September 2009 Archives

After a couple of hours, the technician came over and unhooked me from the IV.  Manuel would be here shortly and I knew better than to try getting up of the couch before he did.

I had managed to walk here under my own power but that was before the latest chemo dose went coursing through my veins.  I knew I couldn't stand, let alone walk without falling over.  I could probably sit up without assistance but why risk it?  I was feeling pretty nauseous and didn't want to move until I absolutely had to.

I turned my attention to the TV screen.  The narrator of a program on Animal Planet talked about how packs of timber wolves were actually doing musk-ox herds a favor by weeding out their sickest and weakest members.

Manuel arrived with a wheelchair to take me back to my room.

As I was wheeled out of the building, the sun was low in the west and most of the protesters had already gone home.  Those who remained were hired by private insurance companies to beef up the head count and join in on the demonstrations.  They were quiet now because there was no one around to lead them in a yell.  Nobody was paying them to instigate.  Since we seemed to have a ceasefire, I thought it wouldn't hurt to give them a friendly wave.  They didn't respond.  Nobody was paying them to wave either.

When we got back to my room, Les was gone.  Gone too were his clothes, suitcase, and the stack of past issues of Maxim he kept on his bedside table.  The bed had been made with fresh, clean sheets. 

My first thought was that Les had died.  People with cancer have been known to do that.  But he seemed fine earlier.  He could have taken a turn for the worse but that doesn't usually happen this fast.  I asked Manuel if he knew what happened.

"I haven't heard a thing," he said.  "Maybe his family came and got him."

"He didn't have any that I know of," I said.

"Friends then."

"None who ever came to see him."

So maybe Les was dead.  It was likely I would never know for sure.  The staff at Monos Borrachos wanted the patients keep a positive outlook so they didn't make it a habit of announcing that one of us had died.

I spent that night in the room alone, queasy from the post-chemo nausea and wondering if I too might quickly die and have all traces of my existence removed within hours.  No, I decided that was never going to happen to me.  Les' problem was that he never had anyone like Heidi to keep his life worth fighting for.  When I finally drifted off, I slept soundly until morning.

During the night, halfway across the country, rage over national healthcare had turned to bloodshed.

I sat in the rec room the next morning and it was all over the news.  A group calling themselves "God's Own Doctors," or "GOD," had launched a midnight raid on a convalescent hospital in Holland, Michigan.  They brutally murdered 27 patients and hospital workers in the attack.  Throats were slashed with scalpels, fatal embolisms were caused by injections from hypodermic needles filled with air, and one elderly man succumbed to an eight-gallon forced enema.

I sat with my eyed glued to the screen, wondering what would possess anyone to do such things.  I waited for the in-depth report where Anderson Cooper explained everything so I could go to bed that night thinking that maybe the world had not lost its collective mind.

That wasn't going to happen or at least I never got the chance to see it.  The Monos Borrachos activities director turned off the television and said she had an important announcement.  Ms. Lydia Smids, who amazed us at the last talent show with a couple of Kenny Loggins songs performed on a Casio keyboard, would be giving an encore performance the following day.

The activities director then tried to put our minds at ease about last night's violence in Michigan.  She told us about the steps being taken to ensure that it would never happen here.  Armed (albeit bulletless) nurses, a precautionary measure when the threat was more hypothetical, were only the beginning.  From this point forward, all visitors would have to pass through a metal detector.  Card keys would be turned off for all employees except for security staff from dusk until dawn.

She called upon us patients to do our part as well.  We were asked to review the code of conduct we agreed to when we were admitted here.  It required us to refrain from stealing from Monos Borrachos, assaulting members of the staff or other patients, and engaging in activities that endanger the lives of ourselves and others.  We were also asked to stay vigilant and report any suspicious people or activity. 

In return, the center planned to hire a martial-arts instructor to teach us how to defend ourselves from anti-healthcare extremists.  Presumably, the thinking was since we were as bald as Shaolin monks, we would have a similar aptitude for kung fu.

A day passed.  I sat in the main lobby waiting for Heidi.  She was running about 45 minutes late, not unusual for her.  I didn't have to wait much longer.  I heard her voice coming from the direction of the newly installed metal detector.  She had set the thing off a number of times and her mood was beginning to sour.  I went to meet her there to see if I keep her from getting too upset.

"Jesus Christ," she said to the short, stone-faced woman in the security uniform.  "Does this place moonlight as an airport?"

