The Unwinding of the Miracle

by Julie Yip-Williams

  Despite the oddity of it all, I like Dr. G.W. I do think he’s legit. He said that he could have met me in his office at a prominent hospital in Manhattan, but that would have required my information to be logged in to a computer system and would have severely limited him in the advice he could give me. According to Dr. G.W., the medical establishment distrusts traditional Chinese medicine. While there are those who support it (like people at his hospital), that support is kept quiet, for fear of liability. Because there are thousands of herbs and infinite herb combinations, and because little money is invested in testing the use of those herbs in treating cancer and other diseases, doctors and hospitals are paralyzed when it comes to traditional Chinese medicine. Dr. G.W. pointed to the all-powerful and richly endowed Sloan Kettering as the worst of all in their conservative views.

  After reviewing my most recent blood test results, feeling my pulse, looking at my tongue, and just generally observing me, Dr. G.W. felt that the classification of my cancer as Stage IV was a mere “technicality,” and that I am strong and exhibiting minimal side effects from the chemo. He certainly had a hopeful and very reassuring manner, which I really appreciated and needed desperately that day. The objective while I am in treatment is to minimize the chemo side effects, detox my body, and boost my immune system (i.e., maintain my blood and platelet counts at normal levels to obviate the need for painful shots). Once I’m out of treatment (if we get there), the focus will shift to preventing recurrence.

  I’d half expected him to pull out a bunch of herbs from his black satchel like Mary Poppins would pull out a lamp from her purse, but alas, that did not happen. He gave me instructions to go to an herbal pharmacy in Chinatown (the only one he trusts, as they’ve been around for forty years and are known for sourcing high-quality herbs). When I was little, my mother would bring home mysterious brown herbs wrapped in pink butcher paper, dump them in a pot, and cook them for hours. Then she’d force down the bitter black tea resulting from that brew. Fortunately, it’s thirty years later, and now herbal pharmacies have machines that brew teas and package them into vacuum pouches that are easy to use. I am grateful to not have to brew teas for hours as my mother did, because if I’d had to, I might not have ever embarked on this little adventure.

  The day after our meeting, Dr. G.W. sent me the list of herbs that would make up my tea:

  Poria

  Dioscorea

  Atractylodes

  Codonopsis

  Astragalus

  Cinnamon twig

  Mulberry twig

  Perilla leaf

  Ophiopogon tuber

  Schisandra

  Peony

  Ligustrum

  Achyranthes

  Eucommia bark

  Cornus

  Lycium fruit

  Chih-ko

  Magnolia bark

  Lo hon fruit

  Tangerine peel

  I forwarded the list to my oncologist. He approved. I told Dr. G.W. to place the order with the herbal pharmacy, and I went to pick up the tea. Amid the open-air markets of fruits and vegetables and smelly fish and the restaurants with the roasted ducks and chickens hanging in their windows sits the uncrowded herbal pharmacy. The store looks as reputable and clean as a store in New York’s Chinatown can be, with glass display cases under fluorescent lights filled with creams, ointments, and oils, and shelves lined with hundreds of giant glass jars containing things like black jujubes, honeyed dates, lo han guo, and all the other manner of fruit, tree bark, leaves, fungi, roots, and derivatives thereof that could possibly be in the world. One of the teenagers working behind the counter went into the back room to retrieve my freshly brewed teas, all neatly packed in four-ounce clear plastic pouches. The tea was so newly made that it was almost too hot to handle. I authorized a $150 charge on my credit card for a sixteen-day supply and walked out the door. (Credit card acceptance in Chinatown is also a good sign of legitimacy.) Dr. G.W. will reassess the herbal formula at the end of that period to determine if there are any necessary adjustments. My job is to drink the stuff twice a day and to keep him informed via email about how my body is reacting.

  Bottoms up!

  12

  The Surly Bonds of Earth

  An interesting quirk of having a disease is that most of your friends from diagnosis on also have the same disease. Which means that pretty soon, your friends start to die.

