He went back to their bedroom then, and watched TV for a while, but as usual, by the time she went in half an hour later, he was asleep, and she shook her head as she looked at him. He was hopeless. He was so afraid of getting close to her again that he would have done anything to avoid it.
“Maybe he's narcoleptic,” she whispered to herself as she picked up her briefcase and went back to the study. Whatever he needed to warm up to her again, he was definitely not getting it, and she was just going to have to be patient. A woman in the group had had similar problems with her husband, and they had even separated for a year. He just couldn't face her raw need, and the fear of her dying, so he had shut her out. And she had left him. But now they were back together. And she had been free of the disease for six years. They had been back together for four of them. Hearing those stories gave Alex hope. But it still didn't make it any easier to deal with Sam. And the next day they had a huge fight after Annabelle's bedtime.
Just before dinner, Alex had explained to Annabelle that the next day she was going to the doctor and they were going to give her some medicine. And it was going to make her pretty sick. Eventually, it might even make her hair fall out. It was pretty bad stuff, but it was kind of like vaccinations. Taking it was going to make her sick for a while, but then strong again, and it would keep her from getting bad sicknesses. But Annabelle was going to have to be kind of patient with her, because sometimes she'd be okay, but sometimes she'd feel sick, and sometimes she'd be very tired. It was the best she could do, and when she was finished, Annabelle looked very worried.
“Will you still take me to ballet?”
“Sometimes. If I can. If I'm too tired, Carmen will take you.”
“But I want you to take me,” Annabelle whined. She was good about Alex's being tired most of the time, but sometimes it really scared her.
“I want to take you to ballet too, but we have to see how I'll feel. I don't know yet.”
“Will you wear a wig if your hair falls out?” She was intrigued by that, and Alex smiled.
“Maybe. We'll see.”
“That would be really ugly. Will it grow back?”
“Yes.”
“But it wouldn't be long anymore. Would it?”
“Nope. It would be short like yours. We could be twins.”
And then suddenly Annabelle looked terrified. “Will my hair fall out too?”
Alex was quick to put her arms around her and reassure her. “Of course not.”
But after she'd gone to bed, Sam was furious and went after Alex with a vengeance. “That was the most disgusting thing I've ever heard. You scared her to death.” His eyes were blazing at Alex, and as always, she was hurt by his complete lack of compassion.
“I did not. She was fine when she went to bed. I even got her a book about it. It's called Mommy's Getting Better.”
“That's disgusting. Did you see the look on her face when you told her about your hair?”
“Look Goddammit, she has to be prepared. If I'm going to be too sick to do things for her while I'm on chemotherapy, she has to know it.”
“Why can't you suffer quietly? You're always making it her problem, and mine. Jesus, have a little dignity for chrissake.”
“You sonofabitch!” She grabbed at his shirt and it tore in her hand, which surprised both of them. She had never done anything like that, but he was driving her to distraction. She had lost her husband, her breast, her sex life, her sense of her own femininity, her own sense of well-being and immortality, her ability to have more kids. She had done nothing but lose things that were really important to her in the last six weeks, and he had done nothing but criticize her for it. “God damn you! All I do is struggle with what's happening to me, and try and manage it so it doesn't inconvenience you, doesn't hurt her, doesn't overburden my partners at the law firm, and all you ever do is bitch at me and treat me like a pariah. Well, fuck you, Sam Parker. Fuck you if you can't take it.” All her anguish of the last six weeks came spewing out of her like a volcano. But he had so much pain of his own that he still refused to hear it.
“Stop congratulating yourself for how noble and long-suffering you are. All you do is whine about your goddamn breast, which wasn't such hot stuff in the first place. I mean, who even notices that it's gone, and the only other thing you do is ‘prepare' us for chemotherapy. Get it over with for chrissake, do it, don't beat us to death with it. She's three and a half years old, why does she have to go through it with you?”
“Because I'm her mother and she cares about me, and my feeling sick is going to affect her.”
“You're making me sick, and that's affecting me. I can't live like this, with the daily cancer bulletins from Sloan-Kettering. Why don't you just take out billboards?”
“You shit! You didn't even ask about the pathology reports when I got them.” It was the day he had first seen her scarred breast and his horror had superseded his interest.
“What difference does it make? They cut your breast off anyway.”
“It might make a difference if I live or die, if that still matters to you, or maybe that's like the breast you care so little about. Maybe if I disappear too, you won't even notice. I don't see how you could. You don't even bother to talk to me anymore, let alone touch me.”
“What's to talk about, Alex? Chemotherapy? Lymph nodes? Pathology? I can't stand it anymore.”
“Then why don't you get out and leave me to it? You're certainly not helping.”
“I'm not leaving my daughter. I'm not going anywhere,” he spat at her, and then stormed out of the apartment. He stood on the street after that, aching to take a cab to Fifty-third Street, to Daphne, but he didn't do it. He wouldn't let himself. He called her from a pay phone instead and burst into tears. He said he was starting to hate his wife, and himself. He explained that she was starting chemotherapy the next day, and he just couldn't take it. And Daphne sympathized completely. She asked if he wanted to come over for a little while, but he said he really didn't think he should.
