Seattle Cancer Care

My meeting with my new Seattle Cancer Care doctor turned out to be on the lackluster side. We arrived at the office early as requested to run through the necessary registration paperwork and questions. I wonder if there is a socially acceptable phobia of discussing banal personal details with perfectly uninterested strangers. Every new doctor we visit, every new office and reception staff: the script only ever varies slightly. Name, date of birth please, social security, addresses ad naseum, education, employment. I feel like I should keep a profile on myself with all the necessary information and answers and just hand it over upon my entrance. This fantasy of course would be quickly dashed; it turns out it is of tantamount importance that this information proceeds as a direct response from my mouth no matter how many times I assure them that I was still born on the 25th of May, 1989. Then comes the health history pages. I like to pretend with myself that they request the names, phone numbers, fax numbers, emails, addresses, specialties, and most recent appointment information from each of my zajillion doctors for my benefit, like some kind of brain game meant to exercise my long term faculties and not actually some infuriating plot to frustrate me to the point of tears. At the end of the day they have all of this information already and my writing it down will not stop them from asking me at least 4 separate times for all of the same information as if I might've grown an inch or so since having been asked my height twice in the same five minutes that I was measured.

Our check-in at Seattle Cancer Care was really no more or less painful than I have come to expect from the opening act of the doctor dog and pony show. The nurses were no more or less blandly polite but uninterested at the same time and the receptionists had a rather expectable tang of too busy for your questions yet unfortunately reliant on your answers in order to effect the end of an overall disagreeable experience for both parties. We found some decently comfortable high backed recliners facing a wall of windows with a peekaboo view of lake union. The boats were regal and cool, gliding through those green glass waters with pristine sails. A dusty warm glow of money floated on the warm afternoon air over the boats and beautiful condos of South lake union. We had been warned that the doctor was running late so we settled into the recliners and watched the world bustle outside the window between the sunbeams. 20 minutes later we were called back to the doctors exam room and again warned that the doctor was running late.

It is my humble opinion that doctor's exam rooms are one of the more underrated effective stress environments for human physical and emotional discomfort. A standard exam room consists of 1-2 hard plastic observer chairs, a doctor wheelie stool (or less commonly 3rd chair), and the exam table/bed/chairlette itself. The exam bed can vary from the sloping short bench version to the full hospital setup, longer and more dramatic in its ergonomic design. Exam beds are exquisitely uncomfortable to sit casually upon. They are meant for more dramatic posturing for examination's sake: they do not lend themselves well to the kinds of conversations had regarding results and treatments betweens doctors, patients, and families. Sometimes I opt for an observer chair as these at least promote forward facing casual sitting as well as the added benefit of a back and sometimes even armrests. Inevitably however, this leaves me feeling guilty and uncomfortable as it both dooms someone else to the uncomfortable side hunch on the table and also never fails to throw a doctor or nurse for a loop as they find it odd to address you from the observer's chair. Luckily I opted for this option as we had been warned of further tardiness.

We waited an hour for the doctor in the exam room. Waiting is one of my top 5 most uncomfortable activities. It makes me focus on the pain that starts to build up on my right side as my body weight bears down on the tumors in my liver. It makes me sweat which makes me irritable and further aware of the discomfort of my situation. I don't handle this kind of emotional stress well, particularly not around others. I prefer silence, usually the bitter furious sort, and will sit folded around my sore self, mouth set into an angry deep line, as I pinterest with all the force of a raging fire, mysterious as the dark side of the moon.

When the doctor arrived he was a tall thin gentleman with elegant long limbs like a crane. His accent was polished indian and his smile was warm. He assured us jovially that we would become accustomed to his lateness. Our faces were hard and our eyes didn't laugh at his jokes. Some of the easy bounce slunk off the edges of his footsteps by the time he had fully entered the room. We walked him through our story as we had told it a million times before and felt the room fill up with the anxiety and fear and exhaustion of the disease. He asked me if I understood the gravity of my diagnosis. They always ask me if I understand how serious things are. I always say yes. I wonder what else they expect me to say and what they might do if I were to deviate from the script.

