In those first weeks after I signed the purchase and sale agreement, Jim and I talked about the place now and then, though with a certain vagueness. Once, sitting on the couch together at the end of the day, he asked me to show him the pictures again.
“That’s where I’ll smoke my cigar,” Jim said, indicating the porch. The rocking chairs. He liked my idea of sleeping in the boathouse, he said—and though it was too small to hold anything bigger than a single bed, for us a single bed was enough.
“I bet there’ll be trout in that lake,” he told me. “I’ll bring my rod.”
76.
We invited twenty-seven friends for a holiday dinner. I would have been happy setting up tables made out of old planks laid on sawhorses, Jim preferred a less funky look. He was this way about most things, though never about me. I was always rough around the edges, and he never showed any indication that he had a problem about that.
So he made a trip to Ikea and came home with twenty chairs, then spent the next three days assembling them. He bought two long Ikea tables and matching wineglasses. Then he took out his vacuum cleaner.
We set the tables up in our living room end to end so they stretched almost the entire length of our downstairs. I’d always wanted the kind of life that allowed for big gatherings like this one. Of our children, only my son Willy would be at the dinner, but there would be plenty of friends.
I cooked for days, and it felt good doing something that had nothing to do with cancer. Before the meal got under way, I had asked that we go around the table one person at a time to speak of what we’d been most grateful for in the year that was now drawing to a close. I had worried a little, suggesting this, that hearing what everyone had to say might go on so long the gumbo would get cold, but I needn’t have worried.
Every person’s words were a revelation: Alice, diagnosed with breast cancer, was grateful for her dog. Katherine, who’d lost her home in Oakland and had no idea where she’d be living ten days from now, was grateful for the friend who’d offered her couch. Sally, whose son had been very ill, expressed gratitude that he was slowly recovering. Hal, who’d spent three months in Syria and Greece serving food to refugees, was grateful for having gotten to be there.
When it was Jim’s turn, he did not speak of the cancer or the surgery, or the pain. “It might seem strange to say this,” he said, “but these have been the best years of my life.”
“Buen provecho,” I said. Good appetite. (Not easy to accomplish, when you’ve undergone a Whipple procedure.)
We raised our forks and began to eat.
77.
We kept trying for a normal life, but its definition had changed. Every day started with pills—so many different pills that to keep track of them I made a chart, and almost every day required a trip to CVS. If it was a prescription for painkillers we needed—Hydromorphone, the Fentanyl patch—this was likely to be a complicated process, and might require trips to multiple pharmacies before we found one with enough pills in stock to fill the prescription, or a pharmacist able to assist us. One time the pharmacist kept the two of us waiting for an hour, grilling Jim on why he needed the refill so soon, placing calls to the doctor.
“She’s treating you as if you were an addict,” I whispered to Jim.
I paced the aisles of the store. The pharmacist was doing her job, I told myself. Still, I could feel the rage overtaking me. Not just for the hour at the pharmacy, but all the hundreds of hours before this one spent on trying to keep Jim alive, keep him out of pain, or just get him through the day.
It happened a lot now: Times I went into town on errands—bank, post office, Trader Joe’s, and always the drug store—and nine times out of ten the cashier ended our transaction with the words, “Have a good day.” Or (this was a Friday phenomenon): “Do you have plans for the weekend?”
The cashier inquiring about my day didn’t know me. The girl behind the counter at the dry cleaner’s didn’t care. But the question—“How’s your day going?”—always served as a reminder of all the ways my day was not going well, the weekend plans we used to have, and never did anymore. I let myself imagine all the ways I might answer the cashier’s bland, meaningless question: “I’m having a terrible day. My husband has had diarrhea for a week. My weekend plans? I’ll probably drop in at the emergency room and maybe stay up all night Saturday, watching five episodes in a row of House of Cards, to help my husband get through the pain.”
