We end the set with what has become one of our songs. I make a joke about how I only sing in C. My love knows that’s not true, but he humors me because he knows I panic if he says it’s in A minor. Without saying it aloud, I remind him not to sing my verse. You know the one, the one about most Novembers and why they make me cry.  I’m possessive about “Goodbye,” Steve Earle’s “ninth step in the key of C” – a sober song for anyone who has ever been to hell  – and back – for anyone who is sorry for the harm they caused even when they don’t remember causing it; it is a song for November.

Eight years ago, on a too-bright November morning, I was diagnosed with Stage II invasive breast cancer. I am loathe to declare the November date  a “cancerversary,” one of those cheery-sounding sniglets used to mark milestones in cancer country. The scars on this body that carries me from one moment to the next are daily and unavoidable reminders of that Halloween morning when I discovered the lump and the afternoon thereafter when an earnest young doctor, a stranger, delivered my diagnosis.  For cancer patients, there are plenty of these milestones – the date of a surgery undertaken to remove tumors or breasts or pieces of a lung; the completion of radiation or chemotherapy; the momentous day, five years after diagnosis, when a kindly oncologist will make the pronouncement of NED – No Evidence of Disease; and the day we dread most – discovery of metastasis.

Maybe it’s because there are no right words to respond to cancer, that we invent others to minimize and manage its havoc, to shelter us from it or make us smile through the illusion of it even as it terrifies us. And, make no mistake; we are terrified.

Me with Sherman Alexie

Filed away is an imperative from novelist, Sherman Alexie who once told an audience of writers that they “must share the scariest things about their lives.” Intrigued, I bought a ticket to hear him speak at the Heard Museum in Phoenix, bearing in mind advice he had given elsewhere: “Don’t lose the sense of awe you feel whenever you meet one of your favorite writers. However, don’t confuse any writer’s talent with his or her worth as a human being. Those two qualities are not necessarily related.” Accompanying me was my daughter, at the time a junior high student immersed in the words and drawings of Alexi’s Absolutely True Diary of a Part-Time Indian. ALong with everyone else, we laughed conspiratorially as he shared what were surely the scariest things about his early years on the Spokane Indian Reserve.  Describing his father’s booze of choice,”Squodka” – a mix of Squirt soda and vodka – Alexie’s cheery nonchalance belied, I imagine, the anguish of a young boy confronting the reality of an alcoholic father who would disappear for days at a time. He knows, I know, that alcoholism on the rez  is no laughing matter.

Nor is cancer. It is a serious disease deserving of serious words, but we do a lousy job of talking about it in a way that conveys its reality or leads us to knowing what causes it or how to prevent it. So we rely on codes invented to keep this scariest of things at a safe distance. Code is acceptable in the cancer conversation and not just in the pink stuff of Breast Cancer Awareness Month – “save the boobies” fare.  “Mastectomy,” code for “amputation,” causes me to wonder if I were an amputee in the “traditional” sense, if I would ever refer to the day I lost a limb as my “ampuversary.” I think not.

The truth is that in the mythology of cancer, medical euphemisms abound. Myself, I have bandied about “lumpectomy” as though it is the thing we do to remove an inconsequential wart. In reality, it is a partial amputation. When I was first diagnosed, I presumed a lumpectomy was in the cards for me. As a word, it didn’t pack much of a punch, so it didn’t frighten me.  Then I met the surgeon who pointed out that my cancer was not amenable to lumpectomy given its proximity to the nipple and the fact that I was not endowed with large breasts.  Essentially, she didn’t have enough to work with; therefore, the surgery to remove my breast and reconstruct it would be trickier than the “simple” lumpectomy I had anticipated. As her meticulous notes would later confirm, “dissection was very difficult given the very small circumareolar incision used for the skin-sparing mastectomy.” It would require additional time and effort, not to mention skill and patience. So she recommended – and I nodded sagely as though I knew what she was talking about – a skin-sparing mastectomy which entailed removing only the skin of the nipple, areola, and the original biopsy scar to create an opening – a small opening – through which she would remove the breast tissue. Duly spared – spared, no less – the skin would then accommodate a reconstruction using my own tissue. Simple.

Perusing the details of my surgery, you would be forgiven for dismissing  the removal of a breast as painless. At times it sounds regal, befitting a fanfare of trumpets for that climactic moment when my breast tissue was “elevated off the pectoralis and delivered from the wound.”

