Let the Whole Thundering World Come Home

  Yu-kwan and I walk out to her grave in late afternoon, clouds low, almost touching the distant mountains. A wind picks up and cuts a cold slash through my winter clothes. The footpath is lined with dozens of standing red roses, a high contrast to the dry terrain. Only on inspection do we realize the roses are artificial. Her boyfriend, who works with props on film crews, planted them. He is kneeling near the head of the grave. I have never met him before. “Thank you for all your effort,” I tell him.

  He nods and says, “It’s done; we go on.”

  I look at Yu-kwan, who is clutching her coat at the collar, grimacing in the cold. She is wearing a thick, dark-blue stocking cap that I know is not warm enough. With the loss of her hair, nothing is warm enough.

  Rima’s mother and two sisters are buoyed up by all the love and support of people who are connected to Rima. We don’t stay long.

  The car tires jiggle over the washboard in the uneven dirt road. In that moment. as we drive home, New Mexico feels lonely, basic, vast, grounded only in the excruciating truth of our ultimate end.

  16.

  TODAY YU-KWAN finally read to me from her journal and showed me her mastectomy scar.

  First she read from a small bound notebook:

  Ten days ago, my left breast was removed because it had a 3 cm. carcinoma. It looked so perfectly fine on the outside, very much like the right breast that had no abnormalities. My scar looks scary, bumpy, pink, pulled against the flesh as it tries to recover, make whole. I’ll never be whole again, losing confidence, feel like everyone is looking at me. The rational Yu-kwan says: It’s not like losing a leg or an arm. And, it’s still my breast. I am lopsided, a one-winged bird, losing the ability to fly. I always thought that I could handle the worst atrocities, like running away from home, mourning a husband who killed himself, and losing an important relationship. But this is different. I’m helpless after surgery, depending on the kindness of doctors and nurses.

  It was a difficult maneuver getting out of bed and the five steps to the toilet. I had to be unplugged from the heart and oxygen monitor, the leg braces to stop blood clots, and the drips. I had to go often and I needed help. Jenna Sue, my night nurse (I called her Nurse Ratchet), did not like me ringing the “N” button. I was in a special ward (not intensive care) but was to be watched every hour. I hardly saw her except at my calling. After a period of waiting, Nurse Sue came grudgingly, impatiently, and in a bad temper. I found myself apologizing, and I was afraid to sleep for fear of what she might do to me or give me. Were the drugs making me paranoid?

  I wanted to discharge myself when I thought I had to stay another night because of irregular heartbeats. Fighting or pleading my case for discharge with the doctors and nurses warded off the reality of the missing breast. I’ve always been healthy. I don’t go to the doctors. I didn’t have a mammogram for eight years. Yet the last mammogram was clear and it was a self-examination that detected the mass. They called it a palpable mass.

  She finally removed the bandages and looked at herself in the mirror — that long horizontal line reaching all the way under her arm. She thought, Where did my breast go? I don’t feel complete anymore.

  “It wasn’t so much the physical pain — the pain is emotional. Every time I look at the scar, it’s a reminder: I had cancer. Will it come back? With any ache or pain I fear, will it come back?”

  Now she unbuttoned her shirt. I’d glanced at her briefly in the bath and shower, but here is her formal presentation. I held my breath. Would I grimace? Could I be supportive?

  It looked bad, like a sword had slashed her. I’d seen the famous Deena Metzger poster years ago, of her brazen fantastic display of a tattoo over her mastectomy. This didn’t look like that. I immediately hated her surgeon. What was with the extra flap of skin under her left arm?

  “Oh, I can see it’s still healing.” I suggested vitamin E oil. I reached out and touched the scar. Then I touched her single breast.

  17.

  IT WAS EARLY December, three weeks into my ingestion of ibrutinib. I had the bright idea for us to escape — not that there’s any escape — to Florida for a week, right after Yu-kwan’s final chemotherapy. We realized it was possible to go, nothing to hold us back. We took the leap.

  I was in an old bathing suit, one with splashes of blue flowers. Yu-kwan was tired, not comfortable yet in a bathing suit after her surgery. She sat each day in a front garden near a green lawn, reading the biography of Sonia Sotomayor.

