by C. M. Newman
CHAPTER THIRTY-FOUR: BABIES
Monday, with Mitch back in Chicago, Angela at work, and Charlie at school, Vince waited in his oncologist’s waiting room for a midday appointment.
Church the day before had been nice. Mitch had even come along despite never really expressing interest in church even as a child. He might have only gone for Vince’s sake, but for now, Vince would happily take that. Angela’s history with religion still remained a mystery to him, but they hadn’t had any private time to discuss it recently. At least she’d joined him in a quick meeting with Pastor Fenwick after church, at which time the latter prayed for good news the next day at Vince’s appointment. Baby steps, he thought thankfully.
Vince had gone back and forth on whether he was optimistic about the scan results. He’d been delving into a lot of scripture lately, targeting passages his pastor had pointed out and devouring every Bible study he could. He’d sought out stories of miracles, hope, strength against the odds. Even before he’d gotten serious about scripture, he’d already powered through a few books on finding faith late in life and understanding God in light of terminal illness. So his mentor had sent him home with a list of what else to check out at the library. All of this gave him confidence that, if God so chose, remission was a possibility. Miracles did happen, but people were too blind to see them for what they were.
But just around the corner from faith and optimism came the reminder of where he was. An oncology ward at a hospital. Every year, billions upon billions of research dollars went into battling a disease that ruthlessly killed thousands. He’d read his fair share of miracle stories even outside the Bible by now, but every time he became more aware of the room in which he sat, of the sick and the sicker coming in and out, he wondered why in the world he should be the one to get a miracle today. Sure, to die like this would be cruel. He was leaving behind loved ones. But how was that any different for anyone else?
“Mr. Glasser, good to see you again,” Vince’s oncologist said neutrally when he entered an examination room an hour late and closed the door.
“Likewise,” Vince replied. “How did the scans turn out?” he asked, his cottony tongue scratching the roof of his mouth. He suddenly wished he’d given in to Angela’s insistence on accompanying him to the appointment. What if the tumors had shrunk? Substantially, even? What if he was about to find out he’d gone into remission? He wouldn’t have anyone with whom to shed some joyous tears when he heard the news.
“Well, I have good news and I have bad news. Let’s get the bad news out of the way first.” The oncologist gave Vince no room to object, talking while he gave Vince a brief physical. “All of your tumors have grown noticeably, but not quite as much as I had expected, which is part of the good news. The other good news is that the cancer hasn’t spread to any new organs, so you’re still eligible for the clinical trial.”
Vince nodded, processing the news of the tumors’ growth. No remission. Still death. No miracle, at least not the one anyone’s minds. All things considered, this was probably the best news he could have realistically expected. The four sterile white walls of the examination room began to darken and close in around him, but he shook his head rapidly and swallowed his aggravation for later. “Good. I’m still interested.”
“All right. I have the paperwork for you to sign. The study starts soon and it’ll be set up so that neither I nor your nurses at the chemo center will be able to link your name to which drug you’re taking, of course. You do understand that you won’t be able to find out which drug you’ve been on unless you withdraw from the study and go back to your current regimen or stop treatment altogether, correct?”
“Yes, I’m aware,” Vince said with a short nod.
“Now, how’s treatment going for your diabetes?”
“It’s going well,” Vince answered. “My glucose readings are stable and in the normal range as long as I’m good with my insulin. I’ve had a couple hiccups but nothing that’s alarmed me. Getting the hang of it.”
“Good. Are the other symptoms going away? Frequent urination, fatigue…?” the oncologist asked, looking through his notes.
“Everything seems to be back to normal—well, whatever normal was before diabetes hit. Saturday was my last day of chemo for the week and I’m feeling okay today.”
“Pain? Nausea? How are those?”
“Both manageable with medication right now.”
“Good. Question for you.”
“Uh, sure,” Vince said.
“The woman who was with you last week—is that a relative, a girlfriend…?”
“Ah, girlfriend. Sorry I didn’t introduce you.”
“No worries. You just need to be…careful,” the doctor said tentatively.
“What do you mean?”
The doctor clasped his hands between his knees, hunching forward and almost seeming to humble himself a bit. “Have you been sexually active?”
“Actually, no. Why?” Vince felt like an embarrassed teenager and scratched the back of his neck. From wild hopes of remission to blushing profusely at questions about my sex life. Fantastic progress, he thought.