While three surgeons operated on me, my then-alive husband and our girl waited in a waiting room where a set of paintings of the desert at dusk hung on the walls. It would have been about ten o’clock in the morning when my surgeon came out to find my weary, tiny family leaning on each other , waiting for the announcement she would later document, that “the frozen section was negative for metastatic disease.” There were no abnormal nodes and no further dissection was necessary.  Celebrating, she and my husband performed a silent high-five in the hospital hallway. Three hours later, having removed all the cancer she could see, she went about her day, leaving me in the capable hands of two highly sought after plastic surgeons, one being one of the best in Phoenix, the other a master of DIEP flap reconstruction, who had flown in the previous evening from Texas. When I eventually emerged from the ICU, high on Dilaudid, they say I told the young nurse on duty to pretend I was Madonna. Before I went home, she shampooed my hair.

In surgery, they worked on me for the next six hours, and two days later released me back to my life. Eight years later, I am told I look just like myself. You would never know, unless you asked to see, or I summoned the courage to show you, that I really don’t look like myself. Not my original self. Hidden under my clothes, is a trivial but nonetheless relocated belly button, its circumference now dotted with tiny white scars. Below it, a thin crooked scar, faded to white, stretches from hip to hip, with ‘dog-eared’ reminders on either end where JP drains pulled excess bloody fluid for several days after the surgery. I have a right breast too. Sort of. It is in the shape of a breast, impressively so, now that all the post-surgical swelling and discoloration has gone. Its skin is the same, spared by the mastectomy that removed its cancerous tissue through a very small incision around the areola also removed with its nipple.

As a rule, I tend not to dwell on the macabre, but I sometimes find myself obsessing about my old right breast, now a mastectomy specimen preserved in a container of formaldehyde solution. It weighed 294 grams, “the words expressly are ‘a pound of flesh.'”

Contemplating all that has happened in the past eight years – the cancer, the plunge into widowhood two Novembers later, the shift in priorities – I hear my mother say, in the parlance of home, that I have “come through the mill.” Lest I wallow too much, somebody will always be there to point out that things could be worse.

One evening, shortly after the death of my husband, I bumped into a former colleague. He hadn’t seen me for a few years but had still kept up with my professional exploits. Standing in the produce department at Safeway, he tendered his condolences and then wondered aloud if I had ever read Joan Didion’s Year of Magical Thinking. Of course I have. Several times. I know great chunks of it by heart.  It is an exquisite study of loss that blows open my heart. And then he said to me, “Well, at least your daughter didn’t die.”

At least your daughter didn’t die. 

The sentence hung in the space between us for too long. I don’t remember what I said. Something perhaps. Probably nothing. I know I scrambled internally to excuse him as someone who had never lost anyone that mattered much to him. I know I also hated him.

At least your daughter didn’t die.  

No. She is right here. Just 21 years old and beautiful, tough without being hard, unmoored without the man who was her first word and who took her for ice cream to a Dairy Queen, since demolished, on Fridays after school. She learned to drive his Jeep without him and she strode across the stage to receive her high school diploma without his cheers ringing in her ears. He would have liked that they used the Talking Heads for the graduation processional – “This Must Be the Place.” He would have tapped his feet and winked at me and brushed away a tear, because by then, he would have grown sentimental – all the more if he’d had any inkling of the milestones on her horizon. She would earn her first paycheck without the ready winks and smiles that had always encouraged her to keep being great at being herself regardless of the bullshit that comes with a part-time job in retail. In spite of her trouble with math, she is navigating her way through the degree program that will allow her to one day work with teenagers who are lost without their parents.  She is lovely, reminding me sometimes of the kind of bird that only flies in a faraway place.  Exotic. Rare. Endangered.

On one of the anniversaries of his death that November morning when we were far from our home, she told me it was beyond her grasp that one day it would be ten years, twenty years, forty years, since her dad last held her hand in the frozen food section of the grocery store – to keep her warm.

At least my daughter didn’t die.

I still don’t have the words to hand to the man who asked me about Joan Didion’s book. I wanted to tell him I couldn’t remember if I’d said Goodbye to my husband, if he’d heard me say it before my cellphone died the way it always does because I never remember to charge it.  I wanted to tell him the last conversation our little family had was a transatlantic phone call – my daughter and I on top of the Titanic museum in a foggy Belfast, my husband in our Phoenix living room, all of us unaware it would be the last time we talked and laughed together.  I didn’t. Instead, I reminded myself of  Lou Reed reminding me of magic and loss and of Sherman Alexie lighting up the Heard Museum with a coping strategy for those times when we despair at the lack of compassion in the world. Remember, he had said, “the world gave us Hitler – but it also gave us Springsteen.”

