He’s so excited telling me that I am completely caught up in the story, watching him and the way he tells it. It’s the way he told me about the space shuttle taking off at the beach in Florida. He can’t wait to get back to tell his girl.
“Wow, so you just ran out of our tent?” I smile as it finally occurs to me. “While I slept through the whole thing.”
“Yeah.”
“You ran out.”
“Yep.”
“You thought it was a bear.”
“Uh-huh.”
I pause to let him save himself, and he doesn’t. “Were you going to come back and get me?”
He takes a long sip of coffee and then winks. “We’re in Alaska, Nut. When there’s a bear in the camp it’s every man for himself.”
On the last day of the trip we take a walk through a beautiful field of grasses and wildflowers. I pick a dandelion. I make a wish, because I always make a wish, and for five years it has been the same thing. We will live happily ever after. Then I take a deep breath and blow.
Year Five
Turning and turning in the widening gyre The falcon cannot hear the falconer;
Things fall apart; the centre cannot hold.
—WILLIAM BUTLER YEATS, “The Second Coming”
1
I call from the bar of the Delta Shuttle at Reagan National and schedule a meeting of what I’ve named the “Knights of the Round Table.” The shadow we saw on the X-ray before we left for Alaska is clearly cancer. A new CT scan shows that the tumor has spilled out of Anthony’s lungs and is now filling up the free space of his chest so that it can’t simply be cut out. “Call Karen Antman,” Dr. Rosenberg said to me as we left the NIH. He gave me Dr. Antman’s number, but there was no need. I already had it. I let him give it to me. I want to think this is a new thing. That we are not simply retracing our steps. That we are moving on, not back.
So here we are again in these meetings, the heads of the heads in a half-circle around a table in a stark conference room. Anthony sits with John on one side of him, me on the other. His mother and Hamilton on my left. We are here to decide what to do next. Dr. Antman introduces Dr. Mears, the head of hematology at Columbia, and Dr. Jerry Groopman, famous for experimental DNA therapy, is on the speakerphone from Boston. It’s the war room. This is the cabinet.
Diane is here, too. She has been in the wings all along, ready to help when we need her, and now I have asked. Anthony worked with her at ABC for ten years, and she adores him. She has been making calls to doctors around the world to find experimental treatments, and hired a research assistant to follow up and read the studies. She helps me balance all of this with work. And sitting here in this room, as Diane Sawyer, she adds gravitas. We are serious about this, we hope we are saying.
Dr. Mears lays proposals out in front of us like someone pitching time-shares in Miami Beach. At appropriate intervals we nod. I am sitting by the window and Anthony is to my right. He trusts I know what I am doing. I ask a serious question about Decadron and side effects, but I don’t write anything down. I have my notebook, still, with me everywhere, but today I doodle in the margins. CD + AR. I write in loopy letters, Carole A. DiFalco, Carole D. Radziwill, Anthony Stanislas Albert Radziwill. I draw hearts around our names. I look out at the windows of other buildings. There is nothing in this room to hear. No one is going to say, We know how to fix this, so I focus on the cars driving over the bridge that I can see from the window.
“And what, exactly, is your level of expertise?” Dr. Antman asks, and it snaps me back. She is looking straight at Hamilton. He has asked a question about chemotherapy cycles. We are desperate. We are defensive. We want someone to blame.
This is Year Five. It has been four years since the cancer metastasized. According to the medical book in the basement of Sloan-Kettering this is Anthony’s last year. The cancer has performed brilliantly. It is exactly on schedule. It has played out exactly the way the book said it would. Anthony’s tumor has moved outside of his lungs to the mediastinum. It is wedged around his trachea, through his bronchial tubes, near where his heart sits. I am in awe of his cancer.
In Year Five there are five rounds of chemo and two surgeries. There are six radiation treatments and four trips to emergency rooms. There is dialysis three times a week. I am still working, but the stories I produce are a blur. There is a profile of George Stephanopoulos, of Julia Roberts. Anthony still goes to his office, though he is now just filling in time between hospital stints. There is the stale smell of overbleached hospital sheets and white-cotton thermal blankets. I am with Anthony around the clock, it seems, or else I’m on the phone with doctors. I’m researching clinical trials at M.D. Anderson and the Mayo Clinic. I type up his medical history and start handing it out, like a flyer, to anyone who I think can help.