“Well, if you do get to that point, know that there are birth defects linked to the drugs you’re on right now, and even if you end up on the experimental drug during the trial, that would only replace one drug, so the risks would still be there. And obviously, since this drug is new, we don’t know if it carries risks of its own. Simply put, chemo can damage the DNA in your sperm, since it targets rapidly dividing cells.”
“So…hypothetically speaking, conceiving a child isn’t in the cards for me?” Vince asked. Though he already had the nagging feeling that such a discussion with Angela, if they ever got to one, would end in the same result—no baby—he still felt as if his heart had been punctured right now, its beats growing sadder and more pronounced.
“It’s not conceiving that you want to worry about. Your sperm count and quality can go down, yes, but not everyone experiences that. But there is a higher likelihood of birth defects, like I said. I can’t stress that enough. I discourage all my patients from trying to conceive during chemotherapy.”
“Right. I understand.”
“If I’d known you were seeing someone before you started chemo, I would have suggested you bank your sperm, but that’s not really an option now. My apologies.”
“We weren’t together until after I started chemo, don’t worry,” Vince said, cracking his knuckles and sighing.
“Any questions?”
“Yes, actually. I’m not sure if this is really noteworthy yet, but I haven’t been quite as hungry lately, even when I’m not feeling nauseous. Only sometimes, though. Other times, I feel like my appetite is normal. I read that I should expect this with pancreatic cancer especially, correct?” Vince said.
“Anorexia is very common with pancreatic cancer, but you’re statistically more likely to suffer from it given the specific location of the tumor on your pancreas.”
“Anorexia?” Vince hadn’t read that word in his research.
“Loss of appetite. The eating disorder you’re thinking of is anorexia nervosa. Plain old anorexia just means you don’t have an appetite. Like I said, you are at risk for that. We’ll look at your appetite again at your next checkup and if it’s still declining, we’ll look at some appetite stimulants. For now, there are some easy things you can try. Eat when you are hungry instead of forcing a schedule. And I’ll give you a list of foods that irritate your stomach—stay away from those. We’ll also keep digestive aids in mind. You’re good for now, though.”
“Is there anything else I should expect as time goes on?”
“Diarrhea, more pain than you’ve described, especially in your lower back, and if the cancer happens to spread to the head of your pancreas, we could be looking at jaundice, dark urine, and pale stool. If you notice any of those, contact me right away,” the doctor said.
“Of course. How quickly should I expect to decline? How long will it be before I won’
t be able to take care of myself or my son?”
“That’s very hard to say. It all depends on what symptoms present themselves, when, how strongly, and so on. Keep checking in with me and we can discuss symptoms and treatment options as we move along. I wish I could tell you more specifically, but once cancer spreads to other organs, it becomes much more complicated. Everyone goes through it a little bit differently.”
“Right.” Although this appointment consisted of mostly bad news, Vince at least felt less of a need to go oncologist shopping. True, the man was still painfully forthright, but at least he was finally giving Vince the information he needed. Although it would be nice to have someone sugarcoat the information for him instead, he knew it wouldn’t be helpful in the long run.
“I actually do want to bring up one more thing before you go,” the oncologist said, “and that’s whether you’ve thought of what you want to do for end-of-life care yet. There will come a point when it will no longer make sense to continue with chemo and radiation, when it will be more comfortable for you to continue with strictly palliative treatment. You’ll have enough to deal with emotionally at that point, and hospice plans are something I recommend getting out of the way now. You could choose to go to a hospice facility or you could have in-home care. In the latter case, you’ll need to start thinking about who would be your caregiver and if that person would also have the ability to look after your son, because even before you’re bedridden or you go to a facility, you’ll need help keeping up with a small child.”
Vince bowed his head at the mention of his son. “I need to talk to some people before I decide on that.”
“Of course. It’s not a decision I want you to take lightly. You just need to start thinking about it. Any questions?”
Vince shrugged. “I guess not right now.” He stood and reached out his hand. “Thank you.”
“Of course. I have that paperwork for you to sign for that clinical trial. Don’t go just yet.”
—
Not that Vince minded one bit, but Charlie afforded him and Angela no opportunity for a conversation that evening after giving his dad no time to think the rest of the day, either. Excitement over planning for his half-birthday party kept his mouth running right up until bedtime, at which point he asked for and was given a dual tuck-in.
