James Sherry
Written on a Subway Stalled under the East River

Stacy Doris’s death happened too recently for me to compose my views on our literary relationship so I have chosen to describe the events and changing states that we shared. I expose my own mental condition believing that it will illuminate Stacy’s status as a poet dying although I do acknowledge the problem of linking my experience to hers.

                                   We’re puppets since words
                             sing through us from wherever not
                             ours into everyone we’re screwed

I’m not sure I can tell the difference between what I did, what I said and what I wrote, so you will forgive me if I fail to distinguish or even merge the separates. They merge anyway in grief. But I will nevertheless try to compose myself by giving you a range of observations about Stacy, about our exchanges, and about me to expose her. Your opinion can cohere around them.

At one point Stacy calls me or writes me that she has had surgery on her fibroids. Upon biopsy, doctors found a rare cancerous form of a common benign tumor. She speaks in an outraged, sardonic voice about their incompetence. But she is optimistic that they can get rid of all cancerous cells with another surgery. We talk for an hour on the phone. She comes to NY and does a reading, seated with her upper body turned toward the audience in a strange venue somewhere in the 20s. It’s not the poetry site we’re used to, and it feels like alien surroundings. Stacy remains as wonderful as Johnny Carson and Bette Midler in a poetry sort of way.

Then I get a diagnosis of prostate cancer. Like Stacy’s my treatment is questionable; I begin to connect to Stacy as patient. Diagnosis was delayed due to a hole in the process. Initially, the doctor put me on hormones to resolve an ED problem only to discover later that the hormones stimulated cancer growth: all 12 biopsy samples are positive. The urologist tells me that I will have surgery, then radiation, then androgen therapy. I am depressed by the news but optimistic that I can beat it. The post-surgical biopsy shows three areas of extra-capsular extension but no lymph node or seminal vesicle involvement, implying only local metastasis. I talk to upbeat prostate cancer survivors; life can continue. Charles visits me while I’m recovering and we assert the primacy of alertness.

Stacy calls to tell me that she is going to Israel to undergo an experimental immune system booster that helps three out of four people. We talk about her nagalese levels and the blood types where GC-Maf can help improve apoptosis. We talk like that a lot. We read sentences from technical papers to each other and laugh about the implications of a poorly turned phrase. We talk about it on several occasions. Mostly we talk to keep each other company because most others are just sympathetic, trying to help, and we like our doomed company.

The overlap of our Venn diagrams increases. I contact the doctor in Israel who says he usually treats advanced cancer, but that his treatment can be more effective with minimal cancer such as mine. Stacy starts her treatments. She tells me about giving herself injections by pinching the skin of her stomach. I am totally grossed out, but “James,” she says, “it’s nothing.” We talk about the doctor in Israel; she is impressed by him and his knowledge. She says he’s the real thing. I am convinced. Then I start my treatment, and the needles are oddly reassuring. The pin prick too reassures. We are both optimistic. We talk and talk swapping soothing medical jargon. We suppose it means something. Really we’re just a bit lonely; no one is committed like a patient. I tell her the joke about the pig and the chicken at breakfast. She doesn’t find it humorous.

For a long time after our treatments are finished we do not speak as if speaking would invoke recurrence. We exchange some letters and fall away from each other. The Stacy part of me is cured.

                                   Hey Team! Now you’ve arrived
                             at so-called death. Dig in and relish it.

Months pass and someone writes or says that Stacy has recurrence. I call her and we talk and talk. This time we both know what it means, but don’t say it. She talks about her doctor in the Bay area that she doesn’t like and her doctor in Boston that she likes. Her voice sounds more distant. I am worried for both of us, but I try to distance myself from her, to disengage, because I convince myself that her cancer was advanced and mine remains minimal. I don’t want to be dragged down by our community and try to be independent. My PSA remains undetectable <.05ng/ml. I feel safe and threatened at the same time.

