Chapter 15
chapter
fifteen
The Department of Hematology Oncology and I go way back.
Twenty months back, to be precise. There’s nothing quite like treatment.
The rush of benadryl hitting your bloodstream, submerging your mind in cotton candy and turning your stomach into one of those tubes of liquid glitter that kids like to squeeze until they rupture.
That hit of dexamethasone that makes you feel like a bodybuilder for eighteen hours before waking up at five the next morning, ready for a day of persistent nausea and a week of hormonal acne.
The chemo agent that gets pumped in through a port in your chest, taking one sharp turn into the jugular, and shooting directly to the vena cava—the big vein that feeds directly into your heart.
And from there it’s open season. Look out, rapidly growing cells!
No one is safe when the big bad chemo comes to town.
Least of all your blood cells, all the moisture in your body, and your dignity as a human being.
Needless to say, I don’t love my visits to the clinic.
For starters, I have to hike from the city up to the hospital in Evanston that is close to my parents’ house, lest I have to switch oncologists.
And moreover, once I get to the hospital, a poor R.N.
has to watch me unbutton my pants and shoot me in the belly with ovary suppressors.
Every four weeks.
The things we do for our tumors.
“How are you doing?” my nurse, Bethany, asks as she logs into her computer.
“The same.” My hands sweat in my lap. The treatment rooms are sterile and haven’t been redecorated since the nineties. At least the treatment armchair is comfortable.
“Well, we should have you out of here real quick.”
I hum vaguely.
Unbidden, Eitan’s voice interrupts me, giving me goosebumps in a silent room. Go outside. Talk to someone random. Interact with the world.
“How are you?” I spur myself to ask.
Bethany looks surprised. She’s been my nurse several times, and I’m not the most talkative patient. “I’m good, thanks for asking.” She speeds through work on her computer, talking slowly as she goes. “I think the last time I saw you, you said you were going to a wedding, right?”
“Yeah.” I clear my throat, still trying to rid myself of the memory of Izumi’s wedding.
“How was it?”
I suck on my upper lip, my brows pinching together. “Uneventful?”
“Well.” Bethany sighs. “Enjoy wedding season while you can. Before you know it, all your friends will be having kids and you’ll be knee deep in diapers, wishing you had a black tie event to go to that didn’t end in a toddler jumping on your face the next morning.”
“I’ll…keep that in mind.” I laugh.
Bethany smiles at me. “Let me grab you an ice pack and I’ll come back in ten minutes with the shot.”
“Thanks,” I say, even though I don’t feel grateful by any stretch of the imagination.
The shot is painful, as usual, despite icing the area. Within fifteen minutes I’m shoving my way out of the treatment room, ripping my medical bracelet off as I go.
The waiting room is the worst. It’s full of sick people.
Don’t look at me like that, I’m allowed to say it.
Not too long ago I was one of these walking corpses.
A lot’s changed now. I’m not shivering in two turtlenecks, and I don’t have a catheter in my chest. Not to mention, I’m the youngest person here by about twenty years.
My only peers in age are helping hobbling parents and grandparents in and out of wheelchairs.
I could get away with just being a bystander too, except they put a medical bracelet on me at check-in.
A nice white beacon that gives me away instantly: here lies Ruby, cancer patient.
I’m so focused on blazing through the waiting room without making contact with any glazed chemo eyes that I almost run into a bright cloud of hot pink.
“Oof!” Something wheels over my foot. “Ow! Sorry—” The blast of pink clears enough for me to see a matching headscarf. “Louise?” I ask, dumbfounded at the coincidence.
“Huh?” Louise grunts indelicately. “Oh, it’s you.”
I wait for her to say my name. I may as well remind her. “Ru—”
“Gem,” she harrumphs.
Good enough. “Hello, fancy seeing you here!” I smile with all my teeth. Second chances falling out of the sky? Don’t mind if I do!
“Fancy that,” she grumbles, straightening her kaftan, keeping one hand on her walker.
“Seeing your oncologist?” I ask brightly. This is good. This is common ground I can work with.
“No,” she says. Well, there goes that.
“You can’t keep running off!” Alma appears out of nowhere, breathing heavy, putting a hand on Louise’s walker to catch her breath.
I glance in the direction they came from, seeing only Cardiac Imaging and Palliative Care.
