The meditations of springtime making up the mid-section in this book were written four years ago, the year before I was diagnosed with ovarian cancer. I wrote them because friends had sometimes asked for my thoughts about issues of belief. They are a vision of sacramental faith in open-ended community. Its people are of all races, classes, cultures, and sexualities, living as part of an institution where they can play out conflicts and negotiations while yet finding bonds of kindness and communal meaning, even love, because the sacraments engage their many gifts of creativity.

The next year when I was in the hospital during a research stay in Germany–too sick to travel home for initial treatment–I often thought of these meditations. Would they be tossed out with old papers? I did make it home, after all, to continue with treatments. I also gained a new angel of vision on what I wanted to do, in however long a time I would live. With ovarian cancer, one hopes to see a moment five years out from the end of surgeries and treatments. I’m still in treatment.

Here the meditations are framed, before and after, with two stories that give them context. The first story introduces me, the mediator, by telling of my first year of cancer treatment, a year of doctors, friends, and family who took me in and took me up.

The other story is fictional but grounded, a tale of one day in the year 2100. It moves the vision of the meditations into a time when humankind has survived the famines, epidemics, and ecological degradation that demographers and futurologists predict, for the coming century.

October 31, 1999

1. In A German Hospital

December Reading

I went for time to a foreign land,
They fed and healed me and took my hand,
Doctors and scholars and flower bringers,
Green wood walkers and late night singers.

I hear thumps, rolling of wheels, staccato voices with the cheery upswing tones that Germans use when a bad situation must have the best face put on it–standard talk in the Intensive Care Unit. “Oh ja, Frau Hellsky, you will soon feel much better.” The nurses and technicians move as in a drill, fast but unalarmed, hooking up the new patient beside me to machines–a stroke victim it turns out. I’m hooked up to some half a dozen myself, one by suction cups on my chest, for heart rate I guess.

Traveling with my husband and teenaged youngest daughter, I’ve come to Germany this January week with the remnants it seemed of some odd secondary infection or immune reaction after a bad flu. I had low-grade fever, strange joint pains, severe muscle weakness, shortness of breath. (“You can make the trip,” the rheumatologist said, “Just take your prednisone steroid for a few weeks. Taper it down till the symptoms are gone.”)

Now it’s 3 a.m. on a Saturday in the town where we’ve come for six months of library research. As I’ll later learn, my temperature is about 41C. (almost 105 F.), my blood pressure 63 over something, my breath short, and fingers tingling. One machine takes my blood pressure every ten minutes, beeping loudly if the top number goes below 65–then someone hurries over and gives me a shot. I ask what I’m getting, but don’t understand the word for it. They’re treating me as a heart attack case. After a couple of hours they decide I’m stable and let me lie there propped, with aspirin and a bottle of mineral water, watching various accident and stroke victims get wheeled by, in the corridor. The roads are icy.

By Sunday at 8:30 a.m. things are blessedly slow. The townspeople are sleeping. The head doctor of I.C. comes and tells me I’ve been determined, from blood tests, to have a serious bacterial infection, and that Monday morning I’ll undergo procedures for heart wall testing. I’ll have an ultrasound scan, then swallow a plastic tube with a sensor, so my heart can be viewed in action from directly behind it.

“What!?” I say, “What!?” None of this relates in any way to my diagnosis in California, backed up there by numerous blood tests. At this point I look down the corridor, through the glass window that lets the nurses watch me. Something is happening, like a mild version of “the wave” at an Atlanta Braves baseball game: people are stepping to the side and slightly bowing a greeting. A presence is approaching—der Chef, the Boss.

Incredibly, on a Sunday morning in this teaching hospital, the Professor Doctor from a nearby medical university medical school, who directs this branch of the hospital, is making rounds. These Visite are highly organized. The doctor doesn’t go alone but with an entourage of nurse, technician, and possibly extra doctor in tow. They pull files from a cart as needed, and write down care directions as the doctor talks to each patient.

The great man comes to my turn, introduces himself very politely, and says he’s studied my file and determined what I need. He reiterates the planned testing. Somehow because of my steroid high, and sheer alarm, every bit of German I ever knew is in my head and working. I say that by no means will I consent to any such measures, contrary in every way to the medical advice I’ve left home with, unless I’m convinced of the reasons for them.

