8.

THE LIBRARY—or, as we called it more realistically, the “TV room”—of our house must have been built during a brief period of prosperity on the part of the owners back in the mid–nineteenth century, when there were still people around locally who knew how to do such things. It has nicely carved wooden shelves and cupboard doors, and a very pretty fireplace—nobody could call it “elegant,” but it was at once handsome and cozy, unlike the larger, chilly living room, which we seldom entered. Margaret and I tended to gravitate to the TV room for a drink before dinner and a look at the news, and we often ate dinner there on folding TV tables and watched a movie or a miniseries, sprawled out on the big sofa with one or two of the cats beside us. Normally we would have gone out to dinner to celebrate our thirty-eighth wedding anniversary on June 30, but Margaret was still sensitive about the droop in the right side of her lips, so we stayed home quietly and celebrated in the TV room. By coincidence we had both written the same message on the card attached to each other’s gift: “38! May we have many more!”

Since Margaret could only drink through a straw, I had bought her an antique Tiffany sterling silver bamboo-pattern straw, which would save me from bringing a fistful of straws back from Dunkin’ Donuts every few days, and she had bought me a half bottle of champagne. We talked about taking a midwinter vacation, which we hadn’t done for years, but without conviction. We did not talk about the disease, or the MRIs, or the side effects of the medications, which was perhaps our best gift to each other over the past six months—cancer so easily becomes the only subject of conversation, the unwanted guest at every celebration.

As the summer wore on, Margaret’s strength returned. She was still too thin, the facial muscles on the right side of her face were still stiff, simple things like brushing her teeth were lengthy, infuriating tasks, but she was driving by herself now for short trips without me riding shotgun. Perhaps more important she graduated from riding Monty, the reliable old paint I had inherited from her once his competition days were over, to riding Logan go Bragh, her big black event horse—Logan was strong, “forward moving,” as horsemen like to say, with a mind of his own, and plenty of power under the hood. He was too much horse for me—I wouldn’t have ridden him on a bet—but it was interesting to see that when Margaret was mounted on him, she looked as if she had never been ill at all. She still needed a cane to walk, and needed help to eat or brush her teeth, but once she handed the cane to Miguel and mounted Logan she and the horse came together as one, it was a fine thing to see. It gave her more confidence too, and made the ordeal of waiting for her next MRI on September 22 a little easier to bear.

She described the two weeks leading up to the MRI as “tense and worrisome,” but that is putting it mildly. It was not just that each MRI had the potential of being a death sentence, pronounced by a radiologist instead of a judge—each one put at risk all the effort Margaret had made to recover, the hours in the gym balancing on a narrow beam, or trudging up and down improvised steps and around obstacles, further hours of speech therapy and occupational therapy, and all the walking back and forth over our fields, despite the heat, the humidity, and the bugs. It was a huge investment of time and hope, all of which could be swept away in a second by the appearance of new tumors or the return of the old one. You could see the small signs of tension, the constant, nervous shredding of a piece of Kleenex into tiny pieces—was Margaret even aware she was doing it?—the time she spent out in the barn with her horses, listening to their quiet snorts, which are a sign of pleasure in a horse, stroking each silken nose, communing with them, the way she would stop while we were out walking and stare at the fields and fences as if she were trying to imprint all of it on her mind. It did not seem to her fair that all of this could be torn away from her, and of course it wasn’t, disease never is. She had never believed in a God who punishes, she preferred not to believe in Him at all rather than that. She didn’t believe either in the kind of moral equivalency that people express when they say consolingly, “Well, think of all the good years you’ve had . . .” as if the good years had to be paid for by so many bad ones, or that a formula existed by which so much joy and pleasure had to be paid for by an equal amount of pain. Sometimes Margaret asked why this had happened to her, but it was a rhetorical question. She didn’t expect an answer, or even suppose there was one.

By now the secretary behind the desk in the Radiology Department welcomed us back as if we were familiar clients at a good restaurant. I held on to Margaret’s hand until her name was called and waited patiently for her return. It was not a long process, there was never any significant waiting time, and when it was done we walked around the corner to the Cancer Treatment and Wellness Center next door to see Alain. Within a few minutes he appeared, smiling, to take us into his office and tell us that the MRI was clean. We were back out to the car in fifteen minutes, Margaret looking years younger. “Dr. Alain very pleased with brain scan, huge sigh of relief,” I emailed a friend.

The next MRI would be just before Thanksgiving.

It was a turning point. Starting the next day, Margaret began riding two horses a day again, just as she had for years before her illness. Her appetite improved. She still tired quickly, but at times she seemed like her own self again, although that was an illusion of course: cancer and brain surgery change the person in so many ways, nobody is or can be “the same” afterward. Whatever else she was, Margaret was no longer invulnerable. She had survived what seemed like the worst that could happen, but she had not emerged unscathed—nobody does. Her hair was growing back to hide the scar on her head completely, but she had a sense of the impermanency and fragility of things. She began to write cryptic random quotes in huge, uneven capitals in the small notebook she kept on her bedtable beside a photograph of her father and a red leather case containing the Royal Mint gold coin commemorating the coronation of King George VI in 1937, the year she was born: “Walking debris,” surely an ironic self-description; “Yesterday’s gone,” perhaps remembering Brenda Lee’s song, but perhaps also a wistful reference to her own life; “I have a rendezvous with Death,” the first line of Alan Seeger’s famous First World War poem; “Would you cross the Rubicon for me?” perhaps a question aimed at me? More mysteriously, “Remember the Ark was built by amateurs, the Titanic by professionals,” and just below it, “Uncork time!” Of course she would want to go back to the time before the diagnosis of a brain tumor was made, which is perhaps why she added “Age of Innocence,” a reference to the time when she could still ask, “What’s the worst thing that can happen to me?” instead of living with the fact that it already had.

