Zoe
In some ways those first nights after we learned that the cancer was back were the hardest times for me. Lying there next to Spence, aware of the steady rise and fall of his chest as he slept, I felt more alone than at any other time. For as I lay there, awake in the dark, my fears were as real as the monsters our daughter, Cami, had once declared lived in the shadows of her room.
“No, darling,” we had assured her, switching on lights and opening closets and drawers to show her. “There are no monsters, see?”
Cami had crossed her chubby four-year-old arms and observed us with what could only be described as a look of pity. “Well, of course you can’t see them, Mommy,” she had explained. “They’re indivisible, but they’re real.”
“Invisible,” Spence had automatically corrected her, scratching his head as he’d tried to find the words to comfort her.
“You’re the shrink,” I had murmured. “Do something or none of us will get any sleep.”
His solution had been inspired.
“Cami, have I ever introduced you to my friend Leonardo, here?” Spence had indicated a vacant space next to him on Cami’s bed.
Cami had eyed him suspiciously.
“He’s a lion I met when I was in the army and living in the jungle. He went everywhere with me while I was over there and kept me safe so I could get home to Mommy.”
“There’s no lion,” Cami said, crawling closer to Spence and peering around him.
Spence laughed. “Well, of course. He’s invisible. I forgot that part.”
Cami frowned.
“How would it be if I ask Leonardo to sleep here on the foot of your bed? That way if any monsters start acting up, you can just ask Leonardo to take care of it.”
Cami was skeptical, but finally she rearranged her menagerie of stuffed animals to create room for Leonardo. I edged toward the door as Spence gave Leonardo his instructions.
“What’s that?” Spence said to the thin air at the foot of Cami’s bed. “I’ll ask.” He turned to Cami. “Leonardo would like to know if just for tonight you might keep the lamp on. He thinks the monsters might not like the light.”
Cami focused on the empty space she’d made for Spence’s imaginary lion. “I think that’s a good idea, Leonardo,” she said.
Spence turned on the small lamp next to Cami’s bed before snapping off the ceiling light.
“All set,” he said, and kissed Cami’s forehead as he tucked her in.
Tonight, just before switching off the lamp, Spence had kissed me and positioned the covers around my shoulders. “All set?” he had whispered, and I had nodded.
Now, in the dark, I pulled my knees to my chest, making room for Leonardo at the foot of the bed.
Spence
As the news of the recurrence of Zoe’s cancer spread, family and friends tripped over one another trying to do something for us. At the same time, Zoe was determined to get through the initial treatment on her own.
“If I accept rides or hand-holding now, where will it all lead?” she asked when I suggested that letting a friend take her to lunch or go with her to a doctor’s appointment when I couldn’t wasn’t the worst thing.
“There are lots of people who would love to have the kind of support you have, Zoe,” I reminded her.
“I know,” she admitted. “I just—it’s just that—”
Zoe has always been a giver and finds receiving next to impossible. She’s never quite understood why she is so admired and loved. “I’m a pain,” she has said more than once. “I am stubborn and controlling and—”
“Loving and generous,” I remind her.
“I don’t want pity,” she finally admits.
“Oh, sweetheart, they aren’t doing it because they pity you. They want to do something because they love you—and because they are scared for you and for themselves.”
She blinks.
“If this could happen to SuperZoe,” I remind her softly, “then what could happen to the rest of us mere mortals? Do it for them, Zoe. Let them in and let them help.”
She frowns and eyes me suspiciously.
“You have a golden opportunity here, Zoe,” I add.
“To teach my friends and family maybe how to die bravely?”
I shake my head. “To teach us—as you always have—how to live fully.”
Zoe
By Labor Day, it was clear that the medication regimen Jon had originally recommended wasn’t having the effect we had all hoped for. As the days and weeks passed with little change, we sat down with Jon and Liz for some straight talk. Spence wasn’t happy with what Jon offered.
“We’ll get another opinion,” Spence declared. “No offense, Jon, but—”
“Listen to me,” I said quietly. “What we have learned today is nothing we didn’t already suspect. We have always known that time—anybody’s—is finite. So, get this straight, farm boy, I will not spend whatever months or years I have left chasing doctors. I—we—will spend every minute of every day and night we have living.”
