It was one of those lousy late-fall New York evenings, cold and dark and sort of half-raining and half-sleeting. I walked out of my office, and slipped on a patch of ice. It wasn’t much of a slip. I just twisted my left hip, then caught my balance. I went on my way.
The next morning, my hip hurt. I’ve had sports injuries over the years, and it felt like that—a torn ligament, maybe. I figured I’d rest it and it would go away. Then a few weeks went by and then another few weeks, and it still hurt. In January, I went to see my orthopedist. He took X-rays but didn’t see anything wrong.
My hip kept hurting, but I was too busy to see a doctor. A few months earlier, my wife, Didi, and I had bought our first apartment, and we were still getting settled there. In February, I left the start-up magazine I’d been working on to take a job here at New York. And in April, we had our daughter, Abby. I was 37 years old and healthy. A sore hip didn’t seem that important.
By November 2003, though, my hip hurt all the time. I couldn’t run, and it was getting hard to pick up Abby. It’s been a year since I did this, I remember thinking. It’s not going away on its own. I went back to the orthopedist. He ordered an MRI.
I remember worrying about getting claustrophobic in the machine—that was what I considered a major medical issue. But after I got the MRI, I basically forgot about it. I figured, worst case, the orthopedist, whose name is Lon Weiner, would tell me I needed some minor surgery. A day or two went by, and I got a call at work: “Dr. Weiner wants to see you. He’s got your MRI results.”
This is how naïve I was: I thought, Wow, that’s great. This guy is calling me with my test results before I even have a chance to call him.
On November 4, five days after the MRI, I went back to Weiner’s office. They took me straight to an examining room.
One of the things about growing up in the age of TV is that we’ve seen all of the big acts of the human drama—weddings, births, deaths—played out before we’ve experienced them. What happened next had an eerie feeling of familiarity about it.
Dr. Weiner came in and closed the door. He told me to sit down. He sat directly across from me, fixed me with a professional gaze, and said, “I’ve got the results of your MRI. There is a lesion on your hip.”
Only this wasn’t an ER episode. And Weiner’s voice, dispassionate as he tried to make it, contained an unmistakable trace of actual human horror.
“A lesion?” I said. “You mean a tumor?”
“Yes,” he said.
And just like that, I had cancer.
“NO.”
I used to think of denial as a pop-psych cliché. Not anymore. The first thing I said to Dr. Weiner was, “No. No, no, no, no. This isn’t possible. I’m 37 years old. I feel fine.” And then: “I have a 7-month-old daughter. This cannot be true.”
The tumor was nine centimeters by seven centimeters by four centimeters, Weiner told me. Good, I thought. Centimeters. Small. A moment later, he called it “large.”
From the evidence at hand, the radiologist speculated that I had something called a chondrosarcoma—bone cancer. He made a point of saying that the tumor could also be a secondary tumor related to a primary, not yet detected cancer.
I started tossing out crackpot theories and terms I don’t really know the meaning of. The slip on the ice—could this be some kind of calcification or bone spur? Weiner said it wasn’t likely.
The tumor was in a tricky spot, he said. It was in the socket part of the ball-and-socket joint that is your hip. He said I’d probably need chemotherapy, and surgery to remove a large part of my pelvic bone. The best case, he said, was that he could fuse my hip afterward, using a cadaver bone, and create a sort of peg leg. The other possibility, something he implied but was kind enough not to share with me at the time, was that he’d have to amputate my left leg. His euphemism for the time being was that I might be looking at “a much more extensive disability.”
THE 6 TRAIN
Weiner’s office is on the twelfth floor of Lenox Hill Hospital, overlooking East 77th Street. Across the way, there were grade-school kids playing on a rooftop playground. I remember watching them and thinking, My daughter will never know her father. What evolutionary purpose self-pity serves at moments like this I can’t tell you.
The first person I called was my boss. I was suddenly, urgently concerned about being late for work. At the time, I thought the feeling had something to do with being responsible, but I recognize it now for what it was: a way to delay telling the people closest to me. The next person I called was my therapist, Dr. Barbara Gol. She’s a psychologist and psychotherapist, and I’d been seeing her for five years. She occupied that sweet spot that a therapist occupies in your life: She knew me well, but from a certain distance, and had the training and experience to handle a situation like this. I trusted her. I called her, and she agreed to see me right away.
Standing on the downtown 6-train platform, images of surgeries and chemotherapy started flooding my thoughts. I wasn’t suicidal, but it occurred to me that New York, with its skyscrapers, bridges, and subways, offers the terminal cancer patient any number of helpful methods for checking out. An unsung virtue of the greatest city in the world.
