...Thank you. The brother of a good woman died over the weekend. He and I have the same birthday. He found out he was sick two weeks ago: cancer. Now he is gone.
I cannot but be true to myself, so have to quote Spinal Tap: "Too much. Too much fucking perspective." And then lead singer David St. Hubbins apologizes to Elvis' grave.
If we can't laugh when it hurts the most, we are not actually understanding why we evolved the capacity to laugh. I am sorry for your loss: you, who are left here. You, who remain: I am sorry.
Onward.
In the immortal words of the achingly beautiful Spinal Tap ballad featuring Cher: "Just Begin Again." It is off their album "Break Like the Wind."
To steal from a friend's email: Ding! goes the bell for the start of round three, and here we go again.
Today was stew. Goulash. Gumbo. Chowdah! A mix of a lot of feelings, sensations, deeply interesting musings, thoughts, fears, all punctuated with large and small violations of my body. I hope that doesn't explain it all that well, because I am not sure what the hell it was, really, so at least we're all in the same boat.
N and I arrived at the city-state that is the Hospital bright and early at 8:30. The regular rattlesnake installer in the Leukemia wing was off for the day, so we hied ourselves to the older cancer/chemo wing and met our nurse for the day, a gent with a goatee and a watch I believe would be described as 'chunky.'
My veins did not cooperate, as they tend not to, and we could not get 'good return,' which is medical slang for blood flow out of the rattlesnake and into the tubes. It's like a bad stock investment: stuff goes in no problem, but you get nothing back.
The nurse was a man. With pride. Men with pride do not ask for directions, and, apparently, nor do they ask colleagues to try and get good return from a patient. Pride is a sin, I am pretty sure, at least with the mackerel-snatchers--I have no idea if the WASPs held onto the deadly sin thing, or if it got in the way of earning money and defining taste and deportment according to your own puritanical and likely fluid set of beliefs. I should check with N, as she has a almost witch-like capacity to identify Papists from well over seventy paces. She's like a mackerel-snatcher divining rod, which is a metaphor I enjoyed the hell out of mixing.
So, eight syringes of saline or so later, and with no more out-flow than when we started, we hied ourselves the hell away again towards floor 5, where I was to renew my vows with the convivial interaction of man and needle that is a LIVE! DIRECT FROM HELL! THIS IS SPINAL TAP!
Hello-to-you-says-my-butt gown in place, I waited a while--they don't want you to get a tap until they lower your core temp a bit by leaving you in the freezing cold waiting room. Then I waddled down the hall, safely stuck to the floor through my rubber-nibs-because-we-don't-really-believe-you-can-walk hospital socks, and laid myself out on the slab.
A female Dr had me sign some forms likely absolving her of any screeching tears in my spinal column, then poked the hell out of me with the anesthetic, which I have learned is a good sign. The harder they jab you with the numbing needle, the less of an issue the spinal needle seems to be.
And today was no different. She dribbled the 6cc they needed to check and make sure I didn't have any baddies in my spinal fluid. She then responsibly replaced my losses with 6cc of Methotrexate. Let the games begin.
Then it is back to the world's coldest waiting room, where you are mandated to lie flat for an hour. But they do bring the monitor that shows your blood pressure and pulse every fifteen minutes into view. Except you have to crane your neck to see it, and it is above and behind you, so you see it upside down. 116/55 and a 96 pulse-ox are a little blurry upside down while shivering, but I managed.
N had gone to get me food while I was laid out, and I ate it greedily while waiting to see the Drs for the Marrow Biopsy, which would precede the IV Vincristine and IV Methotrexate.
Wait? What's that you say? Didn't you just get 6 merry cc of Methotrexate pushed into your spinal column only moments ago?
Right you are, and aren't you a bright and attentive reader of self-absorbed cancer blogs!
Phase three--the ding you heard earlier--starts with a double-shot of Methotrexate, and the IV Meth amounts get raised every time you get chemo if your numbers are staying high enough to support it. So each time we arrive and get bled, the numbers will be checked, and if the platelets and White Blood numbers are amenable, it is up the Meth ladder we go. Wheeeee!
I did not need to wolf my food, as we were left in the hall for a while, because drilling a hole in some poor schmuck's pelvis and twirling out a nice juicy earthworm of marrow for four different tests of the canceritudedness of my carnal form is a somewhat involved event, so they wanted to take care of the quick and easy patients first. Which, frankly, I understand. I mean, even theatrically, that makes sense, right? Act I: Blood pressure and maybe some bad news. Act II the drawing of blood and a wailing, inconsolable spouse. Then, Act III...BOOM! Drill a hole in a guy's ass! Barnum, Marlowe, and Loeb all woulda loved it.
