In early March the nurses give me the first chemo treatment, an all-day session of chemicals slow-dripped into a vein–cyclophosphamide and carboplatin, with something to prevent urinary tract infection. The doctors at the national cancer diagnostic center in a nearby city have studied my file (that’s the system—they use pathology reports and elaborate verbal writeups done from doctors’ dictation after each appointment or rounds visit); they’ve chosen those drugs for me, even though taxol is the newer, usually preferred drug for ovarian cancer. Apparently they think that the cancer hasn’t yet spread, and the carboplatin will deal best with any microscopic remnants on organ surfaces. Cyclophosphamide is the other anti-cancer drug included. It’s also the indicated treatment for my severe immune disorder. Kill two birds with one stone, they think.
The next morning I can barely move. My stomach has emptied out to the last bile, despite the anti-nausea medication. Nothing will stay in my cramping throat. My sinuses ache and my eyes run. My husband sits with me and coaxes down my cortisone tablet with three swallows of Milchsuppe–warm sweet milk with a few bits of tapioca floating in it. Two days later I’m released. The poisons have hit my mind as hard as they did my body. I feel worthless altogether. I obsess day and night on failures and losses of the past, how I have been silenced at times, allowed no chance to talk over things that greatly affected me. I stare at darkness as my roommate stared at her grave. It will last a week. Every four weeks when I get the chemotherapy, this will happen.
Later I’ll learn to keep telling myself, “It’s just the goddamn chemicals, get through it!”–and ask someone to read me something light and entertaining, or sensational and absorbing. My husband and I have scarcely any such books along, on our supposed research trip. But late one night he will read me the biblical story of Gideon from the book of Judges, his many wives (at home and at their fathers’ houses), his battles, clan politicking, and vigilante revenges on the towns that sent no soldiers for his army. How he ordered his young son to perform one of the executions, and the kid couldn’t do it. Altogether a good read.
For now though, back in our apartment, the very day I’m finally home I learn that my husband’s right eye is bad. The stress of my stuff must have got to him. Not even supposed to be out of bed, I ride with him to an eye-clinic hospital in the nearest city and somehow drive the car home—our new Volvo picked up here, which I’ve never driven before. He’s having detached retina surgery–the rip was too bad for the lasar procedure to be used. We barely got him there in time before he would have suffered severe vision loss. He’ll be immobilized for nine days.
Em answers the phone in German and English, fixes me broth or jello (no mean feat with unflavored gelatin, fruit juice, and a guess at how much sugar). She goes to school when it’s time. Our friends Fritzie and Uli, and the librarians and readers where we had thought we’d be working, organize themselves. Someone brings groceries. Someone takes Em to eat. In three days someone drives me to Braunschweig to the eye hospital. My nightly fevers continue, though they’re less severe now—only up to 102o or so. Finally my husband is released. He can’t see much, but he can cook.
April
Each time I’ve regained just enough weight and got all my blood cell counts just to the minimum, I get the chemotherapy again. I’m told to keep reducing the prednisone and deal with the fevers some other way. I can’t have aspirin because of blood thinning. When a chill starts, I insert an anti-fever suppository—tylenol I guess–drink more of my endless peppermint tea, and bundle up in feather beds. The cyclophosphamide is supposed to suppress my immune disorder by the third dose. Sure enough, after the third chemo, the fever and other symptoms are distinctly better. Finally I manage to sit in the library an hour or two at a time, some days. I read in sixteenth-century books of wise sayings of the ancients–things like “To love and to be wise is granted scarcely even to God”–amare et sapere vix deo conceditur. I’m studying a seventeeth-century book on how men and women played parlor games with these sayings—applying them to pictures, translating them, or elaborating their meaning by inventing little poem-paraphrases.
My sister comes from Florida at Easter, cooks chicken soup and babies me, takes Em on a couple of day train trips. They come back with tales of shopping with Em as translator, getting lost in Halle, finding their way to Handel’s church and hearing a performance on his baroque organ. It’s fun to hear them at the kitchen table, Em telling her how to pronounce phrases from a touristy book—”Das Tischtuch ist schmutzig,” ‘The tablecloth is dirty.’ They both get the giggles over how useful this will be in a restaurant.
Days in bed, I type in a journal, begun my last week in the hospital when my husband brought me my laptop and I could finally sit up and type some things I’d been thinking. In the nights of fever, I saw that I’d been too complacent about what people do for me in my church. I began to wonder what church life will be like in the future. What of the good people excluded or marginalized now? What of the priests struggling to keep their commitments? Does my spirituality have to thrive on other people’s deprivation, when so many priests have no call to celibacy but keep sacrificing, living with depression, because they do have a genuine call to priesthood? I write half-sentence bits in a journal. Will the church ever manage to focus on the drastic issues we face as a species, rather than on enforcing private agonies? Maybe this journal can grow later if I get well. Thinking of the parlor games with wise sayings, I start imagining a game for a future form of T.V., with a moderator and contestants. I think of the year 2100, and things I’ve read about a probable leveling off of population by then, and the likely calamities before that point is reached.
