November 21: On the Road

It has been long since our last entry because chemotherapy is a long and, when one is lucky, monotonous process. Not so much in itself, since that weekly, Thursday needle in Napanee has become the highlight of my active life. One never knows what the needle will do to you, no matter how many times you've tried to strategize around it. But even for the better weeks between the injections, the days have their own, set physiognomy and not much change is to be expected. Thursday is the day of the injection and of 32 steroid and another of these cocktail chemo pills, to which we must add the daily 14 or so, depending on whether nausea or insomnia raise their heads. Once a month, the IV bone strengthening medication, which is to be taken for the next two years, together with steroids, and possibly those 3 antiviral, antibacterial antibiotics, the huge daily pills I most dislike. Imagine that, with all this chemistry doing its work in one's belly, which gets harder, bigger and bigger in order to accommodate those reactions, little energy is left for the goings on in the world. To the every morning question, "what are you going to do today?", the head says, sleep. And sleep I do, most of the time, when the head calls for it by simply shutting my tearful eye. Yes, one of the many secondary effects, tearful eyes uninterrupted. Hard to keep them open, impossible to read, to write, to look around at one's leisure. Never have I understood better those elderly who cry permanently, until now it was only a matter of, yes, appearance.

Since the weather has turned cooler, though, I find things are easier. No more drenching waves of perspiration, cutting my hair short has also helped, my hair has completely changed texture, I was told it would thin out and it did. By the end of the summer, in less than two months I had gained about twenty pounds, and I had to get used to carrying all that new weight and sleep on it, hours on end. It is one thing to acquire weight in time, and I am no stranger to that phenomenon, another, to just have it dropped on you overnight. The first months of this chemotherapy I had to wake up in the middle of the night and eat, at that time I was taking steroids four times a week, four times the ten pills, the doctor was surprised to see that I have not developed diabetes, the natural consequence of that onslaught.

Yet, in spite of the quantities of sweets I inhaled, just to get rid of the bitterness of the medication which, at night, requires to be tasted and appreciated for the poison it is, I did not yet develop the diabetes which haunted my father's life. And one month into the treatment, I had already reached some sort of remission, the numbers lowered to normal, the cancer retreating, it was what these numerical measurements indicate. The rest felt the same or worse, plenty of back pain which sent me, you guessed, to bed, every two hours or so. Yet we certainly did not interrupt the treatment, which will only come to its, possibly provisional end, in a couple of weeks, because we need to prepare for the transplant to come. Stem cell transplant, the making or the breaking, if only for a while, of this ongoing saga of unrelenting symptoms.

That transplant will happen in the beginning of the new year, January and February, at the Kingston hospital. It is for that intervention, now the standard treatment for this type of cancer in Ontario (I was told, sternly, because yes, I have tried to wiggle my way out of it, only to find out that the alternative is chemotherapy uninterrupted, into the future, whatever far or near that may take you), it is in light of those coming weeks of highly pitched biotechnological intervention, supported by shock chemotherapy six times the intensity of the one that I have already undergone, that the past five months get their full usefulness. To keep the cancer at its lowest levels, so that the killing of it, of these undying waves of burgeoning tumors, should be easier to accomplish. We get three weeks free of injection, which seems like a holiday, during the holidays.

This for the medical aspect of our life. We, of course, are used to make the best of it by now. Every Thursday morning we go for a forty minute drive, along the lovely country roads between Belleville and Napanee. We have been assigned to a satellite cancer clinic my doctor oversees there, just so we do not have to drive to Kingston, further away. At the beginning I was not happy, since Kingston does offer a few advantages to the cancer traveller. Pan Chancho and its pastries, olives, vegetarian turkey, being first. But we still get to go there, anyhow, once a month, for our doctor's visit. In Napanee, I have found a pleasant nurse who is half Irish half French, so we get to speak French and that helps. We laugh and carry on. A nuisance for the other nurses and patients, but what of it. Colin gets the half day off, and we certainly enjoy the ride to and fro. Many years ago, when Felix was still with us, we used to go often to Kingston to visit our friends, and we would stop on the way - we took the picturesque roads, in order to avoid the 401 - in front of a church whose parking lot was always empty at those hours, and where we would go for a walk with the dog around the church, to the back, into the lovely, equally deserted cemetery behind it. Felix would have some water, we, maybe a sandwich, he, some of that too, and on we went. There was no imagining how familiar this route would become, so many years later, neither what kind of familiar, what kind of heartening and disheartening at once.

I can say that for the last five months I have come very close to living the life of our dog and cat. Rocky has ceased to change beds, it is the big one he's occupying now, since there's always, or almost, company there. That's me, after the morning walk, after lunch, after the afternoon walk, and early at night. Alice has my company at night, when I cannot sleep for more that a couple of hours at a time. I come into the living room to do my exercises, or to walk around the table, or to have some sorbet, and she requires her water treat. The faucet opened just enough for her to receive this bounty of the cold running stream on her neck for what seems like a long while, all the while drinking from under it.

