was Nil by Mouth. Nobody said as much in so many words, but it gradually became clear that it wouldn’t ever be right again. There wasn’t some soul-dropping moment for that realization. It just… developed. I never felt hungry, I never felt thirsty, I couldn’t be angry because the doctors had done their best. But I went through a period of obsession about food and drink. I came up with the crazy idea of getting some Coke through my G-tube. My doctors said sure, a little, why not? For once the sugar and a little sodium wouldn’t hurt. I even got some tea, and a little coffee. I couldn’t taste it, of course.

  I dreamed of tastes. I was reading Cormac McCarthy’s Suttree, and there’s a passage where the hero, lazing on his riverboat on a hot summer day, pulls up a string from the water with a bottle of orange soda tied to it. I tasted that pop so clearly I can taste it today. Later he’s served a beer in a frosted mug. The frosted mug evoked for me a long-buried memory of my father and me driving in his old Plymouth to the A&W Root Beer stand (gravel driveways, carhop service, window trays) and his voice saying “and a five-cent beer for the boy.” The smoke from his Lucky Strike in the car. The heavy summer heat. Night after night I would wake up already focused on that small, heavy glass mug with the ice sliding from it, and the first sip of root beer. I took that sip over and over. The ice slid down across my fingers again and again.

  One day in the hospital my brother-in-law Johnnie Hammel and his wife, Eunice, came to visit. They’re two of my favorite people. I described my fantasies about root beer. I could smell it, taste it, feel it. I desired it. I said I’d remembered that day with my father for the first time in sixty years. They’re Jehovah’s Witnesses and interpreted my story in terms of their faith.

  “You never thought about it before?” Johnnie asked.

  “Not once.”

  “Could be, when the Lord took away your drinking, he gave you back that memory.”

  Whether my higher power was the Lord or Cormac McCarthy, those were the words I needed to hear. And from that time I began to replace what I had lost with what I remembered. If I think I want an orange soda right now, it is after all only a desire. People have those all the time. For that matter, when I had the chance, when was the last time I held one of those tall Nehi glass bottles? I hardly drank it when I could.

  All sorts of memories now come welling up almost alarmingly. It’s all still in there, every bit. I saw Leap Year, with its scenes in Dublin, and recognized the street where I stayed in the Shelbourne Hotel, even though the hotel wasn’t shown. That started me thinking of Trinity College nearby, where I remembered that McHugh and I saw the Book of Kells in its glass case. And then I remembered us walking out the back gate of Trinity and finding a pub where we were to join two of his brothers. And meeting Kitty Kelly sitting inside the pub, who became legendary in our stories as the only whore in Dublin with her own coach.

  “Are you two students?” McHugh’s younger brother Eugene asked them innocently.

  “I’m a working girl meself,” the first said.

  “Her name is Kitty Kelly,” her friend volunteered. “I’m her coach.”

  I walked into Leap Year with the Book of Kells and
Kit Kelly’s coach and Eugene McHugh far from my mind. The story itself had long since fallen from our repertoire. But it’s all in there in my memory.

  When it comes to food, I don’t have a gourmet’s memory. I remember the kinds of foods I was raised to love. Chaz and I stayed once at Les Prés d’Eugénie, the inn of the famous Michel Guérard in Eugénie-les-Bains. We had certainly the best meal I have ever been served. I remember that fact, the room, and specific people at other tables, but I can no longer remember what I ate. It isn’t hardwired into my memory. Yet I could if I wanted to right now close my eyes and reexperience an entire meal at Steak ’n Shake, bite by bite in proper sequence, because I always ordered the same items and ate them according to the same ritual. It’s stored in there for me.

  Another surprising area for sharp memory is the taste and texture of cheap candy. Not fancy imported chocolates, but Red Hots, Good & Plenty, Milk Duds, PayDays, Chuckles. I dreamed I got a box of Chuckles with five licorice squares, and in my dream I thought, “Finally!” With Necco wafers, there again, the licorice were the best. The peculiar off-purple wafers were space wasters. As a general rule in candy, if anything is black, red, or green, in that order, I like it. In my mind I went to Cracker Barrel and bought paper bags filled with licorice, root beer, horehound, and cinnamon drops. But the last thing I want to start is a discussion of such age-old practices as pouring Kool-Aid into a bottle of RC Cola to turn it into a weapon. Returning to the original question: Isn’t it sad to be unable to eat or drink? Not as sad as you might imagine. I save an enormous amount of time. I have control of my weight. My blood pressure and cholesterol would make Nathan Pritikin cheer with joy. Everything agrees with me. And so on.