How to Have a Worry-Free Day
Now I have a new body part to begin worrying about after a routine scan: There is a nodule on my thyroid that they think is cancer. The word nodule is becoming so conversational to me since the lung nodule. I will begin to say “nodule” as often as I say a common word like “spaghetti.” I speak cancer.
The doctor assures me that it is totally unrelated to my breast cancer. He has to do a biopsy immediately because the nodule looks “cold,” another cancer term. But before the biopsy he needs to take about ten vials of blood. I faint from the blood draw, and then I am so dizzy that I can’t stand up. The whole room is spinning, and I am in and out of consciousness. The doctor’s office finally calls an ambulance to get me to a hospital for evaluation and fluids.
When the EMT comes in, puts me on a stretcher, and gets me into the ambulance, I have one simple request while we’re speeding to the hospital ER. “Could you put on my lipstick?” I want my lipstick to be on when I go through the doors of Mount Sinai Hospital again. How I enter the doors of the hospital is an important statement. I need to convince myself I will be okay even if I have cancer again.
At the hospital I am deemed okay after they give me some fluids, but I still need my nodule biopsied. I wear lipstick to my thyroid biopsy. The doctor comes at me with a humongous, knitting needle–like needle, and pushes it hard into my neck. The topical anesthetic is useless. He covers my neck wound with a large white bandage, with huge Band-Aids and surgical tape holding it in position. When I look in the mirror, I see the reality of my life in the reflection, half-bandaged but oddly glamorous and hopeful in my lipstick.
The results of the biopsy are normal, even though the doctor thought the nodule looked “cancerous and cold.” The thyroid biopsy convinces me that I am not vigilant enough. The person who said it’s the things you worry about that never happen, and the things you never worry about that do happen was right. I never worried about cancer before I had cancer, so I decide I need to start worrying more about everything so there is no way I could miss a possible catastrophe. I hate the feeling that one day my life is fine, and then everything could change with a needle insertion. It’s the uncertainty of it all that I hate most. How will I know if it’s okay to let my guard down? Cancer is like seeing a shark in the ocean: After that, fins will seem to appear everywhere. Is it a sore throat, or cancer? Pulled muscle, or cancer? Flu, or cancer?
As long as I can remember, I have worried. I thought that having cancer would somehow cure me of worrying because it would trump every other worry. It even became my mantra to keep me from worrying about the mundane: Don’t worry, it’s not cancer. But instead I still find that even trivial worries are worthy of worry because if I stopped worrying about the trivial, I’d worry that it meant I was disengaging from my life. I decide that I need to be even more vigilant.
Being a mom has given me an entire new genre of things to worry about. There was the day that Hayden woke up with gigantic balls. We went to the ER, and he was diagnosed with epididymitis, which meant that the lining of his testicles was swollen. So I have to add epididymitis to my list of worries. I am worried that my current list of worries is both too long and might not be complete:
I have tried to relax or even “chillax” as Skye suggested. My parents have meditated all their lives, but I’m too high-strung to meditate. I spend my entire meditation worrying that I am not relaxing enough. But I am open to new relaxation methods: My heart has started racing and I am worried, so Tyler thinks I should try acupuncture. He schedules an appointment with Dr. Cai, an acupuncturist.
When I meet Dr. Cai I sense this man might hold a very strange key to quelling my worry. After a quick examination to determine my energy flow, life force, or chi, he sums up my entire life story. “Traffic congestion is going wrong way” is how he describes it. He puts needles in me, and tells me to “breathe and relax.” And I do feel relaxed, but then I start to worry about all the needles in my body. They remind me of the needles from IVs, from chemo shots. I really like Dr. Cai, but before every visit I worry too much about the stabs of the little needles.
I’ve been in therapy my whole life, and it hasn’t really stopped the worrying, but it has made me more aware of it and what a burden it is. My cancer therapist, Dr. Haber, assures me that sometimes there are no reasons for life’s tragedies: “Geralyn, sometimes things are unknowable. Like why you got cancer.” But she also says, “Why look for clouds on a sunny day?” And she suggests a little bit of medication too.
