All the Pretty Little Horses

Shannon

So I am sitting in the lobby of the Taussig Cancer Care Center at Cleveland Clinic where Shannon is undergoing her weekly cancer care. She is my eldest sister and turned 37 years old exactly 37 days ago. I’ve been in oncology wards before: in my music therapy training I frequented the cancer wing of a children’s hospital for an entire semester. I sang All the Pretty Little Horses and This Little Light of Mine to children who, as it later turned out, didn’t make it. In the last five years, I’ve had relatives and close friends who have lost mothers to cancer.

But it is strange to be here now, bringing someone I know and love to be injected with the powerful drugs of chemotherapy. This is the closest I’ve come emotionally to this mysterious organism called, quite simply, CANCER, a word that carries so many connotations to so many. Suddenly I am more respectful of the word, it begins to breed fascination within me, even as it begins to infiltrate my emotional being and worm itself deeply into my life. It feels like an inevitable invader; I’ve been the winsome hobbit playing about in Helm’s Deep, listening to stories of battle in distant lands, and suddenly I can look over the wall and see the enemy approaching.

Other people walk by and I look at them with newfound interest, wondering which of them has cancer, what kind and in what stage. For some of them it is not hard to tell – a middle aged man sporting a chemo pump walks back and forth through the maze of chairs and end tables as though he owns the place, his tubing flopping wildly down the side of his leg. A woman in a scarf walks with timid steps, closely attended by a younger man, perhaps her son. Suddenly amidst all these people, cancer starts to feel normal.

We walk back towards the exam rooms – the nurse asks Shannon to step on the scale. My other sister Dawn watches the numbers toggle up until they are still and whispers to me excitedly, “She’s gained weight!” I can’t remember a time when my sisters were excited about weight gain. But Shannon’s face lights up too as she steps off the scale, proud to have added three pounds. This is when I am hit with the realization that there is an organism trying to destroy my sister’s body and that her life is on the line.

My pediatrician wife was right; the objectivity of medicine can be stunning at first. The nurse needs to know numbers and statistics: weight, allergies, birth date, etc. Shannon and her experience in the last week are reduced to a checklist, a few quick clicks of the mouse. We sit in the pale exam room to wait for the oncologist and again the realization of cancer hits me in a wave – Shannon suited up in her dressy Russian way, out on the town in her high leather boots and long brown skirt. She looks like she could be attending an Orthodox service on Sunday. She tells me that these are the only shoes she has for going out; she was only planning to be in the States for a few weeks and did not pack extra clothes. But all that has changed since her diagnosis about a month ago. As we wait, Shannon eats some applesauce from a small container she pulls out of her bag. She eats frequently now, in small amounts – she’s tried her best to gain weight this week. Last week was her “bad chemo” week – after her first cycle of the heavy drugs – she lost 7 pounds – she was simply unable to eat.

But the gentle humanity of medicine is just as stunning. The next nurse gingerly rinses Shannon’s pump with saline – she seems comfortable with the amazing direct access to a beating heart. It makes Shannon seem so fragile, having the vein of the port hanging out in mid-air. The nurse’s face is soft and compassionate as though she might be caring for one of her children. The needle of the replacement pump looks like a giant thumbtack and she presses this into the port, buried just under Shannon’s skin. She pulls a little blood to verify access – the tubing flashes bright red before being pushed back into Shannon’s body with more saline. The work is delicate and the nurse performs it with careful precision and quiet confidence.

I think of the bodies of cancer patients as nothing less than a medieval battleground; three armies coming together in an epic war. The invading army CANCER comes in black cloaks, infiltrating swift and unseen, attacking in the dead of night without warning. The white army LIFE wakes up in a daze, startled and shocked, gathering its forces at the sudden call to arms. The red army CHEMOTHERAPY rides upon powerful horses, a necessary ally but also a pitted foe. Its red fury takes out both black and white soldiers alike. There is this amazing interlock of forces, drugs, blood, dividing cells and the will to live. The stake is ultimate: the life and dignity of their host.

“So how has cancer changed your perspective on life?” I ask on the way home.

“It’s helped me to realize how little control we really have over our lives,” she says. She talks about learning that, oddly enough, cancer and peace can go hand in hand. “There’s this odd absence of fear in other areas of my life.”

I pose the theory that; perhaps because she is forced to face “the big one” (the fear of death) then she doesn’t have to worry about all the little ones. Then I reconsider, “– but then, facing the big one isn’t necessarily peaceful.”

“It can be,” she says with confidence, “once you come to terms with it.”

“How have you come to terms with it?”

She thinks briefly before answering. “The bottom line for me is knowing the character of God.” She counts on her fingers as she lists His attributes, “God is gracious, God is merciful, God is loving, God is in control, God is all-powerful . . . if I’m going to believe the Bible, then those are things I have to accept. He knew about the first cancer cell and chose not to do anything about it, He let them pile up on top of each other – there must be a reason.”

I listen intently, trying to let it all sink in. My faith is not quite so clear it would seem. I don’t feel ready to face the big one. I don’t feel quite ready to hand over to God the right to our lives like this.

Shannon shows me a picture of her tumor – it curls up into her esophagus brightly pink. The way its shape resembles a piece of jumbo shrimp is unnerving. I had always imagined tumors as purplish gray, kind of like the stuff that grows on sweet corn, but this one is a luminous-healthy pink – it’s scary how alive that tumor looks. How can that thing, the size of a shrimp, have the potential to bring Shannon down? Shannon: the climber of mountains, the swimmer of arctic waters, the pursuer of adventures, the over comer of challenges?

For all that is going on, Shannon seems to be taking it well. I know that her faith doesn’t always come this easy; I’ve seen her shivering in tearful fear after losing a large amount of hair. But today she is chatty and cheerful; she seems relaxed, almost confident. I realize that for now, this is her mountain and her adventure: driving to Cleveland, talking to her doctor, getting her pump changed, receiving treatment, dealing with side effects, eating as healthily as she can, regaining her strength after chemo, working back up to running short distances – she takes this as her challenge and is, for the moment, without fear, her confidence placed in the unchanging character of God.

“We think we can chart our own course in life,” she says with a half-grin, “but we don’t do anything without God.”

Shannon and Dawn at Taussig Cancer Care Center