Defenses

Yesterday, before my last chemo, I saw Dr. Blue and Brown. His opening was, “I heard you were a bad girl in Florida,” (because I hadn’t seen a doctor about my fever. I could just imagine father-daughter rooms next to each other in the hospital. No thanks. I survived without doctors.) We then took stock of where things stand at this quarter way through my treatment. He had sent me to a breast surgeon, whom I just met before going to Florida. There are pictures of her in her office from the beginning of her practice, and Robert and I did double takes to recognize her. I was glad she has lots of experience.  As she gave me my surgery lecture, I wondered if it got boring for her. I had to stop and ask her to repeat some things because her voice was soft and without modulation. I doubt doctors take speech lessons in med school any more than they get handwriting classes. Her competence and compassion are what matter.

Defenses

Mastectomy is set for Sept 1. Dr. Soft-Spoken said since there is at least one lymph node enlarged still, everything is coming out on the right side. She told me the chemo had shrunk the tumor, yes, but as far as she could tell, hadn’t shrunk the node. This was disconcerting since I know the nodes are my last defense before the cancer metastasizes. She explained what it could be like to live without those nodes, the heaviness and swelling I could feel in that arm each day, the need to move it overhead after surgery. A survivor friend told me she sits beside a lamp and just holds on to the post above her head for as long as she can stand it to relieve the heaviness.

Dr. Blue and Brown pshawed Dr. Soft-Spoken’s assessment. He said it was unlikely the lymph nodes were unaffected, and he poked around to double check. He said if I wanted, he could order another CAT scan to check for metastasis, but he didn’t recommend it because it was rare for cancer to spread during chemo, especially chemo like mine that was working, and if the test showed “hot spots,” all he would do is cancel surgery because there is no cure for metastasized cancer, so what would be the point? The cancer was out the gate. But he thinks so far so good (no guarantees).

So I realize after these four months of chemo that yes, the cancer has probably been stalled, but it’s still capable of spreading, and surgery is my next line of defense. I will live without lymph nodes on the right side after Sept 1 and move on to radiation once things have healed, the third line of defense.

What’s crazy to me is the silence of the battle. I know it’s a life and death struggle, and all I feel are the effects of the chemo, nothing of what’s happening inside. I take these good doctor’s words that my defenses are holding, but I really won’t know for years. I sit in that chemo chair with that final potion going in my arm, and I look at the five other people in my pod connected to IV’s and most of us have care-givers like I do, and most of us are silent. The couple to my left asks our petite nurse Lisa questions about what the drugs do and how the PICC line works, and he has all his hair, so I realize he’s new, but after 4 months, I have no questions for Lisa. At the end of my 6 hours, she takes out my PICC line, making my arm vibrate slightly, but no pain.

For the rest of this year, I’ll have an IV put in every three weeks to finish out my treatments. When they offered me the gong, I said I’d wait until all that stabbing was over. Seemed premature right now to ring it when I have all that still ahead of me. Surgery. Radiation. 13 stabs, which they beguilingly call pokes. (My chemo brain calculated 40. But it's NOT 40. It's only 13! Host Dad caught that one. Yay!) More prayer. Robert said I should practice the gong. One battle down. But I was still thinking about the uncertainty and the invisibility. My guess is that with teamwork like this, it’s always that way, you trusting other people to help you see, help you judge. So little of reality is accessible. Trust, waiting, underscores everything.

Notice the melting ice, the bird trap. You've seen this before: Peter Bruegel the Elder