But eventually we were taken back, I was placed stomache-down for the second time that day, and the lead Dr Himself began core-sampling my tuchus (I could be misspelling that--I am only one quarter Jewish through step-family, and I don't know much about the god-ghost-stories in my bloodlines, so having high hopes for my Yiddish is probably a bridge too far. But, I try.)
The Lead Dr is deliberate, and he does everything the same way each time. He likens it to a Japanese Tea Ceremony, an act of devotion honored for its near-religious repetition and adherence to form. I would have imagined him in a kimono with chopsticks glued to his bald spot where a bun should be, but I was pretty keyed-up by this point.
He pulls your pants down just far enough for you to close your eyes and run through your visual memory of who was in the room when this all started. He cleans the area around where he'll do his digging. He speaks calmly, describing each act before and during.
He numbs the area: "There will be a pinch and a burn, OK? Here's the pinch [Ed note: damn right there's a pinch!] and here's...the burn [Ed note: ow!]"
Then there is the relatively benign thumping and twisting as the core sample of your bones gets started. You are numbed in the places the Dr is cut-poking through. This is the part that feels like a root canal in your butt. There's really nothing that gets as close to that description.
Then the hole has been made and the pull has to happen.
This hurts like shit, for the most part. But in a very, umm...a very--
OK, this is where, as an artist, I get sort of clotted up. I think that it would be even worse for N, because she is a writer, and a writer, even more than an actor, spends a great deal of time and energy and passion and life-force trying to describe events or feelings in a manner that will do them justice and, hopefully, be understood by a broader group of people.
And the 'pain' of the pull is, frankly, indescribable, which is in many ways unbearable to me.
I mean, you could use the word 'hurt.' You could get by on the word 'hurt.' I am certainly gripping the living snot out of the table edge. I think I am making a noise somewhere between a groan, a keen, and a whimper. But I am not sure. It is extremely unpleasant.
But it is interesting. It is fascinating. The Colombian Dr on a learning-residency said that in his country they describe it as 'taking a part of the soul.' And he's not wrong. When I tried to describe it to N I said "OK, pretend I have a huge pair of invisible tweezers that can pass through bone. Now think about something really pleasant, really nice. As soon as you get that thought solid I reach into your brain with the invisible tweezers, and I pull it out, and take eighteen long seconds to pull it fully from your mind."
But that's not really it either.
OK, lemme try again. I can't see what the hell's going on because, you know, it's happening on my ass. But if I go purely by sensation then what is happening is that something very internal, something that has, since the day I was born, considered itself 'me' is being pulled out of my body. Not 'part of me' or 'a section of me.' But just 'me.'
Like when you look at your dog and you see in his eyes that he can't do math but he loves you: that thought is complete, unbroken, and unquestioned.
My marrow has never before been considered an optional body part. My marrow has never before been a component of me, to be separated and viewed in and of itself.
It is that kind of deeply ingrained, indivisible part of you that is being pulled out of you.
You do not know what the word 'inexorable' means, feels like, until a professional sawbones takes seventeen to twenty seconds to extract marrow from your butt.
You feel the slippage, you feel that this particular meat is clinging, doesn't want to go. But the Dr is stronger than the mute wants of my meat.
Slip, catch, drag, pull, slide, catch, twinge.
And it is painful, in a pure sense. But painted with this sense of loss, this tugging uncertainty.
You know what? I'm gonna stop. Because I think it is somehow beautiful to just accept that I cannot describe the exact kind of inner and outer, felt and sensed pain that is eighteen seconds of marrow pull. It is nicer, I am now realizing, to just leave it at that.
The Dr got a great pull, according to N. We will get bits of info over the next few days, but the whole shebang of what we hope to be good info isn't expected until the end of next week at the soonest.
Then we talk for a while while I lay flat, we cover the new rules: I need to drink five liters or so a day because the Methotrexate and the Peg Aspargase will stress the liver and pancreas and other fun stuff.
Phase Three will supposedly not damage my numbers as much as they will strain some internal organs--mainly the ones that strain and clean what passes through you, which makes sense.
Then everyone leaves us alone, we wander over to the chemo area, I get my IV Vincristine in short order and follow it quickly with IV Methotexate, which I notice for the first time--because it isn't going in behind me--is yellow like Gatorade (the original). Hmmm.
Then off to home, walking very slowly through the humidity and the anger of a New York August Wednesday. The subway is crowded, the traffic is limitless and has its collective panties in a bunch, and we get home and order steak for me and shrimp for N because my protein levels have been low--which is a horrid embarrassment when you come from ranch stock.
And tomorrow I get to go back and get the Peg Aspargase and two bags of blood.
Phase three. Left foot right foot, repeat.
Ding!
