The Logistics of Heaven

The summer before I entered the fourth grade, my family moved from an urban neighborhood, with all kinds of houses and a shopping street a block away, to a suburban development of post-World War II nearly-identical ticky-tacky houses a mile or so away from…anything. To get to school, I either had to walk along a cornfield, where garter snakes sometimes slithered out from between the rows, or down an overgrown dirt path that bordered some woods, where I was sure unsavory types lurked, just waiting for the perfect victim (me) to come along.

I desperately missed my neighborhood, my school, my library, my friends. Worse, I’d been recognized as one of the best students in my class at my old school, the favored students had been in place since kindergarten. I was nobody.

In time, I made friends with a girl in my class—I’ll call her Cathy. She had shiny brown hair and brown eyes and beautiful olive skin. She lived in a brick house in a real neighborhood not far from our subdivision—a house with a basement, where her mother led our Girl Scout meetings every week. She had her own bedroom, pink, with white, frilly curtains on the windows and stuffed animals piled on her bed. She had nice clothes and her own record player. I adored her.

Every morning, from fourth through seventh grades, I walked to the end of our long block, then down the scary dirt path, turned left, walked to her house and knocked on the back door. Her mom let me in and I’d wait in the kitchen, chatting with her, until Cathy was ready. Then we’d set out for school together. Sometimes I was allowed to stay and play a while after school, or invited to come over on a Saturday.

In the spring of our seventh grade year, Cathy became enamored of a classmate I’ll call Bev, a ferret of a girl, ropy, with thin brown hair and a whole lot of what I now understand was sexual energy. She had breasts and a knowing air. I was still, physically, a child and completely clueless about sex, though I did have an agonizing, secret crush on a boy named Danny. I lived in a perpetual state of mortification. I had no idea how to navigate the dawning world of adolescence.

I still had Cathy to myself every morning, but only because Bev’s house wasn’t on our route. Increasingly, however, she avoided me at school. The two of them endured me at the lunch table; sometimes they invited me to go skating with them on Saturdays or to a sleepover. But I felt more and more awkward when I was with them, more aware that they didn’t really want me along. I invited them both to my birthday party in May, but only Cathy came—and I was pretty sure her mom had made her.

The two of them decided to go to Bev’s church camp that summer—and mentioned, without much enthusiasm, that I might come along. Though I was unhappy at home, I was paranoid about being away from home, especially for a whole week. But it seemed to me that if I didn’t go, it would be the end of my friendship with Cathy. Plus, the boy I liked was going, too, and I thought maybe, maybe he might notice me.

So I signed up, packed a borrowed duffel, and my dad delivered me to the church parking lot, where a school bus waited to take us to camp. Cathy and Bev sat together on the bus; I sat behind them, leaning forward to participate in their conversation as best I could. But soon the motion of the bus began to make me sleepy and a little nauseous. It was hot. Noisy. My head hurt. I leaned back and rested my cheek against the cool glass window, hoping to catch a bit of the breeze coming in from the raised part. I dozed, woke, dozed, woke—each time feeling a little worse. By the time we reached the first rest stop, I knew I was going to throw up—and dashed off the bus and into the smelly bathroom.

The bathroom was crowded when I came out of the stall. Cathy and Bev smiled slyly. They followed me out, teasing, then stopped to join a bunch of kids were congregated around a picnic table. I stood at the edges for a moment, then went on to the bus, where I noticed a folded piece of paper beneath Cathy’s seat—a note that she and Bev had been passing back and forth about all the things they didn’t like about me.

Had they left it there so I would find it?

I leaned against the window again and pretended to be asleep, listening to them talk about me. “P-U,” they said again and again, bursting into peals of laughter. I guess I did finally sleep, because I don’t remember anything else until, finally, we arrived at the camp.

They hurried off the bus, claimed a bunk bed to share—and, from then on, almost completely ignored me. Worse, the boy I liked came up to me about midway through the week, told me he really liked Cathy and asked if I’d try to talk her into liking him, too.

I’d never been that close to him before. He smelled sweaty, like the woods, with maybe a tinge of cigarette smoke. His voice squeaked and deepened as he spoke.

“Sure,” I said. “Yeah. I can do that.”