A kind of startle goes around the room, but the Professor Doctor smiles and calmly asks me to narrate my two month illness. I tell him of the flu, seeming recovery, migratory joint pains, fevers, muscle fatigue, the many blood tests ruling out numerous bacterial illnesses from lyme disease to Rocky Mountain fever, and my bad reaction to an antibiotic/ methoxysulfate combination drug I was given.

“Oh,” he says, “we don’t teach any use of that in our medical schools, I don’t know why they still do overseas.” He pats my arm sympathetically.

A sabbath calm has settled over the I.C. unit. Now the Chef regales us all—me, stroke patient, and entourage–with an eloquent, ten-minute disquisition, in clear lay-person’s German, on cardiovascular functioning, and blood test distinctions between bacterial and viral agents. What can I say?

The next morning, after sweating down three more fever spurts, I’m taken to the heart scan specialist. As she runs a sensor around my chest, a smoky image of my beating heart appears on her screen. She goes around it sector by sector, picking a slice, cutting it from the image, flipping it up sideways and enlarging it to show the heart wall tissues. If I had more fat and larger breasts, this wouldn’t work so well because she’d have fewer angles on the heart. As it is, she gets enough good images that I’m spared of the tube swallowing procedure that was to come next. Now I know, the only true way to be ‘well endowed’ is with small breasts! Lucky I could offer such abundant bare rib space for the sensor.

After several days in the hospital and many tests, showing no heart trouble after all and no infections, my symptoms are much better and I’m released, still on prednisone. Tentative diagnosis: rheumatic fever, now treated with antibiotics. My husband and I think over whether to give up the sabbatical and head home (tenants are in the two houses of our commuter life, in California and Washington–what to do about them?). Maybe the illness wasn’t so serious, after all. Actually I don’t believe the rheumatic fever idea. Probably the exhausting packing and traveling made the infection after the flu temporarily worse.

Early February

The less steroid I take, the more the symptoms return. Fevers, shifting pains in odd body parts, constant severe fatigue. Now the pains are in the right lower abdomen. I get checked by two surgeons worried about appendicitis, and finally the gynecologic surgeon at the hospital. He looks at my ovaries on his ultra-sound and schedules exploratory surgery immediately. This must be the infection, he thinks–aha! abcessed ovaries.

He goes over the consent form with me–risks of bleeding, death from anaesthesia, and oh, he might accidentally cut a tube from a kidney to my urinary tract–that happened to him once, he says, in his sonorous, kindly bass voice. “Aber ich könnte es wieder zusammennähen”–But I could sew it back together. It occurs to me that no doctor in the U.S. would say this. I sign the paper.

The day after surgery, still drugged, I come awake to find him standing with my husband and youngest daughter at the bed’s end. I look up from a circle of light to their craggy, partly lit faces. The pathology report came back faxed, he says. The ovaries were not abcessed–there’s no infection. They were cancerous. “Aber Sie haben Glück im Unglück gehabt”—but you’ve had good luck in bad luck, being so sick with this other thing. Because there was no tumor growth showing. The cancer’s been found early. It had come to the surface of the ovaries only at one point, on the right tube.

My mind balks totally. He’s made this up, I think. He’s lopped out my organs and there was no infection, and now he’s thought up this excuse. My husband’s and daughter’s faces are blank, mouths slightly open. They’re not succeeding any better at believing it. Em’s German is just up to slight conversation. But as I soon learn, she’s understood him perfectly.

My abdomen is bound in a corset. A catheter removes blood through my vagina, another one urine. Turns out the hysterectomy was excellently done; in a week my belly is well on the way to healed. But the nightly chills, high fevers, strange tingles, pains and bizarre blood protein readings continue. An internist takes over my case, a professor from the closest university medical school, who practices in this teaching hospital. They begin dozens and dozens of tests. Chemotherapy should start quickly, but it can’t be risked if I have Rocky Mountain fever, or malaria, etc. etc. The wipeout of white blood cells would leave me defenseless. Meanwhile I get pneumonia in the left lung, beside one of the usual pain spots in my torso. I remember the night before the surgery when I was bathed in cold cloths to bring the fever down, and the window was opened, letting in a rush of winter air onto my left side–just that spot.

