100 Days of Happiness

by Fausto Brizzi

  Wikipedia is efficient as always.

  A carcinoma is a malignant tumor.

  Tumor. Malignant.

  Two words, are each unpleasant enough taken alone.

  Hepatocellular, on the other hand, means that the organ affected is the liver.

  The liver.

  Outstanding.

  Even newborn babies know that a tumor to the liver is the most dangerous kind.

  Two lines down is the size of the intruder.

  It’s six centimeters long.

  In my cozy tummy I’ve been hosting a hepatocellular carcinoma 6.0 centimeters in length, with a diameter of 0.7 centimeters, as my guest.

  More or less the size of a French fry.

  Even newborn babies know that French fries aren’t good for you.

  I have a six-centimeter tumor in my liver. My blood tests also confirm the excessively elevated values of the tumor markers that show the undesired presence in my organism. There’s no chance it’s a mistake.

  I don’t even wait for the doctor who is scheduled to come break the news to me. I head out onto the street.

  I have a six-centimeter tumor in my liver.

  I wander aimlessly.

  I have a six-centimeter tumor in my liver.

  I repeat the words over and over aloud, like an obsessive mantra.

  I have a six-centimeter tumor in my liver.

  I can’t seem to stop.

  I have a six-centimeter tumor in my liver. . . . I have a six-centimeter tumor in my liver. . . . I have a six-centimeter tumor in my liver. . . . I have a six-centimeter tumor in my liver. . . . I have a six-centimeter tumor in my liver. . . . I have a six-centimeter tumor in my liver. . . .

  I take a few seconds off from my impersonation of Jack Nicholson in The Shining and I finally have a glimmer of intelligence. I wonder to myself: “So is six centimeters very big for a tumor in the liver?”

  According to the oncologist, who frowns as he studies my sonogram, that really is a very respectable size for a tumor. A handsome flourishing robust tumor. The first thing he prescribes, in fact, the first thing he orders me to do is to get an immediate and complete CAT scan of my upper body.

  I schedule one, and in the meanwhile, I spend the night surfing the Web. I go back to doing something I’ve always hated. I study. I don’t feel like doing anything else—eating, drinking, or sleeping. All I want to do is spend hour after hour Googling the words tumor, liver, cure, and so on.

  In the course of the next few hours I become the world’s greatest living expert on carcinomas. I even discover that the first operations to remove tumor masses were done by the Egyptian scientist and polymath Imhotep, a sort of Nilotic Leonardo da Vinci, capable of designing the immortal pyramids and founding Western medical science, and ultimately actually venerated as the god of medicine. At the time, nearly all his patients, operated upon without anesthesia, either died during the procedure or else bled to death immediately afterward. I skip four thousand years of medical history and focus on more recent studies of my buddy Fritz.

  I read a Web page on the subject: “Hepatocellular carcinomas are the most common type of primary liver tumors.”

  I’ve come down with an illness that isn’t even particularly original.

  “It develops in the liver cells and damages the other healthy cells.”

  Great.

  “The uninterrupted growth of the tumor cells can result in a malignant form of tumor.”

  Outstanding.

  “At first, this kind of tumor doesn’t cause any particular disturbance and is very difficult to identify.”

  What an asshole.

  “Once the tumor has reached a certain size, various symptoms may manifest, such as abdominal pains, bloating, weight loss, nausea, vomiting, exhaustion, and a yellowish tinge to the complexion and the eyes.”

  I’ve got every one of them.

  “Men are more likely to develop this type of tumor. Depending on the nature and stage of the tumor, a different array of treatments can be utilized. Surgery or liver transplant are viable alternatives only if the tumor is small and contained within the liver. If however the tumor has spread and expanded, chemotherapy or radiation therapy can extend survival times, but will not cure the pathology.”

  They will not cure the pathology.

  The words echo like one of Pavarotti’s high Cs in the back of the pastry shop. I sit there staring at my laptop, locked into a freeze frame.

  They will not cure the pathology.

  They . . . will . . . not . . . cure . . . the . . . pathology.

  The findings from this search are unequivocal.

  Nothing has changed since Imhotep’s day.

  I’m going to die.

  Up till now, that’s a verb in the future tense that we’ve all known since we were kids. We’re all going to die. It’s just that I’m going to die a little sooner than expected.

  A little sooner than I would have liked.

  A little sooner than seems strictly fair.

  I’m going to die a little sooner. Period.

  * * *

  I still haven’t said anything to Paola. Partly out of shame, partly because she never answers my phone calls, but chiefly because I still don’t really believe it. I don’t want to believe it, and really, I can’t.

  At breakfast, I tell the news to the other two musketeers: Umberto and Corrado. I meet them in a little café we’ve frequented since we were in high school, where neither the furnishings nor the pastries have changed since then. I even recognize a stale but optimistic brioche that’s resided behind the glass display case on the counter ever since 1979.

  It’s a very complicated breakfast. Super complicated.