As for the holidays glistening just around the corner, we wish you to enjoy thoroughly all the good they have to offer. We thank all the wonderful thoughts which come so often our way, messages I have unfortunately so rarely been able to respond to in due time. Be sure that, in spite of that silence, we do rely on your presence in our life, and on your concern.

August 21: Watermelon

“Let’s not say it is special.  We don’t want special.  But maybe we can say it is a little better than average?”

“Yes,” our stand in oncologist said with a smile, “definitely better than average.”

Angela has completed cycle one.  

It ended with three days of special fatigue during which many plans were made, however small, and abandoned, for lack of energy.  

We were in Kingston yesterday to meet the oncologist.  Our regular doctor was away.  We met with his stand in, a woman with an Irish accent whom we are both certain we met before, but who, curiously, tried to convince us otherwise.  She was preceded by a resident who asked a few questions about pain, nausea, fatigue and other potential side effects.  He looked dumbfounded and disappointed each time Angela confirmed that yes, she did have pain, nausea, fatigue and so on.  His favourite phrase was “that’s excellent” which he used confidently when Angela reassured him she had not had a fever, and again when she told him she has no new sites of pain.  We quickly came to know what answers he could handle and what he couldn’t.  “There’s really only one question here,” he said, “whether we continue with cycle two or not.”  In his opinion there was nothing holding us back.  In our opinion this was never the question.

Our Irish stand in did not even sit for our brief encounter.  She reminded us that after all she was just standing in.  She was pleased however to tell Angela that her “counts have improved.”  Her blood protein counts have dropped from 18 to 6.  This, she said, was very good after one cycle of treatment.  

A drop from 18 to 6 is not special, but it’s better than average.  

We were happily reassured by this number 6.  We agreed 6 is a full 2/3 less than 18 and that 2/3 is certainly not nothing.  More importantly we were happy to know there is a score to keep. 

We returned home to start again, hopefully now a little bit wiser.  

We agree with our good doctors that there is little use in focussing on the negative.  There remains plenty to be grateful for.  We have been able, almost without fail, to have our breakfast on our back patio in Belleville each morning, surrounded by walls of flowers that have made us popular with the butterflies and bees of the area.   Every walk, in any direction from our home, is beautiful and serene, close as we are to the lake, the marina, and the river.  Belleville, as it turns out, is a good place for inner battles, calm, quiet, and orderly as it is in all of it’s appearances.  During our good moments, on those walks we manage together, or during breakfast, we put the other moments in their place.  

“I will never get my own shape back,” Angela said.  She has learned that steroids are a component of almost all phases of treatment of this disease.  She has gained 10 pounds in a few weeks, and, as is inevitable with this drug, is thinner in the arms and legs, rounder in the face and belly, more humped in the upper back.  This despite her effort to quench her increased thirst and feed her increased appetite primarily with watermelon.  We agree that watermelon these days seems crispier and more flavourful than ever before.  Angela, restlessly, has been consuming at least one, sometimes two, every night.  As the chemo has somehow perverted her tastes, sweet now tasting sour, she has given up the nougat and pastries that were her previous pleasures.  Also due to interactions with her drugs, dairy has been severely cut down.  “Watermelon is a godsend.”  If it hasn’t curtailed weight gain, at least it is something reaped from this otherwise fleeting summer, and in heavy doses it seems to alleviate the irritation in the bladder that comes from another of her drugs.

There is now little difference in the day and night for Angela.  She is as likely to be awake or asleep in the middle of night as in the mid afternoon.  Following the pattern of the ups and downs of her medications, days of increased restlessness alternate with days of increased fatigue.  One night I woke to the sounds of her rearranging the cups and plates in the kitchen cupboards.  When she finished she woke me to tell me that I’d better not screw up her new system.  She was convinced that if it wasn’t for my absentmindedness she wouldn’t have had to do this to begin with.  She then insisted that my absentmindedness was a sign of my indifference towards her and that obviously I didn’t care at all.  It was 3 a.m. and it was not an option to tell her, true as it may have been, that this was her steroids talking.  She knew this anyway.  Soon she tried to apologize while I tried to insist that I was truly far too absentminded.  We ate watermelon. 

Our doctors remind us that none of this, these ups and downs, are anything special.  What is most important is the number 6.  We agree.  Today I sat with Angela as she swallowed twenty of today’s thirty-five pills, nothing special.  Afterward we walked Rocky along the path by the river and spoke about Tzvetaieva, the greatest of Russian poets, and her quest of the absolute.

July 24: Akathesia

“Only a greater pain can stop this.  I can’t think of much else.”

