Marrow (17 page)

AS THE WEEKS TURN INTO
months, and the winter turns to spring, Maggie continues to experience big swings in her health. One week she feels strong and hopeful; then she spikes a fever, returns to the hospital, and goes back downhill. She comes home again, bolstered by steroids and antibiotics. She throws herself back into life, but then symptoms of graft-versus-host disease reappear. My cells are attacking her cells. This may be good if my cells are going after any remaining cancer cells. But this may not be good if my cells are attacking whatever they randomly determine to be “not me.”

I sit quietly and put my attention on my far-flung cells, miles away, in a different state, in Maggie's bloodstream. Once again, I try to contact them. I start by imagining the blood cells in my own body responding to my calm breathing and my healing thoughts. And then I picture my cells in Maggie's body; I send them comforting energy; I ask them to stop attacking Maggie haphazardly. I envision them as precise warriors who know a cancer cell from a healthy cell. I ask them to make wise decisions.

There are some healing techniques that may seem like woo-woo voodoo, but they have been scrutinized by science and found to be helpful. Research shows that certain meditative relaxation techniques can affect one's health at a cellular level. There have
been studies that prove the efficacy of “nonlocal healing”—the idea that one person, over here, can affect another person, over there, through prayer or visualization. But what about when that person over there actually has cells in her from the person over here? Would that increase the likelihood of nonlocal healing? I search for studies but find nothing.

There must be someone who knows about these things.

I e-mail one of Maggie's doctors—the one who told me way back before the harvest that my stem cells would keep Maggie alive for the rest of her life. I ask her to explain the science of engraftment, the mechanisms of graft-versus-host disease, and the role my cells are now playing in Maggie's body. How much control do I have over the destiny of Maggie-Liz? I ask the doctor. Does she believe the mind-body connection can affect my cells even though they are no longer in my body? I don't care if the doctor thinks I'm slightly mad; I've lost all shame when it comes to asking doctors questions.

The doctor kindly admits that her medical training prevents her from “magical thinking,” but she's intrigued by the notion of the donor's mental state having an effect on transplanted cells or organs. She suggests I submit a proposal to conduct a study at her hospital. I decline. It feels too clinical—a way to distance myself from the job at hand. But I do appreciate her explanation of the science of engraftment: “Maggie's stem cells that are responsible for making all of her blood cells are now yours,” the doctor e-mails. “And inside the nucleus of each of your cells there's an identical copy of your entire genome—a complete set of your DNA. A complete set of what makes you, you. So, yes, you could say that you, Liz, are now swimming around in Maggie. And therefore,
to the extent that you can willfully influence your own immune system, I suppose you could influence Maggie's, but this is way out of my wheelhouse!”

And so I ask someone else. Many years ago, I met a young cell biologist and medical doctor who had recently come from India to teach and practice medicine in Boston. He had just published a book about the mind-body connection. I invited him to speak at a conference I was organizing. This young doctor—Deepak Chopra—became a pioneer in the intersection of meditation and medicine, spirituality and science, and a frequent speaker at Omega. I figured he'd be as good as anyone to shed light on my cell obsession.

In my first e-mail to Deepak Chopra I ask him if he thinks my state of mind is affecting my sister, even though the transplant was months ago. “Is there something I should be doing?” I ask. “Is it like when I was pregnant and eating for two? Am I now behaving for two? Or should I not even think of the transplanted cells as mine? Are they now her cells? Or are they just energy in the form of cells, and therefore they belong to neither of us?” I type out these questions and e-mail them to Dr. Chopra, hoping he will respond with a laundry list of proven healing methods.

Instead, he tells me I have done all I can. “You have given your sister your stem cells,” he writes, “with a clear intention and with all your heart. Now it is time to release control of the outcome.” It isn't up to me anymore, he writes. I will have to trust that something else is in charge now. He quotes Sir Arthur Eddington, the renowned British physicist, who said, “Something unknown is doing we don't know what.” Handing over the reins to that unknown something is the best thing I can do, Deepak Chopra writes.

This is an inspiring yet unsatisfactory answer. I write back, and
use language from Dr. Chopra's own books about the properties of cells and the double-blind studies done on prayer and healing. Isn't there some research that applies to our situation? The more I push for a definitive answer, the less clinical he becomes. After several more volleys of e-mails, his final answer is: “Just think of it all as God. Your cells, her cells, you, your sister—everything—as God. No separateness. And then surrender to the unknown.”