As much as Angela had enjoyed getting to know Mitch, it was nice to get comfortable in the apartment without worrying about invading his sleeping space. She could again hog the couch, sprawling out in front of the fireplace. Vince joined her in silence, pulling up her legs and lowering them across his lap. “So, how was your appointment? In more than one word.”
“It was…very informative. There, two words.”
“Okay, I’ve held it in all day long like you asked. I couldn’t risk breaking down at work and then I got here and we had to keep Charlie entertained, but now I need a straight answer,” Angela said. “Please,” she inserted right afterward.
“Sorry,” Vince mumbled. “I should’ve just had you come with me, but I realized that a little too late.”
“Vince—”
“The tumors grew,” he finally told her. “All of them. Not quite as fast as the doctor was expecting, though, so that’s good.”
“Oh.” Angela cleared her throat. “How did you…make it through the day with no one to talk to?” she asked, her voice breaking with the realization that their time for a miracle was running much shorter now.
“Picked up Charlie not long after my appointment. It’s hard not to be happy around him.”
Angela nodded and invited herself into Vince’s arms. “All that praying, and for what?”
Vince immediately went on the defensive for a God he sure hoped had at least considered all those prayers. “Angie, we have to be realistic. God can’t overturn everything just because someone asks.”
“You’ve never called me ‘Angie’ before,” Angela said softly, her face making an appearance from the scratchy wool of Vince’s sweater.
Vince just grinned before he steered them back on topic. “Listen, it wasn’t all bad news. Yeah, the tumors have grown, but the cancer hasn’t spread to any new organs. That’s great news. The results definitely could’ve been a lot worse.”
“I…I prayed in my car this morning,” Angela said with a loud sniffle. “Nothing long or complicated. I just wanted to establish or re-establish a connection, you know? But…”
“This wasn’t a failure, not at all. Yeah, I had my hopes up too, I went back and forth, but my cancer is responding to the chemo better than my doctor had thought. Just separate yourself from the word remission now and think of what good news this is. When the chemo works, it’s another day or week or even month I might have left. Just…think about it that way, please.”
“Vince, I just found out,” Angela said exasperatedly. “You’ve known all day. You’ve had time to process. How did you feel when your doctor told you the tumors had grown? Wait—you know what? This is ridiculous. I can’t bring you down like this. I’m sorry, I’ll shut up. Tell me the rest,” Angela said somewhat frantically. “Did you get any other news?”
“He asked about you,” Vince said warily. He’d hemmed and hawed all day on whether he would bring up the baby discussion. He’d ultimately decided that he needed to make sure Angela didn’t see it as an option. It would be far better to disappoint her now than to crush her later, if and when they got married, if and when she decided she wanted a child with him after all.
“Well?” Angela gathered all their hands in a knot atop her knees.
“Umm…When he found out you were my girlfriend, he brought up some…things that I think have been on both our minds.”
Angela shifted on the couch and took to playing with Vince’s fingertips and avoiding eye contact again. “Like what?”
“Having a baby,” Vince said calmly.
Angela’s eyes shot up. “Oh. What did he have to say?”
“He said that the chemo creates a high risk of birth defects.” Vince suddenly felt like his doctor. Cold, scientific, painfully unaware of the human condition.
“Oh.” Angela’s eyes still deftly avoided Vince’s as her hands went limp. Feeling awful for speaking so carelessly, Vince saved Angela’s hands from the fall into her lap.
On one end of this conversation was a man who wanted, if he were realistic about it, nothing more than for his loved ones to be happy once he left this world. He knew it was silly to think they would pick up and function normally right away, but eventually, he wanted merely to be a pleasant memory in their hearts.
Vince knew that the most he could do for his son right now was to be the father he’d never given himself the chance to be. All Charlie wanted aside from new toys was to spend time with his father and, to Vince’s delight, Angela.
But giving Angela his all—making this worthwhile for her—seemed like much more of a challenge, or at least less straightforward. He knew what she wanted—a child, a husband, a future. He would give her any of those in a heartbeat if it was within his power and she expressed those desires to him. But knowing that he couldn’t fully grant her any of these wishes left Vince feeling so powerless that his impotence was almost funny.
On the other side of the conversation was a woman who had found happiness with the man of her dreams all too late. A woman who had a rather short and simple list of hopes and dreams that the man’s disease made impossible to fulfill completely.
