Lionel Shriver - So Much for That

“Of course it isn’t,” Shep found himself saying. “We’ll pay whatever it takes to get Glynis well again.” Given his wife’s milk-money income from a chocolatier, the we was more farce. That the well again might also qualify as farce Shep was not yet prepared to contemplate.

Nevertheless, as Knox wrote out the contact details of this famously expensive shaman of the black arts, Shep considered this quantity now officially of “no object.” Of course it had no value by itself. Money was a means. But to ends not readily dismissed as “no object.” Food, shelter, clothing. Safety, insofar as there was such a thing, and thus also the capacity for rescue. Efficacy, power, sway. Ease, freedom, choice. Generosity, charity; if not love, for his children, wife, sister, and father, the palpable evidence of love. Education; if not wisdom, its prerequisite of accurate information. If not happiness, comfort, which could stand in for happiness in a pinch. Airplane tickets – experience, beauty, and escape. From the description of their apparent savior in Columbia-Presbyterian, raw, animal survival. For in the face of a virulent cancer, they would not simply follow directions, and marshal their forces of will; they would buy life. They would buy Glynis’s life, day by costly day, and in the end you would be able to affix a price tag to every one.

“So far, do either of you have any questions?” asked Dr Knox.

“The side effects …” said Glynis. Of course, there was nothing “side” about them. They were effects – big, brutal, and anything but ancillary.

“Each drug and each patient is different. You’ll be alerted what to be prepared for, I promise. Let’s get through the surgery first. Not get ahead of ourselves.”

In the proceeding silence, Shep looked to his wife, then to the oncologist, beginning to panic. He did not want to shake hands and find himself in the car and have the omission, the elision, the craven evasion, steeping the inside of the vehicle like toxic emission fumes. But he also did not understand why he had to be the one to ask. Glynis might have raised this obvious matter before, but if so she hadn’t shared with him the upshot of such a discussion, and that seemed impossible.

When trying to get up to speed about a disease he’d never heard of before last Friday, through the following weekend Shep had spent hours at the computer. Know thy enemy, he figured. Yet on one medical Web page, well into its patient, hand-holding explanations of every test and treatment that mesothelioma patients might expect, he had finally arrived at a section headed “Survival Rates.” He had nearly memorized the first paragraph, having stared it down for so long:

Following on this page is quite detailed information about the survival rates of different stages of mesothelioma. We have included it because many people have asked us for this. But not everyone who is diagnosed with a cancer wishes to read this type of information. If you are not sure whether you want to know at the moment or not, then perhaps you might like to skip this page for now. You can always come back to it.

It was his initial impression that the authors of the text were being patronizing. His first impulse was to scroll down. He had always faced difficulty squarely. But this was different, if only because it was not his difficulty. It was bound, at points, to seem like his difficulty, but he would have to be mindful about that. Still, there was no question that as that paragraph burned on the screen, what bloomed in his gut was terror. He reached for the mouse. He withdrew his hand from the mouse. He did not scroll down. Taking the page’s advice, skip this page , he had returned to the same point on the same website three other times. He had never scrolled down. He wasn’t ready. In this office, with a fellow human being who could speak with all that useless kindness, it was time to scroll down.

“What are her chances,” said Shep, so leadenly that he was unable to lift the end of the sentence to imply the interrogative. “How long.” This was no juncture at which to be unclear. He formed the question fully. “How long has my wife got to live.”

But it was Glynis who spoke. “There’s no way to say. Every patient is different, you heard the doctor. Every patient reacts differently, and, as he said, new drugs are coming on the market all the time.”

His glance darting between them, Dr Knox seemed to appraise the couple carefully. “It’s important to remain optimistic. I’ve often been pressed for a specific prognosis, and even when I’ve relented I can’t tell you how often I’ve been wrong. How many times I’ve predicted that a patient had such-and-such an amount of time left, and then years beyond the point at which I’d have expected to be sending flowers they’re thrashing their best friends at squash.”

“And it helps, you said,” said Glynis, “that I’m in very good health to begin with. I’m not overweight, my cholesterol is good, I exercise, I don’t have any complicating conditions, and I’m barely fifty years old.”

“Absolutely,” Dr Knox chimed in. “Committing to a specific doomsday date is like going to war and choosing ahead of time the day on which you plan to lose. In medicine just as in the military, it’s a positive attitude that gets results.”

Shep was familiar with this talk of illness as armed confrontation: the “battle” with cancer, whose patients are invariably classified as “real fighters,” with “an arsenal” of treatments at their disposal with which to “defeat” an invasion of wayward cells. But the analogy felt wrong. His small experience so far was more one of bad weather. So it was as if the doctor had declared they would “go to war” with a snowstorm, or a gale wind.

“Yes, well, I didn’t mean to sound pessimistic, and there must be a huge variation …” Shep dutifully backed down. Still, he was surprised. Given her ferocity, her defiance, her darkness – of the two, he was far more constitutionally inclined toward the very optimism that Knox was promoting – he would have classed Glynis as the scroll-down type. Doubtless there were more things he would find out about her as this proceeded. Maybe you never really knew anyone until they were dying.

Thus blocked from “getting ahead of themselves,” Shep worked backward.

“Asbestos,” he said. He found it odd that they had spoken so long without anyone mentioning the word. “Mesothelioma is associated almost exclusively with asbestos. How could my wife have been exposed to that?”

“She and I have discussed this, and I’m afraid we didn’t solve the mystery. She tells me that, to her knowledge, she’s never worked with the material. Nor, I gather, have you ever had the insulation replaced in your home. But it was once so pervasive … and it only takes a single inhaled or ingested fiber … The gestation period for mesothelioma is anywhere from twenty to fifty years. That makes it incredibly difficult to identify a particular product as the provenance of the disease. Does it really matter?”

“It matters to me,” said Glynis hotly. Her demeanor thus far had been so meek; finally in the flash of anger, she sounded like herself. “If some stranger on the street stabbed you in the belly with a butcher knife, wouldn’t you want to know who it was?”

“Maybe …” said Dr Knox. “But I’d be much more concerned with getting to a hospital to be patched up. If the misfortune was the result of ‘wrong place, wrong time,’ who – or in this case what – was the culprit would mostly be a matter of idle curiosity.”

“There’s nothing idle about my curiosity,” said Glynis. “Since I’m about to be slit open and gutted like a fish, then pumped full of drugs that make me throw up and go bald and sleep all day – sleep if I’m lucky – I would rather like to know who did this to me.”