Cancer’s Lessons

The chemotherapy rooms at Memorial Sloan-Kettering’s Breast Cancer Center in New York City are small. Maybe 8 feet by 10 feet, maybe less. They have recessed Formica counters, white kitchen-style cabinets and the kind of fluorescent lights I associate with hospitals or principals’ offices, places where what awaits is a needle’s prick or a reprimand. Speakers hidden in the ceiling pipe in New Age chimes. Sliding doors of blond wood and translucent Plexiglas separate those inside from the world.

There are nine rooms, arranged around an interior courtyard. A skylight glows with rays of dirty-looking sunshine, but everything else is white-glove-test clean. Cheery nurses and volunteers in lab coats ask in low tones how the patients are as they hand out cups of liquid or set up IVs.

While they work, I check out the women in the other treatment rooms. One, the startled-looking blond in the hat and jeans, seems so young I wonder who she’s visiting, until I see an assistant help her to a seat and start probing the top of her hand for a vein.

Any other day, I’d probably fixate on that woman, obsess about the horror of someone so close to my age having to confront her own mortality, and wonder what must be going through her mind. But this Tuesday morning, my attention returns to the room in front of me, where I am sitting with my mother, who is about to undergo chemotherapy for the eighth and final time.

A surgeon had excised a 1.6-centimeter malignant tumor from her right breast and some lymph glands from under her arm. When all this is finished--after chemo and a six-week course of daily radiation--she will have a 92% chance of complete recovery, but for the moment, the only thing she’s concerned with is that her white blood cell count might be too low.

During our last visit, she was sent home without treatment because of her blood count, and it’s been a long weekend of worrying, of sullen silences, of raging against the body my mother feels has betrayed her and the physicians who can’t work fast enough to make her sickness go away.

So I breathe a silent sigh of relief when a lab assistant comes in and tells us that everything can go ahead as planned.

As the nurse hangs the drip bag and prepares the solution, my mother puts a pillow over her hand so I won’t have to look at the place where the IV enters her flesh. “I know how squeamish you are about needles,” she says, and flashes me a hollow smile. It’s a small human moment amid the tension, and I find myself touched by her intention, by her attempt to mother me even now.

To see a parent this ill is an unsettling experience. More unsettling even than the first time I realized they didn’t have all the answers. This illness makes me think about my parents’ human frailty, makes me consider the inevitability of them not being around. At the same time, things get complicated, since, disease or no disease, I am still who I am, still burdened with a lifetime’s worth of emotional baggage, with that peculiar parent-child dichotomy of resentment and love.

When it comes to my mother and me, that dichotomy is especially strong. Over the years, we’ve had a tricky relationship, by turns affectionate and contentious, defined equally by hope and disappointment on both sides. From the time I was 9 or 10 until I went away to college, we spent weeks at a time passing hardly a civil word. Even today, it’s hard to think back on those years without remembering all the things we could not be for each other. Just this morning, on our way into the hospital, my mother mentions that she wished she’d raised my brother and me to be more dutiful.

“What do you mean?” I ask, hackles rising. “I’m here, aren’t I?”

“For now. But you live so far away.”

I stare into her face, try to read the set of her jaw. This has been a running controversy ever since I left New York for Los Angeles, but cancer has magnified her emotions, made her feel more alone.

“Listen,” I say. “Don’t you get tired of this? I was never going to move in next door.”

She looks up, eyes wide, irises a washed-out brown. The Cancer Center doorway is a looming shadow a few feet ahead of us, I can feel its pull. Stop, I say to myself, don’t pick a fight, and I recall how easy it is for me to upset her, how I can push her buttons as easily as she can push mine. I take a deep breath, study the worry lines around her eyes. Not now, I think again, then step across the sidewalk to take her hand.

An hour and a half later, my mother is receiving treatment, and we are making small talk as I think about what almost happened on the street. In another time and place, I would never have walked away from that argument, but one thing I have learned is that cancer has its own geography, a shadow landscape that seems to exist a step or two from normal life. In it, my relationship with my mother has been turned upside-down. Since her condition was diagnosed, I have become my own version of the dutiful son she so badly desires, visiting New York three times in six months to be with her and my father as they try to navigate this brave new world. I, too, am testing the territory, constantly unsure of how I should behave.

My mother’s cancer has cast our entire family into suspension, as if the tumor has infiltrated each of us, as if there were some strange, collective component to the disease. When I see the hollows take shape across her bony face, the way the chemo drugs weaken her body and soak her with perspiration, I am struck by the sense that, no matter what happens, we’ve come to an entirely new phase in our lives. It’s not the first time I’ve thought about this; the possibility has been in my mind ever since a winter afternoon two or three years ago, when I saw my mother slip on a patch of ice and nearly fall. Before she went down, I reached out and grabbed her, and as my hand closed around the thin cord of her upper arm, I realized how small she was, how she seemed to be lighter than air.

I had a vision of her as an old lady, bones brittle, bird-like, carefully negotiating these very streets. And in that moment, I could imagine what it might be like to help her, as her frailty continued to emerge.

Back then, of course, all this seemed like a marker, a whisper of a future that, I felt secure, was decades down the line. I thought I’d have a few more years before anything like this happened and that, when it did, I’d somehow feel more prepared.

In the chemo room, the drip bag has run out of solution, and the nurse comes in to disconnect the IV. “Don’t look,” my mother says, as she moves the pillow, but I’ve decided to face it, whatever it is. The nurse peels off the adhesive tape, then gently eases the needle from where it is lodged beneath my mother’s skin. My mother winces, and a spot of blood bubbles up, but we are done.

Outside, we walk a block or two along 3rd Avenue. Traffic snarls at intersections and businessmen brush past on their way to lunch. It’s a crisp fall day, but my mother is sweating, poison rippling through her system.

“How’re you doing?” I ask. Before we left the Cancer Center, I called my father at his office. He will meet us at home with champagne to celebrate the chemo’s end.

“I’m OK,” my mother tells me. “But maybe we should find a cab.”

“Sure,” I say, and raise my arm. Taxis jockey for position up and down the avenue, and within seconds, one screeches to a stop. My mother steps off the curb, her face red, her back wet and her hair beginning to mat with perspiration. I watch her for a moment, thinking that, soon, we’ll return to our lives.

Then I reach out, put my arm around her, and lead her to the waiting car.