“Oh,” Cathy said, when I got up the nerve to approach her. “Him. Ugh.” And turned away from me.

We had Bible class every morning, which was at first comforting because it was like school—and school was a place where I knew what to do: be quiet, listen, raise your hand to ask or answer a question. Trouble was, my parents weren’t church people. We never talked about religion at home; I was only vaguely familiar with the Bible stories all the others seemed to know by heart.

I got curious.

Not in the way the camp leaders hoped, however, which would have led to my taking Jesus as my personal savior at the end of the week.

I got curious about how it worked.

As in, “So, were Adam and Eve cave people?”

They were the first people God made, right? And science had proved that the first people on earth were cave people.

It seemed a perfectly reasonable question to me—and a brilliant insight on my part.

It was met with dead silence from the camp leader—and laughter from my fellow campers.

I don’t remember how the leader eventually answered, just that it was in a disapproving tone, as if I had been making a joke. I do remember that I wasn’t stupid enough to ask the second question, the one that interested me the most.

How does heaven work?

Okay, it’s a place where the people you loved and who went before you will greet you at the golden gate and you will all be together forever. But what if you were married and your first husband died and you got married again and really, really loved that person? Which husband would you be with in heaven? And what if you loved someone, but that person didn’t love you and, for sure, didn’t want to be with you through eternity? Or someone loved you and you didn’t love him and didn’t want to be him forever?

Who got to choose?

Funny. It never occurred to me until right now, writing this, that the heaven question was connected to my feelings about Cathy. Or that if anyone had asked me then what heaven would be like for me, I might have said, “Being adopted into Cathy’s family and being best friends with her forever.”

It also hadn’t occurred to me that those unanswerable questions marked an important moment in my understanding of faith. Before they floated into my mind, I believed in God. I believed that good people went to heaven when they died and that, if I were good, I would end up there myself. After they floated into my mind, the whole enterprise began to seem, logistically, very sketchy to me.

Taken to the edge, for example—those basketball players who cross themselves before taking a free throw? Do they really think God is available to help with such things? And if they do, shouldn’t they just take their chances on the free throw so he can concentrate on, say, world peace? Or just feeding a family in the inner city?

It took me years to understand that religious faith is irrational. It’s just there, inside you, as reliable and enduring as the sun. Questions are inevitable—the most common being, “Why?” Some examine their questions about faith more deeply than others. But true faith doesn’t need a logical answer.

Some of the most intelligent people I know are people of faith. I respect and envy them. True faith makes life easier, I think—especially if it ensures a place in heaven.

I am a person of faith myself, just not religious faith. I believe that things happen to us for a reason, that we are meant to cherish the joy we are given and meet life’s challenges with grace and courage. I believe our time on earth matters. I believe heaven is here and now. I believe, for better or worse, we live forever in the bits of ourselves we give to others as we travel our life paths.

I don't discount the possibility of God. But I believe if He/She/It exists, knowing the "logistics" of who He/She/Is it and how He/She/It works is beyond our human capabilities.

Having breast cancer, considering mortality as a result, hasn't changed what I believe at all--which, I guess, is the test of any faith, religious or otherwise.

In any case, I don’t need answers to those logistical questions anymore. I’ve learned that any question worth asking doesn’t have an answer, anyway.

Being Bald

On the bright side:

Great savings on hair care products.

No time wasted in beauty salons.

No bad hair days.

You can shock the shit out of people by simply taking off your hat—

Oh, wait. I’m too embarrassed to do that. The best I’ve done, in terms of public rebellion, is to wear a black head cover that has little white skulls all over it.

I really do hate being bald. Not in the house, alone—I’m quite used to it. In a weird way, I even think it’s kind of cool. But the way I look to others if they catch a glimpse of my bald head—

For example, not long ago, I was sitting at the dining room table, eating eating my breakfast, and I looked up and saw two 20’s-ish guys walking their dog. One looked up and I saw him see me and think: there is a bald woman eating breakfast in there.

I was embarrassed. I felt like I should run out and apologize for making him feel uncomfortable.

Which I realize is totally absurd.

