10
I
was no longer kicking and screaming when Emma dragged me to the consultation with Dr. Parson that week. Actually, I'd begun to develop a sort of morbid fascination with thyroid cancer, as if I'd been invited to a train wreck and, though I knew it was risky, I couldn't help but climb onboard.
As a result of Emma's prodding I now knew the four types of thyroid cancer: anaplastic, follicular, medullary, and papillary. In the lottery of carcinomas, apparently I had gotten lucky: papillary cancer is eminently treatable, and patients usually have a normal life expectancy if diagnosis is made early. Emma's cousin, Keith, had told us that undiagnosed papillary cancer is often found during autopsies of patients who have died of unrelated ailments such as heart disease or stroke. Since this type of thyroid cancer has no symptoms, people can live their entire lives without being affected by it. Keith's med school stories were of some consolation, though I was still reserving enthusiasm.
Dr. Parson welcomed Emma and me to his office, then launched into a lecture about the basics of a thyroid. As I watched his pretty cherry lips move I wondered about this organ in my body that I'd never even been aware of before. Consider the thyroid, a flat little nob in the neck. My cancer was not related to cigarette smoke, not related to any known factors in my environment. So why had it betrayed me after all these years? Why me? Why now?
Et tu,
thyroid?
Dr. Parson cut off his lecture to take a pompous I'man-important-doctor call, and Emma leaned over to me and reviewed his lecture. “On a scale of one to ten? I'd give him three wormy apples. Thyroid for Preschoolers,” she whispered. “Do you like this guy?”
“I find him humorless,” I answered, “but is comedy really a prerequisite for a suitable surgeon? I mean, do I want a successful surgery, or someone who can kill at Caroline's on a Saturday night.”
“Point well taken,” she said as Dr. Parson returned to us.
“So let's talk about the treatment,” he said. “We recommend a total thyroidectomy. After the surgery you'll follow up with an endocrinologist who will determine your daily dose of Synthroid. And then there'll be treatment with radioactive iodine. Let me explain how the thyroid responds to iodineâ”
“We know all about the magic bullet,” Emma interrupted. “How thyroid tissue sucks up iodine, so you give the patient a small pill containing radioactive iodine. Any remaining or metastasizing thyroid tissue absorbs the iodine and gets nuked in the process. I was concerned about damage to other organs from the radiation, but I've read that the procedure has proven relatively safe. Jane will need to stay out of public places for forty-eight hours while the radioiodine is working through her body since it could harm children and pregnant women. Oh, and I also read that she should suck lemons or tart candies to maintain salivation during that time.”
Dr. Parson was staring at Emma as if she'd just voted him off
Celebrity Mole.
“I see you've done your research,” he said, turning to me. “Any other questions?”
“Actually, we have a list,” Emma said. “How many times have you done the surgery before, and what's your success rate?”
Dr. Parson frowned. “I've done the procedure many times, and I've never lost a patient on a thyroidectomy.”
Emma nodded. “We'll want a second opinion. Who would you say is the grand master of thyroid surgery in New York City?”
“There's no such person.” Dr. Parson was clearly annoyed with Emma and her list of questions. “It's a simple procedure. No controversy here, but you can get your second opinion. Just don't delay too long. In fact, you might want to book a date with my receptionist. I do surgeries on Thursday mornings at Murray Hill Hospital.”
As we were dismissed, Dr. Parson tried to soften the blow with a warm smile and words of encouragement about the longevity of patients with my disease. Emma smiled back, but I could see the truth in her eyes. Dr. Parson had not made the team.
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Working off a list of participating providers from my insurance company, Emma and I called upon three ENT docs. I was disappointed that there wasn't a single female doctor on the list, but Emma scolded that I must leave sexism out of this and search for a skilled surgeon.
A week later, I realized we'd met our match when Dr. Ken Scotto walked into the exam room and welcomed Emma's list of questions. He wanted to examine me, but I held up my hands to ward him off. “Don't even think about plunging one of those probes up my nostril,” I told him.
