Life, on the Line (48 page)

“I have a few ideas,” Keith said, grinning. Robert escorted us to our table and topped off our glasses of champagne.

“Have you made any decisions, Keith?”

“In fact, I have,” Keith said coyly. “Let's start with the ʹ90 Meursault-Genevrieres from Jobard, then some Henri Jayer wines. How about the'78 Vosne-Romanée ‘Beaumonts' and the '90 ‘Cros Parantoux.' ”

Robert looked down at Keith with a raised eyebrow and a giant smile on his face. I leaned over to Heather and said, “Holy shit.”

Keith and Charlene did a great job of keeping the conversation far away from all things cancer. The food started coming and didn't stop the entire evening. A rapid-fire succession of delicious courses and endless glasses of world-class wines were the distraction I needed. But from time to time, the pain in my mouth would bring me back to reality.

Desserts came and chef Shea Gallante appeared to say hello.

The grand meal was over, and I walked out thinking that it could be my last great dinner.

I
was more or less certain that I was going to die fairly soon. I couldn't wrap my head around the idea of having my tongue and jaw removed, but I could somehow accept death. While I didn't express these thoughts, both Heather and Nick clearly knew what I was thinking because they kept encouraging me to press on regardless of how unacceptable the treatment options were. Surgery wasn't great, they would say, but they insisted I was worth more than the sum of my parts. I wasn't so sure.

I returned from New York feeling reasonably well physically, but emotionally destroyed. Sloan was the pinnacle of American cancer treatment, so I lost all hope when the doctors laid out my dismal options. The doctor had said, quite simply, that if I didn't follow his course of treatment, I would die a painful death within six months.

When Heather and I landed at OʹHare I got a call from Nick, who informed me that Dr. Pelzer of Northwestern University was leaving his family vacation early to see me the next morning.

A few days earlier I had received an e-mail from Roger Ebert, the esteemed movie critic and writer at the
Chicago Sun-Times
. Ebert had suffered from cancer of the salivary glands and had gone through difficult years of treatment similar to those that were being recommended to me. The note read: “Dr. Pelzer is a kind, wonderful person. I trust him with my life, literally. I feel safe around him.” Additionally, he was kind enough to e-mail Dr. Pelzer on my behalf. I, however, didn't see the point in going, but I agreed to go.

We arrived early the next morning, and Nick walked up to the reception desk to check me in. The secretary looked puzzled and said Dr. Pelzer was on vacation. Nick explained that he was, in fact, coming in this morning to see Grant, and this confused her even more. “That seems impossible. He's in Colorado.”

The receptionist finally figured out that Dr. Pelzer had not yet left for Colorado and was just a room over. He came out in street clothes and led us into an examination room. In his midfifties, a bit shy and quiet, Dr. Pelzer didn't seem happy to be there, but he quickly explained why. “They all think I left a few days ago,” he said. “Otherwise, they squeeze in appointments like this one.” He chuckled and shook his head. I liked him immediately.

He gave me a quick examination, pulling and prodding on my very sore tongue, then took off his gloves, leaned back and gave a quick sigh. He seemed every bit the quiet, caring gentleman that Ebert described. “What did Sloan tell you?”

I relayed their diagnosis and told him what treatment they had recommended. At this point, I hoped and expected that he would disagree. Unlike the doctor at Sloan, Dr. Pelzer had a quiet confidence devoid of ego. I was hopeful that I would receive a different prognosis and a different recommendation for treatment. He paused a moment to reflect and looked at me square in the eye. “I'm afraid that what they told you is largely correct, although I never would have put it to you quite that way.”

The air left the room. Again, my hopes were destroyed, though this time I didn't have as far to fall and so I merely shook my head a bit.

“What pain medication are you taking?” he asked. “You must be in a great deal of pain.” I told him I was taking some Vicodin—actually, I was eating them like candy. He looked at me in disbelief. “These tumors are amazingly painful—one of the most painful cancers there is. So many nerve endings there. I'm going to write you a prescription for a patch that you put on your arm. It's fairly narcotic, so I wouldn't recommend driving much if you feel spacey from it. But it will relieve the pain and you'll be able to eat again.”

I was incredibly thankful for this, but Nick was impatient and incredulous. Our last great hope was recommending, essentially, palliative treatment. “Doctor. Look, we understand the situation,” he said. “But he's thirty-two years old, he tastes for a living, and really lives to taste. Is surgery really the only treatment? That just seems impossible. Given Grant's priorities and career, there must be something. I've read about other treatments and protocols.” Nick was desperate for an alternative solution.

Dr. Pelzer used a model skull to describe the physiology of the disease. He was thorough, scientific, and engaging despite the macabre subject matter. He discussed in detail the aspects of the type of cancer cells that had invaded my tongue. And he got into specifics that were all too graphic . . . how it would be easier to cut my jaw in half vertically and then open it up side-to-side and have access to the whole tongue to remove the cancerous tissue. How it was critical to remove it all, plus an area around it for “margin.” He would want to perform a radical neck dissection, and having watched the You Tube video that Nick sent me—he was thorough and unflinching in his research—I was terrified.

Then Dr. Pelzer, somewhat unexpectedly, as a way of wrapping up the description of the procedure said, “That is what I would do. That is what I have done for the last twenty years. But I bet Everett Vokes would tell you something very different. I don't know which is better; we can't know. But if it were me, my family, my friend, I would recommend the surgery I described. It's not pretty and it's destructive and painful, but it gives you the best chance to live. I would recommend the surgery and I would do it personally and with the greatest care. But if it's right for you, I can't say. That's up to you alone to decide.”

