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Eleven months ago, Peggy complained to her internist of pain in her right thigh. He first thought that she needed a hip replacement. Her friend Walt, who ended his life three years ago because of cancer, had taken the same path with another doctor, but in his case, he went through with a hip replacement. By late May when Peggy’s problem was diagnosed as stage four pancreatic cancer, I was having to lift her leg so she could get into cars. Several rounds of radiation drove the cancer in her hip into remission.
Marc, her oncologist, decided in December that she had a chance of greatly prolonging her life by having her spleen and lower pancreas removed and hoping that the cancer on her hip remained inactive.
Unfortunately, two of the six lymph nodes that the surgeon removed came back malignant following her February 13th surgery. Marc concluded from this that the cancer might have spread. Ten days later a post-surgical blood test called the CA-19-9 confirmed that the cancer had spread. To discover the location, Marc ordered her second CAT-Scan in three months.
The radiologist wrote that the tumor in her hip hadn’t grown, and he saw no evidence of tumors elsewhere, with the exception of some spots on her lungs that weren’t there in December. However, when Peggy told Marc that she was again experiencing pain and loss of function in her right leg, he concluded that what he had thought was a new tumor was probably a resurgence of the cancer in her hip.
Because her previous chemo regimen had stopped working prior to surgery, Marc ordered a new regimen which she will begin on Tuesday. It will take four hours to get the drugs started, and she will spend another 46 hours receiving additional chemo at home. This chemo is so body-wrecking that it could prove unbearable, in which case Peggy will receive palliative care only.
As the cancer on her hip grows—as it is predicted to do at some point even if she tolerates the chemo—her hip could break, and breaks in cancerous bones are irreparable. This would be especially devastating to someone like Peggy who walks six hours a week. When Marc said that the hip tumor is too large to be removed, I asked that Peggy get a second opinion from an orthopedic oncological surgeon. She initially demurred for fear that Marc would interpret it as a lack of confidence in him, but later agreed that a second opinion was a good idea. Kirk, our internist, concurred and complimented us on our choice of surgeons.
Fear of Peggy’s weakened immune system succumbing to an infection had kept us in isolation until last week when we entertained some longtime friends. Then, this week, an Episcopal priest named Ryan brought communion and visited for nearly three hours. Ryan voluntarily wore a mask except when he took it off for a moment to drink or pose for a photo.
My college friend, Lynn, might be the only person in my life who has experienced what I am going through, and his wife, Christi, might be the only person who understands what Peggy is experiencing. Several years ago, Christi was diagnosed with an aggressive brain cancer called glioblastoma. Her M.D. Anderson oncologist said there was only one treatment, and while it drove Christi’s cancer into remission, it nearly killed her, and it left her immune system so compromised that she and Lynn live in the same virtual isolation that Peggy and I are experiencing. Lynn and Christi believe that the prayers of their family and fellow Christians saved Christi.
Although I don’t believe in personal prayer, I have experienced the sacred through the Episcopal Church since I was an 18-year old convert from the fundamentalist Church of Christ. The Eucharist; the ancient hymns; the Book of Common Prayer; the glow of stained-glass; my congregation’s hand-carved altar, and, most of all, the coming together of diverse peoples to love God as they understand God, and to give the support to one another that their love of God requires, are all precious to me.
I also experience the sacred through Peggy and in art, nature, books, cats, compassion, poetry, integrity, and many other things, both natural and human-made. I see the sacred in my friend, Tom, who, when I asked him to bring me two things from the grocery store, brought two bags that were overflowing with cake, cookies, flowers, and groceries—for which, Tom being Tom—he refused reimbursement. I also experience the sacred through your kind responses to my posts and letters; through the visits Peggy and I make to nearby Mt. Pisgah (see coyote); through the affection and acceptance of priests who know of my non-belief and are sensitive to my struggle; through memories of my online visits with Anna, Louise, and David, who are also friends from church; and through many other things.
Peggy’s illness has caused her beauty to ripen. I have always been proud to be seen with her, but never so much as today because she was never so beautiful as she is now. She told Jackie and Kurt that she no longer has the strength of a warrior in her fight against cancer, yet as I write these words, she is doing her thrice-weekly dumbbell workout. She and I agree that she is facing this ordeal better than I, although she is the one who has cancer. Unlike myself, Peggy is a private person, but because cancer has made it impossible for her to keep her pain and her heartbreak to herself, the intimacy of our relationship is greater than ever, both of us feeling fully naked and fully helpless at times. I admire her for being braver than I, but this makes me no less accepting of those occasions when she is unable to cope. My purpose in life is to support Peggy, no matter how severely her cancer wrecks her body. What, then, will be left to me if my reason for living is destroyed by her death?
“You become. It takes a long time… Generally, by the time you are Real, most of your hair has been loved off, and your eyes drop out and you get loose in the joints and very shabby. But these things don’t matter at all, because once you are Real you can’t be ugly, except to people who don’t understand.” —from The Velveteen Rabbit