Dr. Scotto smiled. “You don't enjoy our distinctive brand of torture?” he teased as he pressed his fingers to my thyroid. “Yep, there it is.”
As Emma handed him the pathology report from the biopsy, I studied his long, somewhat calloused fingers. A friend had told us that Dr. Scotto had “beautiful hands,” which I realized was not literal; the fact that he had removed a neck tumor the size of a grapefruit and left barely any scar put him high on the list.
“What about the vocal cords?” I asked him. “Do you think they'll be damaged?”
He shook his head. “You might be a little hoarse for a few days after the operation, but nothing permanent.”
I cocked my head, reassured by the pressure of Dr. Scotto's hands on my neck. He wore a wedding band on his left hand, but a girl could fantasize. “So I'll still have a chance to sing on Broadway?” I teased.
He smiled. “I can't promise that.”
Emma and I exchanged a look. “Quick, call Julliard,” I said.
She nodded. “They'll need a new understudy for
Wicked.”
“Cancel my road tour, and we can kiss that lucrative voice-over work good-bye.”
Dr. Scotto grinned as he flipped through my chart. “It shouldn't harm your writing career. You'll just need a little time off. A week at least, probably two, until you're able to sing in the shower.”
We booked Dr. Scotto for the middle of January.
11
B
y the time Ricki arrived for her Christmas visit I was ready to take some time off, seize the moment, and squeeze out every glittering charm New York had to offer in my limited lifetime. Even if thyroid cancer didn't send me to that “great writer's workshop in the sky,” I was going to go eventually, from a heart attack or a car accident or some flukey event like a hair dryer falling in the toilet or a bolt of lightning or a paper cut that swelled into an infection of monstrous proportions. I wrote about these things every day; how was it that I'd imagined I'd maintain my humanity without a human exit from this world? Just self-absorbed, I guess.
Her brief tenure in the South had made Ricki nurturing and mellow at a time when I didn't mind being nurtured just a little. Together we soaked up the Christmas experience like two wide-eyed tourists in the Sugar Plum Fairy's Land of Sweets. She dragged me onto the ice at Rockefeller Center, and we laughed every time I went down.
“So much for my triple Sow-Cow,” I said.
Ricki skated up to me and smacked ice shavings off my jeans. “I think you sowed when you should have cowed.” After skating we sipped expensive wine at Morrell's, then sprang for tickets to the Christmas show at Radio City Music Hall, complete with Santa's 3-D Sleigh Ride and the Rockettes dancing their chorus line dressed as wooden soldiers.
By day we posed for photos at Macy's Santaland, sat for makeovers at Sak's, scarfed up candles and candies and ornaments at Bloomingdale's Christmas department, and lined up our shopping bags under our table as we sipped high tea in the lobby of the Plaza. At night we donned the dresses we'd scored that day and carried ourselves regally down the aisle of Broadway theaters. In one week we saw
Wonderful Town, The Producers, Wicked
and
Hairspray.
“Only feel-good musicals,” Ricki insisted, contending that I'd experienced enough catharsis for the year. She kept me on a positive track, looking forward with hope and laughter.
Only once had we cried together about my diagnosisâthe time I called her to spill my fears. I'd felt bad about dumping the news on Ricki over the phone, but not having much choice I had called her one night and closed my eyes against the tension in my chest. While the cartoon kids of
Peanuts
explored the meaning of Christmas on my TV, I told Ricki we needed to talk about something awful.
“That ENT I saw?” My voice sounded small, childlike, but I was unable to pull the volume up with my usual bravado. “He did a test. He says I have thyroid cancer.”
“What?” Ricki sucked in air. “Janey? Oh, no. I can't believe it.”
“It's true,” I said, relieved to have the most hideous words out. “I need surgery after Christmas. And the prognosis is good. Just scary.”
“I just, just can't believe you've been going through this.” Her voice wavered. “What can I do? Are you okay? Are you in pain?”
