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Authors: Teresa J. Rhyne

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• • •

A week after our visit with Dr. Glaspy, Chris and I met with Dr. Blaine, the oncologist closer to home. I was immediately discouraged by the sight of her office. Valentine’s Day was coming up, and thus there were pink and red streamers, Cupid cutouts, and hearts adorning every spare inch of wall and ceiling space. As though chemo wasn’t going to be nauseating enough, I was going to have to put up with a cuteness overdose? I quickly calculated my three months of chemotherapy and realized I’d have to suffer through St. Patrick’s Day and Easter décor as well. My hopes that the treatment rooms were not likewise vandalized were dashed when, thirty minutes after my scheduled appointment time, I was led back to the exam room, past plates of heart-shaped cookies on heart-shaped doilies, more streamers, and Mylar balloons shouting, “Happy Valentine’s Day!!”

I waited in my paper dress uniform for another twenty minutes before the doctor made her appearance. Where Dr. Glaspy had seemed reserved and somewhat humorless compared to Dr. Karam, he seemed endearing, warm, and fuzzy compared to the icicle that was Dr. Blaine.

She quickly introduced herself and then commanded I lay down for an exam. I did.

Her cold hands poked and prodded.

“You can sit up now.”

I did.

“So you’re a lawyer,” she said as she reached for a file. “What kind of law?”

“I do estate planning, mostly for family business owners.”

“Estate planning? Don’t a lot of lawyers do that? Isn’t that just wills and trusts?”

Nice move. It’s always endearing to add “just” in front of someone’s occupation. Aren’t you just a priest? Just a schoolteacher? Just an oncologist?

“No. It’s not ‘just’ that at all.”

“Oh. Well, I’ve had lots of lawyers as patients. Do you know John Allen? He’s not a patient, but we’ve done lots of work together.”

I knew of John Allen. He was a well-known, well-respected attorney who sued insurance companies for breach of good faith and abuses of their insureds. I wasn’t sure how I felt about her working with him so much or how I felt about discussing legal matters. She had a motive for this discussion though.

“Well, my staff tells me you’ve declined to sign our waiver,” she said.

“I did. For two reasons—first, I’m only here for a consultation so I shouldn’t need to waive anything, and second, that waiver reads as though you could completely screw up everything and I’d have no redress whatsoever.”

“John Allen drafted it.” She smiled in a manner clearly meant to convey “Checkmate, bitch.” And she continued, “If you don’t sign it, I won’t treat you.”

I wanted to ask what had caused her to be so defensive about lawsuits, but I didn’t. I was too floored by her response and demeanor.

With my surgical scar still healing, I was not able to discuss my choice of oncologists with Chris in the hot tub. Perhaps that is why our decision was not a good one. I wish I had more vividly recalled my encounter with Seamus’s Dr. Sorority Chick and been able to recognize when I’d walked into yet another alpha-female battle that I could not win, especially not when dressed in a paper towel, stitches in my right breast, and the nightmare of chemotherapy on the horizon. If I had recognized what was happening with Dr. B, I would have spared myself much frustration and pain over the next several months. But once we learned that Dr. B was also the oncologist who had treated the mother of Chris’s friend Ashley (who’d been at dinner with us the day we first met Dr. Karam), and Ashley gave her glowing reviews, it seemed she was an obvious choice. Dr. B came highly recommended by Dr. Glaspy as well.

I was there for health care, not to find a new friend, I told myself. Maybe she’d just had one bad day and I happened in on that day.

Maybe.

• • •

I’ve learned many surprising things, but way up on the list was this fact: by the time a breast cancer mass (fancy word for “lump”; unless you are trying to apply it to your spouse—it doesn’t work the same) can actually be felt, those dastardly cancer cells have been hard at work in the breast for six to eight years. Years! I’ve had cancer for years! (I’m totally expecting phone calls, cards, and flowers from some of you....the way you’ve treated me....and I had cancer then!!!) Modern technology can’t detect the cancer in the beginning years of growth (nope, not the mammogram, not an MRI, and you can’t feel it either....these are just little tiny bad-guy cells), so it’s only after they’ve divided and multiplied and turned into a gang that they get discovered.

Basically, a fertile little cancer cell reproduces to be two cells in about one hundred days, then four cells at two hundred days, eight at three hundred, sixteen at four hundred, up until at about five years the cancer party is now about 1 mm in size. Millimeter....not centimeter. Only at eight years have they divided in number to get to the 1 cm size, which is generally considered the smallest “palpable” tumor (meaning you can feel it—if you were trying; the machines might pick it up before this....if you were getting regular mammograms). At ten years that could be 2 or 3 cm or larger, depending on the rate of growth.

