“One foot in front of the other
One foot back to counter it
Days like these you’ve got to find it in some other way
It’s all or nothing baby”
- Avalanche (Matthew Good, 2003)
My appointment day was bright and sunny, but hardly warm. We went through the registration desk and I received a red plastic hospital red card. It’s even an alarming colour. Was purple taken? We sat down in the waiting area. I was here with my mother, father and Alissa. Half of the people in the waiting room looked fine, but the other half was an assortment of senior-aged people in various stages of decay. Some of them looked okay, except that you could see IV’s poking out of clothes or a bad-fitting wig. Others were barely conscious and had to be wheeled around. I didn’t expect to see any children in this hospital, but was I really the youngest patient here?
I was called into the examining room. It led around the back of the reception area in a dark, snaking corridor. The room was only comfortable for about three people, and already I was surrounded by Mom, Dad, and Alissa. Maybe the Doctor would see the numbers and decide she didn’t want to be a fifth wheel. Too bad, sorry!
A nurse came in and did all my numbers. Weight, Blood Pressure, Temp: all within normal ranges. I was perfectly average in every way, except for the tennis-ball in my chest that shouldn’t be there. She wrote everything down in a very large binder that was already about half full of multi-coloured papers. I guess I wasn’t so average after all. She smiled and said the doctor would be in shortly. We waited in silence.
There were many more posters in this room than at the other clinics. They were packed with type and I could barely make out what they said from across the room. Most of them seemed to be info sessions for various support groups. There was a printed calendar that was full of times and rooms.
March 1st, 3pm – Room B153 : “Coping with Cancer Stress”
March 2nd, 1pm – Room A113 : “Stepping Stones”
March 3rd, 4pm – Room C405 : “Next Steps: Preparing for the End of Life”
I looked over at Alissa. She was looking down at the floor avoiding eye contact. My parents smiled encouragingly. The door opened at the doctor came in.
Dr. C (a.k.a. Cancer Doc) was a Hematologist: A blood Cancer specialist. Solid tumours are where “Oncologists” work; Lymphomas and Leukemias were her trade. She was dressed in a white coat over top a black business dress with matching heels. As she began to introduce herself she spoke warmly and calmly in a professional voice.
Everything about the “blur” and “tunnel vision” of receiving this kind of news is true. I didn’t react, I was completely still as she detailed the situation and my prognosis.
According to the biopsy (biopsies–plural) results, I had an aggressive form of Cancer massing in my chest and spreading throughout my body. It was a sub-type of Cancers that attack the lymphatic—your immune—system known “Non-Hodgkins Lymphoma”. The biopsy had ruled out the more positive diagnosis of “Hodgkins Lymphoma.”
Great. I got “the bad Lymphoma.”
The doctor continued to explain what was to be done with me. My CT scan had revealed the enemy’s position. There was a large white blob about the size of a large orange growing around my windpipe, and several metastatic tumours growing in my lungs.
It wasn’t Lung Cancer, it was Lymphoma cells spreading to other places. Typically Hodgkin’s Lymphoma is “good” because it spreads in a somewhat predictable pattern. The “Non”-Hodgkin’s Lyphomas did not behave predictably. Sometimes they start in the neck, sometimes the groin. Other times they were “mediastinal” or “in your freakin’ chest”. When the alien was large enough it would burst out and spread to other vital organs in the body. In good cases, the stomach, or maybe liver. In worse cases…my lungs. This was not off to a good start.
My supporters were silent, except for my stepmother who asked most of the questions. I tried to nod and respond appropriately. I was thinking about a million things at the same time. The doctor’s calming voice faded into the background as she went on about large B-cells and White Blood Counts. What was I going to do now?
With Cancer, the best chance for survival we know of is to remove as much of the bad cells as possible. In my case the “mass” wasn’t really a “mass” at all, and it was around in a very hard-to-reach area of myself. The next logical step was chemotherapy, which is a really nice way of saying “poison we hope kills more bad cells than good”. Fantastic. When the doctor outlined my treatment plan, she started talking in months, then years.
My battle with chemotherapy would consist of six “rounds”—like a boxing match—at three week intervals. Each treatment was a powerful cocktail of chemicals designed to seek out and destroy all rapidly-multiplying cells in my body. Unfortunately, this meant as many good, hardworking cells would die: blood cells, hair cells, and sperm cells. I would be sterile for about a year, and possibly forever. I would start chemotherapy in three weeks, giving me time to bank sperm.
