“Who told you this?”
“The doctor,” she says. “We went for a scan today.”
“They did a CT scan.” It’s Aaron, at the door. “And a blood test.”
“We need a second opinion,” I say.
“I said the same thing,” Aaron says. “There’s a great—”
I cut him off with my hand. “Where are your parents?”
Bella looks from Aaron to me. “My dad is in France, I think. Mom is home.”
“Did you call them?”
She shakes her head.
“Okay. I’m going to call Frederick and ask him for a roster of his friends at Sinai. He’s on the board of cardiac, right?”
Bella nods.
“Okay. We’ll make an appointment with the top oncologist.” I swallow the word down. It tastes like darkness.
But this is what I know how to do; this is what I’m good at. The more I talk, the more the buzzing dims. Facts. Documents. Who knows what crack-brained doctor they went to? An ob-gyn is not an oncologist. We don’t know anything yet. He’s probably mistaken. He must be.
“Bella,” I say. I take her hands in mine. “It’s going to be fine, okay? Whatever it is, we’ll figure it out. You’re going to be fine.”
* * *
On Monday morning, we’re at the office of Dr. Finky—the best oncologist in New York City. I meet Bella at the Ninety-Eighth Street entrance to Mount Sinai. She gets out of the car, and Aaron is with her. I’m surprised to see him. I didn’t think he was coming. Now that she’s not pregnant, now that we’re faced with this, the biggest of all news, I don’t know that I expected him to stick around. They’ve spent one summer together.
Dr. Finky’s office is on the fourth floor. In the elevator ride up, we’re met with a dewy pregnant mother. I feel Bella turn inward, behind me, toward Aaron. I hit the floor key harder.
The waiting room is nice. Cheerful. Yellow-striped wallpaper, potted sunflowers, and a variety of magazines. The good ones. Vanity Fair, The New Yorker, Vogue. There are only two people waiting, an elderly couple who seem to be FaceTiming their grandchild. They wave at the camera, oohing and aahing. Bella cringes.
“We have a nine a.m. appointment. Bella Gold?”
The receptionist nods and hands me a clipboard full of papers. “Are you the patient?”
I look behind me to where Bella stands. “No,” Bella says. “I am.”
The woman smiles at her. She wears two braids down her back and a nametag that reads “Brenda.”
“Hi, Bella,” she says. “Can I ask you to fill out these forms?”
She speaks in a soothing, motherly tone, and I know that is why she is here. To soften the blow of whatever happens when patients disappear behind those doors.
“Yes,” Bella says. “Thank you.”
“And can I make a copy of your insurance card?”
Bella riffles in her bag and pulls out her wallet. She hands a Blue Cross card over. I wasn’t sure Bella had insurance or kept a card on her. I’m impressed at the number of steps she’d needed to go through to get there. Does she buy it through the gallery? Who set that up for her?
“Blue Cross?” I say when we’re walking back to the waiting chairs.
“They have good out-of-network,” she says.
I raise my eyebrows at her, and she smiles. The first moment of levity we’ve experienced since Friday.
I called her dad on Friday. He didn’t pick up. On Saturday, I left him a voicemail: It’s about Bella’s health. You need to call me immediately.
Bella has often said her parents were too young to have a child, and I understand what she’s saying but I don’t think that’s it, at least not entirely. It’s that they never had any interest in being parents. They had Bella because having children was a thing they thought you should do, but they didn’t want to raise her, not really.
Mine were always around—for both Michael and me. They signed us up for soccer and went to all the games—jumping at things like snack duty and uniforms. They were protective and strict. They expected things from me: good grades, excellent scores, impeccable manners. And I gave them all of that, especially after Michael, because he would have, and had. I didn’t want them to miss out any more than they were. But they loved me through the downturns, too—the B minus in calc, the rejection from Brown. I knew that they knew that I was more than a resume.
