I am trying to understand one experience by what it shares with another. Patterns come to me, clusters of memories that seem to belong together, and I cannot, simply for the sake of ease or sequence, keep them apart. Old memories of the months preceding and the early years after my mother's death when I was seven years old. A panic attack I experienced when Khary was attending a semester abroad, months before the cancer cells won their battle with my immune system and hardened into a tumor. And chemotherapy, which so frightened me I could write neither the word nor the name of the doctor in my journal but had to resort to initials, or watch my barely manageable fears escalate out of control.
I will not perceive the connections among these memories until all the cancer treatments are done. But I am dreaming with vague knowledge of being ashamed, and the shame is always for needing something I cannot have, or something that is not what I thought it to be. Somehow, I am humiliated, not merely disappointed; exposed, not merely wrong. A little beggar girl I saw long ago in a poverty-stricken street in Naples is in my kitchen. She looks at me with the pathetic eyes of a hungry cat and scratches on my refrigerator door with dirty, bitten nails. A river fills with blood, and long-missing bodies float to the surface while I sit in a boat aloof, even dissociated, wondering at the strangeness of what is happening right before my eyes. A distanced critic, I watch the dramas and keep track of all of the themes.
Now, I turn back the pages of my journal to the day I found the lump, a surprisingly undifferentiated hardness I wasn't even sure was a lump at first. I read my brief entry the day I went for a needle biopsy and received the diagnosis. "You are the fifth person I have diagnosed with breast cancer this morning," the radiologist said to me, and it was only noon. "It's an epidemic."
But eight months before that, when I was experiencing increasingly intense panic attacks, I had written: I feel as if an actual illness inhabits me. Something at once foreign and part of me devouring myself.
I appreciate the danger of ascribing facile metaphor to illness, especially to cancer. I can become angry at the many books and acquaintances who advise one to move to northern Maine, where a hypnotic serenity presumably neutralizes the effect of sorrow and loss, to subsist on brown rice and seaweed, or "eliminate stress" from one's life (an injunction that only increases stress in me, as I become stressed by the thought of how much stress there is in my life). I am suspicious of alternative healing methods that overemphasize the "spiritual" core of physical illness and even counsel an avoidance of Western medical knowledge. My life has been saved by Western medicine, an early, relatively small cancerous tumor removed from my breast, followed by harsh chemical treatments that have hopefully destroyed any cancer cells that might have been left behind.
But there is a sense one gains irrevocably after a life-threatening illness, that the mind, or spirit, and body are indeed one, or at least in intimate communion. I believe in the reality of the spirit and that it can be hurt as well as healed. For me, that healing always involves various forms of storytelling -- the kind you recount to a therapist in that space out of ordinary space and time out of ordinary time called a "session"; the kind you write and rewrite in various formulations, experimenting with various designs; the kind you dream. It is in the perception of design that I experience healing, and if that word has been rolled around too often by shallow minds seeking instant and painless transformation so that it has lost its original power to suggest the relief of remedy, the joy of cure, I find that I still remain attached to its old-fashioned, simple promise that what is broken can, at least sometimes, be repaired.
Between chemotherapy treatments are three weeks during which I try to make myself as strong as possible in body and mind, not only to prepare myself for what is a terrifying encounter each time but to build up my immune system in the face of attack. Close friends offer love and gifts, and one of the most treasured is the gift of several weeks' stay in Bellport, Long Island, at the home of my friends, Sally and Bill, who are traveling in China. Reading or sleeping in these large, quiet rooms where all day and into twilight the sun alters the pale off-white colors of the walls, reflecting rosy pink, pale green, a slightly bluish lavender; swimming in the backyard pool, which is surrounded by hedges, maple, pine, and at one end, an old grape arbor; walking the hilly roads to the bay, or biking to the tiny, quiet town, I am at the same time veiled and wide opened, thinking I am perfectly composed, like an elegantly constructed story, then suddenly overwrought, bursting into unfocused tears. I am extremely frightened of cars that, in New York City and here in these quiet streets, seem always about to crash into me, and I leap out of their way as they pass, causing drivers to look at me as if I am slightly mad. My need for love and reassurance is gigantic. I try to keep it on a short leash, afraid I will lose any hope of forbearance. Fear of death races through me like a brush fire, indistinguishable from the hot flashes that have greatly intensified since I stopped taking estrogen the day of the diagnosis, so that one sets off the other by association and it all comes back, weeks of being trapped in my body, its pain, its disease, the certainty of its inevitable disintegration. The only escape is into the details of management.
Chemotherapy changes the body in many small and obvious, as well as large and mysterious, ways, and for the first time in my life I have a skin rash due to the chemicals in sunscreen lotion or to the sun itself. I use #15 to protect myself but spend large amounts of time wondering if I should escalate to #45 or return to #8. I plan my meals of spinach, broccoli, brown rice, count off a small pile of vitamins each morning. Despite my undiminished craving for hamburgers, vodka on ice, cigarettes, bread and cheese, I research and create a dozen vegetable dishes and I eat them. I eat them every day and I follow them with glasses of clear, purified water. Despite my desire to sit and stare, read or think or write, I walk, and I walk fast. And despite a lifelong ambivalent love affair with death, I have never been so certain that I want to live as long as I possibly can. During the months of treatment, the clearest reason for living is to see Adam and Khary develop their lives, their children born, their ambitions fulfilled, not to have to leave them. Only much later will the desire to live include the wish to see my own life develop. Now, hope is only sought after, not yet reclaimed.
