Out of the Woods (14 page)

Yes, Reichman said, it was true more or less, and after that I calmed down. I felt more in control, if only of the facts. For me, there was some peace in seeing spelled out in print what the word
incurable
makes fairly clear: most women with breast cancer will eventually die of it if something else doesn't get them first, whether that something is a car wreck or old age.

The experts will tell you that survival in the wilderness or even in the shopping mall, if that's where you happen to be lost, depends on optimism and pragmatism, on a healthy dose of hope and the ability to read the altered circumstances you confront with some degree of accuracy. But then there are the cases, like the Peruvian plane crash, where about all you have is an attitude, not the odds, but a way of coping with the odds: to face death walking out of the jungle or wait for it to come to you. I think that whatever understanding I gained about direction, about orienting myself in an unfamiliar world, began in earnest then, when I learned how to face the present without blinking and decide for myself how I would cope.

 

C
hemo would not be so bad if it were not for the insects, such ugly things, with their sharp mandibles and terrible teeth and pincers that tunnel so deeply, relentlessly into the brain. I had not known that insects could be made of metal. The beetles are big and black and they dig their way into the nightmare place; I can't remember in which part of the brain that's located. Medulla oblongata? I should have studied more. If only there weren't so many of them, if only their bodies didn't rub against one another, making that terrible scritch, screech, scraping sound, like the lawn mower when I haven't oiled its blades. Why won't they stop? If they did, then I could sleep through these endless hours while delicate insect legs skitter across the soft tissues of my brain and insect talons work away. I have been on this sofa, unable to move, for hours. I look at the clock. How long has it been since last I looked? Five minutes.

The third day of chemo was the worst, a gray shadowy pit of time full of nightmares and fever dreams. Then the days gradually got better until the third week, when I would feel nearly normal, when it was time to do it again.

I had the chemo in Dr. Reichman's office in Midtown Manhattan. Having seen other chemotherapy delivery rooms when Lee was ill, I knew how lucky I was. Dr. Reichman had set up hers more along the lines of a cozy small-town beauty parlor than a grim factory for pouring lethal chemicals into fragile human containers.

There were only three chairs in what I came to think of as the chemo salon, leather or at least leatherlike recliners of a size and magnitude that demanded either a huge helmeted hair dryer hovering above or a basin for pedicures placed at the foot. On one side of each chair stood a small table for water bottles and other necessities and on the other a wheeled metal dispenser from which the bags of chemicals could be suspended while they dripped through plastic tubing into a needle taped securely to a forearm.

A well-stocked folder of take-out menus was in reach next to a pile of magazines and extra blankets and pillows, as well as DVDs of movies that could be popped into laptop computers. Tucked into one corner of the room was a kitchenette with a small refrigerator filled with bottles of water, juice, and diet soft drinks, a sink, and, on the counter, a bowl of healthy low-calorie snacks—granola bars, hundred-calorie cookie bags, dried fruit.

There were a few chairs placed for friends and family as well, but most women came alone. The chemo took about four to six hours to deliver, depending on the particular cocktail prescribed, so there was time to talk, and over the months we got to know one another a little. The patients varied in age and income but also in how many times they had had cancer and how advanced it was. First-timers were probably the majority, and most of us had fairly good prognoses, but there were patients who were back with a recurrence, or a metastasis.

There were lawyers, and housewives, and grandmothers; there was a woman in her seventies who was a psychoanalyst by day and a cabaret singer by night, who had chemo four times a week and would do so for the rest of her life: the cancer had spread to nearly every organ in her body. She would spend the time going over musical scores with her husband/manager for that evening's performance. We were all in awe of her.

