Just as my mother had dreamed.
I went blank, my mind tuning out almost as soon as he began to speak, but I caught various bits and pieces.
Adenocarcinoma… more common in women than men… more likely to occur in younger people… non-small cell… slower growing than other types of lung cancer, but unfortunately, it’s advanced and the CT scan shows that it has metastasized to other parts of the body… both lungs, lymph nodes, bones and her brain… malignant pericardial effusion… stage IV… incurable.
Incurable…
My mom was the first to let out a cry; the plaintive wail of a mother who knows that her child is dying. Liz followed a moment later and my dad took her in his arms. He said nothing, but his lower lip trembled while he squeezed his eyes shut, as if trying to block out reality. Marge sat unmoving on the bed. Watching her, I felt as though I would topple over but somehow, I remained upright. Marge kept her gaze fixed on the doctor.
“How long do I have?” she asked, and for the first time that day, I heard fear in her voice.
“It’s impossible to say,” Dr. Patel answered. “Though it’s incurable, it’s treatable. Treatment has improved exponentially in the last ten years. It can not only prolong life, it can alleviate some of the symptoms.”
“How long?” Marge demanded. “With treatment?”
“If we had caught it earlier,” Dr. Patel hedged. “Before it had metastasized-”
“But we didn’t,” Marge said, cutting him off.
Dr. Patel stood a bit straighter. “Again, there’s no way to know exactly. You’re young and in good condition, both of which increase life expectancy.”
“I understand that it’s not a question that you want to answer. I also understand that every patient is different, which means you can’t really know for sure. What I want, though, is your best guess.” Marge’s voice made it clear she would not be deterred. “Do you think I have a year?”
The doctor didn’t answer, but his expression was pained.
“Six months?” Marge pressed, and again, the doctor didn’t answer.
“Three?”
“Right now,” Dr. Patel said, “I think it would be best if we start discussing treatment options. It’s critical that we get started right away.”
“I don’t want to discuss treatment,” Marge said. I could hear anger in her voice. “If you think I only have a few months, if you’re telling me it’s incurable, then what’s the point?”
Liz had collected herself enough to wipe her eyes. She moved toward the bed and took Marge’s hand. Lifting it to her mouth, she kissed it. “Baby?” she whispered. “I want to hear what the doctor says about treatment options, okay? I know you’re afraid, but I need to know. Can you listen? For me?”
For the first time, Marge turned from the doctor. The trail of her tear had left a streak on her cheek that the light caught, making it shine.
“Okay,” Marge whispered, and only then, did Marge begin to cry.
Systemic chemotherapy.
Over the next forty minutes, the doctor patiently explained to us his reasoning for the course of treatment he was recommending. Because the cancer was so advanced, because it had spread throughout Marge’s body and reached her brain, there were no real surgical options. Radiation was a possibility, but again, because of the spread, the benefits weren’t worth the costs. Usually, patients were given more time to consider all the pros and cons of chemotherapy-including side effects, and he went over those in detail-but again, because the cancer was so advanced, the doctor strongly recommended that Marge start immediately.
To do that, Marge would need a catheter. When that part was underway, my parents and I left the room to go to the cafeteria. We didn’t speak; instead, we sat in silence, each of us simply trying to process what was happening. I ordered coffee that I didn’t drink, thinking that chemotherapy is essentially poison, and the hope is that the cancer cells are killed before normal cells. Too much poison and the patient dies; too little poison, and the medicine does no good at all.
My sister had already known all this. My parents and I had known all this as well. We had grown up knowing about the cancer. All of us knew about stages and survival rates and possible remission and catheters and side effects.
The cancer, after all, spread not only through human bodies. Sometimes it spread through families, like mine.
Later, I returned to the room, and I took a seat in the chair, watching as the poison began to be administered, killing as it flowed through her system.
I left the hospital when the sky had turned black, and I walked my parents to their car. To me, it seemed like they were shuffling rather than walking, and for the first time, they seemed old. Beaten down and utterly wrung out. I knew because I was feeling the same way.
Liz had asked us if she could be alone with Marge. As soon as she asked, I felt guilty. Lost in my own feelings about Marge, it didn’t occur to me that the two of them needed time together, without an audience.
After watching my parents pull out of the parking lot, I walked slowly to my car. I knew I couldn’t stay at the hospital but I didn’t want to go home. I didn’t want to go anywhere. What I wanted was to be able to rewind, to return to yesterday. Twenty-four hours earlier, I had been having dinner with Emily and looking forward to an evening of laughter.
The stand-ups at the Comedy Zone were good, and although one of the routines had been a bit too profane for my taste, the second comedian was both married and a father, and the humorous stories he related had the sweet ring of familiarity. At one point, I reached for Emily’s hand and when I felt her fingers intertwine with my own, I felt as though I’d come home. This, I remember thinking, is what life is really about. Love and laughter and friendship; happy times spent with those you care about.
As I drove home, yesterday seemed impossibly distant, a different lifetime altogether. The axis of my world had shifted, and like my parents, I’d aged in the last few hours. I’d been hollowed out. And as I squinted through eyes that had gone blurry with tears, I wondered if I would ever feel whole again.
Emily texted to ask if I was still at the hospital, and when I replied that I’d gone home, she said that she was coming over.
She found me on the couch, in a house illuminated by a single lamp in the family room. I hadn’t risen when she’d knocked at the door and she’d let herself in.
“Hey there,” she said, her voice soft. She crossed the room and sat beside me.
“Hi,” I said. “Sorry I didn’t get the door.”
“It’s fine,” she said. “How’s Marge? How are you?”
I didn’t know how to answer and I pinched the bridge of my nose. I didn’t want to cry anymore.
She slipped her arm around me and I leaned into her. Just like earlier that day, she held me close, and we didn’t have to talk at all.
Marge was released from the hospital on Sunday. Though she was weak and nauseated, she wanted to go home and there was no reason to stay at the hospital.
The first dose of poison, after all, had already been administered.