Part 9 (1/2)

It's back-to-school time and, for the first time in her whole academic career, Cheri has no school to go back to. She wakes up with the thump of I'm late for cla.s.s only to realize another long day stretches ahead of her. Still, fall is her favorite season: crisp air, fresh start, new notebooks. The review committee did nothing in the August doldrums but she's heard that they will soon start interviewing students from Richards's cla.s.s. The thought of her peers questioning her former students about her work is demeaning. Does her entire career really all hinge on the interpretation of her questions about prost.i.tution? Every act of translation is interpretation. How many times did she say that to her students, never antic.i.p.ating that one of them would turn the idea back on her. Unlike when she was in college, kids like Richards feel ent.i.tled, as if merely showing up means they should get good grades. And the university certainly doesn't dissuade them from that notion.

All she can do is hope that the wheels of the academic gestapo churn faster than those of international consensus for a war in Iraq. It's not exactly a consolation, but progress on the Tell Muqayyar tablets is as stalled as she is. With talk of UN inspectors returning, it's possible that Saddam will acquiesce to Western demands for full transparency of nuclear sites rather than risk war. In a perfect world, the sea would part on both fronts, and they could be able to get into Baghdad. She has the urge to e-mail Peter Martins to ask once again how the photocopying is progressing. Samuelson didn't mention her suspension to anyone at the British Museum, but, in stark contrast to her own wasted summer, Peter has a museum's worth of projects on his desk-ones that aren't bogged down by external events. She gnaws on a pretzel she rescued from an untimely demise and thinks it's time for her luck to change.

The car ride to the doctor is thick with what Cheri and Michael leave unspoken. Cheri relegates herself to duckling status, silently following him into the waiting room and, once the doctor beckons, into his office. She's about to introduce herself since Michael hasn't bothered when the doctor abruptly announces, ”It's not what we'd hoped for.” Michael's a.s.s hasn't even hit the chair and the doctor barrels on: ”Your biopsy results indicate pancreatic cancer.” The doctor's mouth is moving and he's talking about early detection, surgical options. Michael holds up his hand. ”But what about celiac? All my symptoms.”

”Pancreatic cancer is hard to diagnose because the symptoms are so vague; it's often mistaken for something more benign. That's why we did the endoscopy and took a biopsy. Now, if you'll look here, I can show you what we're talking about.” Michael is clearly blindsided. All Cheri knows about pancreatic cancer is that it's one of the bad kinds. This is all happening too quickly.

The doctor displays images of Michael's pancreas, then fans out laminated diagrams of the organ and points to the salient features like he's a car salesman.

Cheri stares at the diagram of the pancreas like it's a Rorschach test. ”You're positive? No test is one hundred percent accurate, is it?”

”Tissue doesn't lie. You're welcome to get a second opinion, the faster the better. It's imperative to stage the cancer so you can form a treatment plan. I'll refer you to an oncologist at the cancer center here. Likely he'll do a pancreatic-ma.s.s CT to a.s.sess the tumor for size, location, and involvement of the surrounding organs.”

”f.u.c.k me,” Michael says. His left eye twitches like it does when he's overtired or lying.

”But we've caught it early. He hasn't been feeling sick for that long. It's in the early stages, right?” Cheri asks, grasping to put this into some kind of perspective.

”That's what we're hoping for, which is why it's important to move quickly and aggressively. This is a very tricky kind of cancer, and we won't know if the tumor is operable until we see if it's contained or if it's spread to other organs.”

The doctor's voice sounds like the teacher in the Peanuts cartoons, Wah-wah-wah. Michael's lost in the fog of news too bad to absorb. ”Can you hold on a second?” Cheri fumbles through her purse to get a pen. ”Sorry, so sorry.” She writes: Ampulla vedar (sp?) spread to lymph nodes? Exocrine system. After staging determine if ressectable-pancreatoduodenectomy, Whipple procedure. Can't give chances of survival until tumor is staged. Her handwriting is loopy and her hand is shaking.

