Every Thanksgiving, I am glad to be alive

Thanksgiving is always a very strange time, for me. Sixteen years ago, the day before Thanksgiving, I was diagnosed with cancer.

Several weeks later, after the chemo had eliminated the superficial symptoms, and before it had completely debilitated me, I wrote the following:

Dr. S returned, but things were now serious. I could see and sense his concern. I don’t remember the exact words, but he explained that there was something on my chest x-ray, something that wasn’t supposed to be there. His next words I remember exactly:

“It might not be serious, but it might be serious.”

“Cancer.”

It all became so simple then. The dreamlike quality from my fever persisted, but life had changed. Forever. A door had closed behind me; more were opening before me. There was no real fear yet, just a sense of bewilderment. It wasn’t real, and yet, somehow it was too real; like I had known something like this would happen. It seemed now that it was inevitable. In a teleological sense, maybe it was.

I drilled him for more information and could see that he wanted to help, to know, to reassure. He couldn’t.

It was between my lungs, more towards the left. It was about three inches long, larger than a silver dollar.

It could be just a serious infection, he said. The radiologist said it might be a rare, treatable disease that usually occurs only in black women. He was trying to help. Groping. I appreciated his effort, his honesty, the fact that he wasn’t trying to hide anything. It could be one of a number of things; but certain things seemed more likely. The answer, he confessed, was beyond his area of expertise. A pulmonologist was already being notified. There would be more tests; probably a CAT scan and biopsy.

Certain words carry certain weight when you first hear them applied to you; “biopsy” rates high on the list. He said there were three types. The simplest would involve a long fat needle injected into my chest, where it would snip off several samples for a pathologist to look at. I wouldn’t feel much; local anesthetic would be used. Another procedure would involve a small incision and a sort of tube being run inside. Again, local anesthetic and little pain. The third type would involve a simple surgical procedure: a small piece of rib would be removed to provide access, and a sizable piece of the growth taken. I would be put out for this procedure. He didn’t need to tell me that it would hurt. In my mind, I decided the needle sounded best.

“I know this is a shock,” Dr. S understated, yet stated so exactly correct. I liked him. On some level, he understood. He was shocked himself. He asked if I wanted to use a phone. I said I’d rather wait for the privacy of my room. He explained the details of my checking into the hospital. He asked about insurance because, “we don’t want to break you.” I can’t emphasize enough how lucky I am to have been insured.

I remembered my bills, my rent, my thirty days’ notice because I was about to move north, and asked if I could run a quick errand before checking in. I had my first slight shudder of fear that such concerns might now be just a matter of going through the motions. He thought deeply, then stared me straight in the eye.

“You’ll have to promise me,” straight in the eye, “promise me you’ll come straight back.

I promised. He asked what I needed to do. I told him. He said he could probably arrange for a nurse to cover it. He was relieved. It was arranged.

I asked about my car; it was in the Emergency parking lot. He said I could leave it; better yet, he said, swing it into the side lot. He followed me outside and watched. He wasn’t going to let me get away. He was no more than a few years older than me, but there was something paternal in his demeanor; and something honestly very concerned. I was grateful to my fever. The dreamlike quality was becoming my dearest friend.

Back in the examination room, a lab tech came to draw blood. My symptoms, even before the chest x-ray, had suggested several possibilities. Many of them involved the taking of blood.

When I’d told Dr. S about my persistent fever, night sweats, cough that wouldn’t go away, and general fatigue, he’d immediately begun with the obvious questions: was I an IV drug user? Did I engage in anal sex? Had I had a blood transfusion? Even as I’d responded “no” to these questions, a chill had raced up my spine and I’d literally broken out in a cold sweat. I hadn’t led a high-risk lifestyle for AIDS, but neither had I been entirely risk-free. He asked if I would submit to an HIV test, although he assured me that I lacked some of the other symptoms; he said that he didn’t think it would be positive. There were other more routine blood tests as well. I assented. Now it was happening.

The lab tech was training an assistant, explaining everything. My fever kept me from paying too much attention. All I noticed was the three large phials. She explained what they were for, but again, my fever fogged my receptors.

