Since someday a medical test could discover within you the thing long feared, the doctor’s office might be a good setting for the beginning of this story. Yet this story has insisted on beginning weeks earlier when my wife and I were traveling to her maternal family reunion and I recalled flowers we had seen decades before that. We were in dairy country, the Herefords lying beneath thick clouds, and after passing several barns of almost black hemlock that made brilliant the white farmhouses against the gnawed timothy and heaps of dung and raggedly wooded hills, I pictured the enormous field of sunflowers we passed on a journey decades earlier, all those golden-laced bonnets, heads bowed in prayer over a table that ended where it met blue sky. As I recalled the flowers, I suddenly supposed the cause of Margaret’s mysterious illness.
“Something’s wrong. You look upset. What is it?”
“Nothing,” I said. “Nothing’s wrong.”
Despite her ferocity in any fight, Margaret was losing her struggle against invasive fatigue and absconding memory. By the time her doctor told her that he could find no cause of her symptoms and suspected she had the baffling and untreatable condition known as chronic fatigue syndrome, her inner forearms were purple and puffed from the many laboratory extractions. I was worried he had missed something more dangerous and told him about Margaret’s remove at her father’s funeral months earlier, where she was like a small, dry island amidst a bog. She had been someone who would weep at the wake of a stranger — say, a sibling of some guy who taught second grade up the hall from her — but during the doleful warm-up music at her father’s sendoff, she leaned against me on the pew and whispered, “He had one foot in the grave and the other on a banana peel. Then he slipped.”
After my funeral anecdote, the doctor said, “Maybe they had a relationship problem.”
I asked about a brain scan.
Probably unnecessary, he said. Maybe later, he said.
He ordered a psychological evaluation.
Now she and I were nearing her family reunion in her cousin’s backyard in a small town in western New York.
We were late because that morning she had taken nearly an hour to dress: I had already put the cooler in the car when I found her sitting on the edge of our bed with one leg in her jeans and then, 15 minutes later, still only one leg. When finally I steered the car onto her cousin’s driveway, Margaret’s eyes were closed. I squeezed her shoulder. She asked, “Are we there yet?”
Out on the gravel, I smelt sizzling blood and fat. I said, “Hurry.”
On our way to the family reunion, I had been remembering how we got to the flowers. We saw them during the long journey we planned shortly after I told her I had been offered a university teaching assistantship out in North Dakota. She had responded, “So are we getting married?”
“Are you pregnant?”
Despite my obnoxious question, our children would be undreamt for a decade. To reach North Dakota, we traveled a day and much of a night through New York and Pennsylvania and Ohio and Michigan and Wisconsin, belongings squeezed into a rusty sedan, a bank check representing our pooled savings of under a grand stuffed in the glove compartment with the registration and map and the wedding cards from kin who back then were yet alive. We felt rich, or as we assumed the rich felt. We talked almost nonstop even after nightfall, and in the background the DJ blather and rock music and jingling sales pitches and the bad news that could never catch us came and went on the radio like the flashing of lightning bugs back East.
She parked the car on a wide shoulder of U.S. Route 2 when we were exhausted. We moved a large box of winter clothing from between us and into the passenger seat so we could sleep propped upright against each other, swaying to the gusts of big trucks. We woke to dawn in western Minnesota and saw that we edged a field of sunflowers which faded into horizon. I peed on gravel. She took her turn. We soon were back on the road, and soon she must have said, “You’re speeding.”
Hungrily lifting its multitude of heads, the great field intoned amen.
Several weeks after the reunion, an optometrist found that Margaret’s field of vision was splattered with blind spots, and he explained without surprising me that the cause was not in her eyes. It was “somewhere behind the eyes.”
He sent a report to her doctor, to sink in somewhere behind his eyes.
On the wall opposite my wife and her sister and me, and behind the doctor, a pharmaceutical advertisement brightly illustrated a diseased bodily organ. He was talking about the CAT scan he had ordered. He was young and pudgy. He stood in place but rocked slightly like a beach ball on the verge of rolling away in a breeze.
