So far it had been the best year of my life. In love and friendship I was lavishly endowed. I'd recently published a new play -- my twelfth book in the twenty-two years since my first, A Long and Happy Life. They'd all been received more generously than not by the nation's book journalists and buyers. I'd been steadily rewarded with understanding readers of many kinds; and I'd earned a sizable income from a brand of work that was mostly deep pleasure in the doing. For twenty-six years I'd also taught English literature and narrative writing at Duke University. The annual one semester's work with good students was not a financial necessity for me but a test of sanity against the touchstone of merciless young minds. I'd lived for nearly two decades, alone by choice, in an ample house by a pond and woods that teemed with wildlife; and in February I'd turned fifty-one, apparently hale.
The previous fall, October '83, I'd gone with a friend to Israel. It was my second visit in three years to a place that had fed my curiosity since childhood and was promising now to enter my work. To save at least some of the goodness of the year, I'd begun to keep a daybook called Days and Nights. It consisted of quickly written poems, each triggered by some aspect of the pile-up of happiness and recompense in the long calm days. By the spring of 1984 I'd finished the first third of my sixth novel, Kate Vaiden.
But as the son of a father who'd always doubted his rare good luck and who died at fifty-four, I'd begun to hear occasional ominous chords. In all the elation of recent months, I somehow knew I was on a thin-aired precipice. I knew I'd come down gently or hard; and by early April the daybook poems, more alert than I, were well aware that an end was near. One poem called "Caw" even sounds a knell for the run of luck.
Splayed face-down on the last pool of sleep,
I'm gaffed by caw-caw from one distant crow.
What Roman would rise to face this day?
Half an hour later I loom at the pond window,
Glum while my two globes of barnyard cholesterol
Gurgle behind me in salt-free fat
To the tune of the radio voice of charles Simic
Who suddenly flings out a cold crow poem.
What human would join me to face this day?
But I barely listened to the curious warnings, and the next few poems are about new love. My main response to the racing days still had to be thanks, thanks and the care to save these memories against an ending.
Then on a clear day in mid-April, I was walking through the crowded Duke campus with a friend and colleague, George Williams, a man more watchful than most. After a few silent yards, he said "Why are you slapping your left foot on the pavement?"
I laughed at what seemed a rare error in his observations and said that I wasn't -- I was wearing thong sandals that tended to shuffle. But I took a few more steps and heard he was right. This was no shuffle; I was lifting my left foot higher than usual and slapping it stiffly down on the pavement. If I thought the motion was more than odd at the time, I didn't act on it or begin to worry.
A few days later in my neighborhood video-rental store, I was laughing with the manager about our mutual plight as temperance fiends in a nation drunk on exercise. She said she'd started to jog at home on a stationary platform beside the TV. On the spot I tried to jog a few steps in place. My right leg wouldn't flex back off the floor. I could easily pull the foot backward with my hand and touch it to the back of my thigh, but on its own it couldn't respond to a mental command -- couldn't or wouldn't? Before I could register puzzlement, my friend said "You're even worse off than me."
We laughed and dropped it, but later that day I phoned the cardiovascular-health unit at Duke to ask about joining a new middle-aged exercise group in which a few of my contemporaries were already thumping and jerking and lunching on sprouts.
And that same evening I started at least to face what I believed was the problem. I was just past fifty-one years old, weighing 167 -- thirty pounds more than I'd weighed in high school. In measuring my height recently, I'd discovered that I'd somehow lost an inch -- I was now five-nine. Age was firmly staking its claims; I was starting to soften. For several years, when walking down stairs, I'd felt a sense of risky balance -- I'd sometimes even take the arm of the person beside me -- but I chalked that queasiness up to the bifocal glasses I'd worn in recent years.
Over the past months I'd also noticed a slowing down in sexual need and exertions; and though that need had won me a large part of the pleasures of my life, oddly the slowing didn't alarm me. I didn't feel unmanned, I didn't feel compelled to retire prematurely from an ongoing joy, I felt a natural change under way and was ready to let it define its course. Then in roaming the steep hills of Israel, I'd damaged the cartilage in one of my knees, but that eased quickly once I was home and took a few weeks of an anti-inflammatory drug.
From memories of my own father's early fifties, and from watching older male friends through the years, I'd assumed such losses came with the territory. Hadn't Father often fulminated that "These damned bifocals will kill me yet"; and hadn't my mother always said "After forty, it's maintenance, maintenance, maintenance"? Well, now I'd need to admit there were problems and begin to confront them. But the prospect of regular huffing and puffing with squads of garrulous heart-attack survivors in designer sweat suits was hardly beckoning, so I pushed the unattractive details of the cardiac-health unit to the back of my desk. Drastic remedies didn't seem called for. I'd handled this aging body on my own.
On my own had been the motto of most of my life -- in exercise, in work and much else. As a boy who spent his early childhood with no brothers or sisters and no playmates, I'd missed an early exposure to communal games. My pastimes were mostly solitary. And once we moved into town among other boys when I was in the third grade, I was soon aware not only of my inexperience on teams but also of a full set of butterfingers at the ends of both arms. I caught and threw badly; and after a burst of hard play, I'd often need to stand very still till my jumbled vision and whirling head could take their bearings. By the age of nine, with the private help of an older boy, I'd grown into a dependable touch-football lineman, a middling batter in softball; and later I became a roller-skate ace; but I loved none of them and was often the last team-member chosen from a motley pool. So once I was past compulsory gym class in high school and college, I gladly quit the playing fields.
Even in the bone-chilling torpor of my graduate years in the Thames valley of England, where I'd gone on a scholarship that expected physical vigor of me, exercise was never more strenuous than the odd walk or occasional swim. Generally I saw both activities as pointless interruptions of all that mattered, which were love and work -- friends often called me "The Great Indoorsman." And now, by the early eighties, the exercise fads of the 1970s were alarmingly widespread. In the late seventies I'd bought my first pair of running shoes and glumly circled my big upper pasture for a few months at the urging of an orthopedist whom I consulted about a stiff lower back. But I soon gave in to the boredom and bugs and retired the shoes. Surely this new flock of driven joggers and jerkers were insuring a future of agonized joints. Why not take comfort in the memory of my numerous kin on both sides of my family? They'd been virtually motionless through long lives yet were clearheaded straight to their fully dressed deaths. So sure, start working it out on your own, but gradually.