The days grew shorter as autumn began, the mornings began to be crisp, the leaves started to turn, it was sometimes even chilly—perfect riding weather, probably the best time of year in the Hudson Valley, “good sleeping weather” as they used to call it up here from the days before air-conditioning, when people put on a sweater and started to think about pumpkin pie and turkey. Margaret put on a little weight, not much, but she was moving in the right direction. Her hairdresser Tom had somehow managed to perform a small series of miracles to make her hair look good. I emailed a friend that things were beginning to look better.

I should have knocked on wood when I wrote that, or whispered, Inshallah, God willing.

Never tempt fate.

We celebrated my eighty-third birthday on October 8 quietly at home, it wasn’t a “significant” one like seventy or eighty, we used it to celebrate the rate at which Margaret was recovering, clinking our glasses together on the sofa in the TV room. It seemed like old times.

But it wasn’t. A week later her symptoms began to return with a vengeance, the trembling right hand, the facial paralysis, the problems with speech and finding the right word. They were minor at first, one could pass them off as fatigue, or perhaps the result of trying to do too much too soon, but a few days later it was apparent that we were back in full crisis mode. After a call to Alain her MRI was moved forward urgently, and with it the anxiety returned.

This time there was a lengthy wait between the MRI and Alain’s appearance to show us into his office. We sat glumly next to the tropical fish tank in the slightly surreal surroundings of the Cancer Treatment and Wellness Center waiting room. The tropical fish did not cheer her up—she disliked the whole idea of confining any living creature in a cage or a tank, even fish, and for that reason she always avoided zoos. She was not a vegetarian—quite the contrary, she was happy to eat a Dover sole properly cooked and served—but she hated the idea of keeping anything trapped behind wires, bars, or glass.

“I know it’s going to be bad news,” Margaret said. “He’s never kept us waiting before.” The same thought had occurred to me, but I tried to reassure her: there might be a snag or a problem with the MRI, or Alain might have a patient with an emergency. From where we were sitting we could see the door to his office, and after some time we observed Dr. Julie Choi, the radiologist, go in and shut the door behind her.

“That’s a bad sign too,” Margaret said. “He never needed her help to look at my MRI before.” Margaret had not, as they say, “bonded” with Dr. Choi during the Gamma Knife radiation, although I myself had found her perfectly pleasant, but for whatever reason the two did not seem to have hit it off, and the long time that Dr. Choi spent with Alain increased Margaret’s anxiety sharply.

After a time Dr. Choi left his office, and Alain came out to greet us, with rather less ebullience than usual. The results of the MRI were ambiguous, he explained once we were seated. There were signs of swelling, perhaps a delayed reaction to the Gamma Knife radiation. His notes describe what he observed from his physical examination of Margaret, and from the MRI. There was, he wrote, “a slight increase in the right-sided facial droop . . . [and] decreased coordination affecting the right hand,” as well as the fact that she “was taking smaller steps,” which I had not noticed at all. I ought to be paying closer attention, I told myself. On the MRI he saw “a significant increase in the edema surrounding the resected lesion as well as a slight, but noticeable, increase in the size of the lesion,” and “a slight increase in size of the much smaller right parietal lesion that was treated at the same time [that is, the time of the Gamma Knife radiation].” It was possible that “the increased size of the lesions could be due to the delayed effect from the radiation treatment”; however, it could also be a recurrence of the tumors, or worse still a combination of the two.

We sat in silence for a few moments contemplating all this. As was usually the case when confronting bad news, Margaret was stony-faced. Alain explained that a course of steroids might bring down the swelling, and prescribed dexamethasone, accompanied by Pepcid in case the steroids gave her stomach problems. I was to keep in touch with him about her neurological symptoms, and we should return for the pre-Thanksgiving MRI that had already been scheduled. Hardly any doctor could have been more sympathetic in giving a patient bad news than Alain; on the other hand, he did not hide the fact that Margaret’s recovery was no longer a sure thing, if it ever had been. She had been making progress. Now she had hit a setback.

In the car on the way home she sat in front next to Rob Tyson, with whom she usually enjoyed chatting, silent and staring at the road ahead. Rob knew the signs of bad news and was silent too.

When we were home, Margaret put the kettle on and we sat down in the kitchen waiting for it to boil. “If I die will you look after my horses and cats?” she asked.

I told her I would, of course, but said it hadn’t come to that. She should wait to see how she did on the steroids.

The kettle whistled, Margaret got up to make tea. She had never looked healthier or better since her diagnosis in April, she always made an effort in any case to look her best for Alain. She put a biscuit on the saucer of my cup for me. She shook her head.

“I can tell,” she said, “I’m entering a new phase.”