an explanation, not wanting to accept what we had seen: dark spots all over Randy’s liver and spleen. Surely there had to be some mistake. I kept thinking this as I splashed my face and washed my hands. I returned to the examining room expecting the nurse to have disabused Randy of his silly notion.
Instead of the scene I had expected, Randy and the nurse sat there looking sad. Moments later, the oncologist entered the room and carefully confirmed that Randy had read his scans correctly: the cancer was back. He said it was as aggressive a return as he had everseen: nine tumors in the liver and too many in the spleen to count. Three to six months of good health was all we could expect. Then he started talking about palliative care strategy with Randy.
My mind was racing to understand the turn of events. I was confused about what palliative care meant, and the doctor explained that they would now focus on slowing down the cancer in order to buy Randy as much time as possible, but the goal was no longer to eradicate the disease. I couldn’t fathom the idea that my husband wasn’t going to win, that he would one day very soon not be tubing with me at a water park or winning an extra-large stuffed animal. How Randy was able to accept the situation, his death, so calmly and quickly is something I’ll never fully understand. Maybe he was able to disconnect his intellect from his emotions more easily than most. Maybe it was because he was an excellent chess player, former captain of his high school chess team, always two steps ahead of the game. He did his research, knew the statistical probabilities for various disease advances and scenarios, and understood that a recurrence almost always ended in death. Science was his faith, and he understood the world in which we live according to its laws. The steps for dealing with pancreatic cancer were quite clear. The first rule was to remove the cancer via surgery. The second was to kill the millions of tiny defective, replicating cells with toxic chemotherapy and radiation. The third was to get your affairs in order if the cancer comes back. In Randy’s case, he had been successful in following the first rule, but had failed to succeed at the second, which resulted in the third situation. It was black and white to him.
But not for me.
“What about a liver transplant, even a pig’s liver?” I asked. Randy and the oncologist shook their heads. No surgeon would do a transplant after cancer has metastasized, because by then the body’s circulatorysystem is flooded with cancerous cells. For a successful transplant, the patient’s immune system has to be suppressed, during which time the cancer would gain a foothold in other organs or perhaps in the transplanted organ. In the end, it would be a waste of resources and time. And time was precious.
I think it was about then that I started to cry uncontrollably. “That’s it?” I asked incredulously, beginning to sob in one of those really embarrassing, she’s-lost-it kind of ways. The doctor came and sat next to me, holding my hand. It was the first time he had ever had any physical contact with me. He usually sat in front of the computer after having examined Randy and consulted the lab results displayed on the screen. The conversation stayed in the technical realm. Now, our oncologist showed how truly great he was: he showed us his compassionate side, comforting me by talking to me in a calm and soothing voice and explaining what medical science now had to offer Randy. Randy stood watching us, an observer of the scene. I was the emotional wreck, not my husband, when it was he who was going to die. I sat there crushed, sobbing and sniffling. Cancer had blindsided me again.
When we left the examining area and entered the waiting room, I had my emotions under control, but my face couldn’t hide the bad news we’d just received. Randy and I leaned on each other, holding hands as we walked past our comrades in the cancer wars.
A
Instead of the scene I had expected, Randy and the nurse sat there looking sad. Moments later, the oncologist entered the room and carefully confirmed that Randy had read his scans correctly: the cancer was back. He said it was as aggressive a return as he had everseen: nine tumors in the liver and too many in the spleen to count. Three to six months of good health was all we could expect. Then he started talking about palliative care strategy with Randy.
My mind was racing to understand the turn of events. I was confused about what palliative care meant, and the doctor explained that they would now focus on slowing down the cancer in order to buy Randy as much time as possible, but the goal was no longer to eradicate the disease. I couldn’t fathom the idea that my husband wasn’t going to win, that he would one day very soon not be tubing with me at a water park or winning an extra-large stuffed animal. How Randy was able to accept the situation, his death, so calmly and quickly is something I’ll never fully understand. Maybe he was able to disconnect his intellect from his emotions more easily than most. Maybe it was because he was an excellent chess player, former captain of his high school chess team, always two steps ahead of the game. He did his research, knew the statistical probabilities for various disease advances and scenarios, and understood that a recurrence almost always ended in death. Science was his faith, and he understood the world in which we live according to its laws. The steps for dealing with pancreatic cancer were quite clear. The first rule was to remove the cancer via surgery. The second was to kill the millions of tiny defective, replicating cells with toxic chemotherapy and radiation. The third was to get your affairs in order if the cancer comes back. In Randy’s case, he had been successful in following the first rule, but had failed to succeed at the second, which resulted in the third situation. It was black and white to him.
But not for me.
“What about a liver transplant, even a pig’s liver?” I asked. Randy and the oncologist shook their heads. No surgeon would do a transplant after cancer has metastasized, because by then the body’s circulatorysystem is flooded with cancerous cells. For a successful transplant, the patient’s immune system has to be suppressed, during which time the cancer would gain a foothold in other organs or perhaps in the transplanted organ. In the end, it would be a waste of resources and time. And time was precious.
I think it was about then that I started to cry uncontrollably. “That’s it?” I asked incredulously, beginning to sob in one of those really embarrassing, she’s-lost-it kind of ways. The doctor came and sat next to me, holding my hand. It was the first time he had ever had any physical contact with me. He usually sat in front of the computer after having examined Randy and consulted the lab results displayed on the screen. The conversation stayed in the technical realm. Now, our oncologist showed how truly great he was: he showed us his compassionate side, comforting me by talking to me in a calm and soothing voice and explaining what medical science now had to offer Randy. Randy stood watching us, an observer of the scene. I was the emotional wreck, not my husband, when it was he who was going to die. I sat there crushed, sobbing and sniffling. Cancer had blindsided me again.
When we left the examining area and entered the waiting room, I had my emotions under control, but my face couldn’t hide the bad news we’d just received. Randy and I leaned on each other, holding hands as we walked past our comrades in the cancer wars.
A
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