Inside giant machines, having needles or tubes put in me, swallowing a liter of phosporescent dye in fifteen minutes, or having capillary blood drawn by mashing of my earlobes, I get a habit of praying the Memorare for relaxation. “Remember O most gracious virgin Mary, that never was it known that anyone who fled to your protection, implored your help, or sought your intercession was left unaided. Inspired by this confidence, I fly unto you, O virgin of virgins, my mother.” Every night I wake up shivering until, in forty minutes or so, the chills flip into sweats lasting a couple of hours.

In a mid-sized town in deepest protestant Saxony, with Martin Luther’s city down the road, there’s yet a popish church–two in fact, but only one priest. The overworked man comes to see me, a handsome blond fellow who seems younger than he is, as I soon notice. I tell him about my Marian prayers. He says, “Wer an die Mutter Gottes ruft hat eine mächtige Fürsprecherin!”–Whoever calls on the mother of God has a powerful advocate [female]! It’s said with bright eyes, with more conviction than anything I heard from him in his sweet, by-the-book homilies, the two times I got to church last month. Why does he cultivate that manner in liturgies? It’s not that he’s effeminate, which would be fine. It’s some good-little-boy persona—he needs it for protection from many things, I guess. Anyway he’s happy about the Memorare–prays it in Latin. The short-tempered doctor on call interrupts us for rounds, and the Pater leaves with both of us making a hasty sign of the cross. I’m glad he came.

Cards arrive from friends, why don’t I pack up and come home, call top doctors, organize treatment, get myself to a major clinic. I look at the oxygen tube to my nose, my I.V., my bony body, my nausea cup, my soy-based Astronautenkost. I should have gone home last month. Now there’s nothing for it but to trust these doctors. The cards and letters are a lifeline anyhow.

One evening I’m breathing badly. Our local good friend Fritzie appears with blue corn-flowers and candy-covered almonds. A doctor’s wife–teacher and affirmative action officer for the education ministry–she sees that I’m low and asks can she do anything. I’m thirsty but my hands are shaking. I ask her to feed me the cup of yoghurt on the nightstand. She hasn’t fed anyone since her kids were little. But she does it.

I start telling her what I’d wanted to tell my husband that day but didn’t because other visitors were here and it seemed too awkward. We’ve never planned for these things. If I don’t make it, I say, I want to be cremated and the ashes buried in Davis (where he teaches, and near where our grown daughters live). Fritzie starts to cry. Don’t, I say. You have to get this, then I’ll feel better. She pulls herself together. Yes. And the third thing is, I want Sister Mary Pat to give the homily at my funeral mass.

This is the co-director of the Newman Center in our California town, now being fired after several years of vibrant work and rapport with the community, for no reason but that she’s female. It’s even admitted to be so. The new bishop wants only a priest, only a man, to run Newman. The co-directorship structure is being abolished. But surely he wouldn’t nix a dying person’s request, I think. I picture Sister MP reading the gospel before her homily, as she used to. Right away I feel better. Fritzie promises she has the things in mind. I fall asleep.

Early March

Through nights of high fever and days of watching nurses at their routines, the high-dose prednisone steroid keeps me hyper-stimulated and awake, but I’m not well enough to read. My mind races. I search my memory for resources, and am glad for whatever I find–poems to say over mentally, scripture passages, prayers like the Hail, Holy Queen and the Anima Christi. . . . Good Jesus hear me, within your wounds hide me. Shakespeare sonnets, “A Dust of Snow” by Robert Frost. The vision from Isaiah 6: In the year that King Uzziah died I saw the Lord, sitting on a throne, high and lifted up, and his train filled the temple. I get to the part about the seraphim, each with six wings, two covering his face, two his feet and two in use for flying–which makes me chuckle. Then the part about the burning coal touching one’s lips. That’s a propos.