Those of us going through our first bout with cancer tended to be a chatty bunch, especially at the beginning of the session—some of us arrived slightly hyper from the steroids taken the night before to keep the nausea at bay. We spent a lot of time discussing surgical options and side effects with the gusto of a convention of car mechanics or tax experts or any group possessed of arcane knowledge of passionate interest only to themselves. But after the intravenous Benadryl began to take effect, we were all pretty stoned, and the chemo salon took on the relaxed, slightly louche atmosphere of a high-class opium den. Sometimes, in the background, we could hear, as if in a dream, Dr. Reichman's low, patiently insistent voice trying to convince a frightened woman to continue treatment despite the side effects, or explaining the options left to someone for whom they had contracted to very few.

I grew to love these women, even the ones who couldn't seem to move a muscle to help themselves, especially the ones who couldn't, who needed more blankets and more water and more attention than anyone else; their anxiety spoke for all of us. They tended to be the older ones, the last remnant of the generation that had depended on husbands and fathers to make everything better; they had never had to cope by themselves. It was much harder to know what to say to the younger women, because of the monstrous unfairness of it, women who hadn't even had time to have children or had two small ones at home—and Jane, our oncological nurse, said the patients were getting younger all the time.

I would drive back to Castle Dismal a day or two after the infusion. On the bad days I would rest in bed and stare out the big picture window in the bedroom at the bare trees, fixing in particular on a big birch that stood out in its white bare perfection from the dun-colored branches of the others, staring at it as if the strong sturdy pillar of its beauty could somehow anchor me, if only I held on tight.

That spring was my first mud season in Vermont. Some mornings after it had rained all night, I woke up to murky waters rising, puddles pooling, torrents reaching up to Henry's flanks when he ran outside to see what was going on. The water rushed down the road from the woods, taking out most of the driveway. The floor and the furniture were patterned in muddy paw prints, and my clothes were caked with dirt. I was fascinated by this wet and rushing violent change, the muck and ooze, the motion of it, water and road and wind and rain, the loud smacking, streaming, sucking, crashing, moving, falling, melting mass of it. If you had to be in the middle of a catastrophe, then I was in the right place, because spring in New England is a catastrophic season.

 

O
ne night, a couple of weeks after the first infusion, I absently ran a hand through my hair and a few strands came away in my fingers.

Such an odd sensation, the slight tug as the scalp released its hold on the roots, an instant of realization of what is happening and then the visual evidence, there in your hand. I had tried to prepare for the hair loss—watching Internet videos on creative head scarf tying, buying yards of fabrics in ridiculous colors, practicing with the free makeup given out by the American Cancer Society at one of its “Look Good Feel Better” sessions, in which volunteers demonstrate the use of foundation and blush to look less sick. But I don't think I ever believed it would happen.

When it did, I headed to the yarn shop for a pattern and some wool to make myself a hat. Something that wouldn't make me look too cancery, I said to Karen, the young woman working the desk that day. But the women of Whippletree were way ahead of me: they had designed a hat—the Darling Beret, they called it—and Karen had knitted it in a soft mauve cotton with a couple of darker stripes around the brim. It was beautiful and perfect and I had no words for their kindness.

After the first round I had waited nervously for the first sign of the coming change, tugging nervously at my head about fifty times a day. I had read the discussion boards about how traumatic it was to lose your hair, as well as the psychological studies, in which many breast cancer patients claimed that losing their hair was much more upsetting than losing their breast.

But while it was strange when it actually happened, my reaction, past the first little rush of fear, was relief: Now it begins, I thought. Now there is something I can actually do, beyond waiting in dread.

It was late at night. I went upstairs to the bathroom, put a towel around my shoulders, and in the clinical glare of the fluorescent light, I cut my hair as close to the scalp as I could with a pair of scissors. I had read somewhere that it was better to get rid of your hair once it began to fall out, much better than waking up every morning with the evidence all over the pillow.