The best of her sleepless nights consisted of thinking about what the lack of a future would mean for their present relationship. The easy nights were spent wondering if this was the kind of marriage she wanted. She had thought at length about whether she wanted to be a widow, whether that was worth getting to be his wife for such a short time.
All the thinking about their relationship status was, sadly, a relief from thinking about what it would be like to see him waste away and how difficult it would be to say goodbye. That was how she spent her worst nights—the nights where, even
after a lovely time with Vince and Charlie, she would snap awake in her bed and lie there for hours on end, wondering if he would die in his apartment on some hot, muggy night with a couple of lonely crickets chirping outside the window.
Angela was going to these places now and wasn’t hiding it well. The thumb of a crumbling man touched her cheek and wiped a way a tear. In her scramble to organize her past thoughts into some sort of decision, she had actually forgotten she wasn’t alone.
“I’m so sorry. I don’t want to bring these things up because I know they’re painful—it hurts me too, trust me. But I didn’t think it would be fair to lead you on in any way. There’s never a good time to hear these things, but now is better than somewhere down the line. Right?”
Angela nodded in quick, tiny strokes. “Yeah…” She pulled her hands free and swung her legs off of Vince’s lap so she could sit forward, elbows on her knees. Vince’s hand smoothing along her back was the only thing keeping her world together, the only thing keeping her even remotely sane. “I’m not in my reproductive prime, anyway. That’s already a risk right there. And…” Her throat closed up and she paused to squeeze free as many tears as she could, wanting to get it over with. It was never pleasant to put off saying something until the right time, only to have that right time finally come along and rear its ugly head. “I love you, and I hope you never doubt that for a second, but…I don’t think a baby—a child—is something I would have wanted to take on without you anyway. Without you, it sounds too—and now I feel like a coward…” She rolled her eyes and leaned into Vince, willing him to wrap his arms around her tight shoulders.
“It sounds too what?”
“It sounds too…hard. Too scary. It sounds painful. Like it would be even harder for me to move on. And that kills me inside, because I know that on one hand I do want this. I want it so much. But not enough to be thoroughly disappointed in what you’re telling me. I guess what I’m trying to say is that it’s okay. It does hurt to hear that it’s not our choice, but it’s okay. Thank you for being honest with me.”
Vince’s now red, glistening eyes, sopping wet cheeks, and troubled sigh didn’t begin to do his emotions justice. Finally, after a day full of denial, he was yielding to the pain. “I love you. I’m so sorry.”
“I love you, too. Like crazy. And no apologies. Really. I want to hear about the rest of your appointment. Any other news?” Angela asked, rising abruptly from the couch and venturing into the kitchen, knowing full well that Vince was right behind her even if his feet didn’t make a sound. Her intention wasn’t to make him chase her around the apartment, to make him tell her everything would be okay. Her intention was to get by, to get past this obstacle until another one came along tomorrow. That was the standard operating procedure for almost every day.
“Vince? You there?” Angela asked, sounding rather aloof herself.
“Sorry. Uh…nothing we haven’t already read about. He actually repeated some advice you already gave me about keeping up my appetite. Just…lots of stuff we’ve already read about, except for the information about having a baby. Anyway, even if I’d already heard most of it, it was still unsettling to hear someone else say it.” Vince watched Angela rifle through the cabinet of coffee and filters. “Are you okay?”
“Do we have any tea?” she asked, her hands shaking as she looked through the same two shelves over and over.
“I think we’re out, sorry. I can run to the store.”
“No, no, I’m fine. Was your doctor any nicer this time around?” Angela asked, leaning against the counter and picking at a rough fingernail.
“Actually, a little, yeah. Maybe I was just an easier patient, gave him questions to answer…He’s still a little gruff, but that’s okay. I’m not looking for someone to hold my hand.” Vince placed a scratchy kiss on Angela’s cheek and left his lips right there. “I already have you.”
“Then use that to your advantage. Tell me what you’re thinking about. I want to know how you’re feeling.”
