It is the darkest day and Christmas week. Class parties, holiday recitals, sugar cookies and gingerbread men, that uneasy word survivor fluttering around us like those last leaves on the oak. It has been almost a year since diagnosis—weeks since I’ve seen Dr. Cavanaugh—and I am on the second-to-last of thirty radiation treatments: the final step of my cancer protocol. My mom has been gone almost exactly four months.
My lower back has been bothering me since I started radiation—sometimes an ache or a throb, other times more of a spasm—but I have been going to physical therapy and trying Pilates in an attempt to rebuild my core strength, which has been decimated by months of chemo and decreased activity.
I see my radiation oncologist, Dr. Rosenblum, each week, and each week—with great sympathy in her eyes—she commiserates about the woes of back pain. She had a bulging disc when her son was a toddler. She prescribes painkillers and muscle relaxants. She sets up a referral to an orthopedist: She is concerned I have a slipped disc.
Some days I can hardly get out of bed. John brings my dinner upstairs. The kids act like they are visiting me at a nursing home. “How have you been, Mom? Can we get you anything?”
My dad brings me a heating pad and a back brace and my mother’s old walker. He sits on my bed and rubs my feet.
“Oh my God, I hate that walker so much,” I say. It is covered in tan Burberry fabric. But it helps me get out of bed, shuffle to the bathroom. “This is pathetic,” I say over and over. Sometimes I wince and curse if my back starts to spasm while I am walking. The kids hate it. I see them freeze when I yelp.
“Can you not do that anymore, Mom?” says Freddy. “It’s scaring me.”
My mother broke her back three years ago—multiple myeloma attacks the bones—and she was in ungodly pain for a couple weeks. I am a little worried about the connection, but my pain improves from time to time, and my dad and John keep reminding me: You are not your mom. It isn’t helpful to compare your situation to hers.
When the pain gets even worse, my dad shows up with the portable bedside commode my mom got after her back broke. I haven’t seen it since the weeks when she was dying, before she lost the use of her legs. She was so weak that we would need to stand beside her to hold her upright—her bruised arms trying to grip ours.
“You haven’t earned your place in this world until you’ve wiped your mother’s bottom,” she joked to me and Charlie.
“Oh please, Mom,” I would say, “Montaigne would say you haven’t lived until you’ve wiped your mother’s bottom.”
Later it was diapers.
“Now this is more like it,” I said when she would lie there muttering I’m sorry I’m sorry I’m sorry as we would roll her from side to side, perfecting the art of withdrawing the used chuck at the same time as lying down a fresh one. “Now we’re really earning our keep on this planet.”
“Oh, fuck that thing,” I say when my dad walks in with the portable commode. But since the moment yesterday when I tripped on the sidewalk, I have hardly been able to move. Step on a crack, you break your mama’s back I keep repeating to myself.
I can’t sleep, and when I am able to manage to even get on the toilet seat, the pain is such that I can’t relax my bladder enough to pee.
“I am suffering,” I say to John in the night, feeling a little melodramatic but also thinking: Yes, I believe this is what suffering is. John drives me in for treatment the next morning and I need a wheelchair.
“Don’t you think I should be taking you to the ER?” John says. I can tell he’s trying to hold it together.
“No! That’s insane,” I say. “We’re already at the hospital. We’re fine.”
The receptionist slaps a yellow FALL RISK bracelet on my wrist. Marie and the other techs are playing A Motown Christmas and dancing. Someone has made bags and bags of snickerdoodles. I can’t get on the radiation table without a spasm.
“This is getting ridiculous,” says Marie in the kindest way someone can utter those words. “I think we need to page Dr. Rosenblum.”
*
A bus. A cough. A rusty nail: Death sits near each one of us at every turn. Sometimes we are too aware, but mostly we push it away. Sometimes it looks exactly like life. Orange: The colors of the sky are the same when the sun rises as when it disappears.
“Dying isn’t the end of the world.” What would Montaigne have made of my mom’s little quip?
When Montaigne was thirty years old, his soulmate and best friend, étienne de La Boétie, died of the plague—sudden and gruesome. Montaigne wrestled with love, horror, and a rudimentary understanding of contagion at La Boétie’s bedside and then recorded his friend’s death with unflinching detail in a letter he later wrote to his father. He adored La Boétie so deeply: “The greatest living [man] I have known . . . truly a complete soul whose beauty shone forth in every direction.” The loss provoked much of Montaigne’s signature commitment to live with an awareness of death in the room—an awareness of being always in suspicious country.
*
Someone pages Dr. Rosenblum. There is a stretcher. We are wheeling through corridor after corridor. I’m no longer in the radiation wing of the cancer center.
In the Emergency Department, death enters the room looking like a young, cheerful attending. “Good news is,” he says, scooting close on the rolling stool, “your labs look mostly normal.”
“But one thing to note.” He squirms a little on the stool. “It seems from the MRI that you do have a significant fracture in your spine, at the L2 vertebra. And the way it is broken is very worrisome. It’s not a trauma break. It’s a pathological break, likely caused by a tumor that has metastasized from your breast.”
“Okay,” I say. I can’t look at John. “Any chance it could be anything else?”
“I am so sorry, but no,” he says. “I’m so sorry. I hate telling people these things and I’m not very good at it. We’re going to admit you upstairs. You will probably have surgery right away.”
A stream of doctors after that—one, a radiation resident I have come to know, crouching down to eye level with me, gripping my hand and not pushing away her tears. Then a surgeon. Then a neurologist. Then Dr. Rosenblum standing over me with the face of a mother whose daughter is very late for curfew. She keeps patting my hair: “How could this have happened? I am so, so sorry.”
John’s eyes from the visitor chair reflect my own face back to me again and again: Wait, what? We kept asking each other, What?
2. Helicopter