So I cut it off in hanks, laying the fistfuls of brown hair on the linoleum counter. At that point, with the sheet wrapped around my shoulders and my hair sticking out in short cropped patches, I looked so comical, I had to laugh. I took a lot of pictures on my phone. Then I shaved off what was left as close to the scalp as I could. The actual doing of it was not as sad or frightening as I had expected; I was more curious than anything else and weirdly detached. I didn't achieve the perfectly finished billiard ball look I had in mind because I couldn't get close enough to my scalp without cutting myself—I was left with a sort of kiwi fruit fuzz. I took more pictures of the person in the mirror. She had a nicely shaped head, I thought, but she was no one I knew.

The hair had fallen all over the sink and the bathroom floor. I gathered it up and put it in a resealable plastic bag. I couldn't throw it out. I would need it, wouldn't I, after the treatment was over? I knew that was nuts, but still I pressed the seal on the bag and placed it in one of the bathroom cabinet drawers.

I took more pictures. I took a picture of my bruised and battered breast. Then I tried on the wig and took a picture of that. It looked weird. I waited to be upset, but I wasn't really—the experience was so bizarre, so beyond anything I could have imagined, that I was more fascinated than anything else.

The hair would grow back, but in other ways, I would come out of this permanently altered, my bones and heart weakened by the drugs and five years of hormone deprivation, the shape of my body different—perhaps drastically so, depending on what surgery I had—and fatter, if the statistics on the percentage of women who gained weight during treatment were to be believed. Even the color and texture of my hair might come in differently, gray most likely, or white (like Gandalf, I liked to tell myself, in
The Lord of the Rings
). And while all of that sounded pretty scary, wasn't it just a sped-up version of the changes that getting older would inevitably bring? Would I be changed in other ways as well? Would the fear and the anxiety and the confrontation with mortality ingrain themselves so deeply that they would become a permanent part of me?

I slipped under the covers, but my head was cold and the stubble was prickly on the pillow. I got up and found the hat that Karen had knitted for me and put it on. It was soft and warm against my scalp, and wearing it I fell asleep.

 

E
ven catastrophes have routines. Gradually a latticework of daily chores provided a kind of structure to the new world in which I found myself, one in which the only thing I had to do was cope.

Henry was still a puppy then, and he took my illness hard, whimpering at the side of the bed when I wouldn't get up, or laying his head on my lap while I fought down the nausea. He forced me, more than I could myself at the beginning, not to surrender to the misery, as luxurious as that temptation was. On a more basic level, he needed to be walked, and I needed the exercise if I wanted to retain any sense of normalcy.

So we began to walk up and down the hill that led from my house to Noah Wood Road. It was only a mile each way, but it might have been Everest then. To cheer us both up, I made up a kind of chant, based on the ones the GIs used to sing during marching drills in the days when my family lived on military bases:

I have a dog, his name is Henery

He's my friend he's not my enermy.

He will come when he is called,

'Specially when there's food involved.

He will sit when you ask him to

If he's got nothing better to do.

Sound off ! One, Two!

Sound off! Three, Four!

Sound off one two three four!

Slowly, over the next months we walked farther, taking the right onto Noah Wood, and going up the hill, in the beginning just until the first rise, then as far as Harriet and Dean's, and finally up to where the pavement ended and the road became a Jeep trail. We stopped there—chemotherapy is cumulative in terms of its debilitating effects, and I didn't trust going out of sight of passing cars, even as sporadic as their appearance was.

In the beginning I had to stop every few steps on the uphill, and the dappled shadows, the glinting of the white quartz in the sunlight, the sound of the brook—loud as it rushed forward during the spring swell, a soft plashing in summer—distracted me whenever I felt like fainting and muffled the dreadful voices that sat in judgment day and night. They did not dare follow me on those walks up and down Noah Wood.

Because I walked so slowly, I felt, for the first time, the broad back of the earth beneath my feet, understood, if only faintly, the great consoling immensity of the world as it rocketed on its way, and it was steadying, reminding me of all that endured when much would not. I claimed the road and it claimed me, rock, stone, light, leaf, shadow, and sun. I owed it everything that was good.