by Amy Cross
"Okay," I say, feeling surprisingly calm. In a way, I'm glad to know what's happening. Three tumors doesn't sound too bad; it's certainly fewer than last time, so I guess I'll just need some more chemo and another operation. I've been kind of expecting this moment for the past six months; somehow, I could sense something growing inside my body again. I remember when I was given the all clear after the first bout; I knew at the time that it all seemed a little too easy.
"Obviously, this isn't the news we wanted," he continues, "but it's the reason we've been doing the bi-annual scans, so at least we've caught it nice and early. I was hoping the cancer wouldn't come back, but as I explained previously, it was always a possibility. In fact, with this type of cancer, it was almost a formality. It usually takes two or three rounds before there's a chance of it being beaten back permanently". He pauses for a moment. "These tumors are smaller than the ones you had before, but size isn't a primary indicator of how treatment might progress".
"Like berries," I say.
"Excuse me?"
"Like how sometimes smaller berries are juicier than bigger ones". I pause for a moment, as I realize how dumb that must have sounded.
"Quite," he says politely. "My point is that there's no reason to panic, Kate. In a way, this is a perfectly normal part of the process, and it's one that we anticipated. We can have a damn good try at beating this".
I nod politely.
"So how are you feeling?" he asks. "I can understand that this must have come as quite a shock".
"I knew there was a chance".
"Still... to have it confirmed must be rather daunting, especially since you've already got experience of this type of thing".
I stare at him, trying to work out what to say. What would a normal person say in this kind of situation? Am I supposed to cry? Am I supposed to run screaming from the office? Am I supposed to be cold and business-like? Suddenly I realize that I've spent so long thinking about how I should react, I've inadvertently given the impression of being a little dazed. "I..." I start to say, before pausing again.
"Don't worry," he replies. "There's no right or wrong way to feel".
"Okay".
"I'm very sorry that it's bad news," he continues, "but what we have to do now is make a decision about how to proceed. I must remind you that you're totally in charge of your own treatment, and anything I say to you is really just a guideline. Having said that, I would strongly recommend a course of chemotherapy followed by fairly swift surgical removal of the tumors and of the surrounding liver tissue".
"A transplant?" I ask, shocked at the prospect of having an entire organ removed.
"No. Not at this stage. I should think we'll just take thirty, perhaps forty per cent of your liver, which leaves more than enough to regrow. Then we'll monitor the situation and see if any more growths develop. If we're sitting here again in six months' time, then we'll start to think about the transplant options, but I don't want to jump the gun at this stage. Hopefully, we can be lucky and deal with the problem in one fell swoop. A transplant is a very big operation, and it's a risk that I just don't see as being justified at this stage".
I take a deep breath. It's strange, but I'm feeling totally overcome by this amazing sense of calm. When I got my original diagnosis a few years ago, I turned into a sobbing mess; I was unable to function for a few days, and I barely got through my course of treatment. This time, though, I just feel as if I've been given a huge new job to do. After a moment, I start trying to work out how to fit the cancer into my current schedule.
"Kate?" he says after a moment. "Did you hear what I said?"
I nod.
"And what are your thoughts?"
I stare at him. "Isn't that what you did last time?" I ask eventually.
"The procedure is the same, yes".
"And it didn't work last time".
"As I said before, it sometimes takes multiple treatment rounds before we can really nail the cancer".
"Okay".
"I don't want you to be down," he continues, "or to think that the past few years of treatment have somehow been a failure. The fact is, we've already pushed this thing right back, and now it's staging a small recovery, but we're not done yet. It would have been nothing short of miraculous if it had all been dealt with the first time around. It's like when you push an entire army back, but then you find there are a few snipers still holding on".
I look over at the large painting on the wall: a scene from a Napoleonic battle. In one corner of the painting, there's an injured man, covered in blood, being treated by a doctor. I guess Dr. Martindale sees himself as the general, commanding the troops into the field, rather than as the doctor tending to the injured man.
"Although I'm optimistic," he continues after a moment, "I must warn you that this remains a very serious diagnosis, and there's no guarantee that we can treat it successfully. Your chances are good, Kate, but it would be remiss of me to not mention the dangers. Even if we get the cancer and it hasn't spread, any operation is risky, especially with an organ such as the liver which is so prone to bleeding. Cancer is always a serious business, especially when it's in the liver and can spread so easily".
"But it hasn't spread," I reply, turning back to face him. "Not yet, anyway?"
"There's no evidence that it's spread," he says. "That's one of the things we're going to keep under close observation, and it's one of the reasons I want to get started as soon as possible. If we wait, it'll certainly move to other parts of your body".
"So when do I start the chemo?"
He looks down at his papers. "We have all your insurance details, so we can get you started in a few days. I'm sure you remember what it was like last time, it'll be exactly the same, so you should see if Mark can come and pick you up when each session is over".
"Actually, I'm not with Mark anymore," I reply, bristling a little at the merest mention of his name. "But I'll be fine".