By the end of April '84 thought, I'd got two more warnings. On the night of the final examination in my Milton class, I made myself a sandwich at home and ate it quickly with one gin and tonic -- two ounces of gin. When I parked in the dusk and set off toward the building where my students waited for seven o'clock, I was startled to feel that I was nearly drunk. All my life I'd had a glass head for even small amounts of alcohol, but this slip on a class night was unprecedented. I took the firmest grip I could get on my faculties, proceeded across campus with the exaggerated caution of a Chaplinesque souse and gave the exam. No one seemed to notice; and before the students were done three hours later, my equilibrium had returned, though my sense had deepened that something was eerie.
Two days later as I parked on campus again to return final grades, I glanced at my watch and saw it was nearly five o'clock; the registrar's office would close on the dot. I should hurry along. I know I thought Run, a conscious signal, but I couldn't run. The command had got no father than my brain. Some bridge was out. I stalled like a man on a menacing plain in a nightmare, inexplicably paralyzed. In a moment however I found I could walk at normal speed, though I had to concentrate not to veer or stumble.
I was concerned but still not quite scared enough to mention the newness to any friend or to see a doctor. I'd seen the needless punishment my parents took in their sad deaths, and I'd skirted doctors whenever I could. Again I reminded myself that I was just a man in broad mid-life with the muscle tone of a raw scallop. I still wouldn't join the old puffer-bellies at cardiac care. I'd start again jogging in the buggy pasture and cycling on the stationary bike I'd bought a few years back and quickly abandoned. And I really applied myself to the bike, half an hour twice a day. My legs obeyed me on the go-nowhere pedals, but after each session I'd feel like an octogenarian who's barely survived collision with a brick wall. I'd yet to feel any trace of pain, just immense exhaustion.
A quickly written poem in the daybook tries to paper over the widening chasm. It describes my fatigue and ends with
Rest. The promise of a week like silt
In a sweetwater delta, stirred only by minnows
And the mutter of each slow skin of nacre
As it welds to the pearl of a somnolent oyster --
Mindless companion while I too mutter
Round my gritty core, this ruined glad life.
I'd give myself that week of rest, then return to work on my novel Kate Vaiden. With any luck I'd have it finished by the end of the year.
The relaxation and busywork on the indoor bike eased my mind, despite the fact that in public I had to pay even closer attention to walking straight and that I'd begun to dwell on two words in the night -- multiple sclerosis, a generally slow process in which the body's immune cells attack the protective sheathing of the nerves and produce effects that range in severity from blurred vision and mild numbness to blindness and total paralysis. An old friend of mine had it in a bad form. She lived in a wheelchair now; and I'd visited her recently to find that her husband had moved out, leaving her alone and vulnerable in an insecure house. So her plight was a fearsome possibility; but on down toward the end of May, I went about my work and friendships with no concession to the gathering weakness and with surely no thought of seeing a doctor.
Then on Saturday, May 26th, I served as best man at the wedding of my friends Jeffrey Anderson and Lettie Randall -- a fine mild afternoon, the guests uphill beneath a tent, live music beyond us in the trees. When the moment came to climb the incline toward the tent, Jeff motioned to me and led the way. I fell in beside him but by the third stride, I was in real trouble. There was no pain or dizziness, no fear of falling, just the fact that my legs were barely hearing my will to walk. I honestly didn't think I'd make it up the gentle slope. But some old overdrive kicked in, and somehow I was there at last on level ground with the bride and groom. The service went on and at the reception no one seemed to have noticed my trouble, so I laughed my way through a bibulous hour. But how much of this is in my mind?
On the Monday afternoon I went to a humane physician, an internist at Duke Hospital, a man slightly younger than I. He spent five minutes checking my reflexes with a rubber hammer. The responses looked normal to me. But the doctor stepped out and came back immediately with a staff neurologist, who repeated the check -- no words between them. Then both men went out and shut the door; three minutes later they were back, poker-faced. Some of my long-nerve tracts were blocked. I'd need to come in for further tests, "a complete neurological work-up."
I said I was off to New York in a few days for a week's business but would then be free.
They glanced at each other; and the internist said "No, we need you now." I noted that they needed me, not that I needed them.
The neurologist stood in silence, nodding blankly.
That was my first real body blow from fear. They're in earnest. This is big. I recall that the cramped examining room seemed near to exploding with excess light.
I've had very little success through the years in my efforts at keeping a journal. In numerous attempts since adolescence, the process has left me even more detached and introspective than is natural for a bookish ex-boy who became a lone writer through most of his youth and adult life. For me, despite sporadic tries at a diary, my writing life has found sufficient pleasure in managing characters in fiction and plays. It's left slim need to manipulate friends to perform more interestingly for their next appearance in a journal. And the tedium of rehashing an uneventful day at the desk has likewise discouraged me -- most productive writers live calmer lives than winkles.
But since the late 1950s when I got my first job teaching, I've needed simple daily calendars. And I've saved them all since, while they mostly record nothing more momentous than who I saw at dinner, I've sometimes noted a crucial event. Unlike the daybook of poems that I'd lately been keeping however, my calendar for May '84 shows oddly no suspicion of the growing strangeness in my body till it summarizes the doctors' advice on the 28th -- "my immediate entry in hospital for neurological tests." It adds that I phoned two friends that evening with the news. Then alone I watched the film All That Jazz, a choice that proved inappropriate -- there's a gruesomely depicted fatal surgery near the end.
But I have no memory of feelings from that night, the following day or the next half-day before I entered the hospital on Wednesday, May 30th '84. The calendar shows that on Tuesday morning, for encouragement, I phoned a friend who was studying in South Africa; and I met a friend at noon for lunch and another for dinner that night, after which -- alone again -- I watched another film, The Last Wave, a humorless Australian fantasy.
Surely during that hollow pause my mind must have run the odds time after time -- multiple sclerosis, brain tumor, an inoperable cerebral aneurysm of the sort that had blinded and killed my mother. And since I've been an unorthodox non-churchly believer all my life, I must have prayed for stamina and mercy. I must have phoned my brother Bill in Raleigh, the man who'd bear the brunt of my care if care were needed. I know I told very few other people; that could wait for a clear diagnosis.