“You mean he won’t be able to have kids?” Alissa broke her silence. Her voice resonated my shock. I grabbed her hand tighter and she looked at me; her eyes reflected my fear. We had talked for three years about what we’d do once I had a job and could support having children. I didn’t have a backup plan, and I could see that she didn’t either. It was time to see what “in sickness and in health” really meant.
“We have good results with this treatment and we’re confident that given the disease’s aggressive behaviour that will increase our chances.” The doctor explained that it was like two freight trains colliding: the faster they are going the more damage they will do on impact. Of course, there would be some collateral damage.
The side effects would be almost as bad if not worse than the current effects the tumour(s). It wasn’t the Cancer that was going to wreak havoc on my body, it was the medicine that would be overseen by a doctor and administered by a registered nurse. Fatigue, Nausea, Dizziness, Constipation***, Loss of Appetite, Insomnia… These were the drugs sent to help.
My red and white blood cells would suffer the worst of it, depleting my energy and immune system. My hair would fall out by the end of the first month, and in her words it was going to be “sudden and terrible”. I would not be able to get Alissa pregnant for at least 3–6 months after the end of treatment. In fact, I wouldn’t be able to have sex with her for a few days after each treatment my system would be so full of the poisonous chemicals. I was going to be radioactive, man!
I tried to ask intelligent questions, but I didn’t have the slightest idea what was going on. I knew I had Cancer. It was in my chest and in my lungs. It was slowly choking me to death, and if it didn’t stop growing it was going to kill me. I was going to spend the next six months getting chemotherapy and if I was lucky that was it.
“What are his chances?” my Mother asked from beside me. She was also visibly upset and her voice cracked when she spoke. Dr. C explained that she doesn’t like to frame things in terms of stages or odds of survival; they prefer to deal with each patient as an individual person.
“Good. His chances are very good” the doctor spoke as one mother to another. Her bedside manner was spectacular. “He’s young and the treatment responds very well to aggressive Cancers. We’ll do four rounds of therapy and do another CT scan to assess his progress.”
“So what stage is he?” The doctor smiled at Alissa’s inquiry. Again with the stages.
“I guess based on your current condition it would be a Stage Four.” See what she did there? I’m starting to like her, and not just because she is my best chance for survival.
“How many stages are there, ten?” she asked. I too, was ignorant.
“Four.” Please be the good four… please be the good four…
“And Stage Four is….good?” I spoke, going almost full falsetto; almost begging.
“No. Stage Four is bad.” Dr. C was patient and informative. “You’ll probably want to take up to a year off after–”
I froze. What about work? I was a month into working for the next big dot-ca, and it was going well! I was knee deep in banner designs, website code fixes, and marketing materials. My desk was awash in paper printouts, half-eaten meals and cough drops. What was I supposed to do, just stop going to work? I had only been a full-time employee there for a couple months!
All other medical jargon and timelines went out the window. If I had to stop working, I’d lose my chance to get on the rocket ship! I had stock options! I was going to make Internet millions and raise babies on my yacht! The minute I tell Boss Man that I’m this sick he’ll replace me and get the next hot shot kid in line. I barely know what I’m doing half the time. I found that if you say ‘yes’ and put in the hours you either succeed or you fail upwards. I was good at saying yes and had pulled more than a few rabbits out of my hat in my short tenure.
I had just gotten there. I had just made it. We were right where we had always talked about being, but around us was a storm threatening to dismantle our embryonic family.
“Get your sperm banking done and we’ll see you in a few weeks.” Dr. C stood up to leave, and my parents thanked her. I tried to thank her, but I just held Alissa in my arms. She was crying and so was I. We left the room and walked down the aqua-green mile towards the parking lot. I would be back soon, and not just as a visitor. I would be a patient.
Researching was a bad idea. The doctor made it sound so manageable, like when you look down off the top of the play structure and go “it’s not that high” and jump. When I entered the search terms this time I had a better idea of what I was looking for.
With most types of Cancer, the overall survival rate over 10 years is about 50%. That means after ten years half of people diagnosed with Cancer will still be alive.
Half. 50/50. One in two.
I’ll let that sink in if you’re not acquainted.