  Someone ought to urgently publish a guidebook titled: How Should You Act at Breakfast When One of Your Best Friends Tells You He Has Liver Cancer? It’s the most difficult conversation you can have, out of all the billions of possible conversations. The main problem is nailing the correct tone for the dialogue.

  DIALOGUE WITH GAFFE

  “Friends, I’ve got liver cancer . . .”

  “Really? My uncle had the same thing last year . . .”

  “So how is he now?”

  “Oh, he’s dead!”

  ABSURD DIALOGUE

  “Friends, I’ve got liver cancer . . .”

  “Ah, what a relief, I was expecting something worse!”

  “Worse? Like what is there that would have been worse?”

  “Well, for instance . . . now let me see . . . ah yes, being a paraplegic is worse, I think.”

  “Thanks. Now I feel so much better.”

  EMBARRASSING DIALOGUE

  “Friends, I’ve got liver cancer . . .”

  “Oh my God! You were always my favorite musketeer!”

  “Why are you using the past tense?”

  ENCOURAGING DIALOGUE

  “Friends, I’ve got liver cancer . . .”

  “Don’t worry, you’re strong, you’ll beat this!”

  “And what if I don’t?”

  “Don’t even take that possibility into consideration.”

  * * *

  At this point in the encouraging dialogue the tears start to flow and we all sob wholeheartedly together for half an hour or so.

  * * *

  I decide to break the tension myself and discuss my own disease with irony. That’s when I come up with a nickname for the amiable little French fry that lives in my liver. I dub it “my buddy Fritz,” a phrase we use in Italian to describe hypocritical friends you don’t want to name outright. From that moment forward, the word cancer is stricken from my dictionary.

  I tell Athos and Aramis that, in the afternoon, I’m scheduled for a CAT scan and that there are people who had the same cancer I have who’ve gone on to live for four and even five
more years. By now, I know everything about hepatocellular carcinomas. I’m an expert on the subject.

  They’re both overwhelmed; neither one seems capable of getting out a complete logical sentence. Not that I can, for that matter. We wind up playing foosball, me in a duo with the barista’s pockmarked fourteen-year-old son, and we say nothing more about it. Still, the thing is right there beside us, watching us play, never once taking its eyes off me. My team wins 6 to 4—the kid is a phenomenal goalie.

  * * *

  That afternoon I go to take the too-long-delayed computerized axial tomography. Three very complicated words to say that a bundle of rays analyze my torso slice by slice, separating it like a package of individually wrapped Kraft American cheese.

  The result is the ugliest word in the world after war.

  It’s practically a synonym for death.

  Metastasis.

  My lungs are riddled with metastasizing cancer.

  I read it somewhere: the first metastasis of liver cancer usually develops in the lungs.

  I’m a textbook case.

  HOW LONG?

  The main question is: how long?

  How much more time do I have?

  But even as I ponder this one, there is another, which seems even more pressing. How will I tell Paola? What do I say? I can’t even ponder this one. It feels strange, not part of our story. I close my eyes, imagining her face when I tell her, her expression, her eyes. I can’t wrap my head around it, so I leave it alone, something to worry about later.

  Then come the other questions.

  Among those, the one that matters most to me is: how?

  How will I die?

  Will I know what’s happening?

  Will I suffer?

  Will it be agonizing?

  It is only in that instant that it dawns on me that the word agony is even more unpleasant than the much-maligned word death.

  I don’t know why this whole nightmare is happening to me, but I do know that I need to know how long I have.

  I make another appointment to see the oncologist, for whom by now I feel a childish hatred, as if he’d popped the beach ball I was playing with in the waves. At the same time I decide not to wait to know how long. I can no longer keep this to myself. I must talk with Paola.

  “Meet me near the school,” I tell her, keeping my voice casual, cool. “I have something to tell you.”

  She parks her car. She has not seen me yet. I watch her as she picks up her bag, presses the automatic lock. She is wearing a light blue dress, which brings out the blond highlights in her hair, the green flecks in her eyes. I see, as if for the first time, her long determined stride as she begin walking toward me. I go to her. She is vivid and beautiful, and I feel a sharp pang of pain. How will I tell her? What words will best express it? In the end, I decide to keep it very simple, no gilding of the lily required. We stand by her Renault Twingo, which is parked by a broken streetlight. It flickers intermittently as I find the courage to speak the words.

  “I have liver cancer,” I say, “and it’s metastasized to my lungs.”

  At first she narrows her eyes and just looks at me. I don’t know how to interpret her look. It’s as if she thinks I’m joking, or trying to get her to forgive me sooner than she’s ready to. She stares at me as I steadily gaze back at her. I’m no actor, she knows that. If anyone has that gift in our family, it’s her. Finally, she lets out a long sigh. She has decided to believe me. “That fortune-teller you took me to all those years ago, remember? She didn’t really know her stuff, did she, when she promised us a long and happy married life?”

  I grimace. How the past has a way of coming back to haunt you when you’re least expecting it.

  “When did you find out?”

  I tell her what I know in short, terse sentences. “Ten days ago. I’ve done every possible exam and analysis. Unfortunately, there is no margin for error.”

