Today is the birthday of a friend of mine from high school. I haven’t seen her in years, but I never forget that this day is her birthday. As many do, our paths diverged after high school: I went to university; she went right to work then soon became pregnant with her first child. Being from a religious family, they made her choices for her. She would marry the boy she barely loved, or knew well, and raise a family. That boy became an abusive husband and father, who beat her during both her pregnancies and whenever else it suited him; facts she hid from me for a long time.
When she first told me, I felt outraged and wanted to do everything in my power to punish him and to change her situation: she and her children could stay with me as long as necessary so she could figure out what she needed and wanted to do for herself, for them. She never left him because both families and her religion forbade it. Family elders and their priests counselled them, but the abuse never ended. It evolved, becoming the thing that controlled her life, isolated her, made her ill, and a shadow of the vibrant person she once was.
All these years later, I still become overwhelmed with grief and anger, and well up with tears when I think of the smart beautiful funny girl she was and the hopeless woman she became. There is nothing I wouldn’t have done to help her leave him and nothing I wouldn’t do now. On the odd occasion when we talk on the phone because he’s not lurking somewhere nearby, the topic and the possibilities of how she could leave still arise, but the fear she feels for herself and her children outweighs all else. So, I tell her to keep herself safe and reluctantly hang up and wait for the next time she calls.
I don’t know if she received the birthday message I sent to her by text this morning. I didn’t get a reply. I can only hope she did receive it and believe that telling her I love her makes a difference in her day, and in this fraction of her life. When you love someone that’s what you want for them: goodness and the best of everything. Even when you know, the chances of that happening are slim. Nevertheless, just in case, I’ll send another birthday wish into the universe for my old friend with all the love in my heart, and I’ll pray that she’s keeping safe.
A friend, who I love dearly, is losing is wife. She has cancer and she is dying. It started as colorectal cancer, which her doctors believed they had successfully removed and treated the surrounding areas with chemotherapy and radiation. After all that, the cancer still found its way into another area of her body. In her case it was her liver, which means her colorectal cancer became what is referred to as metastatic colorectal cancer. Since then, she has had pieces of her liver removed twice to cut out cancer tumors. Until my friend described the process of waiting for enough of his wife’s liver to grow back to remove the second tumor, I didn’t know what a resilient organ the liver is.
That was earlier this year, in the spring, and while they were waiting for her liver to grow, an MRI that was part of her treatment follow-up found a spot on one of her lungs. The doctors told them the spot was small and there was no need to worry about it at that point. However, my friend worried anyway; and so did I. It didn’t make sense that the doctors wouldn’t try to remove the cancer cells from her lung, or at least treat them, at the same time they planned to remove the tumor from her liver. It didn’t make sense especially because those cancer cells on her lung caused her to develop a terrible cough. According to my friend, she would have severe coughing fits when she talked and all through the nights that made it impossible for her to get a good night’s rest. The doctors prescribed her inhalers – the same kind I use for my asthma – and that gave her a small amount of relief but never stopped the cough.
Fast-forward to earlier this week and a series of appointments. The first was with a targeted therapy oncologist to decide if she meets the requirements for a drug trial, which she didn’t because the cancer has spread to multiple organs. Next, was an appointment with her family doctor to update health insurance benefits forms, where they learned that the doctor had suspected she might not qualify for the drug trial because more than one organ is now affected by cancer. Then lastly, she had an appointment with her personal oncologist. He finally spelled things out clearly for them: she has outlived the life expectancy of the average person with metastatic colorectal cancer also called stage IV (four) cancer, which is an average range of six to 18 months. This immediately put everything about recent steps in her treatment plan in clearer perspective for my friend: there was no urgency to treat the cancer in her lungs because she has survived longer than expected.
Furthermore, “Once cancer spreads, it can be hard to control. Although some types of metastatic cancer can be cured with current treatments, most cannot. Even so, there are treatments for all patients with metastatic cancer. The goal of these treatments is to stop or slow the growth of the cancer or to relieve symptoms caused by it. In some cases, treatments for metastatic cancer may help prolong life.” In this, she has been fortunate because she has had low pain levels throughout the course of the disease, and she is still very active. However, because her cancer keeps growing in different areas, it’s possible that it can no longer be controlled. The literature I read online, states “If you have been told you have metastatic cancer that can no longer be controlled, you, and your loved ones, may want to discuss end-of-life care. Even if you choose to continue receiving treatment to try to shrink the cancer or control its growth, you can always receive palliative care to control the symptoms of cancer and the side effects of treatment.”
