Five years ago this week, I woke up in recovery, afraid to slide my hand under the sheets. My recently acquired gynecologic oncologist had told me that if the large (4 x 4 x 6) mass on my left ovary were cancer, he would put in an abdominal port for chemotherapy during the surgery. I was afraid to check.
The next time I emerged from the druggy fog, my doctor was standing next to my bed. He spoke four words, “Good news, no cancer.” But I don’t recall that he was jubilant. Grave, quiet. I didn’t think about it at the time, but then, I was barely able to think, after anesthesia.
Over the next few days, I learned more about what had happened in surgery. The mass had exploded sometime during the three-week wait, scattering “cancer seeds” throughout my pelvic region, lengthening a four-hour surgery to six. My friends had waited through it all. When I challenged her later, one of them said simply, “Where else would we be?”
I had asked the doctor not to take anything he didn’t need to. During the surgery, he had come to take counsel with these good women, recommending that to be safe, he would prefer to take both ovaries. “Do you know her latest thoughts on the matter?” They talked among themselves for a moment, then gave him permission. One woman later told me that she’d marveled at the size of his hands, those big, gentle hands that had just been in my abdomen, removing everything not nailed down.
Necrosis, tissue death, had begun. When he took my appendix to the lab, the staff there asked what it was, so misshapen had it become.
“It’s an appendix,” he told them.
“No, it isn’t.”
“I took it out; I know what it is.” When he told me about it, he touched the ribbon on one of the vases of flowers in my room, saying a healthy appendix looked more like the tip of a finger, more rounded and short, not flat and long.
The morning after surgery, he came into my room and looked almost accusingly at me. “You do not look like a woman who had surgery yesterday.”
“I feel better. That tells you how bad I felt.”
In truth, I hadn’t let myself know. There were things to be done. A good friend was coming across several states for Thanksgiving. I ordered the meal from a local catering service, even though, by that time, I wasn’t much interested in food, a complete reversal for me. If I had known that a feeling of fullness after eating not very much was a symptom of ovarian cancer, I might have worried. But I didn’t know about the symptoms: bloating and digestive troubles, inexplicable weight gain, pelvic discomfort, urinary urgency or frequency. That knowledge would come much later.
“I sent to the lab four times with your cells,” he went on. “But I’d like to send them to a doctor at Impressive Place. He’s sat in a lab for thirty years, looking at slides. His nickname is God. Ninety percent of the time, he agrees with our guys in pathology, because our guys are good. I’d like his opinion.”
I couldn’t refuse. How special was I, or were my slides, that they should go to Impressive Place? I wasn’t worried about a ninety percent chance of not having cancer. Those were pretty good odds. My biggest worries were my daily walks down the hall.
I remember the day I made it past the nurses’ station for the first time. I was exultant, then turned around to read the words Gynecology/Oncology on the entryway to 5 East. They may as well have painted “Abandon Hope, all ye who enter here,” I thought.
After my week in the hospital, where I had a private room, expense be damned (what did I know from medical expenses?) I went home and began to rebuild my strength. I made rules for myself—no stepping off the porch, even if I felt like I was strong enough. No walking alone, even with my stick. No long walks, realizing I had to leave enough energy to walk back.
Three weeks later, exactly one week before Christmas, I went for my follow-up visit.
“Looking good!” encouraged the tall intern, who’d told me about my exploded mass, as I passed him on the way to the examining room.
“You’re moving well,” approved my doctor, before entering another room.
Of course I’m moving well, I thought. Why wouldn’t I be moving well?
Between the tumor and a week in the hospital, plus a diminished appetite, I’d lost 25 pounds. I was feeling good when the doctor entered my exam room with my patient file and sat down. “It’s as we suspected. It’s cancer. I’m sorry. I can’t think of a worse situation in which to tell you, because our pathologists here were so positive it wasn’t cancer.”
Clearly, he was using the royal we—I had no such expectations. My friend who had driven me to the appointment had asked if I wanted her in the exam room, and I said, “Nah, thanks, he’s just going to tell me I’m fine,” and then, not wanting to jinx myself, I added, “unless he tells me I’m dying of inoperable cancer.”
He must have seen the distress on my face and decided to take refuge in not looking at me. “Let me read you the letter.”
“‘This is a most interesting and difficult case,’” he began, then stopped to say wryly, “You never wanna hear them say that about you.”
too atypical . . . to give it any name other than carcinoma and my diagnosis is mucinous cystadenocarcinoma, grade 1 out of 3. One sentence among the jargon clearly stood out: The mucinous cells obviously allow for the possibility of recurrence.
Stripping the letter of its cancer-speak, my doctor told me I had Stage III B ovarian cancer. He recommended chemotherapy, explaining a new protocol about which oncologists were very excited. In clinical trials, it “bought” patients sixteen months; he explained that it might not sound like very long to me, but most treatments bought only two to three months. I was too stunned to realize he was talking about my dying.
“I need your permission to do this,” he said. “But if we don’t do it, I can guarantee you’ll be back. Six months, a year, two years—you’ll be back, and it will be harder to treat.”
Of course I agreed; even though watching a friend go through chemo I had promised myself I would never do it, I was too frightened not to submit. I figured I was already in process, so why risk recurrence? Just keep going. Six months out of my life, that’s all.
I told very few people, not wanting to spoil everyone else’s Christmas. I made the effort to attend my church’s Christmas Eve service, and sat alone in my usual pew, where I gave up trying to control my emotions. They were an odd, uncomfortable mixture of hope and gratitude (my doctor and I knew the truth, and we were going to treat this aggressively so that, God willing, this would not be my last Christmas) blended with fear and misery (my doctor and I knew the truth, and we were going to treat this aggressively so that, God willing, this would not be my last Christmas). Four weeks after major surgery, I was still weak and glad to sit down again after a hymn.
Everything about the Christmas Eve service was newly, poignantly beautiful. I always tear up easily at the Christmas hymns anyway, needing to omit whole lines to catch my breath. Perhaps my favorite part of the service is the passing of the Light of Christ through the congregation as we light our individual candles while singing “Silent Night.” Our faces soften in the small circles of candle light, and we hold ourselves carefully, conscious of the power we have in our hands. Looking at the flames flickering around the church, we are reminded that we are not left alone in the dark.