Yesterday Angela was in excellent form.  I returned anxiously from work in the evening to find her making a salad.  We took Rocky for a long walk.  She had already swallowed more than 30 tablets of various medications by that time of the day.  She was happy to say that the pain in her right hip already seemed to be less.  She thought the new steroid was giving her more energy.  It was day 2 of chemotherapy.

Day 1 had been a workshop.  We were 5 hours at the Kingston Regional Cancer Centre.  We met the members of her new care team, each in their turn: oncologist, lead nurse, chemotherapy nurse, pharmacist.  Angela gave more blood.  There were new images taken of her hip.  By the end there was a binder of information.  There were a number of instructions, each frequently repeated: take your temperature daily, avoid dairy, avoid the sun and wear sunscreen, protect you pets and others from the medications that will be in you (always flush the toilet twice, if you vomit or bleed wash contaminated cloths separately, wear plastic gloves to clean spills), carry your fever card at all times, avoid green tea.  There were many warnings: mental changes are often the most difficult, expect hair thinning but not complete hair loss, extent of nausea is variable, could be restless or exhausted, cell lines will drop so prepare for infections, bleeds, bruises, and anemia.   To complete Day 1 Angela received her first injection, a harmless looking fluid injected subcutaneously in the abdomen.  We left the cancer centre with a bag full of medications.

The oncologist spoke softly and seriously. “There’s nothing cosmic in this,” he said.  Angela had wondered why now.  She had mentioned how before her recent MRI she had been feeling well.  The summer had been perfect.  She had twisted her ankle though, only a month ago, and how could we forget that not long before her initial tumour, four years ago, she had broken her other ankle.  She said that she regretted her shoes.  Our serious oncologist said he wasn’t certain what Angela’s question was.  Angela was certain she didn’t ask a question.  He proceeded with his explanations.

He reviewed Angela’s MRI and skeletal survey.  There are now a number of small tumours apparent in multiple vertebrae, a rib, and in the trochanter of her right femur (the bridge that connects the long bone of her thigh to the ball that fits into the hip socket).  Her blood work has otherwise been stable.  He recommended starting chemotherapy immediately.  He told us about CYBOR-D, the recommended regimen of chemo agents (CYclophosphomide, BORtezomib, Dexamethasone).  He told us that we would have to drive to Kingston every thursday for the next four months to get an injection of Bortezemide.  The other two medications will be taken orally at home, albeit in an irregular schedule, some days on, some off, over a one month cycle that is repeated over four months.  Everyday she will take an antibiotic, an antiviral, and other side-effect medications.  After four months the hope is that Angela can be prepared for a stem cell transplant, a one month process by which stem cells are removed from her blood and preserved.  Then there would be a four week admission to hospital for high dose chemotherapy intended to kill her existing bone marrow including the cancer cells, whereupon her stem cells would be returned to repopulate.  Then, with some luck, recovery, which, our oncologist says, “is not usually fast.”

We asked nothing about the measures of success in this.  Angela had told me previously that she was not moved by statistics.  We know already that outcomes are variable.  Some people can see their myeloma pushed into remission for a year or two, some people much longer.  There are too many variables to give meaning to averages.  Much of this, of course, is cosmic.  A lot, we must believe, is left to will.

Expect surprises.  The road won’t be smooth.  Already we know that the tumour in Angela’s femur is, most particularly, in a threatening spot.  It lights up in the very place where hips tend to break.  There is nothing cosmic in this.  Our good oncologist will look at the X-rays and decide if an orthopaedic surgeon needs to fasten a metal brace to the bone to prevent a fracture, or if radiation can be used to shrink the tumour.  He will let us know.

 At the end of day 1 Angela commented that she could feel the medicine moving through her, into her nose and her mouth.  In the morning she showed me the pink blotch on her abdomen where the medicine had spread from, like a large birthmark.  It was cool to touch, but not tender. We shrugged our shoulders.

At the end of day two Angela wanted to watch television.  We watched a couple of TED talks.

Tonight Angela was anguished.  She stayed in bed this afternoon, sleeping off and on.  She used stemetil to fight nausea.  She skipped dinner.  A crawling feeling took over her legs and back.  She felt tired, but had to move.  I walked behind her, back and forth, from one bedroom to another, watched her lie down and stand up, roll, stretch, rub her legs.  I rubbed them for her.  I turned around and found her pressing a wooden spoon into her thighs.  “This has to stop,” she said.

“Don’t do this to people,” she said.  “Don’t give these drugs to people.”

And then she cried for the animals.  “They test these drugs on animals.”

I told her she was experiencing akathesia, a crawling, restless feeling, in her case quite severe, caused, I hope, by the stemetil.  I told her it was a rare side-effect that will subside.  I gave her extra lorazepam.  She’s now sleeping.  I hope I’m right.

