A family recipe, a childhood memory, a Depression-era handout
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Now I bring my running shoes everywhere I go. I’ve run on the cobbled streets of Lake Como and the dusty roads of Tulum. I’ve run in crowded Québec City and deserted Old Orchard Beach, through the hilly vineyards of Tuscany, under the St. Louis Arch, and along Cape Cod National Seashore. I’ve been chased by black flies on dirt roads in Vermont and stalked by a rusty pickup truck on a secluded stretch of gravel in Michigan’s Keweenaw Peninsula. Throughout it all, I put one foot in front of the other, watching the gray ribbon of road unspool beneath me.
But ten years ago, instead of putting on my running shoes, I was putting on turtleneck sweaters to cover the engorged lymph nodes in my neck. The nodes in my groin had grown to the size of golf balls, and I had to drag myself out of bed in the mornings even after twelve hours of sleep. My doctor thought I was fighting a virus or had a rare case of cat-scratch fever. When my glands grew even larger, he sent me to radiology for a biopsy.
There I waited in a beige room with other women wearing hospital gowns and reading out-of-date Good Housekeeping magazines.
The examination room was small and full of medical supplies, as though they had just happened to place a gurney and a radiology machine in a storage closet. I lay in my underwear while the radiologist slathered my groin with cold gel and slid his probe across my lymph nodes.
“It’s good you’re thin,” he said, staring at his computer screen. “The nodes are right near the surface.”
Then he painted dark-red iodine on my skin, pricked me with anesthesia, and inserted hollow needles to harvest cells for the biopsy. I stared hard at the ceiling.
Days later I was looking at a chart in my oncologist’s office that showed how unusual it is for someone my age to get acute lymphoblastic leukemia — a cancer most commonly found in children and in adults over sixty.
I was thirty-five. I practiced yoga. I ate organic food. I was not supposed to be on her chart.
She pointed to a stack of pamphlets and a three-ring binder filled with information for cancer patients. The chemotherapy would be divided into three month-long protocols called A, B, and C. There was no D. Maybe D is for death, I thought, but I didn’t ask. After the initial three-month cycle, she explained, the regimen would be repeated, followed by two years of maintenance chemotherapy.
“The cancer is young and aggressive.” She handed the binder to me. “We’re going to give you as much as you can stand, but sometimes we have to destroy the village to save it.”
My oncologist was focused on treating the cancer, but my first question was what this meant for my reproductive future. I’d always assumed I would be a mother someday. Now I wasn’t so sure. The oncologist mentioned the cutting-edge practice of oocyte cryopreservation — egg freezing — at a hospital in Montreal, a few hours away. But she warned me that we needed to start the cancer treatment as soon as possible.
When I met with the oncology nurse to go through the paperwork, I couldn’t help but notice that she was six months pregnant and younger than I was. I told her I wanted to investigate freezing my eggs in Montreal, and she convinced the medical team to grant me a short extension before the cancer treatment began.
Back at my parents’ home, I googled leukemia over and over until I could spell it correctly.
What had I worried about before the diagnosis? This became a game I liked to play.
I’d been fighting a losing battle against a lone brown mouse in my apartment. My landlord had come over one evening, after a frantic call from me, to smear peanut butter on mousetraps. Each morning I’d approached the kitchen with dread, expecting to find a dead mouse in a trap.
I’d struggled with my English department colleagues. As a new professor I was anxious and overworked. I’d argued for more nonfiction in the curriculum, for courses where students could explore stories that were true.
I’d worried that the bookcases in my tiny office weren’t full enough, and that the gaps on the shelves conveyed the wrong message to my colleagues and students.
I’d worried about my hair and how it wouldn’t stay straight, even after I spent a long time wielding a hot hair dryer.
My partner, Pierre, and I drove north across the Canadian border to the McGill women’s clinic, a dark-gray building that looked like a castle. We took an aging elevator up to the main floor, where we entered a labyrinth of corridors with peeling paint and yellowed floor tiles. No one was around.
In a corner office a secretary in a tight skirt requested payment up front. I withdrew three hundred Canadian dollars at an ATM deep in the bowels of the building. The colorful bills looked like Monopoly money, and handing them over felt like making a back-alley transaction.
The ultrasound waiting room was crowded with pregnant women, all with full breasts and stretch pants, some holding infants. Each woman held a number as though she were in line at a deli. I felt out of place — and soon realized I was. Two floors up Pierre and I finally found the fertility clinic, where tense couples sat side by side watching a muted television. There was no stretched skin, hormonal excess, or crying babies.
The medical community has had great success freezing sperm, but freezing eggs is more difficult, because they are watery and fragile. The McGill clinic was studying whether premature eggs could be harvested, frozen, and then matured after thawing. I was there to see if my eggs could be part of their study. The word harvest conjured up images of wheat sheaves and gingham shirts. I had a hard time squaring it with something being extracted from my body. I asked the doctor what would happen in the future if I used my frozen eggs to make an embryo in a petri dish. Would my eggs be sodden with cancerous cells? Would the baby get cancer? The doctor didn’t have any answers.