Let’s just think about my rude little invading tumor bastard (just a little pet name I have for it). I have had a mammogram every year since I turned forty. So that would be five mammograms that didn’t pick up on the party going on. The last of these was July. Then in November I could actually feel something. By December it was clearly “a lump.” And it turned out to be a 1.7 cm lump. It had maybe been growing there for eight years??

Quite a party of evil. Which explains the change from July to December. It also, in part, explains the chemotherapy as necessity. We don’t know if there are other cells starting a party o’ bad somewhere else in my body that just hasn’t been picked up yet—some of the gangbanger party attendees could have flowed out into the street and down to a neighbor’s where they are hiding out (cowards, really) until there’s enough of them to make their presence known. We need to flush those out and banish them.

Chapter 18
A COVER-UP

I sat at my desk with the prescription in front of me and read “Cranium Prosthesis.” I flattened out the blue slip of paper, picked it up, put it back down, read the fine print, and ultimately stared blankly.

I needed hair.

I had no idea how to go about getting a wig, yet I would be bald in a few weeks’ time. Dr. Glaspy had guaranteed it.

“And you will lose your hair. Guaranteed. One hundred percent. No question. But it will grow back. It will take”—and here he looked at my hair, a few inches below my shoulder, blond, and relatively healthy—“a couple of years to get back to that, but you’ll get it back.”

Dr. B was equally direct, although she threw in a gratuitous eye roll when I asked if I really would lose all my hair and she answered, “Of course you will.”

Chemotherapy is almost as frightening as cancer. Every chemo patient must hang on to the idea that maybe they won’t lose their hair; maybe they will be one of the lucky ones. These oncologists had obviously had the discussion too many times.

At UCLA, in my initial meeting with Dr. Glaspy, he gave me several prescriptions to begin preparing for chemotherapy (several very serious prescriptions, just to be clear)—antinausea, pain relief of varying degrees of strength, and a cranium prosthesis. The latter cannot be filled at your neighborhood pharmacy—which is why I was sitting in my office, twirling a blue piece of paper, and contemplating synthetic hair.

I’d been stumped for a few days. My “cancer to-do” list was long, and I was busy taking care of most of it with the help of my family and Chris. My mom sent me sweatsuits with zip jackets to wear during the infusions. My dad sent antioxidants, vitamins, and books. Chris stocked our pantry with the foods I liked most or that had been recommended (much as I had done for Seamus, I couldn’t help but note). I read as much as I could on the Internet, and I made an appointment for Chris and me to attend chemo “boot camp” training at Dr. B’s office.

But with only a week left until chemotherapy started, I still had not bought a wig. I was quite simply flummoxed by the whole idea of it. Once again, I could not get from here to there (or, forgive me, hair to…not hair). I felt foolish. I’d been able to handle everything else relatively easily. I’d maintained whatever control I could wherever I could, but the thought of buying a wig drew me up short.

How? Where? When? What? I had nothing.

Online I finally found a cancer center that offered free wigs and fittings for cancer patients. I didn’t need a free wig; in fact, that struck me as odd and wrong. I wondered if I’d have to qualify as financially needy. I recalled my Irish grandfather’s insistence on getting his share of the free government cheese handed out in the Reagan era, even though he didn’t need it. I didn’t need a free wig, but the fitting would be helpful. I had not the slightest idea how one selected, wore, or cared for a wig.

When I called the center to find out more, the woman who booked my appointment and explained the simple process to me was named Hope. This, I thought, was like Destiny calling to see if I was ready to adopt Seamus. I wondered if there was Faith and Charity in my future somewhere.

Once Chris and I knew all the appointments we’d be having and how many days we’d need to leave Seamus, we put out the APB for help. Anyone who offered assistance received a “how do you feel about dogs?” response. Luckily for us, and for our neighbors, many people love dogs and Seamus in particular.

My cranium prosthesis appointment was on the same day as our chemo boot camp appointment. The folks at the Mary S. Roberts Pet Adoption Center, Seamus’s old home, offered to watch him for me for that day, which we all suspected might be a long one. Chris and I kissed Seamus good-bye, dropped him at the offices of the adoption center (with clear and comical instructions he was not to be adopted out, as though anyone else would be so nuts), and headed to the cancer center.

