It began with a burning soreness and difficulty swallowing on one side of the throat. It was as odd as seeing it rain on one side of the street. His doctor didn’t know what it was and the specialist to whom she referred him had asked him on which side he slept. He said ‘the right.’ The smile of diagnosis pronounced acid reflux and also told him he’d save money using Prilosec OTC.
The symptoms went away. The next week he had a fever for a day of high temperatures but it was flu season, thought nothing of it, and the fever broke.
Two weeks later his voice cracked and he became hoarse. There was a lump in his throat when he swallowed. The doctor this time sent him for a CBC and an ultrasound. The blood work returned normal, but the imaging detected a mass. The concerned voice over the phone gave him names of endocrinologists with whom he could schedule a biopsy.
It was there on the first of three tables he would see the black angel. He didn’t want to see it. More like it had come to see him. The first time he saw the angel he thought he was imagining things. He felt its presence though with a movement of air above him as he lay there looking up after he had received a numbing injection and experienced four other people crowding around his head to begin one of five needle aspirations. Only one of the five sticks hurt when the needle went deep into his neck, guided by the ultrasound technician who encouraged her crew like a submarine captain in a panic with orders of “Deeper. Deeper” as she looked at the enemy on the screen. An unknown hand held his and he gripped it when he felt the pressure of the needle’s final descent. He swore that he had seen something on the ceiling as he looked past the heads around him. It was over too soon to tell. He sat up and saw the bucket, five thin needles pink-tinged with tissue samples, sat upright like fancy vodka glasses in the chipped ice. He returned to work.
Two days later at work he receives an email on his hand-held device saying that he has a phone message at home. Recognizing the doctor’s number he pages the doctor and punches in his work number for the callback.
“You’re at work?”
“I am. Assume you’re calling with results from the biopsy.”
“The results are positive for papillary carcinoma. I’m sorry. Your thyroid has to come out.” There was another pause, a smaller one. “I’ll call you at home so we can talk some more. I’ll give you the name of a surgeon.”
He doesn’t hear ‘thyroid’; he hears ‘cancer.’ The image of him running a sub-par seven-minute mile in a 10K comes to mind followed by the cocky smirk and Keith Richards’ skull ring strumming chords. Mortality. It made no sense. He is healthy and fit. He knew the definition of cancer as an ‘abnormal growth of cells,’ but rather than thinking of his own cells proliferating and fornicating he thinks of one of those large beetles with pincer-claws holding the butterfly wing of his thyroid and trying to wrest it free.
Lunch hour the next day he finds himself standing in an office with his hospital blue card and insurance card for the surgeon’s receptionist to photocopy. The consult is with a young doctor, dressed in an expensive suit, his initials on his cuffs and held in place with elegant cufflinks. He is told the name of the procedure, ‘thyroidectomy with modified right neck dissection,’ which confuses him because he had thought only his thyroid would be coming out; but the surgeon explains as he traces his pen across the bottom of the throat that the ‘smile’ removing the thyroid will extend upward into a line along the carotid artery up to the right ear to complete a ‘hockey stick’ in order to remove lymph nodes. The cancer had spread to the lymph nodes. ‘Metastatic’ is a frightening adjective.
Day of surgery, after the correct side of his throat is marked with ink, he watches the anesthesia nurse whose name he can’t remember, except that it was lyrical and Irish, giving him lidocaine before inserting the IV catheter and taping it in place.
“What anesthesia will you be using in the OR?”
“Propofol,” he answers.
“The stuff that killed Michael Jackson?”
“Yep, but our doctors, unlike his, know what they are doing.” He says something else: ‘fast-acting’ and ‘fewer complications,’ but all he hears is the humor in the voice and the Gaelic grin.
“One thing you should know and I told the surgeon this also is that if you need to speak to me use the right ear since that’s the only good one.” The man had listened.
There was no backwards count from the number ten; no watery descent or seaweed haze on the second table, but there was the black angel on the ceiling again. Looking down. He felt the expanse of those black wings spreading a shadow over him. He blinked to confirm what he was seeing. It was an angel indeed. No face was visible. It did not speak but it sent him a thought that they would talk.
