Christmas Cytotoxins and other gifts

Christmas Eve chemo, some encouraging news, and the one thing your friend with cancer needs from you.

Early morning mists rising from the Vidourle

My ninth chemo was the morning of Christmas Eve. I was grateful it was in the morning for a change, so that we could wander the festive streets of Montpellier in search of a few last-minute stocking stuffers afterwards. Theadora and two older teenagers, the daughter of a dear friend in Australia and her friend, came with us so they could have an outing in the city while I was in the hospital. They were delightful company for Theo—and for us during the drive down and back! It helps the soul to have friends around.

The chemo nurses had dressed for the occasion, with glittering, oversized reindeer or candy cane earrings, decorative headbands, and sparkly makeup. I appreciated the effort they made to spread cheer, although sparkly eyeshadow could do little to lessen the toll of cytotoxins. To the vast buffet of holiday food the nurses were collecting in their breakroom we contributed a box of chocolates and a card. It’s the least we could do for the people doing the daily, thankless labor of trying to save our lives. I should have brought them diamonds.

For the first time, I was in a room with other women. While we had less space than usual and Tim had to read to me more quietly, I appreciated being in the company of people who share my experience. While the woman across from me mostly slept, she and I exchanged many quiet looks of solidarity.

Brimming with holiday cheer! Christmas Eve chemo.

The saddest part of the day was the situation of the woman next to me. She was sobbing in her chair, asking to be taken back home. Apparently she had been left waiting for treatment for a long time, hadn’t eaten, and didn’t want to miss time with her family. While her husband sat uselessly beside her staring at his phone, her taxi driver came in from outside to be sure the nurses were looking after her. (Another wonderful thing about French healthcare is that cancer patients are entitled to free transportation to and from the hospital. If I didn’t have Tim, a taxi would take me there). The taxi driver, who seemed a kind and efficient woman, was a far more effective advocate for this woman than her husband. He didn’t even try to comfort his wife or talk with her. He didn’t touch her, didn’t stroke her arm or hold her hand as she cried, repeating “I am afraid, I am afraid.” I missed some of the conversation, but Tim told me later that she was in treatment for pancreatic cancer, which has an even grimmer prognosis than ovarian cancer. It broke my heart to hear her say what I think all of us were feeling in some inner sanctum of our own bodies.

The nurses fetched her a muffin and some tea and were able to give her the treatment she needed. Eventually, she slept.

Somewhere before or after or during all of this, Tim read to me from the short story collection, Murder at Christmas. I bought it at a used bookstore in Seattle in 1991 and it never gets old. Tim was reading an Hercule Poirot story, giving the detective a brilliantly comic French accent. I had hoped it would make the others laugh, but I don’t think anything could. (Tim had asked their permission to read to me, and had done so quietly). None of the other women had a companion except the woman with pancreatic cancer. No one read to them. No one held their hand. No one tucked them under blankets like Tim tucked me into my chair. I felt guilty for my good fortune, for having Tim, who is the best support team anyone could want. I can always feel him wanting to help the other women too. Often it seems that most of the people there are women alone.

When I was freed from my IV, we hopped on the tram to the old city to meet up with the young people, who had had a happy day. They also spent Christmas Day with us, and their lively company brightened the holiday considerably. I love having guests in the house, particularly guests Theo enjoys so much. Tim cooked us a feast: snails (not for me! But Theo insists on them every year), herbed salmon, coconut-roasted Brussels sprouts, green beans with garlic, mashed potatoes, turnips, and carrots, Christmas pudding, and Christmas pudding ice cream he made himself (all gluten-free!). Our guests contributed a tasty salad and roasted pears. It was all divine.

We ended up burdening our little live tree with so many decorations Tim may regret having left us alone with it.

On Boxing Day, we took our traditional long hike. But it didn’t take me long to realize that this last chemo had hit me far worse than any of the others. My legs shook on the way up, my muscles weak and burning. I wasn’t sure I would last the whole three hours, but I did—and went straight to sleep on my office sofa for the entire rest of the day. Yesterday I felt much the same, not even attempting a walk. I slept all day.