“I’ll request a leave of absence,” Spence said. “We’ll travel. You’ve always wanted to go back to Paris. The house—maybe we should sell and get into something more manageable. Maybe full-time help. Maybe—”
“Stop it, Spence,” I whispered. “We’ll get through this as we always have—together.” I squeezed his hand.
I pulled my hand free of Spence’s and wrapped my arms tightly around my middle as if to hold myself together, for surely Jon’s answer to what I was about to ask would break me in half. “How long have I got?” It sounded like dialogue from some bad tearjerker movie and yet there seemed to be no more original way of putting the question that was the two-ton elephant in the room.
Jon watched as Spence got up and walked to the door leading to the sunporch and back. He was standing behind me then, his hands on my shoulders.
“It’s early, Zoe,” Liz began, her mouth refusing to utter the but that must have been there.
“How long?” I repeated, and was not at all sure I had uttered the words, even though they were a constant drumbeat in my brain.
“The average—and I am saying average—is three to six years after onset of symptoms,” Jon replied.
I did the math. My shortness of breath first appeared at least a year and a half ago, even though I hadn’t mentioned it to Spence or allowed myself to credit it as anything more than lack of proper exercise.
Jon was still talking, so I forced my attention back to his moving lips. “There’s significant spread, Zoe, and while we don’t have a magic pill or surgical procedure to fix what’s there, we can treat it, contain the spread.”
If we can went unsaid.
He glanced down at his hands and I found myself wanting to reach out to him, to console him and let him know it wasn’t his fault that he had little to offer.
Liz—bless her—tried to half fill this rapidly emptying glass. “On the other hand, you are anything but normal, Zoe. You quit smoking nearly forty years ago. You eat right and exercise regularly. You’re in good health….”
A sardonic laugh escaped my tightly pressed lips. “Yeah, except for the fact that you’re telling me that my lung capacity is already compromised, which has to mean that my heart will need to keep working harder than it should. Yeah, great health will definitely help here.”
Liz looked as if I’d slapped her. Don’t shoot the messenger, I thought and forced myself to calm down. “Sorry. Reflex action.”
Liz accepted my apology. As my best friend, she’s well aware that my weapon of choice when I need to gear up for a fight is pure unadulterated rage.
In spite of all attempts to put up a brave front, I was terrified and I fought back in two ways. First, I became manic, filling every hour with activity no matter how meaningless. Anything so I would have a few seconds or minutes of respite from worrying about the fact that the new medicine might not work, either.
Second, I got angry—at everyone and everything. I began with me. How stupid had I been five years earlier when I had blithely assured myself that skipping a couple of annual mammograms was not a problem. There was no family history of breast cancer. I had none of the risk factors beyond having breasts and being a woman, and who could blame me for not exactly embracing a situation where my small breasts had to be smashed and flattened by a torture machine while I held my breath and waited for the camera to click? I would have the test next year.
On top of that I had little patience for others—especially my friends and family—getting on with their lives. Of course, I had insisted on just that. “Please be normal,” I had begged. “Go to work. Talk about the future. Tiptoeing around doesn’t help.”
They had taken me at my word—even Spence. He would come home from the counseling center filled with stories of patients or new ideas for programs they might institute to help victims of natural disasters like Hurricane Katrina. I would sit across the dinner table from him, nodding and smiling and occasionally offering a comment. But inside I was seething. It wasn’t fair. I knew it was a cancer cliché but, Why me? I had so much left to do.
Spence
The medicine isn’t working. Not only is Zoe not getting any better, but lately the number of days when she has no energy—or real belief that there’s any purpose to any of this—has been on the rise. And yet she insists on doggedly sticking to the regimen that Jon originally prescribed for her.
“There are other options,” I’ve tried suggesting.
“I know what I’m doing,” she always replies, without looking up from feeding herself her morning brew of medications.
This wasn’t the first day we’d had this conversation. It wasn’t the twentieth time, either. It was more like the fiftieth. Each time, I try a different strategy. Today, it was, “Maybe we should drive up to Rochester and see what the folks at Mayo Clinic recommend.”
That gained me direct eye contact. Zoe was horrified. “The folks at Mayo? Do you hear yourself? You make it sound like we might go out to the farm and see if the corn grew another inch.”
“I’m just attempting to—”
“Well, don’t,” she growled, returning to her breakfast. “Just don’t,” she whispered, touching my face in apology.
