The thing about a tumor is, it’s not just malign tissue.
(Well, the first thing is that it’s not “malign” at all; tumors aren’t evil, they’re just obstinately disinterested in the well-being of the organism that supports them. They’re more like Libertarians.)
A tumor isn’t just malign tissue, it’s a factory for malign tissue. It swells up somewhere, on your testicle, for instance, which you discover in the shower on Sunday night because your doctor told you when you were fourteen to start checking for tumors, because being fourteen wasn’t already an age replete with anxieties about uncontrollable forces destroying your life, you had to add in fucking tumors.
You find a mass on your testicle, and you know how tumors work, you know that it’s metastasizing even as you think about it, sending out fucking saboteurs to the rest of your organs.
I’ve had an ache in my thigh for a while now; is it a muscle pain, or is it a metastasized tumor that lodged in the muscle tissue of my leg? My back hurts, my spine is crawling with tumors. There are tumors in my intestines, in my prostate (prostate cancer is what killed my grandfather) and my colon (colon cancer is what killed his brother). There’s a pain in my groin roughly in the spot where my lymph nodes are (lymphatic cancer is an extremely common and dangerous variety).
If it hasn’t metastasized, maybe they’ll just cut off one or both of your testicles. If it’s spread to your muscles and your bones and your intestines, maybe they’ll just have to amputate my entire lower body. People can survive like that – you have colostomy bags for the rest of your life, and a wheelchair obviously, and you don’t fence or do kung fu or do a lot of things anymore, really.
I call the doctor on Monday morning to make an appointment. I assumed I would be able to do this calmly, but the only thing I can think about is what happens when they check me out and find out my body is riddled with cancerous flesh and tell me that I’ve got six months to live.
“My wife is pregnant,” I’d tell them, “I’m going to have a son in two months.” It’s a kind of special pleading – don’t give ME a cancer diagnosis, I’m going to have a baby, I need to be around to see him, to raise him, this isn’t fair, this isn’t justice. Of course, this argument is a non-starter; every minute of the day, someone dies who better deserves to live than me. Besides that, the doctor doesn’t decide that you have cancer, he only discovers it. Besides THAT, cancer doesn’t give a fuck about your life or your baby. Cancer doesn’t give a fuck about anything but growing and spreading and consuming, so I’ve got no real negotiating power on that score.
I already know that I’m not going to be able to do this with dignity. That I’m going to yell and scream and complain, that I’m going to demand they sign me up for any experimental treatment with drugs or lasers or magnets or crystals I don’t fucking care, I don’t want to die.
I’m trying figure out how to schedule a consultation, and I’m fumbling it because I’m embarrassed to explain what my problem is, and the office manager at the urologist is pretty snappy with me. “Well we don’t have any space until the end of the month,” she says when I say I need to see someone immediately. “What’s so urgent that you need to see someone right away?”
I tell her, and I tell her I don’t know what to do, and I think she can hear my voice crack. I’m sure she’s heard this kind of thing before. Her voice is softer after that. She tells me I can make an appointment with my primary care provider, she gives me a list of things that it could be that aren’t cancer, that aren’t as bad as cancer, and that helps.
I start crying after I make the appointment with my doctor, and I try to stop, but then I change my mind. I’m in the car, in the parking lot of my office, before work. There’s no one could see me – it’d be different if someone could see me – but right now I’m alone, so I let myself cry for a while.
For fuck’s sake, if you can’t cry because you’re scared you’ve got a metastasized cancer that’s going to kill you before your son’s first birthday, when the fuck are you supposed to be able to do it? What’s it FOR even, why do we have tears, if not for something like this?
I try not to imagine what it would be like for my son to grow up without a father, with his mother going out of her mind working, trying to pay the mortgage and keep him in food and clothes. We were barely going to be able to do it with just the two of us, now if there’s only one? I’ve got some life insurance, but not much, not enough.
I try not to imagine what it’ll be like for him, having a father that he only knows through pictures that his mother kept. I complain about those pictures all the time, why do we even have them? I’m grateful for them now. What am I supposed to do, how am I supposed to handle this? What am I leaving him?
