Every day began with the making of his smoothie, with the goal that he be filled with as many immune-boosting herbs and supplements as I could get into the Vitamix my son Will had sent us when he learned about the diagnosis. I laid them all on the counter: frozen berries, banana, nuts, coconut oil, pea protein, chia seeds, kefir. Jim hated Boost, but sometimes I added that too, for the extra three hundred calories. He might not finish the drink—usually didn’t—but I’d follow him around with it over the course of the morning, or whirl it up in the machine a second time, and a third, augmented with new ingredients. In a manner not so different from how, at age seventeen, I’d been obsessed with keeping weight off my own body, now my obsession was putting weight on Jim’s—or more realistically, keeping him from losing any more. Sometimes, if he was in his office, or reading his Kindle in the living room, I’d set a tray down with bowls of nuts and slices of cheese. “If you could just eat ten cashews a day,” I told him, “that would add on five hundred calories.” I knew the numbers from my own days as a teenage anorexic. I kept a running tally every day of where he stood.
Always before, I had loved it that Jim had such a firm, fit body for a man his or any age. He’d been a runner all his life, and a cyclist, and had always been lean. Lying next to him on the bed, I could make out every rib bone.
But his lean physique no longer served him well. He had no reserves. His weight dropped from 145 to 135, then 125, then 120. Somewhere over the course of those days, I developed an odd new habit when walking down the street with him: If I saw a man with one of those bellies that men of his age so often possessed, I’d think, “How lucky he will be if he gets cancer. He could lose fifty pounds and not be in trouble.”
Sick as he was now from the chemo, Jim still headed out to the gym almost every day to work out with his trainer, Eddie, lifting weights, climbing a rope, riding a stationary bicycle to build his stamina. We knew he’d need it.
A single goal remained unceasingly in our sights: to shrink the tumor sufficiently that Jim might qualify for the Whipple procedure. “The tumor,” I called it—never “Jim’s tumor.” I never wanted to take possession of that 2.5-centimeter mass in his pancreas. If anyone was listening, it didn’t belong to us. “The Whipple,” I called the surgery now. We were on a first-name basis with what may well be the toughest kind of surgery a person could undergo. And there was nothing we wanted more than that Jim might qualify for it.
43.
Days passed. Jim was feeling the effects of the chemo all right—but this was good news, in a way. I liked to think that the same thing that was knocking him out was knocking out the cancer. There were clumps of hair on the floor of the shower now—his beautiful hair—and his fingers were starting to get numb, and so sensitive that he could no longer take a carton of anything cold out of the freezer, or even open the drawer. Whatever I cooked for him, he had no appetite.
Still, we continued to go through our days in a manner that approximated our old lives—allowing ourselves to pretend a tragedy was not taking place. We still started our day, before the sun came up, in the hot tub out under the live oak tree. Every morning we had our coffee together, then sat side by side at the kitchen table reading the news and, in Jim’s case, playing online Scrabble.
How do two people get through the day, when one of them has a tumor inside his abdomen that may be killing him, and the other is simply consumed with grief? We installed new light fixtures in the bathroom. We invited friends for dinner and took long drives and listened to music, watched Downton Abbey. We played ping-pong and worked on memorizing poems—“The Love Song of J. Alfred Prufrock” for Jim, “Dover Beach” for me. Between visits to doctors, we took our walks when Jim was up to it, to the place down the road—blocked off by a gate we chose to climb over—that led to a few miles of hillside trails some rancher had donated to the county, that almost nobody knew about but the people like us who made their home in the canyon. Sometimes we heard coyotes howling off in the distance, and one time we saw a fox. Jim brought his camera along, snapping my picture. I picked up pieces of owl scat, looking for mouse skeletons.
We made a point of talking about other things besides cancer on our walks—scientific discoveries Jim had read about, plans for our garden, trips we wanted to take—the most imminent being to my house on the shores of Lake Atitlan in Guatemala, where for almost a year now we’d been planning a Christmas gathering with my three children and one of his, along with all their partners. “No way I’m missing that,” Jim said, heading out to work with his trainer.
A singer we both loved, Richard Thompson, was playing at the Freight and Salvage in Berkeley, and though this was taking place shortly after the infusions got under way—the pain constant, not to mention the sorrow—we had tickets, and decided to go.
The Freight is a relatively small, intimate space, and our seats were right near the front. This particular night, Richard Thompson had announced that he was playing all requests. Though we did not ask for any particular song ourselves, the very first one he played was our favorite.
The song is called “1952 Vincent Black Lightning.” It’s about a young, wild motorcycle rider named James who meets a woman named Red Molly. “That’s a fine motorbike,” she tells him. “Red hair and black leather,” he says back. “My favorite color scheme.”
He gives her a ring. He robs a store, and gets shot doing it. Red Molly is called to his bedside, and with his last breath, he gives her one last kiss before handing over to her the keys to his motorcycle.
I had always loved that song, and played it for Jim when I first met him. You could call it a melodramatic story, probably, but I was always a sucker for stories of big romantic tragedy. I just didn’t want to live one.