Heidi pulled the silver bracelets off her wrists and dumped them with the jewelry already sitting in a plastic tray.  I didn't recognize most of the stuff.  She must have bought it recently.  A little retail therapy.

"I'm not trying to smuggle in a gun, for God's sake," she continued.  "Come on, now why would I want to waste bullets on a bunch of people who are probably going to die anyway?  Oh Richard, there you are.  Would you mind telling this lesbian that I am not a terrorist?"

"My wife is not a terrorist," I said.

The guard shrugged and waved her through.  Heidi kissed me on the cheek and then dabbed her lips with a Wet Nap.  As we crossed the lobby, she gave a broad sweep with her arm at the window overlooking the parking lot.

"Roger insisted on staying in the car so we could have some time together.  Isn't he just a dear?" she said.

I looked out and saw Roger in the driver's seat of a parked BMW, his hands not budging from the ten and two o'clock positions of the steering wheel like he was still a teenager in driver's ed class.  Funny, but I seemed to recall him driving a Honda Civic.  I thought for a moment that this car could be a rental but then remembered that the "N2CUGRZ" vanity plate was definitely his.

"Before I forget, you need to call the principal at Tyler's school," she said.

We walked into one of the meeting rooms.  It had two chairs, a small table, and a framed poster, a sunset with an affirmation in calligraphy, bolted to the wall.  An energy-efficient fluorescent light flickered from the ceiling.

"Did he get suspended again?" I asked.

"Expelled."

I asked if I could argue that he was once again acting in self-defense.  Not this time.  Tyler had tackled a smaller boy, pantsed him, and proceeded to see how many fingers he could fit in the kid's anus.

The answer was four, but only two without drawing blood.

"I know," Heidi suggested.  "You can play the cancer card.  Just tell them that you illness is exacting a terrible toll on Tyler's childhood.  Sounds plausible, doesn't it?"

"Yes, I suppose it does."

You see, what would you do without me?  Now then, I went over the books and it looks like we need to liquidate some of our home equity until you get back on your feet.  So be a dear and sign this application for a second mortgage."

"Well, if you think it's necessary," I said.

"Absolutely.  I went over my calculations several times and I only plan on taking out the bare minimum to keep the household afloat."

It must have been a real emergency because the bare minimum came close to every bit of equity we had.  I signed the application and handed it back to her.

"Thank you, now I really must scoot," she said.

"Can't you stay a little longer?"

"Oh sweetheart, I can't.  Roger said that if I didn't make it back to the car within twenty minutes, he was going to start riding the horn.  He is such the impetuous one."

"When will I get to see you again?"

"Richard, I just don't know.  My life has been so hectic lately.  In fact, I don't know if we can do our weekly talks on the phone either.  You can write me though.  Yes, I'd like that."

"Heidi?"

"Yes, Richard."

"I love you."

"Yeah."

And she was gone.

I sat there for a few minutes and then started back toward the rec room.  Ms. Lydia Smids' performance was already and I could hear the chorus of "Danny's Song" pour out from her Casio.  I didn't much care to be entertained right then so I turned and headed for a side door that led out to the garbage bins.  Ms. Smids dedicated the next song to the talent show's first runner up, who gave us her last tap dance before having her leg amputated below the knee.  It was a few bars into "Footloose" when the door swung closed behind me.

It was peaceful out there, blissfully cut off from the protesters by the main building.  I saw an orderly I didn't recognize, probably a new guy.  He was banging a pack of cigarettes against the heel of his palm.  Smoking was not allowed for either of us but for the first time in years, I really wanted one.

I asked him if I could bum a smoke and he said OK.  He reached into his pocket, I thought for a lighter, but he pulled out a wallet, flipped it open, and showed me a badge.

"Monos Borrachos security," he said.  "Please come with me."

He led me away from the main building, toward the windowless one with "RCU" in block letters on the wall.  I wasn't sure if I had ever actually seen anyone go into that building before.  I was quite sure I had never seen anyone come out.  

I heard footsteps coming down the hall.  At first I thought it might be Manuel coming to take to my chemo appointment but realized it was too early for that.  It turned out to be Donna, one of the nursing interns.

Donna was young and very good looking, and her physical beauty really stood out compared to us bald and wasting cancer patients.  It was an uncomfortable contrast for her as well as us.  I wouldn't go so far as to say we repulsed her but it was clear she would have felt better around a different clientele, perhaps people recovering from rhinoplasty or minor sports injuries.  Or maybe just less depressing than we were.