Maybe I would make a video and tell him what, exactly? That his father barely finished two novels, that were so shitty he had to publish them himself? I’m going to leave behind a couple of plays that no one gave a shit about, screenplays I kept in a drawer. This fucking blog? This fucking blog. Christ.
I’ve got a few hours before my doctor’s appointment, and nothing to do but go to work. So, I go to work. It helps to think about solutions. “What if I’m going to die?” doesn’t have one, so I skip it. “What if they have to cut me in half?” I don’t know what I’m going to do, at least I’d be alive. I couldn’t teach my son to fence. I couldn’t do a lot of things with him. At least I’d be alive. “What if I need a testectomy?” It’s easier to think about this kind of thing when I use the scientific words for it.
Well, I think. You spend thirty years living in a culture, you can’t help absorbing that culture’s values, and in American, our entire conception of manhood starts at the balls. But masculinity isn’t based on your fucking balls. Actually, even that is a bullshit way to think about it, because the idea that you have to be “masculine” implies that there’s more worth in being male than there is in being female, and when you say that there are other ways to be masculine, you’re just saying that there are other ways for you to matter more than women.
The whole thing is bullshit. I don’t matter because of my genitals. Nobody’s god-damn genitals matter. They’re just sacks of meat that are eventually going to get tumors in them, like all the rest of your ruined rotten treasonous fucking meat.
Anger helps. Despair is enervating, anger is energizing, and I still have hours left to go.
Maybe they’ll just remove the one. Lance Armstrong won the Tour de France a bunch of times with one testicle. He cheated, of course, but I don’t actually want to win the Tour de France. I don’t even want to be in the Tour de France. Maybe I couldn’t be one of the greatest athletes in the world, but I already wasn’t going to do that.
There’d still be a course of chemotherapy. How long is that? Six weeks? Three months? I can’t take three months off of work. We have a fucking mortgage. We’re going to have a baby. We’d have to sell the house and move in with my parents. I try to imagine packing all of our things up, taking the nursery apart, stuffing everything into boxes, only Jeanine is pregnant and the doctors are trying to poison the cancer out of me.
If I do have six months to live, what am I going to do? I cross “travelling” off of my list. I want to go to Prague, and I want to see the Shaolin Temple in China, I want to see Tangiers, Granada, Toledo, Florence, Rome, Heidelburg. There’s a town called Braak in the Schleswig-Holstein province in Germany, I want to see that place.
But if I’ve got six months to live, I don’t want to spend any of that time on a goddamn airplane. Except this is the same problem as the chemo problem. What am I going to do? I can’t quit my job. No one gives you “imminent death money”. I’d have to go to work.
I’d have six months to live and I’d still have to go to work.
Fuck that, I think. I’ll go, but I won’t do anything. I’ll finish my novel. At least I’ll have one more done.
(I take a brief moment to imagine Jeanine getting a letter from an agent, telling her that they’re interested in taking me on, but of course I’m already dead. I think I’m developing an allergy to irony; my eyes are watering.)
I could give my son that much. But is that all?
I gave my dad a kidney in November, and don’t get me wrong. I am glad that I did that. I am pleased that I did that. I think it was the right thing to do, I think it was a good thing to do. But I don’t exactly take pride in it, per se, because what is there to be proud of? There’s a cohort of doctors reminding me how much success they’ve had, how safe the procedure is, how they’ve never lost a patient, how I won’t even have to change my lifestyle except that I maybe need to wear more pads on my left side if I start playing rugby for some reason. And of course, even if I DID have to change my lifestyle, if I had to give up meat or candy or something, of course I’d still do it. It’s my dad.
Anyone would do it, anyone who had a reasonably good relationship with their father – I know some people hate their fathers, but I think even a lot of those people might consider it – anyone who didn’t hate their dad would give him a kidney, this is a pretty normal thing that I think human beings can expect from each other. Like I said, I’m glad I did it, I think it was the right thing to do, but I don’t know that I’m going to leave a video message to my son describing it as the proudest moment of my life.
