Sitting with a Dying Physician

Paul Rousseau

The smell of sickness saturates the room.

A vomit basin, half full, lies on Mary’s lap. Her thin lips quiver. “I can’t eat or drink anything.” She shakes an unused cup of melting ice in her right hand; a tangle of tubes and wires jostle. She grabs an ice cube and slides it into her mouth. She turns her head to the side and retches. “I need a feeding tube.” She shoves her breakfast to the side. A sob rises in her throat. “It’s getting hard not to think about death.”

She pulls herself up with the bedrails. I glance at the mattress; there is barely an imprint in the sheets. She is nothing but sallow skin and bones. There is a grumbling deep in her belly. She leans forward and spews a bilious, blood-tinged fluid. She swishes her mouth with water and spits into the vomit basin.

We sit in shared silence, the shrill cadence of the heart monitor the only sound. She fidgets with the bedsheets. “I know I’m seventy-nine, but I’m not ready to die. Do you understand? I’m not ready to die.” I grimace and nod. No one wants to die, no one; we cling until we can cling no more. Still, disease carves its own reality. Her cancer has continued to progress despite radiation, surgery, and several cycles of chemotherapy. “The oncologist wants me to give up.” Her brow creases, her hands clench. Her eyes swivel side to side, feral and agitated. She flings her arms into the air. “I’m not ready to die, dammit, I’m not ready. Doesn’t anyone listen to me? Are you listening?” Her existential suffering is profound. I stand and cradle her shoulders. She adjusts her oxygen tube and collapses back in bed, clumps of flesh settling like spilt mercury.

There is a stack of medical journals on the bedside table. She studies her disease. She knows the data, she knows her options, she knows her prognosis. She glances at the journals. “There are miracles.” And she is right, there are miracles, but beneath the grit of struggle, she knows her fate.

I remember, before I was sick, I loved to lie in bed. Pull the covers over me and hide from the world. Make love. Read a book. Now I abhor the bed. It has become a prison, a coffin, a grave.” She balances on her elbows, pauses, and lowers her head. “I wonder how many before me died in this bed?” Her face crumples like linen; fat tears leak in rivulets. “If I’m honest, I’m closer to death than life.” Her voice is despaired and resigned.

She turns toward the window, pensive. The sky is grey, rain falling with weight. “I love this weather.” She pivots. “But the droplets remind me of my cancer and the renegade cells that escaped the slurry of poisons.” A nurse slips in and doses her with morphine. Within minutes, she is in an opioid twilight. She heaves a heavy breath, and closes her eyes. “Forget the miracle,” she murmurs. Her face relaxes and puckers inward.

The phone rings later in the evening. The rain has cleared, the moon a sliver on the horizon. The nurse tells me Mary has died.


The Pact

Photo of Moon and Venus by NASA/Bill Dunford

November 4, 2017. Last night, Alex, Ben, and I flew down to say our goodbyes to you. Doug has been here for over a week, and his going back and forth since September has become a part of our marital rhythm. N, of course, has been helpful: she drove up from Alabama a few days ago to be with you and, earlier today, picked us up at our hotel in Atlanta.

We’ve been in your house for a half hour and haven’t seen you yet. The boys have caught up with their father, but now he’s in your room, helping you out of bed. We’re in the kitchen where N is keeping the feeling light while we wait for you.

Y’all like Candy Land? she says and smiles. She cocks her head to the side. Can you believe all these games I found downstairs?

Ben stretches out his arms and yawns. We can play, he says, but I’ll beat everyone.  

Of course, that game’s right at your level, Alex tells him.

Hey, I love Candy Land, N says. And I’m pretty darn good at it. There’s Trouble, too. Y’all like Trouble more? Another smile. (You know how beautiful her smile is.)

Alex and Ben get along with her, always have, but they haven’t seen her in over a decade. Yes, they’re twenty-four already, only a few years younger than she is. She’s grown into a lovely young woman, an artist who works as a nanny, and she’s told me about her boyfriend, how he’s the one. They live together in Alabama. Sometimes you’re hard on her and criticize her for what she might not know, but it’s clear how much you love her. In your eyes, she’s your only child. I can’t remember the last time you called her your stepdaughter.

