I’ve always hated roller coasters. Even as a kid, or maybe especially as a kid, they scared the bejesus out of me. I never really understood the exhiliration or the excitement of careening defenseless in a screeching metal cart atop a teetering pile of steel-and-wood toothpicks, fighting the physical urge to puke fried dough on the people behind me.
The roller coaster metaphor has long since passed into cliche. “That was a real roller coaster ride” simply means that there were emotional ups and downs. Cancer for us has indeed been a roller coaster ride, but more in the sense that I have always experienced them. Wary tension at the beginning quickly escalating into heart-clawing terror as you realize there is a gut-punching drop immediately ahead, followed by a long stretch of hurtling uncontrolledly, getting thrashed about, then the long climb where you’re actually feeling pretty good – hey, look at the view – before plummeting into a pit of panic and dread.
On Saturday we enjoyed our son’s football match and went out for a marvelous celebratory lunch. On Sunday we went for a hike in the mountains, enjoying the crisp autumn air and colorful foliage. On Monday Susan started throwing up, and on Tuesday I effectiveley had to haul her out of bed to get to the emergency room at her hospital. She has another intestinal blockage. On Wednesday she is moved to a different hospital, because there are no more available beds at hers, partly because of Covid-19. On Thursday I visit her and find her so weak and sedated that she doesn’t even recall our visit, and is able to mutter only one sentence while I’m there: “I don’t care what they do to me.” That is, she doesn’t care as long as they stop the pain, fix the situation. This morning she is brought back to her usual hospital to have the nephrostomy tubes in her back which drain her kidneys changed. I get a call from the hospital. A woman tells me that I’d better get there quickly, there are decisions to be made. Speeding down the highway I get another call, asking me to please hurry.
The ground has dissolved under the roller coaster and I’m suspended in mid air, then precipitated into the abyss.
I have no idea what to expect when I arrive. What I don’t expect, but what I find, is a perfectly lucid Susan sitting up in bed and making jokes. I’m dumbfounded but infinitely relieved, although it takes several minutes and several tears for the adrenaline to leach from my system.
She seems fine. But. The urologist was unable to insert tubes back into her kidneys. Well, okay, we’ve been here before, they’ll just have to try again. We wait. We chat. We wait some more. She’s in excrutiating pain from the urine backing up in her kidneys. The waiting continues. Then a doctor shows up, a tall, somewhat severe-looking woman with an intern in tow who looks less like a medical professional than a guy who throws drunks out of bars.
She pulls me into an empty room and closes the door. “Well that’s a bad sign,” I say. She tells me that they cannot drain her kidneys. That the oncologist at the other hospital has advised that Susan’s body is too ravaged by her disease to make saving her worthwhile. I’m told that they can make her comfortable, that it will only take two or three days for her to die.
I argue with her. She’s had intestinal blockages before, and they’ve cleared. She’s had nephrostomy tube trouble before, and it’s worked out. She shakes her head. “I’m sorry,” she says.
So I’m left to go in to tell Susan that the doctor’s plan is to dope her up and let her die. “Well, that doesn’t seem like a good idea,” she responds. I agree. I send her regular oncologist, who didn’t know that she was there, a frantic email explaining the situation and ending with one word: Help!
When he shows up I want to hug him and smother him with kisses. His name is Jorge. He is a wonderful doctor, a good man, a calming presence. He knows Susan’s case, but more importantly he knows her character. If he had been presented with this case, without knowing Susan, he says that he probably would have advised the same thing. Make her comfortable, let her die. But.
Jorge makes some calls, gets another doctor to try to tap and drain her kidneys again. As they wheel her out for the procedure, I leave to go home to take care of the boys. Driving home, I’m not sure if I’m cruising safely into the slow, safe space at the end of a roller coaster, or about to be mercilessly shot off again on another hair-raising ride.
But I keep talking about me. How must this feel for Susan? I can’t begin to imagine. Discussing her death as an imminent possibility. Weighing the pros and cons of keeping her alive. How fucking eviscerating must that be? I’d be crippled. She’s defiant.
Best case scenario? The kidneys are drained, she stays in the hospital until her intestinal blockage clears, and she comes home to enjoy carving pumpkins for Halloween, having Thanksgiving dinner with friends, sitting around the Christmas tree in some fuzzy pajamas drinking a cup of spiced cider.
Worst case scenario? It doesn’t bear considering, much less relating. But it must be planned for, prepared for, provided against. We’re at the top of the roller coaster, about to take the plunge.