Kate Reimann

muse & ponder; ponder & write

Writing for my life.

Side Effects

"This is it? Where's the entourage?", I joke as the doctor moves past me to his chair in the corner, trailed only by the nurse practitioner and research coordinator today.  The cramped room, normally packed with interns and fellows, all eager to examine my husband's betraying body, seems strangely vacant even though there are still five of us for today's checkup.

The joke goes unacknowledged.

"A number of people have died on your arm of the trial," the doctor dives in, "most were frail, old; probably dying due to high toxicity in the body.  I wouldn't have allowed them to participate, but it's a national trial and I don't have much oversight.  So, in any event, your arm of the trial as been suspended pending further review".

I feel the blood drain from my face and then heat creeping up my neck; I grip the seat of the chair with my arm locked at my side, a reflex to keep myself from falling.  I try to listen to the words he's saying as he continues, but I only hear the word "died" on repeat in my head.  I try to focus on the doctor.  I remind myself that my husband is healthy, alive, sitting next to me.

I take a breath.

"How many people died, exactly?" I ask, hoping I seem unaffected.

"Around six or so, out of four hundred", he says.

"And how many of them were old and frail, in their eighties, as you said?"

"I can't say for certain", he responds, crossing his leg, left ankle atop his right knee.  He wears a pin in the shape of a heart with the letter M on his lapel.  I focus on this as he speaks, "and this was all in the first twelve weeks of dosing."

"So, to clarify, none of them after the initial twelve weeks?" I press him, wanting to know if my husband is at risk.

"Again, I can't say for certain, but I think most of them did.  We'll know more after the review in six weeks, at which point we'll let you know if the trial will continue or if we're done," he uncrosses his legs and sits a little straighter, pointing his body toward the door.

I glance at my husband, seated by my side, a buffer between the doctor and me.  He has not spoken.  My silence is his cue.

"So, I might be done with the trial in November?  And then what happens?" he speaks, shaking off the surprise, stepping into his proactive patient role.

"Then that's it, you're done," the doctor says, opening his hands.  Ta-da!

Just moments before, I think to myself, we were scribbling notes about TSH levels, waiting for blood work results, thinking my husband's high TSH levels were indicative of a pituitary gland side effect.  We were worried about the wrong side effect.

We recap the news but it is clear that there is little else to discuss at this point.  The doctor rises, shakes my husband's hand, then mine.

"See you in six weeks," he says as he strides out of the small room. 

Some chit chat ensues, some tying up of loose ends.  The nurse practitioner mentions a waiver she'll provide for my husband for work, the research coordinator tells us to follow up tomorrow for the blood work results.  All light and fluffy comments: have a great week!  and see you soon!

We walk out of the cancer center at Georgetown and into the autumn sunlight, handing off our valet stub and waiting for our car's return.  I rest my purse on a cement pylon and lean into it, supporting the weight of the news.  The breeze blows the first of the fall leaves across the circle drive and the scent of crisp leaves mingles with freshly-laid asphalt--a strange combination.  I watch as college co-eds traverse the parking lot in groups, excited chatter, their enthusiasm written on their faces.  An odd juxtaposition, these young students, entering and exiting the cancer center.  I feel our life changing again, I feel us entering another state of flux, and I watch book bags full of knowledge bounce in front of me on the backs of students whose biggest challenge is a paper, an exam, an unrequited love.  I watch them jealously, longingly.

"How are you doing?" my husband asks, leaning into my sight line and trying to make eye contact.

"How are you doing?" I volley back, wondering which part of this news hit him the most.

He shrugs as the car pulls up, scattering the co-eds, and we are back in motion.

"It's just ironic," he throws over his shoulder before he slides into the driver's seat.

I remember a few hours ago, lunch on the other side of the Potomac, sitting across from my husband at an overpriced by lovely restaurant in the heart of our town--our favorite.  I sip my latte and listen as he explains all of his career options and possible moves come the end of his clinical trial in May.  I gaze out the window as the city bustles with lunchtime traffic, taking another sip.  He continues exploring every options, every possibility.  I pepper him with questions.  The waitress delivers our lunch but he doesn't slow down--too much to consider.  I see a nanny walk in front of the window, talking on her iphone while pushing a stroller that cradles a sleeping toddler.