One time I actually lectured a bank teller when he asked about my day. He meant well. It just didn’t occur to him—lucky man—that a question like that, asked of someone like me, presents only two options. Either you give him the real answer—a guaranteed conversation stopper—or you lie.
I had already dealt with the “how’s your day going” question three times in a row by the point Jim and I got to the CVS that afternoon to fill his hydromorphone prescription. Three times that afternoon I had said my day was going fine. But it had taken something out of me too. All that bland disapproval of our real lives had left a bitter taste in my mouth.
I had planned on buying a hairbrush along with the pills. It was in my hand, and no doubt I was gripping it more tightly than a normal shopper might hold on to a plastic brush. The unfairness of everything was making my temples throb.
I looked at Jim—leaned against the counter, looking weary—and at the couple in front of him, with their purchases of sunblock and toothpaste, a child wanting a toy car his mother told him he didn’t need because he had one just like it at home, a pregnant woman buying vitamins. I was angry at them too and angry at myself for the fact that this was so. It wasn’t their fault that they got to spend their morning doing regular family errands, which did not include filling a prescription for opiates.
That plastic hairbrush was still in my hand when they finally called us up to get our pills.
I could feel it happening then: the crack, breaking loose. A small, not-very-dramatic act of rebellion, enacted at the counter of the Lafayette CVS store. I took out my credit card, but I did not set the brush on the counter with the rest of our purchases.
I didn’t conceal it. I just didn’t pay for it.
Back in the BMW with his medication, I told Jim, my Eagle Scout husband, what I had done. In some other moment, he would have expressed shock. He would have gone back in the store himself to pay, probably. As it was he just sighed and put his key in the ignition. This cancer had brought us to so many dark places we would never have imagined ourselves going. The fact that it had turned me into a shoplifter was the least of those.
78.
December brought more digestive issues for Jim. More wine for me. The FODMAP diet was helping a little, but Jim was still losing weight, and worse than that, he was losing muscle.
I haunted the supermarket searching for things Jim might be able to eat. Two trips a day sometimes, hours in the kitchen concocting dishes that might appeal to him, though I threw away as much food as we consumed.
I went back to the pot dispensary where I’d procured a card months before, studying the strains of marijuana that might help Jim get through the nights. We paid a visit to a new nutritionist. I started setting out an extra shot glass of MCT oil for Jim with every meal, to help put weight on him, and bringing him protein shakes multiple times a day, though these sat next to his chair largely untouched. Jim’s old clothes fell off of him now, but every day or two a box arrived with a new pair of pants or a shirt in the smallest size. Not lawyer pants anymore. These were sweatpants, and even the small ones hung on his body.
Another of the men in the pancreatic cancer breakfast group died—the third, since Jim had joined the group.
Something was happening to Jim’s muscles now that seemed to bear no relation to the food he took in or the supplements I pressed on him. Jim’s forearm was so thin I could almost encircle it with my hand.
“I need to start working out again,” he told me, and so before bed every night I joined him for planks and pushups, counting out loud
how many we did. But the number kept getting lower. We still walked our trash cans to the end of our driveway, Thursday mornings, for pickup. But when they were particularly heavy, I’d suggest putting the can in the back of the BMW instead of walking it out to the road, and Jim didn’t argue.
The beautiful BMW. Our road trip car. Mostly we drove it back and forth to the pharmacy, and to deliver those garbage cans up to the road.
Still, when John Prine came to town that month, we got on a BART train to hear him and held hands when he sang our song, “Glory of True Love.”
“There has to be music,” Jim said. “Give up that one and you’re dead anyway.”
79.
We put up a Christmas tree. But for the four days surrounding December 25—on the run, as usual—we went to New York City.
It was a trip that almost didn’t happen. At the airport in Oakland, preparing to fly out, I’d been given a TSA clearance that allowed me to sail swiftly to the front of the line, but Jim had not, and the holiday line was so long it was clear he’d never get to the front in time to board our plane. “I know it’s not your style, Jimmy,” I told him, “but you need to pretend you’re me. Push hard and cut through the line. You can play the cancer card.”