  I fluttered by from the pool to the ocean, licking an ice-cream cone. I bent down to kiss her. “Kiss me again,” she said, licking her lips, hoping for a taste of ice cream. Her cancer was estrogen positive, thriving on that female hormone, so the doctor told her to avoid dairy. Also sugar and simple carbohydrates. Cancer feeds on them. I was given the same diet. I was eating an ice-cream cone anyway.

  Deep down I was sad she could not eat to her heart’s delight. No one I’d ever seen — including my fat father, gorging on my grandmother’s blintzes, and my friend Eddie, who even ate the reheated food in gas stations, both big men — could outeat Yu-kwan once she got going. I was still astounded that such a petite body could consume so much.

  Though she loved the biography she was reading, it was open on her lap, face down, as she relaxed in the shade, watching families saunter by. A young boy with blond curls. A girl dragging a racquet. A grandpa holding an infant wrapped in a light blanket. Occasionally she shaded her eyes with the back of her hand and looked up at the soft southern clouds. She sighed. “America is a beautiful place. Anyplace else” — she was thinking of her childhood — “I could have died of this cancer.”

  I went to the lap pool, the Atlantic’s waves crashing nearby, with that flat even horizon in the distance that goes on forever. Barefoot, looking down at the water, I felt a shift in my body — a sudden space inside, and a tincture of plain happiness spreading through me. Can this be possible? The ibrutinib is working? After twenty-one days, maybe it had gained enough accumulated muscle. That powder in each capsule, years of research and thought, experiment, had now reached fruition. The ibrutinib was winning.

  I didn’t say anything to Yu-kwan.

  My energy built through the rest of the week. The morning we were in the Miami airport, about to fly home, I skipped the escalator and bounded up the stairs, my heavy suitcase a mere trinket that I checked in and flung onto the conveyor belt.

  When she caught up, Yu-kwan said, “Natalie, it’s like you’ve lost your senses, become manic. Are you okay?”

  I only turned up the two corners of my lips and revealed nothing. Is it really happening? I didn’t want to jinx anything that might be transpiring. I held it all close.

  But I was exuberant. The cells in my body were coming alive again, because of that new drug that had been out only a year. While I taught writing students new angles to express what they wanted to say about their mother, sex, toast, their first taste of avocado, researchers in the east of our country were for years relentlessly creating new paths to cut the production of cancer cells in the human body. Thank you, thank you, thank you. You, who I have never acknowledged before.

  18.

  WHEN I RETURNED home, the exuberance I had felt in Florida dropped completely, as if it had never existed, like a shattered dream. Maybe I was hallucinating in the southern sun?

  I saw the oncologist every six weeks, each time getting the dreaded blood test. My blood looked okay, but so what? Last fall it was fine and I had cancer galore.

  I was scheduled for another PET scan in February, to see if the drug was working. That big test in the middle of the second full month of winter would tell me the truth. Every ounce of me lived in dread and hope.

  I fantasized endlessly what I would do if I was clear. How I would get in my old car, the one I loved — the navy Volvo station wagon with the wide seats and turbo engine. I would travel the empty boundless Midwest, stopping in small, lost, sometime
s suspicious towns. These would be dark American places where my Jewish genes were not allowed but places that mirrored my own boundless emptiness. I also imagined showing Yu-kwan Big Sur, driving down along the high cliffs at the edge of the Pacific, the big water stretching to Japan, where I also planned to go and follow the trail of Basho, the great seventeenth-century haiku writer. Oh, I had plans. Over to Paris, gaze again at Monet’s water lilies, drink hot chocolate at Les Deux Magots. Come back to the States and follow the rough coast of Maine, go again to Grandma and Grandpa’s graves in Elmont, New York. Drive to the tip of Long Island and swim in the brown Atlantic. Go to Canio’s, the poetry bookstore in Sag Harbor, where they sell poetry books by Mr. Clemente, my ninth-grade English teacher.

