The Beginning of the End

Clark was thinking about how lucky he’d been. Not just the mere fact of survival, which was of course remarkable in and of itself, but to have seen one world end and another begin.
- Emily St. John Mandel, Station Eleven

There’s a scene in my favorite Christmas movie, The Family Man, when a little girl is playing outside in the snow with her dad, played by Nicholas Cage. They fall down together, and it seems like a regular moment in a regular day, until she suddenly holds his face in her mittened hands, gazes at him, and whispers with a slight lisp, “I knew you’d come back.” She’d been the only one who had noticed that her dad was different (naturally, she assumed he’d been replaced by an alien), and her quiet comment marks the moment in which we all realize that Nicholas Cage’s transformation from high-powered Wall Street businessman to tire-selling suburban father-of-two is complete.

Finishing chemo feels like that, something best named in retrospect. When did I start to feel like I might be coming back—was it that night I cooked dinner without being left depleted? The afternoon of our daughter’s spring choir recital, feeling able to be fully awake to two hundred voices soaring inside a high-ceilinged chapel? There are the physical signs: the rashes on my legs are fading and my nail beds aren’t as stiff and cracked. Last night was the first night I wasn’t woken by my dry mouth.

This was the week I would have gone back for my next dose of chemo: instead, two days ago I received my first of eleven HER2-antibody infusions. Is it strange to say I didn’t really feel done with chemo until that moment? It took moving on to realize what was already over.

People say these immunotherapy infusions are kind, and that is mostly true. I thought maybe it would even feel like nothing—but no, it’s not nothing the way you feel nothing after swallowing a pill. There was still the port being accessed, the feeling of something cold running into my chest, a funny feeling in the head and a wave of fatigue. But it was all much better: compared to chemo, it was as if the nausea had been removed and all the other side effects dialed down from a ten to a two, in duration and intensity.

It's sinking in that the worst may be over, and part of that is processing What Just Happened. My husband and I were lucky enough to get away earlier in the week to a small city on the northern coast of California that we visit every year. He loves the sun, but that cloudy, colder clime is where I belong, with its craggy cliffs and giant redwoods. There is nothing like the vastness of the ocean or towering forest heights to make you feel small and folded in, dwarfed in a way that gives you a cleaner perspective on life.

Marinating there, breathing in the fresh, crisp air, we gained enough critical distance to see what the year has meant for us: for me, surrender; for him, survival. It must be difficult, I think, for caregivers to recognize what they go through, what it’s like when something is not happening to you yet is happening to you. I lived a year that magnified my inner self as my external life simplified; his inner life became subsumed by a more complicated external one. His year was less about reflecting on any given moment than shouldering its fallout—working, running the house, planning the summer, fielding needs from the kids, and apparently worrying about me more than he was letting on. The cognitive load alone is staggering, yet he handled it all with such apparent ease that we nearly neglected to examine its cost.

We got to this place because we had to. What does it mean now to emerge from it because we can? For me to return to an external life marked by the awarenesses I’ve gained? For him to surface from survival mode and regain both a sense of self and the space to process?

We hiked this year to a waterfall we’ve trekked to in years past. Nothing about the contour of the terrain had changed, and yet the experience was altogether different. Last year we came during the rainy season, and the water thundered down in noisy abundance, suffusing the space with mist. This time it was drier, the flow reduced to softer sheets and trickles coalescing into quiet pools between the rocks. The rocks themselves were more visible, and though the effect was less majestic, the stark boulders rising above us had a beauty all their own. I sat there, gazing up and catching my breath, and thought about how it felt nine months ago, waiting for that first biopsy result: nothing’s changed, and everything’s changed. Same waterfall, different season, different perspective. Life is regaining some of its old equilibrium, but we are only beginning to understand the different people we’ve become. I took my husband’s hand as we got up and left, the two of us walking beside each other as we have year after year, and thought about how the walk out is as much of a journey as the walk in.