My psychiatrist, a.k.a. “Try Not to Worry So Much” Dr. Goodman (that really is his name), believes that I can worry less. He has even set a goal for me: I should try to have a worry-free day. “Wouldn’t it be nice for you to have a worry-free day and just relax and be fine with that?”
“Okay,” I tell him in all seriousness, “I’ll make a list of all the things I need to not worry about to have a worry-free day.”
He laughs. “That isn’t what I was expecting.”
When he speaks with me, Dr. Goodman always finds a way to find something positive about what I’m worrying about. It is a rare gift. And he seems impressed with my progress. We kept discovering good things that I hadn’t thought could ever happen to me, but they did.
“You were worried you wouldn’t have a baby because of your cancer, and now you have two. You were worried you wouldn’t live, and you did.” He also writes me a prescription for Klonopin, which really helps with the worrying.
When I take my first Klonopin, it’s like I can’t worry anymore. It is the weirdest feeling. I think I should be worrying that I can’t worry anymore . . . but finally, I’m not.
After I google how Klonopin actually works, I feel a bit less worried. Wikipedia tells me:
Clonazepam acts by binding to the benzodiazepine site of the GABA receptors, which enhances the electric effect of GABA binding on neurons, resulting in an increased influx of chloride ions into the neurons. This further results in an inhibition of synaptic transmission across the central nervous system.
Yeah, baby! Bring on that inhibition of synaptic transmission across my central nervous system. Oooooh. That feels so good! It is sort of awesome but terrifying. If Klonopin makes me less worried, I’ll be less vigilant, and if I’m less vigilant, how will I be safe? How can I let my army/navy/air force/marine guard down about cancer, about life in that ambiguous world?
The K helps so much that I start to worry about what I would do without it. I worry that I might become addicted to something that makes me feel so calm. I worry I could never not worry without the drug. And then I feel gratitude that a doctor has clearly worried enough to invent an anti-worry drug.
I have read some self-help books about being in the moment, the “now,” and just appreciating the present tense. I find a quote I love: Mother Teresa says, “Be happy in the moment, that’s enough. Each moment is all we need, not more.”
But every time I am in that moment, I need to know there is a next one coming. How can I feel the moment is enough? I just want to know my ending, know the cancer won’t be back, and know that I am okay. I want to know that I lived “happily ever after” like a fairy tale. My brother counsels me, “Don’t future-trip.” I love to make up endings to all my problems, which involve doom and strange and awful events.
And then, something more surreal and horrible than I could make up: Hawa has a sore throat that isn’t getting better. We were worried she had the flu, that she needed antibiotics. But she is diagnosed with stage 4 cancer, a head and neck tumor. It also seemed insane that I finally got to have my miracle children, met this kind and wise woman who would always be there for my kids if I got sick again, and now she might be taken away because of cancer. She was the one who was supposed to be a stable presence for my kids. I remember when my mom and I interviewed Hawa. I remember what she looked like when she first held Skye. I knew they fit together.
Hawa knew all the answers I didn’t about how to raise kids. Like when we were at the pediatrician with Skye when she had to get four vaccinations in one day. I was panicked.
“Hawa, I don’t think I should stay in the room, because Skye will think that I’m letting someone hurt her. I’ll wait outside.”
“No, Mommy!”
Hawa called me “Mommy” and I called her “Mommy #2.”
“Mommy, stay in the room. Skye needs to know that whatever happens to her, you are there for her.”
I entered the doctor’s exam room and cradled my daughter on my lap as she screamed with each successive needle that was jabbed into her fleshy little arm. Hawa held my hand as I held Skye’s, and she squeezed my hand so tight, it distracted me from Skye’s wailing. Telling me to stay in the room was the right advice. I was there for my daughter.