Bella was smart in school, but disinterested. She floated through English and history with the ease of someone who knows it doesn’t really matter. And it didn’t. She was a great writer—still is. But it was art where she really found her stride. We went to a public school and funding was nonexistent, but the parent participation was hefty, and we were granted a studio with oil paints, canvases, and an instructor dedicated to our creative achievement.
Bella would always draw when we were kids, and her sketches were good—preternaturally good. But in studio she started producing work that was extraordinary. Students and teachers would come from different classrooms just to see. A landscape, a self-portrait, a bowl of rotting fruit on the counter. Once she did a painting of Irving, a nerdy sophomore from Cherry Hill. After she drew him, his entire reputation changed. He was elusive, compelling. People saw him as she’d sketched him. It was like she had this ability to uncork whatever was inside and let it spill out joyfully, excessively, messily.
Her father, Frederick, called me Saturday afternoon, from Paris. I told him what we knew: Bella had thought she was pregnant, she went in for an ultrasound to confirm, they did some tests, and she left with an ovarian cancer diagnosis.
I was met with stunned silence. And then a call to arms.
“I’ll call Dr. Finky,” he said. “I’ll tell him we need an appointment first thing Monday. Stand by.”
“Thank you,” I said, which felt natural but shouldn’t have.
“Will you call her mother?” he asked me.
“Yes,” I said.
Bella’s mother started sobbing instantly on the phone, I knew she would. Jill has always had a flair for the dramatic.
“I’m getting on the next flight,” she said, even though, presumably, she was in Philadelphia and could drive here in just under double the time it would take to get to the airport.
“We’re getting an appointment for Monday morning,” I said. “Would you like me to send you the details?”
“I’m calling Bella,” she said, and hung up.
Last I heard Jill had a boyfriend our age. She was married once more, after Bella’s father, to a Greek shipping heir who cheated on her rampantly and publicly. She’s never made good choices. If I’m honest, she’s modeled Bella’s romantic history—but hopefully not anymore, not with Aaron.
Monday morning, sitting in the office filling out papers, I don’t ask about Jill because I don’t have to. I know what happened. She lost the paper with the time, or she had a massage she couldn’t cancel, or she forgot to buy a train ticket and figured she’d come tomorrow. It’s always a million different reasons that all say the same thing.
Bella makes her way through the paperwork, and Aaron and I sit stonily, flanking her. I see him pop his foot over his leg, jiggling it nervously. He rubs a hand over his forehead.
Bella is wearing jeans and an orange sweater even though it’s too hot outside for either of those things. Summer will not quit, even though we’re now nearing the end of September.
“Ms. Gold?”
A young male nurse or physician assistant wearing wire-rimmed glasses appears in front of a glass door.
Bella shifts the paperwork nervously in her lap. “I didn’t finish,” she says.
Brenda at the desk smiles. “It’s okay. We can get to it after.” She looks from me to Aaron. “Are both of you headed back?”
“Yes,” Aaron answers.
The nurse, Benji, chats happily to us as we move down the hallway. Again, with the cheer. You would think we were walking to an ice cream parlor or waiting in line for the Ferris wheel.
&n
bsp; “Right this way.”
He holds his arm across a doorway to a white room, and the three of us enter in the same formation: me, Bella, Aaron. There are two seats in the corner and an examining chair. I stand.
“We’ll just do some quick stats while we wait for Dr. Finky.”
Benji takes Bella’s vitals—her pulse, her temperature—and looks inside her throat and ears. He has her get on the scale and takes her weight and height. Aaron doesn’t sit, either, and, with the two chairs and us standing, the room seems small, almost claustrophobic. I’m not sure how we’re going to fit another person in there.
Finally, the door opens.
“Bella, I haven’t seen you since you were ten years old. Hello.”
Dr. Finky is a short man—round and plump—who moves with a precise and almost dart-like speed.
“Hi,” Bella says. She extends her hand, and he takes it.
“Who are these people?”
“This is my boyfriend, Greg.” Aaron extends his hand. Finky shakes it. “And my best friend, Dannie.” We do the same.