I extrapolate from her disease to mine realizing that she is not me, but the link is established. I make a thousand other linkages; my mind turns into an inference machine. The level of the linkage needs to be examined but often goes unexamined. They all feel threateningly the same. More thoughts cross my mind than I can keep separate. Anacoluthon dominates my sentence structure. You think I am writing about me but I’m writing about her because no one wants to burden you with their death. We’re too well bred.

Stacy has a variety of other medical treatments, we talk, more surgery, we talk, and I can tell by her tone of voice that she is beginning to fade. The connections between the treatments and her reasoning become more flimsy, sometimes jump, sometimes the gap is too far. Sometimes she makes a connection to some reference that only she sees. The chemo isn’t shrinking the tumor. The tumor is pushing against her liver, her kidney. Reassurance doesn’t make a difference to her.

Frankness doesn’t work either; it’s inappropriate. I say that Chet is a great father; her kids are alright. She says I’m not supposed to say those kinds of things to her. I try to separate my fear for me from my fear for her. I think I succeed in that I focus on many other things. I take on other activities. I occupy myself with Occupy. I start new writing projects. I don’t call Stacy. I’d rather feel guilty than magnetized to her.

                                   Unsupported catastrophies
                                  hitting the agility exhausted
                                   so fury only’s left offence

On Feb 1, 2012, I get a call or an email from Rob that Stacy has died. I am sad and worried because I had a blood test that same day. Have I truly disconnected?

The next day, Groundhog Day, I get my test results. My PSA has risen from <.05 to .05. I see Stacy’s shadow. I think about Bill Murray and Stacy. I remember what Drew says about fighting his diabetes more aggressively than the doctors. I make an appointment for three weeks later to retest because, I am assured, there are frequent bulges in PSA readings. It’s a bad three weeks. This is no longer about Stacy, but you may hereby know what Stacy felt, because no one wants to burden you with their death; we’re too well bred.

I race through all possible reasons, all possible outcomes. I think about radiation. It will burn my bladder and rectum and will not heal for a year. I will have to wear diapers again. My sexual function, slowly improving since surgery, will fail again, this time for good. My recurrence, coming as it does in the second year after surgery, implies remote metastasis and the need for androgen therapy that will cause significant cognitive issues. All I want is to be alert. No, I want to be alert and sexy. No, I want to be alert, sexy, and cancer free.

I need to take action on my own behalf and think of Drew again. I talk to Michael frequently since he had prostate cancer before me but no extra capsular extension. I make an appointment with the urologist to discuss the various approaches. He has been prescribing supplements to suppress cancer growth and improve apoptosis: mushroom, turmeric, pomegranate, red wine thank you. This time his reassurances imply that he doesn’t see any good alternatives for me; he appears fatalistic who once was adaptive. Then he says his son is dying of cancer. He says he’s there for me.

I think about my retirement nest egg; I think about how my family can survive without me; I think about the gloating survivors; I think about the sad survivors; I think about survivors who identify with my situation; I think about survivors who dismiss my situation as not about them. I think about unfinished projects. I think about daily radiation, pain and weakness. I think about my body slowing down with radiation, then rebounding, then slowing again with androgen therapy. Then rebounding and then slowing again with death. My mind jumps from one thought to another; the usual montage clips shorten.

I focus on my body; I move my body slowly and focus. My mind settles down. I resent that I can control my mind but not the cancer. I stop concentrating thinking to find a solution by letting my subconscious do the work. I realize that all my life has been the same situation: connect to someone else to understand what’s going on. I think that is like my doctors’ reassurances: helpful but implying that there are no alternatives. I think about Invasion of the Body Snatchers, Animorphs, Yuri Geller. I remember that people say they cure cancer with laughter. I think about how it feels to die, I think about pain, humiliation, suicide. This all takes about three seconds. Then it repeats in a different order with the same conclusion. Then it repeats in a different order with a different conclusion. Then it starts repeating in the same order with the same conclusion. I always come to the right conclusion after trying all the others. Then I go do something else.