”Is this a death sentence?” Michael's hand covers his face. ”Is that what I'm looking at?”

”Michael, no, n.o.body is saying that,” Cheri says emphatically. Who is she trying to convince, she wonders. Herself or Michael?

”It's far too early to speculate; there are new treatments and if you're a candidate for surgery and the cancer is contained to the pancreas, it can be successfully eliminated. The oncologist will go over all of this with you.” With a loud sc.r.a.pe of his chair, Michael is up and out of the room.

”It's quite common to feel overwhelmed. It's too much information to process all at once. Here's a handbook with treatment options, support groups, et cetera-I'd stay off the Internet, as there's a lot of misinformation and worst-case scenarios. Call Dr. Perry right away. My nurse will give you his card and can help you schedule an appointment. He's very booked up.”

”I appreciate that, Dr. ...I'm sorry, I didn't catch your name.”

”Fishman,” he says, handing her his card.

”I meant first name.”

”You can just call me Dr. Fishman.”

Cheri looks at the card. ”Thank you, Karl.”

If there was one thing Sol had taught Cheri about doctors, it was that you needed to level the playing field. She imagines her father had the same lack of bedside manner as Karl.

When she walks into the waiting room, Michael isn't there. Cheri gets Dr. Perry's card from the nurse. ”My husband, did you see him leave? Tall guy, salt-and-pepper hair?”

”Just got here, so no, but he can't have gone far,” the receptionist chirps, giving her a big smile. What a job, Cheri thinks. You'd have to be a cheerful idiot to survive.

By the time Cheri reaches the elevator bank, she can feel the edges of panic nibbling at her chest. She has the car keys but Michael might have taken off anyway. He did it once before, after a fight outside a restaurant. She'd driven around for hours trying to find him because he wouldn't answer his cell. She eventually went home and found Michael already there-he'd taken the bus. The thought of him right now taking a bus, surrounded by strangers, makes her throat catch.

Following a full check of the main lobby and the downstairs men's room (she had a janitor go in to call his name-”Michael s...o...b.. anyone in here named Michael s...o...b..”), Cheri races to the parking lot, which now seems nothing short of Kafkaesque. Didn't she just walk past that gray Toyota? She knows she parked on level four, green, so where is the G.o.dd.a.m.ned car? Her hand shakes as she takes an Ativan from her purse and swallows it dry. Cheri briefly wonders how many she has left before Dr. Vega forces her back onto the couch in exchange for a refill. Cheri wanders up and down the aisles, holding out her keys like a divining rod. ”f.u.c.k,” she says. ”f.u.c.king f.u.c.k!”

”Where the h.e.l.l have you been?” Michael suddenly appears, stomping down the middle of a ramp from the level above. ”I've been waiting for you for thirty minutes. You insist on driving, you take the keys, but then you never remember where you parked.” He turns on his heel and walks back up the ramp. ”Green Four. How hard is that? Number-one rule of being the driver, note the signage.”

”There's a West Green and an East Green, it wasn't clearly marked.”

”It says Four West right here, with a green square. h.e.l.lo? Now give me the keys.” Just because he's scared, does he have to be even more of an a.s.shole?

She hands him the keys. ”We're going to get on top of this.” She gets in the pa.s.senger side of her Jeep. ”We'll get other opinions. Chicago has the best cancer facilities in the country, but if we have to go out of state, we'll go out of state.”

”Duane's father went to Johns Hopkins, and we know how that turned out.” Duane was Michael's accountant. It takes her a moment to remember-his father died of pancreatic cancer. After ratcheting his seat back as far as it can go, Michael struggles with the ignition, turning it on and off. She'd been meaning to fix the starter. ”Give it some time,” she says, and he lets out an exasperated sigh. He turns it off and then on and then he floors the gas pedal. The engine finally lurches to life.

