Chapter 4: Celebration

It’s not all about the cancer.

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From: Laura
Sent: Monday, March 19, 2007 4:36 AM
To: Jennifer
Subject: David’s birthday party

Hi Jen. Since you're my "gentle reader," let me tell you about David's 50th birthday party last night. (Note the ungodly time on the email; I’m still on the five days of prednisone from the R-CHOP, and it continues to get me up from 3-5 am daily. Maybe I should call my book "The Prednisone Diaries.")

I'd been thinking about throwing a surprise 50th birthday party for David for a long time. A few years ago, we went to a party for our closest friends, the Berkowitzes. Our dear friend Steve Berkowitz turned 50, and his wife Monique (we call her “Q”), threw him a fabulous dinner party that occupied a small floor of a little bistro downtown. Q had invited friends from all times in Steve's life: growing up in Boston, playing in a band, and rising through the record industry in NY. Each of them got up and told moving and funny stories about Steve from his childhood through his adult life. The party inspired me to do something for David’s 50th birthday.

I enlisted Q to help me plan the party. Given everything that was going on, we decided to keep it simple, with just the four of us (me, David, Nate, and Emma) and the four of them (Q, Steve, and their sons, Nick and Ben). Our families have been close for years. Our nanny had befriended their nanny in Carl Schurz Park when Nick and Nate were babies, and the boys bonded right away. I first met Nick when I was pushing Nate, then 18 months old, in his stroller in the park. Nick waved and said, "Hi, Nate!" It was the first time, to my knowledge, that somebody with whom I was unacquainted knew Nate. In that moment, Nick taught me that Nate was someday going to have a full and independent life that did not always include me! Shortly after that, we all met in the park. Q and I became pregnant with our second children at around the same time and became close friends. The eight of us have spent every New Year's Day together for about 15 years, at our place or theirs.

David still loves jazz, and loves to take the kids to jazz clubs. One of his favorite clubs in the city is a funky place called the Jazz Standard, which has great live music and serves dinner. Q and I looked at the schedule of who is playing, and it turns out that this weekend they had a quartet with a pianist named Bill Charlap, who I knew David liked. We decided to do it on Sunday night.

The kids liked the plan, especially the part about keeping it a surprise from David. Nate tried to help me make the reservations, but when he told them it was for a party of eight, they said you can't make reservations for 8 people. So I called back the manager and said, "Listen, I have cancer, and we need to celebrate my husband's 50th birthday on Sunday because after that I'll be hospitalized." And guess what? It turns out that you CAN make reservations for eight people! So cancer is a good news/bad news thing. Yes, you need toxic chemo—but at least now you can get dinner reservations!

I booked us for the 7:30 set and finalized the plans for Steve, Q, and their kids to meet us there. I had casually mentioned to David earlier in the week that maybe we could go out to eat on Sunday for brunch or dinner. He said dinner is better because the kids need to do their homework during the day (I had been counting on him saying that). Emma overheard the conversation. After David left the room, Emma looked at me admiringly. “Mom, if I had a hat, I would take it off to you.”

When Sunday came, David was full speed ahead in superdrive mode to make sure that the kids got their homework done, and he said he wasn't sure we'd have time to go out to dinner. Emma was worried—what if we can't talk Dad into going? But I reassured Emma by reminding her of the line in My Big Fat Greek Wedding where the Greek mom says that the man of the house may be the head, but the woman is the neck, and she can turn the head whichever way she wants.

Here's how it went down. About 5:45 I was alone in the family room and David came in and asked, "Where are we going for dinner?" When I hedged, he began to suggest restaurants, and then he realized I had a plan. His face was apprehensive and his arms were crossed, something he does in the rare moments when he gets upset. He said he wanted me to tell him what's going on, because he can't deal with any more surprises after the shock of my diagnosis. I told him that I'd made a surprise celebration for his 50th birthday, that we had reservations at the Jazz Standard, that Bill Charlap was playing, that the Berkowitzes were going to meet us there, and that there would be cake and presents. David looked puzzled, like he didn’t understand. He asked, "How can I celebrate my birthday and be happy in the middle of all of this?"

I explained it to him. I told him how much fun it had been for all of us to plan this wonderful dinner, how the kids had been bumping into each other for two days trying to keep it a secret. I told him that we can't make the next six months of our lives all about the cancer. That one of the things that will get us through this is to find the moments in our lives that deserve to be celebrated and to celebrate them. That he was having a birthday, and that Emma is going to Paris for her spring break, that Nate survived the SATs, that I finished 1 of my 18 chemos (only 17 left!), and that after 24 years of marriage we’re still together.

