A Song Everlasting

by Ha Jin

  “Will that cure him?” Tingting asked.

  “It will help him breathe better for some time,” Dr. Hartley said. “To be frank, the cancer is already too advanced.”

  Tian asked him bluntly, “How long do you think I might live?”

  His question surprised the doctor, who replied without lifting his eyes, “Maybe six or seven weeks.”

  Tingting gasped. Tian placed his hand on her arm and gave her a squeeze. He then told the surgeon that he’d consider the procedure as an option, but he hadn’t made up his mind yet. “Let me have a day or two before I can come to a decision,” Tian said.

  In fact, the previous night he and Tingting and Funi had talked about his treatment options. Both women believed he should choose “the conservative treatment,” a palliative approach that combined herbal medicine and hospice care. They wanted him to suffer as little as possible during his final days, but they hadn’t convinced him yet.

  44

  Tingting discussed her father’s condition with her mother, who also suggested Tian choose the conservative treatment. He hadn’t talked to Shuna since their divorce. Unless she contacted him directly, he wouldn’t bother her with his problem. Tingting had told him that her mother would be remarrying soon, though she didn’t say who the man was. Perhaps he was Professor Bai, whose wife, Tian was told, had died the winter before.

  His daughter couldn’t stay with him every night—there were early-morning classes and tests that she needed to keep up with. When she wasn’t there, Funi stepped in for her. One morning he found Funi sleeping on the sofa. Soon his cough woke her and she sat up, rubbing her eyes. Her lids puffy and her face tired and slightly swollen.

  She went into the bathroom and brushed her teeth. When she came out, seeing Tian set breakfast on the table, she said, “Gosh, I’ll be late for work again. I didn’t fall asleep until three in the morning.” She speared a potato puff he had just microwaved, dipped it into ketchup, and put it into her mouth.

  “You shouldn’t have stayed up so late,” he told her.

  “I couldn’t sleep. Whenever you coughed, I was worried you might suffocate. Whenever you didn’t cough, I feared you might have passed out and stopped breathing. I was all nerves.”

  What she said touched him. He put his hand on her strong arm, saying, “Sorry to make you feel that way.”

  “I’m fine now. I have to run to work.”

  “Come, have some breakfast.”

  “No, I can grab a bagel at the train station.”

  After she’d left for the day, as planned the night before, he began to call his friends, just to say goodbye. He spoke with Tan Mai and Cindy Wong, telling them that his days might be numbered, and he thanked them for their friendship and the help they had given him. Cindy broke into tears and wailed, “My dad died of pancreatic cancer. It’s so awful, Tian! You’re a good man but have such terrible luck. I will pray for you. But don’t give up so easily and a miracle might happen.” Unlike Cindy, Mai took the news calmly. She urged him not to surrender to the disease without a fight. Her aunt had had lung cancer for almost a decade but was still living now. She’d been treated at a hospital in Houston. “In fact, a good number of her fellow cancer patients are still alive and active,” Mai told him. Her words made him rethink his situation.

  Then he called Yabin, to whom he had more to say. He’d like to have him as the executor of his will, and he had to get his affairs in order quickly.

  “Of course, Tian, I’ll do everything you want me to,” Yabin assured him. “But I don’t agree about the conservative treatment. Chinese medicine just makes you feel better and can’t cure the disease. Boston has the best hospitals in the world. Why not take advantage of the medical services there?”

  “My cancer is almost stage four,” he said.

  “That shouldn’t be your reason for giving up. Some Chinese cancer patients have flown to Boston for treatment and their conditions have been either cured or improved considerably. Without exception, they all said the trip was worth it and their money well spent. Imagine, they would pay out of their own pockets to get treated in Boston.”

  “They must be very rich,” Tian said.

  “They’re well off, I’d say, but not super-rich. Many Chinese can afford such expenses nowadays.”

  “Do you know at which hospital they’ve been treated here?”

  “Mass General, Dana-Farber, Brigham and Women’s Hospital—just a minute, I remember someone who used to work at Mass General. I’m going to contact him and also see if we can find some connections. It shouldn’t be difficult. You have health insurance, don’t you?”

  “I just got it, but I’m not sure if they will accept it. I’m covered by the Massachusetts universal care.”

  “By law they have to admit you first before they check if you’re covered or not, especially in Massachusetts. Let me call around—I’ll get back to you very soon.”

  Tian was moved by Yabin’s readiness to help. He was unfailingly resourceful and seemed to have infinite connections. True, he had shortcomings, but he was like his guardian angel—whenever Tian ran into a quagmire or dead end, he would stretch out his hand to pull him out.

  * * *

  —

  Funi had also begun to cough. She didn’t need to hold a foam cup like Tian, but still from time to time a flush would rise to her face. He urged her to have a checkup right away. To his surprise, she said with a grin, “I don’t care. If I have lung cancer too, let’s die together. I’ll be happy to die with you. We can take a bottle of sleeping pills together.”

  Astounded, he didn’t know what to say, though he was touched to the brink of tears. Again he urged her to go see her doctor.

