A Field of Narrowing Options
“These essays are getting harder to write,” I told Dad on another trip home from the doctor.
“I know,” Dad said.
We didn’t say anything else; there wasn’t anything else to say.
I spent my free time searching for distractions, and plenty of them offered themselves up to me, from the practical to the completely irrelevant. I took all comers, because then I could avoid writing about Dad.
Dad weaned himself off oxycodone because he hated being loopy (and worse, being plugged up like the Colorado River behind the Hoover Dam), and he was much happier for it. His solution to the painkillers was re-framing his problem as being less about pain and more about mobility, and it worked wonders for him, though I wasn’t sure whether it was mind over matter or sheer stubbornness that tipped the scales. Dad’s hip bones, deteriorating because of the cancer living within, were being blasted with a second round of radiation therapy; there was hope that once he was done with ten days back in the nuker, he’d be less hobbled and more mobile once again.
It was Dad’s PSA numbers which hung ominously overhead. Six weeks before, when his blood tests revealed a return of the cancer into full bloom, the doctors put Dad on Casodex, a drug that was supposed to bolster the hormone therapy’s efficacy and to stomp down whatever testosterone was left. In doing so, we hoped that his PSA numbers would level off, maybe even go down again. Instead they’d quickly risen, despite the Casodex. And since his testosterone was undetectable but his PSA numbers were ascending anyway, one could extrapolate that the cancer just wasn’t taking “no” for an answer any longer.
The doctors had been, if not silent, not specific in explaining Dad’s options for us. This was one of the hallmarks of our experience: anxiety as we waited to discover what the various tests revealed, then sitting with the results while other things fell into place. In this situation, it meant that even though we knew Dad’s cancer was zooming into high gear, we had to wait for his system to clear of any remnants of the Casodex (six weeks) before they offered him other therapies.
Those therapies were going to be clinical trials, which was a whole new kettle of fish. Because Dad seemed to have run aground with the main treatments, he was left with only risky options not approved for anyone but those with the most terminal conditions and aggressive cancers. This gave us pause: We were at the fork in the road when Dad would decide whether the choices he was offered were worth the bother.
It was a deep question, though I didn’t fancy the process. There was a peculiar type of logic involved, the cost-benefit ratio of living and dying. If these as yet un-offered therapies were going to lay Dad out for a few weeks, but give him an earnest few extra months of relatively unencumbered life, was it worth the effort? Put another way, if the therapies statistically offered Dad two or four extra months of life but made him sick as a dog while he was going through it, was it good enough? Or was it more important to call a spade a spade and enjoy what was left without the medical interventions, scheduling, errands and invasions that constituted late-stage cancer care?
We had a few weeks to chew on this.
Portland was warming up in earnest. Early spring had been mild, but the weather had a personality disorder and made April wintry again. Once the sun was bright and the light could fall on Dad again, he opened like a flower. It was a tonic for him; every warm day was a precious gift.
Dad had always burned hotter than your average human, and as such he kept the heat down too low in his house for his reptilian daughter’s taste. I was always cold growing up (except in summer, when our house was so stifling that I sometimes crawled out Chris’s window to sleep on the flat part of our roof), and I was always chilled in Dad’s little bungalow. Dad was a conscientious, conservation-minded soul who, no matter the weather outside kept his thermostat at a sensible 68 degrees. At night the thermostat was set to “arctic.”
As his health declined, it was confusing to see Dad bundled up when the air had only a slight crispness. When I grabbed his hand in the doctor’s office, it was cold. He wore a jacket no matter the weather, and Dad almost always dressed in a heavy wool sweater, like a fisherman on the coast of Ireland facing down an arctic sea blast, not a Portlander facing another pleasant day in the mid-sixties.
So each warm day was worth its weight in helium since it gave Dad that little extra bit of comfort. It gave him the perfect light to paint under, clean brightness falling through the skylights in his studio, released from the bonds of Portland’s overcast murk.
The other side of the coin was that there would be a time when there were no more pleasant days again. Fall would arrive, bringing with it the damp that seemed to bother Dad more and more as the cancer became entrenched. So I was of mixed mind about the usually mundane weather—I was glad that it was beautiful so that Dad could bask in the glory of Portland’s spectacular spring, but I wished that I could stop time so that, if Dad began to decline in earnest, he did so at the pinnacle of beauty and light. I did not want Dad’s light to fade as the weather did.
