A Cancer Catharsis

The AC was the worst. Not AC as in air-conditioning or alternating-current, AC as in adriamycin (doxorubicin) / cyclophosphamide, a chemotherapy drug. It wasn't the side effects or the administration or even the unknown results that made it so bad; the physical existence of the drug, coming face-to-face with it, knowing it meant suffering and that you were advocating its use, that was what made it bad. You're there in the infusion room which, though quite medicinal, is comfortable and staffed by caring, competent nurses. For more than an hour you get a series of prep medicines ... steroids, anti-nausea, saline ... and suddenly, it seems, they bring out the AC. There are multiple large syringes full of this almost impossibly evil-red medicine which they set on the tray next to your infusion pump. Instead of running this through the pump, it is injected in the tubing that is connected to the port in your chest, which was surgically installed just for this purpose. The injection doesn't hurt, much; the port and the cold spray helps with that. The nurse goes through a check list with you:

"your urine will be red today"
"let me know if you feel any burning as this may indicate leakage of the medicine outside the vein"
"be sure you flush twice when you get home, you don't want to breathe any of this"
"how are you doing?" 

As you are processing this, you glance at the tray and notice that there is another AC syringe, yet to be administered. Another one? "My God," you think, "this is freaking me out, what can possibly be going on in her head?"

The AC was the worst. You sit and watch your wife injected with a toxin. There is nothing you can do. You've been married for 30+ years and you can feel her fear. You can feel it. It's tangible. And there is nothing you can do. No hand holding. No hugging. No kiss on the forehead. No butt squeeze. You know that none of that will provide comfort and your mind buzzes, searching for words to reassure. Nothing comes, and you resort to joking, distractions ... "Is that color more like strawberry jello or cherry kool-aid?" In sickness and in health they say. Who knew you would, at some point, be advocating sickness, praying for the poison to work in the hope for long term health. Those devil-red syringes, laid out so carefully, looking so proper and yet so sinister, they symbolized everything up to this point. The danger. The unknown future. The dark arts and butchery of the prescribed treatment. The AC was a trigger point. That was when it got real for me.

It was easy to be brave at the diagnosis. I've had cancer and a little surgery took care of that, no muss, no fuss. It's easy enough to be reassuring when you don't know what's ahead. You both know you're lying, but lying with good intentions, and besides, there is really no need to over-react, or start the pity-party, or rally the troops ... we are a long way from needing support and why burden them? Everyone's life is hard. It's just another project to manage, another challenge to face, another test like the job losses and relocations, losing a parent, the pregnancy that wasn't to be. Given our history, there was every expectation that the challenge would be well met. And so, it has been. It's been 18 months, and the reconstruction surgery, a major milestone, has just been completed.

You might think that the bi-lateral mastectomy would be the worst thing, and it was pretty bad. No one wants to lose body parts, but it had to be done. It had to be. The lack of options made it easier, but the drains, the recovery, the expanders, the scars ... they all leave a mark. Do you have any big scars, from bicycle accidents or surgeries or unrequited love? If so, you know that place remains numb for a long time, and that you will never have the exact same sensations in that place, but it had to be done, so you live with the numbness and you hope that some day you won't miss the sensations any more. You understand that adjustments will have to be made and hope there will be, at some point, a new, workable normal.

You also might think that the chemo side-effects would be the worst, and they were pretty bad, too. They give you a prep list to mitigate the worst of it. They load you up early and often on anti-nausea meds. They are big advocates of laxatives and mouth hygiene and hydration. Before long you get used to the routine and the weeks become marked not by the calendar, but by how far to or from infusion you are.

  • Chemo day, feeling pretty good. Steroids in the infusion room give a nice boost.
  • Chemo night, no sleep. Hyped from steroids and anxiety.
  • For a day or so after that, surprisingly okay, until the toxins catch up to the feel-goods.
  • A few days out, in the bed, on the sofa, at the toilet.
  • Three to five days out, in the bed, on the sofa, at the toilet with some moments of small comfort.
  • Six to ten days out, more human, no energy, on the sofa, in the bed.
  • Nine to twelve days out, better, some appetite, sleeping is easier.
  • Twelve to thirteen days out, taking care of business, re-grouping, organizing, resting up.
  • Chemo day. So soon?