  The first week of 2014 brought this part of the experience home, vividly. I celebrated my thirty-eighth birthday, observed the six-month anniversary of my diagnosis, and learned of the cancer-related deaths of two individuals and the impending death of another. One of the dead was a veritable celebrity in the colorectal cancer community, and the other I had known and worked with shortly before my own diagnosis.

  John was a partner at my law firm, a distinguished-looking man in his mid-fifties who, despite having lived all over the world practicing law, hadn’t managed to rid himself of his midwestern accent. I didn’t know him as well as I knew many other partners of the firm, but I was briefly assigned to work on a transaction with him only last June, just as I was first experiencing symptoms. He was one of those partners who was always involved, who actually read the documents and called to check on the status of various aspects of the deal. Of course, I was going on vacation to L.A. in early July, so John decided to replace me with another associate.

  Little did either of us know then that deadly tumors were thriving in both of our bodies. In early December, I learned that John had just been diagnosed with brain cancer and the prognosis was grim. And then, two months later, he was dead. It took me two months just to begin processing the fact that I had cancer. He didn’t even have a chance to put up a fight.

  John passed away the day after Gloria died of colon cancer–related complications. I didn’t know Gloria personally, but I read her entire blog, which chronicled her three-and-a-half-year battle, when I was first diagnosed. She had a loud voice in the colorectal cancer community, since she’d started her own nonprofit to raise money to find a cure. Diagnosed at age twenty-eight with aggressive Stage IV disease that involved widespread metastases, she was given one year to live, two at most. She was known for her warrior attitude, relentless positivity, and even enthusiasm for fighting the disease—so seemingly fearless, positive, and enthusiastic was she that she never really wrote of her fears or sadness, and instead seemed almost happy about the “opportunity” cancer presented in her life—which to me verged on the delusional.

  To those of us who followed her progress, it certainly seemed that until the day she died she truly believed that she would beat the cancer, that the cancer had picked the wrong person, that, in her words, “Cancer, your time is up.”

  She had been quiet publicly about her decline in part because people believed that by virtue of her unyielding ferocity in the face of this deadly disease, she would indeed somehow win her war. The fact that her body had succumbed alarmed many who drew inspiration from her and felt that if the fierce WunderGlo (her chosen nickname) couldn’t overcome, how could they?

  And then there is lovely Kathryn, a tall, fifty-something Minnesotan who has lived long past her initial prognosis. She’s been a dedicated source of support and information for others and a devout builder of the colorectal cancer community—she was the one who found me and brought me into Colontown (a support group on Facebook). I’ve met Kathryn but don’t know her well at all, unless you count the real intimacy of her writing on Colontown. I admire her brave decision to stop all chemo a few months ago, and I admire how she is spending the last days of her life on this earth, at home in hospice care, with her family and friends, even as her body is slowly being starved to death because a tumor is obstructing the path into her stomach. Even as she is constantly vomiting what little water she can ingest, she makes the effort to inform everyone as she has always done of the details of he
r medical condition and her mental state, which is calm and gracefully accepting of her coming death. In so doing, she is demystifying the process of dying, helping all of us who will also one day die be less afraid.

  In so doing, she is giving those of us who love her a chance to bid her farewell, to say our piece.

  Those of us who face cancer, any type of cancer, are prone to use the metaphor and language of war to describe the way we deal with our disease; I myself have described chemo as the most powerful weapon in my arsenal, the receipt of bad news as a defeat in one battle among many, and all of my supporters as my army. In many respects, it’s an appropriate and useful metaphor because it lends a visual image to an often long and arduous process with an uncertain outcome in which the mind and body are brutalized; it fires up passion and gets the adrenaline flowing and can push one to keep enduring. But what happens when the body can no longer tolerate further treatment? What happens when death is the outcome of the war and not life? People hate to think that Kathryn, Gloria, and John have ultimately “lost” their personal wars against cancer, and yet there is no denying that reality; John and Gloria are gone, and Kathryn will soon follow.