They are hoping that my current round of interventional radiology will be enough to cut off the blood supply to the legions of tumors in my liver, a sort of modern-day medical siege of Vicksburg in two part s. We revamped my battle strategies for pain management, switching from a pain patch to heavier baseline painkillers a few times a day. This change has made the last few days a bit more bearable, a bit more lucid. Hopefully I will continue to improve as I go back in to see the radiologist on Friday to determine the start of the second half of my radiation. I hope I am well enough recovered that I will be left with some remaining liver function. Regardless, I think i'll be clearing my social calendar for the next week or so as I do battle with the diamond backed green dragon that lives in my right side.

If I'm lucky and successful, this will allow my doctor to treat me with some new cocktail of immunotherapy drugs aimed at teaching my body to identify tumor cells as dangers and allowing my immune system to then go about targeting and eventually destroying them. He tells me about a patient that has lived through the 3 year mark following this course which is a marginal improvement from the last set of stories dating back up to 2 years. Thinking about numbers like these is surreal. I cannot wrap my mind around them as facts that could apply in any relevant manner to my life. Hiding my fear as anger, feeding it with my frustration gives me the strength to look my doctors in the eye when they talk to me about death. Somehow standing strong in front of those doctors is enough for me to feel strong about this burden I carry. Holding myself upright and without shedding a tear is my first step towards being stronger than this disease. My upturned face and dry eyes are lines in the sand.

Massage Limbo

I would like to create something of my time spent suffering. I want something more to remember this time by than bitter memories of hot flashes and the way the skin peels in my mouth from all the drugs. The pain pills they give me are becoming less effective. I feel a little more myself which is a nice change. More myself but halfway unable to do anything;  halfway weakened, halfway beat down. My body is a mess of twitches and spasms. My teeth chew at my lips and my back pulses in long slow aches. The bruises from my IVs are slow to heal and splotchy. They match the shadows under my eyes.  Never have I slept more and yet been so tired. Never have i slept less, eyes rolling in the early hours of the morning. I am learning a new kind of sickness. It is a way of being and acknowledging this fact is the first step to accepting the hostile take over of your body as it wastes away; becomes sick and not yours any longer.

I would love to embark on a journey of self discovery: bake something every day, explore some passion and find some purpose. If I don't beat this I want my life to have been fruitful in some meaningful way. But the pain gets in the way. Writing helps. I have always fought my fears by naming them. Describing them. Calling them forth where their power becomes mine. But these are deeper more adult battles and I fear my customary wit will not suffice its usual quick pass through the doors. Once I am inside I will have no answer for the long stares from vacant eyes. It is once you reach this point that bravado fails you. Behind these doors you don't find people who want to ask you questions. Behind these doors "what is your pain at?" is a way of life: people live and breathe on that 1-10, find reserves of strengths, and watch as all that they are fails them in their moment of need while some fish-lipped onlooker goggles at you next to the picture of the tumors like a snowstorm in the trunk of your body. While visitors certainly are the best and boost the spirit in ways unparalleled by non social contact they have to be the right kind; a quintessential goggler can sour the fight to survive like milk in an overly warm stomach. The mouth slightly ajar, the eyes unapologetically wide and wondering while the swirling vapid nothing behind careens a little drunkenly around the still births of undeveloped dreams and dim ideas, tripping in the dark like a late night walk through a cluttered garage. I am very afraid of becoming one of these people. I'm afraid i'll slowly slip into a sad husk of pain, rattling around inside myself as the days become longer and more unbearable.

So I try to fit in activities to remind me of me and kindle that inner spark or madness. We are born with but a little of it and mustn't lose it lest we lose ourselves. I make long mental lists of dried fruits and match them in my head with the antioxidants they provide like vitamin flashcards. I take stock of my reserves and start considering netflix candidates for new shows to watch. This is uninspiring and only vaguely bohemic in an urban outfitters kind of way but it's a start. I make myself a mental note to do better later. Today I go to see a new panel of doctors and it would behoove me to prepare treatment questions for them. I wonder how the interaction will go. I am hoping for a charismatic, take-charge, young doctor that will be bold and outspoken regarding my chances. I want someone with a little steel in his spine who isn't worried that i'll sue him if he can somehow jury-rig my body to stop this self-destruct clock that ticks away in the background like a little emotional terrorist. I'm essentially holding out for a hero till the end of the night. At the end of the day it won't matter, I'll take the time and attention of any qualified doctor willing to stand between me and death.

