NKRF
When I got the news, I was standing in the kitchen of the home I had hoped to live in forever.
I saw the house for the first time in the weak sun of a winter day, an old house in a neighborhood of old houses on Essex Street. I was infatuated when I stepped through the massive double front doors. I turned circles in a hallway laden with ornate woodwork that glowed like warm honey, taking careful note of the plaster ceiling medallion and the grand staircase. As I climbed the wide stairs, well worn in the center of each tread, I fell more deeply in love at each landing until I reached the third floor.
The condominium was carved from converted attic space, full of sharp angles and surprising corners. Crowning the top of such a tall house, the apartment felt untouchable, floating high above the street and far above the world. Rows of skylights and big windows made it shine with a soft light, as though it had just materialized out of some mist. There were cream-colored walls, gently scuffed floors, and transom windows above each door. Even without the trees in full leaf outside it felt private and joyful.
Despite my passion, I couldn't buy the first condo I looked at -- that's not how it's done. So I stomped through the snow from house to house with my broker, looking for something else. After a few weeks I asked to see the house on Essex Street again and brought my friend Sarah along for that all-important second opinion.
Sarah walked through the rooms in silence. I could feel the broker's tension as he fingered the pen in his breast pocket. He was brand new to the business and impatient for the initiation rite of his first sale. Sarah stopped in the kitchen, hooking open each cabinet door with one long finger to peer inside. She asked me to remind her again about the price. She pondered the dollar figure for a moment and then said, "I'd pay more for it -- and I'm cheap."
She was cheap in that odd way of people who have money. She also had superb taste. I had the broker write up the offer on the spot and I used his fancy pen to sign. Six weeks and a stack of paperwork later, it was my home.
Sarah and her family lived only two streets away, so my new home's location meant I could spend more time with them. I would linger daily at the big kitchen table they had shipped from Europe, drink coffee thick with cream, and get invited with an almost embarrassing frequency to stay for dinner.
Sarah's family ate fruit and cheese for dessert, and practiced German at the table. They took grocery shopping very seriously and traveled to a great many stores to find just the right ingredients. They served meats and cream and butter without apology, and somehow stayed whip thin. I thought they were exotic and elegant.
On a warm June evening, one of the rare nights that Sarah wasn't cooking, I treated her to dinner. Between the appetizer and main course, she winced and put her hand on her stomach. Over the next few weeks the pain would never fully subside.
Sarah's doctors speculated that an ulcer was at fault, but several weeks of treatment provided no relief. Sarah called me from the library where she had been researching what little information the doctors had given her. Her voice was high-pitched and sharp. "They won't tell me, but I know what they're testing for now."
It was an aggressive stomach cancer. Within days they performed surgery in Boston, removing her stomach, some intestines, and part of her esophagus. They were very sorry, they told her, but they couldn't get it all, and they didn't think chemotherapy or radiation would be helpful in her case. I visited her in the hospital and I didn't know what to say except, I'm sorry. Then I hugged her, which felt odd because Sarah was not someone who liked to be hugged.
The doctors sewed Sarah up and sent her home, like a book they had closed because they were no longer interested in the story. She searched for clinical trials but didn't qualify for any of them. She spent her days at home doggedly researching, trying to find a way not to die. Although she was an practical woman, she let well-meaning acquaintances drag her to homeopaths and faith healers.
Her family flew in from three states to camp out for the duration. Her husband, Steven, began to stay late at work every night. A hospice nurse named Patricia came every day and the family worshipped her like a visiting angel. A truck delivered "liquid yummies" for Sarah that she injested through a tube. Her mother, sisters, and brother now ruled her kitchen and gathered nightly for gloomy family dinners. One evening when I joined them, they spoke, in a "pass the butter" tone, about giving Sarah enough morphine to stop her heart.
As Sarah grew sicker, her siblings began to guard her with ferocity and I was rarely allowed past the front door. I would ring the bell and wait for the shuffle of footsteps. The door would crack open and I would always be told the same thing: "This isn't a good time."
I didn't try very hard to gain entry. Sarah wasn't someone's grandmother or a name in the newspaper; she was my first peer to lie dying. I was afraid of her, as though her death was something I could catch, and I didn't know what I would say or do if I did see her.
One day, Sarah's daughter Eliza delivered a brief handwritten note, asking me to visit. I imagined the effort it had taken for my friend to scratch out those sentences and felt ashamed, finally caught in the act of avoiding her.
I presented the note at Sarah's door like a passport at the border. In the living room, she was buried under blankets on the couch, the morphine choking her speech. I tried to remember our last real conversation. I had missed my chance; Sarah was already lost to me. She would never divulge her recipes for the soups we shared on Sunday evenings. She would never again lecture me affectionately about my poor taste in men. She would never grip my hand and extract a lifetime promise of a watchful eye on her daughter.
When I touched Sarah's hand, the skin felt tight and dry. She was rarely lucid from that day on, though she hung onto life until Eliza's eleventh birthday passed. She died just after Christmas.