“This won’t hurt,” she assured me.

“That’s easy for you to say.”

She smiled. It didn’t hurt. It would soon be a matter of routine. When she was done, I lay back on the table, running a hand slowly through my long hair.

I’d walked into the Emergency Room because I had no local doctor. I was moving north right after Thanksgiving, but I’d had a persistent flu and didn’t want to give it to my grandparents over the holidays. I was concerned at the length of the illness, and various fears had crossed my mind, but I’d really thought the doctor would just give me some antibiotics and send me on my way; that was it: a bad flu and off you go. Now, I was waiting for them to prepare me a room upstairs. A growth in my chest. Not serious or serious.

I feared hospitals. People die there. My hand steadily stroked through my hair. I lay back on the examining table. A peculiar faculty took over my mental processes: my mind began to go blank, neither dwelling nor denying; an inner silence began to pervade. I took deep breaths. I listened to that silence, the hospital’s ventilation system, the footsteps in the hall.

I thought of W, who owned the best video store I’ve ever seen: all the classics, foreign films, and the rare cult favorites of any videophile’s dreams. He ran his business like a friend, always forgiving late returns, running bizarre specials on such things as films starring actors who were “newly dead”, and was a wealth of information on the history of cinema. When a local paper ran a contest on film trivia, he not only won by getting all the questions right, he also corrected them on errors they’d made in the questions. The next year, they had him run the contest.

One day, about a year ago, I went to the store and it was closed “due to illness.” A day or two later the news was around town that W had walked into a doctor’s office with what he thought was a bad flu, and had been hospitalized with AIDS. He was dead within days. It was still stunning and heartbreaking to realize how swiftly, how suddenly, and how completely he was gone. I knew I was low-risk, but I couldn’t help thinking about it.

I also thought about people I know who had been told they were dying, and beat it. My Great Aunt H had had terrible abdomenal cancers, with horribly painful operations, but she’s alive and well, and seemingly always in a good mood. My cousin J had had a radical masectomy with chemotherapy and radiation for a cancer that had metastasized, and her prognosis had not been good. That was ten years ago. She’s since changed her life, remarried, moved from Portland to L.A., and seems one of the most content, glowing people I know. This was in part helped by the breast DIEP-flap breast reconstruction she had which made her feel normal again after the surgery that altered her apppearance, and sense of femininity, seemingly forever. A childhood friend and friend of my family’s, had had a malignant brain tumor that was supposed to kill him within three months. I remembered how people had talked when he and his fiancee decided to go ahead with their marriage. He’d decided to simply get on with life. That was also ten years ago, and he’s fine.

I was thinking about a lot of things and thinking about nothing. There were so many angles, so many perspectives, and they all came flashing through my head, then vanishing. I didn’t know what to think. I was waiting for my room. Waiting for the privacy to call my family. Waiting to find out just how serious this might turn out to be. Tom Petty’s song slowly seeped into my consciousness. It became one of my themes for the next couple weeks: “the wai-ai-ting is the hardest part.”

About five o’clock, I was finally wheeled up to my private room. It had a view over the town and out to the channel where the evening sun sparkled on the water. It was nice to finally have some privacy and a phone. My parents weren’t home and neither was my brother. His roommate T, a childhood friend and my high school prom date, was the first person I told. I told her what I knew, which was everything and nothing, and she was, of course, stunned. Her sister, my brother’s girlfriend, walked in T’s room, and later told me that her knees almost buckled when she heard. I don’t remember much else except that my brother would soon be home.

I called my sister. Same type of reaction: shock, concern, the need to know more, the hope that it was nothing serious. She told me Mom was out to dinner. Dad was at the Blazers game. I’d have to reach them later. I probably layed down again for a while after that.

A nurse came, took my vital signs: pulse, blood pressure, temperature, stethoscope to the lungs in case of pneumonia; and then she took me across the hall, to be weighed. I figured I’d lost some pounds from two weeks of the flu, but my weight was normal. I took that as a good sign. If I had cancer, I thought, I was bound to have lost some weight.