This was not what I had in mind. So I contact a well-known science writer who has authored books on the subject. Her answer is so similar to Dr. Chopra's that I wonder if the entire mind-body community has received a memo warning them about the crazy lady who donated her stem cells to her sister. I go as far as asking a psychic who speaks to dead people who tells me that my parents are trying to get my attention but I keep ignoring them. “They want you to know,” the psychic says, “that they will take over now. They are proud of what you did, but they've got it covered.” Everyone—doctors, researchers, spiritual teachers, even my dead parents—seems to be saying the same thing: “You've done all you can. Now just let go.”

And so I try. I try to let go. I allow myself to feel helpless, powerless, useless. These are uncomfortable feelings for me, but I'd rather be uncomfortable than crazed. I listen to the advice of Deepak Chopra, reminding me that I am not the one in charge here; that there are forces far greater than my own little ego; that the destiny of my sister's life, of my life, of all life is out of my control. And that on some level, everything is OK, just as it is, and my work now is to know that, to trust that, to be at peace with whatever comes next. Yet every time I release my vigilant need to
do
something, I hear Maggie saying, “You have to stay connected to those cells, Liz. I need you to.” And I'm right back where I started.

One early spring morning, Maggie sends me an e-mail after an emergency visit to the hospital:

whoaaaaaa. our cells are in battle. i have gone from 95% engrafted to 75%. diarrhea. nausea. they put me on steroids. saw both my kids on the way home and that helped tremendously. then grabbed my garden clippers and just walked about hacking away at things. i think it's time to see the therapist again. i think it's time for me to take over. i think those cells need me to lead the way now. love you m

A wave of relief rushes over me. I can almost feel a weight lift from my shoulders as I think of releasing the impossible, erroneous task of saving my sister's life. That line Deepak Chopra quoted, the one from Sir Arthur Eddington, comes back to me: “Something unknown is doing we don't know what.” At this point, something unknown sounds far better equipped to handle the situation than I am.

I call the therapist and we pick a date to see him again. He wants to know what we have in mind this time. I tell him my intention is to hand off the transplanted cells to Maggie and, even more than that, to “something unknown [that] is doing we don't know what.”

“Good idea,” he says.

“And Maggie's intention is to take her health, her life, whatever comes next, back from me or from the doctors. To gather her courage and follow her own instincts.”

“An even better idea,” the therapist says.

MAGGIE AND I CLIMB THE
stairs to the therapist's office and arrive on the landing. The door opens right away, and the first thing the therapist says is “Do you realize that this day—May thirtieth—at this very hour—three p.m.—is exactly one year since we saw each other last? One year to the day, to the hour!”

We follow him into the room, say hello to the dog, take our perch on the couch, and jump into the session as if no time has passed at all. Except time has passed. Apparently one full year. You can read the passage of time in Maggie's postchemo hairdo. Instead of wearing a hat to cover her baldness, she now proudly displays bristly tufts sticking up all over her head, as if she had gone to a salon in a Dr. Seuss book. But for someone who has been through so many medical procedures and on so many drugs, her face looks the same. She still looks inexplicably, adorably, like a girl.

Once again, the therapist asks why we are here. Maggie gets right to it. “I don't really know why we're here,” she says. “At first I thought it was because our cells are battling it out in my body. Liz's cells are attacking me. And I'm rejecting her cells. And maybe by being here we could stop that cycle. But I don't think that's really why I'm here. I don't think that's the problem at all.”

“What's the problem, then?” the therapist asks Maggie.

Maggie exhales sharply with pursed lips. “I'm just so tired of riding the roller coaster,” she says. She coughs and sighs. “I wake
up every morning fighting pain and nausea, and thinking it's all hopeless, because the cancer's going to come back anyway, and I should just give up and let whatever happens happen. I go to the hospital for tests and they say everything is OK, but I don't believe them. And then sometimes I do believe them and I get optimistic, which fills me with fear. I have to fight that fear, that panic, all day long. Sometimes I feel so much love for everyone, and then sometimes I'm so angry because no one has the foggiest idea of what this is like for me. And it makes me want to curl up into a little ball and die. Because it's just all too much—how much I love everyone, everything, and how terrified I am, and how exhausted I am, not just by the physical symptoms, but also . . . I don't know. Sometimes death looks comforting. Like the only way out.”

“Out of what?” the therapist asks.

“Everything. People. Me. I just can't do things the way I used to. And I think it freaks people out.”

“How did you used to do things?” the therapist asks.

“However anyone wanted me to. I tried to know what they wanted even before they knew what they wanted.” She shakes her head. She has tears in her eyes. “I lived like that for most of my life.”

“What was that like for you?”

Maggie puts both of her hands on her belly. She looks straight at the therapist. “It made me sick,” she says. “It made me anxious, and then it made me sick.”

“And the only way out of that is to die?” the therapist asks.

