Jay Lake: Last Plane to Heaven

You’ve promised yourself you’ll be open, accepting, strong enough to deal with whatever comes. The blood work was no big deal. The CT scan with its strange bodily warmths and curious surges was almost entertaining. The PET scan was just strange, like a B-list superhero’s origin story writ mundane. The colonoscopy, well, the less said the better, but at least it didn’t hurt. The best way you’ve been able to describe that procedure was as resembling a small-budget alien abduction experience.

Tests, tests, tests, to prove that it’s really all okay.

You’re young. Sort of.

You’re healthy. Mostly.

You have the love of family and friends. At least, that’s what they tell you.

Whatever this is, you will get through it. Whatever this is, you won’t let it beat you out of all those precious moments that you’ve suddenly realized make up your life.

“I’m sorry,” she tells you, finally locking eyes with you for a moment. “It’s definitely colon cancer. The good news is that there doesn’t seem to be any metastasis. The bad news is it appears to have interpenetrated the colon wall, which means the disease has spread past the original site. I’ll be referring you to a surgeon in the Digestive Medicine group for a resection. After that, we’re probably going to have to prescribe a course of chemotherapy.”

At least she delivers the information concisely, using words you can mostly understand once your sense of horrified denial has settled somewhat. There are so many questions, but you can’t ask them all, not right then. Cancer’s got your tongue.

You feel the demon settling in where it clings to your back. Its long, barbed tail circles your waist then slides into your anus and upward along the Hershey highway to begin the slow, mortal feast that will eat you out from within.

The world is different now. You have something to believe in after all. Your oncologist is your psychopomp. Your surgeon will be your ferryman across that river of dread.

There’s another side of life, and you suddenly realize that you have seen it far too soon.

iii:I confess that I am but a sinner in the hands of an angry cancer. There is no way through this thicket of tumor and metastasis save to go forward to whatever end cancer has prepared for me, to feast at whatever table cancer has laid for me. My loves, my family, my friendships; they will all be placed as sacrifices upon this, the altar of my suffering.

Surgery takes you strangely. Going in you joke and smile bravely and pretend this doesn’t concern you very much. The surgeon and his assistants have disclosed risks to you, side effects, the various debilitations and deaths which can befall anyone unlucky enough to be splayed beneath the scalpel upon an operating table.

Still, you don’t know what to expect, so you try to expect nothing except a new experience. Cold and naked under a ragged little swatch of oddly printed cloth, smiling strangers wheel you away down vacant corridors into the countries of the knife.

It is the anesthesia that puzzles you most. Even in sleep, you know if you’re warm or cold. Your bladder tells you when to get up for at least a few stumbling moments. Time still passes. A crying child or a lover whispering your name will wake you.

Anesthesia, though… It’s a little death. Not in the sense of the French petit mort, but a preview of finally dying of this dread disease. Like a movie trailer for the blank nothingness that is eternity once consciousness has been extinguished. One minute you are counting backwards to a frowning woman in a surgical mask, the next minute you are swimming in fog, surrounded by curtains, hearing machines peep and bing the measures of your metabolism.

“I’m still alive,” you say. Your aunt chuckles and squeezes your hand and tells you that’s the fifth time you’ve said those words in the last twenty minutes. It must be important, then, is all you can think in reply, but self-consciousness has returned with the rest of your awareness, so you just smile and squeeze her hand.

You lie there laced with needles and tubes and think about the irony that you have for a few hours touched that far shore, and can remember nothing of it except a blankness so profound it cannot truly be called a memory.

Cancer has brought you another lesson closer to finally understanding death.

A few days later, home from the hospital, you slyly enquire how the surgery seemed to other people. Your friends tell you they knew you would be fine. Your mother pretends not to weep. Your spouse rolls their eyes and tells you not to make so much drama of it all. Your kids hide from you, needy and avoidant all in the same moment in that way only children can manage to be.

It takes you a week to be able to get yourself out of bed. Your morning shit turns into hours of sitting, waiting for gravity and intestinal gas to do what peristalsis cannot manage for far too long after the surgical insult to your colon. You have a lot of time to think while perched on the toilet. You think about softer toilet seats and moisturized toilet paper, but you also think about how people don’t tell you so many things lately, how even many adults are as avoidant as the kids, even if they’re more subtle about their abandonment. You think about what it means to go through this, and what chemo will do to you, your family, and your friends.

You think that if you were finally going to find faith in your life, it could have been focused on something more constructive and less disturbing than fucking cancer.

Someone comes into the room because you were yelling without realizing it. You can see the fear naked in their eyes. It doesn’t matter who this is, because that same fear has stripped itself bare and slipped into the eyes of everyone who cares about you.

That is something you can believe in as well.

iv:I acknowledge that my life will be spared or spent by the dark arts of medical science, at the mercy of statistics that can never tell my true story but only tell the story of my cancer cohort as a whole. I understand that my fate is in the hands of the cancer god, and that no matter what we do or how well we do it, I may never see an effective treatment. Or I may outlive you all. I accept what the statistics say about that, as well.

Chemo is an entirely different chamber of horrors than surgery. You find new fields of pain and loss there, novel revelations to feed your burgeoning faith in cancer. There are needles, of course, but you have rapidly grown accustomed to them. The drugs aren’t so bad the first time or two.

But where surgery dropped you swiftly into a hole which then took a month to climb out of, chemo lowers you slowly, inch by inch, week after week, into a hole which you may never climb out of. Starting with your dignity and ending with your sense of self, chemo takes everything away from you.

Those mornings of yours grow later and later. You begin to miss work and misunderstand your spouse and children. The smallest things become difficult and the largest things become impossible. You never knew how large a thing standing in the shower could be.

You can’t drive, and you don’t have the energy to be a passenger for long, so you stop going out even when people are willing to give you rides. You stop seeing your friends unless they make the time to come to you. Your kids avoid you because you smell funny, like sweat and puke and chemicals. Your spouse doesn’t hold you at night anymore because they are afraid of somehow hurting you.

You become ingrown, a tumor on the body social of your family and friends. Silent, mostly quiescent except for the daily violence of various fluids irrupting. You straddle the line somewhere between deadly and dead.