The first battle may be lost, but the war isn’t over…
Mark’s latest CAT scan did not reveal happy news. Although the chemo cocktail was continuing to control the tumors that were discovered in October, new tumors have sprouted, and these new tumors are resistant to Mark’s current drugs. So, we are now done with this course of treatment. Dr. C told us that this would happen, and we should have been prepared, but we were still stunned.
The new tumors caused a resurgence of Mark’s ascites (the accumulation of fluid in his abdomen). This is an extremely uncomfortable condition, since the fluid makes it difficult for him to eat and breath, and puts a lot of strain and extra weight on his body. It also leaches away valuable nutrients. Every few days now, he has to undergo a minor surgical procedure to drain the fluid.
Mark has applied to participate in an ongoing clinical trial involving the administration of a different pancreatic cancer drug, combined with a second drug currently used for other cancers, but new for pancreatic cancer. We are awaiting the results of blood tests which will determine if he qualifies for the trial. This new drug combo is administrated by way of pills, not infusions, and is described as having minimal side effects.
If Mark doesn’t qualify for the trial, the next step will involve infusions of another combination of chemical agents. This particular infusion combination has significant side-effects, and so it remains to be seen whether he can tolerate the treatment.
Chemotherapy is not for the faint of heart, but I am thankful that there are still options, and that we still have paths we can pursue.
I’ve been thinking about the Kugler-Ross model of the five emotional stages of grief that supposedly occur after a life-threatening or life-altering event. She identified them as denial, anger, bargaining, depression and acceptance. I’ve embraced denial, and will continue to hold onto it as long as I can. I’m not sure about anger and bargaining. Depression, right on. And acceptance, well, I guess that comes after you give up on denial.
But there are so many other intense emotions wrapped around this experience. Emotional exhaustion is a biggie, and understandable, since issues of life and death loom over our daily experience and dog us constantly. On my part, there’s a feeling of guilt when I sometimes just want to run away to escape from this stormy world of illness and pain. Mark feels guilt that he’s pulling me through this dark place with him. And the feelings of helplessness are profound. In truth, we never have as much control over our lives as we think we do, but now I feel like a piece of dandelion fluff tossed in a high wind.
And strangely enough…there is gratitude.
I’ve heard people say that when their time comes, they want to die quickly and painlessly, with no advance warning. I know this is an enticing notion. But though what Mark and I are experiencing is sometimes excruciating, we understand that it’s likely we have a finite time together, and so we plan and make sure we say what needs to be said, to family, friends and to each other. And for this, I am grateful.
And a little bit of time travel--
This last weekend Mark and I drove to a memorial service in Surrey BC (near Vancouver) for my cousin Andy’s wife, Sharon.
Andy, his brother Bill, my younger sister Linda and I spent our early years together in Victoria, British Columbia. The four of us are the children of two sisters who emigrated from Great Britain to Victoria Canada in the early 1950’s. My mother's third sister, who was childless, also lived nearby. Holidays, and many weekends, were passed in the company of this extended family. Linda and I had a significantly older brother, and later Andy and Bill’s much younger sister was born, but I remember best the four of us similarly-aged cousins, playing tag on the street at the magical twilight hour, or climbing the old cherry tree in our backyard. (There was a large apple tree too, but true tree-climbers know that cherry trees have smooth bark and wonderfully spreading branches, while apple tree bark is brittle and scratchy.) We were all just one step or so above being close to dirt-poor. I wore thrift store clothes, but we always had enough to eat. My memories of those days with my cousins are knit into the fabric of my childhood.
After my immediate family moved from Canada to the States when I was in junior high, we cousins only saw each other on vacation trips. Then, as we all grew up and were launched, our contacts were limited to occasional catch-up notes in Christmas cards.
In recent years, though, I’ve been pulled closer into the orbit of my cousins. Andy and his wife Sharon visited us in Alaska, and later in Washington. Andy has been diligent about recounting the comings-and-goings of our far flung family in England. Without Andy’s reports, I think I would have lost track of half of them by now. In this last year, Sharon fell very ill with an incurable condition that caused the blood vessels in her brain to break and bleed. After several months of hospitalization and nursing home care, she lost the fight. Andy and Sharon had been married for forty-three years.
Mark and I drove north to Surrey on a cool cloudy day, quiet and lost in our own thoughts. I worried that Mark might find attending a memorial service demoralizing, but that wasn’t the case. We stayed in a hotel on the beach in White Rock, where the outgoing tide reveals a vast swath of sandy beach, and locals and visitors alike descend to beach comb and run their dogs. The trip was a good distraction as we waited for Mark’s CAT scan results.
When the extended family gathered together before the memorial ceremony, I realized that my cousins and I have become the “old folks.” Cousin Andy looked strong and calm, but unspeakably weary, as he prepared to give Sharon’s eulogy. Cousin Bill still has his rakish grin, but, like Mark, he is struggling with a very serious cancer. Andy’s children are now parents themselves, and Andy’s grandchildren swirled through the crowd, unable to hold themselves still for very long.
It is just the way of things, I guess. I don’t know how I’m supposed to feel at this age, and I don’t think about my age very often. But there, in that room of multiple generations, my mind kept flashing back to that time years ago in Victoria, when my cousins, my sister and I danced around and through the legs of the old folks, knowing for certain that we would never be that old.