How do you thank the person who saves your life? How do you tell them, and what words do we have that truly express such a debt of gratitude? The countless other lives this person has impacted by saving your measly live, that you thought was insignificant, but when you faced death head on, you realized that even if you didn’t have meaning for yourself, even if all the years of therapy hadn’t allowed you to recognize your own self-worth, that despite the dirty secrets you harbor, the sins you have committed, those other things you call your ‘idiosyncrasies’, that there are people who love you regardless. People who love you in spite of these things; in spite of You.
It is to spare their grief that you wish to live. Maybe you don’t believe that, but if you have ever been close to death , and maybe you have, then you know that the worst thing of all is not your own fear, but the fear and the pain you see on the faces of those you love. They visit. They take care of you when you can’t take care of yourself, you invalid. They make you tea and bring it up to you in bed, place it next to your ever-present IV. Some show up with small gifts of pastries or fruit salad. They dodge between home nurses and physical therapists. Some of these friends will quietly cry next to you on the bed when they think you are sleeping in a narcotic induced haze. Others will step out into the garden and hide behind the hollyhocks and shed their grief to the pollen, to the grass. Still others, at least one, grasps your hands firmly, stares you square in the eye and pleads with you not to die. Please, he says, Please don’t leave me. I can’t do this without you. And this, this means everything. This is where you get your will to live. So it’s circular, but you live for them, not so much for you, because for you, you are tired of the pain and the surgeries and the drugs and the diagnoses and the countless doctors and scans and radioactive shit they pump into you. You would give up, but you can’t. Not yet. Not now. You promised.
It all happens so fast; whisked from diagnoses (cancer) to surgery (surgical oncology). You are appointed to the best of the hospital; the best melanoma surgeon they have. His name is David. You meet him twice, but hardly notice any details about him. He seems kind and blushes easily. But really, all you notice, all you hear, are the details as he outlines your lymph node biopsy and removal, the wide-excision they will have to make to get “clear margins”, the chemotherapy that will surely follow, the depth of your melanoma (over the line), the doctor he recommends you to at Dana Farber. You take his card. You take the information about Dana Farber Cancer Treatment Center. You make the requisite calls, but mostly you are numb and all of this organizing is automated. Not quite real.
What you don’t notice, what you don’t realize (at least, not in that moment), is that this gentle man who speaks to you now, will be the same man who leans over you in the operating room and gives the signal for the anesthesiologist to send you off on dreams you won’t remember. Before you are completely under, this surgeon leans over you – the drugs have put you in twilight – it’s not so bad, you think. It’s kind of nice, really. His eyes are blue and large. You notice this, but you can’t remember his name. Not now. He says, Everything Will Be All Right. And you believe him. This is the contract of cancer. Absolute faith, based on nothing, but isn’t that what faith is? Don’t we all take the ontological leap, believe when there is no solid proof. Faith is about believing despite science or logic that may say to the contrary. It is about the intangible. So I have faith, despite statistics, despite prognosis, despite what I’ve heard and what I’ve read. I am a confirmed believer. Baptized and delivered. Amen.
The recovery is too awful to bother writing about, and too banal. It’s so ordinary. A few details: It hurts like hell. It stinks. It’s frightening. When I see my leg, see how much of me is missing, I mourn. I cry for the lost part of me. I cry for lost freckles that once seemed so innocent. I call my mother and tell her, I am dying of freckles, and I laugh through my tears and she laughs through hers. That is all I remember. The rest is a pleasant, poppy-colored blur. It is like living through wrapped gauze, the world is muted.
Returning home is not a home-coming in any traditional sense. When I return home, it is with a daily nurse, sometimes two, a physical therapist (who tells me her fiancé died from melanoma just a month prior – very cheery), an IV drip that sometimes the nurse changes, but eventually, both my husband I will learn to do and will learn the language of hospitals: Heparin lock, a long lead versus a short lead, making sure there are no air bubbles in the line, hooking up the antibiotics and pain killers. This is necessary because of all things, I have contracted a particularly virulent infection in both of my wounds: they call it cellulitus, or necrotizing fascitis. My body is eating itself with infection – with cancer, with cellulitus.
