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C. Cancer.

3 November 2011

about six weeks ago, my mother-in-law was diagnosed with a grade 4 glioblastoma, which is a highly malignant brain cancer, with tumors about the size of a golf ball in the left frontal lobe of her brain.

have you ever seen a weather radar tracking a hurricane?

it looks like that, but on someone’s brain.

and my vibrant, active mother-in-law? she’s far too young to have a hurricane in her brain.

there’s a lot that is interesting about being close (and getting close) to someone who finds such a dark weather system in their head.  what i found most interesting was the process by which you discover that a loved one does, indeed, have cancer.

it was harder than i thought, more unsettling and less straight-forward than i ever imagined.

in this (and most, i believe) situations of diagnosing brain tumors, the process is similar: one has reason to get an MRI of their brain — usually because they are experiencing weird neurological symptoms or, in many cases, seizures — which shows the dreaded hurricane.  the scan is sent to a specialist; the specialist recommends a craniotomy to remove the tumor (or debulk it, if a complete resection isn’t possible) and biopsy it, and then once the pathology report comes back, begin treatment.

so, what happens as you embark down this road is that for weeks, from diagnosis to getting the pathology report, you only have one word to describe this terrible thing that’s happening: a tumor.  an evil, unwanted visitor.  a hurricane on a ghostly outline of the brain you’ve never actually seen before, only self-consciously been cognizant of. and you desperately avoid resurrecting your kindergarten-cop-movie-circa-1990 impression of arnold schwarzeneggar saying “it’s not a toomah!“, because, unfortunately, it actually is.

but this is immediately what your brain jumps to, because you are emotionally 12 years old, apparently.

the more people you talk to, the more people want to know exactly what kind of tumor it is.  benign? malignant? and you search for answers, desperate for some finite facts you can lean on, good or bad, because whatever the new reality is, at least it’s real.  you can trick yourself into preparing for the absolute unprepareable.

the not knowing keeps your proverbial one-shoed-self squinting up at the sky, looking for signs of the other one to come tumbling down at any moment.

you speculate, conjecture, discuss, google, and dance around the word that you’re wondering about, but fearful to verbalize out loud.  you make a list of all the other things this tumor could be besides…no, you’re not going to say it.  why think the worst, right?

at this point, about 2.5 weeks post-hurricane-tumor spotting, my mother-in-law had surgery.  the surgery debulked the tumor by half (note: this is not the most positive scenario) and also found that the hurricane was building energy, growing in size since the last radar picked it up.  the surgeon shares this with her husband, her mother, my husband and i in a tiny room that seemed to be losing oxygen by the second.  he also shares that he is hopeful for the best, and we should have pathology in a week.

we were hoping for news; we got hedging.  i suspect that our very wonderful, gracious neurosurgeon knew what he was most likely dealing with, but being the prudent and professional doctor he is (and exceptionally nice to all of us), he followed protocol.

she recovered for a few days in the hospital, and then about a week at her family’s home in grand junction, where many of us were staying with her.

it was a tough week.  brain surgery, of any kind, is no picnic.

and with all the discussion of care, talks with medical professionals, little by little progress in recovery, questions coming from concerned friends, we still have…no answers.  no ground on which to plant our feet and determine our course.

i think: this is not how it happens in movies.

in movies–and books for that matter–the diagnosis is wrapped up nicely.  in fact, sometimes the process of diagnosis is not mentioned at all, instead all focus centers around the emotions and trials of recovery from and life with cancer.

i realize: this is not how it happens in real life.

1 week post-surgery, we have a meeting with a chemotherapy doctor.

now, i have to say this: in retrospect, it seems so obvious what she has.  i mean, think about it — a growing brain tumor that’s not an infection, a concerned neurosurgeon, a meeting with a chemotherapy doctor–this obviously equals cancer, right?

but, a) what if we’re wrong about that, and now we’ve fixated on cancer as being her disease, and b) if it is cancer, what kind?  doesn’t cancer go in stages?  what stage is this?  is it fixable? maybe chemotherapy is used in non-cancerous tumors.  what do i know?

so, we go to meet the chemotherapy doctor, and only when we walk in the entrance do i get my first answer.

it’s definitely cancer.

we meet with the chemotherapy doctor, who, it needs to be said, is remarkably abrupt and cold.  my mother-in-law and stepfather-in-law sit on one side of the room, with the boy and i sitting at a small table.  we fill out forms, and glance around the room: brochures about head & neck cancer, booklets about how cancer stages work, various charts and graphs about leukemia, lymphoma.

for as much cancer awareness as there is these days, i realize how little i know.