Now, silver linings are never something I have been a fan of. Don’t kick me in the stomach and tell me “at least I didn’t shoot you in the face.” I know it could always be worse. There are worse things than a 50% chance of survival (like 0%). But that doesn’t mean that you should feel grateful that something horrible happened. Humans just don’t work that way. Some things just suck, and the fact that there are worse things doesn’t make them suck any less.
According to some data, my particular Lymphoma was actually one of the most treatable Cancers. Generally if it didn’t spread to far outside your lymphatic system and you were under the age of 60 you were okay. Some statistics showed that the five-year survival rate for my age group with my cancer was as much as 96%. So this would be hard, but the data said I would probably live. There was some hope for survival.
How much would this disrupt my life? My self-worth was so tied up in professional success for so long I could barely see anything but my work. I couldn’t take a year off work; I couldn’t take a week off with everything going on. I was a valuable member of the team! …or so I perceived myself. How quickly could they replace me if I die?
My thoughts turned to my personal situation. We’d have to put off getting pregnant for at least a year, that was pretty clear. What if we couldn’t get pregnant even after that? Would she wait around when all she’s ever wanted was to be a Mother. The Wife part seemed almost optional. Her mother had raised her alone and she had no knowledge of her biological father. How quickly could she replace me if I died?
Alissa had been decidedly quiet since the appointment. She sat on the couch with the cats, smoking a cigarette and watching TV. She had barely comforted me at all, and I was in serious need of some love and affection. I stood in the entrance to the living room, not entering the space that was filled with her acrid smoke.
“Do you think,” I began. “Maybe while this is going on you could smoke outside?”
She considered my statement for a second and then replied “It’s too cold, and they haven’t opened up the rooftop patio yet.”
So there was that. I considered putting up a fight but I was too depleted from the day. I went to the bedroom and collapsed. As I tried to fall sleep, I thought of all the places I’d never visit. People I’d never meet. Money I’d never earn. Children I’d never have. For the first time in years, I cried uncontrollably until I fell asleep.
Preservation of Fertility is pretty important to someone under the age of 30. Most people who get Cancer have either had children already, or they never wanted them. In order to ensure little Travis Jr. could some day say “I love you Daddy” I had to do the unmentionable. I had to go above and beyond the call of duty.
I had to jerk off into a cup.
It gets better. We didn’t have a fancy pants sperm bank with nice clean rooms with adult magazines in Ottawa at the time. The lab’s procedure was for you to “produce a sample at home” and transport it to them within 60 minutes. Also, you have to keep it in your pocket so that the “sample” (a.k.a. your jizz) stays…warm.
I didn’t have a car, and I was not going to ask someone to drive me and my 20 million friends to the sperm bank. No, it was OC Transpo for me.
Do be able to obtain enough “good sperm” in one “shot”, you have to abstain for seven days—that’s a whole week—without any ejaculations of any kind. Master of your domain. If you so much as have a nocturnal emission because of Dream Cindy Crawford (you had to grow up in the 80’s), you cannot go through with banking sperm. I’ll let all the men think about that for a minute.
It wasn’t overly difficult. Our “newlywed” period was long over and the recent circumstances had put a distance between us. I kept having half conversations with her, and then retreating to my office to do more research (avoiding 98% of the Internet). The only close encounter we had was the night before I was going to the bank. While I was cleaning up after dinner, Alissa came out of the bathroom in a sheer red lingerie getup. She had my immediate, undivided attention. My wife did a slow, sexy dance for me while I dried the dishes. She removed her tiny coverings and brought me into the bedroom. We hadn’t had any sexual congress in weeks, and here she was going the extra mile when I was least able to participate. I couldn’t remember the last time she was this aggressive or aroused. She wanted me and I definitely wanted her, but had she forgotten where I was going tomorrow?
I resisted, she pouted. By the end of our encounter she was satisfied and I hadn’t been in that level of pelvic discomfort since my first girlfriend at 16. What did she want out of that? To ruin our chances of having children after this was over? Or did she hope to get pregnant now? I didn’t know how to approach the situation, so I just rolled over and went to sleep.
Early the next day I’m sitting on the bus with a urine test jar full of my own semen. I have about 45 minutes to get downtown, and barring unusual traffic, I should get there with about 15 minutes to spare. I looked to the old lady sitting next to me and couldn’t help laughing under my breath. I resisted the urge to share the joke with her.