I keep waiting for the gravity of this situation to hit me. I feel as though I walk around peering up at the sky, forever waiting for the other shoe to drop. Death is a bottomless pool and when you drop your stone over the side you are doomed to be disappointed if you are left waiting to hear the echoing response as it finally finds rest. Death is what I am afraid of. It is too big for me to understand and I cannot control it. But I am ambitious as the most industrious of ants. I know how to break down these problems into smaller pieces and carry them bite by bite to the side of the river where you do not feel the gravity of the entire undertaking but rather the individual arduous journey of each piece, in who's rest you can find peace.

Today I have a massage in the afternoon and I cannot wait for the degree of relief it should afford my aching back and side. I feel as if I live in the lap of luxury as I have been lucky enough to attend three different massages in the last week; those sixty minute intervals are probably the calmest, pain-free moments that I remember of this time. They say that the chemo drug they dosed me with causes memory loss and hazy memory, both of which feel in real time like operating in life from behind a sneeze guard. Everything is mostly visible but also just a touch smeared underneath a plastic film that leaves little bubbles between the screens. The pain pills add a sheen of sweat over the whole equation and leaves you feeling like you're sitting in a diner in linen shorts that stick to your legs and the vinyl seats as the air conditioning breaks down and life slows down 50 years or so. Outside it rains, heavy fat drops that make quick deep mud puddles to soak the unsuspecting shoe. Inside the sweat trickles downs the side of my eyebrow in spite of the late April chill. It makes me want to take a shower, a quick and cold one, but the ache in my side says don't bother.

Breathe

Thank you to everyone who has donated to the gofundme online campaign to help fund my treatment in fighting this disease. The campaign can be found here http://www.gofundme.com/teamallison and please let me know if you have any questions!

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The chemo treatment has reduced my world to a series of static images. Red, still frames of consciousness flip gently through the days as they progress. I live life through long moments in the morning when everything is clear and still and bright. I try to lie just as still as that moment in time in hopes that the slow tide carries away aching white walls of pain that crash against my shores. My energy comes in bursts these days: one moment I am ready to take over the world and the next I rest my head for but a moment and I find i've lost time; my consciousness careens off down some pain-addled rabbit hole and soon all you can see is the drifting trail of bubbles as they rise, pop, and disappear into air.

The main source of my pain is my right side. It starts in high on my hip and deep in my central spine and arches up around my right hip, careful to dip its fingers in between my ribs and hook its claws in deep. When I turn or inhale that fist clenches and the soft core organs beneath protest and spasm in sharp resentment.

When i curl myself up carefully, just so,  i can feel some of the muscles relax and the much needed breath and healing begin. I like to spend as much time as I can outside on these days. A breeze reminds me that nothing is constant and movement in my peripheral, the world around me is comforting in that it goes on without me, in spite of my distress. More maddening then the pain, more frightening than the fact that it does not pass, is the unapologetic fact that the suffering does not necessarily demarcate any positive progress. I could be in pain like this indefinitely and it could have no outcome on my end game. Doesn't answer any of my questions, abate any of my fears. I don't know how to make sense of logic like this. The pain frightens me and clouds my judgement.

It isn't fun or entertaining to talk about pain. It makes people uncomfortable, alienates them and drives them away. Talking about pain always implies some unequal circumstances between people; the onlooker cannot truly sympathize with the sufferer and from the dim recesses of those dismal lows the cares and concerns of the well wishers seem to echo as if off the walls of a long forgotten dry well. In these times it is good to have familiar faces to grasp towards as you drift through that long suffering river Styx which bears you half-way alive to a grey twilight at dawn where you stand judgement again before the hordes that lust for blood and life. They bang their swords and roar at the skies. They will have their day in the sun and leave their footprints in blood on the ground. These hordes are the pain. They cannot be stopped. They are fickle and strike without warning or strategy. They promise me nothing.