I had expected to hear the diagnosis in singular, but he kept using the plural. Tumors, tumors. Margaret’s sister and I asked questions that sped his rocking. Margaret didn’t speak from her seat.
I rose early and somewhat unrested on the morning after the day of the hard seats. I peed on the lawn and stretched in milky light. I dressed. I ate eggs and toast and then finished a cup of strong coffee as I checked email. I again went outside and trailed my dog around our pond while from high pasture a John Deere barked at us. The sun floated orange near the horizon. A hillside stand of pine shed faint mist.
Margaret was still in bed as noon neared, curled on her side, leg draped over a ball of blanket. Standing at the foot of the bed, I launched into what I liked to insist was our song. When I serenaded her with Rod Stewart’s “Maggie May” — Wake up, Maggie, I think I got something to say to you — my artistry normally received from her some veiled criticism. Such as, “Oh — please shut up!”
I stopped myself as I realized verses neared that, this time, I should suppress. Yet, this time, her eyes still closed, she whispered them: “All you did was wreck my bed/And in the morning kick me in the head.”
Two weeks before the surgery, she visited with our daughter in Manhattan. One night while she was away, I brought home a green bottle of Jameson whiskey. The dog eventually rose from carpeting, beckoned me to the front door by scratching at it urgently, hastened out, lay on the cold September lawn and would come back inside only after my howling ceased.
During the worry-filled predawn ride to the cancer institute up in Buffalo — our car funneled by a glacial valley past the faded billboards and dim diners and homemade Deer Processing signs along sinuous NY Route 16, the hills still dark, October foliage unseen — I recalled a story about my grandfather Barley Phillips and the first of his eight children, Sam. It had been told to me by my short-lived father and two of my long-lived uncles, each of whom added to it bars of his own tune.
It always begins with throbbing.
Because the throbbing has become so strong, Sam can no longer work as a draftsman. And he tells Barley why. Barley says there is some mistake. Sam explains that a second doctor made the same diagnosis.
“Well — you can get better. Right?”
He stares at his father across the table for a long moment. “I dunno, Pop. Who do you know who ever got better from brain cancer?” He shrugs. He looks away. “I guess I can hope. I mean — my kid.”
Barley nods. “You’ll get better.” He stands and moves slowly to a cupboard. He removes two mugs.
Sam shrugs again. He stands. He shrugs once more. He follows his father down the cellar steps to the tapped barrel.
The next day, when Barley calls in sick, the foreman kids him. “Nice morning. Going fishing?”
A strong suggestion is made that the foreman should fish the phone out of his colon.
Late in the morning, father and son listen as the man with the long and unblemished fingers explains the surgery. Finally he asks, “Do you have any questions?”
“No. I guess not. Nope.”
“Me either. But I just want you to know I’ve decided I’m gonna watch you operate.”
“I beg your pardon?”
“You’ll be more sure to be careful with my son.”
During the surgery, Barley watches from above, through glass in the floor, a security guard at his side.
He sees the shaven scalp peeled, the skull reminding him of the mysterious domed mosques he has seen in pictures. He sees the searchers, who are locked out of the mosque, cut through the wall and lift away a section. He sees them enter the interior that throbs with watery music, curtsy and circle, and lead out with utmost courtesy, what little of it they can, the interloper.
I thought again about my grandfather and his eldest child while Margaret was under the knife, strangely solaced by the cadences of the ancestral fugue, even sleeping for a while on the waiting room seat, although I woke thinking no longer about Barley and Sam. I woke feeling like the hare caught by the tortoise. “Are we there yet?” the tortoise asked.
Wondering, I rubbed my eyes.
About two weeks after the surgery, a doctor reported that one tumor was benign and the other an unrelated malignancy that might or might not have spread. He added a caveat. The cancerous might was more mighty than the might not. The pathology report reminded Margaret and me of those corny good-news, bad-news jokes, and eventually we joked without laughing about the unintentional truth from Bill Clinton that much “depends upon what the meaning of the word is is.”
The benign growth — how benign is the meaning of benign? — had hugged the optic nerve and the pituitary or “master” gland, and the malignancy had squatted in her frontal lobe. Post-surgery, she came under the care of an oncologist and radiation oncologist and endocrinologist and hematologist and ophthalmologist and neurologist; and one of them informed us “the chance is good” the cancer would reappear within 10 years.
