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Wednesday, March 30, 2011

Chihuahua Tears

Today's entry requires a back story:

Annie loves big dogs. Great Danes, St. Bernards, dogs bigger than people. So deep is her affinity for giant canines that she has a hard time recognizing small dogs—especially Chihuahuas—as dogs at all.

Now. One day in late November we were walking downtown amid the first weensy flakes of snow, and she started crowing about having predicted that the first snowfall would be on that exact date.
"Yeah, but, this isn't really snow," I told her, eyeing the insignificant specks."Certainly not the first snowfall."
"What do you mean?!" she cried. "There are flakes falling from the sky! How can you say it's not snowing?"
Back and forth we went, both unwilling to give any ground until finally—tempers actually flaring—I conceded that it was Chihuahua Snow. Not really significant enough to be recognized in the Snow family, but Snow nonetheless.

I bring this all up because today, for the first time since I found out I had cancer, I finally cried. Well, I didn't really cry. But I did shed a few Chihuahua Tears.

The ultimate irony is that after all this—the shocking news, the sudden abandonment of my life as I knew it, the diagnosis, the hospital stays, the bone marrow biopsy—it wasn't the cancer that broke me.
(Well, maybe it was a little bit the cancer, but only as it pertains specifically to the now-constant state of discomfort I feel in my abdomen, from my sternum to my pelvis, thanks to Mega Spleen and it's ever-present domination. I will admit that is in fact making me a little cranky at this point.)

But besides that, what was it that actually brought me down? Shook me from my perch on the good-attitude tree, and ripped the rug out from under my take-every-day-as-it-comes happy place?
It's probably not going to come as that much of a surprise. Spending 8 hours over 2 days shuffling paperwork at the local Social Security Office and the Tulare County Welfare Department could do that to anybody.

Long story short: have spent the last two days chasing my tail trying to prove emergency disability status to the state government, who will then grant me access to MediCal, which will then start paying for my chemo, which will enable me to get an appointment for my first treatment.
The amount of paperwork and runaround it takes to achieve this access is staggering. Staggering, but not really surprising. Since when has State Government—especially as it pertains to the needs of people with little to no income—ever been friendly, accessible or prompt? Apparently not even a Stage 1V cancer diagnosis will stop them from casting me away day after day, telling me I need to return with yet another tedious document that must be unearthed to provide proof that I have no money, no income, and no property.

Before I continue on with that rant—and I will be continuing—everyone should relax and know that in spite of this hot bureaucracy mess, I have actually managed to obtain an appointment for my first treatment this Friday. I can't divulge all the details here and now, because my parents have found a loophole in the system and if I want to slide through it it's probably smart not to broadcast it publicly. So, just know that I will be getting the treatment I need, and soon. It's just thanks, once again, to my overprotective parents and not the Tulare County Office of Public Works.

Really, the most striking thing is power that all those bleak government offices have over the human soul. What is it about those places (and the DMV, too, though I thankfully haven't had to visit them yet) that is so extremely dis-spiriting? Why, after 10 minutes sitting in the hard aluminum chairs of the Social Security Office, do I want to scream, jump out of my skin, break a window and run for the hills?
Is it the florescent lights? The ugly chairs? The terminally bored faces of the people all around you? The complete lack of any color to be seen outside the grey-scale? Are they piping some insidious chemicals through the air conditioning?
It's just amazing how quickly whatever positive energy or vital life force you come in with is utterly stripped away by the very environment. Looooong before you come in to contact with a person who might be able to help you.

And so it was when we returned from our miserable errands. I had no life force left. I was hungry, but everything in my belly region screams "don't put anything else in me!" The self pity welled up as I started preparing the swiss chard I have to eat every day to retain basic bowel function. I couldn't even make eye contact with Annie, because I knew she'd see the Chihuahua tears dancing in my eyes, looking for any way to fall.