  As I’ve said before, battling cancer occurs in not just the physical realm, but also the nonphysical realm, where the mind and spirit are challenged to find the will to keep fighting, to feel happiness despite the sadness, to find light amid the darkness, to laugh through the fear, to live with abandon and joy under the specter of death. I hope that no matter how difficult the physical war becomes for me and no matter how I may struggle through the nonphysical war, I will always confront my disease with the same kind of courage, honesty, grace, and acceptance that Kathryn has exhibited, she who learned so much about her disease and its treatments, both established and experimental; she who shared that knowledge as no other; she who recognized when chemo was compromising the quality of her life during the little time she had remaining; she who chose to accept with dignity the overwhelming power of the cancer in her body.

  Cancer is a force of nature that acts within the human body, just as the winds and rains from a hurricane are forces of nature that act on the earth. We are so small, insignificant, and powerless in the face of those unleashed forces in spite of the marvels of shelter and modern medicine. There comes a time when one must admit that powerlessness and evacuate ahead of the deadly hurricane, rather than remain behind and make some kind of empty symbolic gesture of “fuck you.” Similarly, there comes a time when one must recognize the futility of continuing the personal physical fight against cancer, when chemo is no longer a desirable option, when one should begin the process of saying goodbye and understand that death is not the enemy, but merely the next part of life. Determining that time is a deliberation that each of us must make with her own heart and soul. This is what Kathryn has done; she respects the force of nature acting on her body and has no delusions about somehow still overcoming; she made the cogent decision to evacuate ahead of the hurricane. To me, she has won her war against cancer so valiantly fought in the nonphysical realm.

  Yet another dying friend, C, just posted on Four Corners (a subgroup of Colontown that is exclusively for those of us with Stage IV colorectal cancer, where we can freely and safely say the things that would terrify those who live with a lower-stage cancer) about what it was like for her—as per the family therapist’s suggestion—to sit in the next room as her husband and sister-in-law told her children that treatment was no longer working and that their mother was going to die from this disease. What it was like to hear her children’s cries and not be able to comfort them, for that heartbreaking task had to be left to their future caregivers.

  These are the times in life when we feel almost more than we are capable of feeling. These are the moments when—paradoxically, as we are closest to death—we are most painfully and vividly alive.

  13

  The Crossroads of the World

  A crossroads is a place where multiple roads converge, and is a point at which a decision needs to be made about what road to take as one continues on the journey. Which way to go? When my final day of chemo arrived, on January 13, it certainly felt like a crossroads, a decision point where scans would soon follow and Josh, my doctor, and I would have to decide what to do next. So somehow it felt right that I should end up at Times Square, known as it is (ostentatiously) as the Crossroads of the World.

  January 13 felt like a momentous day—Cousin N, who is like a sister to me, had flown from Los Angeles the day before to be with me for the last session and to spend the week; Cousin C, who is also like a sister to me and who lives in Connecticut, left her young children for twenty-four hours (something she hadn’t done in four years) to sleep over the night before so she could come with me to chemo as well. My actual sister, Lyna (who lives in New York City), also came to spend the night—Lyna and Cousin N slept on the full-size air mattress, and Cousin C took the couch.

  As we like to remind each other often in a half-joking way (especially when one seems to have become spoiled by her soft life), no matter how Americanized we have become, we can never forget that we came to this country on a sinking boat from Vietnam and should have no problems sleeping on couches, air mattresses, and floors; a carpeted floor covered by a flat cotton sheet was where we slept often as children, with not even the padding of a sleeping bag—what did a bunch of Vietnamese refugees know about sleeping bags?

  That night, Josh stayed home with Mia and Belle, and we four Yip girls went out to a dinner of fancy Asian fusion fare at a restaurant in the South Slope, opened by a Top Chef winner, laughing and gossiping just as we used to when we were little girls, except now we gossiped and complained about our aging Chinese parents, husbands, children, money, careers (or the sudden disappearance thereof), and all the stuff of ever-impending middle-aged adulthood. It felt so comfortable and yet poignant; how sad that it took something like my last session of chemotherapy for advanced colon cancer to bring us together again without boyfriends and husbands and children, in a way we hadn’t been in more than twenty years.