I can’t walk, and I have a wheelchair. It is sleek and black and matte it is the Saab of wheelchairs. If you have to have one, this isn’t so bad. Mostly, I am in the bedroom upstairs with my IV and lots of films that I’ll watch but not remember and a friend by my side. I take pills of different colors: my favorite is one of a deep purple color. It makes the pain go away and everything come in waves. The white ones are tiny, like after-coffee mints. I take them when it starts to hurt.
I make a point of going down the stairs (which I do on my rear-end, slowly, step by step) at least once a day. I sit in my wheelchair and listen to opera because I have just realized how much I love it. I always liked it Even worked for the Boston Opera Theater, so this is nothing new to me, but the way it sounds now, the intense emotion it holds, touches me like never before. O Mio Babino Caro becomes my favorite. What little I remember from my surgery is waking up to this aria. That I heard a beautiful voice singing in Italian. But I can’t confirm this. It may have been the drugs, or my desire, or both. Either way, I hear it, and now, I want to hear it all the time, so I put it on repeat and play it over and over. It is one of few things that makes me happy in those dark days. I sit in my wheelchair at the garden door and watch the coneflowers blow in the wind. One day, I see the soft grey-mauve of a storm front moving in; one of those humid, sultry summer storms with heavy rain, and yes it’s corny, but I don’t think I have ever seen anything so beautiful.
All these things I’ve taken for granted are suddenly alive. What a fool I’ve been. This, I am sure, is an experience common to all patients who suffer serious illness. Who come to that thin place that is the edge of death. But I did not die; I was saved. I was lost, but now I’m found. And I didn’t even notice the one person who saved my life – not til later.
Later, when I could walk again, I saw my surgeon in his office. It was a routine check to see how the incision was healing and to get the results of my the lymph node biopsy. He looks kind to me. That’s my first impression. He wears really nifty, well-tailored, peg-leg suits and a dark tie. Eventually, I will find out that almost all oncologists wear dark suits and ties, but I can tell you, none of them look as cool as David. And cool is the word. He looks like Maxwell Smart, only better looking. He has light-brown hair and freckles and big blue eyes. I remember the eyes from the OR. He speaks softly, and even the worst news is when it is delivered by him doesn’t seem so bad. I begin to like him. He keeps me out of pain, he has saved my life. He has held my hand when I was frightened. He has returned every page. He has always been right there. Of all the people around me, he is the one person I think truly understands what is like to live in that thin place between the living and the dead, because that is where I live. Not dead, not quite alive. A thin place.
It’s not fair that those I’ve loved all along can’t truly understand what this is like. It’s not their fault. They try, but no matter, they just can’t understand. Nor can I explain. It is a tacit understanding that exists between surgeon and patient. Who else but your lover or your husband enters your body so intimately? Who else renews you with his spirit? At first, my cancer seemed to draw my husband and I closer than we had ever been, but eventually, he began to pull away. I felt it, every inch he moved away. He wanted to save me, he wanted to be the hero, and he wanted this because he loved me. When he realized he could not save me, then he turned. He talked to women at his office about his grief, but said little to me. A year later, when my cancer returned, again he pulled away and found a woman at the office. They developed one of those office “things” that for some, seem to defy definition. To me, it’s simple: it’s an emotional affair or a crush or both if there are sexual feeling involved. There could be a checklist to determine the nature of the relationship.
Question 1 Are you lying or have you lied to your spouse about this person?
Question 2 Do you feel sexual desire for this person – lust.
Question 3 Do you hide this person from your spouse, avoid introductions, get nervous when the two are in the same vicinity…
So you get the idea. If the answer is Yes, they’re on you’re the slippery slope to wherever you want, but not anywhere that will ultimately be of consequence. It may be fun for a while, and who knows, maybe you’ll even fall madly in love and divorce your spouse, in which case, have the courage to just say Enough and then do what you want and move on. But please god, stop dragging us all through the muck and mire. It’s deadening and blistering and it sucks.
. I imagine being with her was lighter, such contrast to the darkness that seemed to shroud me, no matter how hard I tried to shrug it off. With her, the contract was simple: make her laugh, make her smile, make her want you. It was easy, far easier than what our life had become. When I found out, as one always does when there is some form of infidelity, I was shattered. I’m still shattered, and although it’s illogical, perhaps in some subconscious way I blame my husband for not being able to save me. For not being able to make me laugh in my darkest hour. For defining me, seeing me, as nothing more than a PATIENT, as if the word had been stamped in indelible ink on my forehead. I was and am more than the sum-total of illness; there is so much more to me, both good and bad, but it seems cancer has put up a road-block or a scrim, and it is difficult for anyone to look at me and see anything else other than this. I am a sick girl. A very, very sick girl.