What I remember most of my first serious cancer surgery is the surprise I felt when I discovered that the surgery was merely the first step of a process that would require to completely readjust my paradigm. Like the chime of a clock, cancer changed the lenses in front of my eyes; a quick, efficient change, no more than a "ding" to denote the passage yet there it was. I felt great strength in sharing this self-awareness with the people that surrounded me, that loved and supported me. I felt I could let them into places inside of me that resonated with truths that could be felt and clasped hands and shoulders from states and cities away. But as I completed my treatment protocol my body grew weak and my condition did not abate. I felt I had discovered a hideous fallacy, somebody's idiot mistake: the surgery was completed, the radiation treatment completed, the implant removed, but the pain had not abated. This made me bitter and reluctant to continue to share. At first my words had come easily, springs of doubt, fountains of regret, mountains of poetry were mine for the waxing. But how was I to share repeated frustration or doubt? How could I ask people to indulge my lists of things I feared would go wrong? I had stood fast through great trial with a fair amount of grace, how to reconcile that person with the trials still ahead, and how to burn at the center of the fire so hot and so fast without changing who I was and burning all that I loved and cared for?

This time around I am sadly more familiar with the bitter taste left in your mouth when part of your life burns away through illness. I know which spots to check for. I wish a were a more still person by nature. My mind always strays to active and stillness is not a native habitat for me. Stillness is important because it brings acceptance in the door with it. I hate the bruises up and down my arms and on my hands. I hate needles really. It is always a passing nuisance to wonder how skilled the flobotamist will be with her poking and I can never quite look at the needle as it passes through my skin, drawing blood beneath. The port they gave me for the chemo left a bruise the size and shape of an eggplant in the softest part of my upper thigh. It is royally, unapologetically purple and is tender to the touch. The whole area feels sore and there are deep cords of pain that run underneath the superficial pass of purple flesh. Sometimes these cords ache and draw me back and forth against my own bones as I seek to inhale through the spasms until they pass. Sometimes they are drawn tight and I gasp to turn to the side or sit up; they have no give and are stiffer than corduroy.

I had a massage today and highly enjoyed the experience: I had not worked with her before at Pearson/Pollard Chiropractic but was as communicative as possible regarding the tenderness in my right side and back, my obvious difficulty laying myself flat on her table gave her an acute picture of the gravity of the situation. She used hot stones to a wonderfully soothing effect to in-essence press the pains out of my lower back and flank. Once my back had loosened a bit I felt some measure of relief and she gave the affected area a rubdown that fully incorporated the warmth and healing of the stones followed by a gentler hand massage that made it possible to rise from the table several minutes thereafter, unassisted.

I have an ever aggregating appreciation for the power of human touch in healing. In my darkest moments, it is a forehead massage, not a powerful painkiller, that makes all the difference where it counts. Perhaps this is why massage appeals so much to me. Even now i can feel long thin knives sticking just between my ribs on the right side. They are the thinnest of needles but I can feel their metal edges cutting into me. Massage reminds me to keep breathing anyway. It is a third option. Not a yes, not a no, a third option. Can't make it stop, can't make it go, but breathe anyway while that hand rubs beneath bringing just a little healing, just a little love.

I think about what I will do for the rest of the day for tomorrow or the next and it terrifies me. I don't have plans. Today's plan is to make it to tonight. I have some visitors coming at 6, they'll bring some food; people and food tend to be events in my life right now. But I have no lasting plans and certainly no comitments because who knows? In 2 hours I could be over the moon crazy or set the world on fire. I could live or die, make a million different decisions, and change my life five times over by tomorrow.

But I won't.

I want to shake a fist at the world because it seems like the classy thing to do. I want to roll down the window of my vintage limousine and tip the driver to hold the car still while I yell "goddamn you all to hell" at the gentlemen and baby dolls of broadway: those lost, champagne-dampened wanderers of F Scott Fitzgerald dreams that all just need a little love.

