by Various
Her neoplasm, she learned, took the technical—and to Inez familiar—name of glioblastoma multiforme, the second term, “multiforme,” tracing to such tumors’ heterogeneous nature. Being a mixture of cell types, GBM was essentially incurable. Even with surgery, radiation, and follow-up drugs, Inez surmised, she had no more than a year to live.
“I’m going to fight and win,” she declared, believing none if it. Welcome to Coney Island, ladies and gentlemen. Ride the Sarcoma Coaster.
“For your oncologist I recommend Jacob Leibowitz at Sloan-Kettering,” said Dr. Goncourt. “His success rate is second to none.”
And Inez thought: second to none because with GBM success is unknown.
Later that week, speaking with Dr. Leibowitz at the celebrated Manhattan cancer center, Inez learned that, just as there are varieties of infinity, so are there gradations of hopelessness. The tumor was inoperable, which meant that her twelve months on planet Earth had in all probability been reduced to six. Radiation appeared to be the only viable—if that was the word—choice, followed by the usual chemotherapeutic coda. Dr. Leibowitz proffered no cluster of straws at which she might grasp, nor a singleton straw, not even one splinter.
At this low point her fortunes, Inez could hardly have imagined that an amusing little man in a derby hat was about to enter her life, explaining that his employer routinely removed malignant tumors painlessly and permanently. But even in the fatalistic world of cancer, Inez would soon see, eucatastrophes will occur, though she herself had once railed against what she called “the immorality of miracles.”
“Even as I set down these words,” ran the penultimate sentence of her most famous book, The Beauty of the Morbid, “an angel is stalking indignantly out of God’s executive suite, disgusted with the vicissitudes of divine justice, making a total of ten billion such resignations since the beginning of time.”
The encounter with the dwarf occurred shortly after Inez’s fourth consultation with her oncologist, at which she, Alexis, and Dr. Leibowitz agreed that her treatments should begin at once. Before leaving Memorial Sloan-Kettering that Friday afternoon, Inez arranged to receive her first jolt of radiation on Monday at 8:00 a.m., with subsequent doses occurring each morning throughout the week. The women took the Q train back to Brooklyn—no bourgeois taxis for the Montaugh sisters, not when a populist subway was available—Alexis functioning throughout the journey as a human crutch, so badly had the tumor compromised her sister’s mobility.
Instead of returning to the apartment, they decided to stop off at their favorite performance bar, Franju’s on 9th Street in Park Slope. Inez wanted to get very drunk, and Alexis wanted Inez to get very drunk. The Slavic hostess didn’t mind seating them in the little theater in the back, since the evening’s entertainment, an American funk band called Off the Rails, would not be setting up before sundown. Both sisters ordered cocktails, a Boulevardier for Inez (Carpano Antica vermouth, Bulleit bourbon, Campari), a Jose Gregorio Stinger for Alexis (Pampero rum, Pernod, Galliano), which they consumed sitting on stools, hunched over a little round table, the surrounding brick walls hung with banal surrealist paintings by a local artist who called himself, or herself, Barbican.
“Stop me when I get to three,” said Inez.
“Be sure to drink some water in between,” Alexis cautioned. “Otherwise you’ll get a headache.”
“I already have a headache,” Inez noted. “A glioblastoma lollapalooza of a headache.”
The sisters were on their second round when the dwarf appeared, marching officiously into the room as if they’d been expecting him, his stubby hand wrapped around a martini glass. With his derby hat and three-piece, pin-striped suit, one lapel sporting a brilliant red poppy, he struck Inez as a clown employed by a particularly seedy traveling circus.
“Good afternoon, Inez,” said the dwarf. “Hello, Alexis. I’m Sandor.”
“My sister and I would like to be alone,” said Alexis.
“No, you would like to hear what I have to say,” said the little man, pulling up a stool.
Sandor sipped his martini and fixed Inez with an impish eye. She found him at once cuddly and repulsive, like a teddy bear with leprosy.