Finally one Sunday I’m able to get up and dress. We go to the town’s main Protestant church, designed by a famous architect of the late sixteenth century, and now elegantly restored, including its organ. The gold leaf flowrets of the ceiling and the painted saints’ lives running up the spiral wooden stairway to the high pulpit delight one’s eyes, in the light from the high windows. The pastor preaches a potent sermon, partly keyed to the dressed up pubescent kids about to receive confirmation that day.
He tells how when he was a kid and the Confirmanten were separated into boys and girls groups, his buddies decided one day to play a trick on their old pastor, as they were waiting for him for confirmation class. The boys strewed messy food and sticky softdrink all around the table and floor of their meeting room, expecting he’d blow up at them. Instead, upon arriving he took a long, slow, sad look around, and said “Boys, I think really well of every one of you, and I know you don’t deserve to have to sit in a mess like this while we have class. Let’s move to the room next door. I’ll clean it up later.” Smitten with conscience, they never gave him any more trouble.
“Now,” said the preacher, “sometimes I think this is how God deals with us. Our lives are messy. Sometimes it’s partly our fault and sometimes it isn’t our fault at all. Why do people have to suffer so much?” He moved on to give more adult examples, then said, “Why can’t we explain the bad things that happen? Why do some people have to live without love?”
I don’t know, he said, I just know that God is like that good pastor I remember–he means well by us–“Er meint es gut mit uns.” Inside our faith, we get into a better room, where we can talk to each other from our best selves, with our dignity around us. He’s taken the cleanup of the mess on himself, and that’s what it means that he suffered for us. “Er meint es gut mit uns.”
As the sermon finishes, I’m thinking how well he worked up that colloquial phrase, also how very German this whole homily was—the distaste for mess, and the boys’ inclination, drilled in from toddlerdom, to submit to calm, kindly male authority. I bet the old man’s tactic, and this sermon based on it, wouldn’t have worked as well on American kids. But the pastor was preaching to Germans, and homilies have to work where they happen. I as cultural eavesdropper could still catch his kindliness, and the point about God. The Protestant seminary training here must be big on homiletics—you can often walk into a small town or back woods church, and hear a sermon that sounds ready for print, it’s so polished and in tune with its audience.
May
I’m in an outpatient bed at the hospital, getting the third chemo dripped in over eight hours. Between doses I get I.V.s of glucose or saline solution, then a drug to prevent urinary infection. I’m wondering about my odds for surviving, given my supposed diagnosis of stage 2A ovarian cancer. (Hindsight later would show it should’ve been 2B or C—the cancer had spread, though not visibly.) The doctors have given me a copy of the newest definitive article (in English) on long-term survival odds for ovarian cancer, after surgery and chemo, for patients diagnosed at stage 3, when treated with platinum-based compounds vs. with taxol. The same either way at three years out from chemo: some 80 to 85% are dead. But what that means for me I’m wondering. I ask the nurse if the doctor on call could talk to me about that.
A woman doctor comes, mid-30s or so. She sits with me almost an hour. She doesn’t think knowing the odds helps much. In her experience, the cancer patients who do best are the ones with the strongest will to live. “Wenn der Wille stark ist, dann wirkt der Körper zum heilen,” she says. If your will to live is strong, that helps the body to heal. It reminds me a little of the line in Beowulf, after the hero has swum from Sweden to Pomerania, fighting sea monsters all the way, and the narrator says “Fate often saves an undoomed man if his courage is good.” She’s giving me a bit of a pep talk, but a gentler one than that.
She asks how I think of getting back to my health and active life.
I don’t tell her about my moments of wanting to die. I say I’m a teacher and a researcher and have always enjoyed my work, though I wonder how I’ll feel, trying to get connected to it again.
We talk about being a teacher and being a doctor. I ask her if it’s hard, if you have to concentrate all on the science of it, and not let feelings for the patient get in the way–if you have to defend yourself from emotion. She says yes, that much of the time you do, namely all the while that you’re considering or carrying out treatments, or reviewing test results—things that require full intellectual concentration. And you know it’s best for the patient to shut out feelings and concentrate that way, so you get a habit of it. But then you try to make some time at other moments to know the patient and learn the subjective side of the illness.
I say that we teachers have things easier in one sense. Even if I do badly with certain students, they don’t die of it, they get to try their luck at learning another day, from some other teacher. But on the other hand we can almost never put aside feelings for students, we have to work inside and through our subjectivity. So when we fail or have no luck, the results are distressing there too. You put a lot of yourself into the effort.