Yet from here I can read my sense of omen in the fact that I wrote no daybook poem on the prospect of my first hospital stay in twenty-nine years, and I made no other calendar notes beyond the bare facts of time and place. Of the Wednesday itself I only recall that my friend and fellow writer Elizabeth Cox came to my house in midafternoon. She'd offered to drive me in for the tests; I'd leave my car at home for safety. I took up my overnight bag, and Betsy and I paused in the yard to register the weird dull-pewter light from a partial eclipse of the spring sun which we watched in safety through a pinprick filter that I'd just made with two shirt-cardboards.
Then we rode four miles to Duke Hospital North, a big new complex on a street I'd traveled thousands of times since I'd come to town as a college freshman. As I left the car on my own steam, I moved again in the still-strange light of the eclipse. Recalling my boyhood reading about the superstitions of ancient Romans, I laughed back to Betsy and said something like "No self-respecting Roman would do this in a real eclipse." But I took my bag and walked through the wide doors, wobbly though upright, still with no trace of pain -- my last free walk.
After the usual welcoming session with a sullen admissions clerk in the lobby, I was installed in a private room on the neurology ward. Once I'd provided a painless technician with unnervingly large amounts of fresh blood, I was interviewed by an especially confident young resident -- the usual family history back to Adam and stage-comic questions to explore my sanity: "What day is this? Who's the president of the United States?"
Like most of the sane, I tried to answer amusingly; the resident was too young not to laugh. So only at the end of his clipboard of questions, when I crossed my right leg over my left and exposed my naked heel, did gravity reassert its grip.
The resident leaned down, touched a spot in the soft of my heel, stared for five seconds and said "That's called vermiculation."
As a Latin student I knew that words containing the syllable verm- tend to involve worms; and when I looked, the skin he'd touched was writhing steadily in silent tremors as if a knot of thin worms just under the surface was boiling upward. I asked what it meant.
He said "In general, pressure on nerves."
Someway I stayed even-keeled after that. The legacy of physical dread I'd got from my hypochondriac father had suddenly left me. I managed an undisturbed afternoon nap; and after routine pre-dinner visits from my internist and neurologist, I knew nothing more. Inquisitive to a fault though I'd been all my life, some deep-down voice was running me now. Its primal aim was self-preservation. Don't make them tell you, and it may not happen. Whatever they tell you may be wrong anyhow. Stay quiet. Stay dark.
In the evening I had my first CAT scan with a pleasantly jokey woman technician who gave no opinions; and I asked for none, though the core of my spine was displayed there on a screen before her. I was gambling that her levity meant that the images were good. I said to myself They'll tell you in time.
That proved to be at five o'clock the next afternoon; and the news unfolded decidedly on the staff's time, not mine. In the morning I'd had an unanesthetized hour of excruciating tests that required the insertion of large blunt-needle electrodes into the major nerves of my legs to measure the speed of motor impulses. Bad as it was, the hour provided my first acquaintance with the dry little knot of hospital pride that would be one of my few medical pleasures in coming months. However briefly, I could think They may not have thrown the worst at you yet, but so far you've caught all their pitches.
When the doctor who was measuring my nerve velocities learned that I was a writer, like so many laymen he deputized me an instant confessor. In a quiet hurry he all but told me his main secret. Something had bent his life nearly double several years ago -- he got as far as saying he'd dropped out from medicine entirely and had returned only recently.
A seasoned listener, I dug no further but went on nodding.
Lately he'd come back from where he'd gone and had restarted here, this small clean lab. But for whatever reasons, he stopped his personal story there -- he was a big-framed gentle creature. One final time he gouged his metal probes into my cringing long leg-nerves and said "You're tough. Just yesterday we had a professional football player in here for this, and he had to be led out screaming after thirty seconds."
By now the playground-dud buried in me was forced to smile.
The conclusive test was a myelogram, another thoroughly uncomfortable study involving the injection of an opaque dye into my spinal fluid, followed by a set of X rays down the length of my cord. It was less gruesome than the nerve-speed probes; but it added weight to my growing sense of being consumed by a single vast live idiot creature concealed throughout this enormous building. The creature had just one blank eye of the keenest focus and not one atom of self-awareness or even remorse at its endlessly accumulating knowledge, its power over the building's inhabitants -- sick and well -- and its impotence or refusal to help them.
At five o'clock on that second day, I was lying on a stretcher in a crowded hallway, wearing only one of those backless hip-length gowns designed by the standard medical-warehouse sadist. Like all such wearers I was passed and stared at by the usual throng of stunned pedestrians who swarm hospitals round the world.
My brother Bill Price was standing beside me, trying as ever to lift the tone with continuous jokes -- a trait of our mother's; our brilliantly comic father would have been lugubrious here.
I was keeping up my lifelong role, straight man to his quips, when we saw my two original doctors bound our way with a chart in hand.
The initial internist would show his concern through years to come; but all I recall the two men saying that instant, then and there in the hallway mob scene, was "The upper ten or twelve inches of your spinal cord have swelled and are crowding the available space. The cause could be a tumor, a large cyst or something else. We recommend immediate surgery." I could hear they were betting on a long tumor, though I'd never heard of a tumor inside the cord itself. They mentioned the name of a young staff neurosurgeon they admired, and they suggested I go back to my room and await his visit.
Then they moved on, leaving me and my brother empty as wind socks, stared at by strangers.
As a member of the last American generation reared by the old-time family doctor of endless accessibility and tact, I'll have later chances here to expand on the well-known but endlessly deplorable and faceless -- sometimes near-criminal -- nature of so much current medicine. For now I'll flag a single question, familiar to millions in similar corners. What would those two splendidly trained men have lost if they'd waited to pay their trump till I was back in the private room for which Blue Cross was paying our mutual employer, Duke, a sizable mint in my behalf?
At least on private ground, with the door shut, the inevitable shock of awful news could have been absorbed, apart from the eyes of alien gawkers, by the only two human beings involved. It might have taken the doctors five minutes longer; and minutes are scarce, I understand, in their crowded days. I also know that for doctors who work, from dawn to night, in the same drab halls, it all no doubt feels like one room. But any patient can tell them it's not, and I've often wondered how many other such devastating messages they bore that day to actual humans as thoroughly unready as I for the news.
