Pete Hamill - Piecework

“Last week’s chest X ray?” he said. “Well, we looked at it again and there’s something on it we don’t like. …”

I laughed out loud. I’d been expecting some variation of this sentence for years. After all, I was a three-packs-a-day man, and at fifty-something, each year’s physical was a kind of lottery. When it was over, and I was declared healthy, I always thought: Okay, got away with it again. Now, a few days after granting me my latest pass, the doctor was suddenly taking it back.

“What don’t you like?”

“It’s small, a dot really, on the upper part of your right lung.”

“What is it?” I asked.

A pause, and then the doctor said: “When are you coming home?”

I flew home the next day and soon began a new rhythm of days and nights. I had no symptoms of anything: no cough, no rebellious blood, no weakness, no pain; but I swiftly entered the strange and private universe of the sick. My doctor sent me to another man, who specialized in the lungs. He in turn dispatched me to NYU Medical Center for a CAT scan. That propelled me down many bland new corridors to a series of desks where I was asked to pay first and be tested later. This was something new to me in my life in America, and oddly original; it was like a restaurant extorting payment before serving me food. At every step of this process, money came first. There was a wonderfully cynical assumption behind the most elemental contact in this new world: You are all potential deadbeats.

So I paid to have blood taken from my arms, to breathe into various machines, to swallow and be injected with chemicals. The good doctors and the excellent technicians hadn’t devised the system of stand and deliver, of course; it must have evolved over the past few decades in the grand republic we all share with the boys from HUD, the S&L’s, and the Medellin Cartel. Nobody else I told was surprised. But all of this was new to me. I’m one of those fortunate human beings who are almost never physically sick. Over the previous thirty-five years, I had been in a hospital only three times as a patient: for the repair of a broken hand and then a broken cheekbone (both sustained while serving my apprenticeship as a young idiot); and finally for the removal of a small cyst over my right eye. As a reporter, of course, I’d been in dozens of hospitals, in pursuit of the usual portion of human folly and calamity; over the years, I’d served emergency-room death watches on shot cops and raped nuns and wounded presidents of the United States. But such duties were really only paid tours in the region of melodrama. The attendant pain, fear, and odor of death were part of my craft, but not my life. Now I was on a private tour.

“What are you looking for?” I asked at an early point in this process.

The doctor shrugged, smiled, and said: “The truth.”

He meant the truth about the spot on my lung, of course, not some grander insight into the meaning of the world. But even this limited truth wasn’t easy. The spot was the size of a bread crumb and it was high up behind a rib. There were four possibilities: i) lung cancer, caused by smoking an estimated 780,000 cigarettes over the previous three decades; 2) a fungus unique to the American Southwest and northern Mexico, both regions that I’d visited in the past two years; 3) a tumor caused by the asbestos I’d worked on for two months in the Brooklyn Navy Yard when I was sixteen; 4) tuberculosis. I am a fatalist about most things. Naturally, I was certain it was cancer.

“I don’t think so,” said my wife.

“Well, we’ll soon find out.”

It wasn’t that easy. For all of the modern technology, the various experts couldn’t decide precisely what was in my lung. They did one test to see if I’d been exposed recently to tuberculosis; the result was negative. The same was true about the fungus. The asbestos remained a possibility. So, obviously, did cancer. The big possibility. But, still, the doctors weren’t certain. They wanted …the truth. They asked me to undergo a bronchoscopy. This meant I’d stay overnight at the hospital, and then, with a local anesthetic, a tube would be passed down my throat into my lung to get as close as possible to the Thing. I agreed.

In the hospital for the bronchoscopy, I noticed something odd about myself: I had no fear. I’m no braver than the average man, but none of this made me tremble or weep or fall into pools of self-pity. I lost no sleep, either to a runaway imagination or to bad dreams. Of course, a bronchoscopy was hardly a major operation, but it wasn’t a day off either. And it might tell me that I had cancer, a word that seems to fill most Americans with dread. But instead of fear, regrets, or remorse, I found myself living almost entirely in the present tense: This happens, this happens, and this happens. If anything, the lack of fear made me sad. A lifetime of reporting had done its work; I’d been cheated of a basic human reaction.