Sarah was cremated and there was an elegant memorial service in a lovely old building that usually hosts weddings. Her friends, past and present, told funny or inspirational stories about her. I learned about another Sarah, another lifetime. I wept hysterically through the comic moments and the poignant ones. More than once, people turned to look at me as if I were not quite right.
I didn't share any stories, though I was bursting to tell all in this arena of intimate moments. Throughout our friendship Sarah had whispered secrets that I vowed to keep: the name of a man she loved more than her husband, and her life's regrets. She looked beautiful, confident, and vital on the cover of the memorial booklet, with smart eyes and glossy hair. Without a body to view, I felt like my friend had just disappeared.
In the late spring, Steven was still riding around with Sarah's ashes in the trunk of his car. "My wife's in the trunk" was the first thing he said when I picked up the phone, a sure-fire conversation starter.
I told him that when I catch sight of a long, lean, forty-something woman, for a moment there is something about the walk, the toss of the hair and the angles of the face that seem to add up to Sarah. My heart runs ahead of my brain and for a split second I always think it's her, and then she's gone all over again.
Eventually, Steven drove Sarah's remains north. There was a strong wind blowing when he and Eliza rowed out to the center of a lake to scatter the ashes. I pictured him in his thick glasses trying to remain calm for the beautiful, pale-faced child who held her mother in her lap while her dad clumsily rowed. What a mess, he said. The ashes blew back in his face and then fell to the bottom of the rowboat, mixing with some water there, making a gray paste that stuck to his shoes. They had better luck with their idea of planting a memorial rose bush in a park. A park ranger viewed them with some suspicion and queried them, but reluctantly let them proceed.
The nurse called me at home on a late summer day. "I'm sorry," she said, "but your biopsy came back and you have uterine cancer."
My friend John asked what it was like to get the news.
"Imagine," I said, "the most unbelievable thing someone has ever told you. And then make it even more unbelievable."
I still remember that frozen feeling of disbelief as the voice on the phone asked if I was going to be all right. Such a stupid question -- of course I wasn't going to be all right. The question should have been, just how not all right are you going to be? I rode waves of pure panic and riddled the nurse with sharp-edged questions that had no answers.
"Well," my gynecologist said, rolling his chair away from the desk, "if you're going to get cancer, this is the one to get."
He drew me a picture of my uterus and tubes and ovaries, a quick outline in pen on my medical records folder. He was not the only medical person who felt compelled to make a sketch, despite questionable artistic abilities. My primary care doctor shaded carefully in pencil and concentrated on drawing to scale. When I went for a second opinion to a big deal oncologist in Boston, he pulled out a book and showed me an illustration instead.
The oncologist, a brilliant surgeon by all accounts, had agreed to see me within days of my call about a second opinion and requested my pathology slides. Although my HMO's pathology office was just blocks from the hospital, when I phoned I was told: "We're sorry, we can't get the slides to him in time for your appointment."
"But you could walk very, very slowly," I replied, "and you could still get them there in time." They remained adamant that I should drive in, pick up the slides, and deliver them myself.
When I arrived at the pathology office, a woman at the front desk handed me a brown envelope with my name on it. It seemed like such a small package for an enemy like cancer.
"I suppose you're used to this," I said, "but this is my cancer."
I began to cry and could not stop. The woman put down her work and came out and hugged me. We sat in silence, holding hands until I calmed down. The woman's name was Emily and her husband had died of brain cancer. She gave me practical advice: bring a friend to each appointment, keep everything in one notebook, and make a list of anyone and everyone who can help in any way.
I left and took a slow walk to the oncologist's office, handing my slides to a young woman when I arrived. "It's my cancer," I said. "Can you look at it and tell me anything?"
The young woman was sorry, could not tell me anything about my cancer. She did tell me the surgeon was a brilliant man, and they had many patients that should be dead but were still living.
Each doctor I spoke to said that with luck I could probably be cured surgically. I might not even need chemo or radiation. They were clearly vying to be the one to cut into my body. I ended the competition by choosing the brilliant surgeon from the big name teaching hospital in Boston, but struggled for my HMO's approval. So sorry, they said, he's not a "preferred provider," which meant that he carried a price tag they did not prefer. They suggested that my HMO gynecologist perform the surgery, something he did once or twice a year. I reminded my HMO that they had ignored my symptoms for years, telling me that I was "just getting older," and that I had a paper trail. They approved my choice quickly after that.
I visited the surgeon's office several times and the waiting room was always full. Some women wore scarves over their hairless heads. Some held hands with men; some were with other women. They all had reproductive cancers, and I wondered which women were dying and which ones would survive. I wished I could tell just by looking at them; I thought there might be some clue.
The brilliant surgeon told me the uterus is only the size of a pear. That seemed so small for an organ that grows and stretches to nurture a child, but large enough for something trying to kill me. I joked that my uterus was out to get me for some unknown reason. The brilliant surgeon stared at me and never blinked, had no detectable sense of humor.
He told me chances for a surgical cure were good. There would likely be no need for chemo or radiation, no hair falling out, no radioactive, glow-in-the-dark humor, no throwing up my guts and looking pale and thin. "Cancer Lite" is how I started to think of my disease and it somehow made me feel guilty.