Roger Ebert was right. This is a doctor who cared deeply about his profession and patients. Clearly he thought his methodology was best, but there was a slight chink in the armor of certitude, a concession that treating cancer is often as much art as science. And while I tried to absorb what he had just said, Nick quickly asked, “Vokes is at Chicago, right? Can you call him for us? I've tried to get in there and haven't heard back.”

Dr. Pelzer recommended we see his radiation oncologist in the afternoon and promised he would give Dr. Vokes a call on my behalf. He wrote me several prescriptions for more pain medication, called over to Northwestern to book the afternoon appointment, and shook my hand. Somehow I felt a bit better.

We left the office and Googled Walgreens on our phones to find the nearest pharmacy. We walked through the city, getting lost along the way just as we did when we were building Alinea. At the first pharmacy they looked quizzically at my prescription and said, “We don't carry that sort of thing here,” and recommended another nearby pharmacy. We chuckled at the thought that they think we must be addicts. I looked terrible—tired, unshaven, and I could barely speak. Nick was an emotional wreck, and though he never lost his cool at the appointments or with me, I could tell his anger and sadness were sitting just below the surface.

We walked for a while without saying a word. It was a perfect, crisp day—unusual for this time of year—and we were only a few blocks from the lake. At a corner, we waited for the light to change and Nick grabbed my arm suddenly and said, “Look, I don't want to have this conversation with you but there are certain things that you should deal with now while we can—before surgery.” He kept talking about the surgery as if it were inevitable. “You need to get your life in order. You need to tell me what you want me to do for your kids. We have a policy on you for Alinea, and I'm sure a portion of that can be set aside for them—the investors are behind you, they're good people, and they're not concerned about the finances of Alinea. You need to write a will. I know you don't have much, but you don't want it in probate. That's a shit-show and lawyers will get whatever you do have. And you need to tell me what you want me to do with Alinea.”

“With Alinea? What would you do with it anyway?”

“I don't know. We could keep it open, doing the recipes and menus in your honor. I don't want the place for me. We could give it to chef Keller. I don't know. I just want to know what you want me to do with it.”

I smiled at him and said, “Why in the world would I give a fuck what you do with Alinea? If you have sole say in the matter, then that means I'm dead. Enjoy yourself, man. Do whatever you want.”

Somehow, we both found this unbelievably funny. We laughed out loud . . . looked at each other and laughed some more. We missed the light. We laughed at our idiocy and my misfortune.

We laughed because it wouldn't be at all cool to cry.

 

I helped Dagmara put the kids to bed and went and sat in our den, staring at the wall. I had been totally withdrawn for months, beginning with my mom's stroke and continuing right through Grant's diagnosis. I internalized it all, except when I was short-tempered, rude, and generally not great to be around.

Dagmara sat down next to me. “You know, people survive cancer all the time. Think of all of the women we know who have gone through hell with breast cancer and have come through it okay. You're doing everything you can, and he's a tough guy.”

I told her about the diagnosis at length and the hundreds of pages of abstracts on head and neck cancer I had sorted through on the Internet. Her father had provided me with data and patents on anti-angiogenesis drugs, and I sifted through the American Cancer Society website for hours looking for clinical trials or some other hope of alternative treatment. I looked at her and said, “Yes, dammit, I know it's not a death sentence. It's worse than that. It's a disfigurement sentence. The Grant that we know will cease to exist in a few weeks, and I'm sorry, but that is just tragic. And after everything with my mom, I'm just not certain that he isn't right.”

“Right about what?”

“That he might be better off not fighting.”

She paused and looked at me and hugged me. She could see I was struggling. I pushed her away for a second and she thought I was angry, but instead I pulled out my phone and showed her the picture of the duck dish he had made that night. “Look at this. When I came back from Michigan that night he made me duck.”

I lost it completely. I started sobbing uncontrollably as Dagmara looked at me.

Then she hugged me again and let me be alone. And I determined that it would be the first and last time I let that happen. From here on out, we were moving forward.

 

I had told my parents and the staff at Alinea. We had seen three doctors at three different hospitals. Nick was reaching out to pretty much anyone who might know something or someone to see if there was another treatment option. At some point, my story was going to leak to the press. “A Top Chef Has Tongue Cancer” is a man-bites-dog kind of headline. It would definitely make the papers.

Nick and I were alone in the front dining room of Alinea trying to decide what to do. We had a long talk about scheduling the surgery. The more set I became on doing nothing, the more Nick turned the conversation to Alinea.

“What do you want to do regarding the press? I think it's going to leak out soon enough. There is no way that our entire staff keeps silent on this, let alone all of the doctors and friends we've called. I think we should draft a very simple press release and send it off to a few key food writers.”

“Fine. Do it,” I said.

“What do you want to say?” he asked.

“Say I have cancer and am going to die, but will be working here in the meantime.”

Nick went off to the computer in the basement. I sat looking around at the dining room for a minute, then grabbed the clipboard to see what the reservations looked like for that evening. A few minutes later he returned. “I wrote something up. I figure, keep it short and to the point. Do you want to read it?”

“Absolutely,” I said.

It read:

“That's fine. I want to send out a few of these personally first. I was thinking that writers like Penny Pollack, Phil Vittel, Ruth Reichl, and Pete Wells need to see this come from my e-mail address. Then send it to Jenn Galdes and let her put it out to everyone else.” I was reluctant to tell the world. I knew that once I told everyone it would be real.

 

I called Jenn, our publicist, from my car and let her know that Grant had sent off the press release. “He wanted to do it personally,” I said.