Sunday, May 1, 2011

The story of a cancer patient

I spent this past Thursday with my parents at Mayo Clinic. I may have mentioned in previous posts that my dad is very ill with lymphoma of the bone marrow. He is 82. My dear mother is 80 with the physical energy of a 50-year old (most days.) She needs it because there is much to do when one's beloved is in pain, is wobbly on his feet, and needs help with many of life's simplest tasks. She is a saint and has been for most of my life.

She emailed on Wednesday:

I am wondering if you would be free tomorrow,Thursday, to go with us to Mayo? Dad is a bit weak and wobbly this week, and an extra person might be nice. I know this is very short notice; and it is perfectly okay to say no if you cannot go. His first appointment is not until 9:30, for blood, so we do not have to leave at the crack of dawn----if we leave shortly after 8:00, it would be fine. His last chemo may not be over until nearly 6:00, however, so this might mean you would want to stay over here Thursday night, or even tonight.

sorry to spring this on you, luv, Mom

"Sorry to spring this on you." From the parents who diapered me, fed me, clothed me, educated me, loved me, nurtured me, taught me to garden and cook and sew and told me to act and design and love.

"I can go," I said after clearing my schedule.

I went. I left at 6:45 a.m. (I am sooo not an early morning person.) Their Camry was warming up when I arrived. Dad drove. He can't stand the thought of losing his independence. We drove west out of Northfield on Highway 9 toward Hwy 52 which takes us into Rochester. More than once, I commented on how beautiful it was. The black dirt, newly turned for the seeds, the wispy brown trees feathered with lime green buds, a white clapboard church with its proud steeple, the barns red, the color of dried blood, fields of green patch-worked among the dirt. The road curved, it climbed soft hills and descended into quiet misty valleys. At one point, I said, "This reminds me of parts of Tuscany, the beautiful hilly farmland. The cypress trees are missing. Okay, and the Medieval fortresses on the hills. But otherwise, the colors and the feeling are similar."

After parking, gathering our gear for the day, which included backpacks and water, we made our way to the entrance where dad found a wheelchair and I became the driver. My mother was grateful alone for this blessing! Having to push my father all over the clinic has become too much for her.

Like good soldiers following orders, we moved from one appt to the next - from having his blood drawn to meeting with my father's doctor of thirty years, Dr. Louis LeTendre, a hematologist and oncologist. A direct, proper man - perhaps only a few years older than me - Dr. LeTendre treated my father for lymphoma thirty years ago when it first appeared in a lymph node, then for a secondary cancer ten years later. He has "cured" my father of cancer two times. When he saw Dad walk into his office last October, he knew he was dying - without so much as a test. In fact, the tests revealed that some form of lymphoma had awakened from its long sleep and rapidly spread through his bones - in a matter of months. At his May 2010 check up, there were no signs. By October, he was weeks away from death. Dear Dr. LeTendre said, "Mr. Krebs, I've given you bad news before. This is different. I cannot cure you this time." Then he went on to ask my father, "Have you had a good life?" Every time I think of this level of care, I weep. It means so much to my parents.

He said there are only two options: hospice or chemo, which may or may not help. He said, "The right choice is one you choose." Dad chose chemo. Apparently, he wasn't quite ready to die. He told me he wanted to make it to the 60th anniversary of my parent's wedding, which was in Mar this year. Dr. LeTendre backed the decision and suggested 6 rounds of chemo, once a month for 6 months. Each "round" is 3 different types of chemo for a total of 5 hours of poison / medicine dripping into his veins, causing chills, nausea, vomiting, exhaustion. Hell in a bag I call it. But, the poison that wracks his living body, also kills the cancer.

It has been 5 months since the chemo treatments began. I sat in the office with the doctor, my mother and my father. He, in his examining gown, on the edge of the examining table, thin, hairless legs dangling, shoulder blades like the remnants of angel wings on his shriveling back. The hair on his head is not even gray, but just pale and sparse - this from the head of thick black hair he had most of his life. His face is gaunt, sometimes ghost-like to me, his sharp, elegant nose more prominent now.

Watching the doctor examine my father, it seemed old=fashioned somehow. Instead of technology, he used the old tools of the trade, testing reflexes, listening to his lungs, pounding on his chest, using his hands to feel his neck and around the orbits of his eyes. He watched him walk, asked him to stand on his toes, raise a leg - when he couldn't do this, he began a new line of questioning and testing with a feather. "Can you feel this? This? This?" as he moved the feather from his thigh to his hips to his feet. After spending 45 minutes in his office, I agree that Dr. LeTendre deserves the reputation he has in our family. In fact, they think Dr. LeTendre walks on water. 45 minutes. When was the last time you spent 45 minutes with a doctor? His care for my father was palatable, caring, and kind.

He went to the first chemo treatment, sitting in a chair in a room with 5 others receiving chemo at the same time. My mother thinks its "neat" how it's set up, how the nurses bring snacks around. I don't quite share her view. It seems remarkable how they care for the body at Mayo - but I don't think I would describe it as "neat" - or, in the vernacular of my own generation, "cool." After one hour, during which mom and I found something to eat in the cafeteria, we wheeled dad to his next session - a fairly new German chemo drug developed by a man with the last name of my father (Krebs). Seems a coincidence, no? For this one, he is in a single room, in bed for the whole 3-4 hour drip. He would rest - so would we. Mom and I went to the Mayo quiet room - a heavenly dark room with a circle of recliners and soft, clean flannel blankets in a pile in the corner. Mom and I both napped for an hour or more. What a good idea this is. I realize how exhausting the emotional work can be.

We returned to Dad's room with fresh coffee to keep us going. It was now 4:30 and he had another 2 hours to go. (Remember we left Northfield at 8:00 a.m.!) He had the chills and could barely speak. This was so upsetting to me - to see him shivering, unable to say what he needed. I asked the nurse for more blankets and she brought two warm ones. It helped. He was in a great deal of pain - there is cancer in his back and ribs and it can be incredibly painful. I felt he needed to be alone - so I left the room and left mom there with him.

After an hour or so, I went back in; he was almost done, the clear bag flattened and soon the beeping began. Chemo over for today. The nurse came in, prepared him for leaving. It was 6:30 in the evening. We would have to leave at 5:30 the next morning to make the 7:00 a.m. chemo treatment the next day. He began to vomit, although with almost nothing to eat all day, it was mostly dry heaves. I don't recall seeing my father sick like this in my whole life. At least not in a way that made me feel so helpless - there was nothing I could do but be there for them, to help him get to the car, wobbly and weak from the chemo, exhausted, in pain and probably tired of it all.

On the drive home, we again, took Highway 9 west toward the sunset. I drove. My mother couldn't have done it - emotionally ripped apart by this process each and every month. My father sat next to me in the front seat, eyes shut, trying to hold back the nausea, but miraculously able to tell me where to turn, what speed to drive, that I had a green light and when to get over from one lane to the other. Some things never change.

The beauty of the landscape - the iconic images of the farmland in the spring - and the matter of driving my father through it all brought tears to my eyes. I thought of how this would be the
last spring he would see, this man who grew up on a farm, who farmed until I was ten, and then continued to work with farmers in the insurance industry. A man who knew exactly what he was seeing in the soil, knew what was green in the pastures, knew what would likely be planted where. Without a miracle, this is the last spring he will see and the last spring I will say to him, "Isn't this farmland beautiful?"

1 comment:

  1. blessings on you and your family.
    "blessings of earth," as the poet galway kinnell says.

    - elliot