The neurosurgeon entered my room a half hour later. He was Allan Friedman, then a small-bodied man in his early to mid-thirties with mad-scientist spectacles, a full mustache and a square jaw. My mother had undergone brain surgery at Duke Hospital in 1963; so I was familiar with the general staff attitude toward neurosurgeons -- that they're the most brilliant, most heavily pressed and difficult of that strange band who've made the choice to spend their adult lives cutting people. And at first sight Friedman did look a little extraplanetary, largely because of his thick glasses and intensely grave demeanor.
I'd experience his attentive concern in years to come; but at first sight I only thought in bold colors, He's alarmingly young, at least fifteen years my junior; but that may be good -- his hands will be steady. I also thought that his youth might link him with the test-pilot daring which characterized American neurosurgeons of earlier days. And in fact early in our first meeting, Friedman distinguished himself from those older heroes by saying that neurosurgeons now tended to be a good deal more restrained in approaching organs as fragile as the brain and spinal cord. He said in effect that the old-timers loved "heroic procedures," going in and tearing out an alien presence, however devastating to the patient; current surgeons were more cautious.
But first he sat with me and Bill and gave us his version of my possibilities. There seemed to be something foreign within my upper spine -- the normal cord is roughly the size of an adult thumb. The thing inside me had put a sizable kink in my vertebrae, a curve that might well explain my lost height. Worse, it had swollen the volume of my cord till the cord was crowding the hollow canal through the vertebrae.
That crowding resulted inevitably in a compression of the thousands of so-far-irreparable nerve fibers that make the cord such a vital but vulnerable cable. The crowding had probably, for months or years, developed slowly enough for my cord and brain to accommodate the pressure. But lately they'd run out of dodges and detours. That would explain the relatively sudden rush of symptoms after healthy-seeming decades. Our best hope would be for a large cyst that could be surgically drained and permanently shunted. A worse case would be a benign tumor that might or might not lend itself to harmless extraction. Successful removal would depend upon whether the tumor was self-encapsulated within the spinal tissue or had infiltrated the tissue so intricately that it couldn't be dissected without my death or total paralysis.
The worst case would be an infiltrating tumor which proved malignant. No further external procedures could tell us much more about the problem. The magnetic resonance imager or MRI, so useful now in soft-tissue studies, would not reach most American hospitals for another few months. Having laid out that bill of particulars, Friedman recommended immediate surgery. This was late Thursday afternoon; his Friday schedule was filled -- on Monday morning then.
I remember asking "What if I decline surgery?"
He said my symptoms would rapidly worsen. He didn't elaborate.
As a child-veteran of the polio epidemics of the 1940s -- one who'd visited an iron-lung ward with its rows of trapped children whose lungs were paralyzed -- I understood that the nerves controlling my lungs and diaphragm would likely be next to surrender to the pressure. I was only beginning to realize that all my doctors had now entered their laconic "Tell-him-nothing-he-doesn't-ask-for" mode, but I doubt I asked another question -- no fishing for predictions or probabilities. My buried censor was guarding me still against news I couldn't handle at present.
With the keen sympathy of our forty-three years together, through thick and thin, Bill likewise asked nothing.
Since I was in one of the world's major hospitals -- one in which I'd be treated by my university colleagues and where virtually all my expenses would be paid by the generous insurance policy provided by an unusually benign employer -- I never considered taking second opinions. I turned to Bill and said "There's no choice."
A veteran of Vietnam and the Navy, Bill had always made quick decisions like mine, for good or bad. He nodded now and said "Apparently." It was another trait we'd learned from our mother, an instinctive quick-mover; our father would agonize for months at the simplest pair of options.
I also know that at the moment I could recall our half-blind mother's voice, long years ago, in this same hospital. After days of primitive and excruciating tests in an effort to find the cause of her blindness, a blunderbuss neurologist had loudly told me at her open room-door, "It's the worst thing it could possibly be -- two large aneurysms deep in her brain."
When I'd gone in to her moments later with a gentler version, she'd borne it strongly with a single nod -- "All my life I've been the Jonah" (the single passenger thrown overboard at the height of a storm to save the ship, then caught and trapped in a whale's dark belly).
Was I the family's next stunned Jonah? There was no time to think.
Friedman was on his feet to leave, silent and staring.
I told him to make plans for Monday morning.
A moment after he left the room and shut the door, I heard a firm knock. It was Dorothy Roberts, a friend of long standing and of wolf-den loyalty. She also worked in the English Department, we'd been sworn friends for three decades, and now she'd brought me a stack of the day's mail. I'd stood with her through two removals of ruptured discs in this same place a few years back, and the sight of her great dark eyes at this moment caved me in. I was with two people I trusted as much as anyone alive; they'd never done me the slightest harm. For the first time yet, I broke down and wept.
Bill and Dot stayed near till I calmed a minute later, and then we laid out the little we knew like a stockade around us against the unknown. Neither one of them stooped to sham consolations. What they had to give was their honest presence; and while that constituted a lot, soon I asked them to let me be. If I was going to fold up again, I'd do it on my own time.
Once they'd left I ate a cold supper and spent the evening in the dark watching a televised documentary on the history of the ballet Giselle. I don't recall indulging in any hard fear or deep soul-searching. Doubtless I prayed for God's will to be worked, and I'm sure I added the usual clear postscript reminding him of my wishes in the matter -- he mustn't act on an insufficient sense of my needs. This much though is sure from that night; before I slept I wrote another poem in the daybook.
At five p.m., grim as Charon's punt,
The neurologist finds me on my stretcher by the door
Of the radiological torture-tank
In which four searchers kind as children
Have found the fault -- "A ten-inch tumor
On your spinal cord."
Now at nine
I lie here alone, flanked by chatter and howls,
And watch TV -- a flabby endless
Documentary "Portrait of Giselle,"
Starring Anton Dolin with clips of Markova,
Alonso, Makarova: each her own
Absurd self blazed by white elation,
Cause of the helpless joy I sport
In this hot stale proliferating dark.
My hands had been coached since early childhood by excellent teachers to attempt such fending at the first sign of threat.
And Saturday morning I managed a final entry before the surgical pause.
