Go into the light

Finally I'm about to be radiant. It's about damn time.

Normally breast cancer treatment goes as follows:

1. Surgery - to cut out of your body whenever cancer that they can find, see, feel, or infer. Get it the hell out of the body.

2. Chemotherapy - only if it is determined that some cancer cells have moved outside of the original tumor area, i.e., they are either found in the lymph nodes or your actual cancer cells, or even worse, actual other tumors, can be seen somewhere else in the body, other than the site of the original tumor. In my case, I had a tiny group of cancer cells that showed up in two of my lymph nodes, and so I had chemotherapy even though there was no other evidence of cancer anywhere else in my body. (Note: occasionally a patient undergoes chemotherapy first, to shrink a large tumor before surgery is done.) If your lymph nodes are clear, you get to skip chemotherapy. 

3. Radiation - zapping the original tumor site with zapping radiating zaps that kill any remaining cancer that could still be there. Ironically radiation also gives you cancer but let's think about that later.

4. Hormone therapy - many breast cancers, in fact I think probably most of them, contain cells that are extremely sensitive to estrogen and progesterone. If this is the case, which is true for me, then you take an anti-hormone pill for 5 to 10 years after everything else is done. There are several brands of these types of pills, the most common is called tamoxifen. The other day driving and twirling through radio stations trying to escape pop tedium, I hesitated on one station a sec so I could navigate IH35, and in that tiny universe of a moment I heard a woman call in to tell some kind of story of happiness on "joy day" and her story was "Oh my goodness praise the Lord, praise Jesus, we are so happy that my mother can finally stop taking that horrible dreadful medicine tamoxifen - that was the worst thing she ever did! We are so happy!" I changed the station and laughed out loud. You don't need to tell me that most people don't have too many bad side effects with this medicine, believe me I've heard way too many stories about it, both bad and good. I thought it was absolutely hilarious that in driving down the highway at 70 miles an hour slipping around radio stations that I happened to pop into this sound byte. Was it a warning? A joke? An insult? Or nothing, more of the dadaism that is my life? I think it was that last one.

Most patients pass through these four stages fairly quickly, and in an orderly fashion, boom boom boom. You should have chemo a few weeks after surgery, you should start radiation a few weeks after chemo, etc. blah blah blah. For me, I got hung up in the surgery loop in a Spongebobishly absurd way. I had to have four surgeries - two before chemotherapy and two after chemotherapy. This completely goofed up the entire system and calendar for everyone involved...all of the doctors and nurses and schedulers and offices and telephone answerers all pretty much forgot what was happening who was on first base who is Amy Adams who is which doctor and what doctor has done what or is planning which and should be talking to which who? When did somebody have what surgery and who where what why who is in charge?  I sort of fell off the calendar and off the rails. 

At the center of this swirling mass, this fluffernutter jar of dates and fates, was me. I was standing still at the eye of the storm, the tornado of my treatment. I was quietly wondering: does anyone remember where I am? I knew every every every single thing that had happened and every every every single thing that still needed to happen. I felt that my plan had been erased or had blown away off of the desk.

I already knew something but I learned it again: you must be your own advocate when you're going through the shit. There is no magic staff of people that are managing my case, or my cancer, or my body. The pretty pictures on the pretty website pages of the pretty people in the pretty white coats are stock photos, even when they're real people. They are not bad people. They are busy people. And only I am in charge of me. It is the staff of me, and I have restarted this case.

Tomorrow I go to Seton Northwest Hospital for a CAT scan. A friend jokingly said that this is when you get a hold of a kitty cat while it lays on your chest and purrs. I would like to order a tabby for this particular section of treatment. But no, this is not the type of CAT scan I will be getting tomorrow. 

Tomorrow my entire body will be inserted into a huge white tube that will measure the topography of my left chest - which is called the radiotherapy field. I am to be converted into a field. Someone will map me, and mark me, so that some other machine in some other office in some other part of town on some other day can direct beams of light to enter and crisscross inside my breast. Apparently when the beams crisscross each other, like when Darth Vader's saber hits Luke Skywalker's saber, the radiation is at its most intense. The beams' intent? To kill.

The thing that is so very weird about all of this cancer therapy business, is that you can read up on it, and even talk to a doctor about it till you're blue in the face, but you still don't really get exactly what's happening until you do it. So I don't really know about tomorrow. Everything I've read says that they use the CAT scan so that they can "very accurately aim the radiation beams at the tumor site." However, what the fuck? 