If the only thing my son is going to get is this fucking blog and a couple shitty books, and maybe a video of me barely able to keep my shit together while I deliver a message from the past, I want to be able to tell him something worthwhile.
On the way to the appointment: how in the FUCK is there a traffic jam at THREE O’CLOCK ON A MONDAY AFTERNOON? What fucking constellation of slimy suppurating shitheads, of stumbling rotten fucking MORONS decided to design a civilization where we have to spend this much time DRIVING IN CARS. What asshole is responsible for this god-damn country? I drive an hour and a half to work, roundtrip, five days a week. That’s seven and a half hours a week, that’s a whole work shift every week, a whole work shift spent in my car, time I can’t use to read or write or get a part-time job, time I’m not paid for but is nevertheless devoted to my employer. Every year I spend fifty-two whole work days in the car. If I work until I can retire, that’s in thirty years, that’s 1500 work days spent driving, that’s four years I didn’t get paid for, I didn’t get to use for myself, I just threw away on the garbage pile of my job.
If I work for thirty years. If I don’t die by January, if I don’t have to quit my job because I’m on chemo and I can’t get out of bed.
I keep trying to think of good metaphors to describe how I feel. “Drowning” is a cliché, but I think that it’s also not clear. It’s not just a feeling like you’re drowning. It’s a feeling like you’ve been thrown into breaking waves with your clothes on. The weight is dragging you down, and the waves are knocking you back and forth. You can’t tell which way is up. You keep trying to reach out for something, to grab a hold of a something, you try to put your feet on the ground, but there’s no ground and there’s nothing to hold on to, you just keep reaching and reaching and every second you can feel your strength ebbing away.
I understand why people pray in a circumstance like this. It’s solid. It doesn’t matter if there’s no reason to think it will work, it doesn’t matter if you don’t believe in God. When you’re here, in this moment, you have something to do. The forms of petition, of transaction, all of those are still in place. They’re solid. Your body can betray you; you can find out in an instant that it’s changed its mind and it’s going to start ripping you up from the inside. Prayers are always the same.
I don’t pray. I don’t believe in God. I don’t believe there is an order to the universe. It feels like I’m drowning in the ocean, that my life is being wrenched away and there’s nothing for me to grab on to, because it is being wrenched away and there isn’t anything for me to grab on to. I’m not going to pretend there isn’t, even if it would make me feel better.
It would make me feel better to get a fucking drink. I wish I could drown myself in bourbon. I don’t do that either.
I don’t take any especial pride in either of these things.
At the doctor’s office, there are two magazine’s in the examining room, there’s People magazine and there’s Auto magazine. I assume one magazine of vapid nonsense for men, and one for women. I don’t know why I care about gender norms right now, but I guess I do. I read People magazine. It’s stupid bullshit from beginning to end, but I also can’t hold two thoughts together in my head for more than a second, so why should I complain?
The doctor is professional. The nurses are professional. They examine me and schedule me for an ultrasound. The ultrasound operator is a professional. I’m embarrassed to say what I’m here for, I’m embarrassed to take off my pants and let someone handle my balls, I’m embarrassed to lay on the table with my scrotum hanging out so a woman can slather an ultrasound wand with lubricating jelly and smear it all over me.
She gives me a towel to put over my penis while she uses the ultrasound wand on my scrotrum. This is so I’m not completely exposed. Sure. Fine.
I’m embarrassed about all this, but I’m more embarrassed about being embarrassed. No one makes a joke, no one laughs at me, no one sexually harasses me. Of course they don’t. I feel like an idiot for being worried about them, for having thought, even for a moment, of delaying an exam because I didn’t want to say “testicular mass” to a nurse over the phone.
Everyone’s competent professionalism helps. I still don’t know what I’m going to do if I find out I’m going to die. I still don’t know what I’m going to do if I find out I need surgery, or chemotherapy. I don’t know what I’m going to do. In the ultrasound room, on the ceiling, they’ve got a bunch of the tile replaced with photographs of a magnolia tree, so it looks like you’re looking up through a window at it. It’s supposed to be distracting, I guess. It’s better than looking at ceiling tiles.