Another trip to Southern California. Just a month since the diagnosis, Jim’s weight was down to 120 pounds, but that didn’t stop him from doing his pushups every night with me alongside him, and sometimes he still did pull-ups on a bar we’d put up over our bedroom door. “You know the great thing about losing all this weight?” he said to me. “It’s easier to pull myself up now.”
Only it wasn’t, of course. The cancer was never out of our minds, and he was hurting more than he liked to tell me, but he still headed out to his office when he could to work on a case and edit photographs from one of our previous adventures, and on Tuesday nights, if he was feeling up to it, he drove to his Storkzilla practices in the city. One night we drove to Sausalito together to the home of our friend Jerry for a day of playing rock and roll, and dinner after, gathered around the table with our friends. Everyone told Jim how good he looked. Baldness became him, they said.
Driving to doctors’ appointments—there were so many of those—we tried resurrecting our Wanda and Buddy routine and Jim’s Topo Gigio imitation. We talked about my longtime resolve that we take dancing lessons together, and about inviting the guys in Jim’s band to the house at Lake Atitlan when Jim was over this, to play music in the shadow of the volcano. At the end of every day, we slept naked in each other’s arms, clinging to one another. One night the phrase came to me, with a whole new meaning: holding on for dear life.
At the point Jim was diagnosed, he had been seeing a therapist, as I was too. For Jim, this had marked a moment—possibly the first in his life—when he had felt able, finally, to explore his relationship with his father. Some of this he kept to himself, but sometimes, too, on therapy days, he had come home after wanting to talk with me about the work he’d been doing with Dr. Geissinger. He was excited and hopeful about understanding the ways in which that early experience of being terrorized, and his perpetual sense of himself as having fallen short of being the son his father wanted, had shaped other aspects of his life. He was looking in new ways at his relationships with his children, and his relationship with me.
Some real sadness accompanied these sessions with the therapist. But something else too, which was the possibility that he might at long last free himself from very old wounds. Both of us might.
Then came the diagnosis. And suddenly, discussions of one’s childhood injuries—parents who’d hurt us, marriages that failed—became another luxury we could no longer afford. We were fighting for Jim’s survival now.
Jim still went to Dr. Geissinger now and then, but he worried about the cost of the visits. And anyway, there were just so many other appointments on the calendar. Every day, almost, another trip over the bridge.
I gave up my therapy. (Too expensive. Too costly of time.) Jim hung on a little longer. But as much as he liked talking with Dr. Geissinger—who had told Jim he no longer planned to bill him for their time together—he went to see him less and less. And finally, not at all.
It would probably have been a good thing exploring, with a therapist, what the cancer had done to our lives. But the cancer was taking everything we had.
44.
The end of the year approached. If the days were dark now, they were only going to get darker. Same thing that was true of our canyon, as we moved toward winter solstice, and the rain kept falling, and more and more of the small tasks we’d taken care of around our place went unattended as we struggled simply to get through another twenty-four hours.
We did not speak of death. All our focus went to shrinking the tumor so Jim could get the Whipple. And how best to accomplish that. The clock was ticking. We had to wipe the tumor out faster than cancer cells could grow.
The urgency that accompanied this knowledge never left us. Dr. Miracle had explained to us what it was about this particular form of cancer that made it perhaps the most dreaded form of the disease. Where some cancer cells are permeable, he said, pancreatic cancer forms a hard shell around itself that makes the tumor nearly impervious to chemotherapy. For treatment to be successful, these cells need to be tricked (this was the word employed by more than one of the experts with whom I spoke, and in the articles I studied) into allowing the elements administered in chemotherapy to gain entry into the tumor.
Something about the way these articles were written and the language of the doctors with whom we spoke led to an almost inevitable perception: that the cancer was not simply a highly unfortunate fluke of mutation, but an actively malevolent force within a person’s own body, going to war with itself—as if the cancer had a personality, a nasty and villainous one. In the same way that I had projected onto the rat we still heard outside our bedroom window every night a kind of premeditated intention to destroy our peaceful home, now I saw the cancer cells that way—as possessing ill will, and even more than that, true evil, like Lord Voldemort or Darth Vader or the villain played by Javier Bardem in one of Jim’s favorite James Bond movies, Skyfall: brilliant, sadistic, relentless.
But James Bond—the movie hero he loved best—had triumphed, and so would Jim, I said. In the face of all evidence to the contrary, I willed myself to believe this. And because I believed this, it appeared that Jim also did.
45.
It was a lonely business, fighting cancer. This one in particular. The word pancreatic left little room for anything good.
You didn’t want to tell your old friends how it was. They’d sympathize, of course, but they wouldn’t understand—or, if they did, that might be worse. “I don’t want to be the cancer patient wherever I go,” Jim said. But this was happening.
Then an unexpected group of new friends entered our lives. Sitting in the chair at my hairdresser’s one day—my own faint attempt at carrying on some semblance of a normal life—I heard a woman in the next chair talking about a men’s group in our town whose members were all fighting pancreatic cancer. When I got home I told Jim about the group.