Even more absurd. Some years back, when I was buzzing my own hair, I once forgot to put the attachment on. Standing in front of the mirror, I took the first swipe up the middle of my head with the shaver and—

Crap. I had a freaking reverse Mohawk. I stood there, horrified. Then (what else was there to do?) finished the job. I wasn’t completely bald, but close enough that I felt like I needed to wear a hat everywhere.

(“Hat! Hat!” my then two-year-old granddaughter, Heidi, said, alarmed, whenever I took it off.)

And even with the hat on, one day I was picking out fruit in the produce section at the grocery store and the woman standing next to me glanced over at me and asked, quietly, “Are you undergoing treatment?”

I should have said, yes; accepted her sympathy and, perhaps, commiseration, which she clearly wanted to give—then fled. But, no. I tried to explain what had happened. The more I talked, the stupider I felt.

She was the one who fled, no doubt thinking that it was bad enough to have cancer, but really pathetic to pretend you don’t.

I’d love to be the kind of person who said, “Fine. I’m bald. I’m just going to be bald. If people have a problem with that, so be it.”

I don’t actually know if I believed I would be that sort of person if the occasion arrived, but I’m guessing I did. Or at least hoped I would be. I know I’ve always admired women who have the courage to do it. But it turns out that I am not that kind of person.

I feel a little diminished by this piece of information about myself.

Meanwhile, my hair is growing. If I look in the mirror and squint, I can see a faint halo of hair on the sides and in the back. Not much on top, though—which is making me a little anxious. God. What if I end up with a permanent Bozo effect?

But that’s a whole other story.

All right, then. Moving On.

I had my final radiation treatment last Tuesday and left with a celebratory pink carnation and the well-wishes of the extraordinarily nice radiation technicians I’d gotten to know over the course of my month of daily visits.

“Congratulations!” they said.

Which seemed odd to me, since congratulations generally have to do with having accomplished something—and all I’d done was go where I was supposed to go and let nurses and technicians do what doctors had decided should be done to make me better.

And, honestly, it wasn’t all that bad. I don’t think having cancer will turn out to have been one of those before/after events for me. It didn’t feel like a challenge met, it didn’t change me or make me want to change my life in any way, it didn’t show me anything about myself that I didn’t already know. It was interesting, in an unpleasant way. It certainly made me think--which, in my view, is always a good thing.

For example, I used to think attitude made a huge difference. Now I think now it may make a difference: the chemistry of the body is changed by stress and fear and maybe it makes the body’s task easier if you don’t feel that.

But how you feel is how you feel.

You can defy feelings by acting against them. Or decide to act exactly how you feel. But either way, it's deciding how you're going to act despite or because of how you feel. Maybe negative feelings can shift in the process of acting against them, maybe not. If you're cheerful and optimistic by nature, lucky you. If not, you shouldn't be blamed for what you can't change. Being of the latter disposition, I've found that cultivating a matter-of-fact, Just Do It, attitude works best for just about everything that comes my way.

In any case, I feel like my body was the one challenged by this experience—and met the challenge very nicely. My body is what fought a battle and survived. Not me. If there is a story to tell about surviving, it’s my body’s story, not mine. My story is about hanging in there while it did its work. Giving up any idea that I could control what was happening to my body and how my body was responding to it. Being curious. Trying to learn what I could about the strange world of illness along the way.

I didn’t become one with my body, didn’t even have a moment of intuition of what that would be like. It’s still it and I’m still me. I feel grateful to my body for saving my self. This is probably a very weird way to be thinking about the experience.

But it explains why the language surrounding cancer just doesn’t work for me. Fighting and winning the battle against cancer. Cancer survivor. My body did that. It survived. Not me.
Not to mention the fact that a whole lot of people have it way, way worse than I did. I’m embarrassed when people use those terms talking about what I’ve gone through.

Plus, like faith, dealing with breast cancer feels private to me. Not that I’m unwilling to talk about it. (Anyone who knows me knows that, for better or worse, I’ll talk about anything.) Just that the experience itself belongs to me, alone. Only I can come close to understanding it. I don’t need or want a “church” of survivors to give it meaning. I don’t need or want “Pink.” (Though I very much respect those who gain strength from that community.)

Of course, you can’t have cancer without wondering if/when it will come back. And then what? But I’m trying not to go there.