  I wanted to see the Art Institute of Chicago, eat at Detroit’s Greek restaurants, for the first time behold Birmingham’s Civil Rights National Memorial. Go to the Phillips Collection in DC, then over to Fort Worth’s water park, the hamburger shop on the corner with the red-checked tablecloths, visit again the city’s three art museums, right in a row, on the same street. The Amon Carter, the Kimball, the Modern. I’d walk from one museum to another, getting a strong whiff of the stockyards a mile off. Then the Oregon coast, Seattle, Vancouver, Mill Valley’s library, and the lettuce fields at Green Gulch. I wanted to spread my happy no-cancer arms over the whole universe.

  I would abruptly stop those rolling thoughts. I didn’t know what the results would be. I didn’t know anything. That was the truth.

  And beyond anticipation, in a much more primal place, fear raged. It bowled through me, uncontrolled. No meditation, yoga stance, massage, deep breathing, allayed its force. All I could do was acknowledge it, realize it was innate. On an animal level, we all want to survive.

  February 17 was D-day for getting the PET scan. While I waited for that day to come, in my restless, nervous impatience, I painted two self-portraits. Each time I’d look over the sink into the mirror and say, talking to the pen in my hand, “Make me pretty.” Then I’d make the initial sketch. I’d draw quickly, place the pad on the table and look down at the sheet of paper. Was that me — at the edge of fury, hysteria, madness? That’s not what I saw in the mirror, but on the page a more unvarnished reality stared back.

  I grabbed for the brush and dipped it in a light cadmium green, the color of split pea soup, and painted the whites of my eyes, changed them to the color of terror. I painted purple on the haunted, bruised cheekbones, a pale pink mouth, slightly opened in stunned recognition, hair streaked in orange, bare branches in the background.

  A week later I tried another self-portrait. Pretty was not in my hand’s vocabulary. I had to accept the raw emotions on my face. In life it was harder. I was living them.

  I took the three ibrutinib pills each day at noon. I also did normal things: got my hair cut, went to acupuncture appointments, met Miriam and Susana for lunch, had my teeth cleaned, visited with my friend Sean Murphy from Taos, even went to a talk on James Baldwin at the Lensic Theater downtown. But whatever I did, I lived for one thing: the results of taking those pills for three months. If they weren’t working, the cancer would be further along — and I would be closer to death.

  The day finally came. Susana drove me down to Albuquerque in her yellow car. I hadn’t slept at all the night before. My muscles ached, and a headache was forming over my left eye. The miles of sagebrush we passed through looked dry and desolate. No snow. Bare ground.

  As usual, the lab tech in the Cancer Center couldn’t find a vein. She was inexperienced, and after two tries I asked for someone else. Her replacement, a young man who didn’t smile, managed to shoot the nuclear sugar into my veins. The big crazy machine snapped pictures while my body slid back and forth inside like a ham on a conveyor belt.

  Afterward, I fell back into the waiting room. I found Susana, and we drove straight home.

  As soon as I got inside the front door I stripped off my clothes, dropped them on the floor, and got under the bedsheets. It was just after noon. I lay there staring up at the ceiling for much of the rest of the day.

  Originally I was scheduled to see Dulcinea the next day to go over the results. But the week before, the center had called and rescheduled our appointment for Friday, three days after the test. I tried to explain to the woman how much stress was involved in a longer wait, but she was curt: “I’m sorry.” And hung up.

  I was indignant, called her back. That changed nothing. Once again I had to accept that I was not in control. I was contending with the big industrial machine of American health care. (I learned later that Dulcinea knew nothing about this switch.)

  So, instead, the day after the PET scan, I took comfort in not knowing the results. I had all day Wednesday and Thursday to bask in ignorance. A part of me understood the verdict was already in — whatever was happening in my body had been happening in my body for a while. But on Friday my conscious mind would meet my body’s performance. It had been responding — or not responding — to ibrutinib for months.

  So on that knowledge-free Wednesday afternoon I was painting a car green — I’d stopped the self-portraits — and the car was slowly morphing to blue. I planned to call it Homage to California because I drew the car at my friend Helen’s home in Palo Alto. It was an old Rambler Ambassador with flat tires that I saw in someone’s driveway every time I visited her. I’d attempted to draw it before, but the sketches never worked. I’d almost given up. But one morning I woke early, marched out there in my pajamas with great determination, and did a new sketch. Even though it wasn’t a perfect rendition, I caught its spirit. Now, many months later, I was finally painting it.