When they get home, Michael takes his yoga pillow and mat and retreats to his office. An hour later, she goes to check on him. She finds him on the floor in the lotus position. She can tell he's straining to quiet his mind, and his exertion is clearly visible; his T-s.h.i.+rt is damp around the neck, his left eye twitches. When Michael was a kid his mother would tell him, ”That's good but imagine how well you'd do if you tried harder?” Cheri can't imagine how hard he's trying now. What can she say to or do for him? She would like to take back the words, the horrible news of today. But she can't take back all of the moments big and small that led to disappointment and hurt until they were so deadlocked that they stood over the dishwasher, panting from anger. She had been slowly acclimating herself to the discomforting but liberating notion of an exit and now their lives were unalterably changed. She would like to bend over, wrap him in her arms, in spite of, because. But even in his newly vulnerable state, Michael seems unapproachable. He moves his neck from side to side, sighs heavily, eyes tightly squeezed shut.

Cheri roams the house like a dog searching for a comfortable spot. Of course she's going online. How could she not? Pancreatic cancer, she learns from her first hit, is Napoleonic. Nasty and short, it invades everything around it. Everywhere she goes, she's hammered with facts and statistics she doesn't want Michael to see. Her finger remains poised to close the browser at the first sound of his footstep. One website comes with a warning: Some patients may not want to read the following. Cheri reads it all: thirty thousand deaths per year, average one-year survival rate, only 3.2 percent of patients survive more than five years. She finds a few defeating-the-odds comment threads: a woman who says qigong healed her; a man who claims to have survived through diet and prayer; patients who were told they had three months left and had lived three years. She reads that the chances for five-year survival increase to 30 percent with a surgical procedure called the Whipple.

Cheri's stomach is gurgling. She reads that by the time pancreatic cancer patients are showing symptoms, the disease has already invaded other organs. It could have been lurking for months in silent invasion. She ignored his constant exhaustion, writing it off as laziness and disaffection. Now that she thinks about it, he had been complaining about his stomach after meals. She should have paid more attention. The struggle to feed and be fed is a battleground, per the website. ”Enjoy your food,” Milton the Penguin's wife says as she serves him kippers. How can she be the penguin wife? Hunting she could do, but Michael does the shopping. She hates grocery stores and will wind up getting the wrong things, and he'll say, ”What the f.u.c.k is that, you know I can't eat that. It will kill me!” Only this time he won't be exaggerating.

Michael is in the den, sitting on the sofa, watching the news. ”Do you want anything? Soup? I can order in.” When he doesn't respond she says, ”Listen, we can't get ahead of ourselves; we'll take it step by step. Make a plan.”

”We? This isn't a group activity last I checked.”

”I'm obviously not going to say the right thing now. Which is fine. I can't walk in your shoes, but I'm here. For whatever that's worth. You are not alone.”

”I need to feel what I'm feeling without you trying to make it better. Can you respect that?”

Cheri had always believed she could do anything she set her mind to; it was a matter of will and perseverance. But she hadn't gone through a major medical crisis with anyone close to her. Sol's death was immediate and unexpected-he had dropped dead in the middle of the street, carrying a Thanksgiving turkey. She stands with the refrigerator door open and feels lost. Is prosciutto still edible after four weeks? Is it milk or water you put in eggs for an omelet? She pulls out what's left of her mother's cured pork and peels off strip after strip, hardened edges and all, chewing mindlessly until nothing is left but the wax paper.

The next days are a muddle of exam rooms, expectations, and fear. Waiting for doctors who a.s.sure them they are the best; for Michael to be inserted and extracted from machines; for insurance to preauthorize; for medical records to transfer; for the phone to ring with results. The hospitals feel like airports-transitory places with too many people, bad lighting, overpriced food, and chairs that hurt your back. A place you want to get out of quickly, but it's never that simple. One in three. One in three people will develop cancer in their lifetime, but who will be the one? She tries not to stare at the pretty young Asian woman sitting across from her in the waiting room. She's wearing a scarf to cover her baldness. What kind of cancer does she have? Cheri imagines asking her, So, what are you in for? As for Michael, he keeps looking like Who is everyone talking about? I'm not sick. I don't have cancer. He looks nothing like the gray, gowned ghosts shuffling down corridors trailing IV lines like mutant jellyfish.