It was nearly impossible to be around her and not be affected by her appearance.  I was a happily married man but when she walked in the room, I caught myself preening for her.  I sat up in bed and tried to straighten my hair, forgetting that it all fell out a couple of weeks ago.

Les' reaction was far more spirited.  He was holding two Post-it pads and dropped one of them on the floor.  When she bent over to pick it up for him, I was content to simply admire her posterior but Les had other plans.  He quickly scribbled a note onto the pad he was still holding, peeled it off, and slapped it onto her butt. 

This made her let out a yelp.  When she spun around to face Les, he was laughing, or his jawless equivalent, which sounded more like someone raking wet leaves on cement.  It must have been too much for the poor girl.  She fled the room with "Property of Les Chinn" stuck to her rear end.

Manuel arrived after a bit to take me to my chemo appointment.  As he helped me out of bed and to my feet, I noticed that he was wearing a gun belt and sidearm over his sky-blue scrubs

Les saw it too.  He scribbled a note on his Post-it pad and showed it to Manuel and me.

"Don't shoot me.  She wanted it," the note said.

"Huh?  Oh this", Manuel said, pointing at his gun.  "It's a new security precaution.  We're required to wear them when we go outdoors.  Try not to let it bother you."

"Do you think you'll ever have to use that thing?" I asked.

"I hope not," he said.  "We're not allowed to load our weapons."

I walked with Manuel down the hallway toward the door that led to the grounds.  I was hoping that even without bullets in the guns, Monos Borrachos administrators had erred on the side of caution.  After all, this wasn't a Planned Parenthood clinic.  Since the reformed healthcare system came into effect, there had been no shootings at clinics that did not provide abortions.  Well, there was that paintball incident at a hospital in Delaware when a homeless man was going in for a kidney transplant but nothing with real bullets.  Not bad for three solid months.

On the other hand, the anger level of protesters had increased after Fox News aired two-part series of special investigative reports about abusers of the system.

The first was titled "Cancer Cells, Terror Cells" and claimed that treatment centers such as the one I was in aided and abetted Al Qaeda.  According to an unnamed homeland-security expert shown in dark silhouette, members of this group have been getting tumors from handling WMDs during training exercises and are using free American healthcare to get well enough to carry out their suicide attacks.

"Day Laborers, Healthcare Nightmare" was the second piece and the story was about clinics and hospitals of every sort, rather than just cancer-treatment centers.  In this segment, an unnamed legislative analyst (also shown in dark silhouette) said that somewhere in the legalese of the bill signed into law was a provision that American citizens have a lower treatment priority than illegal immigrants due to an alien-reparations rider amendment tacked on by Ted Kennedy just before he died.

The Obama administration dismissed the allegations as pure fiction.  Fox News viewers, on the other hand, took it as gospel.

"Don't worry," Manuel, who was Latino, assured me.  "As long as no one thinks that I am the patient, everything is going to be OK."

We walked outside through the automatic double doors.  We must have surprised the crowd because at first, there was no shouting, no insults.  They stood around talking and joking withe each other like they were friends gathered at a weekend barbecue.  And for the briefest of moments, I didn't feel like I was their enemy.  I was not a parasite bleeding society dry to them.  I was simply Richard Terkel, a friend and neighbor who just happened to be very sick.

The moment didn't last.  When the protesters saw us, they mustered into a united opposition.  The exception were the Westboro Baptist, who had been yelling unintelligibly and waving their "God Hates Remission" signs from the get go.

 The bulk of the crowd started with a chant I was pretty sure they had been doing off and on all day.  I couldn't make out the exact words when I was indoors but the cadence and meter were the same.

As we neared the chemo/radiation building, the tempo quickened and the volume increased.  It seemed like they were nearing a boiling point where they would charge us.  Maybe it was basic civility that stayed their hand.  Maybe it was Manuel's pistol.  Things would turn violent for someone but not for us, at least not right now.  We made it inside the building safe and sound.

Manuel led me to one to one of the chemo couches, which looked like a Barcalounger with an IV unit set up on the side of it.

"I'm sorry about what happened outside," he said while helping me onto the couch.  "Can you do me a favor?"

"What?" I asked.

"Outlive them."

He said he'd be back in a few hours to pick me up and left. 

The room I was in sat twelve.  All the couches faced a TV screen showing Animal Planet so the patients didn't have to look at each other.  The struggle for survival of gazelles and sea otters is a lot more fun to watch.