  The phone rang. It was Erica, my primary care doctor. She had a spring in her voice. “Natalie!”

  I gripped the paintbrush tightly. I knew she had my results. I’d given the nuclear department her fax number but had forgotten. My heart was banging in my chest.

  “It’s good. It’s good,” she said.

  “Tell me! Tell me!”

  “See if you can take this in.” She read from the report, “ ‘The bones have dramatic decrease of the multifocal metabolic activity.’ ”

  “Is that good? Is that good?”

  “Wait. Listen. ‘The previously described hypermetabolic lymph node activity has resolved.’ ”

  I was trembling. I heard fragments: “ ‘no longer avid…no longer pathologically enlarged.’ ”

  “Erica, tell me — what?”

  “Nat, it’s very, very good. That drug is a miracle. The cancer is gone.”

  “Really? Really?”

  “You’ll see your oncologist and go over everything. She’ll explain. Nat, congratulations.”

  “Yippee!” I yelled, like a cowgirl. We hung up.

  Outside the window above my painting table, the aspens cast long shadows across the fence. I stood up, hugged myself, and grabbed for the phone.

  First I called Yu-kwan. “I do not have cancer. Nothing lit up. I can’t talk. Come over.”

  Then I called almost everyone I knew. In each call I repeated those first two essential lines, then said, “I have to go,” hung up, and dialed the next person. After that I paced my studio, then the house for several minutes. Finally I careened into the backyard in a thin T-shirt, talking to myself among the frozen fruit trees.

  I finished the Rambler painting a few days later. The car was big, fat, and ready to roll. I changed its title to Happiness.

  * * *

  —

  On Friday, knowing the results, I drove down with Annie to see Dulcinea, who had a bad cold, caught from her young daughter.

  “Her dad, her grandma and grandpa, all have it,” she explained. “We couldn’t stay away from holding, cuddling, kissing her.” She was wearing a white mask to protect her patients, so her usual expressive face was hidden, but her eyebrows popped up and down as she talked. I could feel her deep satisfaction at the results.

  S
he reminded me that, though the results were good and there was no sign of cancer now, I had a chronic condition, “Someday,” she said, “the cancer will figure a way around the ibrutinib.” I had to continue to take the pills as maintenance, but no one knew how long the drug would continue to work. A year, two, three? It was still a new drug, and each person’s cancer is different.

  She told me that the radiologist, who analyzed hundreds of scans, remembered the test from four months ago, and she couldn’t believe the new results. My insides, which had been drenched in cancer, were no longer pathologically enlarged.

  I couldn’t believe it either. It was as though I’d been kidnapped, with death like a sharp knife swinging constantly over my head, and then suddenly flown back home. I identified with Iraqi war veterans — the change was so sudden.

  I was supposedly normal again, as if no hole had been blown through the center of my life.

  19.

  DURING THE WEEKS that followed, I thought a lot about my parents, reaching back to when I was young. How my father carried loneliness, the same way another person carried his royalty or her athleticism. His loneliness was big, broad, and open. He sat in the middle of it, never trying to break its spell, never struggling outside its circumference. It didn’t have a grip on him, exactly because he didn’t fight it, didn’t deny its place in the human plentitude. Even in the middle of family gatherings, with all of his blood relatives from Brooklyn at our dinner table, he was in an independent sea.

  My father faced one of life’s truths squarely, and because of that there was an authority about him, a wisdom — and a plague. People were afraid of him, of what he’d say because he was fearless. His second shoe had already dropped; he was no longer trying to defend something, keep up appearances, be someone.

  I’m not sure how he came to this, but seeing it all of my life had a potent influence. I wanted that freedom. Maybe fighting in the war, or the rejection of his orthodox Jewish parents, or the opening of the camps — that a human life could be considered worthless — effected his brooding single distrust, his wariness. But it also created a humanizing independence. I remembered him when I was a child — he’d become a champion swimmer in high school — using the crawl to go farther out than anyone was allowed to at Jones Beach, into the rough salty expanse.