Three cancer patients walk into a bar…
(There is no joke like that. I had to make that one up).
“Crucified on Friday, risen on Sunday,” I say as the nurse sticks the IV into my arm. I’m referring to the Gemzar going into my vein, and to the more truncated recovery time on this particular chemo regimen, but the nurse doesn’t laugh. She looks confused as she tapes the bandage over my port. She tosses the wrapper into the trash, then hands me the remote for the overhead TV. “Want a pillow?”
Did I get the days wrong? Is that what offended her? I’m Jewish, the kind of sequestered upbringing that required avoiding even contiguous pavement when it came to churches. Usually, I can find a better joke, or sympathetic questions which get the nurses on my side, or a compliment on their hair or jewelry. I know it should be the other way around but it isn’t.
Each time I come in here I try to understand why they’re so crabby. I try to think how it might feel to see these chairs empty out over the months, over the years, despite their most intensive efforts—the tunneling in of IVs and the swabbing of port sites, the monitoring of fluids and appointments, the constant round of explanations they must offer to new inductees: This is your Decadron. This is your Tagamet… This is your Anzamet—for nausea…it’s a great new drug. We’re so lucky to have it! It should keep you comfortable for the first twenty-four hours…and then you can take another one tomorrow as soon as you get up… (Ha ha ha). I try to imagine saying these things over and over and over, try to imagine what it’s like to see misery lined up like peas in a pod.
One morning I’m the only patient in the infusion room. “I see everyone got cured,” I say.
That one makes her laugh.
A Jew, a Catholic, and a Protestant get cancer…
—The Jew complains.
—The Catholic prays.
—The Protestant keeps her mouth shut.
They like the Protestant.
My best friend has cancer too. She calls me and we talk for hours. Sometimes she’s the only one I talk to—as myself. With her, there’s no extra wrapping, no tinselly good cheer. We curse alot. (Shitty cancer! Motherfucking cancer!) We describe symptoms and procedures in gory detail. We say how many times we puked, how loud we groaned, how savagely we pulled our hair out before it fell out on its own.
Frequently, we talk about food, not just what we can keep down but what keeps down the chemo taste of metal, that taste of something scoured from the bottom of a pot. We discuss our horribly loud burps, how bizarre they are, and then we demonstrate—like boys at a sleepover having a contest.
My boys, in fact, love these burps. They think that surely I must be kidding, especially when I say afterwards, “Is that your final answer?”
They never get tired of that one.
Cancer see I’m trying to get some sleep in here?
Sometimes that’s all I want to do. The bed is my refuge, my prison, my barge ferrying me from one riverbank to another—day/night…day/night…day/night…until this side effect is over, the ‘fatigue” as they call it, as if the French shading makes it lighter, fluffier somehow.
All I know is that fatigue is relative no matter what you call it. On Taxol it takes six days to get out of bed. On Carboplatin, it takes five. On Gemzar, only two.
And no matter how glad I am to finally resurrect from my bed, I keep on thinking about sleep, with eagerness and love, almost as much as I think about food. I wonder why I want it so badly. “You can sleep when you’re dead.” Isn’t that what parents say to their children, to those good-for-nothing children who won’t get up for school, who try to see how late they can sleep on a Saturday morning?
“You can sleep when you’re dead.” It’s something I know inside out and yet I long for it, for the precise softness of my pillow, the warm flannel sheets. Nothing feels better than falling down that deep, dark well. Nothing.
“On a scale of 1-10 how much does it hurt?”
The pain scale for morons. It hangs in my surgeon’s office on a laminated card next to the examining table. For those who can’t articulate their pain there’s this simple chart: 0-2 has a smiley face (for the lucky ones), 3-5 is for those who can’t commit (a mouth that’s a neutral line), 6-10 shows variations on a frown—with and without tears (or maybe those are sweat droplets? for the really stoic?)
I wonder who on earth needs this chart, what patient would ever actually admit to being a ten?
I wonder whether the doctor ever uses it. He never uses it with me, knowing perhaps that I wouldn’t tell the truth, or fearing, maybe, that I would, that such a question might unleash a frenzy of complaints.
I suspect that he uses it with other people though, that he marks their answers meticulously in his notes, or dictates them into his tape recorder (Moderate pain…only moderate pain, Thank God!…) the way I hear him sometimes whispering about me, intoning my doom out there in the hall where I can just barely hear him, (Carboplatin treatment was not effective… Following biopsy, tumor has returned…) just enough details to send frills of panic through my body.
As the perfect complement to pain, there’s also an anxiety scale. This is the one they routinely ask you about as you wait for your surgery, as you pray there hungry and trembling, Please let me be okay…Please let me be okay… Please let me be okay… The nurse will watch you twitching on the cart and ask redundantly: “Are you nervous? On a scale of 1-10 how would you describe it?”