Every time I stop the thoughts recur, mostly the same ones; I am making no progress; I am annoyed with my limitations. I read voraciously. I focus on alternatives and think about the immune system boosters I have taken. Are there others? All the papers I find are vague and not encouraging. I read about the immune system and realize there are innate responses that can’t find the cancer. There is also adaptive immunity with its macrophages, lymphocytes, killer T-cells, and helper t-cells that can’t find the cancer. The cytokines produced by the cancer disguise it from the immune system, an additional function that the immunotherapy has to provide. There are so many components that have to be stimulated and brought to bear on the cancer cells. How can the cytokine disguise be overcome and the cancer be seen as non-self, removing my connection to my body, removing my connection to Stacy? I despair about immunotherapy. I think about Stacy going through these same thought processes. I wonder exactly how she feels about them. Oops! I am wondering how she felt about them.

After three weeks of speculation about deterioration and death, I have another blood test. The PSA is now <.05. I am bumping along the bottom. I will live without radiation, without hormone therapy. I spend some money. I reassure the friends like Anne and Evelyn who I told about my rising PSA. I wonder if this rise and fall is a precursor to an increase that is more permanent or if it’s just stimulation from my breasts and urethra. I equate this pattern to the 10 year bond prices at the end of a 30 year bull market. I equate it to stirring ingredients into a recipe; they merge and become one: a mixture, a solution, a suspension. All the other meanings of these words connect to their analog in the disease.

                                        Figures explain lives
                                   that’s why cheering counts.

I equate the pattern to Stacy’s. I think about how she must have felt and wondered if she was as afraid as I am. Well, of course, that’s what it meant that we spoke for hours about the facts and minutes about how we felt about them. Did she acknowledge to herself that she was dying or did her thoughts jump from extreme to extreme in an effort to extricate herself from the growing cancer. Each time it was cut out, it regrew. Each time it regrows it becomes more plausible. How can she not have known? We’re going to die anyway, but seeing it coming specifically is hard to do without flinching.

Then I am scheduled for my regular blood test again and again it has risen to .05… This time I am inured, accepting the step closer. It seems much more reasonable that it’s just bumping along the bottom, dithering between < and = .05. If I objectify my body is the disease still a thing or has it become my person? And if next time it’s .06, what will I do? The doctors will still disagree and the choice will be up to me: radiate or not, androgen therapy or not. How can my decision be more informed than the doctor? And yet they want me to make the decision like choosing a tie; therefore, they must think I know more. But how can I know more when my mind is flighty?

I read and read and get diverse opinions: but death is not diverse. Imagine how Stacy must have felt gradually sinking into her disease, into her death. Each time death appears closer, becomes a more plausible conclusion even though it’s always the conclusion. The doctors keep giving her choices to make, bazaar with our bodies the wares. The doctor holds our hands while we die; I had hoped to be paying for a cure, and maybe I will not recur; maybe I am cured. I continue to hope that. I continue to realize that I should only think about it when necessary, but it is my constant subtext.

Stacy’s fate was largely (not entirely) sealed when the surgery was done without knowing that the tumors were malignant. My fate was largely predictable when the doctor gave me hormones without first doing a biopsy. And yet the majority fare better under statistical treatment models. Or the costs stay low under statistical treatment models. Or it’s easier to justify statistical treatment models reducing the insurer/provider risk. I revisit all my thoughts again, hoping the conclusions will be different each iteration.

I know what to do and am seeking the controls. I don’t want Deborah to read it because it seems depressing. She says it’s just literature. What me worry?

This is about Stacy, about me, about us, about you. I’m suggesting that I can only know what Stacy went through by examining me and assuming we are human similar. Kim thinks I risk exposing myself this way. I recognize that we're also different. Stacy was more level seeming on top of her game, uncommon yet reassuring about the possibilities. Her disease was uncommon. Stacy was most uncommon.

                                    comes from “bleeding”
                                     subtlety’s violence.

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