1. How do you know you’re a rich white person? Your cancer gets diagnosed.
Early in the summer, we learn that my wife has thyroid cancer. Papillary Thyroid Carcinoma. She’s seen a mob of doctors, gone through invasive biopsies, given vats of blood for tests, scheduled and rescheduled consultations. At each turn, the doctors have said the same thing: 95% chance it’s nothing, these things are rarely malignant, don’t lose sleep. But as I look at the final lab results, there’s that word, carcinoma, in such close proximity to my wife’s name, like a turd stuck to a Picasso. I mouth it to myself over and over—carcinoma, carcinoma, carcinoma. She’ll need surgery and some form of radiation. My tear ducts clench. I want to cry and punch elbow-deep holes through the drywall, but I don’t. Instead, I start thinking about how I’ll tell concerned friends. “Ever try spelling Papillary Thyroid Carcinoma correctly?” I’ll ask them. “Talk about dangerous.”
We don’t dare talk of fairness because it could be so much worse. We should be clear about that: in the whole spectrum of cancer lethality, Papillary Thyroid Carcinoma is pretty Fisher Price. Beating pancreatic cancer is like climbing Kilimanjaro barefoot; beating thyroid cancer is like using a step ladder to reach the Jonisk Floor Lamps at IKEA. People rarely die from it. Our endocrinologist even jests once, calling it “the good cancer.” But it still derails lives. She’ll suffer from hypothyroidism and will need to stay on hormone therapy for the rest of her life. From now on, we’ll always worry that it will recur, or that she’s just prone to cancer invasion, or that basic mathematical odds do not apply to her. And we’ve all heard stories about someone’s cousin going under anesthesia and never waking up. The gut shot is that we can’t get pregnant for another year, not until she sweats out all the radiation. When the doctors explain that, I have to watch my wife swallow down her tears as if they’re made of lava. Generally, my wife is no crier. She’s the toughest person I know, mentally and physically. Put her in a cage with a grizzly bear, and I’d feel compelled to give the bear a samurai sword just to make things more even.
I’m furious, I’m helpless. It’s a personal affront, this cancer, despite the fact that it’s not even my cancer. A valve in my brain builds pressure, and I don’t have the proper distractions in place to ignore it. One afternoon, I find myself out in my workshop, running scrap 2x6s through the table saw, over and over, mindlessly shredding them into dust. There’s something comforting about the reckless destruction, the control, the ferocity of 5,200 RPMs. I wait until my wife leaves and attack the heavy bag in our basement until it feels like my lungs will rupture. When I go for my run, I convince myself that my last mile is critical, running it in 6 minutes will mean I’ve imagined this, we’ll return to our privileged lives where the universe will have left a note apologizing for its oversight. These are temper tantrums that I hide from my wife, remnants of the little boy in me, but they pour out of the man I have become, a man without enough wisdom or grace to process the world’s seemingly random malice.
The trajectory of my fury is predictable. Slowly the valve opens. I calm. Slowly I internalize. I start imagining these absurd scenarios in which her cancer is personified into a villain with a top hat and monocle, like a villain from a Bond movie. I tell him his time is up. How does he like that? Then I stomp on his neck until he dies and drag his carcass back to my wife, like a retriever with a game bird. By July, this anger re-focuses on humor. Cancer jokes. I start writing them just for me, these selfish little therapy sessions that make my wife’s cancer into something trivial. They make me feel less helpless. Am I technically allowed to write cancer jokes? I wonder, but then I do anyway. Most of them are too bad to even be offensive. It’s just a way to steal my attention from the microbial barbarians laying siege to my wife. This is what happens when you have a writer try to apply his skillset to something important, like modern medicine. I’m out of my depth, a guy who brings a bonsai tree to a gun fight.
But unlike many people with a cancer diagnosis, we have a profound luxury. We know from the outset that she’s going to beat this. You don’t often get to say that about cancer. We just have to weather the emotional trauma, the derailing of our family-planning schedule. My wife hates feeling like a nuisance most, hates that people put her in the foreground. She’s magnanimous about everything. She goes to doctor’s appointments, then goes back to work. She doesn’t tell people, doesn’t complain, doesn’t look for causality. She plows through. Pugilists would call my wife a counterpuncher, never looking for her own offense but always staying poised to throw a straight right when the opening shows itself. She won’t outpoint the universe this way, but she’ll be nuisance enough to survive into the championship rounds.
