What We Have (21 page)

She kept going over what had happened: The pain wouldn’t stop, and she’d seen two different back doctors. The first suspected it was osteoporosis; the second thought she might have a degenerative problem with her disk, but when he reviewed her history he said just to be on the safe side, because of the breast cancer, he thought it made sense to have a bone scan done.

The safe side
. I remembered my father’s toast at Christmas, her five-year anniversary coming up, the sense that she was almost home free.

Where was the safe side now?

She’d had the bone scan yesterday. Thursday. It had taken most of the day—first, they had to inject her with radioactive dye, which took hours to be effective. My father insisted on getting the results right away, and the radiologists did their best to rush them. Dr. Kempf met them late Thursday afternoon to read them the report. The news wasn’t good. “Poor Dr. Kempf,” my mother said sadly. “You should’ve seen his face, Mellie.”

The dye lit up where the tumors were. My father called them “metastases.”

All of this had happened yesterday, a whole day ago, and we hadn’t known. I tried to picture what we’d been doing—driving up to Maine, joking around with Julie and Jon. Watching Sacha turn over. Why did they wait to tell us? My mother seemed to read my mind. “Dr. Kempf got me an appointment with a new doctor—an oncologist,” she said. “His name is Dr. Brenner. We didn’t want to tell you until we’d heard what he had to say. We saw him late this afternoon—he squeezed me in at the end of the day,” she added. My mother had that everyone-is-being-so-nice-to-me tone in her voice. I guessed it was the old superstition kicking in: She thought if she were appreciative, a good sport, thanked everyone a million times, maybe then—just maybe—

My parents had gone out to dinner afterward, to talk strategy. They called Sara first, then us.

I pictured them coming into the house through the garage, putting their things down. Looking at each other. My father heading slowly toward the family room, where the telephone was. My mother on the kitchen extension.

Here’s what Dr. Brenner had told them: The cancer had spread to her bone. It was “advanced.” He wanted her to start treatment right away.

It all made sense now, her rib pain, her back pain. “We knew it could spread,” my mother reminded me. “Remember what Dr. Kempf said?”

LLBB, Lung Liver Brain Bone, that was the acronym Dr. Kempf had taught her five years earlier.

“But,” I said, my voice wobbling, “it’s been five years.” What happened to tiny? To 95 percent curable?

My finger flew, instinctively, to the place where my lump had been. By now, it was almost gone. My throat was dry as sandpaper.

“It can happen,” my mother said. “I guess all it takes is one microscopic little cell, jumping off into the bloodstream. Dr. Kempf said it’s possible,” she added, her voice catching a little, “that it’s been going on for a while. Maybe a year. Maybe longer.” She cleared her throat. “Sometimes it happens right away, at the very start. But they just don’t know.”

Anger took over. Why hadn’t they found this earlier? What had Dr. Kempf been doing all these years, joking with her about cruise ships and grandchildren? She should’ve gone to Mayo, I thought, my stomach in knots. We should’ve listened to my father. Where was all our Alpha Medicine when it really mattered? Where was our obsession with “experts” when we needed it most?

We’d let this happen. We’d forgotten to worry, or maybe we were sick of worrying, battle worn. We wasted worry in the wrong places so it was all used up when we needed it. We let our guard down, sent the troops home, and now—

This was supposed to be the
good
kind of cancer. This was supposed to be the kind to want! We were supposed to be glad she’d gotten this, instead of the awful cancer, the Sylvia and Pody and Gail killer. But we’d been duped. This was the Trojan Horse of Cancers, rolling into the city all affable and benign—here I am, a gift for you, you’ve been spared, no warriors here—and so we flung open the gates, welcomed it,
Come in, OK, thank you
, closed the gates again. And then one night, while we were all sleeping, the horse opened up, out sprang the warriors, thousands of them, no, millions, springing out on whisper-light feet, racing through the citadel with their spears of pain—

Did we think we were an ordinary family, that we could just take our 95 percent and be OK?

Not L, not L, not B, but B. Bone. Scaffold, frame. Bone of our bone.

I was holding the phone so hard my hand was sweating.

“Nothing,” I said to her, my voice breaking, “can happen to you.” I said it low and hard, half incantation, half command. In that tone of voice she used with us when we were little and she’d really had it.
Girls
.

My mother started to cry. She passed the phone to my father, who tried to keep his voice inside the clipped medical range of solid facts. Reporting what needed to be reported. I came away with only phrases—
the nuclear medicine department of Rougemont
. Injections of radioisotopic dyes. The room where she waited while the scan was being done. The films, meeting with Dr. Brenner. Treatment protocols.

My father kept emphasizing that this wasn’t bone cancer but breast cancer, which had spread to the bone. He said this several times. Was that better? Apparently it was, in terms of prognosis. “So we know what we’re up against,” he said, and I nodded, but of course he couldn’t see me. He cleared his throat, said something I couldn’t quite hear, and gave the phone back to my mother. She was in control again.

“Dr. Brenner says I could be OK with this thing for a long, long time,” she began, and I waited for the rest, guessing there would be a lot of this ahead of us, the Dr. Brenner-says, the quoting and citing. We were all so steeped in the culture of experts and he was our leader now. My mother seemed to trust him—I could hear the relief in her voice as she said his name—“
Dr. Brenner says
he has patients who are able to live with this for years.
Many
years,” she added, her voice finding a bit of its buoyancy again.

“This is
not
a death sentence, Mellie,” she added firmly. She explained they were going to start first with a drug called Megace, not toxic, almost no side effects, a kind of man-made progesterone that was especially effective with metastatic breast cancer. Megace was a tumor shrinker, and Dr. Brenner said many of his patients got a good response from it and didn’t have to graduate to anything stronger—not for a long time.