He knew he was too vulnerable now, he needed her too much. And he couldn't let her be the excuse for ending his marriage. He had to work this thing out, and see it through. He had to do something, but he didn't know what. He didn't understand it, but he hated Alex suddenly. The poor woman was sick, and he hated her for what she was doing to his life. She had brought sickness into it, and fear. She was going to abandon him. She was destroying everything. Without knowing it, she was keeping him from Daphne.
He walked all the way to the East River and back again. And all the while, Alex lay on their bed, staring at the ceiling. She was too angry to even cry, too hurt to ever forgive him. He had abandoned her. He had failed her completely. In six weeks he had negated everything they'd ever shared, denied anything they'd ever felt, and destroyed all the hope and respect they had built in seventeen years together. And the promise of “for better or worse, in sickness and in health” had been completely forgotten.
It was two hours later when he came in, and she was still lying there. But he never came to see her. He said not a word to her. She lay there, awake, all night, and Sam slept on the couch in the study.
Chapter 12
The oncologist Dr. Herman had referred her to was located on Fifty-seventh Street, and was a woman. Alex had been told to expect to spend an hour and a half with her the first time, and forty-five minutes to an hour and a half thereafter. There would be two visits a month, unless of course there were any problems, in which case she would see her more often.
Alex had scheduled the appointment at noon, and was expecting to be back in the office at one-thirty.
Both Brock and Liz knew that she was starting chemotherapy on that day, and of course Sam did too. He had left for the office, after their massive argument the night before, without even bothering to have breakfast. And he never called her in the morning to tell her he was sorry, or wish her luck with the chemo, let alone offer to go with her. She had already figured out one thing, she was going to
have to get through this without him.
The building was a modern one, off Third Avenue, and the waiting room was well decorated and had an open, airy feeling. It was warmly lit, and decorated in soft yellow, and everything about it was deceptively cheerful. If they had led Alex into a dark tomb, it would have seemed much more appropriate. And for some reason, she was relieved to see that the woman she'd been referred to was her own age. She seemed quiet and capable, her name was Jean Webber. And Alex was pleased to see, from her diploma on the wall, that she had gone to Harvard Med School.
They talked in her office for a while at first, and the doctor discussed the pathology reports with her, and what they meant. It was a relief to be treated like an intelligent human being. She explained that the cytotoxic drugs they would use were not “poisonous,” contrary to common belief, but that their purpose was to destroy bad cells and spare good ones. She explained also that Alex's tumor had been Stage II, which was not great news, but that other than the four lymph nodes involved, there had been no further infiltration. It had gone no further. The prognosis, as far as Dr. Webber was concerned, was good. And like the other doctors involved, she felt absolutely sure that chemotherapy was necessary to obtain a complete cure. They couldn't take the risk of leaving even a fraction of a cell to divide and spread. Only a hundred-percent cure was acceptable, and would assure Alex that she would remain free of cancer. Because of the mastectomy, radiation was not necessary. And because of the nature of her cancer, hormone therapy would not be necessary either. The final results of the tests had indicated that it would not be useful. A chromosomal test had been done too, to examine the DNA of the cells involved, to see if there was a normal or abnormal number of chromosomes, and they had found that Alex's cells were diploid, which meant that they had the normal two copies of each chromosome. She had had the optimum outcome. It was a relief hearing about it, except that even with the good news came bad news. The bad news was that she had had cancer at all, and she had six months of chemotherapy ahead of her now, which profoundly depressed her.
When they talked about it, Dr. Webber understood. She was a small woman with dark brown hair flecked with gray, which she wore pulled back neatly, and she wore no makeup. She had a sympathetic face, and small, neat-looking, immaculate hands, which moved to emphasize what she was saying.
She tried to explain to Alex that while the side effects of chemotherapy could be disagreeable, they were not as fearsome as people believed, and with proper treatment they could be managed. And she assured Alex that none of the side effects caused permanent damage. Dr. Webber said she wanted to hear from her if she was having any problems. And the side effects to be expected, and discussed, were loss of hair, nausea, body pain, fatigue, and weight gain. She might also experience sore throats, colds, and problems with elimination. She could expect to stop menstruating immediately, but she told her that it was not impossible that she would menstruate again after chemotherapy. The eventual sterility rate was fifty percent, but that gave her an even chance of still having a baby, if she still had a husband, Alex thought to herself, as she forced herself to listen to the doctor. And Dr. Webber went on to reassure her that there was no evidence of birth defects afterwards.
There were potential, but remote, problems with bone marrow, though, and her white count getting too low, but these were less than likely. And bladder irritations were not uncommon. Only the weight gain surprised Alex, it would have seemed that with the nausea and vomiting she would lose weight and not gain it, but the doctor explained it just seemed to be an unavoidable factor, like the hair loss. She suggested that Alex go out and select a wig she liked immediately, even several of them. Given the drugs she would be taking, it was almost certain she would lose all or most of her luxurious red hair. But it would grow back afterwards, the doctor reassured her.