She says yes, but when you suceed, you must feel the same elation we do when someone recovers, especially if their outlook was bad.
That’s right, I say, with the weaker or less bright students, when I see them take criticism well, not give up, and grow in their abilities, even if they don’t achieve anything terrific, it makes me even happier than when the sharpest ones do well.
She says it cheers her lots when she gets to see a former patient coming back for checkups, and just exchange a brief greeting.
It’s a Saturday, not much action for her on the ward, so we’ve had a chat.
About five days later I start some decent eating again. Though I’m still pretty weak, we make a little trip, the only one we’ll manage. For Pentecost, a big holiday weekend in Germany, we drive slowly north to the Baltic. Our friends there who are retired high-school teachers of sports and English take us sailing on a fjord, in bright sunshine and a stiff, class-4 breeze. We’re bundled in three layers of clothing, the outside one vinyl. As we set sail I wonder if I’ll be seasick, two weeks out from that latest chemo and still very anemic, but no, it’s like a dream of waking up. They even let me take the rudder of their forty-foot boat a while, pointing for the lighthouse on the opposite spit of land. The next day I nap off and on, exhausted. But it was worth it. They get Em into online skates and head out roller blading.
June — Frau Holz The Rider As Early Widow
My long companion pain,
My company before the dawn,
We take the night’s best air.
The cherries coming on
Beside the patio on scented branches
Etch against the east their mini-orbs.
My mentor unsolicited,
You come and make yourself
At home with me.
I’ve got away too long with
Not attending to your many friends
Around me and their hollow days,
Left you unaccounted for
While riding my high horse
Across your fields of darkened rye.
Now you make me stoop
And work your stretching rows of bitterroot,
Pulling out the weeds to ease its growth.
Farmer of the bottom lands
And busy with the flooded rice of anguish,
Still you sit with me each night.
I thank you for the company
But if you should decide to go
I would know how to treasure solitude.
I will not leave your bitter bread
Uneaten in my nights and rides,
However many more may be.
Early August
After a month in California–unpacking, repacking, getting chemotherapy twice more, losing fifteen pounds, regaining them, losing them again–it’s time to head north. I’ll get in my red Passat and drive. We’re going in two cars. My sixth chemo was delayed four days because my blood cell counts were too low. Now it’s done, and the five days of nausea and non-eating past. Just to head for the mountains seems wonderful. A cooler full of pop and juice will get me through it.
At noon on the first day we leave the freeway to start northeastward into scrub pines and sandstone hills. For the first time since this last chemo, I’m hungry. At the community college in this small town, we pull under a stand of tall dense fir trees. I push the seat back, open the windows, recline, and soak in the deep shade and dry air. My husband wants to jog on their track, and shower. He’s done it often. The custodian thinks he’s a faculty member. After a short rest I head down to the local cafe. Hearing country music playing, I slide into a booth and start searching the menu.
“Then only saaaay that you’ll be mine,
“In no other arms entwine,
“Down beside where the waters flow,
“Down by the banks of the Ohio.”
Burgers, tuna sandwiches, liver with bacon and onions, cream pies. I’m just standing up to leave when a waitress comes over. Not wanting to offend, I try to explain, telling her I had chemo a few days ago and would need something very low fat, but no salad or raw things.
‘Don’t you worry now,’ she says. ‘We’ll do you a char-grilled skinless chicken breast on a white roll, with no sauce or nothing.’ She brings me iced tea and lemon. I don’t chance the lemon, but put in sugar and it’s just right. Amazingly fast I get the sandwich, with thin-sliced tomato inside to moisten the bread and chicken. I take out the tomato but it’s done its good work. The waitress checks on me twice to ask if I need anything. The huge basket of fries I’ll take along for my husband. As I leave I tell her it was the best tasting sandwich I just about ever had.
We drive on into the high desert with lines of blue mountain peaks always on the left. In the shade of each rest stop, I rub my feet in the soft, thin-bladed grass around the sprinkler heads. I think of Walt Whitman, “I lift up the grass in handfuls–flag of disposition, of hopeful green stuff woven.”
September — Waiting For News Of Second Surgery
How to outlast the sun
Of this noon,
Mottled green through bouganvilla,
I cannot seem to find
Though the brooding air takes me for its own. I float on cricket hum
And racoon rustle
Beneath the ivy [no stanza]
Dense around the cork oak
With tendrils working up its trunk.
Mother death whose warm dark beams are This unaccountable sun,
Do you want me?
I seem just to have found
Your ebb and flow
And livelong pull
That draws my innards
In, back out, and in again.
I could let go and spread and be
No more,
Take in no saving poisons more
But sit against the oak, and rock to sleep.