I finally let them loose on my pillowcase, curled up in bed. Annie called me out having cried, as I knew she would, but there was humor in her voice and it made me feel better. Then she obliged me by re-enacting the scene in Fried Green Tomatoes where Ruth is laying dying of Cancer and Idgie tells her the old story of the ducks landing in the frozen pond and flying it all the way to Georgia. It might sound morbid, but it made me laugh.

Then there was nothing left to do but take beach blankets onto the front lawn, lay down, and stare up at the sky. (See photo).

Tuesday, March 29, 2011

Diagnosis

The results are in. I have now officially become one of the 7 in 100,000 people that are diagnosed with Diffuse Large B-Cell Lymphoma each year.

For those of you who enjoy extracurricular reading, this site does a very nice job explaining "DLBCL," including information about what it is, what the symptoms are (mine), how it is diagnosed, how the staging is classified, what the treatments are, etc.

I hadn't gone looking for a lymphoma info-site until this morning (have been completely uninterested in digging around for cancer facts on the internet until now) but, after talking to the doctor yesterday, was pleased to see that this site completely confirms everything he's talked to me about, from diagnosis to treatment.

I went in with a list of questions, and came out with several pages of notes (see photo). Between that website and this Q&A recap, hopefully most of your questions will be answered.

Q. What stage is it?
A. Stage IV. But, before you freak out, please know that this is not a death sentence. I repeat, this is not a death sentence. This just means cancer cells are present in more than one organ system (spleen and bone marrow). Staging is just one factor in the prognosis, which includes lots of other factors that are in my favor, youth and otherwise good health being chief among them.

Q. What will my treatment be?
A. A combination of chemotherapy and immunotherapy. Most people are familiar with chemotherapy—it kills bad cells and good cells alike, makes you sick and vomitous, makes your hair fall out and that's what makes you look like a cancer patient, even more than the cancer itself.
Immunotherapy is—from my experience in the hospital last Friday—a far less toxic intravenous drug that directly targets and kills the cancer cells ONLY. In Dr. Gandalf's words, it triggers the immune system to kill lymphocites (baddies) and adds 10% to the long-term cure rate. Yay!

Q. How long will the treatment last?
A. Each treatment cycle includes one day of chemo+immunotherapy, followed by three weeks of recovery. That's one day of medicine intake and 20 days of sitting around my parent's house in my Target loungewear, vomiting or not vomiting, losing my hair or not losing my hair, who knows?

Q. How many cycles of treatment will there be?
A. Best case scenario: 6 cycles. They'll do four rounds, and then check the level of cancer cells. If they don't see any, they'll do two more rounds just to be sure.
Less-than-best case scenario: 8 cycles. They'll do four rounds, and then check the level of cancer cells. If they are greatly diminished but not gone, they'll do four more rounds.
(Optimism Interlude: DLBCL has been shown to respond positively to these treatments 85% of the time.)
Least disarable scenario: 4 cycles + other procedures. They'll do four rounds, and then check the level of cancer cells. If they are not diminished enough to satisfy my doctor, I'll go to Stanford for a bone marrow transplant.

Q. When will my mega-spleen start to diminish (thereby releasing my stomach to return to normal proportions)?
A. Doctor hopes to see great reduction in spleen size even after the first round of treatment!

Q. When will I have my first treatment?
A. As soon as I can qualify for official disability status and the State of California lets me get on their state-funded insurance. (Allegedly within 72 hours from today). My first application for Medi-Cal was denied because I'm over 21, am not pregnant, and don't have any children. Ha! Bureaucracy is even more ridiculous than cancer.

