Promise Me (17 page)

I
didn’t let much grass grow under my feet. Within a month of changing the locks, I went to work as an account executive at a terrific advertising agency in Dallas and started dating a great big swashbuckling rancher. Other than the cowboy boots and mud-spattered Mercedes and private jet, he was a throwback to that born-to-be-wild boyfriend I’d loved in college.

Suzy didn’t like it one bit.

“Nan,” she sighed. “It’s hard enough to be a good mother without all these distractions.”

“I hardly call life a distraction. Someday when you’re old, you’ll be sorry you never had any fun.”

“I have fun. You were at Steffie’s birthday party. What’s more fun than sixteen four-year-olds?”

“You really want me to answer that?”

“No, I want you to meet a nice Jewish man who wears regular shoes and hasn’t been divorced twelve times.”

It was a joy to kibitz over sisterly things instead of the dark cloud. To ask each other, “What are you making for dinner?” or “Did you see
All in the Family
last night?” We laughed about the clothes people were wearing to Studio 54 and chattered over plans to visit Mom and Dad in Florida that summer. Those months were like an oasis. A luxury. I see that now. Once again, the heartbreak was that it didn’t last.

Six months after her original diagnosis, Suzy called me, beyond distraught.

“Nan, there’s a hard lump under my arm.”

“Oh, God. Oh, Suzy.…”

I covered my mouth with my hand. Denial. Anger. Bargaining. Depression. I felt them all hit me at once. Everything except acceptance.

“You can fight this, Suz. We will fight this together.”

“Nanny, I’m scared.”

“I know. Me too.”

I brought up the idea of M. D. Anderson again, but Suzy wanted to go somewhere familiar. When Mommy’s uncle was dying, she’d taken him to the Mayo Clinic in Rochester, Minnesota, and Suzy had gone there to visit him and to support Mom. So Suzy went to Mayo.

She and Stan had chosen not to tell their children about any of this, and she was adamant about keeping it from them as long as possible. For me, not telling Eric was a simple choice; he was a preschooler, far too young to understand, and didn’t see Suzy on a daily basis. It was a more difficult call for Suzy and Stan: Scott was a smart, sensitive boy already in elementary school, and Steffie was this tender, tiny girl still at that age where Mommy is everything—love, warmth, water, light, the house you live in, the center of the universe. Suzy loved them both with the ferocity and vigilance of a mama tiger, and what was best for them was the touchstone by which she made every decision over the next two years.

The first step would be to open her eyes, and she was ready to do that now. She was ready to know everything she didn’t want to know. At the Mayo Clinic, she saw an oncologist and began a battery of tests. Scans showed the cancer metastasizing to lymph nodes under her arm. There was also a tumor in her right lung. Other “suspicious shadows” haunted the images elsewhere. The oncologist who assessed her recommended thirty days of radiation.

“Then what?” I asked when Suzy called to update me.

“Then we watch it for a while,” she said.

I had to physically bite my tongue. We all felt like we’d just stepped out of a storm cellar into a tornado;
watching
wasn’t a course of action that really resonated for me. Suzy considered it, talked it over with Stan, and decided to do the radiation, but at the end of the thirty days, scans showed the cancer advancing unabated, raging through her lymphatic system, lungs, and other organs. Watching wasn’t even an option.

“The next step is an oophorectomy,” she was told. “Sometimes there’s
remission or at least some shrinkage in the tumors after removal of the ovaries.”

Of course, we now have a better understanding of the connection between estrogen receptors and certain types of breast cancer, particularly the type of breast cancer that strikes younger women—thanks in part to research funded in Suzy’s name. Scientists had been speculating since the early 1900s, but in 1978, finding the estrogen-breast cancer connection was still a bit of a fishing expedition.

“What happens if that doesn’t work?” Suzy asked.

The oncologist shook his head. Suzy went ahead with the surgery, hoping for the best, but we didn’t see any immediate improvement.

Less than thrilled with the reconstruction she’d had after the subcutaneous mastectomy, Suzy had previously consulted a plastic surgeon in Peoria. She liked and trusted him, and when she asked his opinion, he recommended M. D. Anderson in Houston.