But it would be lost on them.

So instead you just take a breath instead. This is a good place to start. If you look around your mind's eye you can focus that intention if only for just this inhale. Somewhere good. Somewhere deep and decent. If you can build these roots, keep hydrated and eat your prunes you've got a shot at sanity in this post pill-addled fever dream. Like the Anna Nalick song "Can you help me unravel my latest mistake, I don't love him, winter just wasn't my season"

And Breathe. Just Breathe.
It's cliche. and tired and worn thin around the edges like some vocal velveteen rabbit. But the familiar threadbare folds feel right and heal somehow like the memory of an old forgotten blessing.
Rain beats down in a sodden springtime homage to weather. I spend many of my passing moments on the rocking chair on our porch, listening to that rain as it beats down against the protective eaves of the house.  But there is something comforting about the drum of the water against the roof as I write warm inside. A million moments touch a million lives as those raindrops fall and as my little world continues to turn here. My steady breath says "not yet" and the water runs in paths like tear tracks down the glass in the windowpane. Tomorrow the sun will rise again and it will bring struggle. Each sunrise sheds light on the pre-dawn still pain that stirs deep in the bones after the night has flown its bounds. But it all passes. If you just breathe.

the first treatment

On Tuesday they gave me chemo. Since my liver is ragingly infected with tumors they hit it with one of two waves. First to the right side addressing on of the primary blood supplies and then, once I’m recovered, in the left, to go in and address the other half. This is a very aggressive treatment that leaves me feeling rather worse for wear in the meantime; when I stand I buckle slightly on my right side and wonder at which point my soreness will cause be to clutch my side and fall back, I never seem to be quite ready for the long spasmy stretches of pain the accompany these breakdowns. The good news is that my advanced treatment has also rather simplified many of the priorities in my life on the short horizon; I worry conspicuously less regarding my life plan and much more towards my short-term survival goals.

Although I am sore and quite considerably less active that a week ago I feel measurably positive regarding this week’s activities; namely that I participated in any. I feel moderately inclined to continue doing things as well which I take to be encouraging, though life has not seized my hand for a frenzied romp into the unknown I’ll settle for a stroll through the early strains of a sunny Sunday afternoon particularly well shot through with long breaks for beauty naps and thinking breaks. I tire very quickly these days, perhaps due to the sickness, perhaps I just take myself too seriously, but regardless, the beautiful still moments where I can catch my breath and peer into life around me I catch myself watching and wondering, finding the time to look around and inquire, to wonder and appreciate. I believe that I am truly lucky in that my wonderful family allows me to most fully experience this time to its fullest. They have held me up limb by limb and carried me through this process unfailingly. As the true seriousness of my condition has become apparent from passing to serious to threatening and finally even stretching into a reaching unknown wrongness I have had to come to increasing terms with the fact that things might not be okay this time. While this kind of thinking limits many of your horizons it also takes a certain amount of pressure off of your psyche, when you have to accept less it comes with a bit more grace.

           

I hope that this doesn’t kill me. I am not familiar with feeling like my life is soon to be over; while I’m not nor have I ever been enamored of the idea of growing old, it is equally strange to think I might not exist sometime soon, that I won’t live to bear a family of my own or see my friends grow old. I want to think that my young age, my fiery personality, my stubborn tenacity, and my will to win will carry me through this fight but the fear lingers like the clammy sweats that have plagued me since the chemo: maybe things have changed. Maybe this will beat me.

            

In the meantime I try to recount my blessings.  I remember my youth and the rarity of my case and hope it makes me eligible for case studies or experimental treatments that might change my final answer. We are not meant to accept the certainty of our own deaths as natural and at 25 such a thing seems inconceivable. The progression from sick, to in-treatment, to dying is a surreal one that shies away from logical check-ins along rational roads. When I open my eyes in the morning, I wake to pain that flares its fingers underneath my right ribcage. It grabs the edge and twists as I sit up, reminding me that all is not well. With each inhale or turn to the side it digs a bit deeper into my flank like a deep breath I can’t quite catch. The slow progress, positive or negative through my treatment, makes it bearable.  While I don’t have leaps and bounds to draw strength from, I can breathe through the recovery pains, breathe through the spasms until they stretch and pass. As the days roll on I am hoping to build a resistance, build up a fight to the drugs and the pain as the stakes get higher.