We got in the cab, and Nate gave the driver the address. The Berkowitzes met us in the narrow entryway of the jazz club and I said: “Recipe for instant party: add four Berkowitzes, and let the fun begin!” The eight of us went downstairs to the dimly lit foyer. The restaurant had a sprinkling of small tables and booths with an elevated stage in the front, and the walls were covered with signed photographs of jazz giants who had played there in the past. They seated us at a table with a long curvy booth on the left and cushioned chairs on the right, so we could all be comfortable. David and I were in the middle of the table, between the senior Berkowitzes and all the kids.

One of the most wonderful things about the party was how we’re all so close—some of us got up and moved around to different seats, so by the end of the evening, everybody had talked to everybody. It's so rare in relationships among eight people that all of the possible combinations work, but with our two families, they always have. Good food, great music, and then they brought out the chocolate cake that said “Happy 50th Birthday David” that we had pre-ordered with one candle. I decided not to put in 50 candles, remembering the debacle of the waxed cake from David's college days.

I couldn’t resist making a little speech. David is always teasing me about how I tell the long version of the story, never the short version. He likes to tell me the Colin Quinn joke about his girlfriend telling him an interminable story with every possible detail included, and Colin says to her, “Excuse me, but I don’t want to live your life in real time!” I kept my remarks short and sweet. I thanked everyone for coming and said how glad I was that we could all be here for David’s birthday. Then we drank a toast to wish David a happy birthday—the boys did it with Coke, and Emma had a sip of champagne.

At home, after the kids went to bed, David thanked me and said it was "good to have the distraction for the kids." But it's more than that. We live our lives too fast, and don't look around enough. I realized it once when I was dashing through the reef while scuba diving, as if I had to make some deadline. You're in the water and the coral reef is magnificent; you might as well enjoy the view. The good things are not a distraction. They're the point. David has been saying that for years, and I believed him in theory, but didn't really live my life that way. I’m finally getting it. It’s ironic that I’m teaching David the lesson he’s been trying to teach me for three decades.

On another note—I can't believe you and Sophie watched The Devil Wears Prada last night—Emma & I were watching it too! We just got the DVD. We had seen the movie in the theater in Hilton Head this summer—but the problem with seeing it in Hilton Head is that it instills in you the longing to shop in New York, which is tough to do when you're in South Carolina.

Tomorrow I’m going to work, and then Tuesday intrathecal methotrexate. If they can't find the Omaya this time I'm going over to the mammo office so Cindy can do an ultrasound and draw a big arrow on my head.

Love
Laura

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From: Laura
Sent: Tuesday, March 20, 2007 5:29 AM
To: Jennifer
Subject: The Prednisone Diaries

Hi Jen. This may be the last installment of “The Prednisone Diaries" (3-5 am version) for awhile. Today will be my last day of oral prednisone for this cycle. I take it for the first 5 days after the R-CHOP, and today will be day 5. And darn, I had hoped I'd get the whole apartment cleaned while on that steroid rush! Imagine how clean Mark Maguire's apartment must be.

Yesterday was the first day I really went back to work since the surgery. It was a Monday, and on Mondays and Wednesdays I direct the Program for Women Faculty Affairs. I’d love to show you my office. After you go in the front door, there is a kitchen to the immediate right, and past the kitchen is the door to our suite. My office has a desk, bookcases, a round table that can fit three chairs easily, and a window overlooking some trees on the street, my first office window in over 17 years.

I had a bunch of stuff to do in the office, but I took it slow. I had to finalize some details for this Wednesday’s breakfast meeting of Athena, which is our informal group for women faculty. We call this group Athena after the Greek goddess of wisdom and war. In Homer’s Odyssey, Odysseus asks a wise and trusted old man named Mentor to take care of his son Telemachus when Odysseus goes off to fight the Trojan War. It turns out it is actually Athena, a woman and a goddess, disguised as Mentor, who guides Telemachus in the Odyssey. We thought Athena was the perfect name for a group of women faculty who offer each other support and guidance.

Cindy came to see me in the Women’s Office. She brought me a maroon baseball cap that said “Monk,” after the detective with obsessive compulsive disorder (OCD) who is the hero of my favorite TV show. Monk’s OCD makes him a great detective, because he notices everything, but complicates his life because of his many phobias and rituals. Cindy is a cancer survivor, and last year, when she was recovering after surgery, I sent her a collection of Monk DVDs. It seems right that now that I have cancer, she gave me a Monk cap. A few other friends had sent gifts to the office. One of the good things about having cancer is that people are always giving you “cancer presents.” It’s like Christmas in the spring!

