“I’m fine, fine. Just a little apprehensive.”
“You should tell the doctor.”
“He already told me to expect this first day to be frightening.”
“I still think-”
“Mark, please! I know you mean well, but I just want to get this over with. Besides, they have a nurse practitioner in there or nearby while the drugs are going in. There’s absolutely nothing to worry about.”
Her husband, generally not at all demonstrative about his feelings, merely nodded that he understood and, after an appropriate pause, looked at his watch.
“You go ahead to work,” Grace said. “Phyllis will be here later on to take me home and fix dinner. I’m fine, honey, really. Don’t worry. Here, gimme a kiss for luck. Not one of those pecks on the lips; I want the wet, juicy kind you’re so good at. Mmmmm. Now, be gone. The students need you. I’ll call you when I get home.”
Grace watched as her husband hesitated at the doorway, then left for his office. Of all the unmerited gifts made possible by her sobriety, he was by far the greatest. She returned the clipboard to the receptionist. The worst thing about all this, she was thinking, was that she wasn’t the least bit sick when this whole nightmare started. Logically, she was grateful for the early detection of her cancer and the fact that the tumor was small and there was no evidence for spread. But emotionally, all she could think about was that she was feeling fine when she was called into the radiologist’s office for the bad news. No symptoms whatsover. How could anyone improve upon no symptoms?
“I know you’re feeling fine,” the radiologist, Dr. Newcomber, had said, “but trust me and this X-ray here, you’re not.”
Grace scanned the waiting area. Who are all these people? she wondered. What’re their stories? How had they reacted the first time they heard the word cancer applied to them?
“Grace Davis.”
The sound of her name startled her. It was Judi, the nurse she had met during her orientation to chemotherapy. They had sat together in a small, windowless room while the woman outlined all of the effects and side effects of treatment. It had not been a heartening conversation. She had started with hair loss, the most dreaded and expected side effect of the drugs. There was no doubt, she said, that Grace would lose her hair. It would probably occur about two weeks after her first treatment. Most women got their hair cut very short before it happened, but, even so, she should be aware that the short hairs would be annoying when they fell out, getting in her mouth and nose.
It would have been okay if the nurse had stopped at hair loss. But there was a litany of side effects to review. Nausea was of course a major topic. Grace would be given an arsenal of drugs to help alleviate that symptom. Judi had patiently reviewed each pill and its potential side effect.
“Ativan works quite well for anxiety but will make you drowsy. Vicodin is good to take if you have pain, but it is addicting if you take it more often than prescribed, and it may make you constipated.”
It seemed like there was a potential side effect for every part of Grace’s body. Her fingernails might become discolored and break easily. Urinating could burn and bowel movements would be painful. Finally Grace just looked up from the myriad of papers Judi had given her.
“Tell me there is at least one upside, please; tell me that my skin will never look lovelier or it will make my eyes shine brightly.”
Judi responded with a weak, ironic smile. No, there was no upside. At best, Grace could anticipate four months of malaise and an assortment of disrupting discomforts.
“Oh I forgot,” Judi had added, “you’ll be extremely sun-sensitive for a while after your therapy.”
So much for the celebratory getaway with Mark to Aruba after all this was over. Maybe Greenland.
Finally, after Judi had pushed back in her chair, her arms folded, her expression indicating that the number of times she had done this might be getting to her, Grace had screwed up her courage to ask the big question.
“How will you and Dr. D’Antonio know that this is working?”
“What?” replied Judi, as if Grace had asked the single most stupid question in the world.
“The chemotherapy-how will you know that it works, that I am getting the expected result?”
“Well, there is no way of knowing. We can certainly tell that it hasn’t worked if you get a bone, liver, or brain metastasis. But we will never know with absolute certainly if it has worked. From a statistical standpoint, we draw the line at five years, but of course there are some patients who do get a recurrence after that.”
Great.
With memories of that first meeting with the nurse roiling in her brain, Grace followed her into the treatment area. The place abounded with plaques and posters with pithy life-affirming sayings. There were even stuffed dolls carrying placards that read things like: Live large, love hard, laugh often. On every surface there were pamphlets and brochures for a myriad of services. Advertisements for cute hats you could buy online, notices of support groups, including one that showed how to do makeup and scarf tying so you could look your loveliest during this difficult period of your life.
There were also notifications of various financial-aid plans for treatments for patients without insurance-low-interest loans for up to $200,000. Grace said a silent thank you to Steadfast Health or Excelsius Health or whoever they were today. She couldn’t imagine going through this hell and having to worry about how to pay for it. She had seen the statements of benefits for the tests and surgery to date, and they exceeded the value of their Saab. She was sure these next four months would approach the cost of their house.
In addition to the literature, there were huge baskets of hard candies in every room.
“You might want a couple of these,” Judi said. “The taste of chemo can be pretty awful.”
“I thought it was intravenous.”
“Oh it is, but your bloodstream carries the medicine throughout your body, including the nerves in your mouth and nose. You can taste it from the inside.”
They entered the expansive treatment room. Toward one end was a long, cherry-paneled nurses’ station. In front of it was a horseshoe of eight leatherette recliner chairs. Each had an IV pole and a side chair for a guest. There was a bank of TVs above the nurses’ station so that patients could try to divert themselves during treatment.
Grace gazed around the room. All but two of the recliners were occupied. In one lay a woman sound asleep under a blanket, the IV tube twisting to accommodate her position. Her bandanna had slipped off her head, revealing tufts of brown-gray hair scattered around an otherwise bald pate. Her pretty gold hoop earrings contrasted sharply with the grayish cast of her skin.
Feeling nauseous even before the treatment began, Grace followed Judi to her designated recliner. How hale and hearty she must look in comparison to the other women here. She still had her hair. Her skin, one of her best attributes, still had its unblemished glow.
By the next time I come, I’ll look like them, she thought.
She managed a sad smile at the sudden notion that the room looked like some kind of weird day spa in reverse-a place that took beautiful women and made them tired, bald hags.
“Spa Toxique,” she thought, and then realized she had said the words out loud.
“Don’t think of it that way,” Judi said, as if she had heard versions of the dark humor before. “Think of the medicine as Pac-Man hunting through your body, munching all the evil cells.”
Judi donned her latex gloves and asked Grace if she was ready. “First, I am going to insert this needle into the port Dr. Hollister implanted during surgery.”
The port was right below Grace’s right collarbone. She could feel it just under her skin.