Friday, March 16, 2012

January 12th, 2008

            My oldest daughter Haley and I are driving back from Gilda’s Club. Every Saturday morning there’s an art therapy session for kids whose parents have cancer. The club is named for Gilda Radner, former SNL player, who died from cancer.  I’ve been taking Haley, who is seven, for about a month.  Kelly, my two-year-old, is too young to understand what is happening to her mom. 
We’re almost home when I see Hollywood Hot Dog coming up quickly on the left.  Seems like the perfect lunch for this brutal winter day, so I quickly change lanes amidst busy traffic and turn left into the parking lot.  We get out of the car and rush toward the front door as the cold Chicago air bites our cheeks.  Inside almost every seat is taken.  The overworked kitchen warms the entrance of this small, old, wooden building.  The smell of hot dogs, beef sandwiches, and gyros, makes it seem like summer. 
We pick a booth by a steamed up window in the back.  I leave Haley and go up to the counter to order.  I bring back our food to the table.  Haley puts her seven-year-old hands in little fists and shakes them in excitement when I place her lunch in front of her. She is still at an age where getting a hot dog and lemonade is as exciting as going to Disneyland. I sit across from her, looking out the window and watch across the street as the winter wind is blowing the car dealership banner, trying to free it from its ties.  I wonder how long of a winter may be in store for us.
            Haley’s voice snaps me out of my daydreaming. “Daddy, Mom could die, right?” Haley blurts out in between bites of her hot dog.  I wasn’t expecting the question, but thrilled she brings up the topic on her own.  I’ve always worried that if I initiated this conversation I would somehow scar her for life.  So instead, I practiced this conversation over and over in my head, and yet, even in my mind, I could never get it to come out naturally: “Now Haley, did you ever wonder what happened to people when they die?” “Boy Haley, did that weekend go by fast, kinda like our time here on Earth.” “Hey Haley, whatcha playing?  That sure looks like fun, you know what’s not fun though, people dying.  Come on, let’s talk.”
Now, with no warning, Haley asks me if her mom could die and I suddenly feel as if I am in that dream, running in my underwear down the school hallway, late for the final exam, and I need that A.  “She could die, Haley, she is very sick,” I say, trying to keep my voice at an even keel.  “We are going to do everything we can.”
Haley takes another bite, and then picks up her lemonade. The straw is on the wrong side of the cup.  Her other hand is holding the hot dog and she can’t move her straw.  She stretches her neck like a giraffe to the far side of the cup to take a sip.  She puts the cup down. “Right, she probably won’t die.” She says “But she could.”
            “Correct.” I say.
Think Matt think, I tell myself. Say more!  Should I tell her mom probably will die but we hope she doesn’t, or just leave it as is?  This conversation could not be progressing any slower and yet it is moving at lightning speed.
            “If she dies, can Christina be my new Mommy?” Haley asks in the same tone as if asking for a cookie. Christina is her support group leader at Gilda’s Club.
            “It doesn’t really work like that,” I answer.
I’m taken aback how quickly Haley has replaced Lisa. I try to put myself in her shoes and think like a seven-year-old.  Why not?  I wonder.  Why shouldn’t she?  Aren’t we all built with self-preservation?  The needs of a seven-year-olds are basic; if Mom dies, who will be the new Mom to take care of me?  And if I’m seven, don’t I think I get a choice in who that new Mom will be?  At this age, what’s the difference between this and replacing her Winnie-the-pooh stuffed animal the dog chewed up?
            “Christina will of course always be there for you to help you out with your feelings,” I tell her, “but you wouldn’t have a new mom.  I would take care of you girls.  The only way you would get a new mom would be if I found someone I liked very much and decided to marry that person.  But I can tell you, that probably won’t happen, at least not for a long time.” I realize that last part is more for me than her.   
            “Oh… but even if Mom does die, can we still go to Gilda’s Club?” Haley asks
            “Of course, you can go there for the rest of your life - once a member, always a member.”
            “What if Mom doesn’t die?”
            “Still a member, you’ve had a person close to you with cancer; you can go from now on no matter what.” 
            “Cool!!  Boy with Mom being sick, I’m sure going to have a lot of play dates,” she says now with a nervous laugh. I know that laugh and I can tell she understands enough for this to scare her.