“I guess she needed to hear it from someone other than her little sister,” Mom told me. “She’s decided to go there.”

However she got there, I didn’t care. Weak-kneed with relief, I got on the phone to my Houston contacts.

W
aiting to hear her name called in one of the many waiting rooms where we’d spend much of our remaining time together, Suzy elbowed me and said, “Fancy meeting you here.”

In the moment, it felt good to laugh a little, and in retrospect, I cherish the way Suzy and I stayed ourselves, together, through all that was to come. We laughed, talked about our kids, made healthy observations about handsome young doctors, and never stinted on saying “I love you.” All the good moments stand out with intense sweetness, because running through every waking hour was the deep undercurrent of fear and sadness. She felt betrayed, I think, by the handsome surgeon, by God, by her own body, and by her woman’s intuition. The injustice of it was flatly infuriating to me.

“What kind of sense does it make?” I seethed. “Why should this happen to someone who does nothing but good for other people?”

“You’re right,” said Suzy. “I should be rich. Living on the French Riviera.”

“Purely from a personnel management point of view, wouldn’t it make more sense if this sort of thing would happen to an ax murderer?”

“God really should manage these things better.”

“I’d be happy to provide Him with a list.”

Suzy laughed and leaned her head on my shoulder. As an hour or more dragged by, we both nodded and drifted. For a moment we were on a train bound for Munich.

“Nan.”

“Hmmm?”

“I was thinking about Betty Ford,” she said. “She took the chemo. If she can do it, maybe I can too. And if the First Lady of the United States can stand up in front of the whole world and admit she has breast cancer and she intends to fight it, …”

A nurse opened the door and called, “Susan Komen?”

I squeezed her hand. “You can do it, Suz. Mrs. Ford did it. You can do it.”

In a dangerous, high-speed polo match, the all-consuming objective is to hit the ball into the goal. In the process, the grass is torn up, palms are blistered, and noses bloodied. It would be an unusual match if no one was hurt to some degree, but there’s an acceptance of that before the game begins. The players know there will be collateral damage, but they ride out anyway, in pursuit of that all-consuming objective. Not because it’s easy, but because it’s hard.

Perhaps that’s too cavalier a way to describe the people who make their lives and livings in the cancer treatment industry, but I’ve observed that same brand of undeterred passion in one cancer ward after another. The oncologists, nurses, researchers—even many of the housekeeping and clerical staff—are focused on the goal. They know that sooner or later they’ll be hurt, because they can’t insulate themselves from caring, but they show up every day and care anyway.

Up to this point, Suzy was basically in the care of one physician at a time. He told her what to do, and she did it. That’s the way it worked back then. People were trained to follow “doctor’s orders,” and a lot of physicians
were autocratic—and undeniably sexist—in the way they doled out those orders. At M. D. Anderson, there was a completely different modus operandi. Doris Bechtold, the wonderful patient care coordinator, met us at the door the very first day. A team of people was assembled to respond to Suzy’s individual situation. Each team member brought his or her particular strength and expertise, but Suzy was indisputably in charge as they rode out in tight formation.

Her oncologist, Dr. George Blumenschein, was a Cornell man who’d done his postgraduate work at Bellevue Hospital in New York; the National Cancer Institute in Bethesda, Maryland; and Duke University Hospital in North Carolina. His credentials were varied and impressive, his work was well known and respected, and his patients adored him for his gentle good humor. The entire staff at M. D. Anderson was (and is) so wonderful, it’s impossible to list all their names and praise each of them adequately, but I remember being awed by Dr. Blumenschein’s breadth of knowledge and so very grateful for the way he empowered Suzy with hard information and encouraged her with realistic hope. He had enough respect for her strength and intelligence to pull no punches.

“You’re Stage IV,” he said. “The most critical scenario possible. I’d put your chances of long-term survival at about 25 percent. But there are aggressive measures available to you here, if that’s the way you want to go.”

Suzy said, “I want to fight it.”

“Okay,” said Blumenschein. “As long as you won’t give up, I won’t give up.”

“Okay.” She nodded.

“Let’s give it all we’ve got.”