TELLING DIDI
Didi and I met in San Francisco in 1994. She’s an editor, too, and we briefly worked together at the same magazine. Didi’s mother was born and raised in Buenos Aires, her father in Berlin. From the start, I thought of Didi as a mix of European and Latin American cultures—smart, sophisticated, stylish, and passionate.
When Didi is happy, she’s happy. When she’s sad, she’s sad. When she’s angry, she’s angry. All that unchecked emoting is one of her most lovable qualities, but in this case, it made me afraid that she might flip out.
Dr. Gol and I talked for some time—she got me settled down. Then she asked me if I’d like to tell Didi right there, now, in her office. It seemed like a good idea. I called Didi, and asked her to come meet me.
When she arrived, about a half-hour later, Didi had that look on her face that people have when they know their life is about to change. As best as I can recall, this is what I said: “I have some bad news. I got the results of my MRI this morning, and there’s a tumor on my hip. They’re not sure what it is yet, but the thing they want me to do is have more tests as soon as possible so they can figure that out. I asked them if it’s possible it’s nothing, and they are pretty certain it’s not nothing.”
Didi didn’t flip. She barely said anything. She just took my hand and held it.
I didn’t know it at the time—in our six years of marriage to that point, Didi and I had never faced anything together this upsetting—but that’s how Didi reacts when something awful happens.
Didi’s father died when she was in high school. He had a heart attack in the middle of the night.
Didi was 14. She wasn’t old enough to cope with something that big, so she basically repressed it. Now that’s what she does when something upsetting happens. On that day, repression proved useful.
THE LIFE FORCE
That night, I gave Abby her bath, read her a story, and put her to bed. I stood by her crib for a moment. What I remember thinking is, Yes, the universe contains a death force, and that force is closer to me than it’s ever been. But there is also a life force.
SUPERSTITION
I have no family history of cancer, other than a grandfather who had prostate cancer when he was in his nineties. I’ve smoked socially but never seriously. I exercise and eat reasonably well, and drink moderately. Recreational drugs only. So what made me sick?
My main theory was 9/11. I lived and worked downtown on 9/11 and for years afterward. The air, as everyone now knows, was far from safe. Of course, I also learned that most cancer experts don’t believe such cancers would show up this fast.
I used to carry my cell phone in my front pocket, next to my left hip. My family used to tease me about eating nothing but orange food—Cheetos, Doritos, Gatorade. Maybe I should have been nicer to people.
I’m not religious, but I found myself praying. For some reason, it was important to me to pray alone and secretly. It was also essential that I take off my glasses and, when I was done, kiss the bottom knuckles of my thumbs three times. It was a kind of obsessive-compulsive ritual—a distraction. At first, I prayed to God to save my life. Then I started proposing more-limited offers. Let me see Abby’s high-school graduation. How about college? Her wedding?
I latched onto weird, totemic things. Didi’s mom is a professional pianist, and she had traveled to Beijing to play a concert and brought back a little Buddha. I would rub the top of its head for luck (I was an equal-opportunity religion adopter). Didi bought me a stuffed tiger from a hospital gift shop one day. I carried it in my briefcase every day. Not that I ever believed in it, exactly—but it’s still there.
In November, a few days after I was diagnosed, I went to a Korean deli near my office for lunch. I bought a sandwich, a soda, and a bag of pretzels, and when the woman at the cash register rang me up, the total came to $6.66. She didn’t know I had cancer, of course, but even she thought it was spooky. She immediately punched another one-cent charge into the cash register to change the total to $6.67.
YOU MAY KISS THE BRIDE
Didi and I moved to New York in 1995. We lived in a tiny studio in the Village, where for a time I kept my suitcase in the oven. There were new jobs and neighborhood burrito joints and Lower East Side dive bars. In May 1997, I took Didi to the top of the Empire State Building and proposed. A pair of German tourists were the first to know we were engaged.
That November, we were married in the town where I went to college and Didi had grown up. A month or so before the ceremony, the rabbi had asked us each what we loved most about the other, then she told the congregation what we said. Didi said she loved that I was thoughtful. I said I loved that Didi was real.
SORRY, WRONG CANCER
If you haven’t had cancer, you think, at first, that diagnosing it is like diagnosing any other disease. You take a test and it comes up positive or negative, and you either have the thing or you don’t. But cancer isn’t TB or strep throat. There are thousands of cancers, many of them difficult to identify. You often have to have a constellation of tests, no one of which is conclusive. The doctors gather pieces and put them together until a coherent picture emerges.