We sit at the small kitchen table and start to play Trouble, and after a few turns, just as Ben is about to pop the dice inside the plastic bubble, Doug brings you into the kitchen in a wheelchair.

My family’s here, you say, with a burst of energy and a wag of the head. I apologize for how I look. You glance down at the floor.

It’s so good to see you, I tell you, and we all rise from the kitchen table. I hug you, Alex and Ben do, too, and N pecks you on the cheek.

Your eyes are about all that I recognize. They’re big, a silver blue in this room. In another light, the color shifts into the shade of shallow seawater. You used to be fifteen pounds overweight, with a slight belly, and your hair was thick and black. It’s all grey now, and your skin clings to your bones like smoke. You never did bear any resemblance to Ken and Doug. Hard to tell apart, your identical twin brothers. They’re over six feet tall, several inches taller than you, and they’re slim, their hair silken and straight, their eyes green. Being a twin makes for a sticky bond. I see that with Alex and Ben, who, although fraternal, look disarmingly alike.

I turn away from you, thinking I’m too late. I’ve lost the brother-in-law I had in my memory, and I don’t know what to say to who you are now. I race through topics in my head, can’t settle on one. How can anything matter?

I talk about Stockbridge, your home. I’ve only been here twice, I say, for your wedding and when you moved in. So it’s been twenty years or more?

You nod.

The last time I saw you was in Manhattan, I realize, three years ago, for your grandmother’s one hundredth birthday party. You’d see Doug, Ken, and your father often, twice a year, at a resort in Ojai, California. A father/son tradition. You were there this past summer. A few months later, in early October, you were diagnosed with cancer of the esophagus.


Shortly after Thanksgiving, I called you, something I rarely did. It was the longest conversation I ever had with you. You were scheduled for chemo and radiation in the first week of January.

A friend of mine was treated the same week he was diagnosed. I would think every day counts. I don’t mean to be critical of your doctors, but—why do you have to wait until January?

There’s a hell of a lot of coordinating going on. One doctor is at the hospital in Stockbridge and another’s at Emory, but my oncologist is top in the field. That’s what I’m told. Have you heard of this medical center in Texas, the MD Anderson Center?


That’s the place in the country for cancer, and my doctor consults with them all the time. He’s recommending I have an esophagectomy. You know what that is?

They cut out the tumor.

Yep, and the part of the esophagus that’s affected by the tumor, sometimes all of the esophagus, and then they connect it to your stomach. But they can’t promise that’ll help, so I’m gonna take my chances with chemo and radiation.

Can’t you be put on a waiting list?

I really think they’re giving me the first opening they have. I guess I could find a doctor, someone the family knows, who has enough pull to get me an earlier appointment, but it doesn’t sit right with me. You should see these cancer centers, Lori. They’re so crowded. It’s unbelievable. These people are so sick.

I can imagine. Have you been able to eat a little more?

I can’t keep anything down. I’m supposed to drink a lot, water especially, but that’s tough, too.

Have you tried using a straw? You can keep a glass of water nearby and sip it often.

That’s a great idea! I’ll do that. That’s a very good idea.

I can come down this week. I want you to know that, and I’ll stay in a hotel nearby, so I’m not in your way, but I can be helpful.

I appreciate that, Lor, but hold off. I’ll let you know when. Not yet. I’ll let you know. I really appreciate you talking this over with me. I’ve got nothing else to do but think about this, and I’m scared shitless. I have a few friends here who are religious, and they’re praying up the kazoo for me. What do you think of that?

Their faith gives them comfort, I suppose. Praying also makes some people feel less alone, especially if they’re facing something difficult. I pray sometimes. I don’t believe in God, not really, but when I’m distressed or worried, praying clears my head.  It’s a petition of sorts, and I guess it helps me prioritize what counts. Anyway, they say it helps to be hopeful, you know, it helps your state of mind.