A medical technician came along and hooked up the chemo drip, saying the doctor would be along shortly.  From an upside-down bottle hanging from the IV stand, fluid moved down a plastic tube and through a needle into my arm.  Its job was to kill the cancer cells growing inside my body.  It was not supposed to kill the rest of me in the process but after each of these treatments, it felt like it was doing just that.

A short while later, the oncologist came in and started making her rounds.  She asked me how I as doing while she was checking my chart.  I said fine, she said good, and she moved onto the next patient.  There was nothing kindly or maternal about her bedside manner.  It was as if she were overseeing an assembly line that churned out cancer survivors and she was damned if she was going to let anyone die on her watch.

I actually found her demeanor reassuring.  Sympathy and comfort for the afflicted do not cure cancer and they never have.  Chemotherapy and radiation treatment put people through hell but they hold the best hope for recovery.  My oncologist knew that what was best for me was not always what was easiest.  In that way, she kind of reminded me of Heidi when she and I first got together.

It was many years ago just after the death of my grandfather.  The man practically raised me and I loved him very much.  He left me a sizable sum of money that was sitting untouched in my bank account.  I couldn't bring myself to spend any of it because I thought it would cheapen his memory and I had every intention of living out my life grieving this way.

My girlfriend at the time was no help at all.  She was a sweet but plain woman with no ambition.  She had no problem spending night after night curled up with me on the couch in front of the TV, drinking beer and smoking cigarettes together while watching rented videos until all hours of the night.  It was her then best friend Heidi who rescued me from that and showed me that I deserved better.

Heidi persuaded me to dump the girlfriend and start dating her.  I was also to quit smoking (Heidi was allergic) and most importantly, to loosen up and live a little.  She convinced me of something that should been quite obvious all along, that my grandfather left me the money for me to enjoy.

The romance blossomed and within a year, Heidi and I were married.  We lived in carefree luxury for as long as the money would last, which turned out to be just over a year.  I might have slid back into my old ways if it weren't for Heidi.  She gave me the motivation I needed to find and hang onto a higher-paying job, even though that meant working long hours and weekends, so we could continue to live in the way we had grown accustomed.

It was all worth it.  We had a great life together that could be exemplified in no better way than in our beautiful son Tyler.  Even in my fight against cancer, I felt like I was the luckiest man alive.  I was glad I would have two days to recover between this chemo treatment and her visit.  I wanted to show her that I was on the road to once again being the man she married.  After all she had done for me, she deserved nothing less.

It was a glorious time for chemotherapy.  President Obama had gathered enough support to reform health care on his terms without retreat or compromise.  A lot of people were not happy with this but armed with a decisive majority, the chief executive came to the realization that he didn't need to care what they thought.  About anything.  He showed little concern about appearing elitist when he admitted that he never much liked the taste of beer and even less about alienating the Christian right when he dismissed the Bible as "a load of crap."

It was in this heady beginning of universal health care when my doctor gave me my diagnosis and then handed me a bunch of brochures for cancer-treatment centers around the country.  I was assured that they all had excellent reputations in the medical community and all I needed to do was find one that was the most suitable and convenient for me.  I didn't have to worry about the expense.  Taxpayer dollars would take care of that.

When I got home, I broke the news to my wife Heidi.  She put her arms around me, kissed me, and said that we were going to beat this thing together.  We spent some time going over the brochures.

"This one seems nice," she said about a treatment center on Lobster Island, off the coast of Maine.

"It's three thousand miles away.  I'd never see you."

"Oh yes, there is that," she said.

"Here's one that's less than an hour's drive.  Let's go with that."

"OK."

"They even have an outpatient option.  I could continue living at home."

"That would make me primary caregiver," she said.  "Richard, you know I would do anything for you but think about it for a moment.

I had to admit that it was a pretty silly idea.  Anyone who wanted proof of Heidi's absent-mindedness needed to look no further than when she drove off with down the road with our infant son Tyler on the top of the car.  To be fair, it happened ten years ago and she felt terrible about it at the time. Tyler had since grown into a healthy young boy, quite big for his age actually.  You would never guess there ever was an accident except for a dent in his forehead and his lack of impulse control.


There was a four-story windowless building at the rear of the complex with "RCU" written in block letters along the side of it.  According to the brochure, this stood for "Resource Storage and Utilities" and held supplies, equipment, and backup generators that could provide electricity for the entire facility in case of power failure.