the doctor (who incidentally only has one arm and thus plagued me once again with stifling my knee-jerk middle-schooler-obsessed-with-pop-culture response of movie-quoting, this time from the fugitive — “it wasn’t me; it was the one-armed man!”) proceeds to ask questions and examine his fragile patient, while we sit there watching anxiously.  he drives on, not stopping to take a breath, talking about the specific kind of drug she’ll be taking, for how long, and side-effects.

side note: as it turns out, her brain cancer is (chemo-wise) rather simple.  she takes three pills, once a day.  that’s it.  side-effects are usually minimal, but definitely depends on the patient.  we don’t know it then, but her side-effects from the chemo will be zero.

he finally, after about 800 days ten minutes, pauses, looks us in the eye and says: “so, that’s it, unless you have any questions.”

um, yeah, we do have a few minor questions like OH MY GOD, WHAT DOES SHE FREAKING HAVE, PLEASE TELL US SOMETHING FINALLY.

so, then he rattles off her cancer: grade 4 glioblastoma, like he’s telling her she has a common cold and to not worry about it.  he starts throwing around months, numbers, figures, and suddenly his voice suddenly sounds like charlie brown’s teacher.

i mean, you’d be surprised the lack of emotion and reaction involved in hearing what could be, without the miracle we’re believing for, a possible death sentence handed down to someone.  we recently saw the movie 50/50, in which the main character finds out he has cancer at the age of 27.  there is a scene with his doctor–a very cold, aloof doctor–who barely looks up the entire time while telling him his diagnosis.

before my experience with my mother-in-law’s disorienting, confusing diagnosis process, i would have dismissed that scene as pure hollywood dramatics, written only for the screen.

i now know that the scene is entirely, surreally, weirdly, true.

it’s jarring, really.  as the doctor’s talking you look around at the other people in the room, expecting something, anything, that conveys shock.

a sympathetic look? a reaction from his mom/stepdad indicating sorrow?  that tinny, tense strings music in movies that tells the audience in sharp tones THERE IS DANGER AFOOT!?!

nothing.  so, you determine that you surely didn’t hear what you heard.

because if you had, people would certainly react.  right?  or, or…or, the ground would open up.  and locusts and frogs would start biblically pouring down.  something. anything. because you need confirmation that your feelings of worry and life-altering sadness are appropriate.

you hardly hear what comes next, a litany of statistics rattled off with an almost monotone affect.

i interrupt the monologue, asking a follow-up question along the lines of “can you explain to me in plain english what we’re dealing with here?”

not getting an answer.

but i had the answer, in my heart.

i knew it.

i knew i heard correctly.

this hurricane in her brain is an epic storm, of the worst proportions, with the worst (earthly) prognosis.

and in that doctor’s office, before your heart fills with hope again, before prayers are lifted and hands are held, before finding reassurance from survivors, before spending six weeks in close proximity with your newly-minted mother-in-law and someone you now can count among those you really know, before travelling 10 hours a week from our home to stay with her monday through friday while she goes through treatment in a city away from her home, before seeing the strength of someone so radiantly shine through as she turns her face towards the light, before loving and understanding all the cliches about life and hope and survival that you’ve hated hearing before, before the tears and laughs, before the ups (and downs), before the resolute decisions to continue to have faith in God among this uncertain path, to stand strong with the ones who love you, before you end up redefining what this family is really made of…

before all of the hopeful and good things that come out of this journey that you literally see every single day…in that moment, in that doctor’s office–you’ve never wished you were more wrong about what you’ve just heard in your whole, entire life.

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5 Comments leave one →
  1. Christopher Schell permalink
    4 November 2011 1:35 am

    Wow Sara. Such an accurate and moving account.

    Surreal is the only word I can ever think of for these types of moments. When Jenny’s dad was diagnosed it all seemed so… foggy… and yet perfectly clear.

    Like your mind refuses to accept the facts and yet accepts them all at the same time.

    Like all your emotions – rage, fear, guilt, sadness, love, hope do an intertwined dance as they switch positions in your mind.

    Like you want to run away but stay as close as humanly possible.

    We feel for all of you and are amazed by your honesty and outpouring of love and caring.

    Thanks for sharing what so many feel and can’t talk about.

    • 4 November 2011 5:00 pm

      you so captured it exactly — a strange dichotomy of good and bad, all at once. your words mean so much to me, as does your friendship. love you guys!

  2. Sarah Byrd permalink
    5 November 2011 5:30 pm

    sara … you are so eloquent with words. thank you for sharing. continuing to remember you guys in our thoughts and prayers. miss you. wish there was something we could do…

  3. courtney permalink
    8 November 2011 8:05 pm

    my heart and prayers are with you. xo

  4. Robert permalink
    7 January 2012 11:56 pm

    man and I thought I was bad with four types of cancers,,well the best of luck Sara hope all your dreams and memorys come true someday…God-Bless your in my Prayers..always

    Yours Sincerly Robert W, Filby

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