Update: So many of you have kindly asked about Steve's biopsy. Unfortunately those cells were consistent with malignant melanoma. We were disappointed and shocked, but in a strange way, as each life experience evolves from past -- we're more familiar now with helpful ways to handle this. We truly are survivors, in every sense of the word. That doesn't mean it's easy. Cancer is never easy.
We spent yesterday at MD Anderson meeting with surgical oncologist Merrick Ross, MD and plastic surgeon Steven Kronowitz, MD. The lower portion of his ear will be removed, then reconstructed. As soon as the Dr. Kronowitz said "flap" and "stages," then used the word "patience" at least ten times I knew we were in for more than I'd expected. Since Steve had received prior radiation -- which damages the elasticity of the skin -- reconstruction will have more than the usual risks. After the Dr. Ross makes the wide excision and obtains clear margins, Dr. Kronowitz will follow and secure a flap with skin from behind his ear. This skin is sewed on to what remains of his lower ear. In essence the flap will pin his ear to his neck. This will remain in place until a new blood supply is established. Then the flap will be separated, some cartilage may be taken from his other ear, and he'll be good to go.
For a man who cycles six days out of seven the period of infusing the flap -- which could take up to three months -- might be a kind of purgatory. We didn't even ask about a planned trip to west Texas for cycling in March. He'll ask when he's ready for the answer. Yesterday wasn't that day.
We're grateful that -- as before - this cancer is localized. We're grateful we're within an hour's drive of the country's number one cancer facility. We're grateful for an hour spent in the sunshine in between appointments, sharing a cup of coffee and passing the time of day.
*****
Thomas Avena
Cancer Garden
*****
for the inauguration of the Mt. Zion Cancer Center Garden, 1995
The cancer garden, protected by buildings, one unfinished. Still
the wind will continue through the garden when these walls
are sewn in. Everything known in the cancer garden devolves
to breath. If we can, we open gray chambers and fingers
of the lung. Such breath can sting. Here are vermilion
snapdragons, mild blue agapanthus, poppy. Here in our
veins is the blood of the Madagascar periwinkle; its sulfates --
vincristine, vinblastine, effective against neoplasm.
In the garden we find the man whose veins collapsed nine
times, and each time the neon-colored serum stopped.
The technicians tried their tricks to open a vein, a
and the strange, ambivalent poison stained (oh
how to make these poisons more selective - more
devious and therefore purposeful). In the cancer
garden we are grateful for the slenderness of needles,
the wisdom of the phlebotomist's hand. For the plain
explanation of a doctor -- what is known, and what is
unknown. In the garden there is breath, ambivalence
(in the sense of unknowing - you can live with the fall
of water on your brow, drop by drop). Can you live
with the chill, with bright daubs of petal-bruised flesh,
catheter under the skin. You can look at your body
naked in a mirror, with your hands you can defend
its territories. Is the cancer sinister or blameless? Or
just cells, like all life, with a blind and blinding purpose.
An instinct to survive. In the garden, imagine cancer
as weak and depressed. If the cancer is acid, then the soil
of your body is alkaline; if alkaline, then acid. Let us
pray your body inhospitable to it. Your assertion greater
than that of the cancer -- your desire to live so much the
greater. A riot of marigolds shooting up the spine - a firework
of neutrophil. In the cancer garden all the creatures are active.
Every day, a thousand kindnesses, or a thousand suspicions,
hyper-real, like the furniture of the infusion clinic. In
the cancer garden all of nature is laughing.
from The Occident
Reprinted from:
The Best American Poetry, 1996. Series Editor: David Lehman.
Note about the poet:
Thomas Avena, born in Chicago in l959, wrote this poem at the invitation of Ann Chamberlain, artist-in-residence at the UCSF Mt. Zion Cancer Center. "I wrote about the garden as a physical space, but also as a projection of the body and of the internal war -- and the extreme and bewildering (emphasis mine) processes -- that the cancer patient is forced to undergo. I wanted these lines to flush and fill like the movement of blood within the body. Ann has said that "Cancer Garden" distills the experience of people who pass through the garden. I don't know if this is true, but it contains part of my experience, of Ann's experience, and that of my life's partner..." Avena, his partner and Ann Chamberlain are all cancer survivors.