Throughout our UCLA experience, I continued to marvel at the youth of the professionals. But marvel as in “wow, what a young genius” and “wow, you got through Columbia, Harvard, and fellowships at Johns Hopkins and UCLA, and you’re only, like, twenty-five?” That kind of marveling. On this day, we marveled at how young the girls we dealt with were in the “yesterday she was babysitting” and “I realize the bell just rang to let you out of class, but you are working, right?” way.

We were greeted at the Cancer Care Center by a teenage girl at the reception desk. I explained why I was there, and she stared blankly at me. Finally she said, “Today?”

“Yes. I made an appointment.” I must have looked as abandoned as I felt, since another woman hurried out from behind her desk and offered to sit at the front desk so the teenager could attend to me.

Wig-teen is the “cosmetologist” I’d been told would work with me and find the “perfect wig”? I looked to Chris for his response, and he seemed as startled as me. Well, at least it was fake hair she’d be dealing with.

Wig-teen led us to what she referred to as a “wig room.” “Wig closet” would have been more accurate.

“Usually when people come in for wigs they have less hair. So that’s why I was confused,” she said and pointed to a chair in front of a mirror.

Yes, well, hair can be confusing at a cancer center. I sat and explained that my chemo starts this week so of course I still have my hair.

She looked at me in the mirror. “Yeah, but now I can’t get the wigs on your head. I don’t know how to fit them.”

I was worried she was going to want to shave my head then and there just to make her job easier. But she had an idea. She opened a drawer and pulled out what looked to be a wide knee-high nylon. She stretched the nylon over my head, tucking all my hair up into it. Very pretty.

“Do you want to be blond? I mean stay blond?” she said.

“Yes. That seems safest. Let’s stick with blond.”

Wig-teen pulled out a bin of brown wigs. Short, curly, roadkill-looking wigs in styles last seen on
The
Golden
Girls
.

“Those are brunette,” I said.

Wig-teen gazed into her box of roadkill and without looking up said, “No, these are blond. These are our blond ones.”

“Those aren’t blond. Those are brown.”

She turned the box and looked at the label made from masking tape. It said “Blond,” and clearly she was not capable of winning an argument with masking tape. “Yeah, these are blond,” she said, holding up a small beaver pelt.

“Okay, how about some longer ones? At least to my shoulder, but preferably longer.”

“We don’t have any longer ones. Just these.” She held up a guinea pig corpse.

This would have been useful information to have before the half-hour drive, before the nylon was stretched over my head, and before I strangled her. I said, “Okay, well, what’s the longest you have because I’ve never had short hair.”

She selected a hoary marmot and squeezed it onto my head. Suddenly, I was Bea Arthur. Only older. And a lot crazier. Chris and I both laughed. I began chanting, “NO NO NO NO NO!!” and he began singing, “Thank you for being a friend…”

We tried three more rodent-wigs, each more ridiculous than the last. The wigs were stored in their plastic wrappers, flattened out, un-styled, and packed together in a bin on a closet shelf. Like craft supplies. When they were plunked onto my head, they were flat, and the wire-like hairs went in every which direction. There was no way to know what, exactly, or even remotely, the style was supposed to be. And clearly Wig-teen didn’t know so she just randomly moved the wire brush around lightly on top of the wig, hoping something would eventually make sense. Because
Golden
Girls
was off the air before she was born, so really, she had nothing to go on.

Chris broke the spell of despair. “I can’t believe you don’t have any long-haired wigs.”

“Everyone always likes the shorter ones. They look more natural.”

He guffawed. There really wasn’t any other response. “I disagree,” he said, pointing to the thick perfectly straight crease with hair sprouting upward across my forehead.

She said, “No, everyone thinks so.”

I wondered to what they were comparing these wigs. If you are only being offered short-haired squirrel pelts from a box of craft supplies, then what do they look more natural than? The Styrofoam head staring down at us from the upper shelf?

Chris asked the logical question, “Well, what’s the age range of your customers?” This is what I had been wondering but couldn’t find a way to ask, having been stunned into silence by my gerbil head. Even when we had pulled into the parking lot, with one look at the building, I had said, “Why do I feel like I’m going into a nursing home?”

Wig-teen assured us they had many young customers. We didn’t believe her. She didn’t care.

In the next thirty seconds, Wig-teen gave up on us and we gave up on her and her rodent collection. I’d rather be bald than wear one of those, free or not. She removed the knee-high from my head, leaving my real hair smashed down, messed up, and falling into my eyes. Naturally, she had no brush or anything available to help with that, because, as she’d already explained, her customers don’t normally have hair. However, she did suggest we go next door to the boutique so I could see about “turbans” as an alternative.