My diagnosis took three primary doctors (plus radiologists, imaging and lab technicians, and doctors consulted for second opinions), dozens of tests and retests, and two and a half months. It also changed radically along the way.
Dr. Weiner referred me to a specialist, Patrick Boland, a Sloan-Kettering orthopedic oncologist. Boland said it was encouraging that there were no signs of spreading based on the tests done so far, but added that the only way to know for sure what we were dealing with was to have something called a CT-assisted bone biopsy.
Sloan-Kettering didn’t take my insurance. My choice was, have the procedure done there, the presumptive best facility, and pay a fortune, or have it done somewhere else. I had it done at Lenox Hill. It’s inconceivable to me how anyone without insurance survives cancer.
To perform a bone biopsy, a nurse sets you up with IV sedatives and numbs the area in question with a local anesthetic. Then the doctor inserts a needle through your skin until it hits the bone. At that point, a technician slides you in and out of the CT scanner to see if the needle is at the right spot. Because of the anesthetic, positioning the needle doesn’t hurt much. The removal of the bone tissue is another matter. The anesthetic doesn’t penetrate the bone. The doctor got the piece of tissue she needed and sent it off to the lab.
When I went to see Boland for the results, I ran into him in the hallway, carrying the lab report. He hadn’t read it yet, so he opened it on the spot.
The relevant language read “Suspect a plasma cell neoplasm.”
I asked what that was, and Boland explained that it was a form of bone-marrow cancer, not bone cancer. It might be isolated to this spot, in which case it would be classified as something called a solitary plasma cytoma, or it might be the first manifestation so far of something called multiple myeloma.
Multiple myeloma is incurable, he said, while a solitary plasma cytoma can sometimes be treated successfully. The catch, he explained, is that a solitary plasma cytoma often turns into multiple myeloma.
MY OLDEST FRIEND
I’m the youngest of four children. We like to tease my mother about being protective of her kids, and my father for being preternaturally calm. My sister Jen is a savant of a listener and empathizer. Tina hurts for you when something hurts. My brother, Andy, is a legitimate candidate for World’s Most Optimistic Human. I can tell you, those qualities prove useful when you call your family and tell them you have cancer.
On the other hand, several people told me stories about friends who had a solitary plasma cytoma or multiple myeloma and died. One friend told me she “understood,” then proceeded to tell me about a 48-hour skin-cancer scare that turned out to be nothing. A Sikh taxi driver noticed I was limping, asked what was wrong, then browbeat me for my foolish reliance on Western medicine.
The truth is, a simple expression of warmth or sympathy went a long way. A co-worker said, “You poor guy. I’m sorry.” That was about right. A friend from my hometown—we used to walk to grade school together—sent me a letter. Near the end he wrote, “You are my oldest friend.” I don’t know why that had so much power, but for the first time since I’d found out I had cancer, I burst into tears.
DOWN TO THE MARROW
Now that I had bone-marrow cancer, I needed a new doctor. I went to see Steven Gruenstein, a hematologist and oncologist at Mount Sinai.
Dr. Gruenstein is a big lovable bear of a man, the son every stereotypical Jewish mother dreams about. He is a cancer survivor himself—kidney cancer.
Gruenstein’s first job, he said, was to confirm that I had a solitary plasma cytoma, and not multiple myeloma. He did a bone-marrow biopsy in his exam room, and sent me home with a cane. The tumor was threatening to breach the exterior wall of the bone, he said, and he was concerned I might fracture it.
Two days later, Gruenstein called me with my test results. The test was inconclusive—there weren’t enough cells in the sample to get a valid reading. I’d have to repeat the procedure.
In the meantime, Gruenstein ordered a PET scan. Never mind that a PET scan is considered one of the most important tests for multiple myeloma and that detecting the disease early might add years to my life. My insurance company refused to pay for it. To their way of thinking, I had no evidence of multiple myeloma from the tests I’d done so far—so I didn’t have it. No further testing required.
Dr. Gruenstein wrote a letter, and the test was approved. That was one of hundreds of pieces of insurance red tape I had to cut through. People ask, “Didn’t cancer ever make you angry?” Ask a claims representative at Oxford.
THE DINER
I had the PET scan after work one night. They inject you with a radioactive isotope that acts as a tracer for cancerous activity. On my way out, I asked one of the technicians if I was glowing. I meant it as a bit of gallows humor, but he answered by saying, “Well, sort of.”
