Life. You think you’ve got it all mapped out, until fate steps in like a giant roadblock and sends you on a detour.
For example, you think you’ve got a great job, until you end up on a reality show, pursuing a singing career. You think you’ve got a shot at success, until you get voted off the show, just missing the top ten. You think your shot at a singing career is over, until you get a call from a famous pop star, offering you a spot on his summer tour. You think you’re back on the road to stardom, until the pop star tells you he’s sick. You think you can handle being his nurse, until you fall in love with him. You think it’s just a one-sided crush, until he kisses you. You think you might have a future together, until he gets sick again. Even then, you think you’ll be there to take care of him, until the end.
You never anticipate those curves in the road. They’re not always marked. Sometimes, they seem to come out of nowhere.
I was sitting in a doctor’s office when the next curve came, just a month after the one that had come before it, in Dr. Subramanian’s office in Santa Monica. But this office was located right in my hometown of Decatur, and I was there not for Nick, but for myself.
I was diligent about getting yearly gynecological exams. Since my mom had been diagnosed with ovarian cancer at the age of twenty-four, I’d been going for annual check-ups since I was eighteen. I always scheduled them in April, around the anniversary of her death, so I wouldn’t forget. I had a good doctor who knew my family history. She offered me screening tests not usually given to women my age with no family history. She understood that when I was done having children, I wanted to have my ovaries removed, to lower my risk of getting the same disease that had killed my mother.
But on that day, I was still twenty-nine, childless, and totally unprepared to hear what she had to tell me.
“There was an abnormal result in your bloodwork this time,” she said, looking at me seriously. “Your CA-125 level is elevated.”
I drew in a deep breath. I knew that CA-125 was a tumor marker, a protein found in ovarian cancer cells.
“I don’t want you to worry,” Dr. DeWitt added quickly, before I could say anything. “You know an elevated CA-125 doesn’t necessarily mean cancer. It can be caused by any number of less serious problems, or nothing at all – it could be a fluke. But with your family history, I think it warrants further screening. I’d like to do an ultrasound.”
But, of course, I was worried. I agreed to the procedure, and half an hour later, I was lying on the exam table while she rooted around inside me with a probe, studying a monitor that was turned so I couldn’t see it. I could only watch the doctor’s face as she worked. I wondered if she always frowned when she was concentrating, or if she had seen something suspicious. I got my answer when she paused and turned the monitor towards me.
“It looks like there’s a mass on your left ovary,” she said quietly, pointing it out on the screen. I could see it, the blob of bright white standing out against the dark oval that was my ovary. My heart started to race so fast, it made me light-headed, and I was glad I was lying down. “Of course, it’s impossible to tell what it is on an ultrasound,” Dr. DeWitt was saying. “It could just be endometriosis or a benign cyst… Chances are, it’s not malignant. But you’ll need to have a biopsy, to be sure. The best way to do it is with an exploratory laparotomy. That way, if it is cancer, it can be staged and debulked in the same procedure, to save you another trip to the OR.”
My head was spinning. I knew what she was talking about, being in the medical field, but I’d never heard these terms used in reference to myself before. I had always been the health care provider, never the patient. Even though cancer was on my radar, even though it was my greatest fear, I had still somehow never expected to actually find myself here, facing it myself. Especially not now…
“Cary?” Dr. DeWitt asked gently. “Did you hear what I said? I don’t want you to worry. We just need to make sure it’s not cancer.”
“I can’t have surgery right now,” I blurted out, and then, embarrassingly, I started to cry, right there on the table with the ultrasound probe still inside me. Dr. DeWitt eased it out, stripped off her gloves, and took my hand between both of hers. Slowly, falteringly, I told her about Nick, that he was dying, that I was taking care of him, and that I couldn’t be laid up for six weeks while he needed me. “Can’t you do it laparoscopically?” I begged.
Dr. DeWitt hesitated. “The recovery time is certainly much shorter for a minimally-invasive procedure, but it’s easier to miss things when you go in laparoscopically. An open procedure is really what you need for an accurate diagnosis.”
I knew then she was already thinking cancer, even though she kept assuring me it could be something else. She wanted to look for metastasis. Fearing the worst, I asked, “Will I lose my ovary?”
“Chances are, yes, your left ovary and fallopian tube will have to be removed. If it turns out to be cancer, and if you were done having children, we’d probably go ahead and take out the right one and your uterus, too, to lower the risk of it spreading. But since you haven’t had children, we’d try to spare your right ovary, fallopian tube, and uterus, unless they contained cancer, too.”
In the back of my mind, I knew she was speaking hypothetically, but it felt all too real to me, like a nightmare come to life. “So, worst case scenario… if it’s cancer, and it’s spread… you would take out everything, right then and there?”