It was not easy for Jim to reach out to these men he’d never met to announce the fact that was, for each of them, the single most awful aspect in each of their lives. Much as I had done decades before, when my children were very small, and I wanted to make sure they’d have friends, I contacted one of the men myself—Dan, a founding member—to tell him about my husband and urge him to drop Jim a note.
Dan sent a letter, with a long and detailed account of the many stages he himself had gone through since his diagnosis a few years back, when he was still in his forties. The devastation first, followed by months of grueling treatment that had seen his weight drop by seventy pounds. (This was more possible for Dan, who was a much larger person than Jim, and stood well over six feet.)
Dan had managed to undergo the Whipple, he wrote, and after it there had been more months of struggle. But for Dan, the good news was that he had now returned to his normal weight, was working full-time, attending his kids’ sports events and even playing some basketball.
The pancreatic cancer breakfast group—seven of them—met at a local restaurant every few weeks to compare notes on their treatment and share whatever they’d learned in their research about possible breakthroughs in the field of pancreatic cancer, and what clinical trials were on the horizon. That, and moral support most of all. Though none of these men possessed a medical background, they had all become highly knowledgeable about the disease and knew where all the cutting-edge work was going on. They could name every drug and its side effects. Everyone knew about Dr. Miracle and Michael Broffman and all the other players: Temblor at UCSF, Morton at Stanford, Wolfgang at Johns Hopkins, Gonzalez in New York. The gene therapy program in Arizona. The NanoKnife.
The morning he was supposed to meet with the pancreatic cancer breakfast group, Jim thought maybe he’d cancel, but in the end he went, after I nearly pushed him out the door. When he returned from that first meeting, he filled me in on each man’s story. There were five of them—six now, counting Jim—all between the late forties or early sixties. All but one, whose cancer had metastasized, had undergone the Whipple procedure themselves. And even the one with Stage 4 cancer—the death sentence—seemed to be beating the odds, Jim reported. He was in a clinical trial and his tumors were shrinking. He and his wife had just returned from two weeks in Tuscany.
They were a terrific group of men—smart and highly informed, and likable, and every one of them in possession of a surprisingly positive attitude.
And of course we wished we had never had occasion to meet them. Same as they all no doubt wished the same of us.
46.
The breakfast club offered comfort and support, but it seemed to me that the thing most likely to offer Jim joy at this point was playing music with his friends. Rock-and-roll medicine.
So I called Jim’s musician friends, inviting them to our house for a Sunday afternoon music jam to be followed by dinner of seafood paella, a specialty of mine. Every one of them said yes—Jerry and Rich, the two lead guitarists; Tony, the accordion player; Tucker on ukelele; Gary on keyboards and Allan on drums. Wives too, I said. We would finally get to have, at Hunsaker Canyon, the kind of big, noisy dinner with friends we’d pictured that first day we visited on Jim’s motorcycle, when the property first came on the market and the wisteria was in bloom.
As usual, Jim worried more than he needed to about making everything perfect for this gathering. Sick as he was from chemo, he had taken out the leaf blower and then the vacuum cleaner, and then got to work on the French doors.
“You don’t need to do this,” I told him. “These are good friends.” Maybe it was his father’s training—a childhood spent on yard work and chores, and punishment if things weren’t done just right—that made it impossible for Jim to leave dirt on the patio or brush in the yard.
The day before the party, I made four pies and drove to three different stores getting the best seafood for the paella. I wanted not just shrimp and cod and clams and mussels this time, but also scallops and crab and calamari
tentacles and lobster claws to decorate the platter. When I got home, my arms were weighed down by bags that Jim insisted on taking from me and carrying in, though I knew this was not easy for him now. That night he set out his three bass guitars and arranged the music stands, rearranging the chairs for the wives, setting out the charts for songs. I assembled the ingredients for margaritas.
The morning of the party, when Jim got out of bed, I watched him standing there. He was studying his hands as if they were no longer attached to his body. Sometime in the night, his fingers had gone totally numb from the neuropathy. There was no way he could play his bass.
We held off a few hours, hoping the nerve endings might come back to life. Jim went back to bed, sicker than I’d seen him since the first days following the diagnosis.
At ten thirty I called Tony, asking him to get the word out to the others. There would be no rock and roll at our house that day.
“I feel like a jerk,” Jim said—the old habit from childhood of taking on responsibility for anything that ever went wrong. “I’ve spoiled everything.”
I dismantled the big outdoor table we’d set up and carried the extra chairs back out to the garage. Then though it was not yet dark, I climbed into bed next to Jim and we watched three episodes in a row of Downton Abbey—the furthest we could get away from our lives that day, and a million miles away from “Stairway to Heaven.”
Later again—dark now, Jim asleep with his laptop open, his rock-and-roll jeans still laid out at the foot of our bed—I carried the seafood out to the yard. I had tried without success to give it away, though I probably could have tried harder, and in different circumstances I would have. As it was, I flung the whole mess into the woods for the animals. First the mussels, then the clams, the scallops, the lobster even, the crab. I could have frozen the stuff, of course, but I had no stomach for any of it anymore.
The Best of Us Page 17