I don’t respond; I am fascinated with this line of questioning. I wait a few minutes to see what she says next.
“Hey Dad, we don’t want Mom to die, right?” Haley asks, and puts down her hot dog and looks me right in the eye.
I feel my anger at the world build in my stomach; it moves to my face as the blood rushes upwards and my ears get hot, my fingers discreetly squeeze into my palms and form a fist.  I hate that my seven-year-old has to ask me these questions.  She’s just a kid, we’re eating hot dogs.  Shouldn’t our conversation be, “Hey Dad, which do you think is prettier, yellow butterflies or red ladybugs?”  Instead, this girl is trying to sort out the complex implications of guilt verses play dates. Does Haley think because fun things will happen to her if mom dies, that she would somehow be responsible for her death?
            “Right Haley,” I say “we do not want Mom to die. We very much want her to survive this sickness.  However, listen to me, this is important. If Mom does die, it will be very sad for all of us, but it won’t be any of our faults.  Nothing we think or say can change the course of what is happening to Mom.  It will never be any of our faults.”
I wait for her response and she just nods and eats her hotdog.  There is no way Haley is this calm and collected.  It looks like this is going to be a game of patience, even though I want one conversation and have her set for the rest of her life.  But if Lisa is not around for Haley when she finishes grammar school, gets her first boyfriend, goes to prom, gets married, has babies and becomes a mother herself, Haley will grieve the loss of Lisa each time.  It scares me to think when she, Kelly, and eventually Molly, will start to understand the ripple effect of growing up without a mother.  This realization could be in 5 years, could be in 10.  But as I watch Haley trying unsuccessfully to get the ketchup off her chin by using her tongue, clearly, today is not the day she will understand all that could lie ahead. 

December 15, 2008 8:25pm

            Orderlies have wheeled Lisa’s bed from the ER to her own private hospital room.  Five doctors now stand at the foot of her bed; they form a close circle looking like a basketball team during a time out.  One of them is her oncologist, another the cardiologist and the other three haven’t introduced themselves.  Each of their coats is a different shade of blue.  I look around the room to see if there is a chart that explains which specialty is associated with each shade, who knows, maybe this hospital works on the Garanimals system.
The topic for discussion is Lisa’s heart edema.  The doctors talk too fast and over one another for me to hear every word, but they are loud enough for me to pick up bits and pieces. 
-“I don’t like the fluid around the heart, we need to go in and drain.”
-“Wait what about the baby?  You can’t put her under, she’ll lose the baby.”  
-“I’m guessing she’ll lose it anyway.  Her cancer has spread, she has to have chemo.”  
-“I may have a way to save the baby; I have a chemo treatment I’ve used before on pregnant mothers.”
- “Too risky, the fluid is too dangerous and could cause serious damage.”  
-“Couldn’t just put a needle in there and drain using a chest tube?”
-“But that’s only a temporary fix.  Now it could come back, and it could be worse, we should put her under and operate.”   
-“I still think we can work around the baby.”
            Lisa is focused on the doctors, her face unmoving except for her eyes, which bounce from doctor’s mouth to doctor’s mouth, trying to figure out who is saying what.  It surprises me they are having this discussion in front of us.  I feel like yelling, “You do know we’re sitting right here, right?  Why don’t you take this outside, come to a consensus, nominate someone as point, and present it to us?”  But before I can tell them their little pow-wow is upsetting Lisa, they nod to each other and all walk out of the room except the cardiologist.
He walks to Lisa’s bed, sits by her feet, and faces her straight on.  His posture is straight, his head up, and he places his hands in his lap.  He has all the confidence of a man with a winning ticket. He looks at her, but waits to give her a smile - the delay is to let us know he’s in position of power. He finally releases a smile, letting us know, not only is he in control, but now he’s our best friend.  His doctor/Jedi trick is working on me; I am completely caught up in this presentation.  Right now, he could wave his hand in front of my face, and say, “I will run down the hallway naked,” and I’d start running with half of my clothes off before I got to the door. 
“Lisa, as you saw we’ve all be discussing, you have a lot of things going on inside there,” he says.  “And my concern is, if we don’t operate, the fluid around the heart could collapse one of the chambers.  I recommend we terminate the pregnancy tonight and get in there tomorrow and take care of that fluid”.
 “What are the other options?” Lisa asks.
