My newfound enthusiasm for life was made possible by the brave new world of biomarker-targeted therapies that granted me a welcome, if temporary, reprieve from this we’ll-do-the-best-we-can-for-as-long- as-we-can disease. The plain-speaking oncologist treating me described the therapies this way: “Your cancer is a lawn. These medications keep the grass mowed but don’t pull out the grass at the roots. Eventually, the cancer figures them out, and the meds stop working.” Some people’s cancer doesn’t respond, some receive scant months of benefit, while others eke out five years before switching to protocols with potentially harsher side effects.
I braced myself for bad news and the onset of fatigue, intestinal discomfort and prickly skin rashes, side effects that can, in their more extreme forms, render the medication intolerable. While the rest of the nation hoarded hand sanitizer and toilet paper, I stocked up on Imodium, electrolyte drinks, intensive moisturizers, coffee and dark chocolate.
Though cancerous cell growth was held in abeyance, an existential dread set in as I realized that instead of fortifying my system, each day on the medication subtracted a day from the treatment’s effectiveness. Between the unpredictability of the regimen’s efficacy, the uncertain course of the disease and the threat of covid, I caught myself holding my breath through the day, as if taxing my lungs less might preserve them. Brain fog meant that composing effort sentences required herculean, so writing assignments went on indefinite hold. I was napping several times a day, like a toddler. Even driving became too stressful, so conscious was I of my vulnerability. Something had to give.
After my first dose of the vaccine in April, I hit the ground running, determined to carpe every diem. I double-masked and flew across the country for an “end of my life reunion tour,” convinced that this might be my last ambulatory opportunity to see cherished friends. Each morning for two weeks last spring, I trekked to “my” table at a favorite cafe on the Upper West Side in Manhattan. Cherry blossoms swirling like confetti, these reunions careened between celebratory and funreal, leaving me flat on my back for the remainder of the day.
I was overcome by exhilarating, almost inebriating, episodes of gratitude overload brought on by an appreciation of small pleasures. That certain slant of light! French fries! A Katherine Mansfield sentence! (No, I take that back, Mansfield’s prose should bring us to our knees.) A bout of weepy swooning, marveling at the acuteness of an aspartame-induced diet soda headache, was a bracing warning that even joy could be distractingly paralyzing.
My complexion was rosy and my constitution energetic. Through it all, the cough that led to my diagnosis persisted. Coughing during this pandemic, even when masked, is like shouting “Fire!” in a crowded theater. I felt compelled to reassure dining companions, elevator fellows or airplane seatmates, “It’s not covid, just lung cancer.”
But I had a full head of hair and hadn’t lost any weight. Despite my life-altering circumstances, I appeared unchanged, all of which created a confounding cognitive dissonance. The assumption that chronic illness presents visually is deeply ingrained in our culture. My robustness elicited stupefying responses from even the most well-intentioned friends. “I’m sorry I don’t look sick enough for you” turns out to be a reliable conversation stopper.
Side effects flared up, but they were staggeringly capricious, allowing for fleeting moments of invincibility. One day, I couldn’t summon the energy to take even one more step a few blocks from my front door after my daily walk stretched into a satisfying but punishing uphill hike. I collapsed on a grassy median, lying there, inert, until I rallied the strength to shuffle home. If this level of enervation persisted, it could take years to make it through all six seasons of “Succession.” I dialed back my overly ambitious exertions, but not everyone in my life found it hilarious that I had (with apologies to Elaine May) “Not dead, just resting” piped onto my birthday cake.
After learning that the meds had caused my fingerprints to disappear, I added “crime spree” to my bucket list. Why not liberate a favorite Yaacov Agam from the prized art collection at Cedars Sinai Hospital in Los Angeles, where I receive treatment? The drawing hangs in a basement corridor, outside the room housing the CT scan that forecasts my future in three-month increments. It was underappreciated on that dimly lit wall, my cancer dollars had paid for it, and what was the worst that could happen? A life sentence? I tested the security fastenings on two occasions just to be certain I’d made a valiant effort.
“Annabelle, you really need to stop having so much sex,” my concerned gynecologist admonished. I’d shown up at her office, doubled over with discomfort but smiling, nonetheless. I was on my second UTI in the space of a month. Who had time to rest? I’d gotten sunburned on the first day of a Caribbean vacay, melanoma no longer a concern.
“Cancer is my bad boyfriend, and I’m cheating on him!” I giggled like a teenager.
“Just give it a rest for a few days.”
I was still popping antibiotics when I hit my cancerversary. There’d been no progression since my last scan. “Break out the champagne,” my oncologist suggested, but by the time I reached the parking lot of the doctor’s office, I’d received the news that Frank, my first cancer buddy, who’d buoyed my spirits on numerous occasions, had succumbed to the disease. So instead of popping a cork, I took the occasion to declare a moratorium on friends and family sending me TED Talks by people with cancer who announce they’ve completed their first marathon. I vowed to remain an underachiever in Cancer World. I wasn’t going to adopt an indefatigability or aspire to heroic feats that might transform me into anyone’s idea of a cancer warrior. Just keep the cranberry juice coming.