He told me that the isotope has a half-life of about six hours. It wasn’t strictly necessary, he said, but I may want to avoid sleeping next to my wife tonight, especially if she’s pregnant. I told him my wife wasn’t pregnant, but that we had a 7-month-old daughter. “Oh,” he said, “sorry, you should definitely stay away from her.”
That night, I went to a diner, had a cheeseburger deluxe, and stayed there and read until 2 a.m. I was afraid of radiating someone next to me, so I sat alone. I felt like a character in a Hopper painting.
THE GREAT UNKNOWN
On Thursday, December 11, a month and a week after I had been told I had cancer, I met with Dr. Gruenstein in his office. Based on all the tests that had been done so far, he said, he believed that I had a solitary plasma cytoma and not multiple myeloma, and that he could put it into remission.
Remission for a day? A month? A year? Forever?
He couldn’t say.
I asked what the odds were of this eventually developing into multiple myeloma. Again, there was no firm answer.
The good news, he said, was that I wouldn’t need surgery or chemo. Radiation was the indicated treatment.
What were the odds it would work?
He couldn’t tell me that, either. We would have to wait and see.
Cancer is an exercise in uncertainty.
FEAR.COM
I had been warned not to go on the Internet, but now that I knew what I had, my curiosity got the better of me. What I learned was that solitary plasma cytomas are highly treatable if they occur in soft tissue, but much less treatable, and more likely to develop into multiple myeloma, when they occur in bone. I also learned that multiple myeloma has a five-year survival rate of 20 percent. I logged off.
DOES SHE CARE?
I said that I was glad that Didi wasn’t outwardly emotional about all of this, and I meant it. Her strength gave me strength. Yet at the same time, I had begun to wonder: If she never gets upset, does she care? After a while, I started to resent the fact that she hadn’t had a meltdown. We talked about it, and she explained that she cared but couldn’t afford to let her emotions go right now. I understood, but I didn’t want rational assurances. I wanted the meltdown.
MERYL STREEP, ZEN MASTER
New York used to host something called the New York Awards in mid-December. That year, the awards were given out at a lunch at The Four Seasons. Hillary Clinton, Caroline Kennedy, and P. Diddy were among the honorees. So was Kevin Kline. Meryl Streep, a friend of Kline’s, was asked to give him his award. The woman who coordinated the event knew I was sick and let me choose who I wanted to sit next to. I chose Streep.
Streep and I were introduced at the cocktail reception, and when she saw my cane, she asked what the problem was.
“I’ve got a bum hip,” I said, hoping she’d leave it at that.
“What happened?” she asked.
“Long story,” I said.
I kept trying to change the subject, but she wouldn’t stop asking about my hip. Finally, I ran out of bullshit and blurted out, “Actually, I have bone-marrow cancer. There’s a tumor on my hip.”
I can tell you that Meryl Streep is either the most sincere person in the world or she’s an even better actor than we all know. What she did was reach over, put her hand on my forearm, look into my eyes, and somehow convey more genuine human concern than anyone I’ve ever known.
Later, as we were saying our good-byes, she wished me the best. I responded with some throwaway remark like, “What are you going to do?” And she looked at me again with that look—the close-up-at-the-end-of-the-third-reel look—and said, “That’s what life is. Shit happens, and you deal with it.” Buddhism by Streep.
HAPPY HOLIDAYS
Didi and I have thought long and hard, but we can’t remember what she and Abby and I did for the holidays that year. It’s a blank. What we do recall is spending most of the rest of December and January preparing for my treatments.
There were fertility questions, for starters. Didi and I had always agreed that we wanted one child, and no more than two. We were well aware of how lucky we were to have Abby, but now, if we wanted to consider having a second child, I’d have to bank my sperm. Being radiated in my hip wasn’t certain to leave me infertile, but it might.
Didi and I had one of those conversations a couple never thinks they’ll have. The gist of it was, if I die, would you rather have just Abby or Abby and someone else?
We punted and decided that for a couple of hundred dollars’ handling and storage fee, and a few minutes spent watching a bad porn video, I might as well go ahead and freeze my swimmers. We could decide another time whether to use them.
And so, on December 16, a clear and sunny Tuesday, I found myself leaving work at lunch hour and walking from my office on Madison and 49th to a fertility clinic on Park Avenue South. I called my sister, Jen, on the cell phone, and said, “Okay, this is what it’s come down to. I’m 37 years old. I have cancer. I have to have radiation therapy, which may or may not make me better, and I’m about to go jerk off on Park Avenue.”
There was nothing remarkable about the experience except that I remember thinking the receptionist was cute. Even in the face of their potential demise, it appears, men are still checking out their options.
