by Charles Bock
Do not pursue the past, she reminded herself. Do not lose yourself in the future.
She needed to appreciate the now.
—
Day three: her nose swollen outward from the nostrils, her cheeks inflated. A deep crimson discoloration had started behind her ears and now covered the underside of her jaw, the top of her neck. “Not all that unusual for daunorubicin,” said the disheveled resident. “I don’t think anything for concern about,” added the visiting fellow (Mongolian, an emerging star, he’d been called in for a consultation).
The next morning, on rounds, the attending physician addressed those students who’d followed him into Alice’s room. Exclaiming his pleasure about Alice’s lack of a fever, he offered similar talking points about her newest rash (not at all unusual, no cause for concern). This one was a purplish shade, creeping out from under her pits, spilling in all directions. The attending possessed the good sense to keep his mouth shut about the possibility of the two rashes joining in a superrash. And no student doctor was brazen enough to broach the subject.
Alice took solace in the attending’s air of authority but also had a flash of sorrow for all the years she’d dismissed Dr. Glenn. “Ointments should take care of the burning,” continued the attending physician. He acknowledged the difficulty of keeping her hands still. Then, as if talking to a child, added, “Staying away from the rash is how we keep it from spreading or getting infected.”
“I’ll be good,” Alice answered. “Scout’s honor.”
Still she scratched. She picked. Oliver also noticed her running her hand over her hair. More and more she did it, like one of those poker tells. This concerned him—he wondered if a catheter had wriggled free from a weak or wandering vein in the crook of Alice’s right arm; if the IV drip was going into her biceps instead of her bloodstream. The resident, the fellow, and the attending were all sanguine. The infiltrating medicine was not a lethal mix; the swelling would recede. However, they also insisted: she had to keep that swollen arm stationary. And still she skimmed. Incessant, straight swipes with that same fucked-up arm, her fingers combing backward. To Oliver it now appeared as if his wife’s face was in the middle of transforming into a mutant boar’s; and watching her—ridiculously bloated, garishly discolored, frail, weak, covered in blankets, hooked up to all those goddamn tubes—all of that was bad enough. But here she was, willfully and continually disobeying doctors’ orders, running her hand over her skull, checking yet again, displaying each new wisp that clung to her finger.
“Nothing like the handfuls you’d expect,” she said. Her voice was hopeful, maybe even convincing. “I’ve heard stories—women who survived all sorts of chemo and kept a decent head of hair.”
The attending physician let Alice get it out of her system. Then he answered, plain as white bread: “It’s all going to fall out.”
—
Of course, Alice’s mom checked herself in to the nearby hospice. The white-haired woman who’d combed out Alice’s tangles, apologizing, always, for the pain she caused; who’d asked that Alice hold still, wrapped her hair into untold ponytails, and taught her girl how to braid, ending each lesson with a kiss on the top of the head. The hospice was available for loved ones of long-terms and potentially terminal cases, and charged twenty dollars a night, more than reasonable, thought Alice’s mom, especially with the lodgings being so homey: hand-stitched quilts and Americana on the walls, lace tablecloth and fresh flowers on the common table. Alice’s mother was calm and rational and not a complainer in any way, and she quickly proved indispensable, each morning finishing her grapefruit, cornflakes, and strong black coffee, then exchanging best wishes with the sad married couple whose son had been in a hunting accident, and then changing and re-dressing her grandchild.
Whenever she and Doe found their way back to the hospital, Oliver’s shift on guard ended, and it became his turn to ride the complimentary shuttle downtown, into four blocks of brick buildings that had been renovated to look historically quaint. This luxury, these few hours to himself, was mainly full of errands: sending necessary insurance faxes from the cluttered rear of the office supply store; settling into the phone booth of the nearby university library’s lobby, where he used his long-distance calling card to update friends and family on the latest; concocting plans for how the biz would deal with things while he was stuck here.
That afternoon, the sky was heavy-handed in its grayness, the wind blowing the hail sideways in unending sheets. By the time Oliver found the weathered woodcut pole that the nurses had told him to watch out for, his clothes had long gone damp, his face and hands turned numb. None of the old men turned from their shaving chairs. Oliver picked through the newspaper’s meager sections, not daring to interrupt banter about the weather.
The wind’s bluster had eased into a mild, overcast evening. The baby dozing, Grandma as well. Visitors to the room were supposed to wear surgical mask and gloves. But in the recliner, Grandma’s head was unadorned, tilted back, her mouth open wide enough to reveal gold fillings. Alice responded to the door’s creak but appeared groggy, confused. Then her eyes went wide, her swollen jaw dropped as if unhinged.
