The Unwinding of the Miracle

by Julie Yip-Williams

  Unconsciously, I use the thoughts to form a wall around myself, a wall with which to keep the person I love most in this world—my poor, beleaguered, hurt, exhausted, terrified Josh—out. I lash out at him in anger; I push him away; I don’t tell him what’s really on my mind; the thoughts are too involved, too depressing, too sad, too imbued with guilt. I feel guilty for marrying Josh and ruining his life. I was the last girl Josh or anyone from his family expected him to marry when he was ten, fifteen, eighteen, or even twenty-five. Let’s be honest. He was born and raised in the true South, in the mountains of South Carolina, where the Confederate flag still flies in the state’s capital. He went to an Episcopal parochial school from kindergarten through twelfth grade and then the University of South Carolina for undergraduate and law schools. No one would have dreamed in a million years that he would marry a legally blind Chinese American girl born in Vietnam, raised in Los Angeles with the occasional ritualistic Buddhist tradition, and educated in the distasteful liberal and Yankee institutions of the Northeast. I can’t help but think that if he’d married a blond, Christian, southern debutante, then I and my illness would never have ruined his life. I know: if I hadn’t met Josh, then Belle and Mia would not be here, and they are our greatest joys. No one says that guilt is rational.

  Josh is angry, too, angrier than I am. He lashes out at me, too, even though his anger is directed at the gross injustice of all of this, at the unseen forces that shape our lives. Why is this happening to us? he wants to know. He feels an irrational guilt, too. He thinks that he should have done something to save me, that he should have known cancer was growing inside me. The guilt eats at him like a parasite. He goes about his life, almost as if everything is normal, working his long hours and thinking about convoluted investment structures that comply with the Internal Revenue Code, putting on his dapper suits to meet clients and close deals, in a sick, twisted manner finding some escape in the pressures of work. The hard things for him are the memories of our life before cancer, especially now, as we near the one-year anniversary of the diagnosis. The NBA playoffs this year trigger thoughts of last year’s playoffs and how we were so utterly and stupidly clueless then. My return to cooking reminds him of what he calls our “Halcyon days,” those innocent days before cancer, when our lives were carefree and happy. But as for me, what’s hardest of all for him is operating under the strain of trying to be normal.

  He agreed that buying a car would be a good idea, and as he sat with Lenny, our car salesman, making small talk, he wondered what would happen if he yelled, “My wife is fucking dying!” And then we smiled pleasantly and drove out of the dealership with Lenny being none the wiser…

  16

  A Nightmare

  Today, July 7, 2014, is the one-year anniversary of my cancer diagnosis. I don’t wake up in the middle of the night screaming, but the memories do come back to me unbidden, sometimes triggered by being in a particular place or by what someone says or by nothing at all; sometimes, they feel like waking nightmares. They play out in my mind’s eye like a Greek tragedy in which I am watching myself with dread, knowing that I, the protagonist, will meet a terrible fate even as I go on so innocently and stupidly believing that my pain was just IBS or some other obscure intestinal disorder, but certainly not cancer. As the tragic hero of my own play, I will be brought down by my fatal flaw, my hubris, which would have me believe that I am young and strong (with my five-times-a-week workout schedule) and that I am immune from cancer. But as a member of the audience, I know what’s coming, and I want to scream at my alter ego, warn her so that her fate might be something other than what it already is.

  I remember feeling sick that first Friday in June after eating my favorite yogurt, and so began four weeks of bloating, belching, cramping, nausea, loud gurgling noises in my stomach, and mental and physical listlessness that would come and go with ever-increasing frequency and intensity. I remember asking Josh the following week to pick up Gas-X for me on his way home from work per the doctor’s orders because it was probably just irritable bowel syndrome. I remember on multiple occasions lying in bed after my nanny had left for the day, dazed, and Josh coming home from work late to find the children were still running around in all their craziness because I simply couldn’t manage to put them to bed.