“I’m…frustrated,” Vince said. His lips had migrated to Angela’s exposed forehead while his hands reached out for hers. “The physical symptoms won’t kill me all on their own. It’s knowing the consequences this has for you guys, for you and Charlie and Jenna and Mitch and our friends. It would be nice if we could get more than a couple of days of peace. I think even this weekend was probably forced to be peaceful because Mitch was here. I’m just scared of us falling into this routine, where at the end of the day at least one of us has to cry it out. But you know what?” Vince said with a resigned shrug of his shoulders and a constricting throat. “That is what’s gonna happen. Soon enough, every day is going to be worse than the one before it. Charlie’s going to start asking more and more questions. And there won’t be easy answers like throwing him a half-birthday party because I won’t be around for the real thing. It was a good idea, by the way, so thank you, but…even that wasn’t good enough.”
And just like that, the dynamic shifted with their hands, their faces, their body language. Angela was the listener now and held Vince’s cheek against hers with one soothingly floating hand, while her other hand swept slow circles over his back. And now he fell almost slack against her.
“I just want a few days,” Vince moaned. “I know better than to get my hopes set on staying. But a few days would be nice. I’ll take the chemo, the radiation, the pills, the shots, all of it…but I just want a few days without the curve balls. I’m—so sick of it.”
“I know,” Angela whispered. “What else?”
“I hate that you feel like you have no options. I hate myself for letting you in. I can’t imagine doing this on my own now that you’re here, but…I hate what this does to you and your future. I feel like I’m robbing you of so many things—”
“You’re not,” Angela said with the calm firmness of the mother she knew she would never be. “First off, it’s not you that’s doing any of this. It’s the cancer. And you’re not robbing me of anything. Even if I’m terrified and I’m an emotional garbage can at the end of the day, I’ve never felt more fulfilled.”
“Really?” Vince asked in hushed disbelief. He locked eyes with Angela and for a moment he felt as if he could see directly into her soul. He wondered if she was experiencing the very same thing right now.
Angela swallowed. “Really.”
—
As he locked up behind Angela after an emotional evening, Vince was more than ready for bed. But once he took a growing collection of medication and settled in under the covers, the future weighed on his mind—specifically, his future. The end of his future here, anyway.
Where do I want to die?
Certainly not in a hospital. There was no point in that. But a hospice center, or at home? Why not home? If he died here, he would be this apartment’s last occupant before it went back up for rent to someone else. Charlie would live with Jenna, never having to come into this place again. If Vince did choose to pass away in the very spot in which he lay right now, then who would take care of him? Jenna could, he supposed. If she were his caregiver, though, it would make more logistical sense for her to do so in her own house. However, Vince would then be souring Charlie’s thoughts of what would eventually be his permanent home, having to walk by the spare bedroom every day and remember his father dying there slowly.
It didn’t make sense for Jenna to be his caregiver now, and perhaps it never had. Before he had gotten involved with Angela, Jenna had been the only option he could think of, so he hadn’t thought about it much, figuring he had no options and also figuring his death was far enough off in the distance that he need not worry himself about that aspect yet. It definitely wasn’t a pleasant thing to think about. The idea of someone who loved him cleaning up his messes, changing his sheets, keeping track of his medications, being there with him for his final moments, had made the prospect of dying even scarier.
He couldn’t do that to anyone. If he stayed in a hospice center, he didn’t need anyone he lo
ved to see him at his very worst, to do the dirty work while plastering on a smile. Nobody he loved should need to put life on hold to care for him twenty-four-seven. He could just as easily die under the watch of professionals. While this sounded like the best solution for everyone involved from his point of view, he knew he needed to take the desires of others into account. What would Angela say if he told her that he didn’t want her to help, that he wanted her to pretend life still held even a shred of normalcy, that he would prefer for her to go to work and pretend this wasn’t as bad as it really was, that he didn’t want her there?
For now, that seemed to be what worked. But he could tell already, after such a short time, that Angela truly resented having to leave him in the morning for the job she loved. Her work was her life and it always had been. But when he had let her in, something for which he still truly hated himself, had he not seen that her priorities had shifted? The Angela he had known before never would have entered into a relationship that would get so in the way of her work. He had to accept that this relationship was something different to her. And if he was right in accepting that—if indeed Angela didn’t want to go on living an empty shell of a life—then he would be a fool to think she would want to stay at work for all that long. The thing that scared him wasn’t that she would want to take time away—it was how much time. As much as Harry cared about her, as much as he cared about Vince and supported this relationship, he didn’t have the power to keep her job open indefinitely, to keep the normally five-person team staffed at three.
And then it clicked.