Q. What will I do for those many many weeks of recovery time in between cancer treatments?
A. Good question. I have visions of setting up several "activity stations" that I can rotate around to suit my mood and energy level. There's no way I can sit in front of the TV for 6 months straight. That would kill me.
My cancer fantasy goes like this: wake up, read and do the crossword. Then perhaps an hour of yoga and meditation. Then I might sit next to a window, listen to classical music and make Art. Then take a constitutional stroll around the block, or get some sun whilst floating on a raft in the pool (sanitation circumstances permitting). Or, entertain my many visitors.
Or maybe I'll just vomit and cry and pick out my hair. But I doubt it ;)

Q. Will I still be able to have children after all this?
A. It's not guaranteed. But if I'd like to preserve the possibility—which I do—I'll get on some kind of birth control, which will somehow protect my ovaries on some level from the toxic chemotherapies.

Q. Can I have visitors?
A. Yes! Yes I can! Whenever and whoever I want. Whenever. Whoever. Everybody. You just can't be sick.

Q. What about Target? The grocery store? The movies?
A. There will be a small window around 7-10 days after treatment when my white blood cell counts will go down, and I'll have to lay the lowest. Otherwise I am free to circulate amongst the general public while employing common sense and, you know, making good choices.

Q. What about Medical MJ?
A. The Oncologist responds: Is it ultimately going to help me heal or cure my cancer? No. But will it hamper my progress or alter my blood levels or have any negative impact on my treatment? Also no! I'll just leave it at that for now.

Q. What else am I leaving out?
A. Nothing I can think of at the moment. But if you've got more questions, lay 'em on me.








Sunday, March 27, 2011

Bubble Boy's Big Day Out

Have been free from the hospital since Friday night!

When I left the hospital, these were the facts:
*I didn't have a bacterial infection in my blood
*I seemed not to have any infection/virus/anywhere
*I felt fine
*Some of my cell counts had risen, ultimately taking my overall condition to a place where my doctor felt comfortable letting me leave.

But even though I've been released into the wider world again, the major theme of the weekend has been an ongoing debate/negotiation between me and my handlers (parents) about what behavior is or isn't going to put my life in jeopardy.
(Fresh fruits and vegetables have been allowed back in, but only alongside what would otherwise be utterly compulsive behavior, like scrubbing the outside of my avocados with soap before cutting into them.)

Yesterday passed without conflict as it was very rainy and I was tired, so I had no desire to leave the house. Shahab—my father, without his Dr. Dad cape on—was kind enough to drive to Blockbuster and rent us several movies, all with the common theme of good triumphing over evil. This includes the entire Lord of the Rings Trilogy. I think I'm supposed to envision the cancer as the Evil Eye of Sauron, my spleen is Mount Doom, and all the cancer cells are a grimy army of snaggle-toothed Orcs. My will to heal and positive body responses are...hobbits? Sam and Frodo? Rudy and Elijah Wood? No, no, much better: I'm Viggo Mortenson! Aragorn, King of Men! Yeah!

Anyway. Today raised more of a challenge as the sky lightened up and we began to get stir crazy. There is only so much sitting-in-the-house-preparing-for-cancer-treatments a girl can take.
I wanted to take a drive, and I wanted to go to Target. When I put this request to the keepers of the keys (it is their car anyway), a series of negotiations ensued, with the following compromise reached:

I would be allowed to drive up into the hills to Three Rivers. Gas would be needed, and Annie would pump it. I would not leave the car or touch the gas pump, or anything at the Gas Station, an obvious location for insidious germs and other unsanitary residues.
Annie would be allowed to enter Reimer's Candy Shop (one of the few destination points in Three Rivers) but I was to sit outside on a bench and not enter and/or touch the kid-covered candy counters, or anything else the general public may have exposed to their random afflictions.
We could go to Target, but I was to sit in the car and wait for Annie. Same reasoning as above. End of discussion.

And what a lovely drive it was. Annie was finally introduced to a part of California more beautiful than the industrial hospital courtyard (see photos) and we were able to get out of the car, admire the river and the rocks, and breathe fresh clean air.