Anything over 5 gets you the IV valium so I always say 6. Pretty darn scared but not enough to be thought a total chicken as I lie there thinking my last thoughts, imagining that cartoon I saw in the paper, the one I thought was hilarious even though no one else did:
Doctor, leaning over a completely empty hospital bed: “The surgery went well. It had spread but I’m quite confident we got it all.”
Hilarious—until it’s actually time for surgery.
Q: Why did the cancer patient cross the road?
A: To get to the other side.
Q: Couldn’t she just have waited?
A mother and her two daughters get cancer…
The mother lives. Both daughters die.
God really laughs at that one.
Q: What did one gene pool say to the other?
A: Are you crazy? Gene pools can’t talk.
But if they could, what would they say? Touche! or We sure showed her! or What made her think she was so special? She wants special? We’ll show her special…
None of the above is really a joke. As it turns out we do have that gene mutation, the one which sounds like a vanity license plate or like a nasty birdcall. (BRCA1! BRCA1!) though we didn’t know until too late. (What a joke!) I’m the one who finally found it after years of repeating my suspicions, prefacing each encounter with the gynecologist with I have a family history…though for all the response that got it could have been a family history of anything, a family history of sleepwalking or thrill-seeking or athlete’s foot.
Oh, I had my mammograms. I had my breasts squished and squashed like dead jellyfish. I saw my problematically dense balloons held up to the light. I saw the mysterious white smoke blowing through them, the geologic calcifications. Here is the spot we find questionable. This is the area we’d like to revisit. If you can come back in six months we’d like to see it again… maybe propose to it, maybe decide to lop it off… but it didn’t matter. The gene I had didn’t apply that way. It was more inventive. Sneakier. It surprised me—and them. Though it probably shouldn’t have. It’s well-known that the one mutation causes both kinds. Breast, ovarian: a cancer which impregnates, imbueing your insides with microscopic life growing willy nilly, coming to fruition more rapidly than you dreamed possible, faster than a real pregnancy though you might think, for a fleeting moment, that you are. Your stomach, after all, bloats like early pregnancy. Your back aches. You’re as tired as the first trimester, though too old for these symptoms. Or nearly too old.
Perimenopause, they told me for a while. No matter what symptom I came up with it all came down to that. Perimenopause. I was forty-five. I was forty-six. I was forty-seven. It had to be that. The beginning of the cessation of my periods. An oxymoron.
Like most other cancer patients, I could just kick myself—for not trying harder. For not worrying more. For not being more assertive. Something is wrong. Something is really wrong with me! I’m positive something is REALLY wrong!
So much for being positive.
What else do I find funny?
You enter a clinical trial.
You get the placebo.
You die the week before a new cure is discovered.
A month before.
A year before.
There are whole categories of exaggeration excised from your vocabulary:
Believe me, I was really dying!
You could have knocked me over with a feather!
Oh God no more please—you’re absolutely killing me!
Say that to someone these days and they’ll look at me twice.(Is she kidding?)
A special joke for writers:
Q: What are you working on these days?
A: Not going crazy.
I’m awed by the people who make art from their dying, who make self-help and healing, compassion for others, an organic form more organic than their cancer. Who make sense of it somehow.
There are dozens of books like this, in fact. More than I could ever have imagined. “To Hell With Cancer”… “It’s Not About the Bike”… “What to Expect When You’re Not Expecting Anything”…
Why don’t you write about it?—a question someone asked me while I was still in the hospital after surgery the first time. Why don’t you write about it? As if I were foolish to sidestep such a wonderful opportunity. A wise person would know how to put even this kind of experience to good use.
I thought she was crazy at the time but apparently I was wrong. Apparently there are many who’ve been inspired, many who’ve risen giddily above. All it takes is a little attitude, a good dose of grateful cream on your paper. A dollop of joy with the suddenly sweetened post-cancer berries of your life.
So how come I couldn’t do it? Why couldn’t I try harder?
Even my own mother thought it might be good for me, my mother who had also lived through this, who never once mentioned her former cancer to me the entire time I was growing up. I never knew until I was twenty and it came back and there was no hiding it the second time around. Or the third time. I was too old not to know then.
My mother, a three time survivor, is almost ninety now, yet most days I’m sure that she’ll outlive me. I made a wish on my last birthday that she wouldn’t—live to see me, her other daughter, die. Should I be wishing that? I mean how sick is that?
I don’t really know. I’m not so sure of anything these days.
All I know is that in Cancerland, everything gets turned around. Mothers outlive their daughters. Time is both curse and blessing. The jokes are all one-sided.
The best one yet is still that cartoon. The doctor addresses the empty bed. It had spread but we got it all. Not quite a joke since the more they take of you, of your flesh, of yourself, the less self there is to turn against you as time goes by.
My mother’s last joke. On me.
Q: Would you have written about it, Mom?
A: Heavens no! I’m not a writer.
Q: Well if you were, what would you have written? What is there to say?
A: I have no idea, honey, I don’t have that kind of imagination but you do. I know you’ll do it eventually—come around. I’m sure you can find something.
See Also: What Happened to Sheila by Dan Chaon