He told me that cases in my age group were rare and made it sound like some sort of perverse achievement. When I asked him what would happen to the empty space inside me once my uterus was gone, he said my intestines would settle into the space. I envisioned my intestines celebrating, like they had moved into a bigger apartment.
In the week before surgery, I floated through an odd, alternative world. When I bought groceries I told the cashier about my cancer. The cashier's mother had died of cancer. When I wandered through a department store, looking at nothing in particular, I told a sales clerk I had cancer.
"You'll be all right," the clerk told me.
When I said I had been given my diagnosis over the phone, I was pleased at the clerk's surprise and quick anger: "That's just not right."
I continued to tell strangers about my condition and fed myself to bursting on their emotions.
In pre-surgery processing, general anesthesia sounded like purgatory, so I pleaded for an alternative. The anesthesiologist reluctantly agreed to a "regional," the spinal-epidural.
I was strangely calm when I was called from the waiting room to surgery. I entered a large area and sat on the edge of a bed, lined up in a row of other patients separated by curtains. Dressed identically in caps and loose gowns, we all looked as though we were waiting for a graduation ceremony.
A nurse hooked up an IV and wheeled me away. "Your surgeon is very good and very fast," she said. "Fast" was emphasized so it was clearly important; I nodded my understanding.
Our destination was an icy-cold room where three women waited. I sat on a silver metal table with my legs dangling. One of them handed me a pill. "Here's something to relax you." Then I curled into a tight ball as another woman slid a needle into my back; I didn't last long after that.
I woke up in recovery with a sore throat, which I knew meant a tube had been inserted -- and that meant general anesthesia. I had a fuzzy recollection, like a dream that fades quickly in the morning, of shouting. The recovery room nurse hovered over me and told me my anesthesia had failed in the middle of surgery. I had sat bolt upright on the table screaming, which did not please the brilliant surgeon.
"They put you down with general after that," the nurse said. She gave me a shot of Demerol in my butt, put ice chips in my mouth, and left me there to drift in and out of dreamless sleep until I was wheeled to my room.
When my niece had her first baby delivered by Cesarean section, her young husband said all he could focus on was the sight of his wife's intestines piled in a heap on a gray table next to her. It was the most disgusting thing he had ever seen. I thought about this as people shuffled in and out of my room, hooking up this or that. I asked the nurse on duty about it. Most likely, the nurse said, my intestines were sitting on my belly while the surgeon worked. Along with speed, she added, this surgeon also had great skill at laying intestines back in place.
"It makes all the difference in recovery time and comfort," the nurse said.
I had this quick, awful image of the surgeon rearranging my insides like a demented art project. I pictured him smiling.
Physically, I recovered quite nicely. I took slow, wobbly walks until my strength returned, and the brilliant surgeon considers me a success story. I left my HMO; I considered them traitors who betrayed me to the enemy. I live in another old house now. It's beautiful, but has no attic space for me high in the treetops. Despite sturdy doors and an alarm system, I am uncomfortable being so close to the ground.
Sarah's family scattered back to their home states a long time ago. Steven sold the house to a young couple that didn't seem to mind that someone had died there. He endured a string of confused and fumbled dating disasters before he remarried. His new wife looks pained each time he refers to Sarah in conversation. Eliza is silent and guarded. Unreachable really. She wears her mother's old clothing and keeps Sarah's driver's license and library card in her wallet.
I talk about my cancer to strangers who sometimes ask if everything is all right. I know I am exposing an ugly wound, but I also know most people can't resist a peek. It's the car wreck you pass, so horrible and disturbing, but you stare; the images can stay with you for weeks. I need the honesty of strangers to answer my unspoken questions: Is this event who I am now? Is this the way I will forever be defined?
Occasionally, people look away or quickly change the subject. I enjoy their awkwardness. Sometimes they share their own stories of illness. I listen intently to sad accounts of unexpected horrors and unanticipated tragedies. I never know what their stories will be; there are no clues. They look like anyone else. The last question is often "how long has it been?" Everyone respects the powerful magic of the 5-year survival milestone, absorbing its sorcery with special hope.
I have pored over texts and articles trying to figure out why I was stricken. I told myself, and anyone who would listen, that it made no sense because I had No Known Risk Factors -- NKRF. I dwelled on those letters for a long time. They were my mantra and should have been my protection. One day a woman in my online support group gave a cyber snort of disbelief to those of us who still clung to that thought.
"No known risk factors! Do you know how many people are dead who had no known risk factors?" She told us about her own family, full of people who did everything they were supposed to do to ensure good health. They were all dead before age 60.
She reminded me that there are other letters to consider. Someone scribbled them, NED, at my last checkup. No Evidence of Disease. Perhaps God is named Ned.
Bio Note
Lois Taylor's stories and poems have appeared or are forthcoming in THE NATION, THE YALE REVIEW, CANADIAN FORUM, PRISM INTERNATIONAL, MID-AMERICAN REVIEW, GLIMMER TRAIN, STORYQUARTERY, COLORADO REVIEW, and many others. She is currently working on short stories and something a little longer. A novel? She wonders.
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Susan
Major
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