Let the Whole Thundering World Come Home

  I meditated in the morning and spoke my thoughts to those alien cells. Listen, you are young, not well developed. You don’t know better, but it’s time you leave. Do it of your own volition: This is a warning. A war will be waged against you. You’ll be destroyed. This was my gesture toward nonviolence, toward my friend John Dear, the Jesuit nonviolent activist. This was my gesture toward his work, a nod to King and Gandhi.

  On another day I told them: We’ve traveled together for a long time. It’s time to go our separate ways. Adios.

  I did not feel hostile. My rage was against time. Not now, I said. I am in the fullness of my life. I know at eighty I will still not like it, but for God’s sake, leave me alone now.

  My acupuncturist said her Indian teacher often repeated: You do not want to run neck and neck with cancer. You want to step in front of it and stop it in its tracks. Meaning don’t mess around trying herbs, potions, incantations. Cancer must be terminated.

  I wanted my illness to be something simple, resolvable with the right homeopathic pills dissolved under my tongue. Or some spiritual, exotic problem. Too much dry heat in my liver or kidneys. Definitely curable by some kind of herbs. Something outside the realm of the medical profession, with its long hygienic halls, oppressive lights, and rigid appointments. My friendly attempt at relationship with cancer was absurd. Cancer cells won’t leave on their own. Most every friend who had cancer and did only alternative medicine is now dead.

  I had to enter the strange industrial cancer world. The big machines, the sterile rooms, the multimillion-dollar research. I knew I had to do this. I wanted to survive. I wanted my best chance.

  6.

  THE SECOND FLOOR of the Cancer Center in Santa Fe was lined with black lounge chairs and long cords attached to infusion pumps, which measured and administered drugs into patients’ arms. Big windows all around provided a view of the Sangre de Cristo Mountains.

  Every once in a while a bleep sounded or a light went on, alerting the nurse that someone’s time was up. In my case the bleep was a signal to hang above my head another big, thick, clear plastic bag, like a cow’s udder, full of medicine that it dripped infinitesimally slowly into a vein in my hand. I arrived at 8:00 a.m. I was the first patient each day. I was released at five o’clock, if all went well.

  My friend Annie Lewis sat with me the first four hours every time. I met Annie in Ann Arbor in 1972, when we discovered we were dating the same man. In spite and rebellion, we leaped into our own uncensored love affair. Back then she was getting a PhD in anthropology on a full fellowship, and learning Hausa, an African language. The next summer she went to Santa Fe to attend anthropology film school and never returned to academia or the Midwest.

  Sitting in the infusion room, we recalled how in Santa Fe she took evening acting classes. She reminded me as we sipped water (must stay hydrated, the nurse urged): “The teacher asked each student to stand up and speak from your deep heart. That’s the four words she used. When I stood in front of the twelve other actors at the edge of the wooden stage, I threw my arms open and out ripped the statement: ‘All I really want to do is sing rock ’n’ roll.’ ”

  “Where did that come from?” I jiggled the cord to the electric lounge chair I was lying in.

  “I sang soprano in the choir in church as a young girl. Maybe that was it.” Annie put together a band called the Quadrosexuals and was the lead singer, with blue hair, high heels, and a fitted one-piece leopard jumpsuit, her right shoulder bare.

  When I moved to New Mexico a year after Annie did, I saw her on an outdoor stage with Allen Ginsberg, performing together. He croaked his Buddhist chants and she improvised lines in a cross between screaming and singing. “It was called Sprechstimme, a German word,” she told me as a volunteer approached with a basket of chips, cookies, pretzels.

  When the band fell apart, she and three other friends opened the Collective Fantasy, a small venue for foreign art films with a café attached. It was an anomaly in the seventies. She baked the brownies they sold. “Only with honey, not sugar. We were very idealistic.”

  “I can trace your life that far,” I said. “How did you make the transition to bookkeeper?”

  “After we sold it the new owners changed the name to the Jean Cocteau — by the way, do you know the theater finally landed in George R. R. Martin’s hands?”

