What We Have (38 page)

EARLY IN DECEMBER, JACQUES AND
I met with my new doctor, Dr. Muto, at the Farber. We were there just to talk, not for any kind of exam.

It was an unusual meeting. Here I was, six months pregnant, Jacques with me, holding my hand, and I was asking Dr. Muto to take my ovaries out right after the baby was born.

“Not
right
after, of course,” Dr. Muto said, looking at me with concern.

“As soon as it makes sense,” I countered. I reminded him I’d be thirty-four in May. We could wait until summer, even late summer. But I wanted to have the surgery before I started teaching again. While I was still thirty-four.

“Remember,” he said, “thirty-five is just a target. There’s nothing magical about that number.”

He brought some charts out to explain to us how doctors had arrived at thirty-five as a recommended age for my sisters and me to have surgery. “It’s not an exact science,” he said. He explained that since genetic cancers often occur younger with each successive generation, doctors liked to subtract ten years from the age of the closest affected relative when she got sick. Sylvia had been forty-three; Pody, forty-five, Gail, forty-seven. After considering the average age of onset in our family (Sylvia, Pody, Gail), they’d decided thirty-five was a safe target for our family.

“But remember,” Dr. Muto said, “thirty-five has always been just a target. Suppose you waited until thirty-seven, for instance.” He drew a graph for us. “Your lifetime risk may be high—forty, fifty percent. But for each individual year, that risk remains relatively low. Let’s say, one or two percent for each year between thirty-five and forty. Then it might go up a bit after forty.” He looked at me, as if he were worried that I couldn’t quite picture this. “For every hundred women in your exact situation who did
not
have the surgery this year, that means only one or two of them would get cancer. The rest wouldn’t.”

Jacques, who does this kind of analysis all the time at work, found this fascinating. He loves graphs, models, statistics. But I couldn’t focus on the numbers. I’m a story person. I was still turning over what Dr. Muto had said about subtracting ten years from Sylvia’s age when she’d gotten sick. Forty-three. I was already thirty-three-and-a-half. That meant I was past the deadline, if you were a stickler. I didn’t find the idea of 1 percent or 2 percent at all reassuring. One or two women! That could be Julie and me. (Sara, long past surgery, was already on the safe side.)

“Now, your mother—” Dr. Muto began.

Jacques put his hand on my leg. I couldn’t go there right now, and Jacques knew it.

This was a week where I hadn’t been able to get through to her. Not even once.

“That’s a different situation, of course,” Dr. Muto said. His eye was on the pad of paper—he couldn’t see my face. Then he looked up at me. “Breast cancer,” he said, shaking his head sadly. “One out of eight women is the latest statistic.” He reminded me that while there was some suggestion that having your ovaries removed reduced the overall chance of breast cancer, it didn’t (of course) remove the risk.

And now that we were talking about remaining risk, Dr. Muto said he owed it to me to point out that high-risk ovarian patients continued to be at risk for extra-ovarian cancer. Even after surgery ovarian cancer can still develop in the peritoneum, the lining of the abdomen. There is something called EOPPC—extra-ovarian primary peritoneal cancer—that women can still get, even with their ovaries gone. Dr. Muto himself (sadly) had a patient who’d gotten that, several years after having her ovaries removed. And she had died.

I cleared my throat. I understood nobody was promising me anything rosy. “But the chances go way down, right?” I asked. I was worried we were losing focus. I wanted this meeting to strengthen Jacques’s support for the surgery, not to give him the sense it would only be partly effective.

Dr. Muto nodded. “Dramatically reduced.” Removing my ovaries would bring my chance of ovarian cancer way down. Still there, yes—but close to nothing.

That was all I needed to hear. I didn’t expect guarantees. I couldn’t do anything about falling meteors. But I had a responsibility—to Jacques, to Sacha, to the new baby, to my whole family, to myself—to take care of what I could. Bringing my risk down to almost nothing—that seemed like a miracle to me. If I had to remove a limb to get there, I’d have gladly done it. A two-hour surgery, removing two tiny organs I was done with?