  I had just finished reading French Kids Eat Everything and was determined to get my kids to eat everything, too, by, among other things, sitting down with them to dinner every night; I remember how I just couldn’t eat as I sat slumped on the couch. I remember lying in the bathtub on the Tuesday evening exactly a week before going to Los Angeles for the wedding and family reunion, hoping that the hot water would ease the pain, and then throwing up and not having the energy to finish the memo I had to write for work about a hugely important Delaware court decision. Later, my internist told me I should have called him then, that I should have gone to the ER then; so many “should-haves.” I remember going to see him two days later and how concerned he was because my symptoms had gotten worse since my first visit, two and a half weeks earlier, and how he had me see a gastroenterologist immediately because I was supposed to go on vacation the next evening, and how he thought that was a bad idea considering how sick I was, and how the gastroenterologist ran blood tests and scheduled me for an ultrasound the next morning, and how the gastroenterologist told me that afternoon that my blood work seemed fine and nothing seemed amiss on the ultrasound so he was giving me the okay to travel. But if I was still having issues upon my return, he would have to perform an endoscopy and a colonoscopy.

  I remember us driving to the Hudson River Valley that evening to hunt for our future weekend home and battling through the discomfort all through that weekend as the severe constipation really set in. I remember getting on the plane to Los Angeles the following Tuesday, July 2, in a zombielike state and somehow making it through that flight with two young children and then the awful midafternoon traffic to get to my parents’ house in Monterey Park (a predominantly Chinese suburb east of Los Angeles) and then eating my dad’s marinated ribs (one of my favorite dishes) even though I hadn’t pooped normally in who knew how long and lying in bed afterward, exhausted and in pain. I remember my mother coming home from work that night and being horrified at how pale I was—“green,” she said in Vietnamese—and at how thin I had gotten in the less than two months since she’d last seen me; I wondered later whether mothers have a sixth sense about their children. I remember…I remember…

  The next day, Wednesday, July 3, Josh and I went to the Staples in the next town over to fax some papers to our Realtor—we had bid on a house, had accepted the seller’s counteroffer, and were about to sign the contract. While Josh was trying to figure out how to work the fax machine, I asked a cashier for a plastic bag, found a corner where I hoped no one would see me, and threw up a warm, yellowish-brown substance into the bag. By evening, I was vomiting water. I called the doctors in New York covering for my internist and gastroenterologist (it was a holiday weekend, after all); they both told me to go to the ER. Josh drove me to Garfield Medical Center, a few blocks from my parents’ house, where I found a bunch of elderly Chinese people waiting to be seen. “I’m not going to wait,” I told Josh, “it will go away,” and we went for a walk around the block instead, hoping that that would make this bout ease. I wanted to hold on until I returned to New York, in less than a week. I should have waited that night, but maybe a part of me knew that if I checked in to the ER, I wouldn’t be leaving for a while, and I didn’t want to miss the big family reunion that was going to happen at my brother’s house the next day.

  On the Fourth of July, we all congregated at my brother’s Mediterranean-style house in the hills of Palos Verdes Estates, where you can see the Pacific Ocean from the backyard. I was gratified to see my girls play in the inflatable pool and run around with their first and second cousins. It was what I had wanted. I was so happy to see my parents, siblings, cousins, and uncles and aunts
all together, laughing and talking in the many languages that I grew up with. For the briefest of moments, I could relive the most joyous parts of my childhood.

  By 4:00 A.M. on the day of the wedding, I couldn’t take it anymore. I woke up my seventy-year-old father and asked him to drive me to the hospital. I didn’t wake Josh because I wanted to spare him whatever this was for a little longer, so he could have a few more hours of sleep; I intuitively knew he would need all the sleep he could get to deal with whatever awaited us that day and in the days to come.

  There was no one in the ER at Garfield Medical Center this time, which was fortunate because I was in so much pain I couldn’t even sit up straight when the triage nurse assessed my condition and admitted me. I’ll never forget my incredible relief when the morphine hit my system; I could understand why people would rob and kill for narcotics. The ER attending told me that he’d seen what appeared to be an obstruction on my CT scan so he was going to admit me to the hospital. I remember thinking, Well, at least a physical problem can be identified. Even at that point, cancer didn’t enter my mind.