In Year Five we find antiangiogenesis, the cure for cancer, it says, on the front page of The New York Times. Antiangiogenesis drugs work by cutting off the blood supply to the tumor. So Anthony starts taking thalidomide—the sleeping pill that produced babies with club feet and webbed fingers, scientists find, will also starve growing tumors. The FDA took it off the market after the babies were born deformed and are carefully doling it out as a last-hope treatment to cancer patients. I file the necessary paperwork, and a few weeks later ten bottles arrive.
In Year Five someone suggests experimental surgery, and Diane comes with me to meet the head of oncology at Mount Sinai. We take Anthony’s CT scans with us—I am shopping them around now—and the doctor explains to us a procedure using a pig valve that reroutes the trachea out of the patient’s back. “There’s really nothing we can do for him,” he says, holding the scans up to the light. He tells us the tumor will likely rupture an artery and he’ll bleed to death, or it will squeeze his bronchial tubes and he’ll suffocate. “He’s going to die a horrible death.” Diane stands perfectly still. I keep my head down and jot notes about the pig valve.
In Year Five, a friend arranges for Anthony to see a healer, and a woman comes to our apartment to teach us to meditate. She works with Deepak Chopra. She writes down our mantras and instructs us to repeat them with our eyes closed. My mind wanders, and I make a mental note to call Dr. Saal at New York Presbyterian and check on the dialysis machine we are getting installed in the apartment. If our eyes were open, I’m certain we’d catch each other rolling them. We are incapable of meditating; there is too much to think about. If there are moments when I am not thinking about cancer, they happen in Carolyn’s apartment, or in the upstairs room at her gym when I meet her there.
In Year Five things are not as they were at the NIH. We left possibility behind in Bethesda, with the pasta pomodoro from Positano’s and the tree-lined streets and Hamburger Hamlet. We are back in New York, and it’s a business again. Anthony isn’t the star patient anymore. We have been here before, and everyone at the Round Table knows his record, and they must have their own guesses at how much time is left. That we are back in New York is a defeat in itself. We thumbed our noses at New York and chemotherapy, radiation. But surgery didn’t work, so we are back, heads down.
The Round Table recommends chemotherapy, and we sign up for five cycles, five separate sessions of seventy-two-hour drips. We have Dr. Best of the Best. You’re in good hands. He’s the best there is, people say, because there is nothing else left to say.
If Dr. Rosenberg was hope and sincerity and a devout professionalism, Dr. Best of the Best is slick and self-assured, tasseled Gucci loafers and rented yachts. Meeting him is instantly repellent, like lifting the lid of a garbage Dumpster. I imagine Dr. Best of the Best clinking ice in his Scotch at the country club, rocking back just a little on his feet—the other men asking him, So what’s the latest on cancer? And Dr. Best of the Best clearing his throat, careful to speak softly, frame his thoughts, move his free hand now and then in a certain way to brandish his words. Careful to reflect his Ivy League articulation. His friends, titans of business, are wide-eyed at how smart and serious the doctor
is—how good to have him in their circle.
But there are not a lot of places for us to go at this point. At this point he is all we have.
When we step through the doors of Columbia-Presbyterian’s gilded McKeen Pavilion, with its concierge and four o’clock tea, I lose my breath. Disease clings to us like wet clothes. I hate how Anthony is marked. The hospital is crowded with residents and interns and nurses, people who don’t know him. People who don’t know there is more to him than this.
Anthony’s treatment is called MAID—a cocktail of four different drugs: mesna, Adriamycin, ifosfamide, and Decadron. Mesna’s sole purpose is to ease the side effects of ifosfamide, to help prevent ifosfamide from destroying his bladder and his kidneys.
The anticancer drugs kill the cancer cells, but they also kill healthy cells. There are no possible side effects; they are certain: vomiting, loss of appetite, hair loss, mouth sores, increased chance of infection, excessive bruising, excessive bleeding from minor cuts, excessive fatigue.