Angela asked me to write this blog.  I struggle, as I write this, with my own akathesia.  Time has passed so beautifully since I last wrote on RockAlice, and yet, at the same time, it has not passed at all.   We find ourselves grateful, once again, for the expressions of concern and the offers of help that have come from friends and family in recent days.  There is nothing cosmic about this, care is important.  Let’s keep in touch.  I will keep you posted.

December 21, happy holidays

Ben, car sick yet always ready to shake your paw

The snow has once again buried our house in Springbrook. All paths which would lead to a place other than the road itself, Springbrook Road, have disappeared. It is only by car that you can get out of the gates, and that, only if Colin has had time to clear the driveway with the help of his fierce, backward moving, snow and pebble spraying red tractor. Behind the house the forest and ponds are bearing with reverence the commanding white coverings which, if the last three winters are any indication, will only be absorbed into the rocky ground by the month of May. Long after the neighboring farms have been released.

These days we are under the threat of that infamous, by now common phenomenon, freezing rain. The rain that freezes all it envelops. Pluie verglassante. Sounds even worse in French, where the expression summons images of beings encased in a cold sheath of ice, unable to move, paralyzed. A sort of return to the Ice age.

Besides the metaphor, the main, objective and justified fear remains the breaking down of power lines. It happens every year a couple of times in winter, and in summer during violent storms. That's when we are left without heat and running water. For now, heat is not that much of a problem, for we do keep those two wood stoves burning night and day. As for water, or the lack of it, the limit of my patience has proved to be three days.

The last time it happened, fortunately, Brother Greg was here, so we had a great time, or at least I did, watching the men bring heavy pales of water from one or another of the ponds close to the house. Its use reserved for toilet-related decorum of course. It swiftly brought home the realization of how easy total breakdown may occur, once the amenities of modern life are taken away with the severance of electricity. Nothing works any longer. No coffee, no flushing, of course no daily shower, that North American must.

After three days I remember calling hydro in a state of hysterical rage, which finally produced results under the guise of a couple of trucks leisurely parked in the driveway, and a couple of guys leisurely talking about what must have been the heroic deeds of the past crisis. They talked for a while before one of them climbed the pole and pushed back the leaver which had snapped out of place so many days ago. All it took was five minutes.  Because we were the only house in the area with a problem, we did not represent a problem. Just a blip on an otherwise good to go map of the back to normal report.

To that we may add how, on another occasion, having called my neighbour across the road for help with the dark (as is often the case, the crisis chose to erupt when I was alone at home), he insisted to call hydro himself. As is well known around here, a woman's voice, calling and pleading, is taken less seriously than a man's. Unfortunately his call proved to be just as inefficient, especially considering that his main argument turned around those quantities of meat in the freezer which were going bad presently. I assume the hydro operator was either envious of so much discounted meat, or thought that a serious household with survival material in the freezer should have its own backup system to fall upon in such events. What kind of a home is that where a proper generator is missing?

Imagine that adventures of this sort make one fret in the face of the next winter power outage. Fortunately I only have to bear with it for a couple of days, Brother Greg is due for the traditional Christmas Visit on Monday and therefore all our problems are a priori solved. Besides his many other talents, Greg is possessed of the most skilled survivor-ready techniques I know.

As you have probably guessed, since this ice warning came upon us, Colin is duly at the hospital, on call day and night, night and day...

But I was going to write about the holidays, and maybe I have already, even if my tone is not as uplifting, as such occasion should grant. First I wanted to thank our friends who remembered, to my amazement and gratitude, that I was due for another scan in December, and asked how that went. To continue along the line I have started, I'll tell you how that morning unfolded. 

I woke up at five and took care of the morning ritual. Fed the dogs, had my coffee, decided what to wear that would agree with the imaging machine, as you know I am bound to. By 7 I warmed the car and readied it for the dogs. Convincing Ben to get into the back of the car is a feat, because he, among many other sensitivities, suffers with car sickness. Therefore, every time we need to drive somewhere, he's torn between the excitement to go and need to be with Rocky, and the abhorrence of those states the moving car induces in him. Since I had no time for enticing him with words, I had to lift him up, which is way beyond my present physical capabilities. Ben is a big dog and he can become heavier if he wants to. Once in the car, he jumped back down immediately, and I had to go through it again. Witnessing this strife, Rocky started having second thoughts about this particular ride. Something was amiss, they were forced to do something against their will. I had to insist, although that is not usually necessary. Once they were both in, and the door shut, I sat at the wheel, panting as if it had run for life.