In all the months he’d never done this, but now, to please me, he did. Over and over, as he pushed apologetically through the line, my soft-spoken husband repeated the words, “I’m so sorry, but I’m a cancer patient. I have to get on this flight with my wife.”
And he did.
From the first time I came to New York, on a bus with my mother, at age ten, for the 1964 World’s Fair, I had loved this city. Every time I came here, my heart beat quicker. I moved fast through the streets, wanting to take in as much as I could in my time there. No time to stop. No time to waste. Too much to see.
Like me, Jim had always been fast on his feet. He was the man who could zip over to the law library to find a relevant citation of a case and back to the courtroom in the space of a twenty-minute recess—but by this point every block we traveled took a long time. Every stop proved costly to Jim. And I moved at his pace now. We sat on park benches a lot, stopped in often at coffee shops. Never mind the coffee part. This was about the bathrooms.
It was a very different kind of trip from our New York adventures in the past, when Jim had followed my lead as I raced around the city all day, hopping on and off subways and walking sixty blocks at a time, ducking into galleries and clubs, riding the subway to remote parts of Brooklyn or the Bronx. This time we took in little in the way of museums. But there was a show of Picasso sculptures at the Museum of Modern Art, and we were not going to miss that one.
The show featured sculptural works made over the course of the artist’s long life, from his early twenties to his nineties. It was this part that moved me most that day: the wild exuberance of the works Picasso made in his tenth decade of life and the extraordinary good fortune he’d known, to have not only lived that long, but to have lived that long making art to the end.
What could be better than that? Despite my mother’s death at sixty-seven, I always pictured that I would live a long life too, and once Jim and I got together, this was my vision for the two of us. I had seen us as a very old couple one day, like those couples I’d studied so often over the years, still holding hands into their seventies and beyond. Now, as we studied the Picassos, I realized how much more modest my hopes had become.
“Let him live to seventy,” I had said that first stretch of months after the diagnosis, though not out loud. Let us travel to Italy. Let him get to see his grandchildren.
Let him know a day without pain, I said now. Let him sleep through the night.
On Christmas Eve we attended a midnight mass at the Cathedral of St. John the Divine. From my spot in the pew, I watched as Jim—an Episcopalian who’d stopped attending church before I met him—made his way to the front of the cathedral to take communion.
Seeing him up there by the glittering chalice, bending his head to receive the wafer, his beard almost all gray now—still bearing a resemblance to The Most Interesting Man in the World—I realized how much thinner he had become than I had allowed myself to take in up to now. When you live with a person every day, you’re less apt to recognize the changes in his body, but that night I saw it.
A couple of years back—in our Before days—Jim had taken a photograph of the two of us on some hike—just our shadows on the ground, elongated in the way shadows get at the end of the day when the sun lies low on the horizon.
He looked like a shadow person now. Almost a ghost—a figure not so different from the one on the cross in the sanctuary.
Our last day in New York was Christmas, and the streets were surprisingly empty, the temperature unseasonably warm. I had gotten up before Jim, and because I knew he’d be staying in bed another couple of hours—in bed, then in the bathroom—I took the subway to Bryant Park. Later, we’d have breakfast together, and then head to the airport for home, but first I rented skates and for an hour circled the rink. Except for one or two skaters, I was alone on the ice. It was a kind of rehearsal.
80.
Deborah in Syracuse checked in again. Her husband, Bob, was going downhill fast and it was terrifying, reading her notes to me, to look into my own possible future. Still, I could not look away.
“Having a rough go of it here, and have been back and forth to Hopkins so many times I can’t even remember when or why at this point. Complications are too numerous to even try to recount.