“You have a good support system; that’s nice,” he says. I feel my stomach clench and release. He shouldn’t have said that. I don’t like it.
“So you came to the doctor thinking you were pregnant? How about you explain how you arrived in my office today?”
Finky puts on his glasses, takes out his notebook, and starts nodding and writing. Bella explains it all, again: The missed period. The bloating. The false positive on the pregnancy test. Going to the doctor. The CT scan. The blood test results.
“We need to run some additional tests,” he says. “I don’t want to say anything yet.”
“Can we do that today?” I ask. I’ve been taking notes, writing down everything that comes out of his mouth in my book, the one that’s supposed to be functioning as a wedding planner.
“Yes,” he says. “I’m going to have the nurse come back in to get you started.”
“What’s your opinion?” I ask him.
He takes off his glasses. He looks at Bella. “I think we need to run some additional tests,” he tells her.
He doesn’t have to say anything more. I’m a lawyer. I know what words mean, what silences mean, what repetition means. And I know, there in black and white, what he thinks. What he suspects. Maybe, even, what he already knows. They were right.
Chapter Twenty
Here is the thing no one tells you about cancer: they ease you into it. After the initial shock, after the diagnosis and the terror, they put you on the slow conveyor belt. They start you off nice and easy. You want some lemon water with that chemo? You got it. Radiation? No problem, everyone does it, it’s practically weed. We’ll serve you those chemicals with a smile. You’ll love them, you’ll see.
Bella does indeed have ovarian cancer. They suspect stage three, which means it has spread to nearby lymph nodes but not to surrounding organs. It’s treatable, we’re told. There is recourse. So many times, with ovarian cancer, there isn’t. You find it too late. It’s not too late.
I ask for the statistics, but Bella doesn’t want them. “Information like that gets in your head,” she says. “It’ll have a higher probability of affecting the outcome. I don’t want to know.”
“It’s numbers,” I say. “It’ll affect the outcome anyway. Hard data doesn’t move. We should know what we’re dealing with.”
“We get to determine what we’re dealing with.”
She puts an embargo on Google, but I search anyway: 47 percent. That is the survival rate of ovarian cancer patients over five years. Less than fifty-fifty.
David finds me on the tile floor of the shower.
“Fifty is good odds,” he tells me. He crouches down. He holds my hand through the glass door. “That’s half.” But he’s a terrible liar. I know he would never make a bet on those odds, not even drunk at a table in Vegas.
* * *
Five days later, I’m back at an appointment with Bella. We’ve been referred to a gynecological oncologist who will sort and determine the course of surgery and treatment. This time, it’s just the two of us. Bella asked Aaron to stay behind. I wasn’t there for that conversation. I do not know what it looked like. Whether he fought. Whether he was relieved.
We’re introduced to Dr. Shaw in his office on Park Avenue, between Sixty-Second and Sixty-Third. It’s so civilized when we pull up, I think we’ve been given the wrong address—are we headed to a luncheon?
His office is subtler, more subdued—inside there are patients who are suffering. You can tell. Dr. Finky’s office is the first stop—the new and freshly washed train, full of steam. Dr. Shaw is where you go for the remaining miles.
Once the nurse takes us back, Dr. Shaw comes in to greet us quickly. Immediately I like his friendly face—it’s open, even a little earnest. He smiles often. I can tell Bella likes him, too.
“Where are you from?” she asks him.
“Florida, actually,” he says. “Sunshine state.”
“It’s always been strange to me that Florida is the sunshine state,” Bella says. “It should be California.”
“You know,” Dr. Shaw says, “I agree.”
He’s tall, and when he folds himself onto his small rolling stool his knees nearly come up to his elbows.
“All right,” he says. “Here’s what we’re going to do.”
Dr. Shaw presents the plan. Surgery to “debulk” the tumor, followed by four rounds of chemo over two months. He warns us that it will be brutal. I find myself, more than once in Dr. Shaw’s office, wishing I could trade places with Bella. It should be me. I’m strong. I can handle it. I’m not sure Bella can.