Instead, I’m celebrating the fact that, at least for now, it’s over.

And working 24/7 on growing some hair.

Tattoo You

Okay, not real tattoos—but they do use them for radiation therapy in some cases: tiny freckles are tattooed onto your skin with a long, thin needle to mark the area to be radiated and guide the technicians in placing you on the table so that the radiation beams goes where they’re supposed to go. My “tattoos” were made with a marking pen, each covered with a round, clear Band-Aid to keep them from getting rubbed or washed away. And they’re not tiny freckles but substantial X’s. That particular part of my body looks rather like it’s been attacked by a toddler let loose with a black Magic Marker.

Radiation is every weekday at 3 p.m. I enter the parking lot reserved for radiation patients, check in with the nice lady in the parking hut, park—and walk past the line of emergency vehicles outside the ER, some with rescue dogs, waiting for their next call. Past the hospital entrance, where there are often patients in wheelchairs sitting just inside the glass doors and I wonder if they are waiting for someone or if they desperately needed a hit of the world in which they weren’t sick and hope, in time, to reenter.

There are more sick people in the radiation waiting room, some with an entourage of family members. Some, like me, are wearing hats or scarves or baseball caps to cover up their bald heads. Others look perfectly fine, just…grim. They don’t talk much, though once I heard a man say to his wife, “Well, we need to get it taken care of by turkey season. It’s coming right up, you know.” Yesterday, there was a woman chomping and smacking her gum, talking loudly on her cellphone, oblivious to everyone around her. “I’m at the hospital. I said, I’ll pick it up on my way my home.”

Fortunately, there’s not usually much of a wait before one of a number of very friendly technicians comes to get me and we wind through the gleaming corridors toward the radiation room. Invariably, there’s an exchange about the weather on the way.

“What’s it doing out there?”
A. Still
a.Freezing
b.Raining
c.Gray
d.Winter
B. It’s actually nice out! It’s so great to see the sun!
C. Ugly big dark clouds coming in from the west.
D. No sign of that snow yet.
E. Do you think spring will ever come?
F. Man, weather forecasting has to be the greatest job ever: they pay you to get it wrong.

It’s cold in the radiation room. The walls are dingy gray-white; the floor, institutional green. Shelves along one wall are lined with the molded pillows and pallets of patients currently undergoing treatment. The gray radiation machine sits on the far end of the room; a bed-shaped table, covered with a white sheet, my own pillow placed at the top.

There’s a small curtained dressing area and, there, I remove the clothing from the top part of my body and drape it with a towel. Then I lie on the table, position my head correctly on the pillow, raise my arms above my head, elbows bent, hands touching. The technicians position my body, tugging at the sheet beneath me to line up my “tattoos” with the red laser beams that emerge from the walls on either side of where I lie. When I’m perfectly positioned, they raise the table, then leave, closing the thick, heavy door behind them.

The motor starts; the huge disc at the top of the machine lowers, twists, and settles with the flat part facing my left side. My head is turned to the left on my pillow, and what I see looks like a small television screen with the shape my right breast reflected hazily in the glass. A closer look reveals that the screen is filled with narrow gray bars placed very close together. There’s a buzzing sound and they split horizontally, some moving down, some up to create the black space through which the radiation beams will come. With a second buzzing sound, the top bars begin to move down at different speeds until they meet the row of bars at the bottom. Then the bars reposition themselves and the buzzing occurs again as the machine delivers the second shot. It doesn’t hurt; in fact, I feel nothing at all.

Now the disc rises, pivots above me, and repositions itself on my right side to blast the area from which the lymph nodes were taken. Same thing: buzzing, two hits. I can’t see the screen this time because of my head placement, but now I can see the video monitor with my chart on it: my name and rows of numbers. As the machine does its job, the rows are highlighted orange, one-by-one.
It’s over in fewer than five minutes. The technicians return, lower the table.

I dress, we say, “Have a great evening/weekend/whatever,” and I head back out into the world.

Before starting my treatment, I talked to numerous people who’d gone through radiation therapy themselves. Those who experienced it ten years ago or more said it was like having a horrible sunburn for weeks; plus, it absolutely exhausted them. “I felt like I was walking in deep water all the time,” one friend said. Those with more recent experiences said that radiation had had little effect on them at all. One person said it energized her. “My house was never as clean as it was when I was undergoing radiation,” she told me. Wow, I thought. That would be nice. But it seemed way too much to hope for.

