The patient was a woman I've known since we were both sixteen. Since I last saw her, five years ago, she'd gotten thinner and more attenuated, and her hair had fallen out and grown back into a sort of default pixie-cut: the hairstyle of the recently afflicted. She'd had breast cancer, the awful aggressive sort that hits women in their mid-thirties, that defies hormones and radiation and chemotherapy and surgery. Lung and liver, bone and brain--she was back for placement of an Ommaya reservoir, a piece of plastic that would let the doctors deliver chemo to the metastatic tumors in her brain, and maybe give her a few more months.
She was one of those real, live, honest-to-God cheerleader types, with long dark hair that she refused to perm. She could buy beer long before the rest of us could, because she looked so much older than eighteen. She was pretty and popular and got a degree in management and married a guy who was successful and handsome and had one child before she was diagnosed. If I was a tiny baby-Edward-Gorey pseudo-Goth in high school, she was something out of a Maxfield Parrish painting.
In 2006, we'd walked down the hall together in the afternoon as she described what radiation was like. Her arm was across my shoulders because really, she wasn't that strong, and mine was around her waist. The conversation turned to science fiction and fantasy novels and Star Trek; it turned out she'd had a geek streak even way back then, but had never let it show.
Now I was digging around in her forearm, looking for something that would let her nurse run a couple of units of blood and a couple of sixes of FFP and maybe a liter of fluids. She was talking about how much she had to clear up before she died. She knew that the chemo to her brain might last her through April or May, but after that it was all up.
"It's sort of like, when I got diagnosed, I got thrown into a pit," she said, "and all this time, I've been living in the pit, watching other people come and go. It's dark, but you get used to the dark after a while. The hard thing is seeing other people leave. They're standing on the edge of the pit, yelling at me to stay strong and to fight, but they really don't know what it's like."
I looked up. "You're saying what I've been thinking," I said, "except my metaphor was a swimming pool."
"What am I going to tell my daughter?" she asked. "I've gone from living with cancer to dying of it, and I feel like I ought to apologize."
I sat for a minute. "I have no fucking idea," I finally said, remembering another attenuated, pixie-cut patient who'd asked the same question. "I have no idea. Kids like to think their parents are immortal. I'm not sure there's anything you could say."
"Parents like to think that their kids will do better than they did," she said, "Except now I wonder if maybe this is something that'll come back to hit my daughter, too."
I thought of Lara, whose blog has the header, "Like Mother, Like Daughter."
"Goddamned if I know," I said. "All I know is that dying is just as hard work as birthing or living. If you feel like you ought to apologize, you probably ought to do it now."
"Yeah," she replied, referencing a Zenna Henderson book I'd lent her back when she first came in, "that bridge is getting higher every day."