WHAT TUMOR SITE????!!! 

The dadaism that is my life.

I've already had four surgeries and six rounds of chemical warfare. Friends of mine that it had double mastectomy still get radiation. 

What in the hell are they going to radiate? How can there be anything at which to aim these magical beams of light if the cancer is gone? And didn't you tell me that it was gone? Didn't you cut it out? Didn't you cut it out again? Didn't you cut it out again again? Didn't you cut it out again again again? Didn't you poison it out with poison? Didn't you? Did you?

This is such a basic question that even a five-year-old could ask it. And I think I have asked it, but yet, it's such a complex question that every time I ask, the answer whirls away in a vapor of smoke and I either can't remember it or I don't actually get an answer. Maybe it's a political question?

There is something very odd, almost dreamy, about this whole cancer process. It almost feels like a scam, a rip off, a mystery, a front, a commercial. For what?  For modernism. Who is the audience?

And what exactly is radiation? We like to use the euphemisms of: beams of light, cancer curing radiation, crisscrossing laser beams, painless nothing! Why it's a bunch of painless nothing you silly girl! Don't worry about it! What "radiation" really is, is high intensity x-rays. You know those x-rays that are kinda mostly outlawed because they're bad for you? Those. 

What is an x-ray?

1. 1.

   electromagnetic radiation of high energy and very short wavelength (between ultraviolet light and gamma rays) that is able to pass through many materials opaque to light. (Online Dictionary)

In 1895 this dude named Wilhelm Roentgen was fooling around with electricity and gas in glass tubes and discovered the x-ray. He probably dropped dead from doing this. I've read and read and read about this, and watched many science shows, but I confess I still don't understand it very well. It's something like this: every atom (Adam?) has a nucleus around which electrons swirl, like planets around the sun, and like suns in a galaxy, and like the galaxies in our universe. After all everything is the same in this universe. (Uni = one, + ver = truth). Okay so imagine the electrons spinning merrily in their orbit around the nucleus of an atom. They each have their own orbit at some specific height above the nucleus, kind of like an airplane, say, flight 779 maybe cruises above the earth's surface at a cool 35,000 feet, while the flight attendants serve first class a cocktail. Other flights are cruising at 42,000 feet or 28,000 feet or 31,000 feet. This is good, because they don't generally run into each other this way. The electrons politely stay in their orbits also. And then boom! Something knocks an electron up to a higher altitude or down to a lower altitude. When this occurs a photon of light, OR, an x-ray photon, is released. 

This is where I get very confused. I'm not exactly sure what the thing is, the "something" is that causes this to occur. I think something or someone shoots other electrons at the atoms in question? Boy that sounds pretty stupid. I don't think you can go to the store and buy a box of electrons and put them in a gun and shoot them at other electrons that are merrily whizzing around and around atomic orbits. Clearly I don't have a firm grasp on this. Which is why I have a radiological oncologist to manage this for me. However, my curiosity bothers me so much so about things like this that I cannot sleep at night. Which is one of the reasons that I have a crush on Neil Degrasse Tyson, but I digress… 

I will endeavor to understand this more clearly.  Doctors kindly tend to talk to us in extremely babyish terms so as not to scare us, but that scares me.

Also, over time, radiation causes what is extremely technically and sophisticatedly known as "radiation sickness" – otherwise known as: it can kill you. Something to do with ions.

So tomorrow I shall embark at the radiation station and start my journey down section three of my four section treatment. I am to have 20 sessions of radiation, lasting about 20 minutes each, once a day, same time every day, on workdays, Monday through Friday, starting next Monday, April 21. I think.

From "Hinge Picture" by Susan Howe:

Light of our dark is the fruit of my womb

or night falling through the reign of splashes   

Liquid light that bathes the landscape in my figure   

Clairvoyant Ireland

eras and eras encircled by sea

the barrows of my ancestors have spilled their bones   

across the singing ear in hear or shell   

as wreck or wrack may be in daring   

There were giants on the earth in those days   

feasts then on hill and fort

All night the borders of my bed

carve paths across my face

and I always forget to leave my address   

frightened by the way that midnight

grips my palm and tells me that my lines   

are slipping out of question