I’ve heard that many patients develop a crush on their surgeon. It’s only natural. He is your savior. All those things you wanted in a man when you were young, before you became an educated feminist and you wanted a savior, a man who was strong and lean and could carry you if he had to. You want the modern-day equivalent of a cave man who will take care of everything so that you don’t’ have to worry. You want the man who can fight off the bad guys and win. A guy who can fight. It’s visceral, it’s probably politically incorrect, but it’s true. What bad guy could be worse than cancer? So David fights them off, and Lo! He wins. He is my instant hero. And as unfair as I know this is to my husband, to others I love, it is David that I put on a silver pedestal. And though in any other circumstance I don’t think I would be attracted to him, years later I find myself strangely drawn to him. I believe the thing that draws me to David is a similar mechanism to the thing that drew my husband to that woman at work. At its root, it is about language and communication; David and I speak the same language. It may be morbid, at times technical, but at its heart, it is about saving a life. My husband seeks out his own savior; someone to lift him out of this grief, this dark, thin place.
So how do I thank him – this man who has held my life and given it back so gently? Several surgeries later, all performed by him, all for cancer, how do I thank him. He’s kept me alive, kept me out of pain, he’s been my number one advocate, he’s told me I’m ‘tough.’ He’s told me, ‘You’ve been through a lot,’ though I ever thought of it that way. I just made my way – groped the dark corridors and prayed I’d come out the other side. In all of this, I never felt sorry for myself. I felt sorrow, I felt grief, I felt rage, and I felt regret, but never self-pity. Is that hard to believe? It’s the truth. I was too busy fighting, too busy dealing with just getting through. There was no room in my schedule for such pity.
If I felt sorry for anyone, it was those I love, as I’ve said. For them, I felt sorry. Sorry that I was the cause of their pain. Yet if anyone I love had to get cancer, I am still glad that it was I, because if it had been one of them, I honestly think I couldn’t handle it. Then I would rather die. Then I would feel sorry for myself, because without them, I am nothing. It is through them that I live. It is through them that I do good deeds and bad, that I comfort and hold, that I listen to and vent to, that I depend on and always will. Without them, I don’t even know if exist. And my best friend, without him, should it have been he got the cancer and not I, then I would shatter and splinter like glass. Once, he was in a cycling accident too awful for words. He shattered and almost lost his arm. He held the pieces together with a magazine as he lay on the road and drifted in and out of consciousness. When the medi-vac helicopter arrived, he coded – he died – and had to be revived. When he arrived at the hospital, he was rushed to surgery, and again he died. Again he was revived.
I got the call at about 3:30 in the afternoon. My dear friend Carl said, ‘Please stay calm. I have to tell you something,’ and I knew it was bad. He told me, ‘Ian has been in a bad accident.’ Where? I said. He said the hospital and I ran out of my little brownstone on Beacon Hill all the way down the hill and rushed through the doors of the General, and rushed through the pistachio and white corridors until I found his room. He looked so fragile, so broken. All I wanted was to take his pain away. God, I pleaded, why couldn’t it be me, and this was not just something I thought, it is something I meant and still mean. I excused myself to his little bathroom and sobbed. But I did not cry in front of him. I stayed with him. I fell asleep over the vent on the big hospital windowsill. A sympathetic nurse brought me a blanket. I kept vigil. But it was too much to handle, so all these years later, now that I am the one – now that I am the patient, I am sorry for the pain it causes them, but selfishly, I am glad it was I who got ill. Because I am so selfish that I know I cannot handle their illness. That I have lived and I have learned and know that I cannot suffer a loss such as this. That I want to be the one to die first, just so I don’t have to grieve and be left alone. Don’t abandon me, I want to scream, Don’t you dare. Let me go first.
My last surgery, just a few months ago, I spent several days in the hospital with a Demerol drip hooked up to my vein. My husband visited every day and stayed for long hours but all I could do was start fights. Maybe I pushed him away because I was afraid he was losing me anyway. Maybe I pushed him away because last time, he went away and turned to another woman. That if he turns away this time, at least it would be me, not cancer or him, that made the decision.