Maybe in ten or twenty years we’ll look back on chemotherapy and gasp. Another generation may be appalled that we ever did this, dripped poison through a needle into a person’s body to make him well.
We start the first round two days after a surgeon puts a port in Anthony’s chest for the chemo drip. A Wednesday in August, and I have it carefully scheduled:
7 a.m.: Check in
9 a.m.: Yoga
10 a.m.: Sheila and Richard
Lunch: Lee and Herbert
4 p.m.: High tea in the Pavilion, Marc
Dinner: Carolyn and Hamilton (KFC)
8 p.m.: John
The nurse comes in to do a blood test and takes it down to the lab before she starts the chemo drip. The lab checks for liver function, potassium levels, and creatinine levels to monitor kidney function. Then they send the drugs up in bottles, one at a time, starting with ifosfamide. The nurse sticks a needle into the port in his chest, attaches the plastic sack to the IV pole, and weaves the tubing through a machine that controls the flow. Anthony watches television until the yoga instructor comes; then he wheels the IV pole to the center of the room and follows her through warrior poses and breathing and down dogs until he’s suddenly nauseated. I send her away. The nurse gives him a shot of Compazine for the nausea, and by the time Sheila, his boss, arrives with our friend Richard, he’s feeling better but not okay. They bring him a Chinese fish painting, a symbol of good luck, and chat about new projects and office gossip. It lifts his spirits, but they do not stay long. In spite of Anthony’s valiant performance they can see he is not feeling well and say their good-byes quickly.
Lee and Herbert bring homemade consommé and wrap sandwiches from William Poll. He drinks the consommé and nibbles on the sandwich. In the afternoon the nurse comes back to start the second drug. This one, Adriamycin, comes in a thick glass brown bottle. She explains, when I ask, that it is so toxic it would burn through a plastic sack. The nurse wears rubber gloves and places a dark bag over the bottle before hooking it up to the pole. Any exposure to light and the poison will decompose.
When our friend Marc arrives, he spends most of the visit with me in the McKeen Pavilion, listening to the piano and picking at raspberry squares. Anthony rests for the afternoon, and then Carolyn and Hamilton come with dinner. They bring Anthony takeout from Il Cantinori and a bucket of chicken with mashed potatoes and biscuits for us. John stops by after work and eats the leftovers.
The second round is three weeks later. We check in on Friday morning, and the nurses take his blood and start the drip. I go to my office for a few hours. I’m working on a profile of Julia Roberts with Diane and researching other stories that go nowhere. I can’t focus on anything. Carolyn and John are in Italy this weekend for our friends Kissy and Jamie’s wedding. We would be there, too, but there is this. Months ago, we were planning this trip together, trying to decide whether to go early and spend some days in Capri and then head to Lake Bracciano outside Rome. Or stay after the wedding for a few days of fun, just the four of us.
I have abandoned the visiting schedule. In fact, now I am discouraging anyone from coming. My mother wants to visit, and I push back. Anthony is sick from the moment they start the drugs until they stop them. He doesn’t have the strength, only good manners, to make polite conversation.
I spend the weekend bunched up in the armchair next to his bed, getting up periodically to make sure the chemo lines aren’t blocked—the warning beep and the flashing red word, occluded. If the nurses aren’t here, I do what I have seen them do: open the door to the Med-Vac, check for kinks in the plastic tubing, then press stop, pause, reset, and the poison flows again.
I wait for Anthony to sleep before I close my eyes. I miss Bethesda. I miss Carolyn, and our drives to nowhere down the Beltway. We are in New York, where people have their lives to live, and my life is happening in the McKeen Pavilion. I am certain I will die here, with him. My system, too, is slowly shutting down.
After the second round his hair falls out. We wake up one morning and there is a fine layer on his pillow. I brush it off quickly into a wastebasket. For three weeks the hair dusts his pillow every morning. We go to see Roy, who comes recommended by a friend. He does hair and makeup for Meryl Streep.