Often I think of the spiritual meditations I wrote last year. I had thought they could be published but see no chance of that now. I think of the sense of hope for a future that I found in the redness of an early sunset, in the first meditation. I picture the typescript back home in a green folder in the home file drawer where I stuck it, mixed in with old notes overdue to be tossed out, from projects long since published. Probably the kids will dump the whole business some time. What clutter I’ve left them.

Whenever I hit that image in my mental circles, it coheres with something else that keeps working me over. I don’t get the layout of this hospital. The nurses sometimes roust me up and walk me along corridors. But how the different wings are situated I can’t figure. Through the window I see that my room is at a corner where two wings converge. But I can’t picture how many wings there are, or how they go off from each other. I look out over new grass, past hedges and small trees with green leaves just budding. The spring is early this year. There’s a spot on a sidewalk where a white bus often goes by. If I could once get out, and stand with the people waiting, and look from there, I could grasp the layout.

Early one morning a male ring-necked pheasant outside makes his out-and-in breathy double honk of a mating call, just as they do on my hillside in eastern Washington in spring. I think I must have dreamed it, and shuffle to the window, rolling my i.v. mount. But no, there he is really, near the bus stop. It’s the only time I’ve ever heard a pheasant in Germany, though I’ve seen them a couple of times.

A post card of the Oregon Aquarium comes from a friend in Portland, showing lavender-lit, translucent jelly fish floating like half-bubbles, with lacy long white tentacles dangling. She says they remind her how fragile meaning and beauty are. I write her back on a card that if I get home, I’ll definitely go to see them with her. It’s a promise to hold on to.

A lay reader of the local parish, a retired math teacher Frau Schmidt, brings me communion on Sundays, not neglecting to tell me all about the theme of the week, and the special decoration made by the fifth graders, and what the homily said. She’s very warm and happy about her visitation work, though a little defensive–keen to say that she’s not one of these innovator women. She likes the church to be traditional–she adds in one of her prayers that women should be faithful to the church. I shut my eyes tight and pray it too. In a little different sense from hers.

The Protestant chaplain also stops by a couple of times and reads psalms with me, a great boon. He’s assigned to the closest red brick village church across the fields from here, with hospital chaplaincy as half his job. He did his doctoral dissertation on ‘the aggressiveness and fierceness of the Psalms.’ We trade favorite images from them.

On Friday evenings there’s a short prayer service down in a conference room–it alternates weeks, Protestant-Catholic. Patients well enough can go down in housecoats, others can tune it in on their bed-table radio if they like. One night the Pater has, at the last minute, asked Frau Schmidt to say it for him–he’s too impossibly busy. She stops by my room beforehand and tells me she’s nervous, has never done it before. My roommate and I tell her she’ll be great, and get her to explain what she’s planning. She goes down to the conference room. We turn on the radio channel. Flustered, she begins in a surprised voice, “Eine Frau spricht zu Ihnen!”–’A woman is speaking to you– [long pause] this is new!’ The roommate and I laugh and enjoy it.

Yes, now I have a roommate. The doctors are confident of their diagnosis of me as non-contagious, though they can’t get more specific than just “vasculitis,” a sort of umbrella term: swelling and constricting of blood vessels from an immune-system disorder of some kind—certain forms of it can be fatal. (Much later I’ll hear a speculated diagnosis of “tumor necrosis factor”–a protein produced by white blood cells, that normally tries to attack cancer at the tumor site by hindering its blood supply, but that perhaps travels through my circulatory system, causing indeed a very unusual form of vasculitis.)

My pneumonia has cleared. They put me on high prednisone for a week, and order the nurses to get as much food in me as possible, plus vibrating my back every day to clear the lungs. I’m to get strong for chemotherapy.

I start thinking of a poem. Especially when I have fever, the phrases and lines come to me. As I piece each section together mentally, I go over it a few times to fix it in memory. It’s about the biblical Job, spoken by his daughter Jemimah–one of the bevy of new kids he gets after his ‘fortunes’ are restored. Maybe soon I’ll feel like writing and get some of this down. Last week I worked up one in my mind about the gospel story of the ‘city woman.’