David came by very late the night of my surgery. He was still wearing his scrubs and a patterned head wrap. I guess these patterned wraps are all the rage with surgeons. I’ve seen them on TV, on ER. I didn’t know real doctors wore them, but they do. He came in just after I had received another injection of some or other opiate. He sat on my bed and pulled back the sheet to look at my leg. It went well, he said. We won’t know if it was successful for a while, but it went well. He said, I cleaned it out (whatever that means). It did hurt. Even with all of the drugs, it hurt like hell, like a slow and steady burn that comes up on you and you can’t take your hand out of the fire. By that night, we had known each other for four years. He had treated me for every melanoma, large and small. He placed his hand on my knee-cap and gently stroked it. And although the leg hurt, the contrast of his soft touch as he was checking the wound felt so good that it was almost sexual. It was definitely sensual. And then Eureka! It was at that late date that I truly realized the very critical role he had played in my life.
Before I say more, I should make it very clear that I was on a great many drugs at this time. That I had IVs of Demerol and oxycontin and some other things – I’m not sure what. I had no control over what I was saying. If I thought a thing, even for a moment, I announced it. So in this moment, at almost midnight on a Tuesday night in October I professed my undying love for him. I told him I wished I could be with him all the time. That it was only with him that I felt safe. Such insult to my husband who had been there, patiently waiting, for every surgery. Who had taken care of me, ran errands, doled out pills, comforted me. And I did appreciate my husband, so much more than I let him know, but what I felt for David was an almost religious love. And while I knew I would never sleep with him or pursue a real relationship – for many reasons – that I love my husband, that adultery is a mortal sin, that he is married with children and a wonderful wife and in my later years I could never do this to another woman, never be part of such betrayal, but I admit that I did want to make-love to his soul. I wanted to breathe life into him somehow. Oh, I know. It’s too metaphysical, too theoretical. But how do I explain a love that is not corporeal but transcendental. So I declare my love, he holds me hand. He sits on my bed for what seems like a very long time, his other hand on my knee. This must be what they mean when they say ‘bedside manner.’ He was my comforter that night, as he had been many other times, but only now did I realize. I remember his face, I remember him being in my room, I remember the warm, mellow touch of his hand, but I don’t remember everything I said. It was not until a few days later that I realized with horror that I had professed my great love. That it may have seen that I was flinging myself at him, some desperate and unhappy woman.
Friends told me of similar incidents. One dear friend who had breast cancer told me of the great crush she had on her oncologist. I’ve heard of many other patients, and now, in the waiting room to his office, I see the woman fawn and fall all over him. A few weeks ago, a couple of women were talking about him and with a sigh said, Oh, those blue eyes! After that, I felt quite ordinary. Relieved, though still terrified to see him, afraid of how he would treat me now. So I waited, my palms sweated, my heart beat fast.
The nurse called my name and asked me to change into a hospital Johnny with my bare flank visible. This is how hospitals make you vulnerable. My surgeon knocked gently on the door before entering. I was both glad and embarrassed to see him. I apologized, couldn’t say enough to say I’m sorry, and very smoothly and deftly, he told me that I had said nothing to be embarrassed about. He let me off the hook, but I believe we both knew what was said that night and that however you define it, this is some sort of love. It is gratitude en extremis.
All our lives most of us look for love. We seek the perfect companion. The one who will comfort us, stand by us “for better or for worse,” and if you are a woman, in some way, I believe our instinct is to look for a stud, a savior. That savior may be different for everyone, and thank god — what a mess it would be if we all wanted the same man. But love comes in strange forms.
They say love comes when you least expect it, and experience tells me this is true. I have been in love twice, and both times, it was a surprise. Am I in love with my surgeon? No. Do I love him? Yes. But still, after much searching, I cannot define what this love is. I know what it is not, but that does not tell me what it is. It is not sordid. It is not inappropriate. It is not a betrayal of my husband, and the confidences we share are not secrets. Or they are, we call them “cancer secrets.” We share a language that only others who have been to that thin place between life and death can comprehend, and even then, I think there are variations between each doctor and patient. But it is love. Of this I am sure.