PROLOGUE

CANCER AND ITS DISCONTENTS

IN THE EARLY SPRING OF 1998, MY HUSBAND, HARVEY PREISLER, was diagnosed with cancer. The following year, we planned to take our five-year-old daughter, Sheherzad, and my brother Javed’s two children visiting from Pakistan, Musa and Batool, eight and twelve, to San Francisco for a highly anticipated vacation. We had already postponed the trip twice before, but it could be delayed no longer. The children were eager, and given Harvey’s disfiguring facial edema and the enlarging nodes, some form of aggressive treatment—sure to require us to stay put in the city for months—was now imminent. Before any of that happened, he felt strongly that the family needed to get out of the sweltering heat of Chicago for a vacation, even if for just a week.

Our flight to San Francisco was on a bright, clear summer morning. Having arrived at the gate a good ninety minutes before our departure, we split up; Harvey sat down in the boarding area while I chased the children around O’Hare. We got something to eat at the food court and then returned to the gate.

I was shocked by what I saw. Harvey sat, looking dazed, as streams of sweat poured from his body, making little puddles under his elbows on the armrests of the chair and under his knees on the floor. He was beet red. Tributaries of glistening perspiration filled the lines in his handsome face, making it appear startlingly young. He looked at me with hushed anxiety. I sent Batool running for the nearest café to get me a handful of napkins. I dabbed Harvey’s face and arms, wiping the chair and floor. There was no respite. The sweat came in torrential waves. His T-shirt and shorts were entirely soaked and dripping. The children stood around trying not to look, their faces ashen. It was a good fifteen minutes before the deluge subsided. I walked to the gift shop and purchased a fresh pair of pants and shirt. Without saying a word, little eight-year-old Musa stepped forward, quietly took the package from me, and gently escorted a bewildered Harvey to the restroom.

Being oncologists, both Harvey and I understood precisely what the sweating meant. Known as a B-symptom, it is a well-recognized manifestation of many cancers, especially lymphomas, and it is not a good sign. B-symptoms are associated with a more advanced, more aggressive disease with a poorer prognosis. I suggested we cancel the trip and return home, but Harvey, not willing to disappoint the children yet again, insisted on going ahead.

The first twenty-four hours in San Francisco were filled with apprehension as we drove the children around the Crooked Street and the harbor, not knowing what to expect, fearing the worst. Nothing much happened. Harvey began to relax. Then, in the middle of the third night, I woke up with a start. Water dripped steadily on my face. Harvey’s arm was arched over my head and running like a faucet. This time, we not only had to change his clothing, we had to call housekeeping to replace the soaking-wet sheets.

By the time we returned to O’Hare a week later, Harvey had developed another bizarre syndrome associated with many cancers. His left wrist suddenly blew up to twice its normal size. Despite the extra-strength Tylenol I had given him, he was writhing in agony as we climbed into the car to go home. It took twenty-four hours of cold packs and heavy-duty analgesics to control the excruciating pain. The next few days were some of the most tormented. He experienced regular episodes of drenching sweats, once or sometimes twice during the night, requiring fresh bedsheets and clothing changes.

As swelling subsided in one joint, it popped up elsewhere without warning. Fresh lesions began with a tingling, burning sensation, becoming bright red and sizzling hot within hours. Nomadic lymphoma cells meandered autonomously, rudderless. Edema regressed from the face only to reappear in his joints. Lymph nodes in the neck and armpits swelled one day and receded the next, followed by a sudden enlargement of the spleen. Itinerant cells segregated, dispersed, re-collected, vanished, regrouped. They wandered the body with a studied carelessness, entering and leaving organs at will, disgruntled, edgy, exploring possible niches in various organs, rejecting some, settling in others. Horrified, helpless, we watched the drama unfold, Harvey from inside, I from the outside. The lymphoma marched on its aimless, monomaniacal journey into irresolution with a motiveless malignity.

Cancer is what I had been treating for two decades, yet until I shared a bed with a cancer patient, I had no idea how unbearably painful a disease it could be.

It was the summer of our discontent.

Cancer and its discontents.