Some of those who come here have been kind enough to encourage the writing of the book whose mention has flitted through this journal. Last fall I began to long-hand some thoughts. What follows might be the kernel of a first chapter or an introduction; it might be hard for family to read, but I wonder what you think?
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“Your wife has cancer,” the surgeon says, “of the pancreas. I’m sorry.”
“Can you remove it?” I ask.
“I’m afraid not. It has spread to the veins and arteries behind the pancreas and there’s no way to remove or bypass them. The operation to do that hasn’t been invented yet. There’s something we could try but, as you know, it’s drastic and there’s no real chance it would help.”
“So…what are we talking about?”
“She can live another six months or so…nine if she’s very lucky.”
And everything stops. The faces—sons, wife, girlfriend, my father, my brother—are all frozen. Then the tears come, you try to find words for this blow that has just landed: “We had so many plans…”, I hear myself mumble, and then everything stops again.
The surgeons wait; she is still on the operating table awaiting my decision, whether to try something heroic or to just sew her up again—the first of the impossible decisions is now, right now. The surgeons are waiting. I sense their impatience. My mind is full, too many thoughts, feelings, all moving too fast; a blur.
I am trying hard not to break down—all these people looking at me, waiting for me to decide. I have to be strong, strong for them, I think. Husayn, our youngest, Amelia’s traveling buddy of years, her closest companion for all those times I was away, comes around the table, puts a hand on my shoulder. My Dad, too old to have traveled from Arizona, came anyway; he sits to my left. They bring their history with them as they move into my distracted awareness.
I opt to consult, ask everyone what they think; they love her, too, they should have a say. Gonzalo, our oldest, is sobbing but lifts his head. I tell them, “I think they should close her; what do you think?” Gonzalo nods, looks down. Nods around the table. I tell the surgeons; they leave quickly.
We are left alone, amid the pieces of lives that now lie shattered at our feet. What will we do?
The enormity of what has just happened begins to sink in; it doesn’t seem real. Before the operation we had looked at CT scans, blood tests—the phrase “tumor marker” is now a part of our vocabulary—and the doctors said they couldn’t tell precisely what was wrong. Amelia’s pain, excruciating most times, could be the gall bladder, they suggest. There could be some kind of infection; there are other things, too, and then there is cancer—there is some kind of mass in the films but it is too hard to make out behind the stomach, the liver, everything else in that crowded corner of the body. Even if it’s cancer, they say, there is an operation. It’s called a “Whipple procedure,” a six- to nine-hour operation that involves taking out large pieces of every organ in the abdomen, then piecing their ends back together again and hoping they don’t reject each other—risky, uncertain, years of difficulty, but sometimes, success and longer life.
In the worst case, it’s cancer and it has spread, can’t be operated on. Pancreatic cancer kills 98% of its victims within the first year.
When the surgeons came to talk with us, we blew through all the more hopeful scenarios in under a minute. It was as if I could see them go, like so many gates across a downhill pathway, as the doctor spoke and ticked off the things this wasn’t, before giving his final assessment; and inside my head, a voice pleads, “No, stop! Don’t keep going! God, please don’t let him keep going!” But the doctor, remorselessly, does keep going, all the way to the bottom of this terrible hill.
And so our journey begins. Disbelief, anger, appeals to God, the strength of family and friends, working with doctors—many of the seeds that would grow in the time to come were planted then and there, in that family conference room in the suburban hospital.
But first, to be with Amelia when she wakes up.
For a couple of days, now, I've been thinking about what to say--feeling compelled to say something since my voice was among those asking for this. Unfortunately, I'm having difficulty trying to coalesce the thoughts into something coherent. Part of that is due to my own experience with my Grandfather, for whom fighting the cancer wasn't so much an act borne from a will to live as it was an act borne from a fear of death, and I'm hoping to see that difference captured in Amelia's story. The other part is that your story so far is, well, a beginning, which means it's a little early in the telling to capture that distinction.
But, how does one ask, "More, please," knowing full well that more will be forthcoming in due time--knowing also that the telling itself isn't exactly a painless experience for the one telling the story? You can't, really, without feeling pangs of guilt at the mere thought of asking the question.
So, if there's an absence of comments in response to your question at the beginning of this post, I think it's because we're all patient enough to let the story unfold. Take your time, Bill.
Posted by: Rick Schaut | May 21, 2004 at 09:28 AM