Day 1 of chemo
"Can I please have the chemo today?"
Such was the unlikely thing I heard out of my mom’s mouth this morning at the Cancer center where we started our week.
Because it was literally burning holes in her skin, they stopped my mom’s radiation for her stage 3B tumor and were thinking of postponing her chemotherapy this week. Chemo nowadays is a five day process, the first day (Monday) of which is spent in a hospital barcalounger taking various medicines for five hours. Then they give you a fanny pack that’s so unfashionable that the fact that it’s black color doesn’t even redeem it.
Inside the pack is a tiny pump that sends a highly toxic chemotherapy drug into your bloodstream at the rate of 2cc’s per hour until Friday afternoon, when you get a visit from a nurse who pulls it out and takes it back to the hospital. My mom had planned a weekend getaway for next week that would have interfered with the last day of chemo, and so she was hoping to do the chemo this week. Thus, she was begging for chemo. I think I saw the doctor crack a smile.
The rest of the day was spent sitting with her in the barcalounger. Both my parents(*) played Solitaire on my Tablet PC, using the pen-mouse quite naturally. Both my parents are slow to adopt new technology, and so the ease with which they picked up on how to use a tablet PC completely confirms everything you’ve heard me say about the superiority of pen-based interfaces.
After a while my father and I went out to get Italian food for lunch, and after that I hit the cafeteria for what has become my hospital specialty: microwaved Krispy Kremes. I don’t know why people have never thought of that, but every time I do it I get lots of smiles. The afternoon consisted of more solitaire and then a goodbye song from the nurses, since this was my mom’s last chemo session.
The day was actually quite pleasant. It really just seemed like my parents and I were just sitting around shooting the breeze. Sarah was at my mom’s house, telecommuting and taking care of the baby without the benefit of our super-nanny that usually keeps the baby happy during business hours. I called her and kept asking her how she was doing, because I could hear the baby fussing in the background and I know how hard it is to work on a hundred million dollar real estate deal while you’re trying to entertain a baby. (Well I don’t really know, but I’m a good husband, so I can empathize.)
"Don’t worry, I’m fine," Sarah said. "How are you?"
"I’m fine," I said. "What do you mean?"
"Because you’re with your mom at a CANCER CENTER."
I could hear the capital letters through the phone and it suddenly hit me. I’m at a cancer center with my mother. Oh, I had so carefully focused on the good day we were having that I totally forgot that the little machine next to her was feeding her chemo. All day we’d played with the computer, eaten like diets didn’t exist, and just yukked it up that I had forgotten that every person in the chemo room had something less than a 50% of seeing the sun rise five years from now.
If you really want to know what 50% or less feels like, pull a coin out of your pocket and flip it. Heads, your mom lives. Tails she dies. You know what less than 50% feels like? After you get over the joy of flipping heads, check the date on the coin. If it’s an odd numbered year, she dies anyway.
Luckily that feeling passed, and we went back to the only type of denial that I think I can never condemn. Throughout the day as my mom took me on a tour of the radiation ward, and the enormous machines that deliver the radiation, I kept thinking, "In almost any other country, my mom would be dead. The access to care wouldn’t exist, or the techniques themselves would be unknown."
But she’s not. She’s getting about the best care available known to science. She’s even in a special treatment trial for patients with her specific type of cancer. But all that misses, in my opinion, another real significant innovation in healthcare: the experience of adopting a normal life while in treatment. Everything from the tiny pump that lets my mom take her chemo at home on the couch watching tv and playing with her new grandson, to the fact that the nurses don’t care when we bring in food from Grassi’s West Italian deli, one of my mom’s favorite places. The real innovation is the ability to let patients forget they’re patients. For a minute, for an hour, or even a week. It makes the entire process so much easier.
Even now as I type this I can hear my mom coughing up a lung (metaphor, METAPHOR!) in the other room. Do that in a hospital bed, and it’s all part of a downward slide. Do that at home, and you’ve just missed a joke that Charlie Sheen was telling and it’s no big deal. You get on with your evening. You eat your fried chicken. You hopefully, put on a few pounds to offset what you’ll lose from the chemo. You live your life as normally as possible.
That’s the lesson today kids. Now go call your mother and tell her about your weekend. She’d love to hear from you.
* For those that don’t know, my parents’ generation was highly matrimonial. I now have five different people to call "mother" or "father" that have all earned my respect, and I’ve decided not to use "step-" titles any longer.