Listen, sweetheart, I’m going to get off. You’re just a doll to call. Thanks for everything.  

I’ll check in with you very soon. In the meantime, try the straw.

Why didn’t I tell you I had already prayed for you? For several nights in a row, I recited a silly rhyme I’d learned as a child, have no idea from where, maybe from the back of a cereal box or Sunday school. I fired a kid’s plea out into the darkness like a load of buckshot: God, thank you for the world so sweet, thank you for the food we eat, thank you for the birds that sing, thank you, God, for everything. Words so familiar that they slipped out like a whistle. Then I added: Please help him get through this. Let the chemo work. Let him go into remission.

After your six-week treatment, the tumor appeared to be gone. Relief floated through our house, and one evening, I lay awake, aware of my good health, and thought about a scene from Graham Greene’s The End of the Affair, one that has always moved me because of its sacrificial nature. The lovers, Sarah and Maurice, are in bed during an air raid when Maurice steps out of the room. Suddenly the flat is rocked by an explosion, and Sarah goes to look for Maurice. She sees a hand under a door, thinks it’s his, and returns to the room, where she kneels down to pray: I said, I will believe. Let him be alive, and I will believe… But that wasn’t enough. It doesn’t hurt to believe. So I said, I love him and I’ll do anything if you’ll make him alive, I said very slowly, I’ll give him up for ever.…And then Maurice opens the door, and she must, well, you see where the story is headed.

I pressed my hands together under the covers, interlocked my fingers—it’s like putting on a costume, this gesture, it builds confidence—and I said, Please God, if you let him go into remission, I won’t try to get my book published. I’ll let it go.

I’m not sure which novel I actually put up for grabs, the old one I hadn’t been able to sell, or the new I’d just finished, but what a paltry petition. I’m embarrassed by this memory, you should know. If I had offered to give up writing, would my prayer have been more noble? Is the love between two people equal to the love between a writer and her writing?

Had I lost my mind?

Yep, I can hear you say, that’s fucking nuts. You’ve got to be kidding me.


In the den, football is on television and a gas fireplace is lit. It’s 78 degrees outside. A blanket, pillow, and sweater are scattered on the tweed couch. Next to a box of tissues and several vials of pills, there’s a stack of newspapers on the coffee table, and on a side table, a glass of water with a straw.

When you first moved here with N’s mother, into this five-bedroom house, you hired an interior designer to decorate, and the living room reminds me of an Ethan Allen showroom from the 1990s. After the divorce, you didn’t downsize. You never cook, evidenced by the absence of spices, boxes of tea or cookies, oils and vinegars, and paper napkins from the quaint napkin holder on the counter.

I hope we’re not making you miss your game, I say.

Don’t worry. There are games on all day.

Alex and Ben comment on a play from yesterday’s game, which makes you smile. You can tell them apart, I think, because you grew up with twin brothers. You’ve always been fond of my sons, and they feel the same about you. You make them laugh, and you’ve been generous with them; you often show your affection with gifts.

You ask Doug for your painkillers. He gives you what you need, helps you to the couch, and covers you with a blanket. You only want N, Doug, and Ken around you. With the exception of the occasional shower or necessary supplies provided by a hospice nurse, you’ve refused the help of any other professional aide as well as the company of your friends. You weren’t even sure about having me and the boys visit, but you also didn’t stop us.

Look how Doug has changed. Your brother is not, by nature, a caregiver or caretaker, not by any measure. I make just about all his meals, do his laundry, clean up after him, while he looks after our finances—now that’s a throwback to our parents’ time, another kind of crazy if I let myself consider it for long—but in every other way he and I are on equal footing. And we’re rarely apart. Since he has been here, he has been living on take-out. He runs out to fetch you a milkshake, a cinnamon bun, whatever you think you can keep down, and he even lights your cigarette for you, not in his mouth, as a smoker would, but in yours. Although he believes smoking is the last thing you should be doing, he carries out your wishes.