My friend’s work schedule has made it difficult for him to go with his wife to all of her appointments, so until this week there have been pieces of information he hasn’t received directly from the doctors. Now that he has all of this information, he is in shock, but his wife seems unshaken by the gravity of her health situation. He believes his wife may not have a full grasp on everything she’s being told or may be in denial and is still hopeful that somewhere there is a cure for her. However, that seems unlikely at this point because the results of her latest tests show cancer again in her liver, more cancer now in both of her lungs, and cancer in some of her lymph nodes.
Outside of another round of chemotherapy that may extend her life for a short time, after she makes it thru the horrible side effects, there isn’t any more the doctors can do for her. The drug trial – that can only go ahead if the chemotherapy successfully treats the tumors – will at best, add months to her life and give the oncologists data about the drugs’ effectiveness for people with metastatic colorectal cancer and at this stage, stage IV, of the disease. Or, there are the treatments his wife has researched on the internet that she could receive in Cuba, Mexico and Eastern Europe that cost tens of thousands of dollars and promise to cure every form of cancer, but have no scientific backing. Knowing about these treatments may be why she can’t accept what she has been told by her many doctors here.
When I heard all of this in the justifiably angry phone call from my friend, I did the only thing I know how to do. I became the strong sober voice and outlined all the things he and his wife need to do before she requires palliative care. I was able to do this because of the many experiences I’ve had in my life losing beloved friends and family members to cancer. I could also tell he was still in shock and hadn’t been able to think straight since having all of this information dumped on him and his wife within 48 hours, so giving him a practical list of things to do helped to slightly dissipate his anger and get his usually ordered mind working again.
My friend, who I love dearly, is losing his wife to cancer. I wish I could do more for them. Sadly, I know that the best and only thing I can do is be his friend and be there to pick up the phone and listen when he calls.
After two weeks of lots of activity and chatter, my home is quiet once more. My cousins returned home, overseas, on Sunday and they left me with great memories and a gaping silence. I wasn’t sure I’d be able to keep up the pace of activity needed to show them a good time and, more importantly, to occupy the attention span of a six-year-old, while still managing to take care of my health, but I somehow managed to do it; and I had fun in the process. Now that they’ve left, my home feels oddly still and quiet, unlike it never has before. To tell the truth I started missing them before they left for the airport.
I didn’t know that having constant company could be so good for my health – emotionally and physically. While my cousins were here, I had a few days of terribly intense pain, but because I wasn’t alone with it, I think I was able to cope better with it than I usually do. I had the foresight to plan rest days in between activity days that involved taking them out to see city sights and some attractions that took us out of the city for the day. Although those days were hard, not missing any pain medication doses and the distraction of chatter and laughter, helped me deal with all the movement and long drives. I also took full advantage of the days that I scheduled for rest, whether it was sleeping in or taking afternoon naps, that my body made it clear I needed – and still do need.
Surprisingly, I was able to cook many of our meals, which I did with pleasure. I think I might have forgotten how much I enjoy cooking for people these past few years while I’ve been ill and, at times, barely able to cook for myself. My cousin was a big help in the kitchen, doing the after-dinner cleanup and helping with some of the prep when I needed it. I don’t think I would have been able to do as much for as many days, if she hadn’t been so supportive. I didn’t even mind getting up early some mornings to make breakfast for my finicky youngest guest, who was very particular about what she would eat for which meals, and how precisely some items had to be prepared. Children’s food preferences don’t always make sense, but I was thrilled when we finally hit on a few items that became acceptable daily staples for her.
Not everything went smoothly for the visit, but nothing ever does in life. They were able to connect with some other family and meet some of my close friends, but most of the 14-day visit was just the three of us. The only hiccups were due to bad weather (rain or extreme heat) that kept us indoors, the odd event not proceeding as planned, or my body making it impossible for me to do much. There were also playdates that never materialized with the children and grandchildren of friends and family, which I had organized in advance to make sure my cousin’s daughter had company close to her age as often as possible to play with, but it was hard getting everyone’s schedules to sync up with so much happening every day.
With all that activity going on, I didn’t have any time for the anxiety that had gripped me ahead of their arrival to set in again. I also didn’t have much time to myself to do much of the creative things I usually spend my time doing. Before they arrived, I bought my cousin’s little girl crayons, pencils, and markers, and matching sketchbooks for the two of us, thinking that would be a clever way to get us to do something together. Until yesterday, I didn’t drawn a single line in my sketchbook. There was so much activity to plan, whether it was our meals or what attraction or event I had planned for us to do – and I desperately needed the rest days in between – that drawing or doing anything creative was impossible. My cousin’s little girl, however, had plenty of time to play and draw, so my refrigerator is now covered in drawings and handmade birthday cards for which I am truly grateful. When I look at them, my home feels a little less quiet because their bright colours evoke memories of laughter and good company.
My Small Surrenders 