By the time we got to Reimers, I was thinking of diverging from The Plan. For one thing, I had to pee. Public Restroom stops had somehow been left out of the negotiation. (Of course, I'd just as soon have gone in the bushes, but no private ones presented themselves.)
Reimer's port-a-potty was immediately ruled out without any fuss from me. Then Annie went candy shopping while I sat on the bench, held my pee and pondered the cost-benefit analysis of breaking The Rules.

After all, I understand the reason for The Rules, and they are legitimate. The consequences of getting even the littlest bit sick could be dire for me at this point. Any kind of infection in my body could mean more hospital stays, major setbacks, delay of cancer treatment. My inner Aragorn could be rendered powerless. The Orcs could trap the whole f*cking fellowship in a cave and continue to spread Sauron's evil empire. (In other words, it could get really bad.) With that in mind, the question becomes, what risks are worth that possibility? Is a trip to Target really worth the future of Middle Earth?

No, a sane person reasons, no it is not. So much better to be safe than sorry. But it is a struggle to train ones self to go from dirt-eater to germaphobe overnight. How long has it been now since I have openly scorned antibacterial hand gel!

It was the pee that broke me. Once I was in Target using the restroom, this particular battle was lost. Annie and I re-defined The Rules to suit the mission. I would not touch the cart. We would purchase antibacterial hand gel.

That settled, I thoroughly enjoyed the Target run. I now have quite the collection of stylish Mossimo-brand loungewear, perfect for relaxing indoors and idling away the days between chemo treatments. I also bought notebooks, one of my very favorite things to buy! I selected one special binder to collect my medical documents, one lined composition book to take detailed notes with medical personnel, and one tiny spiral notebook in which to record spontaneous inspiration for future blog posts. (See below).

And so tomorrow I will take my notebook to my 2 p.m. appointment with my oncologist—Gandalf?—where we will discuss my diagnosis, and his plans for my treatment. It is he who can shed the most light on immediate fate of the Fellowship. As soon as he does, I will share it here.

Friday, March 25, 2011

Bubble Boy

It was Wednesday. We had just returned from our outing du jour—a drizzly excursion to 7-11 and the grocery store—and Annie and I were laying in bed watching Forgetting Sarah Marshall when I had the sinking feeling my fever was creeping up. (Living with an ongoing fever of 99-100.5 for several weeks, you get pretty good at sensing when things are going out of range.)

Sure enough, 101.7. And then, thirty minutes later, 102.2. Sigh. The parents had to be alerted, and they were of course alarmed, and before Jason Segel could charm Mila Kunis back into his arms with his Dracula puppet rock opera, I was on my way back to the hospital. Sigh again.

*What could have caused that fever spike? Worst case scenario: bacterial infection. Best case scenario that I kept clinging to: maybe the hot Neti Pot water I poured into my face right before I laid down just caused a simple spike in body temperature? Seems possible, no?

Anyway, the big concern is that since the cancer has caused my white blood cell count to drop so drastically, my immune system is so inept at this point that the simplest little grubby germ could totally wipe me out. Or at least render me too sick to begin chemotherapy. I kind of realized this before—see the mention in the last blog post—but now it's gone to a whole new level.

And so it's back to the sardine room, the tv on the ceiling, and an even uglier view of an even uglier pole. (See photo. As far as Annie knows, this is what California looks like). But of course it is the safest measure, and it must be taken.

As soon as I arrived they did a blood culture to see if I had any infection in my blood. Novelty here: instead of the normal little vials they usually put your blood in, the nurse showed up with four mini hot-sauce bottles. Seriously, double the size of a Nip. Maybe three Nips large. They had a little fluid in them already (to mix with the blood and see what bacteria showed up) but the volume of blood they could fit in them was shocking. Also, sorry to the squeamish, but I have to say that when mixed with the bacteria culture, it looked exactly like Tabasco.