The baby kicked.

OK.
Almost
done with, I amended.

This, as far as I was concerned, wasn’t a hard choice to make. It was what Jacques calls a “no brainer.”

“I’m ready,” I said, pushing the graph back to him. “Or at least I will be, as soon as the baby comes.”

“Let’s talk in the spring,” Dr. Muto said, shaking hands all around. He cleared his throat, looking at me. “Late spring, early summer,” he revised. “Meanwhile, try to take care,” he added gently.

I read a million things into that. There was so little, it seemed, that I could really take care of. I couldn’t take care of my mother. I couldn’t fix what was happening to her, what my father was going through. I couldn’t stop myself from grieving. I couldn’t protect Sacha from how sad I was, however hard I tried.

But I could plan the surgery. On the way out, I stopped and made a follow-up appointment for April.

 

WHEN WE WALKED OUT OF
the Farber, it was snowing heavily—snow was already accumulating on the sidewalks. Big, soft flakes. We didn’t know it yet, but this was the first of sixteen or seventeen serious storms between now and spring.

That’s what I remember most when I think about that winter. Snow. Endless, constant snow, as if the whole world were trying to erase itself. A white blur, an absence.

We didn’t celebrate Christmas that year. No tree, no gifts. In the last days of December, the year running out like so many grains of sand, my mother died. Upstairs in the Hilton, my father at her side. Sara, Julie, and I had just been there to visit, and we were all planning to come back again after New Year’s, but this time it wasn’t up to us to make the plans.

 

IT SNOWED CONSTANTLY ALL THAT
winter. Twenty-two inches one storm. Eighteen, another. Snow covered bushes and cars, sat on sills, lay heaped in mountains at the curbs where the plows left it. Turned gray, then black; froze; seemed part of an eternal frozen landscape. Sidewalks were impassable. In the afternoons I cut swaths through the snow with a shovel, panting, and as I shoveled, more fell.

I missed her all the time. Sometimes, trying to move the wet, heavy snow, I cried so hard I thought I’d make myself sick. There’s an emptiness words can’t describe and that for me was the emptiness of three and four o’clock every afternoon, when I would look at the phone, and then away. When I would imagine her voice reaching for me. For all of us.

Sometimes, napping—being pregnant made me so tired this time—I would wake to my alarm and think it was the phone, and for a minute or two, before I was fully awake, I’d swear I could hear her voice. Bright, sparkly, lucid, the way it used to sound, before the morphine and the pain and the constant sleeping. Like she had something exciting or funny or maddening to say, and she couldn’t wait to tell me.

The things I wanted to tell her piled up, like the snow.

 

BY LATE JANUARY, I WAS
hugely pregnant again—dazed, exhausted, heartsick, trying to take care of Sacha, Jacques, myself. Instead of teaching second semester, I did administrative work for the department through February, then took time off. It wasn’t great timing—I’d only taught for one semester, and here I was, already asking to be an exception. But I didn’t have much choice. The baby was due smack in the middle of the semester. As I was coming to see, life makes its own calendar, and if you’re wise, that’s the one you follow.

 

SACHA WAS SAYING NEW WORDS
all the time now.
Slipper-lee. Eenie-meenie
.
Wow
. One night, looking at her alphabet book in the bath, she ran her wet finger back and forth across my father’s photograph.

“
Bop-pa!
” she exclaimed, eyes shining.

I stared at her. “Sach,” I said, trying to rein my excitement in. I turned the page, back to my mother’s picture. Taken three or four years earlier, over the Fourth. Her eyes sparkling. “Who’s this, sweetie? Do you know who this is? Can you say?”

“Boppa,” she said again faintly, losing interest.