“What’s the rush?” they ask, exasperated, before catching sight of me. “Oh, hi, Ruby.”
“I don’t like it here,” Louise says sharply. “I shouldn’t even have to come here anymore. I want a hot dog.”
“You’re not supposed to eat processed meat—” Alma appears to be gaining gray hairs from this hospital visit.
I’ve clearly caught Louise on a bad day. This is a private moment. Best to say a polite goodbye, gently remind her of my name, and try to convince her about the dance-floor ceiling in neutral territory, another day, after a good night’s sleep.
“You.” Louise turns to me. “You’re going to take me out for a hot dog.”
“Me?” I look around. Maybe she’s speaking to the Korean grandmother sitting behind me, or the emotional support shih tzu in the lap of a man dozing against a plastic fern.
“Who else?” Louise throws up an agitated hand.
“Now!” she adds, seeing my further descent into panic.
And she’s off, flinging her ticket at the valet.
I smooth down my awkward-length, poofing-like-a-chia-pet-in-the-humidity hair, and follow her hot-pink shroud outside. Second chance, I remind myself.
Alma drives while Louise sulks in the front seat, neither speaking to each other. I attempt to make conversation from the back, like an only child on a road trip with two parents in the middle of a fight.
“So, Louise.” I swallow down my nerves, my seatbelt almost choking me. “How’s your day going?” I know the current answer is bad, but how else am I supposed to strike up a conversation with someone I know this little? I do recall one thing we talked about: “Any new bucket list items?” I ask lightly.
“Bucket lists are for chumps,” Louise grumbles. Alrighty, then.
“She wants to see the Northern Lights,” Alma says under her breath.
I almost squeal—finally a topic I can talk about. “I saw the Northern Lights as a kid! My family went to Alaska to see them when I was ten.”
“It’s pointless. I won’t be able to travel anytime soon,” Louise says from the front seat. Grumpy would be a criminal understatement.
“Sometimes you can see them here, right?” I’m pretty sure I heard that somewhere.
“Only once every ten years or so,” Alma says.
I sit back in my seat, defeated, and look out the window, praying that this mythical hot dog improves Louise’s mood.
Otherwise bringing up the florist may actually cause more damage.
Pen can kiss the chuppah and the dance-floor ceiling goodbye!
I imagine Louise saying in her scratchy voice. How about that!
Alma pulls us into an island in the middle of a three-way intersection in Winnetka.
The hut sitting on this patch of pavement is fittingly called The Sunny Island, with a geometric palm tree on the sign.
The Sunny Island has clay tile, a flickering backlit sign with hand-placed letters spelling out the menu items, and a pimpled teenager in a visor working the register.
“What can I get you?” he asks, through braces.
“One Chicago-style dog, extra mustard, extra relish, and two pickles,” Louise barks. “Two, you hear me?” She holds up two fingers menacingly at the poor hot dog associate. He gulps and swallows. Nods. As promised, Louise steps out of the way for me to order, assuming I will pay.
The menu is rather dismal for a vegetarian. “I’ll have…” I need to decide between a soy burger, a veggie dog, and a basket of french fries. “A veggie dog.” Louise gives me a stern look that I can feel in my toes. “Chicago style,” I clarify. “And fries.” When in The Sunny Island, right?
Alma elbows me out of the way when I try to take out my wallet. “She’s far too rich for you to buy her food,” they explain, ordering herself a double hamburger and fishing out a crisp twenty-dollar bill.
We perch at the window counter, Louise in a hot pink kaftan, Alma in a denim maxi skirt and blue eye makeup, and me in sweatpants. Three strange and utterly mismatched birds.
The cashier sets two plastic trays down overflowing with fast food. My veggie dog is waterboarded with toppings, but the fries look mouth-watering. Handcut, freshly fried, perfectly seasoned.
Louise takes a large, mustardy bite of her hot dog. “Don’t even think about mentioning the wedding. I’m off duty.”
There goes any lingering wisp of that plan.
“Understood.” I swallow my disappointment, along with the first bite of my own dog.
Immediately, I need to fan my eyes. They’re watering from the amount of mustard it’s slathered in.
The hot dog itself is only mildly plastic-tasting, and the relish adds a much needed sweetness.
I’ll admit, Chicago style may be onto something.
