Sunday, September 12, 2004


b4b.jpgThis is my entry for Blogging for Books #3. The theme for this month is Adaptation; Jay asked folks to "write about a time when you struggled to adapt to a major change in your life."

The doctor walks into the waiting room. He looks worried. He sits down next to me, and tells me that the tissue from today’s biopsy is almost certainly cancer. I close my eyes. Oh god, not again. I realize I’ve said this aloud. I open my eyes, breath deeply. The doctor tells me what appointments to make, and is off to another surgery. And so, a short while later, I am the one to tell my husband Paul that, 22 years after his first cancer diagnosis, he has cancer for the second time.

Then we are sucked into the whirlwind of pathology reports, CAT scans, treatment and physician options, second opinions. We grab onto the facts as they whirl around us: oral squamous cell carcinoma, base of the tongue, perhaps secondary tumor due to earlier radiation, surgery the best chance of cure. Six weeks later, the whirlwind drops Paul into an operating room; he is there for 12 hours. His doctors remove the tumor and adjacent lymph nodes, reconstruct his tongue with tissue from his arm, graft skin from his thigh over the hole in his arm. He gets a tracheotomy and a feeding tube. When the swelling goes down enough, they remove the trach. After 10 days in the hospital, Paul is sent home to finish recuperating. The surgeons believe that they have gotten all of the cancer. There are clear margins around the tumor. The lymph nodes are negative for cancerous cells. Now he just has to heal.

Through all of this, I do not learn that I am stronger than I thought I was, or capable of handling more than I thought I could. I know, and have known, that I am strong, and extremely competent. I do learn about this cancer, and the mechanics of swallowing. I learn some new skills: being my husband’s advocate in the hospital, dressing surgical wounds, analyzing medical billing. I learn enough that trained medical professionals with whom I speak sometimes assume that I am one of them. I do not think of this as adapting. I am simply doing what I need to do to take care of Paul.

A short while – or is it forever? – later, seven months have gone by. While Paul is still learning how to swallow again, he is able to take care of himself. His most recent CAT scan, from the end of June, is clear. I am back at work full-time, but I find that I am struggling. I cry every day. I feel exhausted, and find it hard to concentrate on work that I once loved.

I’ve been in therapy before, and decide that I need to see someone again. During our second session, my new therapist asks me a number of questions. I have a psychology degree, and by the third question I recognize that he’s giving me a standard depression screening. I know the classic symptoms, but is has not occurred to me until this moment that I am seriously depressed.

I bear no physical scars from this experience with cancer. My body has not been cut, reconstructed, left aching or numb or discomfortingly unfamiliar. But cancer, and its treatment, do not wreak these changes only on bodies, but on psyches and on relationships.

My life is not as I knew it. Paul is changed. I am changed. Our marriage is changed. I do not know, cannot quite imagine, what our lives will be six months from now, or two years, or ten. It is not the cancer to which I must adapt, but its aftermath. Part of the aftermath is my depression, and the realization I’ve come to that, right now, I’m really not doing OK. I’m getting the help that I need, and I know that, eventually, I will be OK again.