By 7:30 we were at the pet hotel, where I left them in capable hands. Hands I could have kissed if such a thing were permissible. My dogs were starting a new program of socialization, in the hope that one day the three of us could, like some civilized trio, walk along the streets of some city, or even small town, without looking like a band of crazed three-directional antagonists. For now, we are taking small steps, which consist of sit and stay when the door gets open, stay sit and wait rather than trying to break down the door, rip the door handle, and of course topple without mercy the one who opens the door.

Not only was I in time for my scan, but even a bit early. Five to eight. Just a few people ahead of me. In a few minutes the technician came out, a mild mannered man with a kind smile, surprised to see me again so soon. I laughed and said the last one had been inconclusive, which he received as better news than some dire conclusion would bring. Fair enough. Did not even have to take my boots off, nor my necklace, which he carefully placed so as not to interfere with the process. Three takes where the machine tells you when to breathe and when to hold, with the last hold longer than the previous. It usually turns out that the patient holds her breath more than she breaths, since it's never quite clear when the command will come. Be that as it may, the scan took only a few short minutes and I was free to go.

We will find out the results in January. As usual, there is quite a waiting period between the test and its reading. But since the results are often inconclusive, there is also less impatience to find out. These have become stages along some road which we will have to follow, as if for its own sake. Hopefully.

Ice or not, we are looking forward to the holidays because Colin will be home more, and Greg will be with us, who, besides rescuing us from the hardships of the pioneer's winter, will flood the house with good humor and soulful music. Some of our friends, among them our dear friends from Montreal, will also visit.

In the spirit of kind brotherhood, sisterhood, friendship, we wish you a wonderful holiday season. We thank you for the many generous thoughts and signs you have sent our way during the last year, and wish you many good things for the year to come. 

November 11, Pictures old and new

Maria, Ioan and Elena, circa 1935

The last CT scan seemed to proceed with more ease than usual. In spite of the fact that I was late. I had mentally prepared to spend the whole day around this test. And yet, when the time came to leave the house, I could not find my keys. I went into a panic attack unwarranted by the circumstances. I felt like tearing my clothes off, and throwing myself on the floor with desperation. Forget that the hospital is just ten minutes away from the house in the city. It was raining. Forget that I could have called one of the smelly city cabs operated by disheveled men in pajamas. Who can act reasonably in those moments of panic?

If you take the time to look at it, now that's all in the past again, you will observe something meaningful contained in those apparently mad throws. Ripping your clothes off is of course not how you prepare for the test; nevertheless, having to take them off, that is, principally, your skin, technically and symbolically, is troubling beyond words. Because the machine, of course, does not care whether you are clothed or naked. Between telling you to breathe Now! and Stop! breathing, the feminine voice of this dominatrix sends transversal neon-blue photo-blades across your body, at those places of interest to your interested physician. For the lung specialist it goes to the lung, for the radiation oncologist it goes at the base of the neck, there where the tumor used to eat at the bone. There where a sizeable, sort of memorial hump, now marks the place of this self-digestion.  After which photo-shots, it puts the slides together in the shape of a body. Like a loaf of bread which has been sliced by that toothy guillotine for the convenience of the consumer, the evening before its expiry date, and is sold under its deceitful loafy form thanks to a sweaty plastic bag.

The nurse setting the IV for the contrast die had had her hair bleached. I complimented her, it suited her better than the shade she had put on before. She acknowledged, but maybe because she could not recall anything about me, she did not reciprocate.

The room was cool and I was wearing a scarf when I came in, a pretty one so the scanning cylinder may like me more and be kind to me. The technician, whom I also recognized from my previous visits, spoke for his machine and told me to keep the scarf, even if part of the operation was concerned with throat and neck. On the spot though, somehow, this did not feel right. I remembered, once in there, that i was going to find it hard to breathe, because of the claustrophobic effect of this rounded coffin right above one’s nose, and the little room the gurney allows for the arms while in lying position. I did not need something else around my neck, so, in spite of his insistence, I threw my scarf away. Let the picture be as clear as it can, I thought, even if for the computer eye the scarf is invisible. As the scanned object, you are of course not supposed to wear jewelry or glasses lest they become a suspicious growth attached to your limbs. Some new bone-like, or kist-like formation. Some calcified tissue, or the residue of a long forgotten infection. Granuloma.