My name is Edward Reynolds Price,
So here on the ward I'm Edward Price.
Last night I looked at my new neighbor's door.
He's Edward Reynolds, plain as ink.
Which one of us is the other's doppelgänger?
Scapegoat? Porter of an alternate fate?
Later that Saturday I was rolled back to radiology for arteriograms, X-ray studies of my spinal arteries. Friedman wanted as full a sense as possible of the terrain he was about to enter. Twenty-one years ago arteriograms had been the test that diagnosed my mother's aneurysms. They'd also nearly killed her with pain, shock and violent nausea -- the only event in her life she told me she'd never willingly repeat. I mentioned that memory to the same technicians who'd managed the myelogram on Friday, and they assured me that the opaque dyes had been greatly improved in two decades and were much less toxic. I should only feel a brief slight burning.
The test was brief but hardly slight. As the dye jetted into my right arm, I could follow its scalding path through my chest, up into my brain, down my spine -- with a pause at my butthole -- then out both legs. I never asked the cheerful technicians if they learned any news, and they told me none.
But the young presiding radiologist followed my stretcher out and said he was sorry to have been the one to find my trouble. His kindness was startling in its newness; and before I could thank him, he added a sentence I've often recalled. "See, at first I thought you had something even worse than this."
I asked him what.
He said "M.S." -- multiple sclerosis.
For what it was worth at that bleak point, I knew that my early fear had been realistic; and the laughing atmosphere of the X-ray tank gave me a brief whiff of hope that now I'd entered some big joint effort to rescue my spinal cord and legs -- the kind of World War II alliance I'd known as a boy, to stop the marauder and reclaim lost ground.
After the hot arteriograms there was little to do but wait out a long spring weekend, talking with visitors, calling more friends, searching the unlikely hospital air and the faces of busy nurses and interns for favorable omens. Again I'm sure I must have prayed. Since adolescence, short and long prayers have seldom failed to be a reflex for me. In fear or pleasure I generally find myself saying "Over to you; your will be done."
But I don't recall any special tack from that long weekend or any deals I offered to cut with God in return for life or the movement of my four limbs or the use of my lungs. Maybe I was allowing, barely allowing, for the kind of last-moment rescue I'd known more than once from childhood convulsions and bronchial seizures. I was old enough to believe in catastrophe, but I wouldn't beckon it onward toward me.
Strangely I don't recall dread either, though since shortly after my father's terrible death from lung cancer three decades before, I'd had several bouts of cancer phobia. I'd grow convinced that a lump or spot I'd newly discovered was oncoming death, and I'd often refuse to trust the doctors who'd tell me the little knot in my side or chest was benign. I'd insist on tests that, till now, had always confirmed the doctor's opinion -- nothing there, I was safe. In retrospect, surely the tests had been inadequate.
Now I almost surely wasn't safe. A tumor was almost surely in me at last. Hadn't my unconscious mind long ago detected its alien presence and tried to warn me in general terms through all these years -- terms that had proved unconformable till now and had lulled me falsely? Why had I refused to pursue the warnings and make earlier doctors search even harder? Were we all too late now? And wasn't the only present question Can the tumor come out and leave me alive? Maybe I should have been stiff with apprehension, but the weight of Allan Friedman's answer last Friday in response to my only question -- my surgical risks were death or quadriplegia -- had stunned my mind into silent patience.
I remember the Sunday afternoon in hard detail. It was hot and dry, a fine green June 3rd; and Friedman had said I could visit home if I'd be back by five o'clock. Bill and Pia, my sister-in-law, had driven the twenty-five miles from Raleigh to get me. I walked out in street clothes with them for the six-minute ride to my house, which lay in open country.
On the way neither Bill nor I spoke of the parallel; but both of us thought of another Sunday, in February '54, when our father's surgeon gave him permission to leave the hospital and visit our home before they explored his lung Monday morning. The lung proved to be chocked with cancer; and though they removed it, Father died six days later, suffocated.
At my house Pia made coffee; and the three of us sat and tried to mimic a normal visit with the teasing games of raillery we'd played so well for years, concealing both our care and our mild normal family resentments. But after an hour the strain was too great. I took a wobbly look upstairs in my bedroom at the wall of pictures of friends and loves I'd assembled to face me, morning and night; these reminders of their presence had been both a source of delight and a good wailing-wall for years now -- they could listen mutely.
And since I'd notified all those friends who were still alive, I thought I could sense their hope like a firm wind at my back. It felt like the pressure of transmitted courage, sent from as far off as Britain and Africa; and that was the thing I needed most now -- that and the effort to string a usable line of communication with what I call God. Even a person who lacks any sense of a watchful creator may be excused in a storm for grasping at whatever looks remotely like help, and I've never known a full hour of doubt that I was made and watched by the single source of all life.
What I hadn't felt, except for that brief breakup on Friday, was real self-pity. The odds, however badly skewed, seemed beatable still, though as we drove away from the house again in late afternoon, I couldn't help trying to burn certain sights deep into my mind -- the old beech trees with trunks the color and shape of elephant legs, the pond that for so many years had harbored a particular great blue heron, the house itself that had sheltered me and my friends for nineteen years. When we'd driven our father back to Rex Hospital after his visit home before surgery, he never saw any of it again -- neither the place nor his younger son Bill nor his wife nor me, except through the haze of a drugged last agony.
I was back on the ward by five o'clock -- Bill would join me again at dawn -- and soon Friedman entered with the formal release for surgery. Again he had the duty to repeat his earlier warning of the risk of death or total paralysis, and he didn't attempt to couch his errand in any attempt at consolation. There's presumably no way to make such a moment palatable; and he didn't try, which was just as well. It may even have been on that same visit that he gave the first of several welcome openings onto who he was. At about that time anyhow he told me "I'm the kind of guy who goes to a convention of neurosurgeons in Geneva; and when all the others head out to dinner, I wind up in the nearest library, reading case studies."
I appreciated his bald candor that Sunday afternoon; and since he looked grimmer than I felt, I obeyed an impulse to cheer him up with a recent joke.
He gave me the first grin I'd seen on him; but it faded fast as it always would -- young as he was, he'd seen a great deal of pain.