  Had I thought it might be cancer, I would not have gone to the ER at Garfield Medical Center, a hospital that serves a large, indigent, and underinsured immigrant population, filled with poorly educated and dubiously trained doctors. The surgeon assigned to my case, an idiot whose English was so accented I struggled to understand him—you know it must be pretty bad for me not to be able to understand a Chinese person’s accented English—and whose speech patterns and movements reminded me of a drunk, reviewed my X-rays and told me he saw nothing and that I would just have to wait for the obstruction to pass on its own while on bowel rest. The gastroenterologist assigned to my case, Dr. Tran, the only competent doctor there, didn’t agree with that approach; he was actually intent on discovering the nature of the obstruction. He ordered a CT scan with contrast for a better-quality image for 9:00 that evening, and planned to do a colonoscopy at 9:00 the next morning—July 7.

  Josh and my sister came to see me after the CT scan, sneaking in long after visiting hours had ended in their fancy attire to tell me about the wedding, show me videos of the girls dancing, and let me know everyone was very concerned. Then Josh told me he loved me, told me to get some rest and that he’d see me in the morning, before they took me in for the colonoscopy. That was how the last day of my innocent old life ended.

  The next morning I was taken to a room where Dr. Tran waited to do my colonoscopy. Just as I fell into that twilight state reserved for most colonoscopies, I saw Dr. Tran’s fuzzy face and heard him say, “I saw a mass in your colon on the CT scans.” Then I knew.

  I woke from the anesthesia as I was being wheeled back into my room. Josh was waiting for me. The destroyed look on his face confirmed what I already knew. He was trying so hard to act calm and not cry, but the devastation was obvious. Then he said the words and showed me a copy of the colonoscopy report. “They found a mass that is suspicious for cancer…seventy-five to ninety-nine percent obstruction of your transverse colon.” Of course, Dr. Tran had said we wouldn’t know for certain until the biopsy results came back, but Josh and I knew that there was no need to wait for biopsy results, that words like “suspicious” are loaded in the medical world. We cried together in confusion, shock, horror, and fear.

  Suddenly, my father and sister were there. They said nothing, but their faces reflected what I felt. My mother was at home taking care of the girls—oh my God, what would happen to my sweet, beautiful little girls? Then my brother, who had dropped everything upon hearing the news and driven the forty-five minutes to Monterey Park, was there at my bedside, hugging me and crying. I could see all the grays in his coarse, straight hair as he laid his head on me. I had stopped crying by then as I held his hand—I couldn’t remember ever holding his hand before. When had he grown up into a man and a father? When had I grown up into a woman and a mother? How was it that we were dealing with matters of life and death already—my life and death, to be precise? Here was the person who had taught me how to hold a baseball bat as he sought to transform me into the little brother he never had. And there was my sister, who had always taken care of me, whether it was driving me to buy clothes as a teenager or navigating us through the streets of some foreign place in our many travels together. And there was my father, who had always shamelessly admitted to all that I was his youngest and most treasured child, the only person who could legitimately contend with Josh over who loved me best. And of course, there was Josh, my lover, my best friend, my soul mate, the father of my children.

  In that hospital room, with the exception of my mother and little girls, were the people I loved most in the world. It was a surreal scene, something from my worst dream, except I’d never dreamed this nightmare of the people closest to me in this life crying over me like I was already dead. I wanted to pinch myself awake and find myself back in New York living the life I knew and loved, but the pain in my hard and distended abdomen reminded me constantly that this was all too real and that this was a living nightmare to which there was no foreseeable end.

  17

  The Hand of God

  I follow no institutionalized religion and have no patience for proselytizing, but I do have faith in a higher power—most of the time, anyhow. In my elusive moments of faith, when I am alone and still and no one asks me to verbalize or justify that faith, I know with a certainty that I could never explain that the hand of God has touched my life.