These past weeks we have been plagued again by small yet upsetting animal body concerns. Rocky has had not two, but three molars extracted. Soft food agrees with him just fine for the moment and we suppose some field mice shall live longer if not quieter from now on. After which we went to Kingston in order to have the results of the scan properly interpreted by specialists. My family doctor had seen those and panicked almost as badly as I had, when I misplaced my keys. In fact I spent some time in his office trying to cool things down. For both our sake. "Something soft" and new was showing in the vertebrae atop of the one lost. "Something fuzzy" and new was showing in the lower right lung, there where things, bits aspirated haphazardly end up lodging. Had I aspirated anything of note lately? Probably not, but I could not remember. Maybe at night? No way! intervened Colin vehemently, as if he spent his nights watching my every breath. She has No sleep apnea! It is true that sometimes I feel as if I tumble down, inwardly, sucked by the bottomless pit of dark nonexistence, breathless and gagging. But don't we all? The hour though was not to existential musigs, nor angst. We probably only had 12 minutes in his book of obligatory encounters. Did I sleep poorly? Did I wake up in the morning feeling poorly rested? Under Colin's watchful gaze and barely contained inner outrage, I tried to stay balanced. Then filled, albeit conservatively, a questionnaire asking kindly misleading questions. This form seemed addressed to slowing down seniors of vintage gold. It wanted to know whether I fell asleep while entertaining casual conversations with a group of acquaintances. Hell no! Not me! I'm alert like a squirrel, am following with raptured attention everybody's every word, comment wittily and only fall asleep when the situation warrants such selfish behavior. Colin was afraid the lung specialist would take away my driver's license over a thing I never aspired in the first place.

Ben, on the other hand, aspired he has. One evening just a few days ago, while alone at home, like some billy whose mother goat had warned profusely, but to no avail, he encountered head on - that is, muzzle and soft tissue inside the mouth - the old porcupine. Remeber how Alice was the first to meet him, and only showed quill-trophy on her forearm? Remember how Rocky’s turn came, one weekend again, he whose mouth bore, between here and Peterborough, where the only free vet was available, both mustache and beard? It was already past nine when Ben had to be rushed by a super-tired, overworked, hungry Colin to the nearest emergency animal hospital, an hour away from home. More than 80 extracted quills later and he is almost as new, although hesitant to go to the dog enclosure at the back of the house, which is supposed to be their safe powder room but where, to my dismay, the encounter with this shrewd, cunning, wallet-depleating enemy took place. In fact nowhere around here is there a safe place to loiter about, to smell the tracks of passing or dwelling animal coworkers without becoming the target of their survival techniques.

There will be another CT scan in December, so we know for sure, as "for sure" as possible, what my lung swallowed. In the meantime, I run into an old photograph (circa 1935) of my grandmother’s and her two children. I worked at this portrait for a few days, thankful, first, that this young woman, then of twenty-two years, and in the throws of poverty, had found the means to be photographed, as if by surprise, for they do not seem to be specially appointed, with her children: my father, five, and his sister, two. Many other thoughts, of course, nourished my concentration and gave to my replica the urgent sense of purpose this old portrait communicates, to me at least. Those children, so serious and for good reason aware, much too early, of the impending struggle where life makes her uncertain nest: is it not mysterious how such a simple, un-staged artifact, has the strength to bring forth and preserve the sense of forthcoming struggles?

September 26, Mistaken identities

dog read

It is Monday morning and I'm in one of my favorite seats 7D. I get the whole window and none of that forty year old Via train curtain which some travelers still draw to avoid bathing in the fresh, encouraging morning sun. Cows in the fields are not yet on their feet, still huddled in the order of family or friendship preferences which make them sleep in twos and threes under the stars. The train I take is never full, since it gets to Toronto way after businesses have had their business breakfast. I travel business class simply because, with the rare exception, I get two whole seats for myself. When you look at it that way, it is preferable to economy class by far.

The few times I got company, it was that of important men who liked to talk. Do not get me wrong, I like talking to strangers, I find out a lot of things I would not be entrusted with by closer friends except after years of sharing and being put to the test. But the two hours of listening can be overwhelming, and the last confession disclosed a life filled with events worthy of sharing, according to him. It took me days to be released of that febrile pouring of the soul.

My last two visits to Toronto have been a combination of dentistry and osteopathy. Teeth and posture. The visit to the dentist had left me with pain for a few days in a row, so I finally decided to take a close look in the mirror and see what was going on. A simple investigative reflex. To my astonishment I noticed a small, grayish round filling right in the middle of the one implant I possess, a molar. I had thought that the filling was supposed to correct the last molar of the lower row, but no, that one looked pristine. This one, immediately anterior though, was supposed to be a false tooth through and through. Even falser, if that can be said, than a crown. Do they fix false teeth nowadays? As if they were real? Has our condition of partial cyborgs come so far as to have us treat the artificial parts in our bodies just like we treat the organic ones? These questions troubled me for two weeks; I shared them with visiting friends, who came to think one simple thought. I must have a very incompetent dentist.

Yet I knew this not to be the case. The woman dentist who takes care of us at the moment was an engineer, among other things; I do regard her very highly and, in spite of her young age, I trust her. The only explanation remained for me that artificial parts are prone to decay, in other words, that they behave not unlike the organic ones.