By the fourth infusion the hair is gone, the nails are thin and weak, the mouth is sensitive and, more concerning, the recovery is slower. How many weeks left?

Once the AC weeks were over it was time for the taxol regimen, which was longer and weekly, not quite as difficult and yet still very miserable, just different. Then radiation, 30+ days, every day. Then, mercifully, some peace from doctor's appointments and treatments. Just because they stop putting the drugs in you, however, doesn't mean you've recovered. It's months before you start feeling close to normal, and you're still tired and wondering what the 'new normal' might be. But it had to be done and the cancer is gone, though in your mind you always append that statement with 'for now' which makes you a bit irritated with yourself and then you realize that it's all part of the new normal. Which sucks, but is better than having cancer. Or dying. So not fun, but not the worst.

There are, of course, no good parts. It doesn't bring you closer to your loved ones. It doesn't make you stronger. It doesn't make you a super hero. It doesn't strengthen your faith or affirm your commitments or make you live "healthier" (whatever that means). It makes you aware that you can endure, that you can, at some point, if you are lucky, overcome the misery, but you already knew that and there's little benefit to trying to force something good out of something so bad. It is, more than anything else, a testament to the power of work ethic, of putting one foot in front of the other, to perseverance, to the strength of life. And you, as cancer victim or cancer care-taker, are left to make of that what you will, whether there is joy in the struggle or despair in the helplessness, whether there is a wellspring of strength or of overwhelming weakness, whether there is honor in the effort or shame in dragging others along. Cancer does not make you better; it only tests who you already are.

I'm sure there are many that would say that cancer strengthened their faith. That primarily works for those who have survived, or those who desperately want to find some good in it. "God is good, all the time" is a powerful motivator for trying to find some goodness in evil things, like cancer, but it does not displace their essential, evil nature. I believe that God is capable of creating a perfect world, and I equally believe that this is not that world. Many people believe that God can cure them of cancer. I have no doubt that He can, but I have serious doubt that he chooses to do so. A loving God, which I believe He is, would cure everyone of cancer, and yet, He does not. Some would say that is proof that God does not exist, but I believe that it is simply not the way God chooses to work in this world.

People suffer. It is our lot. Belief in God doesn't make you better or smarter or "more" blessed. It is not God's job to make you feel better about yourself. Buying products with pink ribbons saves not one life, and the lady driving the new Mercedes with the 'BL3SS3D' license plate should likely thank the finance company more than her Lord and Savior. God's comfort is not found in being holy enough to deserve to be healed or blessed, it is found in knowing that regardless of your situation, you are loved, and deserving of the perfect world that only God, not man, can create.

Cancer did not make me doubt God the Creator, picturing Him as arrogantly tolerating evil in this world, watching us suffer. It did, however, help me understand Jesus the Son, the bridegroom, watching his beloved suffer, praying for the poison to work, investing in the goodness and power of life, aching to let us know that regardless of the outcome, regardless of the present situation or our righteousness, we are loved. If I could, I would have taken her place. If you have loved, you know the truth of that sacrificial feeling. I am, however, just an imperfect man, in an imperfect world and I have nothing to offer but love, and that, I feel sure, I do not offer fully and completely enough for anyone's healing. I pray it is sufficient, but I fear that it won't be. As little as it might be, it is all I have to offer. Thankfully, I have faith in an all-sufficient love that does not depend on me.

So there you have it, my cancer catharsis, with apologies to Mr. Nooncaster who first introduced me to the word. There is much more to the story, details and difficulties that I won't give power to by mentioning since they have been overcome. It is not an easy path. I can't even imagine how it has been for her. It has altered our course, but it has not ended it, and that is the best that can be said.