My roommate was depressed when we were first put together. She’s had her third heart attack and must move into a care facility. The first night she told me she’s picturing her grave all the time–the hole in the ground, the open coffin, the cement slab. Can’t get it out of her mind. This is strange talk. North Germans are usually very reserved and formal, even with friends long known, all the more with strangers. Maybe as a foreigner, speaking a little ungrammatically, I seem outside the social categories–kind of a freebee listener.

I think of her grave and my own wish to be cremated. But I pluck up rationality, and say that it might be good to think about dying and try to get ready, but I don’t see why we should think of the grave in particular, because once our body’s in there, we won’t know anything about it anyhow.
She asks how I think of death.

I say I think of the sense of God within me, that I have when I pray, and that either whatever there is of me will be united with that God, or else there’ll be just nothing. And either way, there’ll be no sorrow nor loss nor trouble any more, so I don’t think there’s anything to be afraid of. She turns off her light.

The next day she starts telling me about her life and her children, her tennis playing and her garden–a Tennistante she was, always hopping on her bike and heading for the courts when a little sun came through the clouds. Each dinner time we drag ourselves up, sit at the little table in our room with a vase of flowers, turn on the lamp, and make ourselves gemütlich (a word for, all at once, cozy, friendly, cheery, and well-arranged).

2. Writing and Surviving

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.


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.


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.

3. The Double Hit

Unbelievably, four weeks after my second surgery, there’s still no pathology report. Through October I call and call the surgeon’s office. This is American HMO bureaucracy. The Germans had it the next day. It took me longer to translate it than them to do it.

I am standing, nibbling bites of lunch, about to leave for campus.
The phone rings and the nurse starts talking in a roundabout way. “I finally called the chief pathologist and told him we simply had to have the report now, so he went in yesterday evening and did it. There were dozens of slides, almost all showing no cancer. But there was one place, in a tissue around the colon called the omentum, where there was a growth of live cells, about the size of your thumbnail. But, she hastens to add, “The omentum is gone now—it was part of what Dr. K. removed. It’s a fatty tissue that catches and holds things around the colon, so we hope that maybe, early on, it caught something floating, and so the cancer was only there. But we don’t know that. You need to get three opinions from medical oncologists on what to do next.”

She stops. I’m silent. “Is anyone with you?”

“No,” I say. “No one is here. Thanks. I have to go teach a class now.”

November – Driving To Seattle For Radiation: A Ballad Of The Cascades

Daughters, my undeserved bounty, each
Open-eyed with blessing,
Open-mouthed with questioning,
You swam slowly, one by one, into my body and mind.
Now on wet cliffs I see your faces
Swinging by.
Lovely ones, the first with an artist’s blue almond eyes set apart,
The next, with impish grin keen under gray-eyed thought,
The last with rose-shaped lips and bouncing hair,
All pouncing affection, irrefragable.
To the whine of snow tires.
You carry my mind in three-part song
Of rise and fall

Holy mountain
Sing to me
Sing a new song
Falling free as the pane of snow-melt
Down a sheen of gray rock in amber sun.

Dark fir needles
Sing to me
Of the woman
I yet may be, sing a new song while I twist
Among you, rocks and crags.

Wind in canyons
Sing to me
Of the death
I would fling free from my womb place,
Rivers, sing it out to biting air.

And dear ones sing that you’ll be mine
Even in other arms entwined,
Down beside where the waters flow,
Down by these banks in the day’s last glow.

December, Seattle

I’ve been here almost five weeks getting daily whole-abdomen radiation and, in the first and fifth weeks, taxol chemotherapy dripped in over four days. The first week they put me in the hospital to get the chemo. But for the fifth week I’m getting a pic-line put in my arm, and a pump to carry around. It’s taken all afternoon to get the pic-line in. My veins are too scarred from all the I.V.s and blood draws. Finally I had to go to radiology and have a surgeon put it into a deep vein. Now the bag and belly pack are on and pumping. Late in the evening I get back to my apartment, exhausted. I pull off my coat and sit down.

Blood is soaking the sleeve on my right arm. I manage to find the phone number of the Franciscan Nursing organization that’s going to come each day and change the bag. The nurse answering says get to the emergency room. My husband jogs back out, gets the car again from deep in the parking garage across the street, and drives me to the ER.

