New Growth

            Jack slung his suitcase onto the bed next to mine, unzipped it, and stacked in clean shirts and underwear. I added clean underwear to my own suitcase. I was headed for Denver, Jack for one of his island trips, working with island schools, problem solving. His specialty. At least we could drive to the airport together.

“Which island are you going to this time?” I asked. “Saipan again?”

“No, Ponape. In the Caroline Islands. South of Guam.”

“Is it near Yap?” I’d been to Yap. Yap enjoyed two hours a day of electricity and water. The rest of the time, might as well learn to relax.

“They’re both in the Carolines. Ponape is less primitive. They grow gourmet white peppercorns there.”

“Bring me some! Do they have electricity?”

“All day long. Usually.”

“Have you ever noticed that we never really unpack?” I said. “We leave everything but our dirty clothes in our suitcases. It’s been that way for…what? Twenty years?”

“For you, yes. For me, more like fifteen,” he said. “Are you as tired of it as I am?”

“Beyond tired. Wish I could give it up. We’ve only been married a year and a half. There’s so much to do here at the farm…” I said. “If we can finish the remodel, my dream of starting a computer camp for girls could actually happen. That upstairs dorm room, the two bathrooms up there, and the kitchen—we’d have to finish those first.”

“Catch 22,” Jack said. “Without our salaries, we can’t afford to remodel, and while we’re still working, we don’t have enough time.”

“But the gas well—if it keeps producing, the royalties could pay for the rest of the remodel.”

If it keeps producing. No guarantees on that. And we’d still have to have enough income to pay the farm mortgage and buy groceries.”

“You’ve always said your dream was to be a real farmer, raise cattle.”

“Someday,” Jack said. “But early retirement’s still a couple of years off. Retirement benefits won’t kick in until then. Can’t quit yet.”

“And for me, it’s ten more years to early retirement. I’d settle for a lighter work load, though, less travel, less tension.” I let my shoulders sag. “I’m just so tired—bone tired. It’s never really hit me like this until lately.”

“We’ll work something out,” Jack said. “For now, at least one of us has to work for a salary. But there are always options; we just need to brainstorm, give it some thought.”

My  way was less strategic: I knew things would always change, if we just gave it time. My mother often reminded me, “If something is a problem, it will change, or go away.” My mother Frances was the queen of denial, and I had inherited more of that talent than I wanted to admit. Sometimes, it served me well. Others, not.

“Right, I said. “I know it won’t be this way forever. We probably just need a vacation.” I zipped my suitcase and strapped it into the wheeled carrier I had bought in some airport, tired of lugging my bags through terminals.

It was October, 1982. I hadn’t told Jack yet, but for a few weeks I’d been aware of a growing hardness beneath my ribs in the center of my chest.

After the trip to Denver I went for my three-month checkup with my oncologist, Dr. G.

Three years had passed since the first cancer, and I was a subject in the National Surgical Adjuvant Breast and Bowel Project (NSABP), in a study to determine if lumpectomy alone would be as effective as lumpectomy followed by radiation. Dr. G. had placed me in a control group—those who had no follow-up treatment. That meant I showed up every three months to be examined, probed, and questioned.

“There’s something growing, right there,” I said, touching the place.

Dr. G. pressed his finger into the place where I felt something suspicious, and nodded. “You’re feeling your rib.”

“But it seems to be growing, and it’s hard.”

“It’s your imagination,” he said. “It’s just the hardness of the bone. Come back in a month, we’ll watch it.”

I told Jack, that night. “Will you check it for me, every so often, and tell me if you think it’s changed.”

“It does feel like your rib,” he said, that first time. So I was imagining things, spooked by the threat of recurrence.

For four months, Jack checked it for me, but he couldn’t be sure it had changed. Every month I showed up at Dr. G.’s office and repeated my concern. “It’s growing! It feels to me like it’s growing!”

Every month, the same scenario repeated itself. Dr. G. probed the place I was feeling, frowned, checked his previous chart notes, and said, “That’s your rib you’re feeling. It’s not growing. Come back in a month. We’ll watch it.”

I finally asked for a second opinion. Dr. G sent me back to the surgeon who had done my lumpectomy. Dr. T. informed me that he was retiring. “Next Monday,” he gloated. “I’ll be deep-sea fishing, first time in years. This is my last day on the job.” Then he probed around the end of the incision, the place I thought was growing. He frowned. “What does Dr. G. think?”

“He thinks it’s my rib.”

“Then that’s what it is,” he said, closing my file. His retirement so enticing. He didn’t need new problems.

Now I was having déjà vu. Hearing Ralph’s voice in my head, echoing Dr. G. “It’s your imagination.” Starting to feel a little crazy. Jack tried to discern some change in the place I was feeling, but was never sure. My fears grew, and I had trouble sleeping. Jack lay beside me, often awake himself, coming to terms with his own fears.

I had learned not to capitulate to male authority in the workplace, and even in my personal relationships, but put that male authority in a white coat, hang a stethoscope around his neck, and I was willing to ignore my own clear intuition if a doctor disputed it, wanting it to be wrong, wanting to be reassured.

Back to Dr. G. Two more months, two more appointments, same thing: “We’ll keep an eye on it. Come back in a month.” Finally, feeling so distracted I had trouble concentrating on my work, I demanded to see a new surgeon.

Dr. J. was the chest surgeon in the HMO, an avuncular man with a thick gray beard and twinkly eyes. Santa Claus! He read my chart, then laid it down and pressed his fingers into the scar, then the end of a rib, and finally just inside the scar, next to my breastbone, the place I had been feeling. He nodded. “There’s something there. A low-grade chondrosarcoma, would be my guess.”