I had to get a vaginal ultrasound to determine the age and condition of my eggs. In an examining room I took off my jeans and underwear, climbed onto the table, and covered myself with a thin paper sheet. A female technician came in and explained the procedure in a bored voice as she snapped a condom onto the ultrasound wand, dunked it into a tub of cold lubrication, and slid it into me. She shuttled the wand back and forth while we studied the monitor together. I thought it was beautiful, this interior world I’d never seen before. Hours later Pierre and I left the hospital depleted and disappointed. I’d already ovulated this month, so my eggs were too old to be harvested, and my oncologist wouldn’t let me wait for my next menstrual cycle. In the car I held on to my grainy black-and-white ultrasound picture. It looked a lot like the ones my pregnant friends had on their refrigerators. But mine was different. All I had inside me was blood cancer and old eggs suspended like stars in a night sky. We drove home slowly, following the road signs in French back to our own country.
My oncologist told me I was the healthiest sick person she’d ever seen. On my first day of treatment I wore a pink zip-up sweatshirt over my embedded chest port and put my hair in pigtails. I wanted to feel young and cheerful.
As my nurse, Joanne, prepared a syringe of bright-red liquid, I thought about how I’d spent my life avoiding toxic chemicals — buying expensive organic food, using all-natural body products, postponing dental X-rays — and now here I was about to mainline them directly into my bloodstream. I had believed that if you were careful and did everything right, you could control the outcomes. But getting cancer was a betrayal at the deepest level of my body.
“Here comes the bad stuff,” I said.
Joanne stopped and looked at me. “No,” she said. “This is the good stuff. This is the stuff that saves your life.”
I ’d thought of cancer as a minor interruption, a small rip in the fabric of my life that could simply be stitched back together. But after a few weeks of treatment my body felt as heavy as cement. I was too weak to walk up a flight of stairs, unable to hold a pen.
Leaving the clinic one day, I burst into tears in the elevator. The smell of disinfectant and cafeteria food made me nauseous, and I saw that cancer wasn’t just a bump in the road. Cancer had put me on a different road altogether, and now I was a stranger in my own life.
One month I ended up in the hospital for an extended stay. The chemo regimen had caused my white blood cell count to drop drastically, and instead of rebounding the way the oncology team had predicted, my count was stagnant. No one knew why. Without white blood cells, the body doesn’t have a functioning immune system. Even a stubbed toe can cause a massive infection.
Cancer leads to chemo, chemo leads to side effects, side effects lead to infection. It was a nightmare carousel I couldn’t get off.
The doctors put me in a solitary room where people had to sanitize their hands and don surgical masks before entering. I spent ten days there while nurses gave me pills to stimulate my immune system and pills to help me sleep. Every morning I awoke surrounded by a team of doctors asking about my bowel movements. Their gaggle of medical students nodded politely while scribbling notes. I tried to do yoga in bed, friends brought me lemon cupcakes, and a cute oncology resident downloaded new music to my iPod, but I felt broken. Everything tasted like tin, and I was bald.
In the evenings when Pierre visited, he climbed into my bed and curled around me like a C. All summer he worked outside on the lake, hauling heavy chains and rescuing boats. I could still feel the warmth of the day radiating from his body and loved that he was sun-browned and strong: the opposite of me.
Most days I looked out the window of my hospital room and waited for a woman in denim overalls to appear in a small community garden. She came every day to weed and collect vegetables in a basket. She had no idea that I existed six floors above her, hooked to an IV pole and pinned between the side rails of a hospital bed. A straw hat obscured the woman’s face, but that made it easier to imagine that I was her instead of me.
During treatment I learned that the ovaries, along with the brain and central nervous system, are called “sanctuary sites,” because the body naturally prevents foreign substances from entering them. I was comforted by the body’s instinct for self-protection — until I was informed that I’d need to undergo invasive spinal taps to kill off the rogue leukemia cells in all of my sanctuary sites.
Every month I’d lie on my stomach while my oncologist stood on a stool and shot lidocaine into my hipbone, then plunged in a hollow needle, corkscrewed hard, and pulled out a plug of marrow. My bones were strong and dense because I was young, but I felt weak and brittle.
Much of the language about cancer conjures up images of war: your body is a battlefield of clashing armies, a dramatic scene of invasion and destruction. But the truth is that having cancer is tedious and involves a lot of waiting.
There’s waiting in the waiting room with other patients in various stages of hair loss, holding clipboard forms that ask you to rank your pain, fatigue, depression, bleeding, mouth sores, and constipation on a scale of 1 to 10.
There’s waiting in the examination room on the crinkly white paper while you study wall charts of the female reproductive system or flip through last month’s People magazine. Both depict worlds that feel increasingly foreign to you.
There’s waiting for the chemo to kick in, for lab results, for platelet transfusions, and for your blood count to be high enough for you to withstand the next round.