I can’t seem to exhume the notion of fairness from my mind, though. It’s only when calamity descends that most of us truly engage with the metaphysical. My wife is 32 years old, an athletic director and exercise ninja, a dedicated seven hour per night sleeper. She eats more green things in one day than I do in ever. She’s incredibly kind, patient, humble to a fault. Strangers meet her once and immediately begin texting and facebooking her, hoping she might have time to be friends. In all, she might be the most capable person I’ve ever met, a saint with ginger hair and green eyes and an ornery little grin. She has cancer. There’s no causality here, not from where I’m standing. It’s adorable the way humans try to organize and tame the chaos of this world. But this world is neither generous nor punitive. Read even the most watered-down articles about astrophysics or quantum mechanics and you start to feel trivial, insignificant, a random collection of subatomic crumbs. We’re passengers in a car that someone else is driving to nowhere in particular. We don’t mind ignoring this until our plans run awry, at which point we begin demanding to see blueprints. But there’s no such plan to be found. Let’s remember that this is the same world that deems Trayvon Martin unworthy of life and Blink182 worthy of platinum albums.
2. Oncologist: Sir, I know you only have three months to live, but you do still need to pay your bill.
Patient: No problem, doc. I just won the lottery!
Oncologist: Did I say three months? I meant a year.
Then the surgery, a full thyroidectomy. My wife treats it as a pesky annoyance. I don’t have time for this shit, she says. In pre-op, the surgeon gives her a sedative, but then the procedure gets delayed three hours, and it wears off. When the nurse comes back to check on us, my wife glares at her. “Look here,” she says, “you’ve delayed us, and I’ve been really good. I think I deserve another shot of that stuff,” at which point the nurse reminds her that valium is not a reward. We all laugh. The surgeon struts in to do a final check and to put us at ease. He has the cocksure swagger of a guy who shoots down MIGs on his days off. This one is as routine as it gets, he assures us.
I sit in the waiting room with my mother and my mother-in-law. They’re kind enough to not make me talk. There’s no distracting me from the images of my wife hooked up to squawking machines, tubes and wires poking out of her body, some guy with a knife slicing a four inch gash through her lovely neck. Normally, I despise such negativity and ego-centrism, but the normal rules seem to have been suspended. I end up in a sort of trance in which I’m only able to picture the various ways that I’ll end up a widower at 32, sitting in our house, alone with the quiet and the dark. I walk around the house, searching for remnants that smell like my wife. Intellectually I know she’s going to be fine, of course, but while she’s under anesthesia, it seems I’m incapable of logic or positive thinking. She’s been my best friend since, quite literally, the first moment I met her twelve years ago. That’s my whole adult life. You don’t dumb-luck upon such things twice, that much I do know.
It’s supposed to be a two-hour surgery, but it runs past a third hour. My stewing gains momentum exponentially until it becomes a boil. I’m convinced they’ve lost her and are too frightened to come tell me, a freak accident, which is what every other step of this whole crummy predicament has been. I’ve wandered into too many thyroid cancer forums looking for insider information. I’ve read about too many freak accidents. I go to the information desk and ask what they know. Nothing. I ask again. “Please, could you just call down there?” Anything will do at this point. I’m trying to be polite, but I must look a bit deranged. The poor woman seems to understand that if she doesn’t give me some information, I’m going to come back with a suitcase full of dynamite. She calls down to the OR. “They’re coming out now,” she says, and I have to restrain myself from kissing her on the face. I’m suddenly back on speaking terms with the universe.
The surgery is a success. Iceman chops out her thyroid, along with a tumor the size of a fingertip, this despite the fact that it hugs her recurrent laryngeal nerve. He had to cut the thyroid off of the nerve, peeling it away slowly like an onion. A dicey maneuver that saves her ability to speak. This is mission-critical for me, the awkward loner, because if my wife couldn’t speak anymore, I’d likely end up mute.
My wife doesn’t sit still well, so recovery is tough on her. She wants to go for a run and mop the floors and go to the office. “When did television get so awful?” she asks. In a month, when the scar on her neck has sealed and gone smooth, they leech her body of iodine through a two week diet of no salt and no dairy which, as my wife the foodie says, is way worse than the actual surgery. Every time I wander near the pantry, she glares at me, as if to say: If you eat something good in front of me, I’m going to wipe the cat’s butt with your toothbrush and not tell you about it. I would deserve that. So we end up on a no salt diet. (As soon as she goes to bed, I admit that I cheat with a real ferocity, though.)