Back in my room, she plugged a teflon needle called a hep-lock into my left hand so an open IV could be administered, and they wouldn’t have to keep jabbing me, over and over. Every four hours, ampicillin would be dripped into the little rubber tube, and down into my arm, just in case it was only a bad infection. The heperin keeps the vein from clogging when not in use. There was something psychologically soothing knowing that medication was coursing into my veins, even if it wasn’t the ultimate answer. Next came the pulmonologist, Dr. G.

He was young, intelligent, and warm. He was concerned, but couldn’t give me any major new information. The area of concern was called the anterior mediastinum, between the lungs, behind the heart. My white blood cell count was at twenty-two hundred, about twice the norm, but that could be a sign of any of the previously stated possibilities. He said that even if it was cancer, it might not be too bad. Some lymphomas, for example, are very curable. He urged me not to jump to any conclusions. He told me about the CAT scan in the morning. There wasn’t much else for him to say.

I thanked him. I liked him. In general, I don’t like doctors; when I was a child, I once climbed under the examining table to avoid one, but so far, these doctors defied my bias. This pattern, thankfully, would continue.

For a while, I stared out the window, not thinking about much, then I started thinking. I recalled small incidents from my childhood and adolescence, the many little events out of which a life are constructed. It seemed a long involved process and I wondered that it might all come down to this. I flashed on the possibility that I may never walk out of this hospital again- major surgery, and a quick decline. I thought about all the songs I had written but never recorded. I decided that if I was terminal, I had to get someone to bring me my guitar and a four-track recorder. I wanted those songs recorded for posterity. There was no fear in these thoughts, just a detached sort of musing.

Then came the fear. It was all so unreal, yet so very, very real. There were sailboats on the water.

Eventually, I called D, in New Haven. D had had cervical cancer, the previous summer, and we had pretty effectively joked it off. Her prognosis had been good from the start, and I had teased her that she was just doing it to get attention. Of course, we’d both lost a lot of sleep the nights before her examinations and treatments, but it had all come down to a simple, but painful surgical freezing. Now, we were trying to laugh this one off.

She knew I’d been sick, and didn’t believe me when I told her I was in the hospital. It was only when a nurse poked her head in the door that she decided I wasn’t teasing. She was certain it was just an infection and that I was putting a lot of people to a lot of trouble. She likes to say that I’m a big baby (and I probably am), and now she said this was just a case of mass hypochondria. It was good to be able to laugh about it. She told me to call her at my three a.m. IV change, if I needed to talk. She would sleep on the couch so as not to disturb her roomate. She closed by telling me how embarassed I would be the next morning, for causing such a fuss and worrying everyone over nothing. I felt somewhat better.

This next part is hard to write about, because it seems a little unreal, even beyond the bounds of my fever and shock. A saint came into my room dressed in the guise of a nurse. She was about my age, with large, warm, intelligent blue eyes. She said her name was L, and she would be my nurse the next day. She wanted to take my vital signs, before leaving for the night; this was becoming a regular thing.

I liked her. She was cute. She wore Nike Airs. When she checked the dilation of my pupils, she commented that some people’s eyes are so dark it’s hard to see the pupils. I took it as a compliment. Then she sat in a chair and her halo came out. She asked what I knew, and I repeated all I’d been told. Then she asked how I felt. She meant it.

Nurses see a lot of patients, that’s a given. A lot of these patients aren’t going to make it. In my case, the question seemed very much up in the air. She could have just done her job and wandered away, and she could have talked to me somewhat rhetorically, but her eyes and voice really wanted to touch me, to open me up. She could sense how alone I was.

I told her I was scared and confused. She cared. I can’t explain how I knew, it became more tangible later, but she really cared. I was a complete stranger, possibly very ill, and she was opening me up and actually staying there, emotionally, in case any pieces needed picking up.

I told her I was trying to be optimistic and philosophical: you know, we all go eventually and all that. I told her that the fever was lending a dreamlike quality to it all, and that if it turned out badly, hopefully that dreamlike quality would remain.