  She went to a community clinic the next day. The results of the checkup were all normal, her lungs clear and her X-ray unremarkable. Her cough must be due to a nasty cold. When she told him the good news, somehow a peculiar sadness gripped his heart. This rush of emotion bewildered him, and it was something he had never experienced before. He realized he wished she’d had lung cancer so that she could have accompanied him all the way to the other world. Such a realization disturbed him. He wondered whether this was love, but couldn’t answer the question. He knew he was deeply attached to Funi. For having such a woman in his life, he felt grateful. By contrast, his ex-wife still hadn’t contacted him yet. He gathered that their relationship, the former passion and love, had evaporated altogether. “Oh love, everlasting love, / I shall follow you to the end of the world!” Those lines from a song echoed in his mind. He used to belt them out with so much gusto and conviction, but now they sounded silly and mawkish. So often love could be changed by circumstances.

  He congratulated Funi on the excellent results of her checkup. Then he went out to walk in Merrymount Park to batter down the confusing emotion that kept surging in him.

  * * *

  —

  Yabin called and told him to contact Dr. Rabb at Mass General without delay. Following the phone call, Yabin sent Tian his email exchanges with a friend of his, who was in a fishing group and told the other anglers about Tian’s case. One of them happened to be a doctor, who in turn reached out to the medical professionals in his network. He described Tian as a famous singer and begged someone to take a look at him and see if his cancer could be treated. That was how Dr. Rabb got involved. He replied that he’d be happy to see Tian and take charge of his treatment.

  Tian looked up Dr. Rabb and found he was also a professor at Harvard Medical School, an expert in thoracic cancer. He called his nurse Samantha on Friday morning and made an appointment for Monday afternoon. Meanwhile Samantha would have his file transferred from Quincy Medical Center to Mass General. Tian was impressed by the prompt response. Back in Beijing, he had known that even some high-ranking officials stood in the hallways of hospitals waiting to hand doctors envelopes stuffed with cash so that their family me
mbers could be seen. The officials themselves could receive special medical care in designated hospitals, but their families could not, so sometimes they had to resort to bribes. Funi said to Tian, “If you were in China, you’d have to spend tens of thousands of yuan, and even then you might not be able to have access to such an expert doctor.”

  Tingting accompanied him to Mass General on Monday afternoon. They were led into an exam room, which was almost identical to those in the Quincy hospital. A nurse with a triangular face came in to check his vitals. Except for a low oxygen level, his signs were normal. A few minutes after she left, Dr. Rabb and Samantha stepped in, both wearing white coats that already showed the wear of the day. Rabb was tall and bone-thin, with deep-set eyes and an urbane air. His handshake was rather limp in spite of his large physique. He sat down on a chair and crossed one leg over the other. Samantha stood with her back against the wall, holding a clipboard and a pen. Dr. Rabb said to Tian with a smile, “I reviewed your file and can see how serious your case is. But don’t be scared. I will be seeing you for some years to come. This is our beginning.”

  Those words put Tian at ease instantly. He realized he might still have some years to live, not just “six or seven weeks,” as Dr. Hartley had said. His eyes suddenly went hot and misted over. He turned his face aside for a moment, then said, “Thank you, Dr. Rabb! What you said means a lot to me.”

  After listening to his back and chest and palpating his abdomen, the doctor told him, “We are going to do a biopsy to see what type of lung cancer you have, and you’ll also have a PET scan and an MRI that will show whether there is cancer elsewhere in your body or in your brain. Usually when lung cancer disseminates, it goes to the brain first. Samantha can help you set up appointments with the lab and the radiology department. You should have the biopsy and the scans as soon as possible.”

  “At this stage, how serious do you think my cancer is?” Tian asked, aware that his question might be pointless.

  “Basically there are two types of lung cancer, the large-cell cancer and the small-cell cancer. For large-cell lung cancer we can operate, and the recovery rate is much higher than the small-cell.”

  “Can you see what type I might have?”

  “You don’t smoke and have kept a healthy lifestyle. You might have large-cell lung cancer, but we can’t tell for sure until we have the results of the biopsy. Let’s not worry about that yet. We should go ahead and complete the biopsy and the scans first.”

  His meeting with Dr. Rabb made him feel much better. He was no longer hopeless or worried about his affairs. In the hospital he ran into two lung cancer patients, both Asian immigrants: One was a Vietnamese woman in her seventies who had been under Dr. Rabb’s care for thirteen years, and the other a middle-aged man from Shanghai who had been with Mr. Rabb for nearly fifteen years. They were both there accompanied by their family members for routine checkups. These encounters made a world of difference to Tian. He realized that if kept under control, lung cancer could become a chronic illness. Compared to them, he was younger and in better health and should be able to live for some years. He ought to take heart.

  45

  The biopsy was an easy procedure, though after the anesthetic wore off, the pain of the incision between his ribs set in. It made his coughing more painful. The PET scan wasn’t hard either, but the MRI turned out to be very difficult. He was supposed to lie on his back with his head inside the scanning tube, under the camera system, and remain motionless for ten minutes. Given his nonstop coughing, he didn’t see how he could do it.