The bummers started rolling in when the nurse announced very early on that, again because of my susceptibility to infection, I was to be put on what they call neutropenic protocol. This means excessive measures must be taken so I don't ingest or otherwise receive any bacteria. The first thing to go was fresh fruits and vegetables. (?!?!?@**#%!!!) Bye-bye, Superfood Green Smoothie I'd been drinking for breakfast every morning. Bye bye, avocado-a-day regime (?@*&^!!*!) Bye bye cilantro, parsley, or any other friggin living thing that could have been touched by a pesticide or bacteria-ridden human hand.

The next day I had two visitors. They didn't realize I was going to be hospitalized when they rented a car and drove down from San Francisco, and I was quite relieved when they were able to scoot right past the giant STOP sign on my door and weren't even forced to wear masks and plastic gowns while we all hung out in my cell. I mean, room.

They were kind enough to take Annie out for her first trip down Main Street for some Mexican-food-and-margarita action, and as they planned their outing my stomach started thinking about refried beans. Mmmm....mushy, salty, lardy refried beans, it said, in Cookie Monster's voice. You could probably eat an enchilada, too, Stomach Monster added greedily. Yes, I thought, I probably could. A veggie enchilada, I reasoned, not all cheese. But with a little cheese in there, said Stomach Monster, and a little more melted on top of the beans...

YES! I took over. A veggie enchilada with green sauce and refried beans! My first taste of real Mexican food in the whole time I've been back home! It will all be cooked and I will tell them not to put fresh salsa in it so I'll be safe, and I will eat every bite and love it and eat like I haven't eaten since my spleen took over my insides!

And then, of course, I was neutropenically cock-blocked. The nurses did not have any faith at all in the hygienic protocol of our fine local Mexican eateries (perhaps rightfully so, I can now grudgingly admit) and so my sweet friends were banned from bringing me back any edible contraband. Off they went, with Annie in tow, to feast on the only kind of local cuisine in Visalia worth eating, and I was sent a styrofoam cup of undercooked baked beans from the cafeteria. Sigh again. Stomach Monster was pissed.

"Where," some may at this point be wondering, "have all those blessings gone? And so quickly too?" Don't worry. I know they're still there, and I'm lucky to be in such a safe place with all these people looking after my welfare and making sure I don't tank before I even get started.

But I reserve the right to mention that safe isn't always very fun. And what fun is a cancer blog without some relatively good humored complaints?

As Larry David would say, "No Good?"


Wednesday, March 23, 2011

Thanksgiving in March

(Photo of Annie taken in Northampton the morning I left)

My oncologist called yesterday with some hopeful news. The preliminary results of the bone marrow biopsy indicate that my cancer is probably some kind of large cell lymphoma, and not acute leukemia. This, he says, would be a good thing. He sent my slides to UC San Francisco to get a final confirmation on the diagnosis, so I still won't know exactly what I have or what the plan is for a couple of days.

BUT. I am already seeing silver linings everywhere. If it turns out I don't have leukemia, it is likely I won't have to go to a far-off medical center for treatment. It's even possible I can do all my treatment here in my hometown on an outpatient basis, meaning hospitalization could be minimal. That would be amazing.

Which gets me on the subject of counting my blessings. As crazy and terrible as it seems on the surface, there are so many things going in my favor right now, it almost seems like the best-case-scenario. Here's why:

* Thanks again to Dr.Dad, I was able to get the basic cancer diagnosis in a matter of days. As soon as I got here, he rushed all the blood tests that, in an ordinary situation, could have taken weeks or even months to obtain.

*I was in the hospital for only 16 hours while getting my tests, and then I was freed! I'm pretty sure the local hospital doesn't usually do CT scans on the late-night on Sundays, and the Bone Marrow test happened at the crack of dawn the next morning. Paternal influence again, no doubt.

*I'm able to go through all this here, at home, with my family. That my parents are alive, healthy and able to care for me is not something to be taken for granted. My mom has set to mothering me in ways only a mother can, and provides the voice of reason when my father threatens to go off the deep-end with medical micro-managing. (Yes, even in this situation, there is such a thing). Though I've built a pretty great family in Massachusetts, there is just no substitute for being here in the house I grew up in, having my mom poach me eggs and run errands for me while I relax on the couch watching On Demand and petting her dog.