Your illness has quieted him, and he is not a quiet man. When he’s with you, we try to talk on the phone every night. Once, he told me, you got up in the middle of the night and fell. You called out for him, and after he helped you up, you couldn’t wait to get to the bathroom, and peed. You then said you had to lie down, which you did, on the carpet. You fell asleep. He covered you up, and, from then on, he slept on the den couch, closer to you.

Whenever he can, he spends his time on your fifteen-year-old-old computer, combing through the odds of the football games, and then calls the bookie that you have known since you were eighteen. Doug’s bets are never big; it’s the hedging of bets that excites him, much like playing the stock market. After rehab, you weren’t supposed to gamble, and you didn’t for some time, but then you began asking Doug to put in your bets for you. As much as you loved watching sports and gambling on them, I think you loved even more talking to Doug about the games. The thrill of possibly winning was sweetened if the two of you were somehow in it together.

There’s no doubt you adore both your brothers. You’ve always admired their athleticism. You’re accepting of their closeness—how one minute they can act as if they hate each other and in the next be laughing—but, I imagine, you’ve been jealous of their bond from time to time, which isn’t to say I think of you as having been lonely all these years.

You made it clear for some time that you wouldn’t marry again. Your first wife left you because of your drug use, and N’s mother left you because you had slept with someone. After two failed marriages, you’re sensitive to the layers of emotions that build up between spouses. You’re aware of how close Doug and I are, how much we talk and rely on each other.


So here I am in your home, feelinguseless. I feel like a fool. I might as well be dressed in a jester’s costume, mute, with bells and ribbons dangling from my fingers and toes. I feel as if I don’t really know you, or what I know about your life in Stockbridge seems insufficient, a mere outline: For almost twenty years you were a drug supervisor at a rehab clinic, but you haven’t worked in the past eighteen months. You loved what you did, were good at it, but you gave bus fare to a few clients, which is against the rules, and you were fired. You have friends down here, lots of them, and a few took you to your doctor appointments before your brothers became involved. I know you love the development where you live, Eagle’s Landing, and you used to play golf and tennis at the country club with your buddies.

When I first met you, I was thirty-one, six years younger than you, and I knew you smoked pot, maybe did some coke. I’d heard you were a reckless teenager —my kind of rebel—the boy who had sex in the bathroom with his girlfriend. I liked your taste in music: the Stones; Crosby, Stills, and Nash; Bowie. Your brothers were not like you; they were athletic stars who studied hard.

You lived on your maternal grandmother’s property, a family compound, in essence, in the house where you and your brothers, when you were all in your twenties, used to spend so much time. The house, due to your neglect, was beginning to fall apart. Doug and I, when we were first dating, would come out on weekends to spend a night with you and then visityour grandmother who lived next door. You rarely saw her, and I soon learned how adept you were at hiding. You’d retreat into your room for hours. You’d get up in the morning and drive to your favorite bakery to bring back fresh coffee and a meltaway for us.

You had a cocker spaniel you took everywhere. A dog-lover, an animal-lover in general, you were obsessed with the antivivisectionist, Hans Ruesch, well-known in certain activist circles. You called him in Switzerland, donated money to his cause, and bought hundreds of his books with the intention of giving them away to your friends, but the boxes remained in your house. When you found out I shared your love for animals, you gave me several books and told me, with a feverish excitement, about all the senseless experiments that were conducted under the guise of medical research. At the time, you were working as an insurance salesman, a job you didn’t care about.

That year, you lost a lot of weight and often seemed wired. Once, at a family gathering, you jumped up during dinner and excused yourself, after which your grandmother, who was not at all open minded, said she thought you were as high as a kite.

Ever since you were a teenager, you had struggled with drugs. Doug and Ken, at times, looked down on your absence of willpower. They intellectually understood you weren’t to blame but had trouble empathizing with the damage you inflicted on yourself and others. Your father finally forced you to seek help. Your mother—you were her first-born, her favorite, no second-guessing there—had told him to stop giving you any money. Although they were divorced, they worked together to save you. So when you called your father one day to ask for enough money to buy a sandwich, he said no, unless you promised to admit yourself into a clinic.