He hears a voice in his right ear say: “Can you hear me? Don’t fight it. We need to put this down your throat so you can breathe.” His hand lets go of the tube that he was holding back above his face.
Nothing else he remembers except looking up and seeing those wings pulse rhythmically, holding that other body above him.
He wakes up in ICU to find faces staring back at him. A nurse does a zig-zag with her stethoscope across his abdomen for bowel sounds. He wants to say something but finds that he has no voice. His mouth moves but nothing comes out. Friends are there. She, the endocrinologist, is there also.
“You were intubated for three days. A sensor in the OR on your left recurrent laryngeal nerve malfunctioned so your left vocal cord is stunned. We hope it’s temporary and recovers.”
He couldn’t say it but he thought it.
“The tumor was around the right vocal cord,” she added after he had blinked.
He listens to the five people who make up the radiation-oncology consult. They are explaining external-beam radiation when the oncologist walks in, sits down at the desk, opens a folder and informs him that he’ll be using Taxol and Carboplatin as chemotherapy agents.
“You can’t use Carbo on me” he tells the doctor.
The doctor looks at him, surprised that he is being questioned. He seems to be thinking: “I’m the doctor and you’re the patient.”
“If you use Carboplatin on me you’ll destroy what little hearing I have. I will be deaf permanently.”
The doctor looks through his paperwork.
“You didn’t read my past medical history, did you? You’d see I’ve had profound hearing loss since I was a child. Auditory nerve damage.” The rest of the team in lab coats is quiet.
“In that case you need to get me an audiogram and we’ll research other chemo agents for us to use.”
“How much experience do you have with thyroid cancer?”
“I deal with head and neck cancers exclusively.”
“Mostly squamous-cell. We’ll book you for next week for fitting the mask and I’ll get the physics group started with their calculations after we do the fitting.”
“Next week? I’m barely out of ICU, can’t talk, and have 50% airway. I want to know why seven and a half weeks of radiation? Does all that radiation set me up for another cancer?”
“We fit next week because I’m going on vacation.”
“And my questions? What about chemo? Do I really need it?”
“That’s all covered in the informed consent.”
“No, what? You have the right to refuse chemo,” the doctor says from the desk with the five others still in the room.
“No. I’m refusing you. Thank you,” he said, standing up to leave. The doctor hands him a printout of the pathology report. Nobody in that office bothered to explain any of it to him. He read it on the bus ride home.
But as he was putting on his jacket before he left he sees the black angel sitting outside the tenth-floor window ledge spying at him over the arched shoulder of a left wing. There was long black hair from what he could see, but distracting him were the rows of paired eyes of different colors examining him.
They would meet daily on the third table in another facility where he received intensity-modulated radiation for twenty minutes sessions in a custom-made mask of hard mesh that covered his head, face, and the top of his shoulders while a one-armed machine with a magnifying glass pod moved above him, around him, and beneath him, delivering pin-point precision doses of radiation in emergency broadcast sounds heard on television. The technicians were always polite, always with a smile or pleasant mask of their own. They see cancer daily and it’s difficult not to imagine that behind those grins is the wish that they might keep cancer away from them.
It was hard not seeing through the small cross-hatching of slits in the mask; harder yet not feeling smothered from the tight fit; but hardest to endure was the immobility that came with the sounds of being bolted down by six screws into the table, each click around the mask tightening, pressing down his own features into him like an unwanted reflection in the mirror.
The angel confined itself to the ceiling except for one session. The pod was droning its squeal and he could swear that his esophagus was cooking. He felt a vibration in the back of his throat. He tasted a chemical burn in the back of his mouth and in his throat. Mucus gurgled in his throat. He opened his eyes after a series of rapid swallows to find the angel inches above him looking into him through the mask, a bird-like talon asserting itself lightly on his shoulder as it leaned over him as if sniffing for the cancer in his body.