"Okay," he says. "Sorry. Anyway, I'll give you a call when I know an exact time for your first session, but I'd have thought Monday or Tuesday would be quite possible. There's no point delaying things, since this type of cancer can be very aggressive and I'm worried it could spread to the lymph nodes quite quickly. I'm very much a fan of getting on with things and dealing with them as soon as possible, as I'm sure you remember from the last time we were in this position".
"Can we wait a week?" I ask, suddenly realizing that the chemo could interfere with the seven-day window I have at the university to examine Amin Bell's book. After struggling for so long to get access to that book, I can't possibly allow myself to become distracted at the crucial moment.
"Why would you want to wait?" he asks.
"It's just that I'm in the middle of some work," I tell him, "and I'd really like to have a clear head with no distractions. It's something I can't reschedule, so if we could just make sure that the treatment starts a little later, I'd be grateful". I take a deep breath, aware that my request might seem strange but determined to ensure that I don't lose the Bell book. "It's just a few days' difference," I continue after a moment. "This news really couldn't have come at a worse moment in terms of the things I'm doing. If we could just hold back for a week, it'd make all the difference".
He stares at me, and it's clear that he doesn't approve of my request. "I don't want to over-stress the aggressive nature of this cancer, Kate," he says after a moment, "but any delay could be detrimental to your health. I really can't imagine anything that would be more important that getting on with the -"
"It's just a few days," I reply, interrupting him. "I remember what it was like before, with all the drugs, and my head was totally messed up for weeks. I need to be able to focus right now; I need to be able to think. This is..." I look down at my hands and see that they're not shaking at all; in fact, they're steady as a rock. I feel calm and rational. "This is just bad timing," I continue after a moment, "and I'd like to take a few extra days in order to make sure that there's less of an overlap. I m
ean, you said that I'm in charge of my treatment, so can't I make the decision? Can't I just decide to hold things off for a week, just to make sure I can get everything done first?"
"Kate -"
"Do you seriously think that a few days' difference will be a matter of life and death?" I ask, determined to make him see my point. "Am I really that close to the edge?"
He sighs. "Okay," he says, noting something down on one of the files. "I don't agree, but I'll put it back for one week. It probably won't make a huge amount of difference, although I still think it's an unnecessary gamble. I should warn you that the drugs I'm going to give you are a little stronger than the treatment you had last time. Things have moved on and there's some new stuff on the market, so I think we're going to hit this thing harder and faster than was ever possible last time".
"That sounds good," I say, before sitting in awkward silence for a moment.
"I want you to do one thing for me, though," he continues, scribbling some notes on a prescription pad before tearing the top sheet away and passing it to me. "Take these pills. Three a day, one after each meal. They'll help get your liver in shape. Do we have a deal?"
"Sure," I reply. "Is there anything else?"
"Not unless you have any questions".
I shake my head.
"Then I'd suggest that you get on with whatever work you have on your plate," he says, "and make sure you're ready for your treatment to start. As it's the liver we're dealing with, Kate, I need you to avoid alcohol and fatty foods. Try to look after yourself and build up your strength. This is a fight you can win, but it's a fight nonetheless. Give yourself the best possible chance, okay?"
Smiling, I get to my feet and head to the door. "Thank you," I say quietly as I step out into the corridor, pulling the door shut as I go. The woman is still sitting over at the far end of the waiting room, so I quickly make my way around the corner. Once I'm alone, I stop for a moment, close my eyes and take a deep breath. For a moment, I'm overcome by the feeling that I could scream; I could let out my anger and frustration, and really let rip. Just like last time. In fact, this is the exact same corridor where I broke down sobbing when I was originally diagnosed. A little further ahead, there's the same chair where I sat and wept while Mark put his arm around my shoulder and tried to find something reassuring to tell me. Eventually, he led me away and we went home, and I spent three days in bed before I was ready to face the world.
Things are different this time. No Mark, no tears. I open my eyes and find that I'm just standing in the corridor, feeling calmer than I've ever felt in my life. I guess the one thing I've always hated is uncertainty, and now the uncertainty has been lifted away. I do have cancer, and my treatment is already being arranged. Taking a deep breath, I can't help but smile as I head along the corridor, past the chair where I wept and past the reception desk and out into the busy New York street. Carrying my secret little tumors with me in my liver like marbles in a sponge, I make my way through the crowd, heading to the cafe where I'm supposed to meet Bella. I'm not really in the mood to see anyone, but I need to kill a little more time before I head back to my apartment. The photo is waiting for me, and I'm quite certain that the figure will have appeared once again. I have to find a way to get to the bottom of this before the chemotherapy starts and I end up losing my mind again.
Chapter Seven
There's a knock on the cubicle door. "Hello?" says a woman. "Do you need some help in there?"
"No," I reply, trying my best to sound as if I'm fine. "Just some bad seafood," I add, before leaning back over the toilet bowl and vomiting again. All that comes out is yellow bile.
"Okay," the woman says, sounding a little uncertain. "I just wanted to check".
"Thanks," I splutter, with liquid dripping from my open mouth. I take a series of deep breaths, desperately trying to settle my stomach. After a moment, I hear the woman's high-heels clicking away across the bathroom floor; seconds later, the door opens and closes, and I realize with relief that I'm alone again.