1996—you were forty-two. The clinic was in Atlanta. It was expensive and you stayed for many months, longer than anyone expected. After so many therapy sessions, you learned a lot about yourself, but even in rehab, you broke the rules by having a relationship with another patient, N’s mother. After you and she were married, you chose to live near Atlanta and found a job helping addicts recover, many of them without money or family, nothing like the clinic you’d gone to, and I remember thinking you had found your mission.

You gained weight, and, as a new husband and father, you became a louder, stronger presence in the family. You had your moments when you could be grating, when you felt the need to captain the hour. You’d choose the restaurant, order for everyone, steer the conversation, get irritated when one of your nephews interrupted you, but you were also smart and informed. You were a Democrat, unlike your mother, with whom you could argue without reservation. You were passionate about reform but had left behind anyone or anything associated with your days of getting high, including Ruesch and his books.

As for how you treated me, whenever I moved ahead in my writing—beginning a new project, getting my work published—you were happy for me, at times delighted, although I’m not sure you ever read anything I wrote.

N had a nickname for you: she added “bear” to the end of your name, as if you had no choice but to stomp through a room and knock this person out of the way while trying to protect another.

Some in the immediate family saw you as damaging; others saw you as kind and generous. You didn’t care what anyone thought of you. I happened to like who you were—I think, I hope, you’ve always known that.


We’re still playing Trouble, and now I have things I want to say to the you I do know: I love how sweet you’ve been to my sons, how you care about politics, how you enjoy reading novels, how you’re a Luddite at heart and still use a flip phone, how you don’t back down… And I’ve failed, that’s what I also want to tell you. After our long conversation, I failed to call you as I’d promised, and I’m ashamed of myself. Is that why, when it was clear that the cancer had spread, you pushed me away? I’m shy, try to be truthful, and when I can’t be truthful, I tend to be silent. When I realized you were surrendering to your illness at the end of the summer, I couldn’t lie and say I understood. Instead, I researched clinical trials around the country and came across the name of the wife of one of your father’s close friends, a radiologist at Sloan Kettering. I asked Doug if he thought she would be willing to inquire about one of the hospital’s trials for esophageal/gastric cancer I’d read about.

At first, you were interested. That’s the last time you talked to me with some ease. You were amazed that this friend was able to get an appointment with the head doctor of the trial in just two weeks. The plan was for Ken to fly up with you and for both of you to stay in a hotel close to the hospital. You were already taking plenty of pain killers; you were losing more and more weight, and your despair was thick.

One morning, you called and I answered. You told me to tell Doug that you hadn’t heard from the admitting person at Sloan Kettering and then you hung up on me. I understood your anger wasn’t directed at me, but I was shaken by it. Another time, I was talking to Doug while you and Ken were on a conference call, and I heard you say, If Lori would just stop talking, I’d hear you better. I took that as you wanted me to step away and leave you to your brothers. But I didn’t want to leave. Soon enough, before the day of the appointment, Ken informed Doug that he wouldn’t be taking you to New York. You were too sick. Who were we fooling?

Did that decision come as a relief to you?

Within a month, your stomach began filling up with fluid, and a simple aspiration revealed that your cancer cell count had skyrocketed.


Even before the possibility of a clinical trial came up, you had rejected almost all of your doctors’ recommendations. You didn’t want surgery, and when you clearly needed nourishment, you didn’t want a feeding tube, and when it was almost impossible to find a vein, you didn’t want a port for chemo. You seemed scared of every new intrusion. I was surprised. When you were healthy, you never struck me as fearful. After all, you’d overcome your addiction and worked in a field where you encouraged others not to give up.

Perhaps the idea of a trial, of stepping into the unknown alone—with the required good dose of faith—was too unsavory for you. Better to numb yourself. That old habit. At some point, you told Ken about a stash of painkillers you’d hidden in the ceiling of the basement. He found hundreds sealed in a bag. No one asked you why the pills were there.

Alone with N, I ask her how you might have acquired so many pills. There’s this friend—she guesses—who has a prescription and lives in another state and probably needs the money.