  “I vaguely know the name.” I stretched out my right arm. The catheter was in the left.

  “He lived in Santa Fe, was a struggling writer, loved the Collective Fantasy’s popcorn. Then he wrote A Game of Thrones and it all changed.”

  “Oh yeah, now I remember. He’s a really nice man.” I swiveled my neck around. So many hours to go.

  “I needed something steady, sedentary, calculable, putting numbers in small boxes. I wanted off drugs. I was happy to gain weight and have some padding. I was too lean and on the edge of nerve.”

  “When people ask about you, I tell them that you were Phi Beta Kappa as an undergrad.”

  She threw back her head and laughed. Her hair was now pale blond, short, and she wore baggy beige pants and a trim white, button-down shirt. “You’re the only one it matters to.”

  We ate our lunch together. I had brought an egg salad sandwich and some chocolate sweetened by a god-awful sugar alternative that supposedly would not feed cancer.

  After Annie left in the afternoon to go to work, my friend Susana arrived to keep me company for the second shift. She wore high-styled, understated French fashion, something gray and perfect.

  I looked her up and down. She’d dressed up to visit.

  Susana spoke fluent French and Spanish, was brought up in England, lived across the valley from me in an ancient adobe. I once visited her aging parents in Nice, France. Her father attributed his strong constitution to eating six apples a day and personally shopping daily for those apples. He died at ninety-nine. Her mother died at ninety-six. They had been married seventy-five years.

  A volunteer asked if I needed another pillow. I shook my head no.

  We talked about Susana’s two one-woman plays. I went to each at least three times, taking in the humor, the poignancy, and the language.

  She told me about the recent clothes she’d bought. I mostly do not notice what someone is wearing. I buy no clothes for a year at a time and dread entering a clothing store. I almost didn’t believe Susana’s interest in garments. After all, she read the New York Times thoroughly every day and was up on politics — not only America’s but the world’s. I often relied on her for updates and analysis. Even better, the girl read literature. Thick books did not intimidate her.

  Now, with so many hours ahead of us, I had the space to accept the pairing of fashion and informed intelligence.

  As the days passed and Susana spent one day after another with me, I leaned in to her interest in fashion. I said to her, “I remember it clearly, a Tuesday in January. It had just snowed when you and Stephen popped over to see my new house and studio. You were standing at the door to my studio, reaching for the knob when — don’t you remember? — I noticed your new coat, the one Stephen bought you in France.” The coat had a rough wool weave and some pale purple in it. “What amazed and delighted me,” I told her, “was that I noticed it, woke up to a certain beauty I had been dead to.”

  In the infusion room with Susana I developed a curiosity about style. I showed her an elaborate ad for a turquoise purse in the New Yorker and a frenzied page for Ray-Ban sunglasses in Rolling Stone.

  In that sterile cancer room, I quizzed Susana: What is fashion? Why fashion? I approached the subject as an anthropologist. I still wasn’t interested in going any closer to the clothes racks, but as the weeks went by and we settled into our routine — Annie mornings, Susana in the afternoons — I noticed everything Susana had on — the turquoise sneakers, the black nylon pants.

  During week seven of the infusions I convened a literary salon in the afternoon during Susan
a’s watch. I had been working on a rough draft of a new book. Susana had just read it, and so had my ex-girlfriend, Michele, who drove up from Albuquerque. Usually a discussion with a friend about my recent writing lasted at most an hour. But we had the leisure to fill the full afternoon with discussion. After all, I wasn’t going anyplace.

  Susana liked the Zen essays at the end best. Michele surprised me. She was partial to the hiking story. We discussed: What is a book? What is story? And the inevitable question, Who is the audience? Near the end we fell into a satisfied silence.

  Michele left soon afterward. Susana and I watched the last drops travel from the bag hanging over my head, down the tubes, and into my veins.

  The nurse, eager to go home — I was always the last one to finish treatment — ripped the white tape off my left hand and pulled out the needle. No matter how good the discussion, as soon as the needle was out, Susana and I bolted for the door.