At this point, what’s left of her thyroid is craving iodine, so the doctors take a vial of iodine, mix it with plutonium, and call it medicine. They pump her full of it to scorch any straggler cancer cells that might have migrated over to lymph nodes. Somehow there are no serious side-effects, but there’s a seven foot no-fly-zone around her for a few days. We can’t kiss each other, have to sleep in separate beds. At night we Facetime each other from different rooms, and this, I think, says it all. Lucky people dealing with unlucky things still equals lucky people. Nothing like having good insurance, a two-story house, and a couple of iPhones but still managing to lament about your bad luck.
3. Cancer: Because sometimes God tries to write policy with his left hand.
Now we wait. The year can’t go by fast enough. We work and spend time with friends. We cook dinner together and enjoy all the iodine. Other people seem to have forgotten about her defective thyroid, and we try to do the same. Sometimes we talk about kid names, but mostly we don’t. At the grocery store, we catch ourselves staring at all the adorable young families. It’s probably a little creepy, and I try to convey with my eyes that’s it’s jealousy, not something more sinister. Once you’re ready for kids, it becomes a manic craving unlike anything you’ve ever experienced. The long, persistent pull of evolution, I suppose. “Is everyone in the world a cute little pregnant lady?” my wife asks one day, and I have to nod. “I think so,” I say.
We try not to wallow. All the luck we’ve had in our lives. This episode was the exception, not the rule. Maybe six months would be long enough to wait before trying, we start thinking. It was a low dose, after all. I spend hours trying to calculate the half-life of I-131, the radioactive isotope they flooded her system with, hoping to determine how much it will have decayed in six months. I’m suddenly reminded of the C+ I struggled to get in high school physics. I can’t even convert millicuries into something more standard without pulling a muscle. I get nowhere, but trying feels better than not trying.
We carry on. We work a lot and create new projects around the house. We laugh and are generally happy. The world has a way of shocking you back into the present.
I listen to the news on my daily commute. Agents of Bashar al-Assad’s regime have attacked a neighborhood in Damascus with chemical weapons. To date, more than 100,000 people have died in that civil war. Satellite images tell us that North Korea has restarted the nuclear reactor at Yongbyon. Five years ago, Lehman Brothers collapsed. The NSA, it turns out, seems to think that privacy is a concept for the 20th century. This year, more than 13,000 children will be diagnosed with cancer.
My wife and I can’t get pregnant now.
In my mind, somehow these atrocities are equal.
One day, I’ve had enough. Enough with myself and enough with the focus of the world. I turn the radio off, drive in silence. Where has all the good news gone? I wonder. I’m out of distractions. Soon I find myself back in a familiar orbit. I start writing fake headlines:
Fifth-grader says thank-you to teacher.
Free kittens just too cute!
Man discovers box of doughnuts in cubicle. Doughnuts still warm.
New cancer vaccine now free at Walgreen’s
We could use some good news. It’s out there, I know it is. We just need to look harder. Until we get better at that, we’ll make jokes about all the bad news. When that doesn’t work we’ll distract ourselves with fake headlines about good things. We all throw what counterpunches are available to us.
In a year or so, we’ll get pregnant. In six, we’ll be buying school supplies. In ten, we’ll go to spelling bees and make Rice Krispy treats and stand outside in the rain watching soccer practice. In fifteen we’ll be setting curfews and buying the iPhone 22s and trying not to worry about new designer drugs with names that sound like British punk bands. In twenty years, we’ll be cashing in money-market accounts, packing for college, returning home to a big empty house, just the two of us again, happy and immobile, like a couple of lumpy old armchairs.
Some days I get so excited for all this I can hardly walk a straight line. It feels like looking forward to vacation, which might be as wonderful as the vacation itself. Desire delayed can be astonishing in its bounty. Ultimately, it’s a generous and big-hearted universe out there, that’s what I choose to know, even if I do know better. It’s been particularly good to us. It let me keep my wife and inflated me with the fervor of a teenager. Maybe the doctor was right all along: this was the good kind of cancer.