My Arm Is Steady. My Hand Does Not Shake

My Arm Is Steady. My Hand Does Not Shake

by Beth Walker

Winner, Summer Writing Contest 2023

Buddha at Ajanta Caves, Wikipedia

Buddhists contemplate 32 parts of the body—including the foul, the unmentionable—to serve as an antidote to suffering.

        This suffering is not mine.
        This suffering is not me.
        This body is not my Self.

I am not Buddhist, but my cancer does not know the difference.

                                                                

1-5. Kesa, loma, nakha, danta, taco

Chemo attacks fast-growing cells indiscriminately: hair, nails, skin, gums. Kind-hearted friends, knowing that I have sported a pixie cut for years, offer how lucky I am that my hair is so short already, as if watching my mother sweep my fallout around my bedside, out of the shower drain, could be any less wretched.
        Another woman turns to me in an elevator and says, “I just love your hair. I wish I was that brave.” Then, shocked at my candor that the hair hasn’t grown back from treatment, she stutters how lucky I am to look so good on chemo. Everyone tells me how good I look. Women shout at me across parking lots, “Cute hat!” Though always a vain woman, I don’t mind going bald. I just hate the cold.
        My nails, however, are a surprisingly torturous experience. Like bamboo. Nails bubble away from the nailbed—not at the tip but from the fleshy middle—and turn shades of purple that have no names in my gigantic box of Crayolas. The slightest touch and they bleed. Shoes bruise and make my toes pulse as if on the bad end of a hammer gag from a Tom and Jerry cartoon. I cannot open a can of cat food or a bottle of Gatorade without the nails popping up from the pressure of my fingertips.
        My skin sags, dehydrated. My eyelids puff. My gums swell, swaddling every tooth, on schedule, ten days after each treatment. But the nails will remain a deep corpse blue, then dead white more than a year afterwards.
        During the worst of it, I joke that I look like my own baby picture: the downy hair, the teething gums. When I am through, though, I am left with an old woman’s body. All those “You look so good” comments really make me ponder:
        Who is the truth-teller: the kind-hearted or the chemo?

                                                                

6-8. Mamsam, naharu, atthi

Chemo makes me ache in my bones, so there is fear that the breast cancer has spread. It likes bones, its primitive cravings like microscopic cavemen gnawing down to the marrow.
        Healthy bodies replace the entire skeleton about every seven years, a tiny bit each night as we dream about rock stardom or whathaveyou. You are not you from a decade ago. I am slowly, painfully, being introduced to my new me, one who has osteoporosis, arthritis, a hip that grinds and pops every time I get off the couch or sit down with a student, a foot that feels cleaved in two. Another Tom and Jerry gag.
        A month before my diagnosis, my health is nagging, my strength and endurance lagging. I fall when we are hiking, more shocked that my leg gives out rather than actually hurts.
        How lucky I am, we all say.
        Lucky that I am so fit; otherwise, I could have broken a bone, the bruise on my hip big as my fist.
        And then where would I be for chemo?
        You, dear reader, probably never have been and never will be a rock star, though you still may be dreaming about living your fantasy life. But once I have my “oh shit” moment, I pretend to move past pretending. At age 45, I hallucinate instead weird drug-paced dreams about professional wrestlers and ballerinas, a fanciful midlife career change from my full-time job of bedrest. I covet their hips, their feet, because mine are failing. Only I don’t know it, the tests yet to come in the year after chemo.
        In my chemo dreams, I fly from the top buckle, leap like a gazelle across center stage, and claim no contradiction between the two. But when I wake up, I hold onto the walls of the hallway just to get to the kitchen for a glass of tea. Weak shuffling steps. Stooped over like my grandma before the nursing home got her. My mother threatens to bring over my grandma’s unclaimed walker, tucked up in the rafters of the storage shed.
        After she broke her hip, Grandma used to whack her relatives with that walker, and I have black fantasies of how I can use it to beat The Undertaker in the ring, beat cancer. Instead, I become the ultimate jobber. My part to play in all this is to just lie there and let chemo beat the shit out of me.

                                                                

9-12. vakkam, hadayam, yakanam, papphasam

One of the four types of chemo I take is known to affect the heart. Here writing the first draft, I am three hours away from yet another scan to see if my heart is retaining fluid. Ironically, here again, revising this final draft, I am weaning myself off of a medication that has been giving me heart flutters.
        The port-a-cath, which saves the crook of my arm from becoming a pincushion’s worst nightmare, is surgically implanted onto my left pectoral muscle in opposition to the tumor, which rests on my right pectoral muscle. In a mere six months since my last clear mammogram, this tumor had grown to the size of a quarter before I could even feel it. But the location of the port means that the chemo’s most immediate target has become not the tumor but the heart. My heart races when I sit up. It races when I manage to get to the bathroom. It races on the way back to bed. It is trying to outrun me in our race to outrun cancer.
        Breathless from any exertion, I wheeze like little Stevie in his wheelchair on Malcom in the Middle. My family assesses my daily condition by listening to how coherent I am—whether I can converse in full sentences without taking a gasping breath after each phrase. Or if I nod off in the middle. In a medicated stupor, I watch documentaries about climbing Mount Everest, K2, Kilimanjaro. I recall the Hemingway hero…
        …dying before rescue can come, before getting all those stories written down.