I figured out a plan to structure my days for the immediate future. On Mondays and Wednesdays if I’m up to it, I'll go to the Women's Office. The other days, if I’m not getting treated or hospitalized, I’ll go to my Radiology office to do some administrative work or research. I'll aim to leave work around 4 pm, so I can be here when the kids get home from school. Jen, I'm almost 47, my kids are 17 and 14, and yesterday, when they came home from 11th and 9th grade respectively, I got to offer them milk and cookies and ask them about their day at school. Finally!

When I got home yesterday, I talked to Carmen. I asked her how she thought the kids were doing through all of this. She said that it’s hard on them but they’ll be OK. She told me how much time the kids spend with each other at home these days, talking in Nate’s room with the door closed. I was relieved to hear it. How wonderful if they can support each other. Around 4:30, the kids came home; Emma settled down to schoolwork and Nate closed the door in his room to take a nap.

I went to the laptop to write; Carmen gave me a hug and left. The laptop is on the dining table in our living room, which we redecorated since you last saw it. It still has bookcases on most of the walls, the dining table on the near right, and the piano on the left. We got shades to cover most of the glass windows on the far side of the living room, but left bare the glass door that opens onto the terrace. We bought a big Oriental rug. We also replaced the old couch with an oversized sofa that has big stuffed pillows and got two comfy “glider” chairs in muted colors with a hint of turquoise. I love to sit in one of the gliders and read and listen to David playing the piano. Around 6 pm, the kids emerged from their rooms, hungry for dinner.

We ordered dinner from a neighborhood Italian place called Arturo's, one of our family favorites. I called David on his cell to ask what he wanted me to order for him, and he was glad that I was home. We had a family dinner for a change, and then the kids escaped to their homework. That little extra time with the kids when they get home from school and having dinner all together felt like a gift—I usually don’t get home until after seven. Later I told David that for the next few months I would try to get home before the kids whenever possible, and he said that sounded like a good idea.

Today they’re going to make a second attempt to give me intrathecal methotrexate in the Omaya. David asked me what time the appointment was so he could reschedule his day to come with me, but I don’t want to drag him to all my appointments. He has to work, take care of the kids, and handle the logistics of our lives. If I really need him, like I did when I had brain surgery, I won’t hesitate to ask, but if it’s not essential, I’d rather conserve his energy. Cindy offered to come with me and sounded like she meant it, so I think I’ll take her up on it.

The prednisone buzz is fading, and I may go back to sleep for a little while.

More tomorrow.

Love
Laura

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From: Laura
Sent: Tuesday, March 20, 2007 11:14 PM
To: Cindy
Subject: Oh Me Omaya

Hi Cinderella. Just a note to thank you for your starring role in the drama “Oh Me Omaya.” I appreciate your coming with me for the intrathecal injection today. You were exactly the right person to be there for me when I needed you, and I will never forget it.

Love
Laura

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From: Laura
Sent: Wednesday, March 21, 2007 6:26 AM
To: Jennifer
Subject: Intrathecal chemo: it worked!

Hi J. Yesterday I went to the hospital for intrathecal chemo. The neurosurgeon made his guest appearance and showed the oncologist where to go. Cindy came with me. I figured since she’s expert at using the numbing spray from having participated in thousands of breast localizations, she could jump up and spray my head if necessary.

I instinctively reached out to Cindy, and she was a good choice. We started at Memorial around the same time 17 years ago, when I was a fledgling radiologist and she was a breast imaging technologist who worked with our mobile van mammography screening program. Since that time, she has risen through the ranks and is now the Chief Technologist of Breast Imaging at Memorial Hospital. You haven’t met her—she has blonde hair and looks like Cameron Diaz. In fact, before she became a radiology technologist, she used to be a hand model!

Cindy and I seem to be there for each other at key moments in our lives. Two years ago I came to the office on a vacation day morning to tidy up some loose ends. I called Cindy in the mammography office about some work-related issue, and she told me she had a new breast lump. I read her mammogram, did a breast ultrasound and a needle biopsy that day, and referred her to the breast surgeon who cured her breast cancer. And now Cindy’s there for me.

When I introduced her to my oncologist, I said "This is Cindy, the Chief Technologist in Breast Imaging" and he asked her, "Can you help me schedule a mammogram on one of my patients?" Without missing a beat, Cindy said, "Sure, but only if you get this tap on the first try!" Go Cindy! I could have kissed her feet. They got it and gave me the chemo. I felt nauseated afterwards and had to lie down. Cindy was great—she stayed with me and held my hand while I was getting the chemo and took me home in a cab. When we were in my building, Cindy took me upstairs; I introduced her to Nate, Emma, and Carmen, and then I went to lie down.