  After he handed his wristwatch and pen to Tingting, he was led into the waiting area outside the MRI suite. While he was there, a wizened old nurse said to him, “You might not be able to do this. The way you cough and gag will make it hard for you to keep still and could disrupt the procedure.”

  “I’ll do my best,” he told her.

  “Good luck, then.”

  After he lay down on the bed, the MRI tech, a young, chubby woman with a squarish face, made sure that his head was resting in the groove at the end of the bed. She threw a blanket over him and placed a blue rubber ball on his chest. “Try not to move,” she said. “If you really can’t go on, squeeze the ball to let me know.”

  “If we stop, does that mean we’ll have to start over?”

  “Yep, and it’s best to get it done on the first try. I’m gonna make this shorter for you, only five minutes. Just do your best not to move.”

  He nodded and closed his eyes, trying to relax in spite of the whirring roar of the machine. Time and again his chest contracted and pushed him to the verge of coughing, but he clenched his jaws and suppressed the urge. The harder he attempted to remain still, the more excruciating the urge became. Soon his esophagus was filled with phlegm, which he had no choice but to swallow. Still, the pressure to cough grew stronger by the second. It made him dizzy and short of breath. His mind raced: “You have to do this, have to make it!” He knew there was no other way to find out whether his cancer had metastasized to his brain. Every cell in him seemed to be quivering as he marshaled every ounce of his energy to keep still. Mucus was seeping out of the corners of his mouth and leaking from his nostrils.

  Finally the machine stopped. “Bravo!” the technician cried.

  He struggled to sit up and motioned for his foam cup. The instant he had it he broke out coughing convulsively and spitting out mouthfuls of mucus. What a relief! She handed him a tissue and he wiped his face.

  The old nurse saw him step out of the MRI suite. She beamed with amazement and congratulated him; her round cheeks, which once must have been apple-shaped and -hued, were like a pair of dried potatoes.

  In the days that followed, his cough became more hacking. It continued so violently that another scan showed that two of his ribs had cracked. This made even his breathing painful. Then, during a new appointment, a nurse found that his lungs’ oxygen level was very low. This explained why he was coughing without cease—his lungs struggled hard, often in vain, to inhale oxygen, but his bigger tumor was squeezing his windpipe so much that not enough air could pass through. After getting him a small oxygen cylinder on wheels, Samantha told him that a company would deliver to him an oxygen machine that could help him breathe more efficiently. “Please wait at home for the delivery this evening,” she said.

  Around seven p.m., a yellow van pulled up in front of his building and two men hopped out. They brought in a bulky oxygen concentrator and a pair of steel cans, each about one and a half feet long, like a small drum. One of the men showed Funi how to operate the machine, how to connect the thin plastic line to the outlet and how to fill the can with oxygen so that it could be brought along when Tian went out. Within the apartment, he didn’t need to carry a can and could simply wear the nasal cannula in order to breathe with ease. His oxygen generator rumbled as it worked, so Funi put it in the bathroom and let the plastic line go under the doors into his room. At night, with the machine on, he could breathe properly, though it was still hard for him to fall asleep. Funi still slept on the sofa on the nights when Tingting couldn’t come. He urged Funi to sleep in her own bed so that she could get enough rest for work the next day, but she wouldn’t, saying the noise didn’t bother her and she must make sure he’d get help when he needed it. He could see that she was tired and thinner than she’d been before.

  * * *

  —

  Funi had the afternoon off and accompanied Tian to the hospital to meet with a surgeon, Dr. Moorcraft. Dr. Rabb was there too and told him that since he and Dr. Moorcraft wanted to begin treatment as soon as possible, they needed to make sure Tian understood what it would entail. The surgeon was an older man, in his early sixties, with a domed forehead and curled sideburns and sparkling eyes. Although the biopsy results hadn’t come in yet, Dr. Rabb thought Tian was likely to have large-cell lung cancer, for which surgery would be the most effective treatment. Dr. Moorcraft eve
n said that such procedures had cured many of his lung cancer patients. Tian was pleased to hear this, knowing that small-cell lung cancer would not be operated on in America. In China, hospitals cut lung cancer patients irrespective of whether their cancer was large-cell or small-cell. Doctors there took advantage of their patients’ desperate families, who were willing to spend their savings just to prolong their loved ones’ lives.

  The meeting was quite encouraging and even pleasant. Everything was moving rapidly, as though all the lights were turning green for him. He could see that they treated every patient the same way—all the medical personnel showed a deep respect for life. In spite of the uncertain outcome of his prospective treatment, Tian felt grateful and full of hope.

  Dr. Rabb called the next afternoon, speaking in a guarded voice. He said he had both good news and bad news for him. He told Tian, “The MRI and the PET scan show your cancer has not spread, and we haven’t found anything abnormal in your brain and other organs. But the biopsy results just came out and indicate you have small-cell lung cancer. This is something we didn’t expect.” He paused, as if to give him time to let the news sink in. Then he said, “I’m sorry about this.”

  “So there won’t be an operation anymore?” Tian asked.

  “No, but we should start treatment immediately. The sooner, the better.”

  Tian sensed some urgency in his voice and said, “I’m available anytime.”

  “In that case, I would recommend chemotherapy and radiation.”