Year of Plagues

by Fred D’Aguiar

  11.

  The Maddening Pain

  Morning coffee. How good of you to haul me by my nostrils out of sleep as your maker, preset to brew at five thirty a.m., fills the house with your genteel aroma. Fill my cup, the lash against porcelain gradually muffles as my cup brims. Today you are my only indulgence as I prepare for tomorrow’s surgery. My palate riots with delight. I pick up traces of clementine and apple in the coffee as well as fragrant wood such as the eucalyptus.

  Debbie and I take the dog for a walk. This is my last morning of walking the dog with my prostate intact. I lost teeth in the past and should think of this organ nestled below my bladder as another of the things Bishop talks about in her villanelle “One Art.” Her list moves from the physical to the psychic, the stakes increase as the villanelle progresses. Bishop’s ultimate loss turns out to be the greatest sacrifice of all, love. Mine pales in comparison. The chance that I may not wake from the anesthetic amounts to hardly any risk given my good cardiovascular health.

  The dog pulls me along as usual. My eyes flick from one thing to the next. Could the light be cleaner today? The morning bounces off windshields with an extra spring in its heels. Flowers appear washed by this light, their colors intensified so that yellow and red and purple appear raised above the petals and almost independent of them. There is a thickness to the colors and an extra-sharp point to each inflection of red, yellow, and purple. I drink deep of the morning, holding my lungs full for a second that lasts a step or two before I exhale. Everything appears to be still, no breeze, none of the branches at the tops of palms waves at me.

  Should I be thinking at some point that this may be my penultimate walk?

  No, that would be morbid. You’ll get through this.

  I feel a giant clock is over my head and it’s counting me out.

  I know you must feel terrible. But you have to believe you’ll be cured of this.

  Debbie takes my hand and I hold the dog’s lead with the other. As we stroll, our steps are in line as if we’d marched this way for so long it was second nature to walk in rhythmic harmony. I don’t mean to look at our feet. But every time that I do look down during our walk around the neighborhood and talk about a range of things, I see that we keep in lockstep.

  I am running on empty, fumes, subcutaneous fat. How can I feel so hungry so early, I ask my belly, which grumbles a loud complaint that ricochets off my bones. My jaws that should work for speech for the most part, this morning grind my teeth as if to make nutrient powder. Each thought starts to operate with the ornate punctuation of a food for thought or a thought for food or just plain feed me. At some point I expect salad to decorate the trees and that squirrel curled around the bird feeder to be the pie in the oven that the sun crusts.

  I think of my days in London, a couple of years, summers, during which I fasted to please my single mother, who dated a Muslim man and turned all her children into followers of Islam to please him. Ramadan among English schoolchildren turned out to be the toughest test of all. The English boys knew that I was fasting, and they opened packets of crisps in front of me and scrunched each crisp one at a time, holding out the pack to me for me to help myself. At the end they balled up the empty plastic packet and threw it at me and walked away laughing. The greasy plastic took on a smell of salt and oil just by my staring at it as it unfolded on the ground.

  Just as Ramadan made me tour London, airborne with delight at my superior triumph over the teenage cravings of my body, so I hope this fast before my surgery will embolden me. That I may heal at an accelerated rate. Feel pain as balm. Allow the surgeon to find the bulk of my cancer and extirpate it—that word again. Extirpate. Again in midseventies London, the television show Doctor Who featured aliens called Daleks. Though they were the bad guys, the alien species and invaders, bent on the extermination of humanity, the Daleks were my heroes. They looked like outsize industrial vacuums ready to tidy around the stalls of an outdoor market. Their favorite word, exterminate, resembles, in loose homophone terms, extirpate. I turn those Daleks, their stiff protuberances of malcontent, against my cancer, to exterminate, to blast it into oblivion.

