The chemotherapy room was a small, comfortable place, with magazines in racks, plants in the sunny window. Four huge armchairs were crowded into the room, and a smaller chair sat in attendance on each.
Some kinds of chemotherapy take a long time to administer, I discovered, and patients sometimes sat in these chairs for hours. The atmosphere always was quite placid. People read or chatted, idly flipped the pages of magazines, ignored the paraphernalia linking their throats or wrists to overhead bottles of caustic chemicals.
I was scheduled to receive a combination of three drugs. Though hardly pleasant, the protocol was not as difficult to tolerate as some he prescribed, Dr. Fleagle had said. I would be on it for two weeks out of every month, continuing for six months. I could expect a constant mild nausea through the two weeks; my hair would thin and eventually I might need a wig.
On my first visit, I was tense and afraid. The nurse, Patti Kealiher, put on the Mozart tape I’d brought with me, slipped the needle into a vein on the back of my left hand (with remarkable smoothness, I thought), and taped it down. She explained that they’d prefer never to inject anything into my right arm, because the node dissection had made it very vulnerable to infection. Then she proceeded to attach small tubes of different colored liquids, one by one, to the tubing going into my vein. First she injected Benadryl, which I came to call happy juice. It made me cheerful, dry-mouthed and talkative. Then came clear saline to clear the vein, methotrexate, saline again, fluorouracil and finally more saline. The saline burned a little going in. I would take the third drug, Cytoxan, daily by mouth.
While the nurse was working, a young woman came into the room for a shot. She winced and squeezed her eyes shut when she was pricked. I pounced on her like a clumsy, friendly puppy, making Benadryl-flavored conversation, and she confessed that she had a terror of needles. She also told me that she had a rare blood condition that could be controlled by the drug she had just taken. She seemed anxious to distance herself from this room and its usual inhabitants. Who could blame her? After a few minutes she left, to be replaced by a young man who looked about 30. I wondered at the relative youth of so many of Dr. Fleagle’s patients.
The nurse’s work with me took about 10 minutes. She left, and Bill went to the desk to pay for the treatment. High on happy juice and indescribably relieved because the procedure was over, I babbled cheerfully to the dark-haired young man. He was very friendly, but I retain no memory of what he said. Then I followed Bill out to the desk area, where I hugged the nurse, who seemed a little surprised, and told her she’d done a wonderful job. Once home, I roamed the house restlessly for half an hour or so, then collapsed on the bed and slept. I awakened several hours later to a sick taste in the back of my throat. It was to be my companion, at varying levels of intensity, for the next six months.
My first reaction to the chemotherapy was that it wasn’t nearly as bad as I’d expected. I didn’t vomit. Despite continual queasiness, I could function over the two-week period that I was on it: drive, work, make love, even eat. Many months later, after it was all over, the emotional effect seemed to hit me. I decided then that being on the CMF protocol is rather like being in the punishment machine Franz Kafka describes in his short story “The Penal Colony.” The machine begins by tracing a description of the crime on the perpetrator’s body. This is painless. Then the machine repeats the action. And repeats it. Over and over, imprinting the words ever deeper into the flesh, muscle, tissue and bone of the prisoner until he dies.
The nausea was manageable but pervasive. You couldn’t get relief by throwing up, because the irritant wasn’t in your stomach or your bowels: It permeated your entire system. The pamphlets had described the taste the chemicals leave in your mouth as metallic, but that wasn’t it, really. It was a warm, sick, alien taste that I continually tried to wash down with water and orange juice, but that flavored everything I ate and tainted the nature of my days. I became more and more aware over the months of how assiduously my body was working to expel the poison – only to be assaulted by it over and over again. The weariness this caused was mitigated by a kind of jagged speediness provided by the Cytoxan.
My veins closed up and scarred. Little bumps appeared on the back of my wrist. Visit by visit, it became increasingly difficult for Patti to slip the needle in.
The nausea didn’t come at any particular time of day or any specific point in the drug cycle.
On some days, I ate large amounts. On others I picked listlessly at a chicken salad, afraid my inability to choke any of it down signaled the beginning of drug-induced anorexia. There were certain smells that triggered the sickness; we had to change our brand of dish-washing liquid, for instance, because every time I tried to wash dishes, I was reminded of Dr. Fleagle’s office.
I settled into the regime, and the tilt toward chaos that my life had taken began to even out. The chemotherapy weeks were quite endurable, the two weeks off invariably ecstatic. For six months I alternated between sickness and euphoria, the way you walk through sunlight and shadow on a pathway flanked by pillars.