And now it is I who has to go into the room and squeeze Hawa’s hand. She has been admitted to Mount Sinai Hospital for her neck biopsy, a surgical procedure. I hear her moaning in the recovery room. I want to be with Hawa when the resident goes in to give her the bad news. And I’ll also have to tell the same news to her family, who have flown in from Africa. They have looked so worried, waiting all day in the family lounge, speaking French with each other. Every time I go to check on them they stand to greet me, with such anxious eyes.
I wait for the doctor in the hall outside the recovery room, and beg her to explain to Hawa that she has cancer, but that they can cure her.
The resident, holding her clipboard, annoyed, is having none of it. “I can’t say that. It might not be true.” She refuses to say the word “cure” when she reports the diagnosis.
I want the doctor to be hopeful. Maybe it is unreasonable for me to ask that, but I want to give Hawa hope. I remember when my doctor had told me my own cancer news: “You do have breast cancer. But we are going to cure you.” I had never heard the words “cancer” and “cure” together before.
“I can’t promise that.” The resident is shaking her head and staring at her clipboard, deliberately not making eye contact with me. There is no way I can get her to budge.
“Please just be really nice. Tell her there’s hope. Tell her it will be okay. Please!”
The resident is shaking her head harder. She won’t budge.
“Okay, can I tell her that she has cancer? I’m a survivor. I can relate to her. Let me deliver the news. I know how to handle this. Clearly you’re not being as sensitive as I think you should be. There’s a woman moaning and crying in there; she’s already in pain from her surgery.”
“Hospital regulations require that I tell the patient.”
I am about to freak out on this robotic resident.
“Would it kill you to be nice to her? She has cancer!”
The resident turns her back on me and marches into the room. I trail behind her and give her the evil eye when she is telling Hawa, “You have cancer, Ms. Kane.”
She turns to leave, and I body-block her.
“Don’t you also want to tell Hawa about how she’s going to start her treatment soon and it will be okay? . . . You know, how good the treatment can be . . .”
The doctor sidesteps me and leaves the room.
I climb into Hawa’s bed and squeeze her hand. She is wailing, like Skye did from her vaccinations.
“Hawa, look at me. I am okay. You will be too. I promise. I’m going to take care of you the way you’ve taken care of me and the kids. Hawa, God meant for us to be together. You’ve been my guardian angel; I’m going to be yours.”
I bring her some water because her mouth is so dry from anesthesia. I help her take a sip, and I remember her teaching Skye how to drink from the Big Girl glass and not use the sippy cup. Hawa is so uncomfortable from the pain, and she is crying again. I ask the nurse for liquid Tylenol, like Hawa has given to my kids when they’ve had pain. I also ask for a Klonopin, but the nurse rebuffs me. That has to be ordered by a physician in psychiatry. Hawa is sweating and I give her a little sponge bath, like she has done for Skye and Hayden hundreds of time before bed. I tuck her into her hospital bed and kiss her forehead. I need to go tell her family the diagnosis.
“I promise you, we are going to beat this, Hawa.”
I used to hate it when people told me that. Am I being a hypocrite now?
As I leave Hawa’s room and walk through the hallway, I stumble to the window and hold on to the ledge for support. The hallway is spinning, and I am flooded with the same sensations I had when I was first diagnosed. I feel all hope draining out of me as I look outside the hospital window, sentenced again to the cancer ward. I see the automatic sliding doors opening and closing in front of the emergency-room entrance to the hospital. Hawa and I are somehow trapped together in this hospital, on the same side now, unable to leave. This is our world now; we are on the cancer side. The other side—the normal side—is a world we can visit, but then we must return to the cancer side, where we belong.
When I get to the lounge and tell Hawa’s family, there is so much crying and speaking in French. The word “cancer” sounds so much more elegant with a French accent, but just as deadly.
“J’ai eu un cancer.”
I had done a quick google so I could remind them in French that I had had it too. We all hug. I promise them that Tyler and I will take care of Hawa and get her the best medical care. Tyler and I call doctors and review all the medical literature.
Tyler cries when he sees how dire her prognosis is.