Then I signed his release with what flair I could muster. As I watched his back leave the room however, I told myself You've put your life in the hands of a boy young enough to be your son.
I spent the rest of a dinnerless evening in another small lab with a likable young woman who performed a set of evoked-potential tests on my relevant nerve tracts. They were less painful than the earlier leg-velocity tests; and since I'd been given a mild sedative, they proved an oddly peaceful diversion. By the time they were done, I was tired and -- after more phone calls to and from friends -- I slept with no trouble till a while before dawn when Bill walked in, then Jeff Anderson just back from his honeymoon; and shortly behind them at 6:15, the regulation two men in loose green suits with a stretcher.
What I mainly saw though was an earlier dawn when Bill and I had joined our mother before her brain surgery. Bad as we felt when we entered the room, she was upright on pillows with a scarf round her head. At the sight of us, she tore off the scarf, revealing her newly shaved bare skull and exclaiming "Khrushchev!" -- the Russian leader then, as bald as she. Then she laughed and said "Please finish the Twenty-third Psalm for me." She'd tried all night to get past "He leadeth me beside still waters."
It would be my first surgery since I lost my tonsils at eighteen months, and the thought of a long anesthetized day at the mercy of knives weighed on me more than the prospect of death or paralysis. All through childhood I'd heard adults describe the effects they'd suffered from ether -- clanging noises, sirens and bells, nightmares and the urge to babble secrets. So I won't claim to being eager to lay myself on the narrow stretcher and have a white sheet pulled up to my chin, but I felt as ready as I'd ever be for such an uncontrollable venture, and I moved on my own steam through the short gap from bed to stretcher.
The stretcher bearers reminded me to remove my ring, a black onyx my father had given me when I was nineteen. And for a moment I recalled that for years a simple holograph will had lurked inside my desk at home. I'd made no attempt to update it in the midst of this crisis. It was too late now to do more than take off the ring, the small chain with a cross, and my spectacles. I held them out to Jeff for safekeeping.
The glasses slipped between our hands and cracked on the floor -- an omen of course, however we tried to dismiss it with laughter.
By the time we'd passed a few smiling nurses and were on the elevator bound up, the Martian unreality of bluelit sterile surgical space enfolded me deeper with each set of doors. And when Bill bent to kiss my forehead at the final doors, saying he'd see me the moment I woke, I was gliding at the end of a very long tether, farther out than I'd ever been from my body or mind and entirely at ease (a bedtime dose of Valium, the first of my life, may still have been active).
A ring of surgical technicians closed in around me, low-keyed and undiscourageable as dwarves in a tale; and quickly I was calmer still as they busied themselves with intravenous needles and wrappings. Friedman seemed to be nowhere near. I only recall the anesthetist, a smiling young woman, down near my eyes.
She said "Do you like the taste of garlic?"
I nodded Yes.
She said "Then here comes a taste of garlic." Her hand moved toward the needle in my arm.
A taste of wild onions, not garlic, shot past my throat. I had an instant to say "It's onions," then was totally gone.
Through the next ten hours, there was never a thought or hint of consciousness, no dreams or family secrets divulged (so far as I've heard). Then after a timeless day at the will of a squad of strangers -- each capable of ending my life with incompetence, an honest mistake or malice -- I swam up slowly in a different light to the voices of a man and two women above me.
"Mr. Price, wake up." Their hands were on me. "Do you know where you are?"
I said "I hope I'm in Duke Hospital."
One of the women with a round black face said "Got it first pop!"
I asked the time.
I was still too groggy to calculate that I'd been gone a whole spring day, but I guessed I was living anyhow. My mind requested my right arm to move. It lurched up, stabilized and hung firm before me. I asked the fingers to move; and they did, strong and free. The left hand likewise. But I asked the attendants no more questions. Stay low. You'll know when you need to know.
And when I tried to crane up and see the space around me -- a huge plain covered with fog the color of cream -- the nurses pressed me back and said we were bound any minute for Intensive Care.
I recalled our first sight of Mother back in Intensive Care from her own long day of unconscious waiting while a few men cut deep into her forebrain. As her eyes caught us, she'd said "When are they going to operate?" The long ordeal, which had barely helped her, still seemed an impending threat.
Now at least I knew I'd cleared one hurdle. I know I even tried to think it would prove the last.
It was only in Intensive Care, after Bill had spent awhile feeding me the crushed ice I craved, that the anesthesia wore off enough to let me sense the start of pain that would be my constant companion till now. Though it would grow and diversify with time, it declared its nature and shape that evening. I can still call back that first awareness, the clear sense of a white-hot branding iron in the shape of the capital letter "I" held against my upper spine from the hairline downward some ten or twelve inches and unrelenting.
It would be years to come before Duke Hospital entrusted morphine pumps to its patients, and soon I was asking the splendid nurses for most of the help they were licensed to give. In all my eventual hospital time, I never encountered better nurses than the no-nonsense yet merciful women who worked Intensive Care round the clock. They gave me morphine when orders permitted; so what I remember of that first night and the next two days was filtered through the dense but transparent screen of a powerful opiate, a treacherous friend.
I know that Bill told me at some point in the evening that Yes they'd found a large tumor, removed some of it and that Yes it was malignant though maybe of a slower rate of growth than Friedman had feared -- the final pathology report was still pending. That first night's knowledge of just what I still harbored inside me was buffered so well by frequent morphine that I know my first thought was mild annoyance, couched in terms of the popular-mythical date for a cancer cure. Damn, I'll have to wait five years till I know I'm cured.
And that unreal state of ease prevailed through the next days, Tuesday and Wednesday in a new private room on the neurosurgical ward. Though I mostly stayed in bed, I met my colleagues and local friends with an aplomb they still laugh about. It seems I engaged in lucid personal and business conversations of which I have no memory whatever. All of me floated on the tranquil sea of suave morphine, the nearest chance of a live return to the carefree safety of the womb.
Friedman stopped by twice a day; and unlike most members of the senior staff in a teaching hospital, he never arrived with a guard of students. He came alone with his own intense focus; and I grew increasingly respectful of that, though still I resisted pressing for answers. I do recall that on the Tuesday morning when I was still drugged, Friedman repeated with new precision what Bill had told me the previous night.
