Typing on my family computer one day, just a few months out of high school, I rested my hand on the curve of my neck. My thumb brushed over two small lumps that I had never noticed before. I tried to tell myself that they were swollen glands, a result of an infection or a small cold, but when I pressed my fingers to them, I felt uneasy; they were rubbery and floated almost gracefully, not like any swollen lymph node I had encountered before. I got up and walked into the living room, looked at my mom and sister, and said, “I think I have cancer.” They looked up from the couch and laughed, and my mom sort of grimaced, as if to say That’s ridiculous. I laughed, too, but I went into the other room and made an appointment.
I went to the local health clinic. The nurse practitioner felt my neck and took my temperature, which was elevated. “This is nothing to worry about,” she said. “Just swollen glands because you have an infection right now.” She wrote out a prescription and handed it to me. “Take these antibiotics for seven days, and if nothing changes, come back to see me.” She turned to leave. “Of course, there’s a small chance that it’s cancer, but don’t worry, even if it is, it’s the good kind.” With that, she left the room.
The good kind, I thought.
Seven days later, I was back. “Hmm, let’s see, so the antibiotics didn’t help?” she asked, pushing her slipping glasses back up her nose.
“Nope,” I said. “I mean, I don’t have a sore throat anymore, but these lumps are still here.” She called in another nurse, who was short, needing to stand on her tiptoes to feel my neck.
“Cat scratch fever,” she said expertly, nodding her head.
“Of course,” said the other nurse. “I should have thought of that myself.” She wrote me another prescription. “Take these antibiotics for seven days. If nothing changes, come back to see me.”
I changed doctors and moved to a private practice. Dr. Baschill was an immediately comforting presence. When she entered the small exam room, she smiled at my tired face. “Don’t worry,” she said. “Whatever this is, I am going to make sure you get the best care.” She was honest with me. Lumps like these could mean any number of things: mono, HIV, an infection, cancer. She was firm in her belief that cancer or HIV was a very small possibility, but “I want you to know all the things you could be up against.” After running test after test, she called me into her office. She sat across from me. “Rose,” she said simply, “I think it’s time you see a surgeon.” She took my hand into hers; it was cool against my flushed skin. “You will be fine,” she told me. “No matter what happens, you will be fine.”
I made light of all this to my friends and family. “The good kind,” I said, reassuring them that the worst-case scenario wasn’t “that bad.” I jokingly referred to my swollen glands as my “cancer lumps,” and that made my friends laugh. My family stood at a distance from the possibilities. My mom was concerned but quiet. Sharon was sure I had mono. Over the phone, I could hear her softly inhaling cigarettes as she asked, again and again, “Are you sure it’s not just a virus?” I wanted to take the cigarette out of her hand and place her soft fingers where my pulse should be, so she could feel the unsettling beat of my tumors.
Dr. Baschill sent me to Dr. Cobb, a surgeon. Dr. Cobb played the piano. He had a daughter who was almost my age. He played classical music at concerts to raise money for local charities. I liked him for all of these reasons. I sat very still when he showed me a large, glistening needle and explained that he would biopsy my lymph node to see if there was cancerous material present. Over the next few days I ignored the bruise forming around my collarbone and pretended everything was normal; I kissed a blond-haired boy, I drank rum until three and secretly longed to be in college.
Dr. Cobb called me in to tell me that the results were “inconclusive but suspicious.” I would need to have a surgical biopsy. I relayed this information back to my loved ones casually. Sarah was twelve years old and hadn’t quite reached the stage when her baby fat had melted away, and she perpetually had a boyfriend. She didn’t say much when I told her because the word biopsy didn’t mean anything to her.
The biopsy was scheduled quickly. I liked the antianxiety drugs they gave me when I came in for the surgery. I was suddenly and utterly free from the hidden worry I had been holding in my chest. When the nurses wheeled me through two swinging doors to the operating room, I laughed at the “Booty Free” sign overhead, even after one nurse pointed to the soft slippers he had to remove from his feet before entering the operating room. Everyone kept telling me to relax. I counted down, just like they told me to: 10 … 9 … 8 … 7 … After the surgery, no one said anything to me as I was wheeled back through the swinging doors. Still under the fog of anesthetic, I overheard the doctor tell my mother that I had cancer.