We spend hours on Medline and the Internet and find a clinical trial for Hawa that is high-dose chemo and radiation, created by a German doctor. He is now in Chicago; we get him on the phone, and he explains there is a clinical trial in New York City that we can try to get her into. It is a barbaric treatment of both chemo and radiation, together, in high doses to increase the effectiveness of the toxicity. But it will spare her surgery that would remove her voice box and disfigure her face. In the past, patients like Hawa—if they had their voice boxes removed—had to learn to speak with an artificial voice box. The thought of not having Hawa’s singsong French-accented voice in her son’s life, in my family’s life, is not an option.
I need to be even stronger for Hawa than I remember being for myself. I have to believe that she can be cured, that she’ll live, even though I am not so sure I will. Hawa is my Senegalese sister. We somehow found each other in this world. I always thought she would be there for my children if I died, but now I tell her that I will be there for her son, Mohamed, if she dies. She has taken care of my children; now it is time for us to take care of her.
My visits to Dr. Goodman sustain me. He reminds me, “It makes sense that you’re worried about Hawa, but try to remind yourself that you survived and there’s every reason to think she will too. Try to relax.” He tells me that I have something called “anticipatory anxiety” in addition to the garden variety of worrying, which means that I worry about worrying about things. I see it as an opportunity to take more Klonopin.
I think about the idea that the things we don’t worry about can happen—random types of disasters can sneak up on us. How crazy-making that is.
I’m back in the white hallways of the hospital with Hawa during her treatment. There is one day when her neck is burned very badly from the radiation, and she is whispering to me how much everything hurts. She tells me they are coming to get her to wheel her in for more radiation and she doesn’t want to go.
“Please, Gerrraline. Please, don’t let them take me.”
I ask her doctors to wait and let her rest a bit, and I run home to my apartment to get one of my favorite hats, which someone gave me when I was bald—a bright pink cowboy hat. I never could truly pull it off, but I knew that Hawa would rock it with her dark black, almost purple skin.
I arrive at the hospital out of breath just as they are wheeling Hawa down the hall to the radiation suite. I show her the hat. She starts to laugh, then cry, then laugh again.
“Only for you, Mommy!”
“Ms. Hawa, we love your hat! Wow!” All the technicians have stopped wheeling Hawa to admire her.
I was not going to let my Senegalese sister go. I was going to fight as hard for her life as she had for mine. My kids never had to see me sick, but they did see Hawa in the hospital. Hayden just jumped into her bed and wouldn’t leave. I had to pull him off crying when visiting hours were over. Skye made her get-well cards, and she worried and cried a lot about Hawa. One day, the school nurse called sounding very upset: “Mrs. Lucas, Skye has a sore throat. She thinks she has cancer.”
I bought a wig for Hawa to wear for her son and my kids because she didn’t want them to be upset or scared when they first had to see her completely bald. She had been wearing scarves and the pink cowboy hat, but now there was nothing left on her head.
When Skye saw Hawa in the wig, she asked her to take it off so she could see her without it. Hawa was reluctant.
“I like you better bald, Hawa,” Skye said. “You shine now.”
· · · ·
As I am trying not to worry so much about my Senegalese sister, an invitation arrives for me from my other unofficial “sisters”: the Zeta Tau Alpha sorority. I have been working on breast cancer awareness campaigns across the country with the Zetas on sorority campuses, because breast cancer is their national philanthropy. They would like to officially initiate me as an honorary member of the Zeta Tau Alpha sorority because of the work I am doing to educate young women about breast cancer. When I was growing up, I had always wanted a sister. I had two younger brothers I loved, but there was something about having a sister, like Hawa.
For my initiation I had to wear an all-white outfit—dress, sweater, and shoes. White always scared me—white bandages, white sheets, white hallways—but now white was sorority whites. They walked me into a special room, but I can’t reveal what happened in there because I am a sister now and sworn to secrecy. The room was dark and there were women’s voices, and I cried after the ceremony, standing before my five hundred new sisters, all wearing white for me.
I was an about-to-turn-thirty-nine-year-old sorority sister!
The Law of the Unexpected must apply to happiness too.