“No pain at all. No symptoms. Don't you worry, honey. I'm going to knock this thing on its ass.”
“Oh, Janey . . .” Her voice was fraught with that familiar catch, the flicker of pain that I'd come to recognize over the years when girls in the third grade were making fun of her, when she'd skinned her knee in the park, when a teenage boy had lied to talk her into having sex, when our father had fallen to the table with chest pain and never recovered. It was my job to keep that sound from Ricki's voice, my job to protect her. A sudden memory hit, a green spring day that had burst upon us after a stretch of cold, gray winter. We were kidsâmaybe seven and tenâand in our rush to get to the park before dark we had grabbed our roller blades and left padding and helmets behind. I remember digging into the pavement, shooting ahead with intoxicating speed, laughing and horsing around with my little sister while our mother sat on a bench reading. Ricki knocked me on my butt and in retaliation I whipped her around, sending her rolling away, off-balance. She went straight down, landing on her bare knees, shrieking in pain over her bloody, scraped knees. Mom closed her book and assessed the damage with a frown. “Nothing broken?” she asked, pinching Ricki's legs gently through her fierce wails. Still sobbing, Ricki shook her head frantically, her cheeks stained with sooty tears, her pain evident.
I knelt beside her and slid my arms around her waist and held her tight. “It's okay,” I told her. “I know it hurts, but it's going to be okay,” I soothed, pressing her face into my shoulder. Her chin trembled against me, and I held her tighter to absorb it all. Not so much the pain of the scrape, but the alarm, the sense of losing control, of the world spinning beneath you without an anchor to hold you down.
She sobbed, then hugged me back, allowing me to soothe her. As we followed Mom back to the apartment to clean up Ricki's cuts, I remember wondering why our mother hadn't known that Ricki needed someone to kneel down and hold her. Weren't parents supposed to know those things instinctivelyâthe precise laundry list of what their children required? It seemed odd that she was unable to mother us in the classic sense, but I didn't question her love, which poured through in other ways with a roomful of flowers on our birthdays, trips to museums around the country, autographed copies of treasured books like
A Wrinkle in Time.
Alice Conner cared for her children in the way she thought appropriate, but her aloofness left a gap that I walked right into with open arms, becoming Ricki's champion, nurturer, and caretaker.
The slightest sound on the line jolted me back, reminding me that my sister was crying on the phone.
“Nothing to be upset about,” I'd said as panic rose within me and bombarded my thoughts like legions of angry bees. If something happened to me, who would take care of Ricki? Who? Who would be her family? I had to stay strong, for her, but my body was revolting, my throat thick, my eyes burning with quickly pooling tears. “It'll be okay,” I said hoarsely.
“Oh, Janey, I'm sorry!” she sniffed. “I'm such a baby. Here you've got this scary news and I'm blubbering over the phone, but that's only because I care about you. You're my big sister and I've always relied on you and . . . and now it's my turn to step up and fend for you. I'm not going to let anything happen to you. Do you hear me?”
I squeezed my eyes shut and let the hot tears roll down to my chin, knowing that there was nothing Ricki could do, but also knowing that I needed to hear her pretend she could save me. “God, I wish you were here,” I said, wanting to lean into her, to sink against her slender shoulders and hide there for awhile. I sniffed. “This is bad phone news, I know, but it couldn't wait anymore.”
“Don't apologize. You should have told me sooner,” she said. “Do you want me to come up? I could get a flight out of Raleigh-Durham.”
“You can't leave now,” I said, the practical side of me emerging. “It's your big season. I'll hold out till you get here for Christmas. But you have to come this year. This thing, this cancer may not be fatal, but it's made me realize that we're not here forever. We've got to seize the moment, make things count.”
“Oh, God . . .” There was another catch in Ricki's voice. “I know you're right. You are so right, Janey, and I wish Nate could see that. Sometimes I feel like time is spinning by and I'm just keeping my hands busy weaving snowflake potholders. I know it's what I do, but there's more to lifeâjuicier things that seem to be lingering beyond my reach while Nate is floundering at pulling his life together.”