  We charged down the stairs to the ecstasy of outside, even if it was just a paved parking lot. We jumped into her bright yellow car and zoomed down the road, jolting over the speed humps too fast — anything to get us away from there.

  We skidded up to my front driveway. I grabbed her in a hug and then dashed out the passenger’s side. Another session down, the aberrant cells tamed, I hoped. I was determined they would not run wild in this body.

  * * *

  —

  After each infusion I would open the front door and enter the kitchen. How the same, and how totally different, the stove, the refrigerator, the window over the sink looked. I was home, but I could not leave behind the memory of the infusion room, where all around me men and women entered, fell asleep, were discharged. All received chemo treatments, often delivered through a port in their chest. A man with dark eyes, olive complexion, a straight nose, so beautiful across the room it took my breath away. How could someone that beautiful have cancer? His wife sat facing him, bent over her large purse. They did not speak. They were done in an hour and a half. The next week he was much more sallow, yellow, thinner. He was dying, and everyone could see it. I watched a nurse, who had administered his drug two minutes earlier, sob behind the door so he couldn’t see her.

  7.

  MY DEAR FRIEND Wendy flew in from California and accompanied me for my third infusion, giving Susana and Annie a small break. This was the second time I received two thousand units, the full blast.

  After this treatment I lay in bed delirious with a high fever and bone-rattling, teeth-chattering chills. Wendy administered cool cloths to my forehead. For long hours she sat alone at my dining room table, writing her seasonal gardening column for Tricycle magazine:

  I had planned to write this column on haiku and flower viewing. Forget that. The only flower garden I am getting close to these days is the antiseptic infusion suite of the cancer center. Here, “infuse” goes back to the Latin infundere, meaning to pour in, saturate, permeate, souse, and fill up for eight hours, once a week, the pale blue veins of my gutsy friend with 2,000 units of monoclonal antibodies.

  The medicine my friend is receiving is relatively new, approved in 2009, with the mythic-sounding name of ofatumumab. I learned this a few hours into her treatment. It was quiet in the infusion suite, church quiet, resignation before the sermon. “The name of your meds sounds like Oh Fat Tuna Man,” I whispered to my supine friend. She opened one eye, a wise and ancient sea turtle coming up to the radiant surface of the ocean, schools of tuna far below. We began to laugh, timorously at first, then raucously. Patients rose up in their recliners to stare at us with a mixture of amusement and horror. I noticed a little balcony off the main treatment room where we received immediate permission to relocate. Thunderclouds and the memory of rain saturated the landscape. We whipped out paper and pens. “Ten haiku. Go!” my friend commanded. Five-seven-five: Basho, here we come!

  And so we split open piety and prudence that afternoon to receive a new infusion at the dark rim of medicine and disease. “Don’t imitate me,” Basho commanded his followers. “It’s as boring as the two / halves of a melon.” In response my friend recited her blunt verse:

  Rained last night

  Slow drip into my veins

  Sixty-six with cancer

  We wrote and read to each other all afternoon. We ate brown rice and corn enchiladas and guzzled ginger kombucha. We reminisced about the battered green Chevy pickup under the cottonwood, and for long stretches of time we kept completely quiet. When the infusion was complete, I noticed with surprise that it felt like we had been gardening together. My friend told me then about Shiki, a modern haiku master who died of spinal tuberculosis at the age of 35. For Shiki, she said, the act of creation entailed alert stillness and infusion of intention. He dragged himself to the edge of his tatami mat to overlook the garden:

  One whole day

  Tilling the field

  In the same place

  (translated by Peter Washington)

  After this treatment it became clear that a full dose was too much for my body. I spiked fevers of 105, alarming my doctors.

  I took a week off from treatment. I had programmed myself: Boom boom boom, let’s get through it. Don’t think. Just do it. 1-2-3. But my body couldn’t handle it.