The pamphlet they gave me at the hospital, Understand Your Illness!, told me I was diagnosed with Hodgkin’s lymphoma, a cancer of the lymphatic system. As Hodgkin’s disease progresses, it compromises the body’s ability to fight infection. Hodgkin’s is fairly rare; only about 7,000 people in the United States are diagnosed every year. It is not to be confused with non-Hodgkin’s lymphoma, which affects about 66,000 people per year and has a much higher mortality rate. I was told repeatedly by my doctors that I was lucky to have been diagnosed with the rarer form. With treatment, I had a 90 percent chance of living. I had a 10 percent chance of not making it to my twenty-first birthday or going to college or growing old. If I did not start treatment, I would be dead in a year. No percentages were used when explaining this to me; I would be dead in a year without treatment.
I cried only twice in front of the doctors: when they told me I would lose all my hair, and when they told me I would have to defer college for a year. I did not cry when they told me that I would go through chemotherapy and radiation. I would need to have a port catheter put into my chest, under my skin, sitting just below my clavicle, which would be removed after chemo was over. I had no idea what any of this was, so I just nodded. Sharon told me to start taking a pad of paper with a list of questions already written down and to take notes on what they told me.
My whole life became about being ill. My calendar diminished to only doctors’ appointments. I went to chemo, and my friends went to keggers. I listened to their hungover talk of raging parties and freshman math classes while I sat, a sickly yellow from the Adriamycin the oncology nurse had pumped into my chest the day before. My boyfriend, Phillip, worked in the late afternoons at the local Indian casino until almost midnight and worked out at the gym during the day for at least two hours. On his days off, he liked drinking with the boys and drunk-dialing me while I slept off the previous day’s treatment.
I was put on a chemotherapy regimen referred to as ABVD (Adriamycin, bleomycin, vinblastine, dacarbazine), the first line of treatment for Hodgkin’s lymphoma. I received my treatment at a private practice about twenty minutes from my home, run by a group of oncologists. My doctor, Dr. Bonis, was a tall, balding man who liked to tell me about his other Hodgkin’s patient, a young woman, not too much older than me, who was “regrettably” dying. She was not responding to treatment, the ABVD that I was also receiving.
My chemo happened in a small room with nine chairs for patients. My favorite chair was the blue plaid recliner. It sat in the middle of the room, not too close to the door, which when opened carried a draft, nor too far away from the bathroom, which was important when you had to drag an IV stand in with you. Everyone else getting treatment was at least twenty years older than me. During one of my first appointments, I sat down and an older man leaned over to me. With a kind smile, he informed me that I was sitting in a chair reserved for cancer patients. He looked unbearably sad when I explained that I was there for treatment.
Sharon took me to these appointments. She packed a bucket, blankets, and water for the twenty-minute drive home afterward, in case I became nauseated. To administer the chemo drugs, a nurse would numb the skin over my port, a small device surgically installed under my skin and connected to a vein. The nurse would then take a small fishhook-like needle and attach it to a catheter just below my scarred skin. The first thing injected into the port was an antianxiety drug and an antinausea drug that I lovingly called the “ants in the pants” drugs because for roughly thirty seconds after they were administered, it felt as if my behind was on fire. The antianxiety drug caused me to feel weightless.
About an hour into my treatment, I would look down at my hands, now the sickly shade of a bruised banana. I was not sure exactly which of the drugs did this, but it was the thing I noticed first. When it happened, I knew I would be able to keep my eyes open for only a short time before nodding off in the recliner.
When I went, I went quickly, nearly comatose. My head would drop to my chest. That was when I began to remember. In my chemical-laced dreams, I floated from memory to memory. I remembered red brushstrokes, pumpkins in October, burning my finger by touching a lit match when I was four, lighting lanterns and floating them in a pond. I remembered stars, being late to school so often that the school sent home a notice to my mom, pancakes and eggs when we went camping, the quilt with rabbits on it, watching beauty pageants in the dark, eating popcorn made in a wok. I remembered my mother. I dreamed of my father as a cowboy, before I was born, and saw him riding on a chocolate-brown horse through the desert. When I woke up, I staggered to Sharon’s car, and she drove me home while I nodded in and out of consciousness in the back seat.