  For now I combat a stomachache induced by the eight ounces of magnesium hydroxide (the hospital recommends two doses, each taken two hours apart) that I drink with a tight feeling in my throat, after a cup of coffee. I set out a loose outfit that I plan to wear to the hospital in the morning. When I call the hospital I am told that Debbie has to drop me off at the entrance and leave right away. She cannot return to see me until I am discharged from their care. This means I wake up without seeing her. With no visitors allowed to see me, if I have to stay beyond the one night allocated for my surgery, I will be alone in true terms.

  Let the purge begin! We all know how much a laxative disrupts any semblance of routine, even a reality defined by COVID-19. ’Nuff said about that. What makes me think of Swift and the scatological as an aesthetic for devastating satire? I am at the mercy of my gripes. The fist of kneading pain tightens and eases its grip a little and tightens some more. The way I peed in the sports bar back in the heyday of whatever the body believed that it was, the same force of that output happens from my anus as a result of the milk of magnesia. The result on the toilet makes me glance back the way a dog might turn quickly to glimpse what turns out to be its tail. My stomachache subsides. The rumbles continue as I sip low-sodium chicken broth. I take my meds as usual and wonder if they do not just wash out of me before any useful uptake of them.

  For me all this practice amounts to a purification process to expel my cancer. Now I am in the realm of the body. Where I will stay for days, on lockdown with my cancer, the two of us under a dome of COVID-19. A cancer first hosted by me and now about to take me over. If I let it. If I risk such a high degree of Keats’s negative capability that I champion the cancer’s right to life in me at my expense. I take that chance and slip the moorings of my ego, on the assumption that I stand to gain some perspicacious insight about my disease.

  Surgery under COVID-19 doubles the number of plates that I have to keep spinning on poles, and this from my heightened sense of enough already as I wrestle my cancer. The main battle, surgery, never promised anything but a challenge. Surgery attacks the fortress of my cancer. Success on that front should send cancer’s troops into disarray. Stationed at various outposts in my body, where they stand guard and propagate bad news about my deserving status as a body near the point of being vanquished, their presence so far from the source is testament to the fact. Surgery should sever their links to their main supplier and reason for their existence.

  * * *

  My war with cancer is pain, grief, and death. I skip the dying part for extra pain and sadness. You see, I am a coward in the face of pain. I find out that I cannot think, breathe, or act properly while in pain. What died in me is gone, literally pulled out of my punctured torso, six wounds, with one twice the size of the other five, all across my torso. My midriff is tender, bloated, and stiff. Deep inside, a current of hurt surges up and out, and hits each of those six incisions with a steady pulse. I try to breathe yoga style, deep and slow with a pause between the two breaths heading in opposite directions or it is the same breath sculpting me. I sink my attention into that process. To rob my pain of the whole of me.

  My cancer captured two sites, my prostate and vascular ganglia, a bundle of nerves that power the muscles of the penis and deliver semen or lubricate it for delivery. Both are gone, along with nearly three dozen nearby lymph nodes. It took six hours to cut and clear it all.

  I watch a scythe swing left and right cutting down swaths of my cancer, pendulum to the left and clear, pendulum right, clear, in a slow march and harvest up my pelvic girdle. My medical team of four become Anansi, whose eight limbs wield four scythes. I need compound eyes to follow my trickster’s industry. At a microscopic level, Anansi’s limbs are a flurry. Scythes describe circles in a close dance of almost touch. If one sweep of a blade misses a wisp of cancer, a second blade swoops i
n to catch that wisp and a third so that where cancer stood tall, rooted and branched, there is fresh blood and raw flesh, its upturned ground.

  I, that is, me, whose entire middle section hurts and who cannot think one thought without pain stitched into its formation, must now recall the last four days. I hold out my hands for the warmth of a hearth, stuck in that gesture, so that a word for cancer sounds like the word Cincinnati, and I want those consonants to mean something more to me than an end of things; I say the word aloud many times to test its soundness and the word traps me in its meaning and threatens to keep me stalled there, unable to move against it if cancer needs a course of actions to uproot its station in the body. At some point repetition leads to transformation, I say Cincinnati and it rolls off my tongue as Sing, Sing, Natty, probable title of a reggae hit by someone like Dennis Brown. I could find words to fit that reggae tune to do with my healing. That is one song that I must write once I am around the corner of this pain and can see it out of my rearview. Right now my cancer wants to reign supreme over me. I wish to defeat it unequivocally. We are both still in pursuit of the throne that can never be attained. Since the prize is the body and the body loses if either of us wins outright.

