Last Plane to Heaven (43 page)

It's a different game now, and some blood in your morning shit has proven to be your table stakes. You'd best believe you're playing for your life.

ii:
I have faith that my body will do its best to marshal my immune system against these invaders from within, but I also surrender myself to the tender ministrations of the scalpel and the loving embrace of oncological poison that the days of my life shall be filled with terror, nausea, and fatigue.

Oncologists must take classes in how to deliver difficult news. Their medical specialty is as devilish and soul-crushing as a loaded pair of casino dice is to a drunk's last dollar. You can see the distress in the doctor's eyes as she comes into the room, not quite meeting your pathetic attempt at a frank gaze.

You've promised yourself you'll be open, accepting, strong enough to deal with whatever comes. The blood work was no big deal. The CT scan with its strange bodily warmths and curious surges was almost entertaining. The PET scan was just strange, like a B-list superhero's origin story writ mundane. The colonoscopy, well, the less said the better, but at least it didn't hurt. The best way you've been able to describe
that
procedure was as resembling a small-budget alien abduction experience.

Tests, tests, tests, to prove that it's really all okay.

You're young. Sort of.

You're healthy. Mostly.

You have the love of family and friends. At least, that's what they tell you.

Whatever this is, you will get through it. Whatever this is, you won't let it beat you out of all those precious moments that you've suddenly realized make up your life.

“I'm sorry,” she tells you, finally locking eyes with you for a moment. “It's definitely colon cancer. The good news is that there doesn't seem to be any metastasis. The bad news is it appears to have interpenetrated the colon wall, which means the disease has spread past the original site. I'll be referring you to a surgeon in the Digestive Medicine group for a resection. After that, we're probably going to have to prescribe a course of chemotherapy.”

At least she delivers the information concisely, using words you can mostly understand once your sense of horrified denial has settled somewhat. There are so many questions, but you can't ask them all, not right then. Cancer's got your tongue.

You feel the demon settling in where it clings to your back. Its long, barbed tail circles your waist then slides into your anus and upward along the Hershey highway to begin the slow, mortal feast that will eat you out from within.

The world is different now. You have something to believe in after all. Your oncologist is your psychopomp. Your surgeon will be your ferryman across that river of dread.

There's another side of life, and you suddenly realize that you have seen it far too soon.

iii:
I confess that I am but a sinner in the hands of an angry cancer. There is no way through this thicket of tumor and metastasis save to go forward to whatever end cancer has prepared for me, to feast at whatever table cancer has laid for me. My loves, my family, my friendships; they will all be placed as sacrifices upon this, the altar of my suffering.

Surgery takes you strangely. Going in you joke and smile bravely and pretend this doesn't concern you very much. The surgeon and his assistants have disclosed risks to you, side effects, the various debilitations and deaths which can befall anyone unlucky enough to be splayed beneath the scalpel upon an operating table.

Still, you don't know what to expect, so you try to expect nothing except a new experience. Cold and naked under a ragged little swatch of oddly printed cloth, smiling strangers wheel you away down vacant corridors into the countries of the knife.

It is the anesthesia that puzzles you most. Even in sleep, you know if you're warm or cold. Your bladder tells you when to get up for at least a few stumbling moments. Time still passes. A crying child or a lover whispering your name will wake you.

Anesthesia, though … It's a little death. Not in the sense of the French
petit mort,
but a preview of finally dying of this dread disease. Like a movie trailer for the blank nothingness that is eternity once consciousness has been extinguished. One minute you are counting backwards to a frowning woman in a surgical mask, the next minute you are swimming in fog, surrounded by curtains, hearing machines peep and bing the measures of your metabolism.

“I'm still alive,” you say. Your aunt chuckles and squeezes your hand and tells you that's the fifth time you've said those words in the last twenty minutes.
It must be important, then,
is all you can think in reply, but self-consciousness has returned with the rest of your awareness, so you just smile and squeeze her hand.

You lie there laced with needles and tubes and think about the irony that you have for a few hours touched that far shore, and can remember nothing of it except a blankness so profound it cannot truly be called a memory.

Cancer has brought you another lesson closer to finally understanding death.

A few days later, home from the hospital, you slyly enquire how the surgery seemed to other people. Your friends tell you they knew you would be fine. Your mother pretends not to weep. Your spouse rolls their eyes and tells you not to make so much drama of it all. Your kids hide from you, needy and avoidant all in the same moment in that way only children can manage to be.

It takes you a week to be able to get yourself out of bed. Your morning shit turns into hours of sitting, waiting for gravity and intestinal gas to do what peristalsis cannot manage for far too long after the surgical insult to your colon. You have a lot of time to think while perched on the toilet. You think about softer toilet seats and moisturized toilet paper, but you also think about how people don't tell you so many things lately, how even many adults are as avoidant as the kids, even if they're more subtle about their abandonment. You think about what it means to go through this, and what chemo will do to you, your family, and your friends.

You think that if you were finally going to find faith in your life, it could have been focused on something more constructive and less disturbing than
fucking cancer.

Someone comes into the room because you were yelling without realizing it. You can see the fear naked in their eyes. It doesn't matter who this is, because that same fear has stripped itself bare and slipped into the eyes of everyone who cares about you.

That is something you can believe in as well.

iv:
I acknowledge that my life will be spared or spent by the dark arts of medical science, at the mercy of statistics that can never tell my true story but only tell the story of my cancer cohort as a whole. I understand that my fate is in the hands of the cancer god, and that no matter what we do or how well we do it, I may never see an effective treatment. Or I may outlive you all. I accept what the statistics say about that, as well.