Another specialist was tall and good-humored and stood in the middle of the examination room, while the assisting nurse stood near the wall opposite Margaret’s and my seats, and told Margaret the most recent MRI looked normal except where the tumors had been: “Now you’re holey.” I asked how long it might be before the cancer returned. He didn’t say 10 years. He said three. He paused for a few seconds, looking at the floor, and then said, “But it doesn’t have to come back.”
Was the cancer on a leave of absence?
Yet another specialist told us in an encouraging lilt that among her patients with the type of tumor cut from Margaret’s frontal lobe, “One has been cancer-free for three years.”
One afternoon, I succumbed to fear of the unknown. In a panic, seeking survival statistics from treatment studies, I called the cancer institute where the surgery had been performed — hoping that numbers would heal the cleaved meanings of words. I spoke with a nurse practitioner familiar with Margaret’s case; like the various doctors caring for my wife, the practitioner was empathetic but finally said, because I insisted, that speculating about Margaret’s future “would be like not knowing if the weather and traffic are good or bad and then trying to predict how many red lights you will hit later that day on Niagara Falls Boulevard.”
I was sitting at the kitchen table, bent as if saying grace, jamming the receiver against my ear as if trying to penetrate my skull, attending her tones and rhythms and words as if she were the Pythia.
So far — for over two years now — the MRI report issued each four months has characterized Margaret’s brain as stable, a nice enough word and with a clear meaning when applied to inanimate objects. Yet tell us, Doctor, if you would, what my wife’s is is.
When some kind friend or acquaintance asks me how Margaret “is” or “is doing,” I usually say, “She’s okay.” I actually mean that while waiting for the results of another MRI, she feels like a character in Shirley Jackson’s “The Lottery”; and that five times a day she swallows pills which slightly boost memory and concentration, imperfectly replace several hormones and diminish the threats of seizures and thrombosis; and that her post-surgical history of clotting prevents her from taking the estrogen needed to slow the worsening of her spinal osteoporosis; and that because of her damaged ability to concentrate, she can’t drive even though enough of her vision has returned.
When we made stew one afternoon this past winter, she took about 20 minutes to prepare four carrots for the pot. Each motion took her several times longer than it would have before the cancer: each slow sweep of the peeler, shifting of a carrot, pressing of the knife, gathering of slices, each of those slow movements followed by a pause. That evening, I called her to the kitchen table where I had lined up pills, but a grocery receipt distracted her and she read through it again and again. She then became distracted by the instructions on the back of an electric knife sharpener we had owned for years, reading them repeatedly. “Take the pills,” I kept urging. If I hadn’t, an hour later the pills would have waited.
Margaret is and is not who Margaret is.
I have gone from none to two beers per day before the cancer to none to four after. As for Margaret, whose medications make any amount of alcohol hazardous, she seems not to miss the occasional drink — even though, all those years ago when we were on our first date, she challenged me to a beer-chugging contest. After winning second place, I learned she had read those long, long Russian novels that intimidated me. They still do. She can no longer work as a teacher but somehow finishes more books than ever, though she reads with lips moving as if in prayer, can tell me little about plots and characters, and might begin the same novel a month later as if knowing it only from a review. I would like to read My Ántonia once each month if I could keep forgetting the fate of the Shimerdas and Jim Burden and Lena Lingard, but not if I would misplace the word book. “Did you see where I left it?” she asks at least once a day.
“You know — it, it.”
But her long-term memory is better than mine, her oneiric new days draining around solid old times, like steaming water around potatoes in a strainer. Over dinner, she recently asked whether I remembered her meeting my mother. I didn’t. She reported that it was on a snowy evening in March and my mother was boiling potatoes and the kitchen windows were steamed.
Unlike the thin frosty stubble of my pate, her regrown hair is still dark, and occasionally, in dim light, she momentarily looks to me as she did when decades ago I first glimpsed her: at an ice skating rink, before I knew even her name, Margaret Mulcahy. That long moment ago. Late one recent evening, she shut off the lamp at the couch and I gazed up from my reading in the easy chair across the room and she saw in my look what I saw. She waited until I began to read again before asking whether I recalled when we spent a rainy spring weekend at a cabin and built a fire and “stayed in bed all day.”