"Fuck," I say quietly, feeling my stomach start to tie itself in another knot. I wait for the next wave of nausea; I know it's coming, so why can't it just hurry up and arrive? Finally, after what feels like an eternity, I bring up another small amount of bile, and this time there's a little blood in the mix. It's bright red blood, though, so it's probably just from a tear in my throat. It's nothing. Nothing to worry about yet. I've still got time.
Chapter Eight
"So you don't return calls or emails, you don't reply to text messages, you don't even answer your door when I'm pretty damn sure you're at home". Bella smiles as she sips from her glass of wine. "Don't take this the wrong way, Kate, but I'm struggling to believe that you're really that busy". She pauses for a moment. "Are you okay?"
"Totally," I reply, looking down at the spaghetti in my bowl. We're sitting on the terrace of a small cafe, and I'm trying really, really hard to make sure Bella can't tell that I want to throw up. I've been forcing the spaghetti down my throat one mouthful at a time, while praying that my stomach will remain calm long enough for me to give the illusion of health. Still, I know that my body might rebel at any moment. "I'm not busy, exactly. It's more that there's lots of little things that all kind of add up, you know?"
"I guess". She stares at me. "You understand why I worry, don't you?"
"Totally".
"You'd tell me if it came back, wouldn't you?"
"Of course I'd tell you," I reply. "I wouldn't tell anyone else, but I'd definitely tell you".
"You got a job yet?" she asks, eying me suspiciously.
Shaking my head, I take another mouthful of spaghetti. So far, so good.
"You need a job yet?"
I shake my head again. "Savings," I say as I swallow.
"Look at us both," she continues with a grin. "Remember when we were kids, wondering what we'd end up doing with our lives? And now here we are, sitting in the middle of New York, living off compensation money. What a lifestyle, huh?"
"You're not living off compensation money," I point out.
"Yes I am! I'm married to a conniving bastard with a different mistress in each city, and his money is the only compensation". She raises her glass. "Cheers". After taking another sip, she stares at me for a moment. "Sorry, Kate. I didn't mean to make a joke of it. I know it's not the same. How's the scarring?"
"Good," I reply, looking at my glass of wine and wondering whether I can risk even the tiniest drop. "It's pretty much finished healing now. You can still see it, but I think it's set. I don't think it's gonna change anymore".
"I don't want to see it," she says. "You know what I'm like with things like that. But I'm glad to know it's getting better. I know a great plastic surgeon, if you're interested. He did my tits".
"I think I'll be okay for now".
"You sure? He even gave me symmetrical nipples, which I gather can be a little tricky at times. These things look like they're bolted on. Not that I ever use them for anything these days".
Smiling, I take another mouthful of food. Bella and I are so completely different, it's hard to believe that we can spend more than a couple of minutes together without trying to tear one another's eyes out; fortunately, we seem to be able to tolerate each other's 'failings' without too much difficulty. I guess it helps that we grew up together in the same dusty little Kansas town, and moved to New York together on the same bus. Hell, we even lived together for the first two years after we got here, before life dragged us off in different directions.
"So do you mind if I ask a personal question?" she continues. "How much longer is that money gonna last? I mean, they only paid out so much, and city living isn't cheap".
"A few months".
"A few months?" She stares at me. "Don't you think you should start looking for a job? Or are you still convinced you're gonna be a professional photographer?"
"I'm working on things," I tell her. "I won't starve".
"Dominic and I can always lend you someth
ing," she continues. "Just enough to tide you over in case things ever get desperate. I could also try pulling some strings around town, see if I can maybe get you some work. I have a friend who owns a gallery downtown, he might need someone".
"I'm fine," I say. "Really. Stop worrying about me".
"You need a man," she says. "No, let me correct that. You need a good man. A dependable man. A man who isn't like Mark. You need to find someone before it's too late. Seriously, I can't even begin to explain how a husband just removes all those little worries that haunt your everyday life. Even if he's the Devil incarnate, you just have to learn to look past the horns and the forked tongue, and embrace the positives". She waits for me to say something, but I'm focusing on finishing the late of my meal. I'm also thinking about the photo back in my apartment, and whether it'll have developed the man's image by the time I get home.
"I'm fine," I say eventually, even though I know that such a weak pronouncement is unlikely to ever satisfy Bella completely.
"Are you sure you're not hiding something?" she asks after a moment. "I mean, health-wise. It's just that you seem a little distracted, Kate. I feel like I have a sixth sense when it comes to you, and right now that sixth sense is tingling like a virgin's clit. You'd tell me if something was wrong, right? I mean -" She leans across the table and grabs my hands, holding them tight. "You'd tell me. Promise?"
"Nothing's wrong," I reply, pulling away so that I can take a sip of wine. Damn it, why won't she just believe me? "And yes, I'd tell you. As it happens, I went to see Dr. Martindale today. I have to have a check-up every six months, just so they can make sure it hasn't come back. I get scanned and prodded and all that stuff".
"And they didn't find anything?"
"They didn't find anything".