The surgery is scheduled for Tuesday, back at Sinai hospital. It includes a full hysterectomy, and they’re also removing both her ovaries and her fallopian tubes. Something called a bilateral salpingo-oophorectomy. I find myself Googling medical terms in the car, on the subway, in the bathroom at work. She’ll no longer produce eggs. Or have a place where they could, one day, develop.
At this revelation, Bella starts to cry.
“Can I freeze my eggs first?” she asks.
“There are fertility options,” Dr. Shaw tells her, gently. “But I wouldn’t recommend them, or waiting. The hormones can sometimes exacerbate the cancer. I think it’s critical we get you into surgery as soon as possible.”
“How is this happening?” Bella asks. She drops her face into her hands. I feel nauseous. Bile rises to my throat and threatens to spill out onto the floor of this Park Avenue office.
Dr. Shaw rolls forward. He puts a hand on her knee. “I know it’s hard,” he says. “But you’re in the best hands. And we’re going to do everything we can for you.”
“It’s not fair,” she says.
Dr. Shaw looks to me, but for the first time I feel at a loss for words. Cancer. No children. I have to focus on inhaling.
“It’s not,” he says. “You’re right. But your attitude matters a lot. I’m going to fight for you, but I need you in here with me.”
She looks up at him, her face streaked with tears. “Will you be there?” she asks him. “For the surgery.”
“You bet,” he says. “I’ll be the one performing it.”
Bella looks to me. “What do you think?” she asks me.
I think about the beach in Amagansett. How was it only three weeks ago that she was blushing over a pregnancy test—glowing with expectation?
“I think we need to do the surgery now,” I say.
Bella nods. “Okay,” she says.
“It’s the right decision,” Dr. Shaw says. He slides over to his computer. “And if you have any questions, here is my direct cell number.” He hands us both a business card. I copy the number down in my notebook.
“Let’s talk through what to expect now,” he says.
There is more talk then. About lymph nodes and cancer cells and abdominal incisions. I take precise notes, but it is hard—it is impossible—for even me to follow everything.
It sounds as if Dr. Shaw is speaking in a different language—something harsh. Russian, maybe Czech. I have the feeling that I do not want to understand; I just want him to cease speaking. If he stops speaking, none of it is true.
We leave the office and stand on the corner of Sixty-Third and Park. Inexplicably, impossibly, it is a perfect day. September is glorious in New York, belied even further by the knowledge that the fall will not hold—and today is banner. The wind is gentle, the sun is fierce. Everywhere I look, people are smiling and talking and greeting one another.
I look to Bella. I do not have a clue what to say.
It is unbelievable that right now there is something deadly growing inside of her. It seems impossible. Look at her. Look. She is the picture of health. She is rosy-cheeked and full and radiant. She is an impressionist painting. She is life incarnate.
What would happen if we just pretended we’d never heard? Would the cancer catch up? Or would it take the hint and screw off? Is it receptive? Is it listening? Do we have the power to change it?
“I have to call Greg,” she says.
“Okay.”
Not for the first time this morning, I feel my cell phone vibrate fiercely in my bag. It’s past ten, and I was due in the office two hours ago. I’m sure I have a hundred emails.
“Do you want me to get you a car?” I ask.
She shakes her head. “No, I want to walk.”
“Okay,” I say. “We’ll walk.”
She takes out her phone. She doesn’t lift her eyes. “I’d rather be alone.”
When we were in high school, Bella used to sleep at my house more than she slept at her own. She hated being alone, and her parents traveled all the time. They were away at least 60 percent of each month. So she lived with us. I had a pullout trundle bed beneath mine, and we’d lie awake at night, rolling from my bed to hers and then climbing back up again, counting the stick-on stars on my ceiling. It was impossible, of course, because who could tell them apart? We’d fall asleep amidst a jumble of numbers.
In Five Years Page 11