THE HARVEST
I also needed to do something called a stem-cell harvest. Should my disease develop into multiple myeloma, I might need a bone-marrow transplant. You can get marrow from a donor, but finding a match can be difficult. In recent years, doctors have developed a new method. They harvest your stem cells and freeze them so you can, in effect, give yourself a transplant.
On December 19, I saw Dr. Luis Isola, a marrow-transplant specialist at Mount Sinai. In Isola’s waiting room, there was a loud middle-aged woman who was talking to the woman next to her. She blurted out, in full voice, “Yes, but they caught it too late, and it ate through her spine.” From that point on, I started wearing headphones to my appointments.
To prepare for a stem-cell harvest, you inject yourself with a drug called Neupogen, which boosts your stem-cell count, for three days prior. They give you a little kit, and teach you how to give yourself the shots.
You have to keep the Neupogen in your refrigerator. For four days, every time Didi or I went for a glass of O.J. or the leftover lo mein noodles or a bottle of milk for Abby, there was cancer, in eight tidy little white boxes, right there in the crisper.
Didi helped do the injections, and at first we joked about the whole nurse-fantasy thing. But couples’ injecting turns out to be not that fun.
On the morning of January 26, 2004, Didi and I took a cab to Mount Sinai for the stem-cell harvest. They use a Frankensteinian-looking machine to take the blood out of one arm, remove the stem cells, then pump the remaining blood back into your other arm.
The procedure can cause a drop in your level of calcium, I’d been told, which can make you tingle. What I experienced was more like a fire-ant attack. They started pumping me full of yogurt, but it didn’t really help. I lost the feeling in my feet and couldn’t walk. Eight hours and a half-dozen cups of Dannon lemon flavor later, Didi helped me get into a cab.
My stem cells are sitting in a freezer at Mount Sinai as I write this. My sperm is at NYU. Once in a while, I have the urge to visit everyone.
A NOTE ON THE MTA
By now, I was limping badly and using the cane all the time. I somehow expected that people on the subway would offer me a seat, but almost no one cut me any slack. The city was going to make me fight for my position here, just like it always did. I kind of liked that.
ZAP
I started radiation therapy on February 9, three months and five days after Weiner told me I had cancer.
Several weeks earlier, I’d met with Jack Dalton, a radiation oncologist at Mount Sinai, and he’d laid out my protocol. I’d be radiated five days a week, for five weeks—25 sessions in all. He said that I might be tired, but I shouldn’t be nauseous and I ought to be able to go to work every day. He said that I might have skin burns on the area being radiated and perhaps some lower G.I. issues, but that was about it in terms of short-term side effects. Dr. Dalton also told me that he would build a sort of jury-rigged athletic-cup-type device to try to preserve my fertility, but he couldn’t guarantee it would work. Stray radiation tends to bounce around inside the body.
The radiation treatments themselves were nothing to speak of. You lie down on the table of what looks like a giant X-ray machine. A technician positions you using a system of tattoos and lasers made and mapped out beforehand. Then he swings a large device over you that looks like a TV satellite dish that beams the radiation into you for 30 seconds.
You don’t feel a thing, as they say. It’s so painless, in fact, that I wondered from time to time if I weren’t an unknowing participant in some kind of placebo experiment.
The Mount Sinai radiation unit is in the basement, literally underground. Some of the sickest people I saw anywhere, I saw there. It’s like a ghost network—you realize there’s this whole shadow population of sick people who we shunt out of view. Maybe that’s healthy—maybe it’s too much to stare at the ugly side of life every day. Or maybe we’re callous and afraid.
THE OFFICE
Except for two or three instances when a test or procedure made it impossible, I worked every day during my diagnosis and treatment. People always ask about that for some reason. It’s a cancer cliché: “He didn’t miss a day of work. How brave.” Believe me, it has nothing to do with bravery. In my case, anyway, it had to do with terror. Sit home and contemplate the dimming of the light, or go to work and edit stories about misbehaving politicians or new sushi restaurants. You see my point.
THE TELLTALE VIAL
I met with Dr. Gruenstein on April 8. He told me he wanted to do another protein test, but warned me that it was too early to expect the number to have returned to normal. For now, he wanted to be sure the number hadn’t gone up (a possibility I hadn’t considered). I had the blood drawn that day. I watched the technician carry off the vial. “Make that a good one,” I said.
I CAN SEE CLEARLY NOW
I was born on Saturday, April 17, 1965. On Friday, April 16, 2004, Dr. Gruenstein called to say that my protein level had returned to normal. (Some cancer survivors call this your second birthday, but that term has always seemed a little goofy to me.)