“Feeling better?” I risk asking.
“Much.” Louise nods.
“I’m glad,” I say between mouthy chews. Relish is dribbling down my chin. There is mustard on my shirt.
“I was diagnosed five years ago,” Louise says suddenly.
I frown around my hot dog.
“I’m answering your question, Gem.”
I think back and recall a vague question I asked about her breast cancer during that first meeting, cut off by Penelope’s arrival.
“What was it like?” I ask.
“I found the lump while I was in the shower. By then it was already eight centimeters.”
My eyes widen. Eight centimeters? That makes my two-point-four centimeters sound like child’s play.
“Treatment lasted eleven months total—before and after surgery. They had to remove eighteen lymph nodes.”
My next bite swallows wrong. “Eighteen?” I balk. During my surgery they only removed five.
“Lymphadema is a stone-cold bitch.” Louise purses her lips.
“Well, at least treatment worked, right?”
She huffs a humorous sound. “Worked, past tense. They diagnosed the recurrence two years ago.”
I make a strong effort to push down the recurrence anxiety that threatens to rear its ugly head.
The r-word is a sore subject. Even hearing someone speak about recurrent cancer can send me into a tailspin.
Do you know what the worst part of having cancer in your twenties is?
It’s knowing that you have to live another fifty or sixty years under its thumb, and that’s if you’re lucky.
Laying awake at night, wondering if the cancer is settling into your lungs or making a home in your ribs.
Some cancer is curable, some is only treatable.
You can do all the exercise, eat all the veggies and dark berries in the world, and some cancer will still find a way.
You could waste an entire life beating your fists against the door of fate.
Learning to live with the fear of metastatic recurrence is yet another in a long line of injustices you have to make peace with.
The Dark Place is reaching out its grubby little fingers at me, trying to coax me into another pathetic bathroom cry. I shut it down, thinking about golden retriever puppies, Lake Michigan in August, frozen mangoes during a hot flash.
“Do not get a spine tumor.” Louise points a finger at me, as if I have control over this. “Nasty piece of work. Painful fuckers.”
“I’ll keep that in mind.”
“Louise is a thriver,” Alma says, through a mouthful of fries.
“Survivor, thriver, whatever you want to call it.”
Suddenly I think about Alfred Feeney’s final book, the one about the couple dealing with cancer. “Is that what Blue Rose was about?”
This time, Louise gives me a real, hearty laugh.
“My husband’s least favorite question was always, ‘What is your book about?’ Every time, he would say, ‘Read the book. Then you’ll know what it’s about.
’ But yes, he did write that while I was in treatment the first time.
We had to create a world together, one we could live in while my health was so uncertain. ”
Her words permeate the humid walls of The Sunny Island. What would it have been like to go through cancer with someone willing to create a world with me? A world where cancer didn’t make me lacking, where two people going through something harrowing could still find joy? Connection?
“He died suddenly.” Louise breaks the silence.
“It was a stroke. No warning signs, no notice. ‘Idiopathic’ was the word the doctors used.” She puts down her hot dog.
“I’m not sure which is better. Dying slowly, so you’re aware the end is coming, or going without warning, so you never have to know that you’re in your final days. ”
I think for a second. “I don’t think I’d want to know. There are a lot of things I would trade to go back to living the way I did pre-brush-with-mortality.”
Louise shakes her head fiercely, picking up her hot dog again.
“You can’t look back, Gem. If there’s one thing I’ve learned in many years of counseling, it’s that you can’t waste time on the past. You have no idea what could have happened on any other paths your life could have taken, all you can do is walk the one you’re on. The only direction is forward.”
“I know,” I rush out, reminding myself that even though she’s off-duty, she’s still holding the key to Pen’s happiness, and thereby Pen’s agent. “I do know that. A girl can dream, though.”
“Save your dreams for things that can actually come true. Otherwise you’re living in a nightmare.”
I bite my tongue. Literally. “Ow, goddamnit,” I mutter, soothing the spot.
I try to laugh off Louise’s implication that I’m living in a nightmare.
That feels like an extreme, reductive view of my life.
But considering I almost spiraled when she mentioned recurrent cancer, it may not be altogether false.
“I’m feeling much better!” Louise declares. “Never met a problem a Chicago-style dog couldn’t solve.”
Glad one of us is feeling better.