I buy new sneakers for my daily walks, thick-soled, high-tops. I list the treatment dates, crossing off numbers 1 and 2, beginning the process I will continue for the next four months and beyond, of writing everything down to keep myself from succumbing to panic. But I am frequently in a state of fear. If Douglas is more than fifteen minutes late, I begin to cry with the grief of a child abandoned, incapacitated and alone, and when he returns from a run, a trip to the store, a little late from work, I sometimes have to turn my back on him, close a door behind me, hide my shame.
I try to love my body, take care of it, look at it in the mirror despite its ordinary signs of aging and the not so ordinary long indentation on the side of my right breast. But often, it doesn't feel like mine. It has been cut into, entered, poisoned by strangers. These assaults, I am warned in printed releases I have to sign, may have unpredictable consequences to my heart, my liver, although I am assured that "probably" everything will be fine. But I am suddenly aware of my body parts as if they are delicate infants needing my protection, part of myself and apart from myself at the same time: my liver, my heart.
One night Douglas and I make love, the first time since the surgery, and just as I knew would happen the moment he is inside me I begin to cry. Not so much cry as keen. I sound like a woman in mourning, a low wail to the heavens as she watches a coffin descend. I hear my own voice as if from far away, as I did when I was in the hardest part of labor, giving birth to my sons. In the past months of this lonely journey, I have seen how I cherish beyond measure the old love between Douglas and me. But ordinary vocabulary does not suffice. Old implies worn, or even worn out, but I mean it in the sense of an heirloom, precious, reliable, rich with history. People say I am strong, but he has seen the fear, knows how many nights we have slept with the light on, held me when my sobs seemed bottomless, listened quietly, at times holding his head in his hands while he looks at me sadly, to my shouts of rage at the American medical system, at rude nurses and doctors who are afraid of pain and suffering, at tumors that are over one centimeter and so require chemotherapy as a treatment that perhaps but not definitely, might stop the spread of what, I am informed repeatedly, is a systemic disease. Otherwise, I would have told them to cut the breast off, take it, I would have said, and leave me be. When he gently lays his fingers against my wounded breast or touches the still partly numb right arm, I think of blood, of vomit, of the terror of losing my hair, which I've been assured will not happen with the particular combination of chemicals being injected into me. When he moves inside me I lay my hand on my own hair as if by pressing down I might keep it rooted there, and I am lost somewhere inside my body which is vast, foreign, yet some poor fragile thing. Then in the next moment I fill it again and know the difference between his touching and entering me and all of them touching me, entering me, actually entering the flesh of my breast and cutting away tissue for testing, for saving my life, yes, but cutting parts away, parts I have never seen myself but picture as throbbing, raw, and I am unable to say how hard it has been and how dearly I love him because my need is bottomless, it will swallow us both. And so I surround myself with layers of his silence until I am inside it and can feel the words he might have been able to say at some other time, in some other life. Nor does he cry with me, but tonight I am reconciled to this habitual absence of words and in the darkness of the room, against the comforting, damp sheets, after awhile I am able to say it, it has been so hard, and to repeat it and repeat it as if this simple phrase is a baptism, or a burial song.
The next morning, Ruthie, oldest intimate of my soul, arrives with her dog, Puto. We walk the narrow streets leading toward and away from the bay, talking of our lives, pressing constantly for some deeper knowledge framed in words that will enable us to escape the demons of depression and fear we have so often faced and fled together. I consider her very brave, and often dream of her exploring remote islands I am frightened to visit because of dangers lurking in ocean storms, or in the broad deserts she and her daughter are willing to cross in order to swim in some perfect lagoon. She dreams of me and the places I have lived as havens she comes upon when she is lost. Accompanied by her dog, an exceptionally intelligent animal whose only fault is that he barks incessantly when he's excited, which he always is on long walks, we wander around roads leading to mansions surrounded by gardens, expansive lawns and high hedges that make Sally's spacious and comfortable home seem like a functional cottage. As we walk we talk of love and need, and then she says, after a characteristic silence in which I know she is pondering some thought until she finds the precise words, "You have a great need for love, to receive it and to give it," and the trapdoor snaps open. I have to stop and catch my breath. I am standing at the edge of the darkness. The way down is steep. I am flushed with hot shame. I am the beggar girl with catlike paws. "No I don't," I say to her, a child's voice, as if I've been insulted and have no sensible response. "What's wrong with it?" she says. We are stopped on the road. Puto is barking at us as if he is a sheepdog and we are his wandering sheep. "What's wrong with it?" she repeats. But all I am able to say is, "I don't know. Something is wrong with it. I know that much." I am filled with images shooting through my brain like some video rewinding, spinning its pictures backward in time.