The boutique was twice the size of the wig-fitting room, but alas they had only three turbans for adults. One. Two. Three. Not three models. Three of the same kind—one pink, one red, and one white all in size medium/large. If instead I were a child looking for a turban, I would have had a vast selection to choose from (vast being six). We spent about eight and one-half seconds in the “store”—long enough to get the explanation that they were low on inventory and I should come back in about a week. Right. That reminder did not make its way into my Blackberry.

We barely got out before Chris burst out laughing—because the closet of a store had two “shoplifters will be prosecuted” signs. He still wants to ask exactly how many times the store had been hit by renegade shoplifters desperate for pink turbans before they had to install the signs (which, of course, would scare the hair off any shoplifter).

I had no wig, and only fifteen minutes had passed.

We drove to the lab to get my pre-chemo blood work done. I was taken into the back, and after a short wait a nice, older woman who was about four feet tall came and quickly drew my blood samples. She put the square of gauze and the bandage on and sent me on my way. I was only ten steps down the hall when I felt a little squirt and then warm liquid running down my arm.

Back inside the lab we went. Only now both nurses were occupied with a screaming child and neither could see or hear me over the squirming, terrorized child and her two parents. I put pressure on my blood-soaked bandage, held my arm up, and waited. I hoped I wouldn’t pass out or lose another jacket, and only then did I remember Dr. Karam telling me I bleed a lot. A third nurse finally came by and took me into another room, cleaned me up, stopped the bleeding, and bandaged me.

“Remember to tell nurses drawing your blood that you bleed a lot. They need to bandage you more tightly,” she said.

So I’ve heard.

When I rejoined Chris, I mentioned this to him. “Since I’m busy concentrating on not passing out while they draw blood, maybe you can be the one to remember to tell them I bleed a lot.”

“Good to know. I’ll add it to my list,” he said.

• • •

Our next stop was Dr. B’s office for chemo boot camp.

Chris was seated on a stool next to the hospital bed where I was seated in a small room adjacent to what we had surmised was the chemotherapy infusion room.

“Do you think they give us a tour? Have you sample the chemo?” he said.

“I don’t know. I assumed this would be a group thing. I thought several patients would be getting chemo training together. Though as I think about that, there are all sorts of privacy issues that would create.”

“I don’t know what I pictured, but I know it didn’t involve a hospital bed. Though I’m getting quite accustomed to these wheelie-stools as my regular seat.”

Chris was much too large of a man to be resigned to these tiny stools, but he was. It’s what he’d been given as a seat in every exam room we’d been in.

The door opened, and we were joined by a petite young woman with pale skin and long, stringy, mousy-brown hair (her real hair, I should note, lest the rodent reference throw you off). She shyly introduced herself, opened a large, overstuffed file, and started to read things to me. Slowly. Very. Slowly. And. Quietly. And she. Kept. Getting. Confused. No, lost. Wait. Confused. She was confused. No. Lost. She was. Lost.

Luckily, Chris and I had already read the same brochures, and we could redirect her.

“Okay, so I’m supposed to drink a lot of fluids during chemo. My dad gave me these antioxidants and immune boosters—mega greens and mega reds—they’re powder form and you mix in water or fruit juice. Is there any reason I shouldn’t be taking that?” I said.

She looked at me with a blank expression, highly reminiscent of Wig-teen.

“It’s got vitamins and things also. Like a holistic health, natural thing,” I said.

“You mean like Crystal Light?”

“No, not at all like Crystal Light.”

Nothing.

“Are there vitamins, herbs, anything like that that she shouldn’t be taking?” Chris tried.

“It depends on what it is.”

“Well, do you have a list of the things I should avoid?”

“We’d have to see the ingredient list. You’d have to bring it in.”

I flipped through the materials she’d handed me—including two booklets from the American Cancer Society. I came across a page that lists the foods to avoid. To wit:

greasy, fatty, or fried foods

raw vegetables and unpeeled fruits

high-fiber vegetables

very hot or very cold foods

foods and drinks that contain caffeine, such as coffee

beer, wine, and alcohol

be careful with dairy products

Ummmm….what the hell can I eat?? If I’m supposed to give up even one of the four to five cups of coffee a day I drink, it would have been nice to know that ahead of time to ease on out of the withdrawal symptoms. And what happened to the doctors telling me that if I felt like having a glass of wine, I could?

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