The doctor was as informative and as reassuring as she could be, and Alex tried to pretend to herself that she was listening to a new client, and had to hear all the evidence before reacting. It was a good system for her and it worked for a while, but as she continued to listen, what she began to hear couldn't help but overwhelm her. The nausea, the vomiting, the loss of hair, the relentlessness of it made her feel breathless.
The doctor explained that she would have a physical exam each time she came, a blood test, and regular scans and X rays, all of which could be performed in her office. They had the latest state-of-the-art equipment. She told her that she would be taking an oral drug, Cytoxan, for the first fourteen days of every four-week month, and then she would be coming in for methotrexate and fluorouracil intravenously on the first and eighth days of that same four-week month. After the intravenous drugs were administered, she could go back to her office. She wanted Alex to be careful to rest more than usual on the day before they were given to make sure that she minimized the problems and didn't lower her white count.
“I know it all sounds very confusing at first, but you'll get used to it,” she smiled. Alex was startled to realize they had been talking for almost an hour when the doctor led her into the next room for the examination.
Alex undressed carefully, folding her clothes on a chair, as though each moment, each gesture mattered, and she found she couldn't control her shaking. Her hands were shaking like leaves, while the doctor looked at the surgical site and nodded approval.
“Have you picked out your plastic surgeon yet?” she asked, but Alex only shook her head. She hadn't made that decision. She didn't know if she even wanted reconstructive surgery. The way things were going she wasn't sure she cared. And thinking about that brought tears to her eyes, as the doctor pricked her finger for her blood count. Suddenly, there was a catch in her throat for everything, and as the doctor set up the IV, Alex suddenly found herself sobbing and apologizing for it.
“It's all right,” the doctor said quietly, “go ahead and cry. I know how frightening this is. It won't ever be as scary as the first time. We are very, very careful with these drugs.” Alex knew that that was why it was so important to have selected an excellent and board-certified oncologist. She had heard horror stories of people who had been killed by improperly administered chemo. And she couldn't help thinking about that now. What if she had a reaction? What if she died? What if she never saw Annabelle again? Or Sam? …even after the awful fight they'd had the night before. It didn't bear thinking.
Dr. Webber began an IV infusion of dextrose and water first, and then she added the drug to it, but the IV kept backing up, and her vein collapsed just after they started. It was painful, and Dr. Webber immediately took the IV out, and looked at Alex's other arm, and then her hands, which were still shaking.
“I generally prefer the dextrose and water first but your veins aren't looking so great today. I'm going to do a ‘direct push,' and then we'll try this way again next time. I'm going to inject the undiluted medication right into your vein. It stings a little bit, but it's faster, and I think for today you'll be happier if we get this over with quickly.” Alex couldn't disagree with her, but the “direct push” sounded very scary.
Her neat small hands took Alex's hand, and she carefully examined the vein at the top of it, and then injected the medication into it, while Alex tried not to pass out from the sheer emotions. And as soon as she was finished she asked Alex to press hard on the vein for a fall five minutes, during which time she wrote out a prescription for the Cytoxan, and went to get out a single pill and a glass of water. She handed it to Alex, and watched her take it.
“Fine,” she said, satisfied. “You've now had your first dose of chemotherapy. I'd like to see you back here exactly a week from today, and I want to hear from you if you think you're having any problems. Don't be shy, don't hesitate, don't tell yourself you're being a nuisance. If anything seems unusual to you at all, or you just feel rotten, call me. We can see what we can do to help you.” She handed Alex a printed sheet of side effects that were normal, and those that weren't. “I'm on call twenty-four hours a day, and I don't mind hearing fr
om my patients.” She smiled warmly and stood up. She was a lot smaller than Alex and she seemed very dynamic. She was lucky, Alex thought, as she looked at her, she was doing her job. It was just like the people who came to her, with terrible legal problems, and frightening lawsuits. She could take care of them, she could do her best for them. But the problem and the anguish were theirs, not hers. Suddenly, she envied the doctor.
Alex was stunned to realize as she left that she had been at the oncologist's for two hours. It was just after two o'clock, and her hand was still sore as she hailed a cab. There was a Band-Aid over where the doctor had injected the medications. Alex was beginning to learn all the terms and phrases. It was information she would have been happier not knowing, and she felt enormously relieved as she rode back to the office. She didn't feel sick, she hadn't died, nothing terrible had happened to her. At least the doctor knew what she was doing. She thought about buying a wig as they drove down Lexington Avenue. It seemed depressing to be thinking about it now. But the doctor was probably right. It would be less upsetting to have one on hand when she needed it, rather than going to stores, hiding her balding head with a scarf on. The thought of it was far from cheering.
She paid the cab and went up to her office, and Liz was away from her desk when she got in. Alex answered her calls from the messages on her desk, and she started to relax finally a little while later. The sky had not fallen in. So far, she had survived it. Maybe this wouldn't be so bad after all, she told herself, as Brock came in, in his shirtsleeves, with a stack of papers. It was four o'clock, and she'd been busy for the past two hours.
“How'd it go?” he asked with a look of concern. There was always something very nice about the way he asked her. It wasn't cloying and intrusive, it was just very obvious that he cared, and that touched her. He was almost like a younger brother.
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