After my third chemotherapy appointment, I was told the treatment was working and my tumors were shrinking. I would live. The year went on: doctors, dreaming, jaundice, needles, loneliness.
On Sarah’s twelfth birthday, a bunch of friends and family got together to celebrate. One of my parents’ friends, whom I hadn’t seen since I was diagnosed, handed me a small wrapped gift and card. As I sat down to unwrap the present, I heard a cry of outrage and looked over to see Sarah, surrounded by gifts, with an indignant look, clearly unhappy that I had received something on her birthday. “Oh my god,” she exclaimed, “when it’s your birthday, it will be your birthday AND you’ll have cancer!” Everyone laughed at her vexed young face.
On my nineteenth birthday I was fitted for a radiation mask, a plastic mesh screen molded perfectly to my face. When getting radiation, I would have to lay flat on my back, my arms and legs strapped down so that I couldn’t move. I had to be completely still; they bolted the mask to the table so that my head would be immobile. It was the only treatment-related appointment I cried through. I thought the technicians couldn’t see my tears through the mask, but one of them squeezed my hand, just for a moment. I went to a yoga class in the afternoon, designed for people who were sick or elderly, and walked out to find a parking ticket on my car. I hoped the day would get better. It was my birthday AND I had cancer.
My boyfriend Phillip’s mother had died a few years earlier, and he informed me on the evening of my birthday that it was also the anniversary of her death. We spent the night talking about his mom. He fell asleep still in his clothes. I stayed up, remembering the sound of the mask being bolted down. Months later, I would find the invitation to her memorial while organizing papers in our spare room. Phillip’s mother had actually died weeks after my birthday. He had merged us, his dead mother and his sick girlfriend; he had given me flowers on Mother’s Day. When I showed him the invitation I had found, he wept until my shoulder was wet. We never talked about it again.
I made Sarah and Tess come to one of my radiation appointments so that they could better understand what having cancer meant. They pressed their faces into the glass that separated them from the room where I received treatment. No one could be in the room with me when the radiation machine was on; it was too dangerous. Out of the corner of my eye, I could see Sarah’s face turn serious when my mask went on and I was secured to the table. Next, lead blankets were placed on various parts of my body to protect the rest of me from radiation, the parts that cancer didn’t live in. After that, a large machine was lowered down and lined up perfectly with small tattoos I had received to ensure perfect placement every time.
The technicians left the room. Sarah and Tess became blurs in my periphery. The machine whirred to life, and I closed my eyes. Radiation doesn’t feel like much of anything as it’s happening, sometimes like an instant, stinging sunburn. It was the accumulation of radiation that was painful. That was when skin turned raw, hair fell away, sweat glands gave up. It only took a few minutes, a short burst of gamma rays to attack the bad cells that lived in my body. The good cells killed were regrettable casualties.
When the machine came to a stop, I opened my eyes and strained to see the blur of Sarah and Tess. They were gone. I found them in the hallway of the hospital, Tess holding Sarah as she cried. “I didn’t know,” she said through her howls, “I didn’t know that’s what happened to you.” I knew it was a mistake, in that moment, to have tried to teach her a lesson. She was only twelve. I took her in my arms and whispered apologies into her ear until she calmed down.
Within a few months, there were no signs of Hodgkin’s anymore. In five years, I would be told I was officially cancer-free. My body was never the same. I still do not sweat out of my right armpit. When I get a massage near my lymph nodes, I become ill, feverish, and clammy from released chemotherapy drugs still stored in my body. I am at high risk for breast cancer, the radiation I received having damaged the tissue. I have two scars that will never go away.
Sarah and I were never quite the same, either. I left home just as she went through puberty. I do not know when she first got her period or had her first kiss. There is a betrayal there, to not have been beside her as her body changed. I think of her pressing her face against the glass of my treatment room. We had been allies in our home, and then we faced our own wars alone. We would never live in the same house again. The thing we most often said to each other was “You don’t know me anymore.”