I’m more than halfway through my course of radiation now. I was right: “energized” was too much to hope for. But I feel fine, maybe a little tired—though nothing that a good nap can’t remedy. I’ve had none of the unpleasant “sunburn” effects that some radiation patients experience. (Maybe because of the green tea that my doctor instructed me to spritz on the radiation area four times daily—interesting, I think in light of how herbs and other natural substances were used to treat cancer before we had “real” drugs. Though I also apply a steroid cream every day.)

Plan for the worst, hope for the best. That’s my motto in dicey situations of all types, and it’s always served me well. Sometimes, though, the worst turns out to be something you didn’t imagine—and how can you plan for that? What I hadn’t imagined, hadn’t prepared for was that going to the hospital for radiation treatments five days a week for four and half weeks would remind me that I have cancer for at least an hour every single day. Which, I’ve got to say, is a little depressing.

I know. If this is the worst thing that’s happened to me throughout this whole ordeal I can hardly complain. And I’m not complaining. Just saying: radiation has had an effect on me that chemo, which I knew enough to be able prepare myself for, didn’t have.

Just seven more sessions after the one today.

By then, please let it be spring.



.

Arsenic, Gall of Boar, and Three Tablespoons of Hemlock Juice

I’m an extremely curious (some would say nosy) person by nature, so it still surprises me a little that I haven’t been compelled to find out every single thing I can about breast cancer. I did some initial research; it seemed the responsible thing to do. But I was overwhelmed by the sheer volume of information available, not to mention the fact that my eyes glazed over every time I picked any one article to read because I didn’t have the base of knowledge about science and medicine or the vocabulary necessary to understand what I was looking at. So I gave up trying to be a breast cancer expert and put myself in the hands of my very excellent doctors, learning only enough to be able to ask intelligent questions about my own treatment along the way.

As I tried to put what was happening into perspective, I talked to friends who had undergone treatment for breast cancer over the years; I read some cancer memoirs, including Jan Lucas Grimm’s brutally honest My Beautiful Leukemia. I read about the history of breast cancer, too.

Briefly (and not very scientifically)…

Hippocrates (460 BC-380 BC) named cancer “karkinoma” (carcinoma), Greek for “crab,” because the tumor with its extensions reminded him of the body and legs of a crab. He believed the body was made up of four humors: blood, phlegm, yellow bile, and black bile. When a person became ill, it was because one of these humors was out of balance. Cancer, according to Hippocrates, was caused by an excess of black bile. It was curable only in its earliest stages, with bloodletting, which was believed to purge the patient of bad humors, and by applying a variety of kinds of pastes, most containing arsenic, to the area where the tumor had appeared. The pastes caused tissue necrosis, which sloughed off, leaving the wound to heal by the formation of new tissue.

In the second century, the view of cancer was much the same as Hippocrates’s. But the Roman physician Galen wrote about surgical cures for breast cancer in cases where the tumor could be removed at a very early stage. Surgical tools were primitive, though—scalpels, forceps, hooks, and cauterizing tools that must have struck terror in a patient’s heart just looking at them. And here’s the recipe for anesthesia, which might also have given her pause: “Gall of boar, 3 spoons of hemlock juice, wild briony, lettuce, opium poppy, henbane vinegar. Mix together, boil a little, put into glass vessel, well stoppered. Add 3 spoons of good wine or ale, mix well.” The patient was to drink the whole bottle next to a warm fire, where she would fall asleep and could be operated on. A mixture of salt and vinegar was used to awaken her when the operation was over—assuming the loss of blood or anesthesia hadn’t killed her.

These same practices and beliefs would have informed the treatment of a woman diagnosed with breast cancer well into the sixteenth century, when the first book of anatomy was published. Anesthesia as we know it wasn’t invented until the mid-1800’s. It wasn't until the late twentieth century, when biochemistry and technology combined to create the field of molecular biology, that scientists began to understand what causes breast cancer, leading to the kind of treatments I'm undergoing today.