A medical student writes up my case. I’ll have to wait my turn for the doctor. The med student is told to put thumb and finger pressure on the wound and hold it ten minutes. The poor guy’s fingers turn bluish-white. When he lets go, the bleeding resumes. Finally the doctor comes, pulls out the sutures, resews them, and plugs the wound with a wondergel like playdough. The best guess is that some tape from around the dressing worked partially loose from my arm, stuck and tangled in my sleeve, and was tugging on the chemo line and the sutures. It wasn’t hurting enough for me to notice.

At midnight we get to bed. After five weeks of radiation, four more days of it to go, four days of chemo, five more self-injections of the new stuff to build white blood cells (which they call GCSF), a month of aftermath to survive, then, hopefully I can start eating again, and regaining strength. The doctors have no more plans for me but quarterly checkups. My outlook in general with stage-3 ovarian cancer would be a 15-20% chance of long-term survival (past a year or two). But with these six weeks of individually tailored treatments, they hope to have upped my chances by some large unknown amount. If my colon can recover and I haven’t lost too much bone marrow for normal blood cell production.

This time I’m not only bald but even my arm hair and pubic hair are gone. I feel like a little girl made of silky paper. My kids and one boyfriend fly or drive in, bringing presents, meeting at a motel in the strange city. In my one-room apartment, arranged for me by the med-center, we hang a gold bow ribbon around the floorlamp, and on its switch, a camel decoration from a package. My husband spreads his and the other the presents around it.

Local friends, who’ve helped me through these weeks with rides and groceries and reading the Book of Hours with me, have us all over to their house for turkey dinner by their tree, with red, green, and gold lights, stretching across a bay window and up to the ceiling. Ducked under my German wig that feels like a fur cap, I lie on their couch wrapped in an afghan, defocus my eyes into a blur of tree lights, and listen to their cd of Christmas chants–hodie Christus natus est. I feast on the lights and the conversation. It’s raining in Seattle, but there’s kindness around me.

New Year’s Eve

I’ve been taking anti-nausea and sleeping medicine most of three days, watching everyone pack my stuff, riding home from Seattle, and getting to bed. My sister is here to help again, making soup. I lie on one side. On the other. There is no way to lie. Whatever food I taste is somehow outrageous, barely to be swallowed. She plays the piano downstairs and I hold on to the sound. In a while she comes up and asks if I’d like her to read me something. I think of what I had wanted to work on with my German research partner (I never made it to meet with him)–methods of discourse analysis for studying John Lyly and Shakespeare. So I say ‘yes: Two Gentlemen of Verona.’

A music teacher, she reads it beautifully in her light southern accent, though she’s never seen it before. She says each character’s name again before saying the lines, and they start sounding like tones of different bells to me: Valentine, Proteus, Silvia. She goes through it in three sessions, with breaks to try to get me to drink broth. Not that I can concentrate. Nor sleep either. Later it seems to me that she skipped some parts, though she didn’t.

It’s probably Shakespeare’s first or second professional comedy he ever wrote. Two teenaged ‘gentlemen’ are bosom friends, then the one betrays their friendship for ‘love,’ trying to steal his friend’s ‘lady.’ After denouncing this treachery, the loyal friend then bizarrely seems to offer the other his girl, so as to show that friendship matters more than ‘love.’ The best part seems to be the lines of a scene between their two witty bumpkin servants, reading a catalogue of traits of a wench offered up on the marriage market: “Item, She hath more hair than wit, and more faults than hairs, and more wealth than faults.” That’s the line for me, I think, ‘more faults than hairs.’

But soon comes a better passage, that makes me hope to work again, if I can get past this taxol.

“Ay, much is the force of heaven-bred poesy . . . .
Write till your ink be dry, and with your tears
Moist it again, and frame some feeling line
That may discover . . . integrity:
For Orpheus’ lute was strung with poets’ sinews,
Whose golden touch could soften steel and stones,
Make tigers tame, and huge leviathans
Forsake unsounded deeps to dance on sands.”