Where I Am

Dear Ones,

Last spring I took my last chemotherapy infusion. This was not because I no longer had measurable cancer; it was that, after 15 years, my spirit was no longer able to put up with the barrage of insult and injury to my body, meted out under the auspices of health. I knew, without doubt, that chemotherapy had begun doing me more harm than good. At my last infusion, I received a copy of my blood tests, as usual. However, instead of showing the expected decline in my tumor markers, as had been the norm during treatment for the previous 15 years, my markers had gone up.

I can no longer look at this number as a measure of my health, I thought to myself, after my initial stab of disbelieving grief. When, a couple weeks later, I actually voiced my new conviction—I AM NEVER DOING CHEMOTHERAPY AGAIN—I felt a surge of euphoria that coursed through my body for five whole days. I knew I had made the right choice.

I had made a choice for Life on my terms . . . but choosing no more chemotherapy doesn’t translate into choosing no more cancer.

Late last year I chose to have one more Gamma Knife procedure on the metastases in my brain. In contrast to my previous Gammas, which showed rapid response, this one didn’t appear to have much effect. I had chosen to go through the procedure—the barbaric pinning of the frame into the skull; the zapping of radiation; the steroids; the several weeks of scalp numbness—with the hope that I would be able to buy myself a little time; to sell our Seattle house and move up to Orcas Island.

I don’t know if I bought myself time, or if I merely spent an uncomfortable period during the winter. But the move has been accomplished; the Wallingford sale is pending; and as I periodically glance up from my laptop in our rental house, I see blue sky, firs and madrones, West Sound, Shaw Island, and peace.

Peace.

It’s all around me. The atmosphere so clear that at night I can see by starlight; or be alarmed by the spotlight of the full moon, until I realize what it is and marvel that it’s bright enough to discern color. I can hear the wingbeats of an individual goose, on its way to roost for the night; the dash and burble of the creek running through the gully east of our land; the soft lap of waves against the sliver of public beach. Inside, I can hear the oil-filled space heater cycle on; the blub of the dog’s digestion; Ian idly scratch his head. Sometimes I am held in its thrall—Peace—awed that I have the extraordinary good fortune to be here, in this quiet beauty; to call this place home.

Other times, I can’t get away from my fear. Choosing no more chemotherapy doesn’t translate into choosing no more cancer.

At this point, Western medicine can only offer me palliative care—when I reach a place of too much pain, or lose too much “function” (a dreaded end); or, because I live in Washington State, the legal right to end my life with pharmaceutical assistance. In my darkest days—so far only psychologically dark, if physically ambiguous—I am relieved that I have chosen to pursue this option. I am also relieved that it is, as of yet, a theoretical choice for the nebulous future.

My grandest hope is that being here on Orcas, where I can live much closer to nature than I could in the city—where I can eat fresh pullet eggs and drink raw Jersey milk; where I can labor, with delight and sweat and satisfaction, stewarding my land; where to look up is to see beauty—will allow me to live not only a richer life, but a much longer life than I might otherwise have had.

And I have one additional hope to that—I have recently begun a medicine, learned of through word of mouth, and fitting me like a serendipitous glove—that may be a cure.  

But the ambiguous physical experiences lend color to every mood. In my blithest, most confident days, I easily brush aside the low-grade intestinal discomfort as part of the upheaval of moving: after all, our house hasn’t closed yet and we still have several tasks before we can completely wash our hands of Seattle (plus, the fresh eggs and raw milk?). Occasional low-back pain or other body soreness is, of course, the result of a lot of moving and lifting of heavy boxes. Anyone else would blame the recent spate of almost-daily, short and finite visual migraines, on the continuing stress, plus the new reading glasses I picked up less than a week ago. I’m going over an adjustment hump; it will all work itself out if I’m patient (which I’m not).

But in my darkest, most despairing nights, I’m convinced even the smallest twinge is a sign of my last steps. I wonder if the medicine I’ve begun, even if it is a cure, even if it is a perfect fit, even if I began it as soon as I could, is too little, too late. The mental distress is, for me, a cancer in itself. In my darkest, most despairing nights, I wonder if I have the strength to hope at all anymore.

So that’s it, then. We can go someplace new; even an idyllic, fantastical island of delights, but we go there. Place can ease the tension, and this place certainly has. But place doesn’t change who you are—that’s up to you. Can I do that? Can I find my peace? Can I learn how to accept my strengths and my weaknesses? Can I learn to free myself from the dread, and the fear (and, only therein, the true incapacitation) of cancer? I don’t know. I am trying to learn how to try.

The sky has cleared enough that I can see a hint of the Olympic Mountains materializing beyond Shaw. If only I could see the future even half as well.

But then, I guess I’m glad I can’t.