“My employer, Dr. Vincent Philoghast, does not have a waiting list but rather a wish list—a catalogue of those patients he desires the privilege of treating,” the dwarf continued. “You fit the profile perfectly, Inez. Terminal nonleukemic cancer, money in the bank, sufficient intelligence to understand the procedure. I followed you here from Sloan-Kettering. Don’t feel bad that you failed to spot me. I’m good at my job.” Again Sandor sipped his martini. “Dr. Philoghast hopes you will permit him to save your life. He’s perhaps the only physician in the world who understands the phenomenological essence of malignancies.”
Although Inez did not normally attend to unhinged visionaries of Sandor’s ilk—this Dr. Philoghast probably didn’t even exist—she shared with her fellow cancer patients a willingness to countenance, within limits, any narrative that included the promise of a cure. “And what sort of phenomenological essence might that be?”
“According to conventional thinking, a malignancy occurs when mutated genes give rise to rogue cells that start dividing randomly,” Sandor replied. “Dr. Philoghast, by contrast, believes that tumors are born from entire chromosomes—monstrous chromosomes, to be sure, severely deformed by asbestos, benzene, radon, cigarette smoke, hepatitis B virus, and other carcinogens—but still chromosomes. In other words, Inez, your glioblastoma is a species unto itself, an autonomous creature living inside your head, dependent on your brain for nourishment but otherwise free to do as it wishes.”
Inez realized that, having written The Blood of the Rose, a biographical novel about Gregor Mendel, her sister was better equipped than she to appreciate Sandor’s argument. And so when Alexis said, “Tell us more,” in a voice free of skepticism, Inez experienced a surge of optimism for the first time since boarding the Sarcoma Coaster.
“I don’t know much more,” said Sandor. “I’m not a research biologist. My background’s in chemical engineering.”
Alexis said, “Evidently your Dr. Philoghast believes that, jeopardized though they may be, the chromosomes in a cancerous tumor are sufficiently flexible to achieve a stable karyotype.”
Thatta girl, thought Inez. Be fucking impressed. Let Philoghast’s theory knock your socks off.
“That sounds like something he would say,” Sandor replied. “The point is this. Because Inez’s glioblastoma is a new and aspiring species, it boasts considerably more sentience than one normally ascribes to neoplasms. So formidable are my employer’s powers of empathy, and so great his telepathic gifts, that he can appeal directly to a malignant parasite’s intelligence. His presentation to the tumor is supremely cogent and irresistibly logical. ‘Relinquish the tissues on which you feed, or you will die along with your host.’”
“I assume Dr. Philoghast then promises the neoplasm a source of ex vivo nourishment,” Alexis said.
Again, that blessed acceptance in her voice, that sacred lack of doubt.
Sandor nodded and said, “Faced with the prospect of virtual immortality and unlimited sustenance, the tumor invariably decides to gamble on the wider world.” He grasped Inez’s hand and, turning her palm upward, gently probed her lifeline. “The procedure is simplicity itself. Dr. Philoghast will remove a portion of your cranium, establish a psychic bond with the parasite, and persuade it to exit through the aperture.”
Releasing Inez’s hand, the dwarf slid off his stool and stood at his full height, nearly four feet. He unbuttoned his coat and vest, then lifted his white silk shirt, revealing a livid scar running across his stomach.
“Behold this testimonial,” said Sandor. “Were it not for the Philoghast cure, I would have succumbed to gastric cancer eight years ago.” He tucked his shirt back in his trousers. “A limousine will pick you up tomorrow morning at seven o’clock. Be waiting on the sidewalk. You will hand the driver a three-by-five car
d containing whatever digits and passwords should enable someone to transfer half a million dollars from your various bank accounts to Dr. Philoghast’s.”
“Inez, sweetie, I think we’d better stop drinking for now,” said Alexis. “We need to have a long and sober discussion.”
“Long and sober,” Inez echoed. “I want to do this,” she added abruptly, dropping all pretense of prudence.
“But first we’ll talk,” said her sister.
“Six months, Alexis. I can’t write another novel in six months.”
“We’ll talk till dawn.”
“I want to stage Waiting for Godot in the Port Authority Bus Terminal. I want to learn Russian and read War and Peace in the original.”
The dwarf buttoned his vest and coat. “I must mention one detail. Your glioblastoma will insist on exerting a certain postoperative authority over your life.”
Alexis scowled and said, “What sort of ‘postoperative authority’?”