Before my next appointment I happened upon another perplexing story, this time of a friend, who has been in analysis for many years and still is. Upon returning from her summer holiday, at the very outset of the first visit, she remarked that the armchair, in which she had been sitting for most of the previous year, once she migrated from the couch to the seated position, had been changed. She sat in it, found it less comfortable than the one before it, and wondered aloud, in the direction of her analyst, one of the most respected, well known figures on the North American psychoanalytic scene: how come he had decided to change the old chair with this one? She kept to herself the thought that this, new armchair, being in fact just as old and rather ragged looking as the old one, lacked in comfort by comparison. The replacement seemed therefore hardly justified.

The good analyst replied,  casually at first, that he had done no such thing as changing chairs. That this was the chair that had always been there, from the beginning. Surprised and slightly confused by the denial, my friend insisted. How could he tell her that this was the same chair, tell it to her, who had sat in the old thing for the better part of the year, week in week out, three to four times a week, as he would have it? She, who, as he knew quite well, took some pride in her faculty of observation, she who looked closely at things, noticing carefully their placement and various qualities, she who had a memory of some repute, put to test and reaffirmed through years of training in her field, which, in fact, requires a flawless ability to remember and reproduce, just as much as the flawless capacity to tell things apart? The true from the false, with a very small margin for error?

Indeed, having recognized all these assertions to be true, the analyst decided to enquire further into the matter. Could she tell him more about the "old" chair? What did it look like? How was it different from the "new"? And how did it compare with the numerous chairs rushing now through the open doors of memory, invading the office, overflowing with sentiment musty of distant past? To which question my friend gave him an extensive, detailed answer, going from the size and color, to the rocking qualities, shape of the arms, feel to the touch, all of which made the two chairs if not vastly, at least definitely different. The analyst had to leave his own well protected seat, behind the desk, and come in the open, near the analysand seated on the chair under question, in order to point out the various details which made of this, here chair, a mature, well used, well weathered object, well scratched and therefore hardly deserving, indeed, of the trouble of having to replace another old, well used chair. Point at which my friend started, as expected, to wonder about her own mental process, and the spell under which she felt she had maybe fallen, in this unexplainable and yet so real syndrome of "the other chair".

Even if, to me, the decisive proof that she was not mistaken, that something had changed, lied in the affirmation that, while the old chair would have allowed her to curl up, to comfortably nest by bringing her legs underneath, had she chosen to do so, which she of course never did, but could have, if she ever wanted, the new chair was too tight to allow for that would-be comfort.

In the dentist's chair I was wondering how I would bring about the topic of my molar's mistaken identity. At first my lovely dentist did not quite get my point. I opened my mouth and showed her: see? That smallish, well-distinguishable grey patch? No no no no. What are you saying? It is the last molar we worked on the last time. But you didn’t. Look.

Of course, she did not need to look. And at that very moment, while talking to her, I remembered the words of the other dentist, the arcane torturer who, almost ten years ago, had put the implant in. The grey patch in case of emergency. If there's a need to get in there. In case something goes wrong. A way in.

The pictures of the procedure of two weeks ago were brought up on the computer screen and there it was: the last molar, half way through the process, gaping sorrowfully, and at the end. The filling so shiny, softly white and pristine. Almost invisible. You must forgive me, I said, I have a bit of a neurosis these days. My dog Rocky has two equally broken, probably equally painful upper molars, the largest and more useful of his teeth. They also show cavities, and as we have found out, they have to be extracted. And I do not quite trust the vigor or the competency of the man who will have to carry out that momentous task, a new vet of whom I know close to nothing.

It is not the first time I identify with my dogs' misfortune. Of course. Does it matter, whether those broken teeth are theirs, or mine?

June 26, what about your dreams

The day before the interview I did not feel good. Weak, tired in spite of the kind weather I had yearned for for so long, a sunny fresh spring. I did not feel I was going to be able to take the train to the city the next day, as promised.

Behind the expression of commiseration, a thin but tenacious nuance of disappointment made itself felt in her voice. Appointments are set three and four weeks in advance. Rescheduling is extremely difficult. "You are very tired though, aren't you."

I suggested we do it by phone. I had dreaded a two hour phone interview, yet something had to be done, and we left the appointment stand for the next day.

I prepared by printing the letter I had sent in a while ago, which contained the names of all the medications I take, and why; all the health care providers I see or have seen, why, when, upon whose recommendation. Turned out to be a rather long document which covered the last two years. I brought to the interview room a bottle of water and a few mandarines, although I did not think I was going to eat. I took my medication two hours early. And acting on an impulse I did not think through, neither tried to explain, went to the bathroom to fetch some tissues. Thankfully Luba was there, cleaning. She said, take the whole box. I hesitated and refused, why would I, in fact, need any? I did not have the slightest idea what automatism had made me seek any at all.