  Even as the memories of that period of diagnosis continue to traumatize me, I also recall that time with a certain fondness. It was a magical period full of beauty and incomparable love; and it is that sense of magic and wonder that also resonates for me of providence.

  Even as I and my immediate family were trying to process the fact that I had cancer and fighting through the paralyzing shock in my tiny half of the hospital room that Sunday morning of July 7—I don’t think we had quite made it to the point of thinking about what had to happen next. For I think it was literally minutes after Josh had handed me the colonoscopy report and my brother was still sitting by my bedside—my cellphone rang. A caller from New York with a phone number that was vaguely familiar. Automatically, I answered, “Hello?”

  “This is Dr. F. We spoke the other day when I advised you to go to the ER. I’m just calling to check in and see what happened,” the voice on the other end said. It was the doctor covering for my internist, Dr. N.L., over the Fourth of July weekend, calling me on a Sunday and minutes after I had received this devastating news. Did he have a sixth sense that something had happened?

  I was just so happy to hear a medical voice from “home,” at least the place I considered my adult home, where my life was, where my trusted doctors were. My response was immediate, even if it was somewhat panicky and tearful. “I’m so glad you called, Dr. F. I just received the results of my colonoscopy. I have a mass blocking seventy-five to ninety-nine percent of my transverse colon, and it’s suspicious for cancer!”

  The briefest moment of silence, and then Dr. F. said, “I’ll call you right back.” My phone rang again a moment later. “I just spoke to Dr. N.L., and we both agree that you need to get out of that hospital and get yourself to a reputable facility in Los Angeles and you need to find a colorectal surgeon immediately.”

  A colorectal surgeon? What was a colorectal surgeon? I’d never ever heard the word “colorectal” in my life. And how the hell was I going to find a colorectal surgeon, and how was I going to get to a reputable facility? I was hooked up to an IV that was giving me food and pain and antinausea meds, and I was severely uncomfortable with a stomach that made me look like I was four months pregnant. It wasn’t as if I could just walk out of the hospital. All those thoughts hit my brain at once. I knew one thing for certain, though, even in my shocked state—there was no way in hell the incoherent surgeon at Garfield Medical Center who had said that he’d seen nothing in my X-rays and that the blockage woul
d just clear on its own was ever going to touch me. I hated him and that hospital and I wanted to leave immediately, but not to another facility in Los Angeles. I wanted to go back to New York, to doctors I knew. “Coming back to New York for surgery is not a good idea,” Dr. F. stated firmly when I told him I wanted to go home. Dr. F. and Dr. N.L. knew of no colorectal surgeons in Los Angeles. I would have to find one myself.

  True, I had grown up in Los Angeles, but I had left twenty years earlier. I knew the big hospitals were Cedars-Sinai—that’s where all the celebrities seemed to go—and UCLA, but I certainly knew no doctors at either place. So Josh and my siblings started alerting my cousins, first to let them know what was happening, and then to ask them for any leads on colorectal surgeons. No doubt my mother, true to traditional Chinese values, would have been horrified that we were publicizing the shameful details of my diagnosis, but it’s a good thing we did, because within the hour Cousin C called me—she had also come back to Los Angeles for the wedding.

  Cousin C, with whom I grew up and who is like a sister to me, wasted no time with the emotional stuff—there would be plenty of time for that later. She was all business with me on the phone, as was I. We are Chinese. We are immigrants. Our ancestors escaped poverty and war by fleeing to Vietnam, and we and our parents did the same by fleeing to America, “on a sinking boat no less,” as my cousin N likes to say. Pragmatism flows through our veins. Cousin C lives in Westport, Connecticut, now, but for years she lived in Maplewood, New Jersey, next to a renowned gastroenterologist whose practice is in Manhattan. She hadn’t been in touch with him for years, but she would email him to see if he had any recommendations. Paolo was his name. I never learned what his last name was. Paolo responded promptly to Cousin C’s email even though they hadn’t communicated in so long, and it was Sunday of the Fourth of July weekend.