“Each malignancy acquires its own tastes. Ever since my parasite became partial to lizard meat, I’ve been required to maintain a small herpetorium on its behalf.”
“A small price, I’d say,” Inez declared.
“And now I must return to my apartment,” said Sandor. “The iguanas need feeding. Here is my final word to you, Inez Montaugh. For all the attendant inconveniences, I have never regretted my decision. Such is the ineffable beauty of life.”
And with that remark, in which neither Inez nor Alexis could detect an iota of irony, the dwarf smiled tenderly, pivoted on his heel, and strode out of Franju’s, leaving the sisters to stare silently at their drinks.
In one of Inez’s most celebrated essays of cultural criticism, “Fuck Me Again, Dr. Frankenstein,” she’d discoursed on the “epistemological schizophrenia” with which Hollywood horror movies of the 1930s and 1940s addressed the ideal of scientific progress. On the one hand, the sorts of deranged geniuses played by Boris Karloff, Colin Clive, Lionel Atwill, and George Zucco were engaged in ostensibly benevolent experiments aimed at resurrecting loved ones, prolonging life, curing diseases, contacting the spirit world, and expanding the periodic table of the elements. And yet the doctor’s quest always came at a price, inexorably turning baleful and then destroying him in the final reel (though the denouement normally found his colleagues paying lip service to the desirability of expanding the frontiers of knowledge). The last sentence of Inez’s essay ran, “Such films pose the question, ‘Is science a hubristic, perverse, and ultimately sacrilegious activity?,’ only to answer it by paraphrasing Robert E. Lee’s remarks on war following Fredericksburg: ‘It is well that science is so blasphemous, or we should grow too fond of it.’”
When Inez first beheld Dr. Vincent Philoghast, she noted his resemblance to Boris Karloff’s Dr. Janos Rukh in The Invisible Ray: the burning eyes, the dark mustache, the wild hair surmounting his head like a toupee of steel wool—in short, a man obsessed, the sort of scientist who would travel to Africa in search of a preternaturally therapeutic element, innocent of the possibility that exposure to Radium X might turn him into a death-dealing fiend. Dr. Philoghast, however, did not speak with a Karloffian lisp. Instead his voice exuded Zuccovian suavity, which had a calming effect on his apprehensive patient.
“Sandor has already informed you why the procedure is so effective,” said Philoghast to Inez.
She lay prone on an operating table beneath a brilliant constellation of surgical lamps. “My tumor is a creature unto itself,” she replied, heaving a sigh.
“A creature, yes, and in many ways a pathetic creature, afflicted with aneuploidy—duplicate chromosomes, missing chromosomes, fractured gene strings—and yet obviously heartier than the millions of extinct cells whose nuclei were similarly damaged throughout your forty years on Earth.”
“Sandor told me the parasite will exert some sort of postoperative authority over me.”
“In negotiating with these beasts, I need every possible bargaining chip,” Philoghast explained. “I’m a great partisan of your pen, Inez. The Beauty of the Morbid is a masterpiece. Lie still.”
The trip to the clinic had been facilitated by a taciturn Korean driver and supervised by a smiling Afghan who, after introducing himself as Ahmed, placed a bandana over Inez’s eyes. After twenty minutes of traveling blind, she gave up trying to picture the route in her head. There was no possibility of retracing the path from Flatbush Avenue to the place of her presumed salvation. In time Ahmed pressed a lozenge into her palm, insisting that she swallow it as “a necessary relaxant prior to the procedure.” The pill put her to sleep. When at last she awoke, bandana gone, street clothes replaced by a green paper smock, she found herself in Philoghast’s surgical theater, a distressing installation having less in common with the average such facility than with the locker room adjacent to her high school swimming pool: the walls were covered with shiny white porcelain tiles—a chess board, she mused, though for people who preferred playing without rules.
“Chaos,” she muttered, “the favorite game of tumors.”
“Chaos, Inez?” said Philoghast in a mildly chiding tone. “True, I would never call cancer a rational phenomenon, and yet according to my theory all neoplasms result from lucid Darwinian mechanisms. While the vast majority of aneuploid chromosomes perish, structurally unable to replicate themselves, a select few manage to become full-blown independent animals. Your neoplasm has achieved a level of stability whereby its cells will keep dividing indefinitely. My goal is not to halt that process, an impossible task, but to arrange for it to continue outside your skull.”
