In the Garden of Uncertainty
We must cultivate our own garden.
—Voltaire
There are many kinds of readers, including those who read a novel from start to finish, and those who read the last page first, then skim the rest of the book. I place myself in the former camp — perhaps from my graduate school days of studying six centuries worth of French literature, when anything — even footnotes set in the tiniest of fonts — might find its way into a question on a Master’s Comprehensive Exam. I rode the ups and downs of Candide, Pangloss, and Cunégonde, as they narrowly survived earthquakes, enslavement, and being eaten alive, without knowing if they’d all wind up dead by the end. I let Voltaire toy with my vulnerabilities, right to the final page.
It’s not as if I seek out opportunities to add to my life’s helping of cliffhangers. I don’t really know how I got through the nine months preceding my now-grown-up daughter’s birth, after having lost two pregnancies to infantile polycystic kidney disease — a rare genetic disorder neither my then-husband nor I had known we both carried. Nine months of not knowing if the new life we’d created would have a tragic end, like the protagonists in most French novels. Not knowing if it mattered if I forced myself to down cow’s milk by the glassfuls, despite my being lactose intolerant and allergic to dairy, or choked down pink prenatal horse pills. Did it matter if I kept my heart rate below its allotted maximum beats as I waved white scarves above my head at seated aerobics classes? I surrendered myself to the unknown, believing that whatever the outcome, this time I had chosen to place my bet again — the three in four odds in my favor to produce a healthy baby, which I hadn’t managed to achieve during the last two attempts.
I find it easier to tolerate limbo-by-choice, as happens each time I face a blank computer screen. Despite the late hour, the fatigue, the expectation that no poem could possibly bloom in these conditions, so stark except for the Godiva dark chocolate close at hand, I still hold out hope to be proven wrong. And even if I manage to populate the page with letters and words in combinations I hadn’t anticipated, there’s still the question of whether they will ever coalesce. It may happen overnight, like magic beans. It may take nine months. It may never happen.
Sometimes uncertainty flushes us out, despite our best efforts to hide. I’ve always been a bit of a hypochondriac, so to lessen my anxiety, I’ve tried to follow a healthy regime of diet, exercise, and sleep, though I’ve never been able to kick the sugar habit. I drink in moderation, never smoked, and only dabbled in drugs that are now legal for recreational use in eleven states. Six years ago, I was blindsided by a diagnosis of early-stage invasive ductal carcinoma, grade three. The four-day wait between the initial mammogram to the confirming biopsy was unbearable, as I felt myself free falling into the existential néant. The post-diagnosis second-guessing was worse. Lumpectomy or mastectomy? A full course of radiation, or just nineteen days? A boost or no boost of x-rays directly aimed at the tumor bed, close to my heart? Tamoxifen or aromatase inhibitors as follow-up treatment? The most difficult decision involved whether to go four rounds with chemotherapy, with the likelihood of losing all my hair, as well as experiencing some of the plague-like list of side effects described on the drug information sheet which included nausea, neuropathy, thrush, constipation, diarrhea, low white cell counts, anemia, leukemia, scarring of lung tissue, and panic attacks. The choice was mine, as there was no data to confirm that the chemo would significantly reduce my chances of a recurrence. At most it could lower my risk by a few percentage points. Or not at all. My Oncotype score, based on an analysis of twenty-one genes from my tumor sample, did not provide additional insight. Neither did the six medical oncologists with whom I consulted. In the end, I based my decision on knowing I would worry less if I did everything I could possibly do to reduce my risk. I tried to make peace with the fact that my body still had the upper hand, as there was no way to address whether a cancer cell from the original cluster of cells might have stowed away on a blood vessel bound for a distant port. From September to December I focused on dealing with the havoc wreaked by docetaxel and cyclophosphamide and making it to the next round of infusions. When they had to postpone the second round to install a PICC (peripherally inserted central catheter) because they’d managed to permanently mangle the vein they’d used three weeks earlier, I allowed them to thread a thin tube through a vein in my upper right arm to my heart, where the PICC tip eventually met up with my superior vena cava. As I read the release I was required to sign, I tried not to think about all the possible risks and complications, and though it wasn’t listed, bleeding to death from an inadvertent tap to the PICC’s spigot while I slept scared me the most.
After the initial infusion, when side effects appeared out of the blue over the course of the ensuing weeks, like an extended stay in a haunted house, I got used to riding the curve of the 21-day cycle. Some days I barely left my bed. I would go into lock-down mode from Day Five to Day Ten, during which time my blood counts were at their lowest and I was most susceptible to any germ that might happen to cross my path. I flitted around the house like a hausfrau, wiping counter surfaces, doorknobs, and handles of drawers with a paper towel drenched in rubbing alcohol. On days when I couldn’t reschedule the graduate Counseling Ethics course I was teaching, I’d appear in person in a hoodie covering my bald scalp, and a mask stretched over my nose and mouth. I was barely recognizable to my students. I hardly recognized myself.
And now, in this COVID pandemic, I’m no longer the only person I know to have experienced self-quarantine. In the past five months, I have left the house only to walk the dog, weed, and get a mammogram. The garden itself shelters in place, enclosed by a deer-proof fence. A garden even Voltaire would be proud of. No one knows when or how this pandemic will end. No one knows if they will get infected or how their body will react. No one knows how many more people will die by its hand. What we can be sure of is we’ll find out soon enough. For some it will be sooner than later, and they may end up wishing they could return to these days of not knowing. I hope the curve we’ve been working so hard to flatten will have dramatically subsided by the time my tomatoes ripen. For now, each time I step outside, I don a disposable surgical mask. I keep my stash of N95 masks (purchased years ago) under my bathroom sink.