Talk about perspective! That little dose of history made a lumpectomy and moderate courses of chemo and radiation look not so bad, after all. Nonetheless, I know that this experience will change me--and I knew from the moment of diagnosis that, eventually, anything and maybe everything from small, seemingly insignificant details to the essence of the experience will make its way into a novel.

The novelist Muriel Spark said of being a writer, “Nothing is lost,” which I believe, absolutely--and which makes me wonder sometimes, What do people who aren’t writers do with the joys and sorrows of their lives?

The Chemo Living Room

My good friend, Mike, who was diagnosed with lymphoma in 1988, was one of the first people I knew who was anywhere near my own age to have cancer. I remember feeling physically sick, as well as sick at heart, when I found out—and a lot of times along the way, as he endured six months of chemotherapy, then radiation. Within three months, it was back again and he had to start all over. A third bout several years later required a bone marrow transfer, daily chemo treatments that had horrible side effects and brought him just to the brink of death, and weeks in isolation.

He rarely complained throughout this long ordeal and, somehow, even maintained his wonderful, irreverent sense of humor.

‘Time to visit the chemo living room,” he’d say, heading for a treatment.

I didn’t quite know what he meant until I took him one day and entered the big room lined with cancer patients in Barca-Loungers and a big TV in the center. Some of the patients were watching whatever was on the screen—probably a game show. Others were reading or knitting or doing crossword puzzles. A few were swaddled in white blankets, sleeping or looking miserable. Mike was a friendly guy. He chatted and joked with the nurse, who settled him in to one of the empty Barca-Loungers and put in an IV. The chemo meds were in three separate bags, which would be administered one at a time. She hung the first on a steel “tree,” connected the clear tube to the IV. You could see it start to drip.

What you couldn’t see was Mike’s dread, which was so great that he’d gotten out of the car upon our arrival and vomited in the parking lot just at the thought of having to do this again.

Everyone’s heard about the horrors of chemotherapy—the violent nausea, the mouth sores, the fatigue, fingernails that turn yellow and crack and fall off. Who’s not afraid of it? I certainly was. I just hoped I’d manage it with a minimum of whining and a maximum or humor and irony.

The chemo living room at IU’s Simon Cancer Center is a circular pod. Each Barca-Lounger is tucked into its own cubicle with a half-wall separating it from the one next door. Each has its own TV, which I must say created my most anxious moments when, during one treatment, my neighbor, apparently deaf in addition to suffering from cancer, watched “The Price Is Right” at what seemed like full volume. And me with no iPod to drown it out.

The nurses there are pros with IV’s: sting and it’s in. They administer up the anti-nausea drugs first. Then the bags (two, in my case) of chemo drugs, one by one. It was not without some measure of dread that I watched them drip slowly into my system the first time.

I’m pretty good at guided imagery. I can put myself to sleep walking the stone streets of Assisi; sometimes I can banish a headache by imagining the headache as a block of ice and myself on a beach chair near the ocean, breathing in warm air to melt it away. So I gave it a try, visualizing the drip turning into a tsunami of death for the cancer cells in its way. But all I could see were the bright, cheerful good cells, who’d done nothing at all to hurt me, trying to escape. I felt bad, like I should apologize to them. So I just picked up the book I’d brought and got lost in its story instead.

I was prepared for the worst; that’s what I do. I knew what Mike and other friends and relatives had been through. I’d been to “chemo school,” a session at which my oncologist’s nurse assistant laid out all the possibilities, kind of like a little shop of horrors. Prescriptions for nausea were at home, at the ready.

But, thankfully, nausea never came. Mega-headache, yes; serious fatigue; whacked-out taste buds that that made everything taste awful; occasional bone pain in my legs that felt like fingers pressing the keys of a flute, hard—and a series of, shall we say “bodily function” complaints that are better left to your imagination.

Oh, and baldness, but that’s another story.

The worst thing that happened to me over the cycle of four chemo sessions was catching the flu over Christmas break, which sent me to the emergency room twice due to high fever and laid me low for the better part of three weeks. Nothing funny about that. Though I did return home from one of the emergency room visits with a pink band around my right wrist that read, “Limb Alert,” which made me laugh.