Her abruptness surprises me and breaks me out of the spell of my doctor crush.  Unlike me, Lisa is not ready to do whatever he - with his withholding smile - tells her to do.
“Well, we could insert a needle through your chest to drain the fluid; without anesthesia, mind you, because of the baby.  But fluid could come back and collapse a chamber.”
“But there’s a chance it won’t come back,” she says. “Or even if it does, you can drain again,”
“Correct.  But Lisa, this would be a gamble.  You are lucky we caught it this time, you may not be so lucky next time.”
“What are the chances of the fluid coming back again and how long until it would?”
“I honestly don’t have the answers to that; again, there is a lot going on with your body.”
The doctor shifts his position and gets a little more leg up on the bed; by doing so, he inches up closer to Lisa.  Lisa doesn’t flinch.
“I refuse to make this decision based on fear,” she says.  “You don’t have enough information for me to abort this pregnancy.”
“Lisa, it’s that lack of information that worries me.  This is a wild card.  You, right now, are a wild card, and a very sick woman.” 
 “But this is all based on guesses.  I want the option of inserting the needle through my chest and drain the fluid.”
There’s a long pause while the doctor looks at Lisa. “Okay. But I don’t recommend this; you’re risking your heart.” 
He sits there, as if waiting for the nervous girl with fluid around her heart to start over-talking by asking impossible questions like, “but I’ll be okay, right”, questions where he can alter his answers by working on her fears to get what he recommends, “You could be okay, as long as we can operate as soon as possible”.  But Lisa doesn’t over-talk, she says nothing.  After a moment of silence, he gets up and walks out of the room.
A major decision was just made and I wasn’t even a part of the discussion. I guess for something this serious, I was expecting a more over-the-top husband/wife dialogue, like one of those movies on Lifetime, where a doctor comes to deliver bad news to a love struck married couple, and they now must make a life changing decision.  The movie starts and we see the wife in a hospital bed, husband standing by her side, holding her hand. A good-looking doctor, with gelled hair, walks in holding a clipboard.
“I don’t know, Mr. and Mrs. Johnson, we really need to get in there today and remove her heart,” he has a baritone voice that at any moment could break out into a glorious rendition of God Bless America. 
The wife immediately turns to the strong minded husband and says, “I don’t know John, what you think?” 
“Gosh Mary, it does sounds risky removing your heart, but look at him, he’s so good-looking and has a beautiful voice. Maybe we should do what he says.”
“Oh John, you are my rock, I love you.” 
“Oh Mary, you are the light that shines upon my rock, I love you.” 
The doctor laughs and cuts in on the conversation, “Okay you two love birds, I’ll leave you alone for a minute, but then I have to come right back in and take out that heart.”
That is not what happened here at all.  Lisa flew solo in her conversation.  It was right out of Animal Planet, the mother lion, protecting her unborn cub.
Suddenly, I feel guilty.  My gut instinct was to listen to the doctor and terminate the pregnancy, no questions asked.  I’m worried that with the inevitable chemo treatments and now with the pulmonary edema, Lisa has some painful procedures on the horizon and most of her upcoming suffering can be controlled by medication.  But if she’s still pregnant, her painkillers will be restricted.  But to Lisa, pain management isn’t important right now and I wasn’t on the same page of her thought process.  I didn’t check in with her to see where her emotions were.  I guess I want to be on record I pick my wife over anything else.  I want to take her side and worry about the grief of losing a child later, but her side is trying to save this pregnancy.  If I am going to be a source of strength for her, I must learn how to communicate better. 
“Matt, I cannot terminate this pregnancy based on guesses,” Lisa now says, half talking to me, half talking to herself.  “I would hate myself forever for not trying, I know I would.”
            I sit down next to her and rub her hand as a sign of support. 
As we sit in silence, it dawns on me that Lisa sitting on the living room steps, struggling to breathe, was today.  The series of new developments is staggering and seems like a week full has passed.  I start to replay all the events from the past twenty-four hours.  As I go through all the details of the day: the edema, seeing Dr. Benton, the cancer, the idea of starting chemo, the pregnancy, the thought of leaving my job.  One detail jumps into my head, and chills run through me as I feel my stomach turn:  Doctors are going to stick a needle into my pregnant wife’s chest, to drain fluid from around her heart.