“What’s that?”

“A tumor. We’ll schedule an excisional biopsy.”

“What’s that?”

“We remove the whole thing, then biopsy it.”

“Do you think it’s malignant?”

He twinkled, which gave me hope. “Sometimes they’re benign.”

Dr. J.’s nurse scheduled surgery for March 7, 1983, a week away.

I drove back to work, rethinking my entire life. My travel schedule, farm schedule, my job, my marriage—what if? But the “what if” was unthinkable. Time enough for that later, after a biopsy. Dr. J. had said “low-grade.” He had said “sometimes benign.”

Over lunch at Uncle Chen’s, our favorite downtown Chinese restaurant, Jack absorbed the news with his usual equanimity.

“Well, we’ve been planning to go to New York City in a couple of days. Let’s really live it up, enjoy, see a Broadway play, eat in interesting restaurants. Forget about this. We’ve got a week. I’m taking vacation time, and you have only that one meeting at Channel 13. We’ll make it a mini-vacation, get away together, have some fun and lighten up.”

Hard as we tried to distract and enjoy ourselves, our hearts were heavy and our fears barely contained. We stayed at the elegant Plaza Hotel on the corner of Central Park. Riding up in the elevator, I imagined I saw irrepressible six-year-old Eloise, who was said to have lived on the tippy-top floor,  watching  us with her hands on her hips, saying “Getting bored is not allowed!”

We saw Foxfire on Broadway. Jessica Tandy played an indomitable widow of 79. She lived on her mountain farm with the caustic ghost of her dead husband, Hector, played by her husband Hume Cronyn. A pushy real estate developer wanted to turn her land into a vacation resort, but Hector kept showing up to argue in favor of keeping the family’s Appalachian farm intact.

Tandy and Hume seemed invincible, always together, their energy boundless. “I wonder if they ever get tired,” I thought. I was tired, and scared about the future.

After the play we walked, through Times Square and up 7th Avenue toward our hotel, arms wrapped around each other. The air shimmered with a slight mist. We talked about the play, about Jessica Tandy and Hume Cronyn, how apparent was their devotion to each other. How they were in their 70’s, but still showed up every night to perform together. We tried to talk about our own future. Impossible, for either one of us.

“Let’s do the Central Park horse-and-buggy ride,” Jack suggested. “It’s corny and touristy but might be fun.” We went for the ride. I wanted this to be a meaningful experience, but it was hard. I decided to pretend the carriage ride was a simple romantic interlude, like being in a movie. Julie Andrews, maybe, or Audrey Hepburn, twirling a parasol.

Jack’s arm was warm and tight around my shoulders as we sat in the carriage, our legs tucked under a red blanket, his live body reassuringly close. The horses walked around the park in unison, the red plumes on their heads bright in the darkness, and whuffed white steam from their nostrils. Central Park at night was a wonderland of sparkling lights. The trees in the Park had turned that lovely light green of early spring leaves, the green that glows in the dark. I stamped this gentle moment, this whole evening, into an indelible memory.

*   *  *

The nurse yanked the breathing tube out of my throat, and that woke me up, trying to remember where I was, and why. My chest felt constricted, weighed down by something heavy. Dr. J. walked past my gurney in the recovery room and stopped. I fought nausea and focused on his beard until it became one beard, not two.

“You have metastasized breast cancer behind the chest wall,” he said. “You’ll need chemotherapy.” Then he disappeared. Blessedly, I couldn’t stay awake to process this information.

Dr. J. had removed several ribs, the ends of several more ribs, and part of my breastbone, leaving a deep divot in my chest. The tumor, he reported once I was fully awake and back in my room, had been “the size of an orange.”

“But you got it all out, right?” Jack said.

“I sure made my best effort,” Dr. J. said. “But this cancer was behind the chest wall, so we can’t guarantee it hasn’t already spread.”

“The chest wall?” Jack said. “What is that?”

“It’s a kind of cage made up of bones and muscles, that protects the organs inside it. It acts as a fire wall between the external tissue and the inside of the chest.”

“But why can’t this just be a local recurrence, some breast cancer cells migrating to the chest wall?” I asked.

“No. It’s not a local recurrence,” Dr. J. said emphatically. “Breast cancer cells showing up behind that protective wall were certainly carried there by blood or lymph.  Once the  cells are in the blood or lymph systems, they can go anywhere in the body.”

I turned my face to the wall and went into denial. I refused to accept this prognosis.

I spent a week in the hospital, recovering. The first few days, drugged on pain meds, I floated in and out of consciousness, but every time I woke Jack was holding my hand, his warm brown eyes gazing at me with clear, focused attention. I didn’t have energy for the outrage that would bubble to the surface later.

Buttercups grew down to the creek through the spring and summer, every year.

When Jack took me home to the farm, we stood in the driveway to look at the creek. We let the fresh smell of rain-washed cedars replace the smells of anesthesia and antiseptic, let the quiet murmur of the creek replace the sounds of clanging food carts, beeping monitors, and hospital loudspeakers. I filled up my eyes with the yellow of buttercups on the creek bank, and felt the pain and foreboding of the last week begin to drain away. Then Jack carried in my suitcase and we went to bed in the middle of the afternoon. We held each other and cried together until we slept.



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2 responses to “MEMOIR: CHAPTER 21 New Growth

  1. Michael Edwsrds

    You were strong and willfulness with the doctors. Not as much as later of course. But if you had not insisted onsomething WAS there then you would have died then!

    • judyallen

      That’s true! I wonder how long it would have taken for one of them to act on their own…now, of course, I’m a very different kind of patient. We’re peers, my medical advisors and I. I learned so much in these early, complex encounters.

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