I’m very glad that my time in the chemo living room is over. I hope I don’t ever have to go there again. But I also feel incredibly lucky to have been diagnosed early enough that the treatment I needed was comparatively mild and to have been the beneficiary of the research and development of nausea drugs that, at least for me, put that most dreaded aspect chemotherapy out of the picture.

Probably in a hundred years, people will look at the idea of poisoning people to cure them the way we look at certain medical treatments in medieval times. But chemotherapy treatments have gotten a whole lot more bearable in the twenty-five years since Mike received his diagnosis. If you’re about to start treatment yourself, or someone you love, take heart. It may not be nearly as bad as you imagine it to be.

Before and After

My friend Margaret-Love, writing teacher extraordinaire, made up this exercise, a favorite of mine because it never fails to yield a wealth of material, even for the most blocked and/or insecure writer.

First, make a list of the times in your life or your character’s life when something happened that changed the course or your life and/or altered the way you saw the world. The kind of times that, when explaining ourselves to others, we might say “before” or “after.” They might be large moments, like 9/11 or Hurricane Katrina. But more often, they’re small, deeply personal moments. Before Mother died, before my brother was born. After the move, the accident, the bankruptcy.

These times, ML says, are rich with tension, conflict, and scene. So choose one of them, write down every single thing you can remember about it and, suddenly, you’ll have so many scenes to work with you’ll hardly know where to start.

For example—considering your parents’ divorce, you might remember witnessing a terrible argument, eavesdropping on a conversation you wish you hadn’t heard, the evening they sat your down broke the news that they were parting, watching your father moving out, your first visit to his new home, a strained birthday celebration, the first Christmas without him…you get the picture. Each memory is like a little movie. Set one rolling in your mind’s eye and just write down everything you hear and see.

It works for fiction, too. Consider the significant events in your character’s life and brainstorm to discover scenes and moments surrounding them.

Serious illness often shows up on “Before and After” lists. I don’t know yet whether having cancer will end up on mine. At the moment, it feels like a dangerous patch of highway, a time to slow down, bring everything I have in me to navigating it safely and well.

But it certainly has made me think—about a lot of things, including the idea that our bodies have their stories too, moments of before and after happening beneath our skin that are unknown to us until they manifest themselves months or years later as, say, a spot on a mammogram.

Before, my cells were humming along, doing what cells were supposed to do; then, in a particular moment of time, one of them went rogue on me. If my body could talk, it might say, “Before that damn cell ran amuck, I was fine—exemplary! After, I went through hell and never was the same again.”

I’ve never been able to understand why some people find out they have cancer and delay treatment, sometimes for months saying things like, “I don’t want to spoil the holidays” or “We’ve got that trip planned to…wherever” or “There’s no way I’m going to be bald for my son’s wedding.” It’s not uncommon for surgeons and oncologists to tell patients that there’s a safe range of time to wait before beginning the treatment they need.

The thing is, the body’s own story is going on regardless of their plans. In my case, there was a particular moment when the first cell went rogue; another moment when one of the mutating cells separated itself from the others, made it through the wall of the duct; and another when one split and took the available path to the sentinel lymph node. The body keeps its stories to itself, so, while the pathology report after my lumpectomy indicates that it’s unlikely, even my doctors, among the best in the world, can’t know for sure whether there was a moment a tiny, tiny, invisible-to-the-microscope bit of the tiny, tiny bit of cancer nestling in that lymph node had already made it to the next lymph node on a set path toward my bloodstream.

Thus, my body will have a war story in its silent repertoire: chemotherapy and radiation, a search and destroy mission with orders to finish off that cell and any others that might have broken away.

Collateral damage. There always is.

But that will be a whole different story.

A Good Bad Day

I feel pretty good the first few days after chemo, then the Ugh starts to roll in. First a sensation on the tip of my tongue, not burning—more like the numbness that occurs after a burn. Then my tongue swells a bit, there’s a hint of iron at the back of my mouth and soon everything tastes of it. My shoulders are achy, a headache starts at the top of my head and slides down to my eyes. My stomach feels queasy. I get really, really, really tired.