My desire for a linear narrative means I am once again burying the lede. I’m nervous about telling you this. Yesterday I had blood tests in preparation for my scan on Monday. Once the results landed in my email inbox, I ignored them for several hours, too afraid to open them. When I heard Tim bustling about just above my office, I called him to come be with me when I opened them.

And my tumor markers were normal. Low, even! It is the first good news I have had in such a long time. I hadn’t even dared to hope. My insides still don’t work properly, so that had made me anxious. But I am less anxious about facing my scan on Monday knowing my tumor markers have dropped. This means that I will likely have nine more weeks of chemo, but I will know more about the plan once I see my oncologist Monday.

I can’t help but add my fears and superstitions around this. My fear is that everyone will just figure that I’m fine now, and they can stop worrying. Selfishly, I don’t want you to stop worrying and praying and thinking of me. Don’t assume that this means I’m totally fine now. While I promise I am attempting optimism, I just want to remind you that we have been here before, twice, and both times the cancer has returned, as ovarian cancer does more than 80 percent of the time. And if—if—it comes back again, I’ll likely be looking at clinical trials, having run out of chemos. I don’t want to get ahead of myself, but I want to remind you that this wonderful news may not be the end of the story. (At the start of this last recurrence, a former friend asked me what made this recurrence different from the others and the answer was, “well, I am not expected to survive this one. I’m now platinum-resistant, meaning I can’t have the most powerful chemo drugs. My options have narrowed considerably. Each recurrence is worse news than the previous one.” So. Hope that explains it).

The problem with ovarian cancer, is that there is never a time that you can say, “okay, I’m fine now, it’s all behind me.” Because the risk of recurrence never goes away. You just have to live in suspense forever. Which I have written about before. I had a perfectly metaphorical dream the other night that someone was trying to murder me, and I was racing around looking for places to hide, but I knew this person would always be trying to kill me and that I would never be safe.

I guess what I am trying to say is that I am happy, overjoyed even, and I do not feel safe.

Your friends with cancer need you to do just one thing

On a related note, a few words about your relationships with your friends with cancer. And I know you all have friends or family members with cancer, because it touches everyone these days. It is not an easy or even rewarding thing to be a loyal friend to someone with cancer. While I am sure there are cancer patients out there who suffer silently, who gracefully accept their situation, who do not rage or cry at the betrayal of their bodies. But my guess is that they are in the minority.

Cancer does not often improve our worth as a friend. It can suck so much out of us that there are days we cannot ring or write or respond appropriately to others. When we do have energy, we might expend it raging against our outcast state, searching ourselves for shreds of hope, spending time with our children and partners, or just trying to keep up with work, to contribute to our families. Regrettably, cancer has not improved my personality or patience.

Friendships can begin to feel one-sided, one person struggling, one person trying to help. It’s not easy. We get that you may not know what to say or do.

The only thing you can truly do wrong as a friend is to vanish. To stop all communication as if the friendship has never meant anything to you, as if all the years you have been close were an illusion. This requires your malignant friend to edit history, questioning every moment of connection, testing it for veracity. This leaves your friend bereft.

But this is what so many people do. For their own reasons, they are unable to continue to be a friend to someone with cancer. Maybe because the person with cancer is living out their friend’s worst fears, maybe because the person with cancer is too grumpy, maybe because the friend can’t be bothered with the extra fuss. This has happened to almost every person I know who has been through or felled by cancer.

If the friendship has ever meant anything to you, don’t do this. We get that our cancer may make you uncomfortable or fearful or worried about saying or doing the wrong thing. We get that you have your own trials and griefs and heartbreaks. We don’t claim to have a monopoly. We still want to listen to you. We still care about your lives. For me, the only thing you can do wrong is to break off communication and vanish. If you have ever loved us, please don’t go.

Pretending at Zen. Really I made Theo take the photo just because I wasn’t sure I’d ever get into this position again.