There was a short walk from the bus stop to the lab, and it was an unusually cold day for this late in March. I was worried that my tiny soldiers would freeze before they ever got to their frigid destination. I walked a little slower with my hand in my pocket, cradling the microscopic cargo.
When I opened the door, I was greeted by a very nice woman who introduced herself as the doctor’s wife. She was very professional, but the questions she asked were among the most personal I ever had to have written in a medical document.
“How long did you abstain before producing the sample?” she asked.
“Seven days.” I timidly answered. I thought about last night and the red lingerie.
“Where and when was the sample obtained?” she continued.
“At home about 45 minutes ago?” I replayed the last hour in my head. Definitely a memorable one.
“Did you keep the sample warm during transit?” she smiled as she looked up for my response.
“Yes.” Yes, that really did happen. I had a cup of sperm in my pocket on the bus. It was the best day ever. Can I go now?
“Please have a seat” she pointed to the waiting room. “The doctor will verify the sample and we’ll let you know if it’s viable.”
I sat down and waited to hear if I was going to be making any deposits today. After about ten minutes she came back out and told me it was good. I put my coat on and headed to work.
I repeated this process again the following week, and as before it was largely uneventful. I made it to the clinic with only about 10 minutes to spare, but as before there was no problems and they sent me on my way. I had deposited enough sperm for about a dozen inseminations. When the time came they would be injected into my Wife who had been taking hormone injections for up to 45 days prior. My Wife hated needles. If she was serious about having babies, she would have to get over her fears.
There were several more appointments before the “big day”. Each time I was brought in and examined by any number of doctors and nurses. At this point, I was still of the thinking that my body was my own. I was not in control of my body any more, the Cancer was. In order to remedy that I had to admit my body was now theirs, to do with as they pleased. I was like a prize pig being raised for the county fair, and a blue ribbon meant survival.
The worst part was being examined with other people in the room. It’s one thing to have a doctor examine your genitals for evidence of Cancer in the testicles. It’s an entirely different situation when your doctor is instructing others how to do the exam. But as an educator myself, I couldn’t say no when they asked to perform the same exam again. I was of no use to myself any more, but perhaps I could help them learn their craft. If that meant a extra strangers grabbing my junk, I guess it was a small sacrifice in the same of Science.
Each appointment I would go back to work and try to block out what was happening. I wanted to be a good employee, and a valuable contributor to the team. I needed this job. I needed my benefits. I pressed myself to get as much work done as possible in the days leading up to my first treatment. The site had been live for more than a month and the “crunch” period was winding down. I had a great manager, probably the best I would ever have. She let me skip as much work as I needed, and she made sure my deadlines were always achievable. Every morning I would go into her office and we would discuss what needed to be done versus what could wait. It was hard work, but I managed to get enough done every day that I didn’t attract the ire of the Boss Man despite my absences. I was holding it together, for now.
One day I was called in to see the head of Human Resources. She was an older woman who’s experience and wisdom predated even computers, let alone the Internet. She was warm and grandmotherly, but also feisty and quick-minded. It was by her extraordinary efforts that I would keep my job and finances in check throughout this ordeal.
I had spent a lot of time in her office over the last few weeks. I was keeping her up to date with all the test and treatment plans. I had told her about my intention to take some time off to deal with all this, and she began applying for long-term disability on my behalf. I didn’t want to stop working until I absolutely had to; I didn’t think I’d have a job to come back to otherwise. We had worked it out so that I would take limited sick time off for each treatment so that I could ride out the worst of it at home. When I was out of sick time I could go on short-term or long-term disability, and I would get to keep most of my current salary. We wouldn’t be as well off, but we wouldn’t be destitute either.
“I’m afraid I have some bad news.” she began. “As you know, you are within the 3-month probationary period, since you only became a full-time employee in January. The insurance company has decided that because you were officially diagnosed within that period, you are ineligible to claim benefits under the plan. They are calling it a Pre-Existing Condition.”
My heart sank. There goes another plan out the window. If I couldn’t get sick leave benefits, how was I supposed to take time off and still pay our bills? I could apply for government assistance, but it paid fair less than the employee benefits I had been paying for the past two months. The numbers started to spiral and arc around me as I tried to figure out a way to make it all work.