“I wanted you to see it’s just hair,” Oliver said.
Her hands went over her heart. It seemed she would bawl.
“It’ll grow out or it won’t,” Oliver continued. “Who gives a fuck.”
“The most wonderful thing anybody’s done in the history of time,” Alice said. She threw both arms outward, set the IV machine jiggling. “Get over here, silly man. Let me feel, already.”
That night he would borrow the electric shears kept at the nurses’ station. Alice’s hair was more than ready, releasing easily, some clumps falling from vibrations alone. His wife had a long-standing fondness for brightly colored streaks, exotic highlights, any tweak that might lend a bit of glamour. For important gallery openings, industry parties, or runway shows, it was assumed that a chunk of her afternoon would be devoted to some complexly pinned arrangement, be it chopsticks, feathery wisps, or exotic braiding, whatever the most stylish magazines would be cooing over in six months. Less than three minutes it took now to shave her skull.
Afterward they perched the baby between them in the crowded bed, her head its own pink planet, practically the size of the rest of her body. What few hairs she had were still short and translucent, their swirling growth pattern forming an almost imperceptible crop circle on the top of her head. Alice’s mom fetched an overpriced disposable camera from the gift shop. Oliver pulled his little surgical mask down around his neck. He and Alice leaned their shoulders into one another. Doe gurgled, cooed, kicked out chubby legs.
“There they are.” The nurse counted backward toward the flash. “The perfect, bald family.”
—
Some things, however, were Alice’s alone: the way those tiny lips attached themselves to her areola; how the ridge of those gums wrapped around her nipple; holding the baby’s head to her and listening to the soft gurgles, feeling the sensation of her pull and suckle. Through the first five months of her life, Doe had known only her mother’s milk. But the cells in Alice’s bloodstream changed that. The chemo made her milk toxic.
Obstetrics sent a machine that looked like something out of fifties sci-fi, and when Alice’s breasts got too full, she applied the ancient vacuum’s suction attachment and performed a distorted version of her normal routine. A nurse in a blue mask, gloves, and lead-lined radiation gown carried away the results for hermetic disposal.
Without much fuss, Alice’s mother went out and purchased formula from the Olde Town Apothecary. A tenth-grade English teacher for more than thirty years, Alice’s mother was a pragmatic, thoughtful woman. Her daughter insisted, so she had to venture out a second time, scouring the few health food stores for something more natural. It took four days until Alice was sure Doe smelled different. Chemical-y. This new smell made Alice weep, and her body was weak enough that these jags became their own sources of pain. She couldn’t
help herself. She wept because Doe hadn’t ever had a diaper rash before and would now. She wept because her baby still reached for Mommy’s chest, and began her own bawling when she wasn’t allowed to attach. She wept remembering how raw her nipples used to get, and she wept because, with every passing minute, they were getting less raw. At three in the morning, when a nurse came around to take her vital signs, Alice wept with the memory of the body weight of her girl by her side—rustling, half-awakening—the memory of plopping a breast into the little one’s mouth. Whipping out the feeding curtain at Dean & DeLuca. Leakage spreading through silk-screened maternity blouses. Those nursing bras that she knew her husband so despised.
—
The visiting doctor from Eastern Europe had a habit of snacking on junk food in the hallways, and this was humanizing to Oliver, especially seeing that the man consistently seemed gracious toward other hospital staffers, so catching up with him outside the nurses’ station, using words and mannerisms that included everything short of falling onto his knees and pulling down the guy’s pants, Oliver pretty much begged for a promising survival rate, some crack of light, a taste that would help them get through this. “I mean, she’s stabilizing, and we started the chemo, so…”
With the same flat tone that his esteemed colleague had used to tell Alice that her hair was going to fall out, the attending told Oliver these words: “Cancer is hell of disease.”
—
Teen years: lonely Bakersfield afternoons, his dad pounding dents out of cars all day in a glorified salvage yard, Mom making copies for an accountant, the stink of fertilizer constant, industrial farmland as far as the eye could see. His escape was a home computer store in a strip mall, Oliver learning code from his cousin’s dad, who needed to distract himself from the paucity of people who were shelling out money for Commodore PETs and Atari home systems. Even before partial scholarships had gotten Oliver out of that cow town and across the country, allowing him to bust his ass through college and graduate school, his intellectual life—even his understanding of himself—had begun maturing, in no small part, because of his relationship with complexity. Those tedious hours he spent with infinitesimal units, information strings of code, copying the program for another adventure game, whose line progressions were listed in the back pages of Byte magazine. This, Oliver learned, was how massive, elegant structures were constructed. And, gradually, he became accustomed to converting the theoretical into something practical and sturdy and cleanly perfect.