  While in the cab to the restaurant, as we all stared and giggled at the scantily dressed girls freezing their butts off hurrying to a Jay-Z concert, I had one of those strange passing sensations in which I felt removed from my body and observed this current scene of my life as if I were watching a play on a stage, speculating about whether my character would suffer some tragic ending in the play’s denouement. I wondered if one day, perhaps not so far away, my sisters would reunite again without me, and if they would remember that particular moment of laughter. And where would I be?

  Cancer has made me hold these precious scenes of my life against my heart like they’re my very own children; that’s how much I cherish them. And while those scenes can make me feel a longing I’ve never known, they also make me feel an unparalleled joy and appreciation.

  During dinner, Cousin N casually mentioned that she needed to meet one of her “reps” at Times Square at 10:30 the next morning. Cousin N is in advertising; she buys and plans media for a major motion picture studio, meaning she decides where to buy and how to use advertising space (e.g., TV and radio commercials, magazine ads, posters in subway stations, et cetera) for blockbusters and every other kind of movie this studio produces. She has become a big muckety-muck, overseeing large teams of young assistants who do her bidding. “No problem,” I said. “Whatever you need to do for your job.” Chemo was scheduled for 12:30, so we would have plenty of time.

  The next morning, after Cousins N and C accompanied me to drop Mia off at school—my sister had left early for work—we made our way to Forty-seventh Street and Broadway and stood in front of the red steps that are just south of the famous TKTS booth, where tourists line up for hours to buy half-price tickets for Broadway shows. Times Square is normally a place I avoid like the plague, filled with tourists who walk too slowly and too many flashing lights; it’s a place that can overwhelm in seconds
. But it was early on a Monday morning, so it was relatively sane, devoid of the usual mob and the oversize Elmo, Dora, and other characters clamoring for their photos to be taken in exchange for five bucks, and devoid of other crazies like the Naked Cowboy (who goes around even in the dead of winter with nothing on but cowboy boots, underwear, a cowboy hat, and a guitar). Cousin N was talking to Joel, her rep, a few feet away while I was engaged in a heated conversation with Cousin C about how she should make sure her children are appropriately exposed to their Chinese cultural heritage.

  Suddenly, my best friend, S.J., showed up. What a coincidence! I went on and on to her about how really small New York City is despite being home to 8 million souls. Just then, I saw Josh walking toward me, and I was equally amazed to see him. “Oh my God!” I shouted. “Times Square really is the crossroads of the world!” And then I saw my sister approaching. Before I could open my mouth to demand to know what was going on, Cousin N told me to turn around. “Look!” she said.

  Please note that when you tell a legally blind person—or at least this legally blind person—to look!, it engenders a certain panic. Add to that the Times Square environment, where there is an infinite number of things to look at and even more panic, and you fear you won’t see what everyone wants you to see. But even I couldn’t miss the giant screen featuring an enormous picture of me when I turned around.

  There it was, along with, in letters as big as me: CONGRATS JULIE, ON YOUR LAST CHEMO SESSION TODAY! WE LOVE YOU! The picture was up for a long time, four minutes maybe. And then Cousin N announced, “But wait, there’s more!” More? I wasn’t sure I could handle more! Joel gave the thumbs-up to the invisible people looking down at us from somewhere above, and the picture disappeared and the live camera feed went on and there I was on the digital billboard with Josh by my side, along with Cousin N, Cousin C, Sister Lyna, S.J., and of course Joel. And then the people who couldn’t resist the allure of seeing themselves on the big screen in Times Square came swarming in, like moths to a flame. The camera zoomed in on me and Josh, and I covered my face in embarrassment. While Josh might look like a politician on camera with his polished wave, I am no politician’s wife, uncomfortable underneath the weight of all that attention.