The voice at the other end young but thankfully not very young. Thirty something. Nice manner. Used to doing this kind of thing, that is, experienced in dealing with the distraught academic client. Not an easy thing, she admitted from the beginning, this attempt to accommodate the return to work for those whose work is made of 40% of one thing, 40% of another, and 20% of another thing yet. Even insurance companies know this is three jobs in one. While the employer's, that is, the university's strong point, is not flexibility.

This conversation was not going to be about the state of my health. That topic is somebody else's domain. It is the responsibility of the person I talk to every once in a while, she who wants to know if I'm better. "Oh good." Her voice struggles with depression, or despondency, or pure lack of interest, I'm not sure. It takes me some effort to abstain from recommending that she herself seek professional help. (It is not because one works for an insurance company that one is doing better than the rest of the lot.)

This inquiry, or rather interrogation, was to be about dreams. Regardless of the so called medical reality of my condition, and abstraction made of our respective positions, perfect strangers to each other of course, between whom one is to pour out her soul on the confessional mode, while the other, to take notes, literally: in the best of worlds, how do you dream yourself to be, what do you dream to do, from now on?

I have always disliked hypothetical talk. In the classroom it is often the preferred method of demonstration of this or that possibility. "Let's suppose that...". Abstract, non committed reasoning, always disembodied, always indifferent of what things feel or are like. To ask what my dream of the future may be, presupposes that speaking about the future is an easy topic of conversation; after all, why not, we're just speaking, just in case it comes to that. I resent this approach, it has many faults, but the most glaring is the lack of awareness of what an illness like mine does to the concept of future itself.

Of course we understand that it all had to do with my returning to work. I told my young interrogator that, had she called to take my pulse six months ago, I would have said, excitedly almost, yes, by all means, let me go back to my job. It just so happens that in the meantime, for the past few months, I have been going to the city. That allowed me to rediscover, if at a very slow pace, what I might and might not be able to do.

It is one thing to go to Toronto for two days every two weeks, in order to seek therapy; another, to actually go there to work. Not to speak about the fundamental requirement intrinsic to the act of teaching young people. The seventeen to thirty something, mostly inquiring minds, as they are branded, sons and daughters of privilege mostly, are here to discover wonders hidden under the proverbial stone - such things do exist indeed - wonders unveiled by the magic wand of an at once enthusiastic, optimistic, energetic and laid back instructor. The instructor's task, to mainly, wittily, entertain. The students' expectations, quite the opposite of being confronted by a middle aged woman who has just met with some of life's nastier accidents. I did not have, I continued, the emotional stability required by such a demand any longer. Even in the course of this interview, I chocked when faced with the most innocuous of questions: "So then, you came to U of T in 2002?" Or, "do you like your job?"

Can I explain why I such easy questions would bring me to tears? Can I explain what those past ten years mean, in the context of my professional life? What liking your job means, after having spent more than thirty years to become sufficiently qualified?

There is something fundamentally perverse in the presupposition that, while on disability, the employee is to employ herself at getting better, so that she may resume her life from the point where, quite abruptly, she left it. Falling off and out of the normal trajectory came to me, to us, as a powerful, unforgiving and sudden accident. With this fall, something was lost that I cannot, no matter how much I would like to, go find again, intact, waiting to be grasped. Of course, there is some understanding that the work I would be doing should accommodate my present, diminished condition. Yet everybody in the industry, as they call it, knows that the academic profession suffers very little accommodation. It suffers excess under the form of overdoing, but not of underdoing things. University abhors underachievers. Apparently, much more than many other jobs. Hard to know how that is, considering how so much of the current public opinion sees these teaching positions as plum jobs. Do many other professions require quite this much training? Not many. But in a culture which does not privilege learning, the question is not only irrelevant, it is of no interest.

This is another discussion altogether, though. Here the more scary part: if you are deemed able to work, but no accommodation can be arranged with your employer, the kind academia lets go of you so you may seek employment elsewhere. I suggested selling shoes was not an option, having done that already, when I was a student in search of better things.

Thankfully, the conversation did lead to an answer on my part. What I want, I said, and I know this to be true, and not a reaction to the barrage of questions, is to keep being just as I am now. I want to be as I am, keep doing what I do. A year and a half ago I did not dare hope I was going to be here, and yet here I am.  I can only be grateful for what I have received and only wish to hold on to these lovely new days for a while. If, from the point of view of the employer, it means retirement, than that is what I want. In fact, in a not too distant past, I had even put a number on it: 61. In those days I was still part of the plan according to which, when to leave and make room for the many young people waiting in line, would be my decision.

My interrogator was somewhat surprised, yet, as soon as I put the word retirement on it, agreed with my position: what is lost is lost, we cannot go back and recover it.  Getting better can only mean, essentially, finding a way of life which will accept that something irreversible has happened. The accommodation cannot, and should not come from the employer, but first, from the one who has, at the hands of life, known loss.