The trouble with epilogues

The link to our gofundme page can be found here: http://www.gofundme.com/teamallison
Thank you for the kind words, prayers, and well wishes, I love you all

The trouble with epilogues is that they imply that anything ever ends. We carry our experiences through life like glasses with colored lenses. They’re bent and battered from the hits we’ve taken. Every ending, every change tints a piece or so till they’re more like stained glass windows than glasses. We hook them over our noses and each heartbreak, every lesson we’ve learned colors what we see depending on the angle of the glance as we happen to pass upon the idea in question. We look out across the tangle of human lives and opposing desires and use our experiences, our endings to judge the best course of action. Old scars are like road maps; they remind us of older mistakes. We trace our fingers against them and they whisper warnings.  Nothing ever ends.

As March rolled around again this year it seemed as if I looked back across the past 12 months as an enormous expanse of time and change. I had lost my eye, lost my faith, lost my love and my marriage. I had taken back my life, quit my job, and moved back home with my family.

As 2014 came to a close I stood on the precipice of a new year and dangerously on the edge of loving myself. I lost all of the trappings of my adult life but my little red car and lived unsettled in the center of my own judgment. My discomfort stemmed from my contempt for my own circumstances. The wings of my ego beat against my walls of my reality: “how the mighty have fallen” it cawed. The trappings of my childhood room, my pre-adult life, fit as oddly and tightly as my unfortunate senior prom dress. I felt like a failure. I was afraid I had let down the expectations of anyone who had ever called me bright or promising, I struggled to reconcile my situation with dreams of where I could've been by then. 

But even as I struggled to patch a broken heart with shards of the dreams of my adult life I was gloriously in control of my moments. I found a dizzy, guilty new joy in saying “no” to things. I came to the conclusion that my time was valuable and finite and became more efficient at spending it on people and things that truly mattered to me. I sang in the car with the music turned up to a positively ignorant level and reveled in the irreverence of dancing to taylor swift with a seatbelt on and the windows down, stopped at a red light and invading the personal sound bubbles of my horrified neighbors. It was silly but also profound. I had never before experienced such joy with myself for company, such deep true happiness and satisfaction with the person I was in that moment.

 I wondered if it brought me greater pleasure to barrel through moments like this or if this heady peace was rather the lack of reservation I felt in doing so, an unapologetic cheerful malcontent like none I had ever known.

Armed with this new energy I had taken on the early winter with cautious optimism. I am by nature a rather pessimistic person prone towards excessive risk-analysis so while my brisk frolic forward was more stately than kittenish in nature, I felt I had at least maintained a perfunctory devil-may-care snap in my heel.

February had come and gone in a sort of not worth mentioning fashion and as this fell short of total disaster or wallowing in misery I was willing to chalk it up as a point to the good.

I had decided to take on a second job bartending on the side by March, which challenged my ability to find a work/life balance but also my sheer ability to put up with the mundane, the mediocre, and the infuriatingly halfway done air of the place. It had found itself at the crossroads of a fading, palely enthusiastic regular crowd, and a pricey menu. While the patrons seemed as bemused as the ownership in regards to its bland success it was a curiously prosperous environment. The steady nightly tips almost made up for the steady soul-sucking nature of the place and I had settled into a tiresome routine of putting up with life, my head down and nose rubbing against the grindstone as I prepared for summer.