                                                                

13-17. antam, antagunam, udariyam, karisam, pittam

Everyone dreads the nausea, including or perhaps especially the family member who drives the patient to and from treatment. My husband practices squealing to a stop on the by-pass in case I need to hang my head out of the door. Other than the synecdoche of the bald head, throwing up is the most common metonym associated with chemo.
        I deliberately use literary terms to describe the imaginative power—almost myth-like—of cancer and chemo over people. That’s the English teacher at work. Synecdoche: the part represents the whole; thus, the bald head substitutes for the whole person. Or in the special case of breast cancer, it’s the single breast, the scarred chest, that fixates the imagination. Metonym: something closely associated acts as a stand-in; hence, the nausea represents all those moments of suffering during the chemo. In the collective imagination, women with breast cancer are reduced to a surreal Picasso-patchwork of parts: scarred, mangled breasts, bald scalps, bile.
        As it turns out, my anti-nausea drugs are so strong that I can’t throw up, and they make me so stoned I don’t really care if I do. So I eat things I shouldn’t, which leads to my inevitable contemplation of my large and small intestines and their contents. I become a medieval quack studying the unflushed toilet bowl, looking for the signal that my husband should rush me to the emergency room.
        Bob wakes me and asks, “When was the last time you ate, drank?”
        “When I took my pills,” I slur.
        So he stands sentry as I force down a Gatorade or a Carnation Instant Breakfast before allowing me to collapse back into sleep.
        During each week of chemo, my schedule is punctuated by the Marimba chime on my iPhone, which wakes me up every four-to-six hours to gag on a pill. I cringe whenever someone else’s goes off. But an alarm is the only way to remember not to overdose myself, jangling my nerves more than the déjà vu of the counting out, the swallowing, the cracker, the Jell-O.
        Didn’t I just do this? Just do this. This, too, shall pass.

                                                                

18-22. lohitam, sedo, medo, assu, singhanika

Blood, sweat, and tears. “There’s nothing like a year of chemo to cure a needle phobia,” I quip to the phlebotomist in yet another conversation to ascertain coherency. There’s a whole team of them; some I like more than others. I am chatty with the ones who don’t hurt me, frowning and stoic with the ones who do.
        You always come in smiling.
        You wear the cutest hats!
        How’s the weather out there?
        That smile turns sardonic once I feel that prick. For this one in particular, her attempt to draw my blood is so painful that I am dizzy now as I type this.
        “I know what you are trying to do,” I mumble, eyes clenched. She is trying to keep me talking, trying to keep my mind off the fact that she has blown my vein.
        “Is it working?”
        “Nope.”
        And over I roll, just like the vein.

        “The port will be so much easier…” and it is. Except my oncologist told me to save the port for that which it was intended, the chemo, and to get blood taken from the crook of my elbow. Every. F’N. Week. For a whole year.
        Blood has never been my friend. My oncologist has already treated me twice for severe anemia before ever treating me as a cancer patient. Hence, the familiar deathly fatigue and its accompanying panic of imminent heart failure do not scare me into the emergency room the way those symptoms usually scare others on chemo.
        Instead, I start to meditate upon blood in another way. Upon finding my tumor at age 45, I am taken off a birth control pill that I have been on since my early twenties. Doctors warn me the chemo will force me into early menopause. My period has only a twenty percent chance of returning. However, off the really bad chemo for a couple of months “to rest”—I am taking four different kinds over the course of a year, and go right back on the “good” kind after a couple of restful months of surgery and radiation—I can tell a difference already.
        “My period came back, and it’s normal,” I brag, just as soon as I can.
        “I’m sorry,” says my oncologist.
        (She’s always telling me how sorry she is. In fact, at my diagnosis appointment, they are her very first words to me.)
        So the universe punishes me for my braggadocio. Hot flashes behind my eyeballs like the Big Bang. My mother totes a dining room chair into the bedroom and props me up, the bed pillows in my lap to keep me from falling over, a makeshift bumper for the 5’7” emaciated, dehydrated baby. Then she strips the bed of its sweat-soaked sheets and remakes it as fast as her 75-year-old body can go. Then she helps me fall into it again.
        It’s a game.
        As it turns out, sweating is just my body’s way of saying, What the F—! I make phone calls: Am I sweating chemo? Should the cat and the hubby sleep on the couch? Sweat too much, I get dehydrated, get the shakes. Declare it is freezing in July. My mother tosses electric blankets over my legs, a heat pad on my abdomen. I chug Gatorade like beer. A teetotaler—hell, till then, I’m not even a teetotaler, I’m a water-totaler—I fantasize about downing in one dramatic gulp a crystal glass of Victorian sherry or a dirty shot glass brimming with Wild West whisky, those two standbys for the swoons and the shakes.
         I break down. I send my mother to Walmart to fetch home Mary Jane. While she is gone, I can practically taste the medicinal powder in the chocolate brownies she will make for her only daughter upon her return. Though I can’t imagine why: my taste buds have literally melted off. That’s how stupid I am. But I naively think my mother will get to choose baking it over rolling it, you know, like choosing a pill or a liquid for an antibiotic. As soon as I hear the keys in the door, I begin to grill her:
         “Did you have to show your ID? Did you have to fill out a million forms?”
         “Nope. The kid behind the counter didn’t even know what it was, and it cost a whopping ten dollars.”
         The stapled sack rattles suspiciously. We peek inside like Indiana Jones, as if it is half treasure, half boobytrap. Inside are horse pills that could choke Mr. Ed speechless. To pile further insult on top of my naivete, the pills have to be refrigerated or spoil. So much for my mother’s brownies.