Now I have to go, because we're having an Athena breakfast 7-9 am today to celebrate recent women's appointments and promotions. If I feel up to it, I'll stay at work for awhile afterwards; otherwise, I'll come home, and go back to sleep. Phil, the oncologist, wants to give me intrathecal twice a week (Tues/Thurs) for the next 3-4 weeks, until the CSF “clears” (which means has no more malignant cells), and then we’ll see.

Love
Laura

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From: Laura
Sent: Thursday, March 22, 2007 2:16 AM
To: Jennifer
Subject: Athena breakfast

Hi Jen. The Athena breakfast yesterday was OK. We have these Athena events once a month. We usually meet from 5-7 pm, but sometimes we have an early breakfast or lunch, so that women with different schedules can come. Athena is a chance for women faculty and administrators from MSKCC to meet informally. Before each Athena, I get a list of all the recent women faculty appointments and promotions (A&Ps), and then I invite those women to Athena to celebrate. We get RSVPs so we know who’s coming, and we have a little celebration in which we give each of them a flower. The event is pretty low-key—people filter in and out as they can.

For the breakfasts, we order food for the number of people coming and it’s served buffet style. I usually get there around 7 and put in the CD with the background music. We mill around and eat and chat until 8, and then I take 10-15 minutes to make announcements. I was supposed to be there at 7 today, and actually was up before 6. I had showered to go, but then I felt sick, all sweaty and nauseated and faint, and I had to lie back down. David was surprised—“Weren't you going to get up?" he asked. When I told him I didn’t feel well, he helped me crawl back into bed. I asked him to wake me up so I could be at work by 7:45.

When he woke me up at 7 am, I felt better. I showered again and put on nice clothes—a flowing skirt with rust and green flowers, a green shirt, a little green jacket, and my favorite green hat (from Banana Republic). I haven’t started losing my hair from the chemo yet, but my head still looks pretty scary, so I’d rather keep it covered. I took a cab to the Boardroom.

When I arrived, about 20 women were there already, and the breakfast buffet was out. Usually we get a continental breakfast, fruit and bagels and pastries, but today we decided on real food—scrambled eggs and home fries. When I entered, people seemed glad to see me. I told them I had brought the background music, and offered them a choice of Murray Perahia playing Mozart Piano Concertos or the Beach Boys Greatest Hits. And guess what? We went with the Beach Boys! That was my first choice too—the Beach Boys got me through the first round of chemo.

After “California Girls,” I got up to make the announcements. Usually I stand at the podium, but when I stood up I got lightheaded and dizzy, like I do when I’m dehydrated after spending too much time on the beach in the hot sun, so I sat down. The other women sat in circles at adjacent tables. I made the announcements, which, in another deviation from the norm, I had written out in advance.

“It has become our tradition at Athena to celebrate women faculty achievements at MSKCC, particularly appointments and promotions,” I said. “We are blessed to work at the greatest cancer hospital in the world. We save lives, and take away fear, and discover cures, and make the world a better place. And these activities keep us busy, and impact on the rest of our lives. It is important in the midst of all of this work to take a moment to celebrate our achievements and congratulate each other on our successes.

This seems particularly important to me now from where I sit. As many of you know, I was recently diagnosed with lymphoma and am being treated here at Memorial. I need six months of chemotherapy, and have already finished two treatments. This experience makes me believe even more strongly that we need to savor special moments in our lives as they come. So today we continue our tradition by welcoming women newly appointed and congratulating women recently promoted at Memorial. Please join me in the following celebrations…”

We congratulated each woman recently appointed or promoted at Memorial by giving her a flower. We passed around a hand-held mike, so that each woman being honored had the chance to speak. I was especially touched when a terrific surgeon whom I had helped with her promotion package, thanked me for my work with women faculty. Then we went back to milling around. I got faint and Maureen asked a nice pediatrician named Yasmin to put me in a cab and take me home.

I lay down most of the morning, and must have napped off and on. When I woke up, Carmen was there. I guess she’s my nanny now. She was so sweet—she got me water and made me herbal tea. After that I fell asleep for real. By the time I woke up, it was dark outside, and the kids had come home.

Emma had decided to help find me the Zen. She went to Barnes & Noble after school and bought me my own Itty Bitty Buddha, a tiny reddish portly gentleman with gynecomastia (male breasts) and a protuberant belly which apparently brings you luck when you rub it, so rub away I did. Carmen made us dinner, David came home, and Carmen left. I hung out with David and the kids between naps. Emma and I watched the latest installation of America's Next Top Model, and we agreed that we both hate Renee, although she did take a good picture of being dead.