Outside her skull: an infinitely congenial notion on which Philoghast seemed about to elaborate—but then four surgical assistants in face masks and white scrub suits entered, claiming his attention. Before Inez knew it, one team member had activated an electric razor and begun shaving her scalp. Another aide strapped a metal cone over her nose, its hollow filled with a wad of gauze. Someone unstoppered a bottle of ether, releasing cold, barbed, puissant fumes throughout the theater.
“Ether?” Inez muttered. “Isn’t that rather primitive?”
“You’re here for the cure, not the amenities,” said the man who’d appropriated her hair.
“Are you frightened?” asked Philoghast.
“Terrified.”
“An honest answer. I appreciate that. Close your eyes, Inez. Concentrate on the future. You’re going to write a magnificent novel.”
“Good afternoon, Professor Montaugh,” said a husky female voice. “I’m the sleep doctor. Please start counting. One, two, three…”
“One…two…three…”
As the ether permeated the gauze, drop by drop, stars shone throughout the theater.
“Four…five…six…a thousand white tiles, so easy to scrub clean of blood.”
“Keep counting, Professor.”
An infinitude of crystalline specks.
“Seven…eight…nine…”
Billions of suns, filling the room, evocative of the cosmic vistas Karloff beheld through his telescope during the first reel of…
Although Inez had assumed that Dr. Philoghast’s clinic occupied an urban locale, she awoke in a curiously rustic setting, sprawled across an army cot, her cranium cradled by a pillow covered in ticking. Log walls, thatched roof, wooden floor: this space was no more a recovery room than her apartment was a monastery. Groping toward her shaved scalp, she spider-walked her fingers across the exposed skin—evidently Philoghast had decided she’d heal more quickly without a bandage—and gently probed the ring of stitches: she was wearing a yarmulke of flesh, covering the bony hatch through which her tumor had presumably fled. For a full minute she savored the pain in her skull, which was almost certainly not the cruel pressure of glioblastoma multiforme but merely a congenial postoperative throb.
Oddly, there were no nurses in attendance, and so she resolved to evaluate Philoghast’s intervention on her own. Cautiously she swung her legs over the side of the cot. Gingerly she stood
erect. She took a step, a second step, a third. Sucking in a deep breath, she marched across the cottage. No dizziness. Not a twinge of disequilibrium. She was poise personified, an ambulatory poem. Clearing her throat, she sang the first stanza of “Here Comes the Sun,” then danced with herself, twirling about the room in joyful circles, heedless of the green paper smock, as enraptured as Natasha Rostov waltzing with Prince Andrei.
A vigorous breeze wafted through the open window, cooling her bald head. Glancing toward the far corner, she noticed a pleated skirt, a long-sleeved blouse, and various undergarments folded neatly across the back of a cane chair. A pair of leather boots rested beneath the seat. She lost no time shedding the smock, that hideous uniform of the unwell, and arraying herself as a citizen of health’s holy empire.
At last two medical professionals, or so she surmised, entered the cottage, a chubby man in black-rimmed emo glasses, and a saucer-eyed, thirty-something woman reminiscent of Frances Drake playing Dr. Rukh’s love-starved wife in The Invisible Ray. Both wore woolen watch caps and printed sweatshirts: the man had attended City College, the woman had visited the Esalen Institute—odd attire for nurses, but nothing about Philoghast’s enterprise could be called orthodox.
“I’m cured!” Inez cried.
“Of course you’re cured, Professor Montaugh—that’s why you’re here.” Shrugging off his canvas knapsack, the male visitor ran a splayed hand across his abdomen. “That’s why we’re all here. In my case, bladder cancer. Philoghast removed my tumor in toto.”
“Breast cancer,” said the woman, touching herself as if reciting the Pledge of Allegiance. “I’m your next-door neighbor: Meredith Frye, Fordham mathematics instructor, cottage eight.”
The man said, “And I’m Meredith’s next-door neighbor: Barry Curtis, computer geek, cottage seven.”