Here’s the thing about cancer. You know there is not a cure, and you know you’re not even considered in-effect cured until you’ve been cancer-free for five years. But when your oncologist calls and tells you that your radiation therapy has worked and that there is “no current evidence of disease” and that this is “the best possible outcome” from the radiation, well, what you do is you start thanking him like a blabbering fool and telling him you owe him your life but that you really need to get off the phone and call your wife, and that you’ll call him back tomorrow to discuss next steps, and then you hang up and let out a little middle-aged white-male whoop of joy—Yes!—right there at your desk, and then you call your wife and tell her the news and she says, “Holy shit! I knew it!” and you tell her that you could feel her confidence all along, and you thank her for being wise enough not to express it until now, and you can practically feel her exhale on the other end of the line, a big, giant cosmic exhale, and she’s the one who first points out that this news has come on the day before your birthday, and she says we’ll have to double celebrate tonight since we were planning on going out for my birthday anyway, and then you hang up and run around your office telling your boss and your boss’s assistant and whoever else is in your lunatic path, that, for the time being anyway, you are going to live and not die, and then you leave work immediately and go to meet your wife for your celebration dinner.
Didi and I may not be especially religious, but we are Jews, and so we are guilty. We go to fancy places only on special occasions or for expense-account lunches, and even then we have a hard time indulging ourselves. You would think that night would have been an exception, but the truth is, it wasn’t. Our initial euphoria gave in to a set of more complicated emotions. The good news somehow also brought back to the surface all the sadness and difficulty we’d been through. Having only just set down a burden, we were exhausted. We had forgotten, in some weirdly practical sense, how to be happy.
My subconscious, however, was apparently less conflicted. The next morning, my 39th birthday, a song popped into my head that I didn’t even know I knew the lyrics to. I was standing in the shower, and there it was: “I can see clearly now, the rain has gone / I can see all the obstacles in my way / I think I can make it now, the pain has gone / Gonna be a bright … bright … sunshiny day.” I wouldn’t blame anyone who doubted it happened that way. Only it did.
FALLOUT
Cancer is a nuclear bomb, not a tactical weapon, and so there is fallout. For starters, there is the threat of a recurrence. Beginning three months after I was pronounced cancer-free and continuing through today, I’ve undergone scores of follow-up tests. For a time, I had to do them every three months; now it’s six months. After every blood test, I still have to wait a week for the results. After every pet scan, I still haunt some diner and read. You learn little tricks—I don’t have scans on Fridays because then I have to wait an extra day to get the verdict—but the tests still jangle your nerves every time. So far, so good.
As a result of the radiation, I’m at increased risk for a secondary cancer, like prostate or colon cancer, and am more likely to fracture my leg. And I did wind up infertile, although that situation has been gradually getting better.
Because of the damage to my pelvic bone and the surrounding tissues, it was a year before Dr. Weiner cleared me to do even light, non-weight-bearing exercise. And it was another year before he allowed me to do physical therapy. Along the way, Dr. Gruenstein had put me on a bone-strengthening drug called Zometa. But Zometa can have serious side effects (it can cause bone death, of all things, in the jaws of certain dental patients), and it’s administered monthly, by IV. Gruenstein decided the costs outweighed the benefits and took me off it.
Today, I don’t limp or use a cane, but my hip hurts like an arthritis patient’s (some days good, some days bad). I can swim and ride an exercise bike, but I can’t run or play basketball or ride a real bike (no hard falls allowed). Some people ask me why I don’t have my hip replaced. That procedure fixes the spot where the top of the femur meets the pelvic bone. That’s not where my tumor was; it wouldn’t do me any good. Because I’ve been compensating for three-plus years now, I developed arthritis in my good hip. For a time, I took Vioxx—you know the rest of that story.
During the time I couldn’t exercise, I gained twenty pounds, and at my most recent annual physical last fall, I was told my cholesterol was sufficiently high to merit a Lipitor prescription. I begged for a reprieve on the premise that I could diet and exercise my way out of it, and my request was granted. I couldn’t tell you what my cholesterol is right now (I’m scheduled for a follow-up soon), but so far I’ve lost sixteen pounds, four short of my pre-cancer weight. I call it the Fear of Death diet.
ZING!
On Sunday, April 18—two days after I was pronounced cancer-free—Didi went to pick up a grocery bag, and—zing!—a jolt of pain shot up her spine. That night, she woke me up at two in the morning. She was crying. She couldn’t move. The paramedics came and took her to St. Vincent’s, where they gave her painkillers and muscle relaxers and diagnosed her with bulging L5 and L6 discs. She had never had back problems before.