Roy makes a plaster cast of Anthony’s head. He takes almost three hours to finish, measuring his head carefully, taking hair samples to match the color. He is serious about his work, but it is fun, like getting fitted for a costume party. There are props all over his apartment, a collection of Barbie dolls in perfect miniature replications of Bob Mackie gowns. He makes two wigs so that while one is cleaned and re-shaped, Anthony can wear the other. He makes them with a special double-sided adhesive that is strong enough to shower with or for swimming in the ocean. You don’t take them off for anything until it is time to swap, and then Roy will come to our apartment or to Anthony’s office to remove one wig carefully and affix the other. If we are in the hospital, he comes to the hospital.
The wigs are perfect, but this is a setback, losing his hair. The scars on his chest could be from anything—Anthony is fond of telling people “shark attack” and watching their faces recoil in horror. But the hair loss is swift and brutal. It marks him undeniably. It’s the thing more than anything else that makes you look like you have cancer.
The third round is in September and Carolyn is back, and while Anthony drifts in and out of sleep we sneak off to Wendy’s for a junk-food fix.
I order a number two—a Classic Double, no cheese. “Biggie the fries, biggie Diet Coke,” I tell the cashier, and she punches it in.
It’s a little Wendy’s in Washington Heights packed with moody teenagers and sleepy-looking residents.
Carolyn sighs dramatically after I order. “Can you please stop saying ‘biggie’ every time we come here?” She rolls her eyes at the girl behind the register and jerks her head toward me.
“No, and you want biggie fries, too.”
She rolls her eyes again.
“Say ‘biggie,’” I tease her.
“I’m not saying ‘biggie.’ I want a number two and a Frosty.”
I turn to the cashier. “One more number two with a Frosty,” I tell her, “and biggie the fries.”
If there is anything certain in our lives at this point, it is that I will biggie the fries and she will roll her eyes at me. I drag out our Wendy’s lunch as long as I can. I eat every single fry, dipping each one carefully in ketchup. I talk nonstop, pulling out every single piece of office gossip I can think of. Don’t get up, I am silently willing her. I don’t want to go back. But we do stand up, clear our table, empty our trays in the orange garbage containers, and walk back to the hospital.
Weekend chemotherapy is lonely. People have weekend plans and so won’t be stopping by. We don’t want anyone to come but can’t stand to be alone. Hospitals on the weekend are smothered with emptiness. There is no sense of movement, of change, of seasons. We start the same day over and over. The same false lighting gl
ares down at you everywhere, no matter the time of day, and it is always cold. Somewhere in New York there are people warm and surrounded, and none of them know of this, that we are here.
Sundays are completely dead. We try to schedule the cycles to finish on Sunday, so Anthony can be at work the next day. After our first Sunday, spent searching for someone to check us out, we learned to get his discharge papers signed earlier, before his doctor leaves for the weekend.
By the fourth cycle things are going wrong, and we deal with them the best we can. Anthony can’t walk. He is leaning on me. I have to reach my arm around him and hold him up under his arm. No one remarks on this as we leave. No one says, Hey, are you okay there? Are you sure you’re ready to go? Had they asked, Anthony would have answered angrily, a steely Yes! We would still have checked out. But I would feel better if someone noticed: Yes, you see it, too! I’m not crazy. I need help. But no one says anything, and I begin to think I’m imagining it all. His entire body shaking, unable to walk without my help. I consider mentioning this to the resident when he hands us the discharge papers, but I know Anthony will regard it as a betrayal. I smile and take the papers.
We are referred to a neurologist, who diagnoses Anthony with polyneuropathy. Another diagnosis. They barely register now. The nerve endings in his legs are dying. There is nothing to do about it. I buy him a cane at Zitomer’s on Madison.
On a Friday in October I go to the hospital as usual after work. It’s our last cycle. The tumor hasn’t shrunk, but it hasn’t grown either, so Dr. Best of the Best has encouraged us to go ahead with the last treatment. When I walk into Anthony’s room, there is no equipment, no Med-Vac to drip the chemo. The lights are off, and Anthony is sitting hunched on the edge of the bed.
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