We talked for a while, and she encouraged me not to dwell on the worst possibilities, but more importantly, she encouraged me to feel what I felt. I had every right to be scared, and I shouldn’t be ashamed of it. She asked me if I’d cried. I told her it had literally been years since I’d cried. She told me not to be afraid to cry. Time stopped. It was one of those human moments that you know you will never ever forget.

We talked some more, and then she left. I’d see her again in the morning.

I felt comforted and nurtured, like the wingtips of an angel had softly alit on my shoulders to ease my burden. Again, I repeat, words here fail me.

Again, I lay for a while, not thinking of anything. I flipped around the television channels and didn’t find anything interesting, which wasn’t unusual; turned on Sportscenter and didn’t care- which was.

After another hour or so, I finally reached Mom. She was angry at the doctors. Her son was a thousand miles away, alone in the hospital, and they were telling him he might have cancer when they really didn’t know. I assured her they were doing their best and being their most honest and that we had to face the possibility. She would be on the first plane down in the morning.

Next, I reached my father. He began by excitedly telling me how the heretofore struggling Trailblazers had whipped the hot San Antonio Spurs. He said Drexler had had the best game my father had ever personally witnessed. Then he asked how I was doing. Everyone knew I’d had the flu, the past couple weeks. When I told him, it was like the air was sucked out of him.

“Oh, my god…” he whispered.

He wanted to know more, but I couldn’t tell him more. He called an oncologist friend, Dr. G, in Portland, who made some calls, then they called me back, three-way. Dr. G said it would be strange if I had a cancer in the chest with so few symptoms. That was about all he could offer. Dad clung to the words. He would be on the first flight down in the morning.

My brother called, tried to be philosophic, and asked if I wanted him to come down. I didn’t know what to say. Hopefully, it was just an infection and I’d be out of there the next afternoon. I didn’t want to be a nuisance. He asked if it would feel warm if he came and I said “yes.”

The next morning, my divorced parents would arrive on the same flight from Portland, board a plane with my brother in San Francisco, and arrive at the hospital in Santa Barbara just in time to see the pictures from my CAT scan.

That night my nurse- and I wish I remembered her name- told me they would also be doing an ultra-sound on my testicles in the morning. I knew about testicular cancer. It spreads up the body and can be deadly. If it had reached a person’s chest, his odds weren’t good. She told me that her son, at twenty years of age, had been diagnosed with testicular cancer that was already up in his back. His prognosis hadn’t been good. He’d undergone a painful chemotherapy, along with radiation treatments, and was now fine, a year and a half later, living in England. She said that the National Cancer Society could provide me all the information I wanted, once the cell-type had been identified, and that I shouldn’t give up hope no matter how bad things might look.

I was still hoping for an infection, and despite her seeming assumption that it was cancer, her words helped. I appreciated her advice. If the prognosis was bad, without succumbing to denial, I was ready to fight.

I was released from the hospital the evening before Thanksgiving. Since I was already in the process of moving to the Bay Area, I would be treated at Stanford Hospital. The next day, we would have Thanksgiving dinner at my mom’s hotel. It was a big, bustling resort. On the way there, I dropped off the overdue videos. The guy at the counter gave me a casual, “Hey, how’s it going?” I’m not the type who just gives a superficial answer. For some inane reason, I always think about it before answering, and answer honestly. This time, the words caught in my throat. The honest answer was that I’d just found out I had cancer. I said “Good, thanks,” and stumbled out.

I got to Mom’s hotel, and walked into the lobby. The atmosphere was loud and festive. Suddenly, it hit me. Slammed me. At the hospital, everything had been nurturing and safe, and I had been surrounded by people who cared for me and were taking care of me. This place was full of people who were going about their lives, celebrating, partying. My life had just hit a wall. No one knew what was on the other side of it. It was expected that I would make it through to find out, but it was by no means certain.

I called on the house phone, to find my mom’s room. I mumbled that I didn’t think I could handle sitting in the festive restaurant atmosphere. She told me to come up to her room. My mom and I have a complicated relationship, and it hasn’t always been easy, but she’d been great, the past few days. I went to her room. She opened the door. I didn’t know what to say or do. I burst into tears and she held me in her arms. It was the first time I’d cried in more than ten years.