But we don’t choose these things, do we?
I was at sixes-and-sevens with Milo, so exasperated that I called Lars to run interference. My exasperation was made up of some part weariness and some part stress, though to be fair Milo was being a complete pill.
I left Milo and Lars to walk the wonderfully uncomplicated dog, whose only desire was to please me, chase small objects and eat things he shouldn’t. If I found Moxie’s missing chewy ball, I was the conquering hero. If I trained him to sit, I mastered a secret language. To walk him was to be loved by him.
On my way home along a narrow path, an elderly couple walked towards me, inching along, the woman providing stability for her companion who was shaky on his feet. They paused to let me by. “No, you first,” I said, pulling up Moxie to make room.
“We’re poky,” the woman said.
“That’s okay,” I said.
“We’re poky, but we’re nice people,” she said.
“That’s the most important thing,” I replied.
She insisted I make my way past them, and I did, but not without a tinge of sadness and remorse. Remorse that they felt rushed on my behalf, that the woman felt the need to apologize for being old and slow. There should be no apologies, no need to justify one’s value as a nice person because you’re out for an evening walk along a narrow path. With any luck, I’ll have my husband’s arm to guide me when I’m slow, or he mine, or we each other’s. If so, I hope I don’t feel compelled to apologize for my age or my infirmity, though I probably will.
I hated that on top of everything else, on top of all the indignities and depredations of age and illness, that anyone felt compelled to apologize for existing.
Dad had just gotten word that his PSA numbers, despite the Casodex, were continuing to climb. We were pensive.
“I guess it’s here to stay,” I said.
“Looks like it,” Dad agreed.
“You’re going to have to think about what steps are worth the candle.”
“I have been,” he said. “Mostly I hope to see Chris. That’s all.”
The only important things left were to be with those he loved, not how much time remained.
Chris experienced a professional windfall. Through fiat and a little craftiness, he’d set himself up for a nice career boost as a focus puller, but to attain this brass ring, he’d committed himself to a long film shoot far from Portland. He waited for updates about Dad’s health from me, full of anxiety and hopefulness in equal measure. The news, unfortunately, was not good. So while Chris juggled chainsaws in his new professional role, he waited for news which, when it arrived, only made him want to drop the chainsaws and come running.
Dad was sanguine. “He’s doing exactly what he needs to do right now,” he said.
When I told Chris this, he scoffed. “Sure, easy for him to say.”
“He misses you,” I said. It was meant to be comforting; only after it left my lips did I realize that it was salt in the wound. Chris missed Dad profoundly, deeply, wanted to be with Dad, but he couldn’t leave his post. To remind Chris that Dad missed him was a lightning strike straight to his exposed tender bits.
I felt compelled to apologize for existing.
The essays were getting harder to write. The medical options being offered to Dad had less obvious benefits, the therapies akin to putting out brush fires when there was a conflagration raging. Dad’s lovely radiation doctor, with whom he had a chaste infatuation, called radiation therapy at this late stage “spot welding:” if something hurt, they’d zap it to make him feel better; if the cancer threatened to encroach too far into his spine or certain organs, they’d beam their mighty rays of doom at it. But there was no stopping the cancer. It was too deeply embedded in the very make-up of Dad now; he and it were wedded until the end.
While the essays were harder to write, the days were enjoyable. I was tired, a little wistful, had some hopes for how I would like things to be which perhaps bordered on the fantastical. But Dad, despite his cancer and the narrowing field of options available to him, remained cheerful. His wants were few, and revolved around the people in his life who mattered to him. He laughed easily. He wrote down meaningful moments in his life, packed up books. He painted cheeky little paintings about his cancer while I avoided writing about it.
I dished up some ice cream for Milo, smack in the middle of the warm May afternoon. Instead of making dessert contingent upon Milo eating proper food, which is how our day started going south the day before, I embraced the teachable moment by giving Milo ice cream just because I love him and life is short. The one dish of ice cream without my nagging was more valuable than the dubious health benefits of two more bites of whatever remained on his plate.
For today, anyway. But that’s all we had.