It seemed androgynous. The topmost set of yellow eyes met his and the angel breathed on him in the cadence of ocean waves, soothing, predictable, in and out. The larger set of outstretched wings covered him completely. An inner set of smaller wings had opened and set down on both sides of his head, their bottom tips resting somewhere at his sides. The second pair of eyes is dark and blinking. The angel’s skin changed color constantly and the face became the faces of all those he remembered and had known in his life if he thought of them the moment he looked into the face of the angel. Only the wings remained black. A thought from the angel tells him that angels have no need for speech though they can talk. He sees no mouth.
Inside the mask he hears himself breathe and then he hears it breathing and before long they share the same rhythm. He closes his own eyes, afraid to look at it. The odor of lavender makes him open his eyes. He hears her voice explaining to him the three notes of a chord and then her playing a phrase of Mozart. He remembers her hand picking up the cello bow, her flirtatious smile; he recalls her long black wave of hair, dark blue eyes, the small touch of white, a speck of rosin, trapped between the half-moon of her nail and the flesh of her thumb. A breeze passes over him before he hears the voice of an old friend reciting Hölderlin. The air changes twice again and he hears and remembers his grandparents talking to him. He is remembering the dead. A tear trapped under the mask has no place to run from his eye but down the side of his face. He wonders whether he is dying and all this is the prelude to his own death, but as he thinks the thought the angel tells him it is not. He looks up at it and finds the yellow eyes again. They blink and he blinks. It is gone.
Two weeks later, after the radiation ends, after the layers of skin fall off him like a burn victim, after the cumulative brunt of the radiation, the bone-tiredness and mucus production subsiding to a tenacious post-nasal drip and constant throat clearing, he takes the mask from his sessions out to the dumpster late at night. He sets down his likeness in the dark and stomps it to unrecognizable death. When he finishes and picks up his twin the black angel is there on top of the dumpster.
It jumps down from his perch faster than he can blink. The yellow owl eyes stare into his and the air cracks with outstretched wings. The angel’s head comes forward to his right ear and sings the music of knowledge, all histories, and cures for every disease, including cancer, before he stops, closes the canopy created by the wings and disappears; and disappearing with him was the memory of the song sung into his good ear. The mask is gone, too.
It took five months from diagnosis to completion of treatment before he could return to work. On the train into work sitting next to him is a man reading a newspaper. The man laughs in intervals. He is curious why this man is laughing.
“Mind me asking what you’re reading that’s so funny?”
Showing the article with a poke of a finger the man answers: “Article says two-thirds of Americans believe in aliens or in life on other planets while half of all Americans believe they are protected by guardian angels.”
“Oh,” he says.
“You know some people name their guardian angels and pray to them, talk to them. That’s what the article says,” the man continues, creasing the paper. “I wonder what an angel looks like.”
“I’d imagine anything divine would be terrifying to look at. From what I remember from Catholic school nobody saw the face of God and lived; they might’ve seen a representation of God’s power, a symbol, but never the face.”
“You a practicing Catholic?”
“No. This is my stop. Nice talking to you.”
Seeing him stand up and the blue scrubs the man sitting down asks, “You a doctor?”
“Nurse,” was the answer as he zipped up his jacket, moving his identification badge out of the way.
“See that your name is Gabriel. That’s the name of a powerful angel. Annunciation and Book of Revelations — the trumpet, you know. Not a bad guardian angel to have.”
“I know about Gabriel, but if I had a guardian angel his name would be Jake,” he tells the man.
“Because Jacob wrestled the angel and won,” he answers and taps the man on the shoulder to indicate that he has to go.
As he departs the train he says, “Wrestled the angel and won…for now.”
p style=”text-align: justify;”>This is Gabriel Valjan’s second appearance in Moon Milk. Ronan Bennett short-listed him for the 2010 Fish Short Story Prize. Gabriel’s short stories continue to appear in literary journals and online magazines. He recently won first prize in ZOUCH Magazine’s inaugural Lit Bit Contest. His prose poems ‘Exile’ will appear in kill author Edition 17 in February. He lives in New England. Roma, Underground, his first novel, has been accepted by Winter Goose Publishers.