The world gave us Bruce Springsteen.

And Prince. And Dolores O’Riordan. And Tom Petty. And Donald Trump.  And Steve Earle, sorry for all the lonely nights he put her through, for not remembering if he said goodbye. And all the people who say the wrong thing at the wrong time. We just have to find the sweet spot in which to live and die.

Magical thinking . . .

How shall I mark this day?

I will climb again to the summit of Piestewa Peak in the Phoenix Mountain Preserve. It has been almost a year since I stood there, arms akimbo, high up and far away. I have missed it up there, looking down and romanticizing the sprawl glittering below me. I think I’ll go back and wonder the way I do up there about Wordsworth when he first stopped to consider the view. It’s ’emotion recollected in tranquility. ‘ It’s just an illusion.

Composed upon Westminster Bridge, September 3, 1802

Earth has not anything to show more fair:
Dull would he be of soul who could pass by
A sight so touching in its majesty;
This City now doth, like a garment, wear
The beauty of the morning; silent, bare,
Ships, towers, domes, theatres, and temples lie
Open unto the fields, and to the sky;
All bright and glittering in the smokeless air.
Never did sun more beautifully steep
In his first splendour, valley, rock, or hill;
Ne’er saw I, never felt, a calm so deep!
The river glideth at his own sweet will:
Dear God! the very houses seem asleep;
And all that mighty heart is lying still!

Profoundly saddened by the recent death of Dolores O’Riordan and news that Tom Petty died of an accidental overdose, I barely looked at the clock yesterday, the way I have done for the past six years, on January 19th.  I am loath to declare the date I underwent the mastectomy and reconstruction of my right breast, a “cancerversary,” one of those cheery-sounding sniglets often used to mark milestones for those ensnared within the disease. There are too many milestones – the day a lump is discovered or a diagnosis delivered; the date of a surgery undertaken to remove tumors or breasts or pieces of a lung; the day, five years after diagnosis, when an oncologist makes a pronouncement of NED – No Evidence of Disease.

Maybe it’s because we don’t have the right words to respond to cancer, that we make up other words – to minimize and manage its havoc, to shelter us from it, to make us smile through it even as it terrifies us. We are terrified.

me with Sherman Alexie

Sherman Alexie. says that writers must write about the scariest things in their lives. Intrigued by this advice, I bought a ticket to hear him speak one evening at the Heard Museum in Phoenix. Accompanying me was my daughter, in Junior High at the time and immersed in his Absolutely True Diary of a Part-Time Indian. Along with everyone else, we laughed as he shared what were surely the scariest things about his early years on the Spokane Indian Reserve.  His laughter as he described his father’s beverage of choice,”Squodka” – a mix of Squirt soda and vodka – belied, I imagine, the anguish of a young boy confronting the reality of an alcoholic father who would disappear for days at a time. I know Sherman Alexie knows that  alcoholism on the rez  is no laughing matter.

Nor is cancer. It is a serious disease deserving of serious words, but we do a lousy job of talking about it in a way that confronts its reality or that leads us to knowing its cause or how to prevent it. We speak in codes that keep this scariest of things at a safe distance. Code is acceptable in the cancer conversation and not just in the pink stuff of Breast Cancer Awareness Month – “save the boobies” fare. Codes. “Mastectomy,” for example,  is code for “amputation.”  It makes me wonder. Were I an amputee in the “traditional” sense, would I refer to the day I lost a limb as my “ampuversary”? No. I would not.  Medical euphemisms abound. I used to toss around “lumpectomy” as though it were the removal of an inconsequential wart, instead of what it really is – a partial amputation. When I was first diagnosed, I presumed a lumpectomy was in the cards for me. As a word, it didn’t pack much of a punch, so it didn’t frighten me. Then I met my surgeon who pointed out that my cancer was not amenable to lumpectomy given its proximity to the nipple and the fact that I was not endowed with large breasts.  Essentially, she didn’t have enough to work with; therefore, the surgery to remove my breast and reconstruct it would be trickier than the “simple” lumpectomy I had anticipated. As her meticulous notes would later confirm, “dissection was very difficult given the very small circumareolar incision used for the skin-sparing mastectomy.” It would require additional time and effort, not to mention skill and patience. So she recommended (and I nodded sagely in agreement as though I knew what she was talking about) a skin-sparing mastectomy which entailed removing only the skin of the nipple, areola, and the original biopsy scar to create an opening – a small opening – through which she would remove the breast tissue. Duly spared – spared, no less – the skin would then accommodate a reconstruction using my own tissue. Simple.