  The warrior woman I married decides to take an active role in my affairs. She decides to bury the hatchet then and there and go with me to see the oncologist. Even though it’s quite clear that her gesture is neither an attempt at rekindling our love nor an act of forgiveness, I feel wildly optimistic. I wonder whether it’s pity, or horror, or some other such ultimately negative emotion that’s inspiring her actions. She has a look of sympathy on her face, which is confirmed when she asks me to come back home to sleep. I hesitate. This isn’t the way I wanted to be welcomed back to the family. Paola guesses what I’m thinking and makes it clear that she definitely hasn’t forgotten what happened. “Don’t start getting any ideas,” she says. Love, as I thought, is a long way away. With those few words, she lets me know that the only reason she’s letting me come back home is that I’m sick. There’s no forgiveness either, for the moment. A truce of sorts is the best way to look at it, where I am home but not reinstated. I must earn back her love. Once I have that, forgiveness will come.

  I vow to learn, to understand. She will need to be healthy for us all now, especially for our children.

  Paola holds my hand while the obnoxious oncologist leaves no room for optimism. He studies my CAT scan and the results of my blood test and decrees: “Signor Battistini, your neoplasm is one of the most aggressive types and, unfortunately, we caught it only at a very advanced stage. The tumor markers in your blood are at very high levels. This is the value here: the choriogonadotropin.”

  This is where I feel Paola’s “I told you so” glare stabbing me like a thousand daggers.

  “Your CAT scan shows numerous widespread metastases in your lungs.”

  I start to get annoyed: “Yes, I know that . . . would you get to the point.”

  “If the circumstances were different, I would have suggested attempting the surgical removal of the primary neoplasia from your liver, but in your condition it would really be little more than an extremely dangerous palliative. As would a liver transplant. The percentages for a successful transplant are very low; the waiting list is very long; and in your case, the metastases have already thoroughly compromised the situation. Forgive me for speaking frankly, but I think it’s important to be clear on this: there is no therapy that can really help you.”

  Silence. I look at Paola, who lacks the strength to lift her eyes. I’ve had the question locked and loaded for ten minutes and I let it fly:

  “How long?”

  “That’s a hard answer to come up with, Signor Battistini . . .”

  The bastard hesitates. Goddamn it, live up to your responsibilities! I need you to tell me how long it will be before they turn out the lights around the field.

  “How long?”

  “We’d need to see how your—”

  “How long?!”

  “Four or five months,” he specifies. “It depends on the resilience of your liver. And the treatment you decide to undergo.”

  Silence.

  “Cases range widely, though,” he explains; “there are some who have lived as long as five years.”

  “ ‘There are some . . .’; like how many?”

  “Let us say . . . very, very few.”

  Very, very few. A very, very encouraging percentage.

  I ask my second question.

  “How long will I be healthy?”

  “What do you mean by ‘healthy’? You’re already a sick man.”

  “You know exactly what I’m asking. How long will I be able to live a normal life?”

  “Here too it all depends on—”

  “More or less!” I drill in, aggressively.

  “A little over three months. Then the dose of painkillers you’ll have to take will render you insensible and the final phase will begin.”

  A little over three months to live. To live a real life, I mean to say. More or less.

  “A hundred days,” I say under my breath.

  “I beg
your pardon?” asks the doctor.

  “I’ve got a hundred days left.”

  “I told you that it could be longer, if . . .”

  I pay no attention to him. A hundred days. The number echoes through my mind.

  Paola breaks in.

  “Is there anything we can do to prolong the time? Anything at all?”

  “Chemotherapy, Signora, can be an excellent aid in blocking the proliferation of pathogenic cells,” he explains. “But it has countless side effects that make everyday life quite complicated.”

  I tune back in to the medical consultation still under way.

  “What kind of side effects are we talking about?”

  I know perfectly well that chemo makes your hair fall out, gives you nausea, makes you vomit, and leaves you exhausted. Everyone knows it—we’ve all seen it in lots of documentaries and movies. And nearly everyone has had some secondhand experience of it from watching the slow demise of a grandparent or an uncle or aunt. But the truth is very different and much worse.

  “Chemotherapy, Signor Battistini, isn’t a very sharp tool. It kills healthy cells as well. In effect, it is a poison we inject into the body in order to kill the main enemy, but on the way to its objective, it causes a bloodbath. There are many more side effects than you may know about. There are cases of anemia, digestive problems, loss of appetite and alteration of taste perceptions, fever, coughing, sore throat, headaches, muscle pains, jangled nerves, hearing loss, loss of sexual appetite, and problems with fertility.”

  Is that all?

  If I do nothing, I’ll die in a few months, with the assistance of kindly medicines to keep me from suffering in my last few days. If I subject myself to the best known type of cancer treatment, I’ll die all the same, though probably later; however, in the meanwhile I’ll be transformed: I’ll no longer be Lucio Battistini but a 220-pound ghost, stunned and languishing on a sofa, confined to endless hours of channel surfing.