                                                                

23-31. And all the other unpronounceable, unnamable sufferings that cancer cares not a whit about

To be so personal, so detailed, is a writing skill I learned as a kid, much to my mother’s chagrin, but man, do I double-down on it in chemo waiting rooms. Trading stories, comparing symptoms, those of us hooked to an IV are all remarkably chipper about those morbid, foul, filthy, unmentionable details. We cheer each other on as if we are rushing a fraternity. To spare you, I will skip the rest of my symptoms and side effects–though Buddhists encourage us to embrace all of our bodily embarrassments.
        There is one last irony. Although we love sharing our numbers, a pastime like studying the racing sheets and betting odds, then cheering our favorite on to the finish line, only one number matters: the white cell count.
        On Chemo Tuesdays, you see, we all get lined up in our off-brand Lazy-Day Loungers and rear back for a day of drip-drip-drip, bag after bag, from about 10 in the morning to about 4 in the afternoon. I might get a little anxious if the nurse starts my IV without dripping my “sleepy-time” meds first, but it almost always goes just fine. Meaning the whole process is so undramatic that I sleep though most of it and leave my poor mother, who I’ve commandeered as my chauffeur, bored most of the day. Yet, despite knowing the routine is bringing me one more Tuesday closer to finishing my treatment, I have to psych myself up to go. We all do.
        That’s why we want to see a bag in the nurse’s hand when she walks up to our Lounger. If she isn’t starting an IV, it is to deliver The Horrible:
        “I’m sorry. But your bloodwork came back, and your white count is too low. You can’t get your chemo today.”

                                                                

32.“The things we choose to dwell on so that we don’t dwell on the truly horrible.”

I observe this little chestnut one day to my oncologist. There must be a Buddhist word or expression for it, but I’ve never found it. Anyway, I say something about counting my IV bags like counting my blessings.
        She nods, silent for a moment. Then she says quietly:
        “Unfortunately, cancer likes bones. Brains. It likes to come back.”
        Thus, cancer’s thirty-second challenge, and the last in the Buddhists’ contemplative catalogue, is chemo’s insult to the brain.
        But here is what I truly dwell on: not my brain but my mind. Will chemo change the way I write? Alter forever my creative process? Perhaps kill it altogether, my imagination sacrificed as just another clump of fast-growing brain cells unnecessary for sustaining life? Writing is my life, all that I know or can remember. This damn cancer is getting in my way. I dwell and dwell and dwell on these things, and write about dwelling. This is not what the Buddhists mean by contemplation.
        My memory, damaged permanently by medications, suffers too. I put the waffles back in the cabinet instead of the freezer, then I leave the toaster oven on and forget to feed myself.
        Yet memory is suffering, so Buddhists try hard to om it out of existence.
         “Be here now,” they soothe-say.
        Where am I again? As far as I can tell I am lost in a word-labyrinth of fragmentation. Broken memories, broken body, broken dreams. Paragraphs and sentences break off in all directions. This essay has no ending, only an end to its treatment. Drafts aren’t so much finished as abandoned. Then other essays, other attempts. There is no antidote to this suffering. Only more writing. The irony: It’s the same damn story.
        Where am I? Bedridden, forgetting what day it is yet counting down the days until my next treatment. I watch patients get turned away on Chemo Tuesdays because their blood count is so low that they can barely walk through the door, yet I feel lucky in never missing a count, never missing a bag.
        There is no cure. Just one more treatment. One more pass at revision.
        The brain, seat of the most fast-faster-fastest growing cells in the body, is supposed to protect itself from chemical assault, which is why chemo is not usually successful against brain tumors. This “protection” is the happy lie that doctors tell us so that we patients will allow ourselves to accept that first prick into the port without kicking and screaming as if we are being dragged into an insane asylum. Because…you know…we are.
        Another particularly pretty lie my beloved doctor likes to tell:
        “It’s a lot like getting the flu every three weeks.”
        Now see? That doesn’t sound so bad. But I know better. My body knows better.
        Chemo is cruel.
        With every prick, my whole body knows that it is going to die slowly, but my brain keeps putting my faith in science, and it reasons, no, calculates that my body will die more slowly than the tumor.
        So my brain tells my arm not to move, tells my body that this is not slow death dripping down that IV pole. This slim grim ghost which shadows my every move, which hovers with his scythe just over my shoulder, ready for the reaping…is indeed life.
        And my arm is steady. My hand does not shake.