This afternoon I have to get another dose of intrathecal chemo. Cindy will come with me again.

Love
Laura

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From: Laura
Sent: Friday, March 23, 2007 6:19 AM
To: Jennifer
Subject: More intrathecal chemo

Dearest Jen,

Notice, first of all, the luxuriously late time on this email—it’s after 6 am now! It’s hard for me to think that only a few months ago, I would have thought 6 am was early. I woke up at 2 am as usual but had some herb tea and a piece of banana bread that Q had bought for me and went back to sleep, listening to the Brahms Clarinet Trio that you and I used to play with Susan, the clarinetist, before she moved to New Jersey. I woke up again at 5 am, showered, took my pharmacy of morning meds, made more tea, had a piece of fruit (not bad nutrition considering the chemo, right?), and now I’m here writing to you.

Yesterday was a busy day—two appointments, neurosurgery staple removal at 11 am and intrathecal methotrexate at 3 pm. I had been a little worried about the staple removal—I figured it would hurt. I wanted Cindy to come with me for the intrathecal chemo, and I didn't want to ask her to come to both. I asked Q to come to the neurosurgery appointment, although I was afraid it might be too graphic for someone who doesn’t work in the hospital, and I figured I'd probably kick her out when the neurosurgeon came in. But it was actually fine—removing the staples took about a minute and didn't hurt at all—it was like taking out a barrette! My neurosurgeon is terrific. I asked how a nice Jewish boy from Tennessee like him got interested in brain surgery, and he replied, “Well, I couldn’t sing.”

After the staples were out, Q took me home in a cab and came upstairs. Carmen was here by then and had cleaned the place and opened the windows and terrace door, so there was fresh air in the apartment. I lay down on the couch and rested while Q and Carmen made lunch. Q had bought me delicious chicken soup and a soft roll from the Vinegar Factory, which was perfect. And then Q left.

I called my older brother; I’d been meaning to call him for days. He seemed apprehensive until I said to him, "So now I've had brain surgery and they're putting chemo into my brain, and I'm still smarter than you!" He laughed, relieved. If I could still talk trash, I must be OK. I asked him to look after our mom, who lives near him in Massachusetts. We had a nice but brief chat until Emma came home. I talked to Emma for a few minutes about her day in school, and then it was time to for intrathecal chemo.

I met Cindy there around 3. They checked my blood counts with a quick “fingerstick,” meaning they just prick your fingertip with a needle. After the results came back, I went in for more intrathecal chemo. The procedure went fine, but afterwards I felt nauseated and I vomited. Wonderful Cindy held my hair back so I wouldn't puke all over it. And another thing I've noticed (as long as I'm using my experience as a patient to revolutionize patient care): have you ever wondered why those tiny little barf basins are so small? Because when you're throwing up, what you really want is not just to puke, but to have to hit a very precise tiny little peanut-shaped target. I asked the nurse, since we’re the finest cancer hospital in the world, don't you think that maybe we could spring for the larger basins? Am I the first puking person to ever want a wider net?

I sat with Cindy for a long time. She is brushing up on her "Reiki" which is a kind of massage that is supposed to have a healing touch, and it helps, or she does, or both, I don't know which. Then we went downstairs. I sat in the lobby (68th between 1st & York) while Cindy got a cab.

A physician colleague named Cheryl walked by. I was still nauseated, and had my head between my knees, trying not to throw up again. Cheryl asked how I was, and I told her I had just had chemo and thrown up, and she said, "Have you talked to other patients who have had similar experiences?" I replied that in the 17 years I've been working here, I have talked to a few cancer patients. And she said, "No, I mean now, as a patient? Maybe you should join a support group." I'm sorry, I know she means well, but here's some advice to people who want to help: if your friend with cancer is about to puke, don’t refer her to a support group. Just give her a bucket.

Cindy got me a cab (just in the nick of time—I was going to use my last reserve of energy to strangle Cheryl), and she slid in and I climbed after her. When I got home, Nate and Carmen were there and then Emma came. I lay down on the living room couch with the TV on. Nate covered me up with a fuzzy green blanket and I fell asleep.

So the intrathecal methotrexate is a bitch. They want me to take nausea meds before my next treatment. I have to get it again on Wednesday. On Thursday I get admitted for the IV methotrexate, which is supposed to be the hardest of all. Phil says I'll be in the hospital at least five days. My spirit can take it but I hope my body's up for it. Bring it on.

Love
Laura