There’s waiting to lose your taste buds, your breath, and your hair, which happens gradually until one morning you find clumps of it on your pillow in your hospital room.
There’s waiting to get to the other side of cancer and return to your normal life, which you don’t yet realize is gone for good.
When I got out of the hospital, I stayed with my parents. My mom and I took slow walks on the dirt road around their house. The chemo was killing off my rogue cells, but it was also destroying the red blood cells that carried oxygen, so I was easily winded. Every day I grew slower, like a toy running out of batteries. In my mind I set goals: walk to the end of the driveway; walk to the neighbor’s green mailbox.
One day I took the family dogs for a short walk in the woods. When we reached the pond, I stopped so the dogs could swim and I could sit. I was in awe of the dogs’ boundless energy, their wagging tails, their keen interest in every smell: downed tree limb, maple leaf, beaver dam.
In contrast I felt leaden. I had what my oncologist called “chemo brain” and had even lost my ability to read. The letters piled up on the page like ants on spilled sugar, rendering the text meaningless. Reading had always been a lifeline for me, and without it I was unmoored.
I watched the dogs charge into the pond. Suddenly I had a vision that I was swimming with them. We were flank to flank, like three seals. I felt weightless and free. When I came up for air, I looked at the shore and saw myself waiting there, thin and pale. I did a handstand underwater to show my body how much fun I was having without it.
I’d always thought that leaving my body would be hard to do, that it would rupture skin or cause psychic trauma. But it was easy, like stepping out of a slip.
At my parents’ house my mom read to me, and Pierre took the dogs for long walks, calling me on an old pair of walkie-talkies. While he told me about the new heron’s nest he saw or the new trail he’d made, I studied the knots in the wood-panel ceiling above me and fantasized about movement. I’d spent so much time lying down, the immobilized target of needles and tests and medical speculation. A question began to take shape in my mind: What is the opposite of this?
And the answer I heard was: Running.
After six months of chemotherapy I was able to return to my job. I had energy for only one thing a day: I taught my classes and then went home and ran in my dreams. And after two years of maintenance chemotherapy, I finally had the strength to join a gym. I’d dabbled in running before, but only in a halfhearted way. I gravitated more toward indoor activities like yoga, where I could stay in one place on my mat. But I’d had enough of hospital beds and infusion-clinic recliners. I needed to move. I needed to feel like I was going somewhere.
I started walking on a treadmill at the gym. Every few minutes I would run for thirty seconds, then slow down, gasping for air.
I stole glances at the women on either side of me in their sleek spandex, who effortlessly programmed their digital dashboards, nestled water bottles on their treadmill’s tray, and ran fast. They didn’t even sweat. Next to them I lumbered in heavy cotton sweatpants, my sneakers slapping the slow-moving belt.
It took almost a month, but eventually I could run for two minutes at a stretch, then five, then twenty. I spent the winter at the gym, watching The Dr. Oz Show and running nowhere. Through the gym window I could see a playground where children bundled in coats played while their teachers huddled by the door. When spring came, I was often the sole runner in a long row of empty treadmills. On the playground the children shouted and chased each other, their jackets streaming behind them like superhero capes. I realized that it was time to run outside.
At first I felt awkward and self-conscious, convinced that people could tell I wasn’t really a runner, only an interloper who ran on a rubber conveyor belt while watching daytime television. The sidewalks were uneven, and there were cars and wind and dog shit and other people.
My breathing was rough and erratic. I’d had no idea how different running outside could feel.
Soon I learned that cotton T-shirts get heavy with sweat, and I bought some with wicking fabric. Then I got a sports watch for my birthday, to keep track of my time and distance.
I began to prioritize running in my schedule, waking up early four times a week. It took a while, but I finally found a rhythm to my breathing. When other runners gave me the runner half wave, I started to feel like I belonged.
Over the next couple of years I signed up for my first 5K, then my first 10K, then my first half-marathon. With each new race I felt stronger. Last year I made a New Year’s resolution to run a race a month and collected a stack of sweat-stained race bibs. Pierre is always waiting for me at the finish line, his red knit hat like a beacon. And no matter how slow I am, he cheers and yells my name as I run to him.
Many dedicated runners track their weekly mileage, analyze their pace, and stick to strict training guides. They know how many grams of protein they need to eat for maximum recovery and how many carbohydrates to maintain their glucose levels. I’m not that kind of runner. I don’t run to compete. I run to run.
There’s so much loss associated with cancer — hair, health, and the future I’d envisioned. But the biggest loss is the belief that you have control over your body. Running restores this faith, if only for an hour. There are the sanctuary sites we’re born with, and then there are the ones we make. Every morning I lace up my running shoes and stretch my tight calf muscles. Running is still hard — perhaps it always will be — but it’s not as hard as not being able to run. It’s better to be outside than in, better to move than to lie still. Running reminds me that I used to be sick and that I’m not sick anymore. I pump my arms and feel the wind on my face, a small person in pink sneakers moving through this vast, unknowable world.