“I’m so sorry,” she said. “I’m going to fight this for you. I’m going to get you as much of your benefits as I can. You just leave it with me, and concentrate on getting better.” The compassion and sincerity got to me. I cried in her office for about 15 minutes (not for the first time, either), then I went back to my desk. I tried to concentrate on work but I was too busy trying to figure out what to do about this new bombshell. I already wanted to work to keep my career, now I needed to work to keep my apartment. What if I became to ill to work? What then?
As I stared at my desk, Josh came up behind me and gave me a strong pat on the back. It jolted me back to reality and I turned to thank him sarcastically for the greeting. He had joined the company only a few weeks after me, and we had become fast work friends. He was my age and this was his first job out of school. Josh was one of the few people that knew I had Cancer from the beginning, and he hadn’t treated me any differently. We got up and went out for lunch.
While waiting in line to order our burgers, we were talking about my situation. Sperm banking was mortifying but it was successful. I didn’t even have kids, but they were already costing me $300 a year in rent. I started chemo in a few days and had a ride and my recovery time blocked out. I was talking about my preparations in the face of the unknowable tide of shit that awaited me, when the man in front of us turned around.
“You have Cancer?” he asked.
“Uh…yeah?” I replied.
“That’s awful. My uncle had Cancer.” Just as quickly as he had joined our conversation, he turned back and ordered a combo meal. What the ever-loving fuck? Josh and I exchanged confused expressions, and continued chatting in line. Thankfully, no one else had any pearls of wisdom and we ate our lunches in peace.
It was nice to be able to talk about things other than Cancer, and Josh was good about steering the conversation away from medicine and chemo and to current events and appreciation of the female form. We had a few laughs and headed back to work.
When I got back to my desk, I was told to go see the Boss Man. I had hardly interacted with him since the website had gone live, so I assumed I was doing okay. Was he going to fire me for all the hours I had missed recently? Could he even do that now? I slowly went upstairs to the executive offices, and poked my head in.
His office was dark, and he was sitting behind a desk with three monitors and more paper than even this designer had. A few plaques and photos abounded but it was mostly a mass of stacks of paper and enviable computer technologies. There was a couch and seating area off to the side, and he motioned me to sit down. He got up from behind his desk, walked around to the front, and leaned back casually.
“I have heard that you have Cancer.” he said. “I’m sorry to hear that.” I hadn’t officially told anyone I had Cancer, but for a company of 50 employees word had apparently reached the top.
“I just wanted to tell you that I don’t think you should have told anyone.” He wasn’t mad at me nor was he going to fire me. He was…disappointed?
He went on to explain that his father had also had Cancer. He fought it for years and he never let on that he was ill. It was obviously something he admired, so I guess he felt the need to try to curtail my forthcoming nature when it came to my illness. Was this his way of showing support? Or did he not want me to become a distraction to the work environment? Or was this about being “a man”?
He wasn’t the first person to give me unsolicited advice, but he was definitely the richest and most powerful person I knew at that time, so I tried to put his motives aside and listen to what he had to say. It was a warning that everyone I share my illness with is another person who will see me differently. This would affect my life in ways I hadn’t considered, so he wanted me to think about it. I genuinely thanked him for his words and as I went to leave he reassured me that I always had a place here and it would be ready for me when I came back. It was the most we had ever spoken, and it was the nicest he had ever been.
As I walked back to my desk I did see my workplace and my coworkers differently. I hadn’t formally announced anything; I had only just found out what type of Cancer was trying to kill me. What were people saying around the office about me? A few people had come up to me to see if the rumours were true, most of them adding the most helpful phrase ever:
“But you don’t look sick!”
Maybe I didn’t look sick, but inside I felt like I was dying. Technically, I was.
The night before my first treatment, we watched the new Dawn of the Dead movie. I found myself laying awake last night contemplating the much more likely fundamental breakdown of civilization itself. Whatever the cause, zombie or otherwise, I couldn’t get over the thought of being besieged by the very end of humanity. I stayed up all night, planning and re-planning what to do in case today was the end of the world. I worked out a rationing plan, where to get supplies, how to barricade myself inside our apartment, and even how to round up others from the building to aid in our quest for survival.
Around the time I started working out which people in my apartment building I would most want to help and whom I would throw off the roof, I decided this event was verging on insanity and promptly stopped. Unfortunately by this point the Sun had started to rise. Oddly enough I found myself hoping a zombie would bust my door down so I wouldn’t have to get up and go to work.