Cheri and Michael are two planets traveling in their separate orbits in the same solar system. They intersect briefly, then return to their own paths. Michael meditates. It seems like whenever Cheri walks into his office or their bedroom, he is on the cus.h.i.+on, eyes closed, palms open or sometimes positioned in mudra at his heart. One night she woke up to a loud ripping sound. Michael was tearing his T-s.h.i.+rt so it fell off his chest, saying over and over, ”Why, why?” Seeing him literally rend his garments was so painful, so private, she burrowed back under the covers. The ripping sound reverberated in her mind even when he'd calmed down and slid back in bed. As for her, she walks around, saying sometimes out loud but mostly to herself, ”He will be the exception, not the rule.”

News from the team at the cancer center isn't good. Michael's tumor is inoperable; the cancer has spread to the lymph nodes close to his liver. The lead oncologist, Dr. Perry-Randall, as Cheri insists on calling him-a humorless man with skin that looked parboiled, has a.s.sembled a team of experts to make their pitches. Michael is still healthy enough to be given a combination of chemo drugs, and the doctors are debating which protocol to use, weighing side effects from nausea to potential nerve and kidney damage. Cheri sees Michael's aneurysm look and feels his rage coming like a pressure drop.

”Let's just cut to the chase,” he barks. ”Are we talking a year?”

”Given the stage of the cancer and location, the prognosis is typically six months to a year after chemotherapy. With a clinical trial, maybe more.” Dr. Perry moves into a hard sell on a combination of chemotherapy and radiation; the chemo guy holds up a port system for the administration of drugs at home. He pulls a tube out of the f.a.n.n.y pack, demonstrates how it will connect to a port Michael will have in his chest. Suddenly it all feels too real.

”You're not going to point to the exit rows and tell me to put my mask on first? I've got the picture, and no, I won't be trying this one on for size,” Michael says, waving away the f.a.n.n.y pack. ”I want to think this through-including alternative treatments. I know you guys aren't high on those, maybe because the drug companies don't make money off them, and the drug companies fund your research. It's to your benefit to push what they're selling. Even if it makes people feel even worse than if they did nothing. But you doctors have to do something so people feel like they've tried everything possible.”

”That's an extremely cynical viewpoint,” Dr. Perry says, ”and misinformed. The statistics on chemotherapy clearly show that it does prolong life in many cases.”

”I'm aware of the statistics. But unlike a lot of people, I'm not a sheep who will just follow the flock, not unless I believe it's right for me.”

Cheri might have been proud of Michael for being true to his stance on Big Pharma if this didn't scare the s.h.i.+t out of her. ”Let's just get back to the options. At least hear them out,” she says.

When Michael asks questions about nontraditional protocols, Dr. Perry officiously recites statistics to show that enzymes, diet, supplements, and daily coffee enemas do nothing more than act as placebos, sometimes accelerating the course of the disease.

”This cancer is extremely aggressive and we've caught it late. If we don't make an offensive strike with chemo and radiation right now, you won't even get to the six-month mark.”

”Other than that, Mrs. Lincoln, did you enjoy the show?” Michael says. ”Thank you, gentlemen, and good night.” Michael laughs ruefully in their faces. The odds are awfully rigged, but if you're going to fight, Cheri believes, at least have the right weapons.

In the car, Michael buries his head in his hands. They sit in silent deflation, and Michael's shoulders start to shake. ”Oh, baby, I'm so sorry,” Cheri murmurs, touching his back. He lifts his head up and she's shocked to see he's laughing. A big peal of laughter rises from his belly. ”What?” she asks, confused. ”What's so funny?”