Here’s the thing that I think of: when I worked for the welfare office in West Philadelphia, one day I was out taking a walk around the neighborhood over my lunch hour. The office had no windows, so I try to go out to get sunshine and what passes for fresh air.
Across the street, I see some kids. Two of them are young, eleven or twelve. Two are older. Thirteen, maybe fourteen. Not many years, but a lot of difference in size. They’re horsing around, the way kids do. Tussling. You see it a lot, kids waiting for the bus and wrestling with each other or something.
Someone throws a punch, and I realize they’re not wrestling, they’re fighting. One of the bigger kids has got a bike. There’s another bike on the ground. The two little kids are fighting the two bigger kids.
There’s traffic on the street between us, so I can’t cross. “Hey!” I yell. “HEY!” I think about what’s going to happen – this is America, this is West Philadelphia. Someone, even a thirteen-year old, could have a knife or a gun. I could probably take a thirteen-year-old with a knife. I’d probably get shot if he had a gun.
The light changes and I can cross the street. I see adults waling by, minding their own business while these kids fight. I realize that whoever else I am in life, I’m not going to stand by and watch while some twelve-year-old kid gets his bike stolen.
I start running across the street, shouting. The fourteen-year-old grabs the bike and runs with it. One of the little kids, god bless that scrappy little fucker, runs after a kid half again his size. The other little kid has taken a hit to the nose and fallen on the ground. I help him up, just as the big kid drops the bike and takes off on foot.
The little kids are crying. The one isn’t saying anything while I look at his nose to make sure he’s okay. The other is screaming about how they tried to rob him, about how he’s going to kill them. He’s terrified, and terror makes him angry. Anger is energizing.
I’m impressed by both of these guys, who refused to get pushed around. I know that, if I hadn’t come over, the bigger kids probably would have gotten away with the bike. I don’t know that they won’t come back later.
I don’t know anything, really. Maybe these kids are going to grow up to be a murderers, or teachers, or presidents, or cops, or firefighters. Maybe that scrappy kid is going to get revenge on the kid that tried to rob him. Maybe the one who took one on the nose is going to remember this the next time he sees someone in trouble and he’ll step in to help. Maybe he’ll forget about it and nothing. Maybe he’ll accidentally leave his bike in the street tomorrow and it’ll get run over by a car.
This is what I want my son to learn. That you don’t know what’s going to happen. You don’t know how they got here, or where they’re going next. You’re never going to find out what happened to those kids, or that bike. You’re probably never going to get the chance to end systemic oppression or poverty or racism.
But probably, at some point in your life, you’re going to get the chance to find out whether or not you’re the kind of person who’s going to watch a twelve-year-old get his bike stolen.
At the end of the day, that small, immediate good is probably the only good you’ll ever get to do, so I guess you’d better do it.
There is, in fact, nothing wrong with me. The ultrasound came back negative, no tumor. Maybe a swollen blood vessel. Maybe I banged it without noticing, maybe in my sleep. Maybe nothing, maybe bodies are just fucking weird. I’ m fine.
I feel an immense relief to hear this, and then immediately feel guilty for that relief. Every minute of the day, someone dies who better deserved to live than me. Someone who suffered worse, who’d done more, who would do more, who’ll leave behind something more than a fucking blog and a couple shitty books.
There are 8,000 diagnoses of testicular cancer in the US every year, that means that, in the two days I lost my mind, forty-two people went to the doctor’s and had the ultrasound and heard “yes, you’ve got cancer.” Forty-two people had to figure out what they’d do when they had the surgery, how they’d make a living when they were out of work, how they’d keep their jobs while they went through chemo. Most of them will survive; testicular cancer is very easily treatable. Some of them will find out they’re going to die, and they’ll have to go to work anyway, they’ll have to figure out what they can leave behind for their kids and have to decide whether or not that was really worthwhile, and how they’re supposed to endure their last months on this earth if they can’t think of anything.
Today, though, it isn’t me, and I’m actually crying with relief when I hear it.
For fuck’s sake, if you can’t cry because you found out you haven’t got a metastasized cancer that’s going to kill you before your son’s first birthday, when the fuck are you supposed to be able to do it?