“I wish with all my heart this was not happening to him, or Jim, or anyone else for that matter, and I certainly have no idea how I would be if the tables were turned. Some days I find it so annoying I can hardly stand to be in the same room with him and then I feel guilty if I go get a damn manicure. I don’t know whether this level of depression (has started on Zoloft, with no obvious effect yet), apathy (on Adderall—if I took as much Adderall as he is on I’d be out washing every car in the shopping mall parking lot around the clock) and general withdrawal from the world is specific to pancreas cancer or not, but it surely sucks. This brilliant mind has ground to an alarming halt. He is not reading, writing, listening to music, watching movies, or visiting with friends. All he does is sleep. He is such a thinker—always thinking up the next study, the next article to write, the next book to read or painting to paint and it is so distressing to watch his mind go blank. One day he asked me what our phone number was.
“He’s got a feeding tube, has had two drains (which just got removed here) that had to be flushed and measured twice a day, dressings to be changed, meds around the clock—you know the drill. I love this man to bits, but I am so angry that he has abandoned me. He is so diminished, I was thoroughly expecting the oncologist to say on Wednesday that the disease had run rampant and we were at the end of the line. At which point I was going to regret every prodding, pissed-off word I’ve said to him in the last two months. When he didn’t say that, I got even madder. How much sense does THAT make?? If you tell me you know exactly what I mean, I will do the following:
A. Worry about you
B. Prop you up best I can from afar
C. Know we’ll be friends forever”
In January I got on a plane again, alone. I was headed to Guatemala to teach my memoir workshop at Lake Atitlan, as I did every January, with the plan that Jim would meet me afterward. Once I had looked forward to these times on my own, but now I hated to leave Jim.
One other thing about that January: I gave up drinking wine, possibly not forever, I told myself. But for now anyway. For months I had told myself I’d do this, but every other time my abstinence had lasted no more than a couple of nights. “My life is hard enough,” I told myself, as I uncorked the zinfandel. “I deserve this.” Jim took Dilaudid. For me, the drug was wine. But lately the thought had been coming to me, that maybe the wine was making my life harder. Or would, eventually.
Giving up my drug of wine that January was a big deal. But maybe because I
was away from Jim then—and away from the constant presence of illness and pain—I found it easier than I had anticipated, doing without alcohol. I was swimming a lot and teaching my workshop. Jim’s situation was the same that it always had been, but having that brief reprieve from witnessing it on a twenty-four-hour basis allowed me to sleep through the night for the first time in months.
For eight solid days, at the lake, I lost myself in other people’s stories, though late at night, when I was done leading the workshop, I’d call Jim back home in California. One night, after I was done filling him in about my day, I could hear him drawing in his breath before he spoke.
“I have a little news,” he said, his voice steady and even. “I got back the results of my new blood test. It looks like my CA19-9 has gone up.”
The tumor markers. The number every cancer patient feared. They weren’t conclusive, but seeing them rise was never good news. I felt the impulse then, to pour myself a drink. Felt it, and resisted.
Some months earlier—after the soft tissue nodule scare with Dr. Ko, Jim had chosen a different oncologist at UCSF, Katie Kelley, whose specialty was liver cancer, though she treated pancreatic cancer patients as well. Now I wanted to know what Dr. Kelley had to say.
“I’m not too worried at this point,” Jim told me. “Katie says that sometimes, all an elevated CA19-9 means is that you’ve got inflammation in the gut, and we knew that already.”
We moved on to other topics. What good did it do to speculate or play out disaster scenarios? I told Jim about the workshop, and about an orchid plant Miguel and Mateo had found in the mountains for me, and about the pizza our friend Henry had made that night. After we said good night, I stepped outside to look at the stars.
When the workshop finished, I was scheduled to teach in San Miguel de Allende. Jim would meet me there, and we’d spend a few days together in Mexico, and then return to the lake for a few more weeks. Back in December, knowing her wedding was coming up in the spring, I had suggested that we buy his daughter, Jane, a ticket to come spend a week with us at Lake Atitlan. This might be the last time, for a while anyway, that Jim would have a chance to spend time with his daughter on her own. That was how we put it to each other, at least, and to ourselves.
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