“Yes. On some days, that's what I think. But I also know there's another way out. And I've been doing it a lot this year, I really have. And it's been amazing. But it's hard to teach an old dog new tricks. Apologies to you,” Maggie says, looking over at the therapist's dog. He wags his tail.

“Tell me about some of those new tricks,” the therapist says.

Maggie pauses. “It's embarrassing to admit it.”

“Admit what?”

“That it's taken me this long to learn the big trick.”

“That is . . .”

“Being who I am. Just being who I am. That's the big trick. I spent so many years trying to be someone else; trying to be what I thought I was supposed to be, or what someone wanted me to be. And then trying to get what I wanted for me from the scraps, or by sneaking around and doing things behind other people's backs. Exhausting. Let me tell you, it's an exhausting way to live. But the cancer stripped me down. Nothing left to lose, as they say. So this year I said to myself, fuck it, no apologies, I'll just be who I am. I'll see how that works.”

“And what happened?” the therapist asks.

“It
worked
.” Maggie says. “It surprised me. The more I stopped trying to be a perfect little human for everybody else, the more I stopped expecting other people to be perfect. The more I trusted myself, the more I trusted other people. It's the darnedest thing. I thought the opposite would happen. I thought it was either me being me all alone, or me being what people wanted me to be. But instead, the more I let myself be me, the better things got between me and other people. Like with you, Liz.”

Maggie looks at me, as if she'd forgotten I was there. “I wanna tell my kids this. I wanna tell them not to care so much about what other people think. Not to be afraid of saying what they want, what they need. I wanna say, don't dim your light; don't live small. You're not damaged goods; you don't need to be fixed. Just be who you are—'cause that's what the people who really matter want anyway. The truth of who you are.”

“Preach it, sister,” I say.

The therapist comes over to Maggie and sits by her on the couch. He takes her hands. “Maggie,” he says, “this is good. This is true. This is how to live. You don't have to die to live like this. Do you understand?”

“Yeah,” Maggie says. “But I backslide all the time. And then it just gets the better of me and I want out. Out of all of it.”

“That's OK,” the therapist says. “We all backslide, all of us, all the time. It's hard to attain what you are talking about, and it's even harder to stay there. It's the ongoing work of a lifetime. The hardest work, and the best work. All you have to remember is this is the way to live. It's a way of life—becoming yourself, being yourself.” He returns to his seat. “Now, what do you want to say to Liz's cells? Speak from the voice of the Maggie who knows who she is.”

Maggie sits still for a few minutes. When she speaks she keeps her eyes closed: “I see your cells, Liz, and they are kind of dancing around and waving good-bye to you. They want you to know they are very, very happy in their new home.” She smiles to herself. “Some of them even like it better in here, better than they did over there.” She reaches over and pats my leg. She opens her eyes. “Really, that's what I see. A lot of happy, healthy cells waving good-bye to you, having a good time, loving their new home. I guess they love it because I love it. It's a very good place, you know. It's fun in here. It's a good place to live—my body, myself.”

The therapist interrupts her. “Say that again, Maggie.”

“It's a good place to live. Me.” She smirks at the therapist, suddenly hip to his tricks. “You made me say that! But you're right. It
is
a good place to live.” She turns to me again. “Your cells want you to know that there is nothing more for you to do, Liz. Just love me, love yourself, and they will do the rest.”

I look at her. I look into her eyes and she looks into mine. I don't think I have ever felt as uninhibited locking eyes with another person. I see her; she sees me. We are ourselves, and we are each other. I pick up my hand and wave good-bye to my cells. “Have fun in there,” I say.

“And what about you, Liz?” The therapist turns to me. “Why exactly did you come here today?”

“To hear that. To let go. To stop being hypervigilant about my cells, about Maggie's health, about my work and my kids and you name it—somehow I have it hooked up in my head that it's my job to stay on top of
everything
. If I do, then maybe I can control the outcome. Like I have to be smart about everything all the time. That's the job description of me.”

“So you think being smart and being in control are the same thing?” the therapist asks. “That hypervigilance is the same as intelligence?” He doesn't wait for me to answer. “I don't think they're the same. I think it's pretty stupid sometimes to try to control life. And pretty smart to let things go. To surrender. And the smartest people, the wisest people, know when to hold on, and when to let go. So maybe you weren't as smart as you thought you were,” he says with a twinkle in his eye.

“Mm-hmm,” I say. “This is what I seem to have to learn over and over. This is the ongoing work of
my
lifetime—to let go, to let the world take care of itself. I mean I know it's good to help, to try to make things better, but people can help themselves. They want to help themselves. And they even want to help me! I stay so hypervigilant that people rarely see I need help too. That's not very smart, is it?”