  I need to control the maddening pain. This operation against my cancer seems like a war of attrition. I pay a price to cut the cancer from me, the bulk of it. The doctor tried to explain the process to me before the anesthesiologist took my consciousness. The doctor said that he would remove whatever bad things he encountered, which may take some time. He said that the PSMA showed him where he needed to go. I said I wanted him to get every last bit of the cancer no matter how long it took or how far he had to go to get at it. I thanked him with the kind of profusion typical of the desperate man completely dependent on another’s generosity and grace. He told me not to worry and we nudged elbows, the COVID-19 poor substitute for a hug.

  The anesthesiologist struck off a list of things that he wanted to be sure I did not have or did not take or that might make me vulnerable to the tool of his trade, a combo of gas and IV fluid that should knock me out along with air pumped through a tube to keep me oxygenated. He wore a silver lambda chain around his open-necked shirt, and that was the last thing I noticed as he slipped the mask on my face.

  I woke to a nurse calling my name repeatedly. And she kept asking me to keep my eyes open and “stay with her.” This is the first time with the increased COVID-19 restrictions that patients have come back from the OR and not had a loved one able to meet them when they came around in the recovery room. The nurse is the substitute for that familiar. I come around to my name. The nurse’s voice is sonorous. She talks me back into my name. The moment I recognize my name, I catch sight of, simultaneously, a sheaf of facts about me. I think I hear trumpets. Her smile is broad. Her lips are painted red and her white teeth emit radiance. I blink and squint. She hands me my glasses. I need her help to place the left handle of my glasses behind my ear. There is the tangle of a drip line attached to a bottle on a stand. The line leads to a port at the top of my left hand. I am laughing. Feeling giggly. Elated. I associate the levity with the relief of being alive. How did it go? The nurse says, Excellent, and the doctor will be along in a moment to tell me all about it. I look around at the wall clock and do not think it correct. What time is it? She confirms the time, late afternoon. How long did it last? When she says six hours, I ask her to repeat that and she says six again and I try to sit up and cannot.

  My mouth is dry. She offers me ice chips on a teaspoon, which she feeds to me. Her nails are long and match her cherry-red lipstick. The chips distribute cool and water in samples that I want more and more of. The ice runs out in the plastic cup and she asks a passing nurse’s aide for more. I swallow what feels like grief and wonder and they are succeeded by a detonation of exhilaration. I ask her as she spoons more ice into my mouth to forgive my British teeth, they are clean and healthy and crooked in keeping with my nonchalance during my youth and adult life in England for orthodontics.

  She checks my vitals and feeds me more bits of ice. Again, I tell her the ice is delicious. Again, I ask the time again and again she tells me and as before I express incredulity as if for the first time. It finally sinks in that that I’ve been in surgery for six hours. It’s after four in the afternoon. She said the operation began at a little after ten in the morning. Is everything all right? I ask, certain that for the operation to have taken that long meant that the surgeon encountered some trouble.

  The nurse smiles and repeats that the operation was a success. She calls Debbie on the phone. Debbie tells me that the surgeon phoned while still in the OR, as his assistants were closing me up (with superglue) to tell her that everything went well, though there was a tricky part to it. Her phone voice is so clear I wonder if she might be standing behind the curtain that demarcates the recovery space from the corridor. I wish she could be here with me. Angelic nurse isn’t enough for me right now. I start to tremble and the nurse unfolds a second blanket and spreads it from my feet to beneath my chin.