He recommended removing the lesion from her lung and offered her a place in a clinical trial—an experimental program researching a state-of-the-art treatment protocol. Suzy started receiving a chemotherapy cocktail of powerful drugs, including steroids intended to beef her up enough to withstand the onslaught of good old doxorubicin—“the red devil”—and other chemicals.

I suppose you could apply the polo dynamic to chemotherapy on a cellular level; you go into it knowing there will be collateral damage, but that all-consuming objective is worth risking everything. These days, far more options and better-targeted treatments are evolving, but in 1978,
there were less than a dozen drugs commonly used against breast cancer, and it was very much a shotgun approach. Chemo was designed to attack fast-growing cells, and there was nothing “smart bomb” about it. The toxins didn’t differentiate between the fast-growing cell in a malignant tumor or the fast-growing cell in a hair follicle, the endothelial tissue lining the stomach and mouth, or any other part of the body that specializes in constant growth and regeneration.

Within weeks, Suzy was bald and fatigued. Her mouth and throat were pocked with sores. There was a translucent, almost angelic cast to her complexion.

“My skin actually looks beautiful,” she said. “Long way to go for a facial, though.”

Over the many months she was treated at M. D. Anderson, we all tried hard to be with her as much as possible. Suzy’s wonderful friends stepped in at home in Peoria so Stan could go with her sometimes, but Suzy was more concerned for her children than she was for herself, and she knew they needed their father when she was gone. Daddy had a terrible time dealing with the strong emotions that came with seeing Suzy in that setting, but Mommy was there for her every possible moment. I took as much time as I could, though I needed to keep my income alive and hated leaving Eric. Every time he saw me packing my bags, his expression clouded over.

“Mama, are you going
again?
”

He wasn’t whining, just struggling to understand. I finally decided to tell him the truth.

“Honey, Aunt Suzy is very sick. I hate to leave you, but she needs me now.”

I knew Eric needed me too, and it tore me in half, but astonishingly, that simple modicum of honesty made all the difference to him. He was a preschooler with no concept of cancer, chemo, flight schedules, comp time—all the heavily weighted factors I was constantly juggling. But he accepted without question that when someone you love needs you, you go to her. Of course you do. It really is that simple, and it grounded me to suddenly see it through his eyes.

Month after month, through grueling courses of chemotherapy and radiation, surgeries that left her feeling truncated and unsexed, Suzy
came and went through a revolving door of emotion: grace, anger, gratitude, sorrow, laughter, grace again. She was stronger than I ever expected her to be—stronger than I wish she ever had to be.

Mommy, Daddy, Stan, and I worked together to make sure she was never alone in Houston. At least one of us would travel with her and stay at the little apartment across the street from the medical center. We were grateful for the place, because it cost a lot less than hotels and offered Suzy a little home away from home. My apartment in Dallas functioned as the staging area, a sort of base camp where she could decompress on her way to and from each treatment. She adjusted her expectations and lifestyle to the treadmill that kept her alive—a little longer, another day, one more step, one foot in front of the other. I tried to make those Dallas days a treat for her. If she was up to it, we went shopping at Neiman Marcus, had lunch at her favorite places, took in a movie, or visited local art galleries. Sometimes I arranged dinner dates for us with two of my handsome friends, and we spent a good hour beforehand getting ourselves dressed to the nines, doing a full makeup job, playing with her hairdo on the Styrofoam wig head. If she couldn’t find the energy to go out, I made sure she was tucked in with fresh lavender pillowcases, silky pajamas, and a good book.

She looked beautiful, despite the effects of chemo and radiation.

“I’m not fat, I’m zaftig,” she said, as steroids filled out her slight form and softened her sculpted cheekbones. Her skin was luminous and lovely, chemo being the epilating and exfoliating demon that it is. After axillary lymph nodes were removed and the area irradiated, she fought off pain and swelling from lymphedema in her arm, but she wore long sleeves and worked around it. For her second course of chemo, they installed a “Gershon”—a subclavian catheter—in a vein above her collarbone, creating a port through which she could receive IV drugs from a little pump that she wore on a strap around her shoulder. A little Frankenstein-ish, but the veins in her arm had collapsed from all the injections, and this meant they didn’t have to keep searching for new ways to stick a needle in her.