He pauses a moment to take a bite, then looks up and asks, "so, what would you like to happen?"

I consider the question as I cup my latte with both hands, trying to warm my chilled body with the hot ceramic mug.  I am not ready for the cool weather.

"I'd like to not move for a little while," I smile at him.  I remember the four different homes in less than eighteen months, then shrug, "but I don't know how much control we really have once the Air Force decides to put you somewhere after the trial." I look again out the window, the tree-lined street hinting at the change of season with a few stray leaves, the busy pedestrians in long sleeves.  The sky is a crisp blue, and despite the changing season, the sun still warm. 

"I love this city, and I'd like to stay for a number of reasons; our family and friends are here," I pause a moment, flashing back to the backyard party we threw a few weekends ago, a crowd full of faces who love my husband all gathered under a dark mid-September evening sky, smiles lit up by patio lights and candles, raising their glasses to toast to his health.  Knowing true friendshipone of the best side effects of cancer, I think to myself, then continue.  "I'd like to know where our kids will go to school, I'd like to not pack up our stuff again, but namely, I'd like you to have continuity of care.  Doesn't that count for something?  Can't we be to stay here for a while based on that alone?", I ask, hopeful.

"Well, in theory," he leans back in his chair, his turn to contemplate the city just beyond the window, "but at least we have until May to figure it out and weigh all of our options", he finishes his last bite and then picks up his coffee.  "It is a great town," he adds with a twinkle in his eye.

We are driving home again on this all-too-familiar route.  "I stay in the left lane, right?" my husband asks as we leave Georgetown, crossing the Key Bridge.  I nod but the question is rhetorical, he knows this part of town all too well.  He is preoccupied by the news, distressed about what this means for our “plans”.  I am preoccupied with six deaths.  Always back to dying.  The familiar sense of the unknown settles between us.  Our life, only a few hours ago, was headed in a certain direction.  We had options, we had time.  And now on the drive home, it's all up in the air--again.

***

Now it is morning, and again I clutch my warm mug and wrap my sweater tighter around me as I try to shake off the morning cold.  My son brings me a credit-card sized brochure that he's pulled out of his daddy's wallet--he is always leaving it within their reach. 

"Look, mommy!  My favorite book!" He flashes the small packet and it registers as something important.  I ask him for it, and his small hand presses it into mine.  He watches me for a second, then decides to read another favorite book.  I open it up: a credit card-sized quick-reference for my husband listing all of the possible side effects of his treatment.

All the information anyone would ever need, all in this tiny little brochure.  And yet, even now, I am still so unprepared for the side effects.

Constellations

Though we chase the fading light of the longest day of the year as long as possible, the stars give way and the sun relents.  From the passenger side of the childless car I look up at the pale blue, darker to the east and lighter to the west, and see the constellations appear.  I remember our last night in Buenos Aires, the warm breeze, the full moon.  The balcony spread before us offering us a view unparalleled; city parks sprawling below us like a carpet unfurled, the tree tops beckoning to us with their swaying branches.  The vibrantly lit and Romanesque fountain a block away, changing colors every night.  My husband and I sip our favorite discovery: an obscure Argentine blend that makes us feel like locals.  We star gaze and whisper and at some point I cry about the fate that awaits us: cancer treatment, no house, uncertain future.  But on the balcony I can postpone my dread for a few more hours, and so we stay.  Looking up, my husband wonders aloud about the stars overhead, the brilliant canopy that seems to shine brighter this night. 

“I’ve always wanted to see the Southern Cross”, he muses, more to himself than to me, and then suddenly he’s a man on a mission, searching for the Ipad, searching with purpose.  He returns a moment later, face buried in screen.  “Didn’t my parents have some star-gazing app?” he asks me without looking up, though an answer is not required.  He has already begun the download.  We wait a moment longer, and then he points the Ipad at the stars, hoping to learn just one more thing about this magical place in the southern hemisphere before we are foreigners again.

He moves the Ipad slowly across the sky as he identifies one by one the satellites and constellations.  And then, victory.