The longer the Megace worked, the better the long-range outcome.

How would we know it was working?

“Well,” she said, thinking this over. “The symptoms will get better.”

“Symptoms?” I asked. Wasn’t this invisible, this thing? Didn’t you need radioactive dye to see it?

“The pain will get better,” she said. “And that will be good, because the pain—” She hesitated. My mother hated complaining. The pain was bad. There was a chance—a good chance—
Dr. Brenner thought
she could have a positive outcome in a matter of weeks.

My father must have thought she was being too optimistic at this point because a minute later he came back on the line and explained that the cancer was not just in her back—though it
was
there, that was why she was in so much pain when she walked—I remembered walking up to the school with her over Mother’s Day now with a pang—but also in her hips, her ribs, her neck. His voice cracked again. Had my mother moved out of earshot for a moment? She must have. His voice sounded different.

“Ame,” he said. His voice was very low. “It’s
everywhere
.”

Trying to get control, he translated that into medicalese: The metastases, he told me, were “advanced.”

For once, “advanced” wasn’t what we wanted. What an irony for our type A bunch. We wanted a remedial cancer, a held-back-again kind, not this overachiever variety. No AP Metastases, please. We’ll take your ordinary, run-of-the-mill C plus.

I hated the word
advanced
. All my life, that’s what it had come down to. Sitting at the dinner table, talking about which language class to take. Of course, take the advanced one! We pushed and pushed. I’d already started doing the same thing with Sacha and she didn’t even have words yet. I had an alphabet book of relatives I’d made her.
Look, Sachabelle. This is the letter
A.

A
, for Aunt Julie and Aunt Sara. For Amy (me).

A
could be for other things, too. Things not in the book, but hanging over it. For AP History, my mother’s subject. For the best grade. For getting ahead. For advanced. Horrible, horrible—
advanced
.

On the other hand, maybe we needed
advanced
now more than ever. Maybe my mother could take this AP personality of hers and turn it on the Megace, full force. What if she aced Megace? What if she were the best of the best? Dr. Brenner’s star student, the Rhodes scholar of Megace?

There was a pause. I could hear other voices (distantly) on our line. We must have gotten crossed with another call—a man and a woman, with southern accents. I wondered what they were talking about. Maybe they had news to share, too. Better news.

On our line, we were running out of things to say. None of us wanted to hang up yet, though, so we talked about talking: how hard it was to be far apart right now, how late it was, how hard this must be for us to hear, hearing and hearing, how we’d be all right, how she’d be all right. We went over dates, times, numbers, when we could come in, what days would work. When she’d be seeing Dr. Brenner again. Each fact was like a pin, tacking us to something real.

We all wanted to come in now, right away, this week. Sara was going to look into rescheduling things at home. Maybe she could extend her visit around the Fourth, make it longer; the girls could come out later with Geoff. We’d talk again, figure it out. It was easier for Julie and me to come in sooner. We didn’t want to wait for her birthday to see her—that was more than a month away.

My father came back on the phone. He must’ve overheard the plans kicking in. “Listen,” he said, his voice low again. “Keep your powder dry here, OK?” A military term from my very nonmilitary father. Meaning “hold tight.” Get ready for battle.

“There’s going to be plenty of times we’ll need you to come in,” he added.

Save your energy, in other words. The hard part hadn’t started yet.

Adrienne Rich,
On Lies, Secrets, and Silence

CALENDARS HAVE THEIR OWN HISTORIES.
Ours, for instance, got completely overhauled in the 1580s. Pope Gregory dropped eleven days in order to realign man time and star time, resetting the year to start in January instead of March. One by one, most European countries went along with the changes, but England (and a few other Protestant countries) held out. For the next century and a half, England kept the old calendar, cut off from the rest of Europe by eleven days. If you traveled, like lots of merchants did, you needed to keep two calendars in your head at once. A little like flying to Tokyo from Boston, except that instead of moving forward fourteen hours, you had to move back eleven days. And then forward again.

Pope Gregory’s calendar was on my mind that summer, because once we learned my mother was sick, we lived in two calendars at once. In Calendar One, life went on. It was June. Realtors came over with prospective buyers; Sandi came, we looked at houses; I went over to my new department to fill out paperwork; I got names of child-care agencies from Annie’s sister. Summer settled in, hot and dull. In the late afternoons, the sky turned the color of a bruise, thunder rattled the house, and Sacha, six months now, scuttled across the shag like a beetle, tried to pull herself up on things, and fell back down again with a surprised grunt.

Sara, Julie, and I strategized, trying to map out visits home. Sara was reorganizing summer plans so she could come out and stay for several weeks, from late June to mid-July. Living so far away, one longer stay made sense for her. Julie and I were already scheduled to fly in for the Fourth of July. But when we heard the news, we decided to go in that next weekend as well. We knew there wasn’t anything we could really do, but we thought we could cheer them up. Lend moral support.

Our plans were made in the old calendar, Calendar One, but they took place in Calendar Two, Cancer Calendar, which had no fixed beginning or end, no set months or days. This was the calendar that governed now. Here, things happened at the same time as other things, preceded other events, superseded or even erased them. It was like trying to keep track of time on an Etch A Sketch. Dr. Brenner and Megace and the call my father got back from Mayo from the oncologists who reviewed her scans and the multiple phone calls to multiple experts that friends of friends knew at Sloan-Kettering or at the Farber—all these took place in Cancer Calendar, which, though none of us would admit it, was not only unstable but somehow inverted, a counting away from what we all knew as real.