I meant for summer this year to be a season aflame. I had meant to burst from the green cocoons of spring to gorgeous flower in summer as I unveiled a new more adult me. I would be helping my oldest friend to the alter, and I was going to take the trip of a lifetime to Italy. Sometime in mid February I had picked up the book “Eat Pray Love” and lost myself immediately in the luscious tangle of fate and destiny between its pages. The author’s search for love and color and beauty and food spoke to me on deep levels, resonated in some inner divine core like a bell at the perfect frequency. Europe was calling to me, I could feel the pull of the culture and the language like a huge descending bouquet of flowers and smells waiting to swallow me up in a personal rebirth; I wondered if I would ever come home. While I waited for my time in the sun I went about my daily responsibilities with ever-heavier shoulders, wiping my brow as I stashed the extra cash in a tampon box. I watched, satisfied as a little nest egg grew and all of the extra work seemed more worth it, made me stand a little taller.

I began to notice limitations. I got tired quicker and deeper. The exhaustion rooted deep in my bones and took up residence for days not merely evenings. My overall health seemed run down, long insipid bouts of nausea plagued me in the mornings and I ate always mindful of how I might pay for my choices in the morning or long after I had tried to go to bed.

I visited my doctors frequently but they found nothing wrong with me, I made jokes about my old age and tried to take more vitamins.  I had developed a late in the game affinity for running and found great pleasure outpacing my problems until a series of small injuries grounded me, tried to replace my running with regular yoga practice only to find that my soreness and stiffness followed me even onto my mat.

I had developed a deep side ache, a pulling stabbing sort of pain that flared when I inhaled like a side stitch I couldn’t lose and soon it had become so pronounced I couldn’t straighten my abdomen to lie flat without significant pain. My yearlong treatment anniversary came and went and I asked that they look into my side pain when I went in for my 1 year remission appointment. The ultrasound was predictably both vaguely terrifying and inconclusive. Ultrasounds I was told, show everything and nothing, but certainly cannot be trusted to tell us anything. This made me wonder why we had bothered but I submitted to some serious painkillers to make an MRI possible after my oncologist had discharged me with instructions to return to the ER if my condition didn’t improve.

So I lay in the ER bed and stared at the ceiling, curled up around my sore right side and wondered what it was this time. They didn’t keep me waiting long. A blessedly brusque ER doc looked me square in the eye and told me they’d found malignant lesions all over my liver. Too many to count. It made me think of Beecher’s “no woman cheese”, lined with burnt sugar and jerk spices.  The black veins snake all through the white cheese inseparable and permanent. I have been through enough tough encounters that I no longer question the outlandish observations that pop into my head in these moments. It is best to acknowledge them and allow them to pass. This teaches you acceptance.

The next few days passed in a slow smear of painkillers and dull fear. I couldn’t eat or drink for the drugs in my system, I developed an equal appreciation for the ergonomically designed green vomit cones and one or two particularly wonderful nurse-aids. It is a hallmark, I believe, of having known true illness to be equally attached to an inanimate object that helps one cling to their dignity and at the same time to the very people who see us completely naked of it at our most achingly vulnerable. 

As I waited in the hospital bed in hopes of a return to a solid diet (or any diet really) I saw a disconcertingly large sample population of Auburn General Hospital’s doctors. None of them had anything new to say to me and they were all smoothly, predictably, uninformed uninterested or uninvolved in what was happening to me. When I was finally released 5 days later it was without having completed any of the treatment goals, although I had managed to keep down a half of a smoothie for an all week high of 4 hours and counting. My oncologist, so underwhelming when I had come to him with my concerns at the remission appointment, had not bothered to make rounds to see me himself, I remained in the dark regarding my final diagnosis, chances, or treatment plan. I was checked out of the hospital with a hollow sort of fanfare that heralded really nothing and told to go see an interventional radiologist at UW med the following day for further instructions.

The surgeries pavilion at the University of Washington Medical center has an imposing view. The building is clothed in wall to wall windows overlooking Seattle’s most majestic pines and maples, a spectacular natural background that changes year round putting to shame the priceless murals, exhibitions, and artifacts that sit poised in the corner galleries of the halls themselves, inviting reflection on the mysteries of time and human creativity. It is meant to inspire confidence, the colors and textures of the place ooze tranquility with a shiny saline tang of new money around the edges. I appreciated the dignity of the place and the stillness. Here I could find things that were older than struggle, older than my heartbreak and pain. Here the trees could look over me like just another soul among the pinecones on the forest floor, another star in the sky, another whisper on the breeze. It helps me when I am lost to think of myself as these things.