“And what would happen, Liz,” the therapist asks me, “if every now and then you let the world take care of itself? How would that make you feel?”

“Useless. And anxious.” The words just pop out of my mouth. “I'd feel anxious that I was falling down on the job, that things wouldn't get done, or they wouldn't get done right.”

“Well, things are falling apart in the Middle East, Liz,” the therapist says gravely. “I think you better go over there right now and make yourself useful.”

I laugh. “You know, I actually feel guilty that I'm not over there right now. And every other place in the world where there's a problem. Maybe I could help.”

“Oh dear,” the therapist says. “You have a huge job on your hands, don't you?” He smiles at me. “There's no way you can help everyone and everything,” he says. “This world will always be falling apart and coming together and falling apart.
You
will always be falling apart and coming together and falling apart. So will your friends and family. You cannot control this unruly life of ours. Can you be OK with that? Can you be better than OK? Can you celebrate the unruliness?”

“I can try,” I say with all sincerity. “I am trying.”

Maggie pats my hand. The dog thumps his tail. The therapist just sits there. After a long silence he says, “You know, I think we covered everything. I think both of you know what you have to do. You sisters work fast! Let's not complicate the beautiful work done here today. Go get an ice cream cone down the street.”

We leave the therapist's office. It's only four o'clock. It feels like we're cutting out of school. We walk down the street holding hands, get ice cream cones, and then Maggie decides we should visit her daughter, who lives nearby. We take the scenic route, following the Connecticut River, which flows between New Hampshire and Vermont. It's a beautiful, bright, windy day. The late-afternoon sun falls on the trees, turning them a color that has no name. Shamrock?
Green apple? Chartreuse? Nothing quite describes the electric color coursing through the leaves, suffusing the atmosphere with an emerald light. The river is glacier green, swift with snowmelt from the mountains. Everything is moving, changing, alive.

The road turns sharp where the big Connecticut River meets the smaller Ompompanoosuc River. As we take the turn, Maggie says, “There's something I forgot to say in the therapy session.”

“What?” I ask. I look over at her. She's crying.

“I forgot to say that this has been the best year of my life.”

My breath catches in my throat and my eyes fill with tears. I pull the car to the side because I don't want to drive off the road and into a tree. Maggie's put way too much into staying alive for me to kill her in a car crash.

“I know I mostly complain about my aches and pains to you, Liz,” Maggie says. “And I don't thank you enough. I know it's your cells that are keeping me alive.”

“You don't have to say that,” I interrupt.

But she keeps talking, as if the same force that is moving the wind in the trees and the water in the rivers is moving through her. Her words come fast and strong. They tumble over each other like a waterfall. “I need to tell you what a privilege it is to live the life I have lived,” she says. “Sometimes I feel like the wealthiest person in the world. Wealthy with our childhood, our parents, our values, our education. Wealthy with my amazing kids and Oliver and the best sisters in the world. Wealthy with a warm home, and good food, and friends, and just being alive here on the amazing earth. I am greedy for more. I want thirty more good years. But I want you to know I'm also at peace with dying. I will embrace it because we all must! And for the record, I have had fifty-eight great years. Even the bad years are OK now because of how good
the past years have been. I know it must sound weird that the years of my life with cancer have been the best years. And especially this year—this terrible year has been the best year of my life. So thanks for that, Liz. And I don't want you to worry about me, OK? Promise me that. I want you to trust that I can handle whatever happens. No matter what the end of this looks like, I want everyone to know that it's been for something. Something good. Will you remember that, even if I forget? Because I probably will forget.”

“Yes, I will remember—for both of us. For all of us. I promise.”

We sit at the side of the road watching the green leaves flutter in the sky and the wild river rush below. I think about the awful miracle of this year, this best year of Maggie's life, and how she turned her crummy fate into something beautiful.

“Amor fati,” I say.

“Amor what? Is this some Edith Hamilton thing?”

“No, it's worse. It's from Nietzsche.”

“OK, lay it on me,” Maggie laughs.

“It's Latin for what you just said. Amor fati: love of fate. Nietzsche said if you could say yes to everything, even if your fate sucks, if you could love it and not just bear it, you would find beauty and meaning everywhere.” I leave it at that. We drive on, the beauty of the day speaking for itself.

Back home, I find a passage from Nietzsche—written in the midst of an illness that would eventually take his life.

I want to learn more and more to see as beautiful what is necessary in things; then I shall be one of those who make things beautiful. Amor fati: let that be my love henceforth! I do not want to wage war against what is ugly. I do not want to accuse . . . And all in all and on the whole: some day I wish to be only a Yes-sayer.