The rest of the center had plenty of windows and was far more inviting.  Most inpatient accommodations, including my own semiprivate room, faced south and were bathed in natural light throughout the day.  There was a rec room equipped with board games and a wide-screen television.  On some days, this area doubled as a showcase for patient talent shows organized by the center's activities director.  Those willing to take the stage were guaranteed a receptive audience as both attendance and applause were mandatory.

There was one design flaw in the facility that no one could have anticipated.  Almost all the buildings were connected.  The lone exception was where patients went for their chemo and radiation therapy.  This was a major selling point in the brochure.  The idea was if people had a physical break between these unpleasant treatments and the rest of their day, the fight against cancer would feel less daunting.

It was a short walk or wheelchair ride there along a concrete path that cut through the pristinely landscaped grounds.  There was an overhead canvas canopy to shield us from UV rays and the occasional rainfall.  Other than that, the path was open to the elements.  Given California's climate, this was a non-issue.  It was also open to any insult an angry mob felt like hurling at cancer patients.  Given the current political climate, this was a very big issue indeed.

The crowd that assembled on a daily basis was a cross section of America's right wing.  These included income-tax abolitionists who didn't want their hard-earned money spent on people they didn't know, religious fundamentalists who believed that the center was a covert abortion mill,  and those who were convinced that any increase in the role of government moved America one step closer to being just the Soviet Union, or worse, France.  The same venting of spleen that had gone on at town-hall meetings was now being aimed at health-care recipients themselves.  And it was getting worse.

I was scheduled for a chemo appointment later that afternoon.  Fortunately, it was Monos Borrachos policy to have a nurse accompany a patient on the way there and.  Even more fortunate was that the nurse who took me was named Manuel, stood over six feet, and weighed in excess of 200 pounds.  He was a much nicer guy than he looked so his mere presence was enough to persuade even the angriest protesters to keep their abuse both purely verbal and at a safe distance.

I usually dreaded the hours leading up to these appointments but was in much better spirits this time.  I had just spoken with Heidi on the phone.  I had been worried about her.  She must have been even more nervous about the cancer treatment than I was because after she dropped me off, she immediately went off to a bar.  She ended up drinking enough to get pulled over and charged with a DUI on the way home.  Since this was her second offense within a year, she had her license taken away immediately instead of getting to keep it until her court date.

Because of this she was not able to visit me in prison, which made me cherish our weekly phone conversations all the more.  I'd tell her about my hair loss and lack of appetite and then regret that I had.  Heidi loved the best that life could offer and I hated to say anything that might bring her down.  Fortunately for both of us, she had no problem changing the subject of a conversation to one that suited her and was willing to do so repeatedly when I wasn't taking the hint.

We spoke at length about Tyler, who always finding new ways to get into trouble at school.  This time he managed to get himself suspended.  While at a petting zoo on a field trip, Tyler punched a baby llama that had spat at him, knocking the animal cold.  I promised Heidi I would call the principal and convince that it was wrong to punish a child for acting in self-defense.

The best part about our talk was when Heidi announced that she would be coming to see me in person in just a few days.  Her tennis instructor Roger had graciously offered to drive her here.  He had been a true friend to her, going so far as screening her calls when she was in no mood to talk.  I remember phoning Heidi one night just after midnight.  It was outside our agreed weekly time slot but I just needed to hear her voice.  Even at that late hour, Roger was there to answer the phone.  There's a level of dedication you don't see enough of these days.

I couldn't keep the good news to myself and told my roommate and fellow patient Lester Chinn all about it.  Les and I had become buddies since I got to Monos Borrachos.  I truly admired the way, despite everything, he did his best to live each day as if he were in the best of health.

Les had mouth cancer and it had spread to the point where his lower jaw had to be surgically removed.  This would be a terrible blow to anyone (and especially painful if your name happened to be Les Chinn) but he refused to be cowed by misfortune.  Unable to speak, Les kept a pen and Post-it notes at the ready so he could communicate.

He was also a total flirt with the ladies.  Whenever a woman came into the room who he found attractive, and by my estimation this was all of them, he would write down a come-on line and hand the slip of paper to her.  Some of his messages were self-effacing and sweet ("Your smile is even prettier than mine") while others were coarser and more direct ("They didn't cut off my tongue, hint hint").

In response to my news abut Heidi's impending arrival, Les scribbled away and handed me a note.

"Conjugal visit?"

"You never know, Les," I said.