Chemo is an entirely different chamber of horrors than surgery. You find new fields of pain and loss there, novel revelations to feed your burgeoning faith in cancer. There are needles, of course, but you have rapidly grown accustomed to them. The drugs aren't so bad the first time or two.

But where surgery dropped you swiftly into a hole which then took a month to climb out of, chemo lowers you slowly, inch by inch, week after week, into a hole which you may never climb out of. Starting with your dignity and ending with your sense of self, chemo takes everything away from you.

Those mornings of yours grow later and later. You begin to miss work and misunderstand your spouse and children. The smallest things become difficult and the largest things become impossible. You never knew how large a thing standing in the shower could be.

You can't drive, and you don't have the energy to be a passenger for long, so you stop going out even when people are willing to give you rides. You stop seeing your friends unless they make the time to come to you. Your kids avoid you because you smell funny, like sweat and puke and chemicals. Your spouse doesn't hold you at night anymore because they are afraid of somehow hurting you.

You become ingrown, a tumor on the body social of your family and friends. Silent, mostly quiescent except for the daily violence of various fluids irrupting. You straddle the line somewhere between deadly and dead.

The worst thing is that chemotherapy robs you of your mind. You lose the ability to focus properly, to create, then to consume. In time you are reduced to watching reruns of old shows on Netflix streaming, because you can process nothing new. You repeat yourself when you speak at all. You feel desperation.

Cancer has covered over your life, a blanket damp with sweat and blood. You are tired beyond measure, like the day after a bad flu combined with the worst hangover you have ever had, and it does not end. Day after day, week after week, month after month, alone with your increasingly muddled thoughts and the whispered gospels of cancer being recited with every beat of your heart and every momentary flow of your blood.

“Memento mori,”
it tells you.
“Respice post te! Hominem te esse memento!”

“Remember that you will die. Look behind you! Remember that you are only human!”

Death becomes a kind of friend. It rides on your shoulder like a carrion crow. This skeletal bird remains as invisible to the people around you as your tumor ever was, but it affects them just as much. You are branded by its talons, blinded by the peck of its beak, deafened by its silent screeches, but this bird and you become closer than school chums, closer than lovers.

In time it grows into a sort of comfort. One way or another, this will all end. The story will go on, and be seen as a tragedy by some. But the promise of chemo is twofold. In death's own language it whispers to you that you might survive, or that you might come to an end. That far shore which surgery showed you unremembered glides past the sinking raft of your suffering. You can see all too well its towering black cliffs and crumbling ravines.

Someday, probably someday soon, you will go home to that place you've never been before.

v:
I know that cancer is my fate and my friend and my boon companion. Whatever becomes of me, cancer has remade my life as surely as the forge remakes the sword, as certainly as rain and sun remake the seed. Even in dying, I am reborn.

There is no devil mocking you. God didn't give you cancer to punish you. Colon cancer has come to you through a combination of losing the genetic lottery, cosmic rays, and perhaps too much bacon in your younger days.

Coming out of chemo finally, you know these things. Your life has been stripped down and annealed. Some friends have drifted away out of fear or a sense of frustrated helplessness. Your spouse might have left you in the face of the disease. That happens more often than even oncologists want to admit. Your kids cry because they're afraid you're leaving them soon. Your parents' eyes are haunted by this potential reversal of the natural order of birth and death among the generations.

Still, you are alive today.

When a Christian friend in mortal fear for your soul begs you to get right with God before the disease claims you, you want to tell him you have already found another faith. You believe in the end of all things, and though it is bitterly disappointing to face that far shore, you aren't so frightened as you once were. Death is no longer abstract. It's now a personal companion. The bird on your shoulder stays with you, and you want to share that with your Christian friend, but this is not a faith for which you can proselytize.

Cancer, like combat, is the Problem of Evil on the hoof. You have met the enemy and he is yourself. Your tumor children may yet claim you, but now you have a dark sort of faith to guide you through these, your darkest hours.

You still dream of that far shore and the blankness that will keep you from ever seeing it. That journey once made will never be remembered except in the echoes you leave behind in other people's lives.

There are no atheists in the oncology unit. Only the catechism of cancer, and the difficult comfort it brings even amid the worst of times.

 

Afterword

Once upon a time, I read a book.

It was on a college roommate's shelf around 1984 or 1985. I picked the paperback up in a moment of careless boredom, sat down to idly turn a few pages, and was hooked forever. On the author, on the language, on the notion that fiction could be joyous, transcendent, and substantial. That novel was quite literally why I became a writer.

The book was
Shadow of the Torturer,
and the author was Gene Wolfe.

*   *   *

Once upon a time, I sold a story.

It was one of my first major market invitations. I was thrilled to send the manuscript to Peter Crowther of PS Publishing. The acceptance put me over the moon. Then the signature sheets for
Postscripts
issue one came around in the mail. This was one of the first times I'd ever had to work my way through a stack of a thousand loose papers. And the other names on the page. Oh, my. A who's who of American genre fiction, from Ray Bradbury to Joyce Carol Oates and beyond. And some newcomer named Jay Lake.

The last name eventually to be signed on the page was that of my favorite author, Gene Wolfe.

*   *   *

Once upon a time, I went to an awards ceremony.

It was the Locus Awards in 2007 in Seattle. They were also holding an induction ceremony at the Science Fiction Hall of Fame. I was wandering about in the EMP building poking at things when I realized that one of the inductees had entered the hall early, presumably to rest his weary feet. I approached to congratulate him when he broke into a huge smile, turned to his wife, and said, “Rosemary, do you know who this is?”

I literally looked over my shoulder to see who it was that Gene Wolfe was so pleased to see. There was no one present but me.