“There!  Right there!” he signals to a small cluster in the sky, switching between his Ipad and reality, “the southern cross!”  A contented smile on his face, he checks it off the list.  There it is: gratitude.  He can’t stay here in the city he loves working a job he relished, but at least he found the stars he sought, and he is grateful.

I smile to myself in the car, remembering the fulfillment of “finding” the constellation right before we left for good.  I turn my gaze over to my husband, steering us home.  The ceremony this afternoon brought us back to yet another time; another part of his life out of reach due to cancer and circumstance.  The change of command ceremony in middle-of-nowhere South Carolina was not to be missed.  A squadron he flew with now to be run by one of his best friends; history coming full-circle. 

I remember my husband’s anxious request.  “I’d like to be there,” he says after receiving an email from his friend announcing his change of command.  And I agree.  We drive 7 hours south from DC to SC to watch the ceremony.  It is a breezy, blue-sky day on base and the roar of the jets makes me ache for our former life.  I catch myself remembering the drives home from my job under the hot Phoenix sun, weaving through the back roads lined by rose fields as I try to catch a glimpse of my then-fiancé in his jet, wondering if he can see me from the sky.  My husband stands in the hangar at attention as we watch the ceremony, wearing his flight suit for what is likely to be his last time.  Among other things, cancer has stolen his ability to fly. The flags change hands and suddenly our friend has become commander, right in front of us.  My husband smiles and tells me to watch the jet in the back of the hangar.  I turn to see an airmen unveil the new commander’s name on the jet, symbolism and history all in one.  My husband claps his hands together in pride and excitement, reveling in the experience.

An hour later we are celebrating and I am talking to the new squadron commander’s wife, the dermatologist friend—our first call after my husband’s diagnosis—who knew before we did what a stage III melanoma diagnosis actually meant.  Between children tugging at her dress and a sprinkling of well wishes from other spouses and airmen, we talk about the last year of our lives, the surprises we’ve encountered, the joys and the heartaches.

And then she asks, “How are you handling all this?” and her eyes begin to mist.  I take a breath.  But the words come easily, because they are true. 

“I made a decision.  I have two options:  I can either wonder everyday whether my husband will die from this, or I can enjoy every second of every day we have together.”  I scan the room to find my husband.  I spot him with the commander, laughing.  He sees me and smiles.  “And I choose to enjoy.”  I catch myself wavering as I finish the sentence.  This is not the place I tell myself.

She smiles and I smile and I know that in a different setting, we’d be crying.  But there isn’t time and it doesn’t matter.  We are celebrating.  Life is happening all around us.  And so we rejoice.

“The longest day of the year and now it’s over!” my husband’s observation brings me back to the front seat as he watches the dark envelope the sky.

“Do you miss it?” I ask him, and he frowns for a minute as he deciphers what “it” I am referring to.

“The flying?”

“Yes,” I answer, “the jet, the flying, your old life.”

He takes a moment and adjusts his hands on the wheel, flexing his hands and then re-grips.  “I do miss it,” he reflects, “but I’m really happy with the decisions we’ve made.  Going to Argentina took me out of the jet, but I wouldn’t have missed it.”  He takes a breath and then proceeds, his voice a little softer.

“I’m just so glad I’ve been able to do all that I’ve done.  I really am.”

And there it is: gratitude. The change of command, the jets he’ll never fly again, watching friends move on and up in their career while he is sidelined by cancer on “patient status” until the end of his clinical trial, none of this bothers him.  He squeezes the good out and discards the rest.  He is the person I wake up to every morning, and he manages to surprise me even now.  In this moment, I remind myself to be more like him.

“Do you miss it?” he says with a grin, well aware of my weakness for a man in a flight suit.

I smile, “Just don’t throw out the flight suit.”

He laughs and we drive into the dark, watching the northern hemisphere stars burn brighter as we go.  I scan the satellite radio and find a Jimmy Eat World concert and we sing when we know the words, and listen when we don’t.  Closer to the city he spots fireworks from a theme park in the distance and we watch like little kids.   Our drive comes to a close beneath the brilliant full moon and we kiss each other before getting out of the car as if on a first date.  The moon full and bright, the stars sparkling, the fireworks, it’s as if the city is welcoming him home. 

And I am grateful.