Could you read this as an instance of a woman who had been carrying too heavy a load for too long and finally cracked because she could? Yes, you could.
NO MORE HEADACHES
Once you’ve had cancer, as the saying goes, you never have a headache again. That’s true. But my paranoia has manifested itself with Abby. Last summer, she developed a mystery ailment in her left leg. She would try to walk on it and just fall down. None of us, not Didi or our nanny, Patty, or me, had seen her fall or otherwise hurt herself, so after a day or two of waiting, we took her to the doctor. She recommended an X-ray, and when we got to the X-ray room, I lost it. Mysterious leg ailment? Check. Left leg? Check. MRI? No, but an X-ray was close enough. The X-rays, of course, came back negative, and the limp disappeared as mysteriously as it had arrived. The doctor said it was probably a sprain or a virus that got into her joints. Later, another theory occurred to me and Didi. Abby had grown up with a father who had been limping for most of her life. Monkey see …
SURVIVOR’S GUILT
I’m aware that I’ve gotten off relatively easy so far. I actively had cancer for just five months and twelve days. I didn’t have brutal treatments, and my prognosis is reasonably encouraging (though it’s hard for me to even type that). I live in a city with world-class medical care, and I can afford health insurance. As Dr. Weiner has pointed out, that slip on the ice was a stroke of luck—“an angel’s kiss.” It tipped me off to the cancer before it had a chance to spread.
I try to appreciate my good fortune for what it is, but sometimes that’s hard. Sarah Jewler, this magazine’s managing editor, who’d been especially kind to me during my illness, died two years ago, at age 56. My cousin Julie was born with congenital heart problems, and died when she was 9. I have childhood memories of her playing the violin in her family’s living room on Long Island, and of my parents leaving us with a babysitter for her funeral. Hanging on a wall of our apartment is a picture of Didi’s father smiling proudly next to a trophy marlin. He’s a fisherman, and so am I. Why am I still here? Why aren’t they?
AN UNWELCOME HOUSEGUEST
Cancer is like an unwelcome houseguest. You don’t want to be too friendly to it, or it might come back. That’s the fear, anyway. That said, there are ways in which cancer has made my life better.
I have a greater capacity to enjoy life. Small things—work problems, midtown gridlock, late trains—bother me less. I spend more time around the people I love, and less around people I don’t. I’m less afraid of death. If you stare into the face of the biggest fear there is, and come out alive, nothing else seems as frightening by comparison.
Cancer is also an excellent corrective for narcissism. If you’re so important, why is the world so indifferent to you? If you’re so powerful, how come you can’t control this? Therapy helped my cancer, but cancer also helped my therapy.
Cancer also seems to have sped the onset of my midlife crisis. In the past six months, I’ve gotten my teeth whitened, had my first-ever facial, and had two moles removed for strictly cosmetic reasons. I think it was about wanting to feel whole again—now that I’m cancer-free, now that I can walk without a limp, now that I’m somewhat fit again, why not keep going?
Like anyone else, I used to fantasize about changing careers—move to Wyoming and become a fishing guide, go to cooking school, teach. But I rarely think about that anymore. When I got sick, I took the same long, hard look at my work life that many cancer patients do, and instead of discovering my true calling, I realized I like what I’m doing now.
Yes, I take better care of myself, but I haven’t gone monastic. I don’t eat faux-orange foods anymore (much). But I use a cell phone and get dental X-rays and still eat and drink too much on occasion.
Didi says I speak differently—slower and less distantly, with more sincerity and emotion.
DIDI AND ME
Someone once said that cancer either destroys a marriage or makes it stronger. In our case, it did both.
Didi was a superwoman. She worked, took care of Abby, came to my appointments whenever I wanted her to, and put up with my moods. Still, we started having problems, and her lack of a meltdown was only one of them.
As brave a face as we both put on, as much as we resolved to “fight this thing” and “go forward” and “stay positive,” the fact was that I had cancer and might die. That reality made it tough to have fun. We stopped going out. Even garden-variety conversation was loaded. “How was your day, honey?” “Great, I had another bone-marrow biopsy. You?”
In retrospect, it’s clear that we were afraid to love each other. The closer we got, the more difficult things would be if I died. It’s as if we were trying to get a jump start on life after my death.