“It will come together,” I told her. “I see lots of juicy things in your future.”
“Right now it's your future we have to secure, Janey. I feel a little selfish, but I don't know what I'd do if anything ever happened to you.”
I took a deep breath, brought back to reality at the image of my sister the former girl scout weaving a potholder. “We're going to take care of each other,” I said firmly. “It's what sisters do.”
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Ricki got to work decorating my apartment, stringing lights on the balcony and draping garland over each picture frame. As the season progressed, I thought less about dying and more about living in each moment. I tossed out my worn socks and lingerie, cleared out the sad soldier boots from the back of my closet, then sprawled on the floor to update the address book on my e-mail.
“What are you doing?” Ricki asked as she wired shiny gold and burgundy beads into a circular wreath of real spruce branches.
“Getting rid of some dead weight, old boyfriends.” I deleted Carter with a quick click. Jeff and Darren and Austin met the same demise. “Ba-bye,” I said in a goofy voice. “Ba-bye, now!”
Ricki laughed. “Breaking hearts at Christmastime?”
“No hearts were involved, believe me. And I'm through with having sex for the sheer fun of it. I'm going to find some meaning in life . . . if it kills me.”
Ricki gasped. “Would you watch what you say?”
I closed the address book. “You've got to appreciate the humor in that. I'm going to live life to the fullest.”
Ricki smirked. “You are one odd duck. But I'm glad you're taking this so well. And you know what else? I'm sort of glad Nate didn't come along on this trip. I thought I'd miss him, but it's fun with just the two of us.”
“Ain't that the truth.”
“Jane. You'd like him if you got to know him.”
“Don't talk to me in that stern schoolmarm voice. I would like your boyfriend if he treated you right, but what the hell was he thinking, dragging you down to that cottage in the middle of nowhere?”
“I like living in the Outer Banks, and putting a few hundred miles between Nate and his ex-wife was the best thing that ever happened to us.”
I looked up from my laptop. “Do you love him, Ricki?”
She took a deep breath. “I really do.”
“But . . . ? There's a catch, right?”
“I'm not sure Nate is as into it as I am. I'm not sure he experiences anything in life with the same intensity I feel.”
“Do any men?” I flopped back on the floor, trying to think of just one man who felt things intensely. Maybe it was the reason I was drawn to intellectual types; I hoped that there might be something potent brewing beneath the surface.
“I think Dad did,” Ricki said. “The way he withdrew before a dig, preoccupied with working out the logistics and mystified by the possibilities. And then afterwards, âthe return to civilization,' as Mom called it. Dad was all sunburned and bearded and smelly. Mom used to tease him that he peeled off another layer on each dig.”
“Like an onion,” I added, smiling. “I can't believe you still remember that. You were only eighteen when he died.”
“Practically grown up. Or at least I thought I was. Thought I knew everything, now, eight years later, I know less.”
“Well, I'm pushing thirty and I know squat.” I stretched my arms lazily toward the ceiling. “Oh, to be stupid and content. You always talk a good game. Are you happy?”
She smiled. “Most of the time. And when I'm not, I just work harder.”
“Like Dad.”
“Honest work soothes the soul,” Ricki defended, twisting a piece of spruce into the ring.
“Tell me you turn life's lemons into lemonade and I will throw your wreath out the window.”
“So I should take a cue from you? âLower your expectations and you'll never be disappointed.'”
“Did I say that?” I grinned. “I used to be fucking brilliant.”
“Jaded.”
“Realistic.”
“Try cold,” she said. “But you've changed. Welcome back to the human race, Jane.”
I turned away to hide a smile. “I've gone soft,” I mumbled as I stared at the lights of the little tree Ricki had set up and admitted to myself that soft wasn't always a bad thing. A soft pillow, a soft bed, soft skin. Soft could be okay in the right forum.
A soft heart? Maybe that was another word for compassion.