At their annual Labor Day potluck, Jon had told me about a new combination of medications that had had promising results with others in Zoe’s situation. A few days later I ventured to ask Zoe if she had come to a decision about switching to the new regimen.
“It’s probably all palliative care,” she said. “Prolong the quality of life,” she added bitterly.
I swallowed the anger and frustration I’d been fighting for weeks. In spite of all my training and research as a psychiatrist, I had been helpless to stem the tide of Zoe’s rampant depression.
“Are you saying you’re ready to give up? That you won’t even consider Jon’s recommendation for treatment?” I asked, working overtime to maintain calm and civility.
Zoe continued to pick at the food she was moving around her plate without eating. She eyed me sharply. “That’s not at all what I said and you know it.”
I felt the spurt of a break in the dam I’d built around my emotions and fought it by getting up on the pretense of taking my dirty dishes to the sink. “Are you finished?” I asked, indicating her full plate. She pushed it away, folded her arms and sat back in her chair. “I’ll take that as a yes,” I said, and removed her dishes, as well.
“I don’t know what your problem is,” she began as I stood at the sink with my back to her, rinsing the plates. “All I’m saying is that—”
I wrenched the faucet lever off and spun around. “My ‘problem,’ as you call it, is you. More specifically, my inability to do anything or say anything to help you—to make you want to fight this thing. My problem is that Dr. High and Mighty Psychiatrist here has not the vaguest notion of how to heal his wife. My problem is that I have become the very thing I warn all my patients not to become—I have become your rescuer and enabler.”
“Meaning?”
“Meaning that I am working a lot harder than you are to fight this thing and I flatten like a cardboard box every time you get on your soapbox about living every day but refuse to even consider other treatment options.”
“I don’t ask you to do any of that and I certainly don’t require rescuing.” She left the kitchen and a minute later I heard the back door slam and the car engine fire.
As I watched through the kitchen window, Zoe roared out of the driveway. In that moment, it flashed through my professional mind that bringing it into the open was exactly what was needed.
We had to stop dancing around the fact that we were both terrified and filled with the bile of panic and anxiety. We needed to face the fact that we both were helpless to reach out to the other for fear of infecting the person we loved most with our rage and our fear. And most of all we needed to bring into the open the pure dread that this might tear us apart before we realized it was too late to fix it.
How many times had I assured my patients that confronting the issue—bringing it out into the open—was best? How stupid and misguided had I been not to realize how gut-wrenching that could be?
Learning Zoe’s cancer has returned should have brought us closer. Instead it’s driving us apart. I try to remember how we survived this distance five years ago—how we found our way back to each other from the brink before it was too late.
Zoe
After I slam out of the house and race the car down the driveway, leaving tire tracks on the pavement, I force myself to swallow the nausea of my rage and guilt and slow down. I wind through the streets of this neighborhood I love. I notice every house and remember everything Spence and I have shared in the nearly forty years we have lived here. We are the old-timers now. Several of the houses I pass are newly occupied, our former neighbors having moved on to warmer climates or downsized once the children left home.
I drive past Liz’s and see a single light burning—a sure sign that she’s away for the evening. If she’d been there, would I have stopped as I might have before when Spence and I argued? Probably not. In the weeks since it became obvious I have a tough road ahead, I have withdrawn into my shell, pushing friends away with a tight-lipped smile that screams, “Leave me alone!”
What’s the point? I think.
Half an hour later, I’ve run out of neighborhood so I circle the block and find myself sitting in front of our house. Light streams from every window, even in those upstairs rooms we rarely light until we go up to bed for the night. I realize that Spence has done this. He is telling me to come home—that we will work it all out as we always have.
I pull into the garage. As I cut the motor and turn off the headlights, the back door opens and Spence is standing there.
“I made popcorn,” he says, handing me his mug of hot herbal tea. “Want some?”
I run my fingers across his thinning hair. “I’m sorry,” I whisper. “It’s just that I’m so tired of the fight.”
“Then I’ll fight for you,” he promises as he wraps his arm around my shoulders and leads me into the kitchen. “All you have to do is agree to take the meds.”
“Oh, Spence. Maybe—”
He stops my words with fingers pressed to my lips. “Not yet,” he says hoarsely. “Not until we’ve looked under every rock, tried every possible treatment. We can do this, Zoe.”