  My next treatment day was on a Friday. On Thursday I snuck off to the woods alone. I parked at the Chamisa trailhead. Two miles up and two miles down. I’d hiked this trail often in the past and thought it would be easy, as it always had been. But at every curve I had to stop; at every small incline I sat down. Under the ponderosas and piñons, the reality of how much my body had diminished soaked in. I can’t even climb Chamisa?

  Eventually, I made it to the top. I leaned against a tree, opened my notebook, sobbed and wrote, wrote and sobbed. It didn’t matter what I was writing — it was all cause for tears. I probably wrote a continuous scream (I never reread it). But I came in direct contact with the groundless disaster — I could not hold on to my old life; I could not manage or form a new life.

  I gave up on writing and decided I’d do zazen. Enough with words. A strong cross-legged posture, breath in and out, would save me.

  I leaned against a straight-up ponderosa for support and crossed my legs.

  I wept the full time. Not snivels and whimpers. Full-out squalling.

  The shadows of trees passed slowly from right to left. I looked at my watch. Three hours had passed since I had gotten up there.

  As I climbed down, my legs ached even more. I braced them against rocks, knees feeling the pull of gravity.

  At the parking lot, my car was the only one left. Though it was the end of June, the air still had a chill as the sun went down.

  How would I face the infusion? I did not under any circumstances — even to be with thoughtful Annie, faithful Susana — want to enter that infusion room, have them plug up my veins for eight hours, and be sick for days after.

  But the next morning I was there at 8:00 a.m. — raw, subdued, pale. And we began again — but this time the prescription was reduced to a thousand units. I was told, and believed, that my body could bear it.

  * * *

  —

  I found a balance with Oh Fat Tuna Man — with the one thousand units I was taking each week. No fevers, no chills. Maybe this isn’t too bad. By the end of October I’ll be done. My blood work is excellent. “No cancer can live with numbers like these,” my oncologist repeated. My white cells are smack in the normal range for the first time in decades. Okay, Nat — a year off and then I’ll get back on the old horse and ride. I have been inconvenienced, but it is temporary.

  I watched my mind grab for reason, for time. Time was my only treasure chest. How much? In my mind I cornered off the year. Made my problem digestible, acceptable.

  But I did notice, when friends visited, subtle differences. Yes, they had more energy, more mobility than I did. They were still busy in the world with the r
outines — the jobs, workouts, hikes, plans — they had before. No interruption. But there was something much more subtle, something I often didn’t catch until after they left: They don’t know they will die. It was constantly with me now, my mortality. It hung out on my right shoulder like an animal, patient yet hungry. It wanted me, and I knew that eventually it would have me.

  I asked myself in the face of it: How do I live?

  I recalled the Buddha’s last words: All things that are born must die. In any case continue with vigor.

  Meanwhile, cancer was proceeding for me.

  HERE WAS MY BELOVED’S LIFE

  I’m in Missoula, Montana, a place I’ve been heading for ever since I read the poet Richard Hugo back in Minnesota in the early eighties. He lived, worked, and died in this town.

  A few days earlier, I e-mailed Peggy Christian, a student who lives here. She studied with me a single week eight years ago. Peggy, who normally never reads astrology predictions in the local paper, saw this week’s message: An old friend from far away will be contacting you. Old Friend from Far Away is the title of one of my books, published in 2008. When Peggy saw from Natalie as the subject on the e-mail, she thought a friend was joking with her. But I wasn’t joking. I told her I’d need help navigating this town.

  Hugo was known as a regionalist, and many of his poems are titled with the names of small broken towns in the Northwest. But what he writes about is not contained only in those places. He writes about death, other people’s graves, loss, loneliness, land, drinking, how we bear up, how strong in the end we are.

  Peggy and I visit the Missoula Cemetery. We run up and down the rows. No Richard Hugo. She calls a friend on her cell, then dictates directions to me. “A northside cemetery over the tracks on Cooley, Saint Mary’s Cemetery, 641 Turner Street, flat marker under a huge elm tree.” I jot down notes.