Reading through the details of my surgery, you would never know that cancer and its treatment is ugly or that it hurts. At times it sounds downright regal, befitting a fanfare of trumpets, especially that climactic moment when my breast tissue was “elevated off the pectoralis and delivered from the wound.”

While three surgeons operated on me, my weary husband waited, leaning on our daughter, she on him. It would have been about ten o’clock in the morning when my surgeon came out to announce to them what she would later write, that “the frozen section was negative for metastatic disease,” that there were no abnormal nodes, that no further dissection would be needed. She and my husband performed a silent high-five in the hospital hallway. And, after three hours, she had removed all the cancer she could see and could go about her day, leaving me in the capable hands of two highly sought after plastic surgeons, one being one of the best in Phoenix, the other a master of DIEP flap reconstruction, who had flown in the previous evening from Texas.

They worked on me for the next six hours, and a day later released me back to my life. Six years later, I am told I look just like myself. You would never know, unless you asked to see, or I summoned the courage to show you, that I really don’t look like myself. Not my original self. Hidden under my clothes, since the DIEP flap reconstruction, is a trivial but nonetheless relocated belly button, its circumference now dotted with tiny white scars. Below it, a thin scar, faded to white, stretching from hip to hip, with ‘dog-eared’ reminders on either end where JP drains pulled excess bloody fluid for days after the surgery. I have a right breast too. Sort of. It is in the shape of a breast, impressively so, now that all the post-surgical swelling and discoloration has gone. Its skin is the same, spared by the mastectomy that removed its cancerous tissue through a very small incision around the areola also removed with its nipple.

I tend not to dwell in the macabre, but I cannot help wonder about my old right breast, now a mastectomy specimen preserved in a container of formaldehyde solution. It weighed 294 grams, “the words expressly are ‘a pound of flesh.'”

Contemplating all that has happened in the past six years – the cancer, the death of my daughter’s daddy, the shift in priorities – I suppose you could say what they say in Northern Ireland. “God love her, she’s come through the mill.” Lest I wallow too much, however, there is always the reminder that I could be worse off.

I recall encountering someone I hadn’t seen for a few years, and he asked me if I had read Joan Didion’s Year of Magical Thinking. Yes. Indeed I have. Several times. I know great chunks of it by heart.  And then he said, “Well, at least your daughter didn’t die.”

At least your daughter didn’t die. 

No. She didn’t. She is right here. She is 20 years old now and beautiful. She is tough without being hard. She is vulnerable without the man who was her first word and who bought her ice-cream every Friday afternoon. She learned to drive without him and walked across the stage to receive her high school diploma without his cheers ringing in her ears. She earned her first paycheck without the winks and smiles that encouraged her to keep being great at at being herself. She completed her Associate’s Degree and is off to complete a degree in Psychology, so she can one day work with young people who have lost parents.  Sometimes my lovely girl reminds me of a beautiful bird.  Exotic. Rare. Endangered.

On the anniversary of his death, she told me it was beyond her grasp that two years had passed and that one day it would be ten years, twenty years, forty years, since her dad last held her hand in the frozen food section of the grocery store. To keep her warm.

At least my daughter didn’t die.

So I didn’t know what to say to the person who asked me about Joan Didion and therefore said nothing. I should know but still don’t that when people show you who they are, believe them.  Instead I reminded myself of  Lou Reed’s reminder of magic and loss and of Sherman Alexie who told us that night in the Heard Museum that when we despair at the lack of compassion in the world, we might remember that the world gave us Hitler – but it also gave us Springsteen.

The world gave us Bruce Springsteen.

And Dolores O’Riordan. And Tom Petty. And, yes, the world also gave us Donald Trump.  And all the people who say the wrong thing at the wrong time. And somehow we have to find the sweet spot in which to live and die.

Magical thinking . . .

So what will I do to mark the day?

A day late, I may just climb again to the summit of Piestewa Peak in the Phoenix Mountain Preserve. It has been over a year since I sat at the top, and I have missed it. Up there, I will survey the valley below. And, glad to be so high up and far away from where I lay eight years ago, I will weep.

I will weep.