*I don't feel as sick as I really am. Yes, I break out in crazy hives when I go in the sun, I'm always tired, I can't poop, and my fever is 100.5 all the time. But I've had the flu and felt worse. I'm not nauseous, I'm not vomiting, I can breathe, I can smell, I can taste, I can read, and I can write. So that's pretty cool, right?
(The only tricky part about this one is I do have to be much more careful about not picking up the odd cough or cold, as my immune system is pretty compromised by now. As I've always had a sort of casual relationship with personal hygiene—really embraced the old "a little dirt makes you stronger" philosophy—I now have to be much more serious about it. No more gnawing on my fingernails, or picking pens off the floor and chewing on them, petting dogs and touching my face, etc. Dr. Dad is this close to making me wear a mask when I go out in public).

*Abby Riley. My best friend and soul sister. She drove me all over California to get my tests done and still took me back to San Diego so I could have a vacation. She made me quinoa with avocados when I didn't feel like eating, gave me a massage, let me nap in her bed and sent me home with lots of hand-me-downs. She is the best best friend a girl could have.

*Annie Lane Clarke. My love, partner and future wife. She has been here by my side since the day after she found out. She keeps me sane, she makes me laugh, she sings to me in bed, she scratches my back. She brought me the quilt from our bed at home, my slippers and my stuffed lobster—a childhood treasure—even though it meant only packing one set of clothes for her trip.Most importantly, she is willing to stay with me for the duration, which means living here, 3,000 miles away from everyone she knows and loves, with only me, my parents and Daisy the dog for company. She loves me and it shows.

*The Clarke family, who made it possible for Annie to be here, took in our dog Bella—in spite of her home-cooked chicken diet—and even adopted our fish, Frank. They took the sheets off our bed for Bella to sleep on, and will be taking care of so many of the loose ends that have already presented themselves. I love you, Clarkes.

*EVERYONE ELSE who is reading this! There are too many to name, but all the love and support I've received from each and every one of you is more uplifting, inspiring and encouraging than you can know. I'm so grateful for the help that's already been given, and from all the help I know is still yet to come. I love you all and appreciate all of you tremendously.



Monday, March 21, 2011

Choose Life!

This is my sudden motto. With every phone call I have to make to drop the bomb on a beloved, I find myself waving my pumped fist in the air above the phone and assuring them that I "CHOOSE LIFE!"

Which means it's very clear to me how to go through this.
There are only two things to fear, death and pain. Death is not an option for me at this point, so that just leaves pain. And pain can be tolerated.
I will get through it, and I will find the humor and the grace and the silver lining in each day—so much easier to do when something like this suddenly bombs your life—and I will have fun when I can, and laugh as much as I can, and I will write about it. And life will go on and jokes will be told and blah blah blah. You know, CHOOSE LIFE!

So, the picture is of me in the hospital last night.
Annie is with me now and as soon as we popped off the plane my dad rushed us to the hospital like I was a lady going in to labor.
The hospital room was, for the record, far inferior to Annie's old digs at Cooley Dick in Noho. Ancient TV barred to the ceiling, toilet behind a curtain, view of a pole. Our jaws dropped a little. Where was the flat-screen TV? The Guest Couch? The private bath?

Of course, that's all cosmetic. It's the care that counts, and it couldn't have been better.
The doctors—wheels greased by the not-so-invisible hand of Dr.Dad—moved quickly and in less than 24 hours I was able to have 2 important tests: CT Scan and Bone Marrow Biopsy.

For me the CT was kind of like a Disneyland ride. You lay down and are propelled in and out of this futuristic-looking radioactive donut, while a lady robot voice periodically tells you when to stop and start breathing.
My CT tech was a very kind guy red scrubs named Clifford, "like the big red dog," he said.
"I'm Kia, like the car," I said.
Then he warned me—grinning— that the contrast dye they'd use to see my insides better would make me feel warm all over, including in my junk, and that I might feel hot down there like I was peeing.
"I'll try not to pee," I told Clifford as he warmed up the machine.
"If you do," he said, "I'll laugh at you."