  One of the doctors who assisted the surgeon appears and says that they got everything. How do you feel? I reply, Elated. I thank him. He looks at the nurse’s chart and scribbles on it, says he’ll see me on the ward and steps around the curtain and disappears just as the surgeon steps into my frame. By this time the light in the room looks softer, thanks to my happiness, and a glow surrounds the doctor and the nurse. I link my life to their skills. I promote them to transcendental status. They may be floating rather than standing on terra firma. I feel luck wash over me as if baptized. The surgeon speaks and I hardly hear him; more accurately, I hear him—the sounds of words roll off his tongue in full incantation—and hardly any of it makes sense. Bits of it do. I string the bits together and construe that my operation presented him with a unique challenge because my enlarged prostate, a part of it, had fused to the wall of my rectum. He says what took a long time was not the removal of the prostate but the many thin layers of it that he had to peel with care off the rectum wall so as not to perforate the wall or leave too little in place and create problems for me later on.

  I thank him as much as I can between asking him more than once if the surgery was a success. He says yes, though he hopes he got all the cancer at that contact point between the prostate and the rectum. He ends by saying that I should rest and that he’ll see me again soon. I thank him. It seems gratitude is my default position as I come to my senses through the avenue of ecstasy. I ask him again. I can’t help it. I feel weird.

  You got everything?

  Yes, I got everything I could find, yes.

  Yippee!

  It was hard, but we got it, I think.

  Fab. Thank you from the bottom of my heart.

  We’ll have to be sure in about three months.

  Three months.

  Yes, once you’ve healed, we’ll do a blood test and see what your PSA says.

  That’s wonderful.

  Yes, for now concentrate on healing.

  You bet. Thank you, Doctor.

  You’re welcome, Fred.

  There is pageantry to cancer. Imagine a set of behaviors that aligns with the growth of the disease and you can see how the show of cancer may grow from a one-person, no-frills event to a full production with the overblown values of spectacle. Both the show of cancer and cancer the show-off are necessary for it to register that it is there in the body. Cancer wishes to be noticed as a part of its destructive procedure. This can be enriching for the cancer and for the person afflicted with it. The cancer sees that the curtain rises and it is center stage, and there in the audience making it all worthwhile is the person for whom the show must go on and for whom the show is devised in the first place.

  I saw a metaphor for cancer’s workings at a West End production of Waiting for Godot starring Patrick Stewart and Ian McKellen. The two veteran actors have known each other since the seventies and they work like a couple in a synchronized swim, or a pair in a knife-throwing act where
one throws the knife and the other is strapped to a spinning wheel. Godot is a dark play about the absurdity of a life that accrues wisdom only to jettison it and begins with an athletic body only to walk it into decay. As the wisdom increases so the opportunities to do anything with it decrease as the body and mind shut down. For any species it is an odd formula on which to predicate survival.

  The waiting room of life leads to no end result, no point to raised expectation and no fruits from the time spent working things out as one waits. The two actors injected a panoply of nonverbal touches and signals between Beckett’s words to denote a stimulus or impulse against pointlessness, as if in search of the point of it all even with the knowledge that there is no point to any of it. Some of their actions blatantly contradicted what they were saying to each other, others implied more than the words signaled. In addition, they appeared to be aware in those nonverbal exchanges and asides that an implicit contract existed between them and they were in this fine mess of life together, rather than isolated and doomed to be alone in their awareness as indicated by their speech. Furthermore, they signaled each other that they would support each other even if to offer help to each other would be just another sign of giving in to the absurd. They celebrated their longevity as well: both in their seventies and alive to witness the absurd, and there was a wealth of pleasure inherent in that fact that they had their health enough to work at a demanding play.

  As a member of the audience I derived a similar pleasure, no matter the triumphalist absurdity of the whole event of Beckett’s play. I was seventeen when I first saw Ian McKellen at the Royal Court Theatre in a play titled Bent, about the treatment of gays in the Nazi concentration camps. Gays, given pink stars and denounced as deviant and decadent, were an invisible and persecuted minority, and this was the first play highlighting the fact. (Not to take anything away from Gay Sweatshop’s smaller-scale works that preceded the production at the Court.) I had seen Patrick Stewart in a number of Shakespeare plays with my high school English teacher Geoff.