Early one morning, I was wheeled down corridors on a gurney. I held my wife’s hand before vanishing into the operating room. I gazed up, seeing faces distorted by my point of view and by drugs. They entered my throat. I woke later from an exhausted sleep.

“We couldn’t get close enough,” the doctor said. “I’m sorry.”

“You mean the bronchoscopy was for nothing?”

“Not exactly. But -”

“But you still don’t know what’s in my lung…”

A pause. “Yes.”

“So…”

“I want you to see a man …he’s the best thoracic surgeon in New York.”

“You have to operate?”

“Maybe.”

I was learning that doctors are reporters, too; some operations are diagnostic, explorations of the unknown; they are done in order to discover the facts. I took a few more tests, and while waiting for results, went away for ten days to stop smoking (that is another story). But because of the location of the Thing (behind a rib, high in the lung), nothing was clear; only a surgeon, opening my right lung with his knife, could give me that clarity. I had to choose: undergo the chest operation immediately or wait and see what happens in the uncertain future. If the Thing was indeed a tumorous cancer, it could be removed in this same operation, along with a larger section of my lung that might be cancerous. I would lose about 20 percent of my lung capacity, but there was a good chance, given the size of the Thing and the fact that we’d found it at an early stage, that I could live a reasonably long life. On the other hand, if I waited, we might discover that the Thing wasn’t cancer. It might remain at its present size; it could even vanish. So I was also learning that much of medicine, like so much of life, is best described in the subjunctive.

In the end, I couldn’t bear the possibility of months of uncertainty, waiting to see whether the Thing got larger. I talked it over with my wife. I took a few walks around the block. Finally, I called the doctor.

“Okay,” I said. “Let’s do it.”

A few days later, I was in the hospital, with more demands for payment, more papers to sign. They even took money for the telephone and use of a TV. God bless America. From one side of the room I could see the Chrysler Building, still the most elegant in the city, from the other, the East River. I stacked books beside the bed, along with a folder full of letters to be answered. “This might even be fun,” I said to my wife, who looked dubious. “I haven’t had any time off for almost twenty years. …”

“Why don’t you get some sleep?” she said.

Late that night, alone in a drowsy fog, I began to think for the first time about death. Hell, this goddamned thing probably was cancer. Maybe it was worse than they were saying. Maybe something would go wrong on the operating table, some stupid failure of my body or their skill; it had happened to men I knew (such as John D. MacDonald); it could happen to me. But I didn’t begin to summarize my life, searching for its meaning or drafting some imaginary farewell. Instead, I began to think about the people I would miss if my life ended: my wife and daughters, my brothers and sister and my friends. Their faces moved in and out of my consciousness; I spoke to some and hugged others. Then I saw and heard some of those other people, places, and things that made my life a life: Ben Webster and Cuco Sanchez, Hank Williams, Max Roach and Ray Charles; tabloid headlines, the poems of Yeats, and the faces of gangsters in the paintings of Jack Levine. I saw light spilling down the valleys of Mexico. I was reading Carlos Fuentes and Octavio Paz, Elmore Leonard and Garcia Marquez. I sat in the Lion’s Head and the Plaza Athénée and John’s Pizzeria on Bleecker Street. It seemed absurd, even outrageous, to think that I’d never again see Casablanca, read Hemingway or Rebecca West or V. S. Pritchett, never again look upon the paintings of Tamayo, never, goddammit, finish Proust. If I died now I’d never know whether Tyson could really fight. I’d never see another World Series. And what about the books I hadn’t written? The places I hadn’t visited out there in the scary world? What would happen to my library? And the cabinets full of files? And what about all the words I hadn’t written (or said) to the people I truly cared about, people I often didn’t see much because I was so busy working? As soon as this was over, I had to call Fred Exley. I had to write to my friends Sam Pilch and Tim Lee. I had to track down … I was thinking such things, and certain I could hear Billie Holiday singing “Miss Brown to You,” when I fell into a dreamless sleep.