It was gut-churning to hear that man say, Cancer is hell of disease. What felt worse, however—wrong in a way that betrayed everything Oliver believed about the cosmos—was the recognition. A doctor involved with his wife’s treatment was openly admiring the elegant complexity eating at her bones and blood.
Comrade Doctor put his hands up. “I try again—” he said.
Damaged English followed. “As personal, I try avoid telling person news he cannot take.” The doctor continued, sharing his belief that honest assessment represent measure of respect, as well as importance give loving ones information so to be prepare selves.
“You’re telling me…” Oliver began, petered out.
“First hundred days,” the man answered.
“What?”
“We see how she doing. Get sense how things going. Know more.” He patted Oliver’s shoulder. “Hundred days.”
Whitman Memorial, 1220 York Ave., 4th floor, Hematology/Oncology (follow-up appointment: patient background/personal history)
He couldn’t afford one of the office supply company’s high-end jobbers, so he’d sprung for your solid, middle-of-the-road, basic ergonomic desk chair. This was what he sat in. As for his diet, he tried, he really did, loading up on greens and boiled chicken, although he still snuck in red meats and fried calamari, more than he’d care to admit. Ever since kids had come into the picture, he’d been lucky to get to the gym once a fortnight. Admittedly he could have dropped fifteen pounds. Twenty pounds. So, basically he was a middle-aged somewhat-overweight white-collar dad going through the rite of manly passage known as chronic back pain. Maybe not a human interest feature in the local paper. But his spasms sure felt newsworthy. Had to pile throw cushions on that desk chair just to sit; pop Advils like they were candies just to get through the day. And rolling around on the carpet with Timothy and Suzy Jo? Please. Then his wife had heard about this acupuncturist from another mom at playgroup. And he wasn’t exactly thrilled about it, but he let them put those pins into both sides of his neck, his shoulders, his elbows, his kidneys, his sacrum, the bottom of each foot, the space between each pair of toes. Afterward, he defecated for the first time in four days. Went home and slept like a stone at the bottom of the ocean.
Four weeks and twice as many visits to the acupuncturist later, the man received a shot of cortisone from his family physician to take care of the discomfort in his back. He got a script for ciprofloxacin to address his urination problems. The physician discussed whether the man needed an ammonium laxative to deal with his constipation and advised the man he needed to exercise more, and could stand to drop fifty pounds. The man followed the little taped instructions on his plastic pill bottles. He found religion when it came to his dietary habits, more or less, and made an effort to shut down his workstation an hour early in the evenings and get to the gym. Stretched his back for ten minutes before and after. But that belt of electric pain remained, strapped across his lower back. His stomach had gone bloated and tight, as if hands were constantly pressing onto his abdomen. And he had unsettling stretches of numbness through his pelvis and lower spine. The man was getting night sweats, and at his office he sometimes wrapped himself in this frayed old beach blanket to warm himself, plus he scratched himself all the time, just couldn’t stop. It was frustrating beyond words: he was doing everything he was supposed to do, then lapping those efforts by half. Was it so goddamn much to find out what was wrong with him?
The gastroenterologist explained that lymphoma was a particularly difficult disease to diagnose, especially when the lymph node beneath the pectoral hadn’t yet swollen, as all indications seemed to be in this man’s case. All the symptoms were pretty much right down the checklist. A biopsy would provide answers. They’d also find out if the disease had spread.
That was the bitch in cases like this, explained the doctor: the time it took for the disease to advance enough to diagnose was also the time it took for the disease to spread.
The now
IT TOOK MORE than a month: her absolute neutrophil counts finally exceeding five hundred, the magic number necessary to spring her from Dartmouth-Hitchcock; the quiet rental car carrying them out of the Granite State, bringing them home, finally surrounded by what was theirs: hanging rolls of Chinese paper acting as curtains along the storm windows that filled the western windows; morning light oozing around the paper’s tight borders. Now was bed, consumed by a comforter. Alice stared, without focus, at the large industrial fan above the bed, its blades dappled with brown rust. Lush carpets stretched across the walls for soundproofing. Thanks to them, and the churn of white noise from the air purifier, she barely heard the clatter from outside, some six floors below—forklifts humming and shrilly backing up; workers groaning and cursing as they unloaded frozen sides of beef from semis that had fallen behind their normal delivery schedules, now downshifting into gear, hitting the road. Even these sounds were part of the comfort of what was known, part of what allowed her fear to recede.