 For the clean open spaces of the surgeries pavilion the waiting rooms are bright and too full of blond wood accents. The lights are sterile and the air feels harsh and I want some answers. My interventional radiologist is named Dr. Sheron Kwan. She is tiny with delicate features and her hands are birdlike. She looks very much like she would like to sit with me and tell me the truth. Something about the way she comes in tells me she wont be able to. They ask me to sit, awkwardly twisted on examination table, my sister and father in passenger chairs as she perches on a round swizzle stool. There is a nurse with her with ruddy hair and cheeks. She perches on the edge of the trash can and I wonder ludicrously why we are all in an examination room and not some sort of table. It feels like I’m about to get fired in my pajamas. I walk her through my story again, answer all the same questions, and she feels all the same spots.

 She tries to tell me I’m dying but she stops just short and she won’t look me in the eye.

She won’t tell me how much time I have left, she wants me to understand that its about giving me as much time as possible with the circumstances at hand but I am hearing her tell me the game is about stealing time back from wherever my life has gone.

She says the cancer has compromised around 50% of my liver and the primary risk is its spread to my other systems. Malignant melanoma like mine strikes fast and deadly when it chooses to spread.

She tells me that I understand that I have a very serious disease and I am trying to understand what her eyes are adding. I tell her I don’t understand what it means for me. I ask if she means months. I ask if she means years. She doesn’t have an answer.

She tells me I’m like nobody else. I’m rare. I think about steak cooked to 145 degrees. Nobody like me has this disease like me. She can’t tell me what will happen. But her eyes are telling me something different.

They tell me they’re starting chemotherapy on Tuesday. In seven days. She tells me they will put a tube in through my hip and run it into the main blood supply of the liver to best try to shut down the damage the cancer is doing in my liver. This sounds like doing a trench run in a souped up x wing fighter with darth vadar and a pair of tie fighters on my ass as I try to send a pair of proton torpedos down a tiny exaust shoot to destroy a deathstar. Pew pew! Just like shooting womp rats back home.

I want to ask more questions but I don’t know what they are. I want more clarity but she has no more to give. The ruddy nurse is misreading the situation and her cloying sickly conversational asides sicken me like bad tea with too much sweetner. I want to ask her to leave but I stay quiet instead, hating her.

Seven days seems fitting. It seems an appropriate measure of time to grieve and to plan and to implement and prepare. It seems like a final countdown, a slow montage to future prosperity or a solemn memorial to 25 years lived.  But instead the time drags. Painkillers don’t kill pain and killing time doesn’t make it pass faster. The drugs slick things down, formless blobs of thought and twinges and fears all squished into a stream that runs slow and slippery, just quick enough that you cant grab onto your fears with both hands, you feel them brush your fingers like fish as they pass, cold and clammy across your brow. When you clench your fists they squeeze out past you and slip away, returning to bump up against you in the night and leave puddles of cold regret to surprise your toes in the morning when you step out of bed full of purpose. 

I do my best to wrap up my lose ends. I fold my loved ones like papers and tie them in fading ribbons like goodbye embraces then tuck them into my soul to carry with me through the dark. I rage in silent impatience at anything that goes awry or amiss or takes too long. I feel the days surge forward and count my sunsets. I hold on with silent regret to moments I recognize as having passed forever and find moments of clarity in which I know unmistakably that I mean to leave something or someone behind. I let it go and acknowledge its passing. Perhaps it was no longer serving me.

I gather my strength. This battle is one against time and against odds. This is a fight that you do not win by strength alone. The greatest courage is to wake up in the morning and face the sun that rises without thought or concern for your struggle. Bravery is not learning from defeat but rather never looking up long enough to be beaten. Be it pain, be it blood, be it suffering, all things know an eventual end and if you can find this truth, curl up in the bow of this ship it will carry you through the roughest of waters to a place inside you where there is peace.

The trouble with epilogues is that they imply that anything ever ends…

To be continued.