“I remember just the all-day part,” I replied — proudly.
“You were such a pig.”
Despite her drastically changed life, she says she will be happy as long as she is without cancer, but I’m unsure whether happy and sad still mean to her anything similar to what they mean to me. Some of her emotional range has returned since the surgery, but tragic films seem unable to touch her. When we watched Sophie’s Choice in a theater many years ago, still a childless couple, she wept when a Nazi forced Sophie to choose whether her daughter or son would survive the Shoah, but while recently rewatching the scene in our home where we had raised a good daughter and son, Margaret looked as if she were listening to a Dow Jones Industrial report. When she told me that one of her beloved cousins had cancer, her tone was suggestive of a weather report. Four to eight inches of snow overnight. After she read a draft of this essay, she said, “It’s fine,” and presently asked, “Are you making anything for supper?”
About a year ago, she began repeating some of her statements in singsong. Especially, “I don’t know, I don’t know-ho!” She soon commenced the uttering of morphemic gibberish, streams of which sound like prayers in a strange language when voiced quietly, and dissonant songs when loudly. On some days these vocalizations are frequent when she is unoccupied by conversation or reading or film. She might punctuate them with bursts of words in English — Oh yeah! Oh yeah! — and the brief clapping of hands and swaying of torso and stomping of feet. She is at times unaware of her sounds and dance but at others is “singing a real song in my head.”
What does real really mean? Her doctors aren’t sure, but they say the definition might be found in her sliced and radiated frontal lobe.
Years before the hours of surgery and weeks of radiation and months of chemotherapy and even the first symptoms of trouble, a fall from the sky startled me as I stood in our yard watching a mallard on the pond. I thought the eagle had missed, although probably its intention was to flush the duck off the water. The second one ripped the prey from midair sunshine. The eagle pair then undulated off while one sheening blue feather seesawed downward, raptor heads and tails rapturous, brightly white as patches of snow in sunshine, circling behind tall pines and out of my view. For a little longer, I heard the drake’s rhythmic squawking.
I made a confession to my wife this past December. It was after she asked me to cut a fir and buy a potted poinsettia. The children would be home soon and she wanted the house to look as they remembered it to be on Christmas. She was in a rocking chair near the wood stove and I in another in a corner of the living room, books in laps — Ma and Pa Kettle, a little prematurely — and between us the dog was asleep on the carpet, which badly needed cleaning. I don’t fully understand why after so many years I chose that evening to confess and why of all my faults and wrongs, of all the apologies I maybe should make, I chose that one.
“I have a confession.”
“Oh, brother. What?”
I was remembering she and I had dated several months when my uncle Al suggested I “take her out to a good restaurant” — and handed me 30 bucks, a lavish amount to a kid who thought of classy restaurants as those eateries which did not serve hot dogs — and that two evenings later, a department store tie clipped to my collar, I bowed and handed her a bouquet as I picked her up from her home, disguised as a gentleman. Now — in our home of 30 years — I asked whether she remembered that first time I gave her flowers.
“Of course,” she said. “So what’s your big confession?”
I confessed I had gathered them from the cemetery near my mother’s house, a few from each of several graves so no one else would notice. Maybe so none of me would be in her largest blind spot, she studied me askance. The fire was nearly out, but it was a warm night, considering the month. “You’re something.”
Again she paused askance, reminding me of a robin stalking breakfast, one eye fixed on earthworm, the other on sky, whispering in her new language as if she had forgotten about me — ah sah lah ooo ish ish — and then was silent a while before using the language we still shared. Out of the right corner of my right eye, I saw a faint, creamy orange glow emanating from behind the thick glass of the stove door. “Well,” she said, “I still think it was still kind of pretty anyhow.”
Mark Phillips is the author of the memoir My Father’s Cabin. His essays have appeared in Commonweal, Salon, The Sun, New York Times Magazine and in many other journals.