At one point, I told Dr. Gol that I noticed I was withdrawing from Abby. My logic was that it was better for her to never know her father than to miss him. Dr. Gol said to me, “Wouldn’t you rather be around her as much as you can, regardless of what happens? Why not enjoy it?” For reasons that are mysterious to me, I was able to follow that advice with Abby, but I wasn’t able to follow it with Didi, and she wasn’t able to follow it with me. We withdrew.
Even after I was declared cancer-free, things didn’t normalize. They got worse. By then, our unhappiness became self-perpetuating. We were bickering all the time. It was as if we were both thinking, This relationship is terrible. It must be the other person’s fault.
On some level, Didi later realized, she was angry. Not at me, exactly, but at what I represented—another potential tragedy. When they say you marry your father, this isn’t supposed to be what it means. And then she felt guilty for feeling that way, and I felt guilty for being the cause of all that.
There was an ice storm. It wasn’t all bad—we had moments of returning to our pre-cancer selves—but it was far from what either of us wanted from our marriage. Then last summer, Didi spoke up. It wasn’t the first time we had had an argument like this, but this was the mother of all of them.
We were in Wyoming—a fishing trip and family vacation—and Abby was asleep. It started out as a conversation about Didi’s work, but somehow the tension started rising, and the next thing I knew, Didi was crying and screaming. The gist of what she said was this: “This is a disaster. We are in the midst of a huge mess. I love you, but I don’t like you right now. I know you don’t like me, either, so don’t pretend you do. What the hell are we going to do?” Shouting and mutual accusations were exchanged. Long-simmering resentments were surfaced. The D-word was spoken.
In past relationships, this is the point at which I chickened out. I’d either blame the other person or pretend that the problem wasn’t a big deal. Didi wasn’t going to allow that.
It’s grossly oversimplified, but Didi had the courage to name the problem, and cancer gave me the guts to listen. We worked out some of the problems by ourselves and some in therapy (our own, not couples), and things got better.
What happened the next day was as much about making up after a fight as anything else, but it did foreshadow the thaw to come. Didi went fishing with a guide friend of ours named Tim Warren. I took Abby to the Teton County Fair. We arranged for a babysitter that night, and I went to meet Didi and Tim at the takeout for dinner.
Didi didn’t catch many fish, but she had a fabulous day. It was the first time she’d taken a day off, on her own, since Abby was born and I got sick. Three-plus years. She and Tim had floated the Snake River through Grand Teton National Park, one of the loveliest stretches of water on the planet. When she came off the river, Didi was sunburned and beaming. She looked reborn.
That night, the three of us went for burritos and margaritas. We ate way too much, and drank way too much. The next morning, Didi and I woke up with hangovers, and spent the better part of the day watching DVDs in bed with Abby. It was sublime.
TALKING TO ABBY
Sometime, I’m going to have to tell Abby. I know how it’s going to come up, or I think I do. One day she’s going to ask me or Didi, out of the blue, why I can’t ice skate with her or go skiing with her. But what do you say? My impulse is to tell the truth. But is it right to worry a 4-year-old that her father might die? No parent can guarantee their child that they won’t die, but most can make the pledge in good faith. Cancer patients can’t do that.
I’ve gone around and around in my head about what to say, and I haven’t come up with a satisfying answer yet. I hope, if I can stay healthy and make it to five years out—she’ll be 6 at that point—maybe then I’ll feel comfortable telling her what happened and saying, “Daddy is fine now, and he’s not going to die for a long, long time.” Once I feel like I can say that, and mean it, that’s when I’ll tell her.
“THANK YOU”
Last month, I celebrated my third anniversary cancer-free, and my 42nd birthday. On the 17th, Didi and I went out for dinner, to Balthazar, and had a nice meal and some wine, and were feeling good.
It was a warm spring night, and we decided to walk home. We could have walked any number of ways, but as it happens, we walked up Broadway. It occurs to me only now that we walked right past the spot where I had slipped on the ice.
When we got home, Abby was asleep. We said good night to the babysitter, and got ready for bed. Didi went to sleep first, and I stayed up to read for a while. Later, I went into Abby’s room. I have a pet little thing I say to her when I put her to bed—“I love you most of all forever and ever, no matter what.” I whispered it to her, and kissed her good night.
In our bedroom, Didi was asleep. I guess it was because of the anniversary and the birthday and the beautiful night. Who knows. But what I did was, for the first time in many months, maybe a year, I took off my glasses, and I kneeled down, and when I was done I kissed the bottom knuckles of my thumbs three times. Only this time, I didn’t ask for anything or offer any bargains. I’m not sure who or what I was talking to—there are plenty of worthy subjects. Anyway, what I said was, “Thank you.”