The other side of a lifetime (2018)
It is the other side of a lifetime and a few minutes past midnight. I am sitting on a gurney in a Boston emergency room, listening to a doctor. He is telling me I have cancer.
The gurney is parked at the intersection of two hallways, flush with one corner and pointing at the nurses’ station. An hour ago, I lay here shivering beneath a pile of blankets. Now those blankets surround me, kicked and shrugged off me, while my head and back run with sweat from a fever. Arms braced on the mattress and bare legs stuck straight out, I try to understand what he is saying. I am fifty-six years old.
My wife found a chair and sits at the foot of the gurney. She has piled my clothes in her lap. Arms draped over the pile now, she turns her phone face down and pushes her reading glasses on top of her head and stares up at the doctor as he talks. He is a resident.
A few days after Christmas, it is bitterly cold and suddenly icy. Many of the patients here have fallen. A large man with a deep gash on his head passes behind Suzanne on a wheelchair. A frail-looking lady rounds the corner in a gurney and parks behind us, accompanied by two of her nephews. She has broken her leg and perhaps her hip. The traffic behind Suzanne’s chair is constant. Wheelchairs fit past her, and people walking with IV poles. But every few minutes she has to stand up, holding my clothes against her body like a package and pulling her chair beside her, so a gurney coming from an ambulance can pass.
They drew blood for labs. The resident has returned with the results. He stands next to Suzanne’s chair, blocking the same hallway that she does. Dark, curly hair. Earnest and intense. Someone who has always been a good student. “Do you want to hear the results?”
“Yes. I do.”
He holds up one finger. He has forgotten something. “This isn’t good news. Sorry. I should have said that first.” He steps close to me while looking over his shoulder at a passing gurney. Suzanne stands and moves her chair at the same time. “We can discuss the results another time if you’d prefer.”
“No, I’d like to hear the results now. Go ahead and tell me.”
So he blows it like a trumpet in our ears. “We haven’t done the smear yet but the results of your blood count indicate leukemia. You will be admitted to the Hematology/Oncology unit as soon as a bed is available.”
A moment passes.
My reaction is like a blank white wall. I don’t accept or acknowledge any emotion. “Can you remind us what leukemia is?”
“Leukemia is a cancer of the blood and bone marrow.”
Suzanne becomes most still when she is most upset. She rolls herself up into a rock, a smooth polished rock, and few people can tell what she is thinking.
“Can you say more about that?” I still sound reasoned and calm.
“There is a cell in the bone marrow called the hematopoietic stem cell which develops into all types of blood cells—white blood cells, red blood cells, platelets. Sometimes this cell mutates and becomes a leukemia cell. Leukemia cells never mature into healthy, functioning blood cells. They divide rapidly and crowd out the normal healthy blood cells in the bone marrow.”
I understand none of this. Still, I ask another question. “How do you know I have it?”
“We don’t know you have it. We think you might have it.”
Suzanne wears that same expression, as if she had rolled herself into a rock, but there is suddenly more red on the polished surface of the stone.
“Ok,” I say slowly. “Why do you think I might have it?”
“Your blood counts.” I have lost the ability to make sense of his answers. He says something more about counting. He talks about a differential, though I don’t understand between what or why it is relevant. I do retain this: Low numbers of platelets indicate leukemia.
“My platelet numbers are low?”
“Very low.” I also have an abnormally high number of blasts in my blood. I get the sense that blasts are related to leukemia mutations, but I could never explain how to another person. He uses the word myeloid. I don’t know what that word means. “Taken together, your low platelet count and the presence of blasts are a strong indicator that you have leukemia.”
Suzanne speaks for the first time. “But you aren’t sure yet.”
He looks at her for the first time. Then he addresses me. “We will confirm it with a peripheral blood smear. A smear is more accurate than a CBC. But a bone marrow biopsy is the most definitive test for leukemia.”
Suzanne speaks again. “So you need the smear and then the biopsy before you’re sure?” I can hear her anger. She is thinking: So why are you telling us now?
I don’t feel the same way. I don’t feel anything.
Then he leaves and I am suddenly crying and she is standing next to me, holding my hand and stroking my hair. We have been married for twenty-five years. We have three children, two in high school and one in college. I catch my breath. And again feel nothing. A blank white wall. More questions start occurring to me. I want to experience my diagnosis as a pure fact—the concepts, the terminology, any and all uncertainty. It’s just a thing to understand. But I can’t understand it.
Two nights later, now admitted to the Hematology/Oncology unit, I wake up crying. I sit up in the dark, hunched over my knees, completely racked with sobs. I don’t cry over myself. I cry over my father, and my mother surviving my father, and my sisters and I surviving with her. I cry over all those years struggling to adapt to life without him and how we grieve even now, on this other side of a lifetime. Will I visit that much loss on my wife and our three children? And miss everything that comes after?
For weeks afterward, I only cried about what was happening to my family after recalling what had happened to his. All the big events mapped to his story. They snapped to his story, like magnets. Yet it wasn’t 1973—we have had forty-five years of progress in cancer care since then. There was no reason to think his story would be my story. Except it already was.