Words for her came from the here-and-now. She was like a tourist, picking up nouns for what was most essential.
Cracker. Mittens. Snow
. She knew my father: He came regularly to see her. To see all of us.

“It energizes me, being with you,” he said one night, looking past me out the dining room window.

“He can’t stand being at Lakewood without her,” Julie said sadly, the one time we talked about it. “She was right to want to sell the house. It’s like—what were those boats she used to teach her students about? The ones the Egyptians used? The house is like that. Filled with her stuff. It breaks his heart.”

Even now, all these years later, Sacha calls him Boppa. All the grandchildren do.
Bomma
—

Sacha never said it—not naturally. It never had meaning for her. Years later, in history papers or school reports, my mother got referred to as “my grandmother.” Distant, historical. “Bomma” was Jenny and Rachel’s word, washed clean of meaning for the rest of the grandchildren, like a Petoskey stone. You had to hold it underwater to see the lines: Otherwise it was bleached and pale, like every other stone on the beach.

 

JANUARY, FEBRUARY. I REMEMBER SHOVELING .
I remember coming inside, tapping the shovel so the snow slid off, Bacchus charging toward me.

Annabel would stand at the window, holding Sacha up to watch my progress as I worked, and from time to time they’d tap on the glass, both of them waving and smiling, but I couldn’t look back.

Which child felt it more, the grief I lived in? Sacha, watching me, trailing me, picking nervously at the hemline of my old, worn Laura Ashley jumper, trying out phrases. “Momma—better now? Momma ohh-kay?” Or this new baby, curling and turning in me, with only my sorrow for succor? What did each inherit?

Would we ever get to that final stage in Kübler-Ross’s hopeful diagram—
acceptance
?

My mother used to love Dylan Thomas’s villanelle, “Do Not Go Gentle.” She didn’t believe in acceptance (unless it was an acceptance from Stanford for one of her “bubbies”). If rage were a season, my mother would have wanted us to stay in it as long as we could.

And we did. I mourned and raged. I shoveled (endlessly) and the paths filled in around me.

Elisabeth was born March 9, six days early. Healthy, beautiful, with a smile so sweet it tugged at me. At all of us. She seemed to come into the world smiling. I know they say those aren’t real smiles—they’re reflexes or indigestion—but with Elisabeth, who we nicknamed Libby almost immediately, honest to God, I swear they were real.

Jacques brought Sacha when it was time for Libby and me to leave the hospital. We wanted Sacha there with us when we left, so all four of us could start our new life together. It was raining—one of those days in March when winter gives way to spring—and already dark out by the time we got everything packed up. We set the infant seat up next to Sacha’s car seat, experts now, and as we drove west on Storrow Drive, me in the back with the two girls, Jacques in the front, windshield wipers humming, I had an uncanny sense of things falling into place.

 

I HADN’T FORGOTTEN MY PROMISE.
A few nights after we got home from the hospital, I was nursing Libby in the living room, watching the shadows, noticing it was staying light a little longer now. Mid-March. Jacques was dancing with Sacha to one of the CDs she made us play over and over again that winter—
Reggae for Kids
. Calypso beat. The two of them, feet tapping, spinning. Laughing. How long had it been since I’d heard laughter? I could see their shadows crossing on the wall. I looked from one to the other and felt as if something in me were thawing.

“I think I’m ready for the surgery,” I told Jacques. “I want to do what we talked about, and have it this summer.”

I was surprised by his reaction. After all, we’d gone together to see Dr. Muto back in December. I thought we were on the same page about all of this. But if Libby’s birth sealed my determination to go forward, it had a different effect on Jacques. Maybe it was the reminder of how joyful it is, bringing a new life into the world.

Jacques didn’t think we should rush.

“You’ve been through a lot,” he reminded me. “And Libby is brand-new. Give all of this time—let yourself be for a while. There’s no urgency.”

No urgency? I was going to be thirty-four in less than two months. I had two babies to take care of now. They needed me. There was
plenty
of urgency.