Sunday, February 7, 2016

On the water

In June 2013, on an uncharacteristically warm night, I was lying in bed wearing a tank top. My right arm over my head, I flung my left arm across my chest, and my fingers landed on a lump.

It turned out to be a knot of cancerous lymph nodes.

I was diagnosed with stage 3 breast cancer, and my life quickly turned upside down, with a rapidly executed relocation to the Seattle area for treatment. We moved to Bainbridge Island, which in some ways is less of an island than Juneau. You can drive off it, for one thing – a short bridge on the north end takes you to the Olympic Peninsula. Or you can take a 35-minute boat ride to downtown Seattle. The Washington State 
Ferry offers departures about every 50 minutes from 4:45am until 1am.

My treatment started with chemotherapy.

A typical chemo day began on the second floor of my cancer institute. After the inevitable wait, I’d be called back and a nurse would access my port. A “portacath” is basically a titanium button with a rubber septum on one side that functions as a pincushion. The other side funnels into a catheter that’s inserted into a vein. The whole thing was sewn under the skin just below my left clavicle. When it’s time for chemo, a nurse pokes a needle through my skin into the pincushion and – voila – maximally efficient transfer of poison through the bloodstream.

But first, the nurse draws some blood out through the port to check my white blood and red blood counts. Chemotherapy drugs target any fast-growing cells, blood cells included. My counts are always low, but never low enough to preclude the next administration of poison.  

Next, it’s upstairs to the fifth floor, where I wait again. Then a nurse takes my vitals and reads a list of questions: “What’s your pain level?” “Any nausea or dizziness?” “Any mouth sores?” “Fatigue?” And my personal favorite, “Have you slipped or fallen this week?” Did I mention that cancer treatment is humbling?

After another wait, I have a similar chat with my medical oncologist. Finally, I am given a yellow slip of paper that says “GOOD TO GO.” I carry my hall pass to the third floor, where I hand it to the denizens of the front desk and sit down to wait with my fellow cancer patients for our infusions.    

We stare at the fish in the aquarium or try to fit a piece into one of the impossible jigsaw puzzles. We have rubber hoses sticking out of our clothes, bandages taped to our hands, clumps of fuzz sprouting from our heads. Some of us lean on canes or walkers or our companions. Some smile, compliment each other’s headwear, flip through a magazine. We are a sad allotment of humanity, but it is a peaceful tableau. Somehow, when one is faced with a potential life-ending disease, the everyday stress recedes. We exist very much in this moment.  

I had three chemo drugs: adriamycin and cytoxan were administered together for two months, followed by two months of taxol. Adriamycin is a bright red liquid that is murder on cancer cells as well as hair, nails, and often hearts. Heart damage can occur quickly or at any time in the future. Adriamycin is considered too dangerous to administer by IV drip as it can damage skin or muscle tissue on contact. A nurse sits next to me and slowly pushes several large vials into my port. The nurse wears gloves and a mask lest any leak out. One nurse buttoned her white lab coat to the throat.

Before she puts the chemo down the chute, the nurse injects a bunch of drugs meant to help you survive the chemo: Decadron, Pepsid, Zofran, Benadryl. All of this tends to make one a little loopy, and I am probably pretty entertaining for my chemo buddy, when I’m not dozing off. 

For each infusion, I have a buddy. Brian is there for some. Friends from Juneau join me for the others. My chemo buddy keeps me company through the long waits, distracts me from the perturbing scene of inbound toxins, runs out to get my favorite organic quinoa from a cart across the street. When I am getting taxol, my chemo buddy is also my ice assistant, helping me chill my fingers and toes in an effort to prevent neuropathy. 

My chemo buddy makes it a party - a party celebrating the ironies of cancer treatment, celebrating friendship and love, celebrating life’s surprises, celebrating the will to live. I couldn’t face chemo without a buddy. 

When it’s all over, some seven or eight hours after the initial blood draw, a nurse disconnects me from the tubing and my port is again just a lump under my skin. I walk the 12 or so blocks downhill to the ferry and head home to Bainbridge.

I have occasional conversations on the boat, particularly while waiting to disembark, when the walk-ons get squeezed together at the chokepoints.

 “I like your hat,” is how these conversations usually begin.

“Oh, thanks,” I say.

“Are you in treatment?” they ask, gently.

Once, following the hat entree, a woman tells me she also had breast cancer. The chemo drugs ruined her heart, she says. She had bad doctors. Now she has a bad heart and a brain tumor. I’m sorry, I say. We walk off the ferry calling, “Good luck!” 

Another time, a man with a rolling suitcase, crushed up near me as we disembarked a rush-hour ferry, starts in with my hat, asks if I’m in treatment, and proceeds to tell his cancer story. His daughter had leukemia at age 15. The treatment was brutal; she was so tough; it ruined his marriage.

And? I ask.

Misty-eyed, he looks away with an apologetic shake of his head, suddenly realizing I don’t need to hear of cancer defeats. I’m sorry, I say. We disperse into the crowd crossing the gangplank.  

Despite the macabre stories people seem drawn to share with me, I like how the ferry brings me into contact with this flow of humanity. We are quite literally sharing the journey. It beats being in a car, alone in your commuter capsule, locked in combat with thousands of other soulless commuter capsules.

And these ferry conversations are exceptions. Mostly, I talk to no one. I don’t do much of anything. I sit and stare out the window, or lie down on one of the long padded benches and rest. I don’t read much, or play cards, or text. I never even see an orca.

But these ferry rides are vital to my treatment. I suppose it’s like sleep – it feels like nothing is happening, but it’s in sleep that our brains consolidate their gains, build new synapses; we heal from the day’s insults.

The ferry is my portal between worlds. In the morning, I’m a mom, kissing my son before he boards the school bus for kindergarten. Crossing the water, I enter a sick zone. I become a cancer patient.
On the return journey, I am cleansed of sickness, returned to an island of healing. On the water, crossing over, I find the peace and serenity I need to redefine myself as whole, healthy, healing, and fully human.   

Bainbridge ferry, spring 2014 (photo credit Brian Hild)
View from the ferry, November 2015

And more recently, Alder at Eaglecrest

Rosie at Eaglecrest

Moms at Eaglecrest ... Sunday morning skin-and-ski with Emily and Cheryl
Winter adventure to Windfall Lake Cabin

Girl with a weapon.