The Bone Marrow Biopsy was less amusing, but not as painful as it could have been. (They numb your muscle and bone surface first). Really, it's the knowing that someone is screwing a rod into your hip and pulling out bone bits that really f*cks with the mind. But the pain? Slamming your finger in a door hurts worse.

Finally, on to what everyone is really wanting to hear. The results:
Bone Marrow results will take a few days, and those are the really definitive tests that will tell me what exact kind of cancer I have (lymphoma or leukemia) and what stage it's in, etc. Then and only then can treatment decisions be made.
The CT was fascinating, as I was able to see the pictures of my trip through the Donut, and understand why I haven't been able to eat or poop in weeks. My spleen is now 8 times its' normal size, and is very probably where the cancer cells are emanating from. (Nobody said the word
tumor, but maybe it goes without saying?) My stomach is a tiny marginalized pocket and it, along with all my other digestive organs, are now sitting somewhere much closer to my pelvis than they would otherwise be.

Still, the Oncologist (cancer doctor) said there was no reason to keep me hospitalized while I was waiting for the test results. Another blessing. Now Annie and I are relaxing in comfort, living in the moment, and waiting. And we are ok.

The Big Reveal

It's Friday, March 18 and I’m finally hanging out in San Diego.
It's morning and I’m sitting at a café, sipping both chamomile tea and lemonade. My best friend is across from me doing homework. I’m holding a Mary Karr memoir while actually engaging in a medium-grade text argument with my girlfriend in Massachusetts, which is taking up most of my mental space, until the phone rings.
Aunt Coral. I let it go to voicemail.

I don’t always listen to my messages right away. This time I do.
“Hi Kia, it’s Aunt Coral. I just talked to your mom and I wanted to say how sorry I am that you’re going to have to go down this road—“

I stop the message. What road? What does she know that I don’t know? My stomach drops, chest starts pounding.
I immediately call my mother. What has she not told me?
“Did you get the test results back?”
“Not yet sweetie,” she says.
“Well I just got this message from Aunt Coral about the long and lonely road I’m having to go down, and it sounds like she knows something I don’t.”
And then she is breaking down and admitting that they did get the results back, that they were just going to wait five more minutes to call me, and saying words like
lymphoma and leukemia and bone marrow.

I can’t believe we are talking about me, and that I’m sitting here in this backyard café hearing my mom tell me that I have some kind of cancer while all the other people sitting around me (probably) don’t have cancer and don’t realize and can’t realize that this is the news I am getting on my phone right now. And would they care if they knew? How would they feel to know that someone in their midst was having this very life changing conversation while we all sipped our breakfast drinks and sat around in the sun?
I guess most people don’t usually find out they have cancer in the middle of backyard cafes.
There is usually a doctor’s office, right? And a stern looking doctor with papers in his hands.

Then Abby and I drive downtown for our hair appointments. We had made them days earlier. Should I not get a haircut because I now have cancer? I can’t find a reason why not.
My mom appears on the phone again with far more information than I can process and the grim suggestion that maybe I shouldn’t waste money on a haircut since, after all, I’d be having chemo within a month.
“Find a new angle, mom,” I tell her, completely put off by her perspective, yet worried somewhere that I’m being an ungrateful brat. Cancer or not, my relationship with her is never without it’s conflicts.

Then I’m sitting through the longest haircut of my life, and I’m bluffing through all those generic conversations you have to have with people who cut your hair and clean your teeth and such. She’s asking where I live and what I do, and she heard I was getting married and when was that happening? And the whole time I’m describing the life that was my life yesterday, but is no longer my life today, or tomorrow, or any day I can yet forsee.