The tumor was pencil-thick and gray-colored, ten inches long from my neck-hair downward and too intricately braided in the core of my spinal cord to permit him to do much more than sample its tissue in several places.
I could taste the depth of his disappointment, but I only asked a single question -- how much of the tumor he'd actually removed.
He said "Maybe ten percent."
It was a further shock. I'd assumed that a whole day's surgery had achieved more than ten percent. That was hardly more than a biopsy sample.
Then he told me that initial pathology reports suggested a malignant astrocytoma or glioma, both of which are tumors arising from nerve tissue. He defined the word malignant as descriptive of tissue which grows without normal structure or control -- I recall his saying with a kind of aesthetic frown that the cells "look wild and ugly" under a microscope. And he added that, while preliminary reports suggested that my tumor was not of the highest degree of malignancy, its presence was still a grave fact.
In lieu of significant tumor removal, he'd taken a sizable palliative step. He'd chiseled off a good deal of bone from seven vertebrae in my upper spine to decompress crowding in the area. Since chemotherapy had not yet shown impressive success in stemming tumors of the central nervous system, he recommended radiation once my long incision had healed -- about a month from now. As a cold comfort he ended by saying that malignant tumors of the central nervous system seldom spread elsewhere in the body.
I remember thinking The standard good news/bad news joke -- congratulations, your brand of cancer likely won't spread; but we can't get it out of the main control room.
It was not till Thursday when Friedman told me he was taking me off morphine, then and there, that the full force of the surgical news and its threat began to reach me. With every hour of time in the real world, minus morphine, I moved toward a single understanding. This lethal eel is hid in my spinal cord and will kill me. From early childhood I'd had a tendency to think in pictures more than in words. My thoughts are mostly silent movies, or wide still-pictures, behind my eyes. So once my mind was sober again, I quickly saw the threat as a thing, a visible object; and from the first that object was a dark gray eel embedded live in the midst of my spine.
The picture-making went on with a vengeance for the next three nights, force-feeding me all the omens and fears that the opiate had screened. On morphine I'd slept too deeply to dream. Now suddenly withdrawn, I felt the pain of both my wounds, to mind and body. On successive nights I responded by staging, for the first time in years, long credible nightmares. They were far more shapely and terrifying than any I could remember from childhood, and they plainly poured through me from the seed of cancer-dread.
The first night for instance I constructed a convincing tale of going alone to a Caribbean island for rest and pleasure. Once there and settled in, I discovered slowly through several days that my deluxe beach hotel -- made entirely of spotless wickerwork and at which I was somehow the only guest -- was staffed by real vampires who'd learned to tolerate the tropical sun. At first they were affable, charming me with perfect service but actually waiting till they'd lowered my caution and could drain me dry.
In the second night's dream I was lost in thick darkness and couldn't find home but wandered with increasing panic through a vicious landscape, balked at all turns. I'd wake and assure myself, then drop back off and be lost again.
The third night was worst, but that dream finally stated its point with brute candor. I was walking the seventy miles from Durham to Warren County, North Carolina to find my birthplace, my mother's home-place in the village of Macon. When I found the house and searched the rooms, it proved abandoned and sadly empty -- no relation of mine had lived there for years. But once I was outside again in the dark, a small young black-haired man appeared like a cringing demon, writhing around me in a sinuous dance; then saying "Now you must learn the bat dance." I suddenly knew that his bat dance was death, death from cancer. Still dreaming, I summoned my strength to refuse him.
Weeks later I'd preserve that third nightmare in a poem that's faithful to the shape of the dream. It's called "The Dream of Refusal"; and it ends with the words that ended the night, a vow to myself.
I will walk all night. I will not die of cancer.
Nothing will make me dance in that dark.
From the moment I made that refusal, asleep, I'd begun anyhow to lean on the only visible prop that couldn't quit me this side of death -- my own self. Like a number of men of my generation, I'd missed the Second World War by some six years (I was twelve in 1945). With college deferments I'd likewise missed Korea; and in the various Berlin confrontations and Vietnam, no branch of the service had wanted me. As a writer who admired the war stories and novels of so many soldier-authors, I'd often wondered to what extent my apparent luck was in fact a deprivation.
Now at last I must enter what was plainly a war, with life-or-death stakes, and assume the fight in the only way I knew to fight -- in the arts of picture-making and story-telling that I'd worked at since childhood. I'd be myself to the outer limit of all I could be, resourceful as any hunted man in the bone-dry desert, licking dew from cactus thorns. So even that early, I'd cast myself as the hero of an epic struggle, and I saw both the ludicrous melodrama of that role and the urgent need for it.
I stayed in the hospital three more weeks. Between the visits from friends and doctors, the start of physical therapy and the fitting for a chromium walker and a shiny quad cane (a cane with four feet for greater support), I managed occasional bouts of the blues as unprecedented symptoms arrived almost by the day. Numbness was spreading all down my right leg, then was taking the sole and toes of my left foot. My genitals were partly numb to one side of an invisible vertical line, ruthlessly drawn through their exact center.
And late in the afternoon each day, I'd be overwhelmed by a rising sense of dissociation from my whole body. My mind would seem to leak out, rise above my trunk and limbs and gaze down at them from a helpless nearness. When can I live again in my body? And where am I now? As much as any specter in a ghost tale, I felt like a spirit haunting the air above his old skin that had suddenly, and for no announced reason, evicted me and barred my return. More than once I felt even worse -- like a butchered steer, hooked up in space above my old home.
When I'd describe each change as it came to Friedman on his twice-daily visits, he'd only say "That's a tumor sign" with blank assurance; and I'd ask no more. My instinct to hunker on in ignorance strengthened with every sight of a doctor. Don't probe for news. News will sink you fast and -- anyhow -- what do they know?
It would be a year before I knew that, aware of my tendency to fulfill forecasts, Bill Price wisely hadn't told me the word he'd got from Paul Bennett, our cousin by marriage and an excellent doctor. When Bill phoned Paul the night after my surgery, gave him Friedman's news from pathology and asked Paul flatly "What does this mean?", Paul had said "It means six months to paraplegia, six months to quadriplegia, six months to death."
