Cancer, Not Tropics

It was mid-October when my 79 year old mother told me she'd had vaginal bleeding. She told me she was going to the gynecologist, in two weeks, to have it checked out. This was big. My mom hadn't had a gynecologist appointment since my birth. Seriously. Oh, of course I encouraged her to go and have Pap tests, but she was somehow convinced that her lack of sexual activity and bubble baths would pickle her reproductive organs safely for all time. She told me outright that she'd die from a stroke in her mid-80s, like her mother, and never would get cancer. I stopped trying to encourage an appointment years ago.

I'm glad you're going, I said. Either I'm dying, or ready to have a baby she said, joking. I told her either way it was fixable. Apparently, even the blood alone didn't scare her off entirely --the final straw had been running into her primary care doctor when he came to visit her elderly cousin, for whom she's been caring. She mentioned to him she'd been bleeding. "I don't want to scare you, D., but that's usually cancer," he told her. That is what it took to get her to make her very first appointment, ever.

The day before I told her to call me immediately afterwards. She didn't get a chance. The doctor called me first. He told me she had a very large tumor that scared him so he didn't want to biopsy it in her small town. He was sending her off in an ambulance to a large regional facility and into the care of a surgeon, because that's what she would need. He was kind and concerned and straightforward in telling me this was very serious, and she needed to go, now. The regional facility is an hour from where she lives and an hour from where I live. Convenient. She was immediately admitted, two Thursdays before Thanksgiving. I spoke to my husband and we immediately assume the worst. You start to prepare yourself for what's ahead and it's daunting.

She ended up having emergency surgery that Monday. In the time between I spoke to doctors and arranged for a holographic will, a medical power of attorney and numerous other things. All the side effects of illness aren't physical, you see, they are actually legal. I have a brother who is likely an actual psychopath (though not of the physically dangerous ilk) and we had to move quickly to assure he would neither get involved in her treatment nor her finances. And yet, somehow, I have to arrange to take care of him. Sigh.

By that Friday, she was discharged and I took her home with me, so she could recover through Thanksgiving. She was a perfect guest and patient. Too strong to take the painkillers, too grateful to complain about anything. She got stronger and more confident every day. The surgeon told me he got everything he saw in the tumor. The tension dissipated as we started to anticipate the end of treatment and contemplate a relatively happy future.

Then I took her for the follow-up. They removed the surgical staples, complimented her looks and her quick recovery. Then they introduced the pathology report by saying it's complicated. The tumor was largely a relatively common endometrial cancer which did make some headway into the uterine wall and is, accordingly, Stage II. But the bad news is that a part of the tumor appears to have started to become a more dangerous carcinosarcoma. Very aggressive. Hell. They aren't sure what it is. But the lymph nodes they sampled were clear. Good. And the surrounding tissues. Good. What the hell does this mean? No one is sure.

She was quiet after that appointment. Now, it's worry again. The recommendation for treatment is a combination of chemotherapy and radiation and now we need to talk logistics. I don't want her driving through the winter or being driven by my idiot brother to the regional medical center. She lacks confidence in the doctors in her town and in either event I can't be there to take care of her if she has a hard time with the side effects. Instead, I persuade her to come here to Philadelphia for treatment. My neighbor is the former head of the Fox Chase Cancer Center, and I'm reasonably sure she'll be well treated. She agrees to think about it; contemplating how much her life is about to change for maybe the last time.

I dropped her at her home so she could prepare for the traditional "7 Fish" of Christmas Eve and gather her wits. She is concerned, yes, but also transparently happy and somehow, surprised that I've stepped up to the plate to help her. She and I have butted heads frequently; in large measure over her religion and her lack of rational behaviour, her need to criticize to show love and concern and her need to protect her son from anyone who might, you know, hold him accountable. And I certainly try to provoke her.

But something about this feels different. This is the chance we have to make it right, to sweep old problems under the rug and make a clean breast of it. We've thought she was dying, and fine, and dying, and fine, and have had no clue what's happening all in the space of a month. Roller coasters bond you. No matter how different or similar you are.