“You would have to give your consent for that ahead of time… but yes, ideally, that’s what would happen. We don’t like to cut someone open twice if we only have to do it once.”
I felt sick at the thought of going in for exploratory surgery and coming out with all of my reproductive organs gone. Without them, I would never be able to have children of my own, and I wanted to be a mother, so badly…
“I really want to have a baby someday,” I said, wiping tears from my eyes. “Can I hold off on the surgery long enough to freeze my eggs beforehand, just in case?”
Dr. DeWitt smiled and nodded. “I was going to suggest the very same thing. Only, since freezing eggs is still in the experimental stages, your best option is to freeze embryos. You can use your partner’s sperm or donor sperm, and the resulting embryos will be preserved for future pregnancies. The cycle takes four to six weeks to complete; I think it’s safe for you to wait that long.”
She seemed to think we had come to a resolution, but I left her office that day with my head still spinning. I was facing a diagnosis of the same cancer that had killed my mother and the chance I might never have children. Nick was dying. My whole world was falling apart. I couldn’t think of the future, but I didn’t want to be in the present, either.
Instead, I dwelled on the past, thinking about my mother. This must have been how she felt when she found out it was cancer causing her fertility problems. There was a difference, though. She already had one child, I thought. She had me. She and my dad had wanted more children, I knew, but I would be happy with just one, if that’s all I could have. One would be better than none.
All throughout the rest of my visit back home, I thought of nothing but babies and how I might never have any, because I might have cancer. It didn’t help that it was Easter, and there were reminders everywhere – the Easter eggs, the cute baby animals, the commercials with little girls running around in frilly Easter dresses and shiny new shoes. When I got together with Jessica, who was due in three weeks, I looked at her big, pregnant belly with envy.
I couldn’t bear to tell Jess what I was going through yet, knowing it would only make her feel bad in her current condition, but I had to tell my dad. I didn’t want to do that, either; I knew he would be upset and worried. But I had given Nick such a hard time about keeping his secret, I wouldn’t let myself make the same mistake.
So I told my dad, and his reaction was worse than I thought. He’s never been great at handling his emotions, and his favorite coping mechanism is to avoid talking about what’s really bothering him and fixate on something else. I knew this about him, but I was still surprised when he flew off the handle and said, “Well, that’s it! You’re not going back out there with him.”
“What?!” I cried, taking “out there” to mean California and “him” to be Nick. “Of course I am! I have to. I’ll get a referral to a good gynecologist in LA, and I’ll have the procedure done there. I can’t just abandon Nick; he needs me.”
“This isn’t about Nick. This is about you and your needs. That’s what you need to be focused on right now.”
“I am, Dad, but I have to be there to take care of him.”
“And who’s going to take care of you, when you’re recovering from surgery?”
I shook my head; I hadn’t thought that far ahead. There was so much uncertainty in the immediate future, I couldn’t say. “I don’t know, Dad, but we’ll figure something out.”
“No,” he said, shaking his head, too. “I don’t want you to go.”
“Dad,” I pleaded. I knew he couldn’t stop me from leaving, but I didn’t want to go back without his blessing. I felt guilty for moving so far away in the first place. “Please understand… I have to go back. I need to be there for him.”
“Why? So you can watch him die? Why would you put yourself through that?”
I was shocked by his sudden coldness. “How can you say that?! You were there for Mom, when she was dying. You wouldn’t have abandoned her.”
“She was my wife.” My dad’s eyes shone brightly in his red face. “We were married.”
“So what? I love Nick. I don’t need a ring on my finger to prove that.”
“You’ve only known him for a year. You’ve given up your whole life for him!”
“You and Mom only knew each other a year before you got engaged.” I looked him right in the eye, and although I was shaking, I managed to keep my voice steady as I said, “Don’t try to argue with me on this, Dad, because you’re not going to win. Nick only has a few months left, and I’m going to spend them with him.”
“And then what?” he asked quietly. “What are you going to do when he’s gone?”
I shook my head. I hadn’t thought that far ahead yet, because even though I knew I’d have to face it one day soon, I couldn’t imagine the world without Nick. “I don’t know,” I whispered, looking down.
My dad didn’t say anything back right away, and when I raised my eyes again, he was just staring at me, an odd expression on his face, like he was trying not to cry. Finally, he said, “Alright. Go take care of him. But… take care of yourself, too.”
I nodded, wiping tears from my eyes. “I will.”
He opened his arms to offer a hug, and I accepted it gratefully, crying on his shoulder as he rubbed my back and whispered that it would all turn out okay. They were empty words. We both knew it wouldn’t work out that way. Sometimes, life just doesn’t.
***