I had the last one Monday and, believe me, I have no desire to prove the point—but I think I figured out the best way to deal with it this time. I am obsessive by nature. Too impatient to watch a series, even one I love, week by week, I’d far rather wait until the DVD’s come out and I can watch them in great gulps. I did it with the first two seasons of "Downton Abbey" and figured I’d have to wait, maybe even a year, to watch the third.

But no! There it was on the rack at Barnes & Noble.

“How can that be?” I asked. “We’re only halfway through it here.”

“The Brits released it early,” the sales clerk said.

It was 30% off and another 10% because I’m a Barnes & Noble Member. Plus, there was the “Cancer Card,” which I’ve found allows a certain measure of indulgence.

I bought it.

And spent yesterday watching all nine episodes, one after the other. I felt crappy, I was tired, everything (except popsicles) tasted awful. So what? I spent the whole day at Downton Abbey, rooting for the family to survive its financials disasters, reveling in the downstairs intrigues, grieving for Lady Sybil, delighted by the repartee between the Dowager and Cousin Isabel, and wishing I had every single that dress Lady Mary wore.

No spoilers here. I won’t say a word. But be ready.

Want to borrow it? Just call.

Body Land

Early last September, after an extensive physical, my family physician pronounced me “an extraordinarily healthy woman of sixty-five.” I’d checked “No” on every single symptom or condition. No, I’d never had surgery. I’d never broken an arm or a leg or even a finger.

I’d always been grateful for my good health, never taken it for granted, but it was hard not to think of good health and boundless energy as a part of my identity. Plus, there's my legendary Aunt Ruth, slowed down considerably at 96, but as smart and funny as she ever was. Why wouldn’t I have those good genes, too?

Looking back, maybe I was a little too pleased with my healthy, energetic persona. Not that it really matters. Though being a little too pleased with yourself about anything does seem to alert the cosmos to the fact that it might just be time for a little challenge.

In any case, September was a great month. I’d just returned from a delicious, restorative few weeks in Italy. I was excited about the upcoming release of my seventh novel, An American Tune, and looking forward to the various book events I’d scheduled to help it make its way into the world. Indiana University Press had made it into a really beautiful book of it and, I confess, I spent a lot of time just looking at it and thinking, nearly ten years of work, the book I felt I’d become a writer to write, and now here it is in my hands.

The publication date was September 24. September 26, Indy Reads Books was packed with friends and family, who’d come to celebrate the book launch and, signing copy after copy, I felt grateful and amazed and even a little hopeful about how the book might fare as it traveled from one reader to another out into the universe. September 27, I received the Eugene and Marilyn Glick Regional Indiana Authors Award at an elegant banquet held in the atrium of the Central Library. John Green, Dan Wakefield, and Christopher Coake—all tremendously gifted Indiana writers—were honored, as well. I was surrounded by my family and friends, many of them writers I deeply admire—and by thousands and thousands of books, some you could see, some living their quiet lives on the dark shelves of the stacks beyond where we sat. Afterwards, my husband, Steve and I, checked into the very nice hotel room the Library Foundation had provided, then went back out into the balmy evening for a walk around downtown and a midnigh. It was one of the happiest evenings of my life.

Monday morning, I received a call informing me that the annual mammogram I’d had the week before showed calcifications at which they wanted to look more closely. “The good news is, the left breast is clear,” the radiologist said about the second mammogram's results. But a biopsy would be required to determine whether the calcified areas in my right were “worrisome or benign.”

Long story short: they were “worrisome,” indeed. In an instant, I went from being an extraordinarily healthy woman of sixty-five to a woman facing breast cancer. Early detection/Excellent prognosis—just four three-week cycles of a relatively low dose of chemo and some radiation would be required. All good news. Still. It wasn’t going to be easy.

I’m a writer: I live in my head. Now I was a writer who would be living very much in my body for a while.

All right, then, I thought. Body Land. What’s that that going to be like?

Early in December I had my first chemo treatment and began to find out.

“I thought you’d blog about this,” a friend said to me, not long ago.

“I thought I would, too,” I said. “I’m not sure why I haven’t.”

Then I had my last chemo treatment Monday and, suddenly, it seemed like the right time. So here goes. Stay tuned for a series of probably fractured scenes and thoughts and moments from life in Body Land over the past few months and who knows what from the future ones.