Yet a few days after surgery, I was taking unaided short walks in the room and the hall outside. I was shaky, to be sure; but I needed no props. And I was still trusting that the pain would cool as the long incision healed and my shoulder muscles found new attachments to the hacked-on streamlined vertebrae. Those tentative hopes were braced by daily visits from my friends Keith Brodie and David Sabiston. Brodie was then a practicing staff psychiatrist; he would soon be president of the university. David Sabiston, then as now, was one of the world's great surgeons and a senior member of the hospital staff. Not only did their visits seem to win me small attentions from the ward staff, they half convinced me to believe their plainly expressed optimism. I recall for instance that Keith and Brenda Brodie gave me a small crystal ball "to contemplate your happy future" and that David Sabiston promised to be at my ninetieth birthday party; so I learned, late in life, that such homely offerings to the gravely ill can have a weight that even the giver may not foresee. They can quickly swell into amulets for health and hope, even in minds more rational than mine.
I also hoped in those hospital days, though a lot less strongly than I'd have guessed, that sexual desire would soon revive and reach outside me. Since childhood, sex had been an enormous motor for my life and work; and while the surgery might have left me impotent, it hadn't, despite the partial numbness. But from the moment I'd waked after surgery, the hunger to know and please other bodies was suddenly and inexplicably gone for the first time in nearly forty years. Was I merely still lulled from the hours of anesthesia (a doctor friend had already told me I'd feel its effects for at least a year)?
When I thought occasionally of the unprecedented and apparently uncomplicated absence of desire, I recalled the words of a friend who'd been a prisoner of the Germans near the end of the Second War. When I'd asked him about sexual activity in his camp, where men were barbed-wired off from the women, he quietly said "Once you're starving for actual food, sex is the last thing to cross your mind." Had some deep need of my life, a need that till now had been fed by sexual warmth, found other nourishment? Or was that need merely dazed and waiting? Would the strange departure of such a crucial component of my work kill or deform the work?
It would be months before I thought I knew answers to any such questions; and even now I'm not convinced that I understand how so powerful a force simply went underground, or became another kind of force, for the better part of six or seven years. In any case, I weathered the long abstinence with extremely few conscious or unconscious anxieties -- I'm a good recaller of dreams, and from those years I recall no dreams that seem concerned with an absence of sex.
As in all hospitals, time bore down between events. For me it hung surprisingly heavy because, for the first time since grade school, I'd run head-on into a block on my work. Aside from the several daybook poems, I couldn't so much as think of resuming my novel Kate Vaiden. Any work as demanding as entry into whole other lives must wait till I was home. Stranger still, I found myself unable to read anything longer than a magazine article. My eyes were normal but my patience was gone. I couldn't sit still for a serious or even a frivolous book, not in my own hands.
But friends had already started bringing me joke books, cartoons, books full of pictures of peaceful sights, and detective novels. My friends at the video-rental store even arrived unexpectedly to hook up a tape player in my hospital room -- to show me an assortment of Marx Brothers films -- but their player proved incompatible with hospital wiring. The one exception to my book-and-movie famine centered on regular visits from a student friend, Yoji Yamaguchi.
Because he was taciturn and I was hardly eager to talk, I soon asked Yoji if he'd read aloud from Robinson Crusoe, which I'd brought in with me. Each afternoon then, he sat by the bed and read in his calm voice for half an hour while I mainly dozed in and out through Crusoe's tale of his own marooned life, his slow invention of tools for his alternate existence. It was days before I began to see the aptness of the book I'd grabbed at random the day I left home -- a shipwrecked lone man inventing a life.
And I listened to music as if it were literally life-or-death food. Again I didn't examine the choices -- they constituted a different fare from my usual listening -- but later I saw clear patterns among the tapes I played so often on a small machine beside my bed. I couldn't for instance listen long to vocal music unless it was choral and coolly distant. No turbulent opera, no pleading egos, no dwelling on loss or grief or chaos. I couldn't even listen to the comic operas of Mozart and Rossini which had helped me through a number of earlier blue intervals. And I couldn't bear the company of any solo voice except the wide reach of Leontyne Price.
Her voice, as it had since the night I first heard it in New York in 1953 (the legendary revival of Porgy and Bess with William Warfield and Cab Calloway), offered glimpses of an ideal sphere of triumphant ease, all the more real because she was so indisputably already there as the voice spun on, in full description of a goal she'd reached ahead of me.
Mostly I listened to the high baroque orchestral masters. I'd spent my college and graduate career immersed in English baroque poetry, and I'd studied baroque sculpture and architecture on numerous visits to Rome; so the intricate complexities of the age, twining as they did round one central cause -- the praise of God and his creation -- had plainly met an old need in me to confirm the order which I'd always trusted was present behind confusion and chaos.
But now with a whole new appetite, I'd lie full-dressed on my bed and listen time and again to Gabrieli's canzone for brass, Cavalli's Missa Concertata, the four orchestral suites of Bach, Handel's august concerti grossi, Albinoni's concerti, Vivaldi's Gloria (RV 589) and more. They were pieces I'd known for years, but now I was hearing them as if for the first clear time. I'd lie alone, as still as I could manage with both eyes shut, and concentrate on letting the actual visible line of the harmony enter my mind -- coiling as baroque lines do, luxuriantly but in strict logic -- till that line reached the core of my spine. Its lucid conclusion in benign order seemed to help me crowd out the idiot killer encysted in me, the blind eel bumbling toward my brain.
Odd as it seems looking back, though I saw the tumor in those terms, I never felt the horror of its presence that so many other cancer hosts describe. I hardly felt comfortable, feeling its large existence within me; but I was never driven, like others I've known, by a constant passion to tear its repulsive life from my body. Maybe again its long presence had let me accept it as a virtual twin (by now I felt deeply convinced of its presence in and with me since the womb, since conception).
I wonder now, though, if the steady presence of music around me didn't contribute importantly to my sense of the cancer as a thing with its own rights. Now it sounds a little cracked to describe, but then I often felt that the tumor was as much a part of me as my liver or lungs and could call for its needs of space and food. I only hoped that it wouldn't need all of me. In any case, along with the few short poems I was able to write in those early weeks, the music of others -- heard as intently as if I'd made it -- was the first big weapon in my battery of healing, my own campaign to outlast the eel. War started in earnest when I went home on June 22nd.
Copyright © 1982, 1986, 1990, 1994 by Reynolds Price