We stay with you until around five. That’s it. You’re tired, and we’re leaving the next day. We invite N to join us for dinner in Buckhead, not too far from our hotel, and Doug will stay with you.

You ask N to fetch your wallet. Take them out tonight, you tell her.

Alex and Ben hug you, and you tell them they’re great young men and how proud of them you are. My sons are close to each other, and the idea that their father is about to lose a brother, as well as that they are about to lose you, is weighing on them. They smile, wish you luck on a bet you made, and back away.

I move closer to you and say, Is there anything we can get you?


I’m happy Doug is here with you.

You shake your head and say, You can’t have him. If he isn’t here, I’m gone.

I know that, I say. I’m hurt by your harsh tone and want to tell you I’ve only encouraged Doug to be with you. Instead, I say, I really am glad he’s here.

You look away for a second and then your eyes are on me again. Thanks for coming, Lor. It means a lot.

I kiss you on the forehead. There’s the faint odor of cigarette smoke. I love you, I whisper.

Outside, I find Alex in the street, on the phone, walking in circles, and Ben and N in the car. Doug steps out to say goodbye, and I bury my face in his chest and cry. His arms tighten around me, and my body relaxes.


Days later, back at home, N texts me: G thought you were one of us helping him today. He was like, That’s it, Lori. Referring to how we were moving him on the couch.


November 14, around ten at night. You die in the den, by the fireplace, in a hospital bed that hospice brought in after we left. Your brothers and N are beside you.

Doug and I fly down a month later for your memorial service at your club. We stay at your house. In your bedroom, I look through your books. I knew you read a lot but didn’t think our tastes aligned, yet I find a novel I admire, Per Petterson’s Out Stealing Horses, a novella I’ve been wanting to read, Ian McEwan’s On Chesil Beach, and books by authors I’ve yet to know, Graham Swift and Jo Ann Beard. I take the books.

Ken arrives the next day, as does N, and while your brothers are out doing errands and tending to estate matters, she and I sit on the floor of the living room to sort through your boxes.

One box is stuffed with mimeographed sheets from several recovery programs and transitional houses in Atlanta. There are business cards, too, one from a police sergeant, one from an aviation safety inspector for the FAA. There’s a pile of letters and cards.

One greeting card is inscribed with Thanks a bunch! dated November 2015, from your mother’s caregiver to whom you lent $15,000 so her daughter, who lives in Ukraine, could put down a deposit on a house there. The caregiver paid you back some of the money and, after you died, forgot about the rest.

There’s a letter from the principal of a law firm, thanking you for putting his brother in the position to reclaim his life.

There’s one letter after another:

    • Thank you for making me feel like I “BLOOMED” because you “got me.”
    • Thank you for being the angel on top of all my TREES and may God Bless You Abundantly for all the joy you’ve brought my way…
    •  Your generous and loving spirit…is a gift from God. The laughter, with a hint of sarcasm, will never be matched… You remind me of King Darius.
    •  I heard that Jewish people are hard-headed and think they are special, guess what? We think you ARE special!!!       

My back is starting to hurt from sitting so long on the floor. I’m about to get up when I come across an agreement for a vehicle loan made out to your close friend, A, who has multiple sclerosis. You had bought a used van so you could lease it to A. I read that, in the event of A’s death, the van will be returned to you, and, in the event of your death, the note will become null and void with the effect of being paid in full.


That afternoon, we all drive over to A’s house. He looks about ten years younger than you. He’s black, with a serene face, dressed in sweats, and confined to a wheelchair. You worked together at your old job until he became too sick to continue. We meet his mother, brother, and an aide. A’s insurance doesn’t cover weekend help. Every Sunday, you’d go grocery shopping for the family, pick up lunch, come over to watch a game, and then pay the aide for the weekend. A’s mother shows us where you used to sit on the couch. They were the best of friends, the best, she says. Like brothers, A’s brother says. I stare at the spot on the couch.

A tells us how much he will miss your visits and how sorry he is that he can’t make the memorial service. He doesn’t say much more. N then gives him a photograph of you, a headshot, and he thanks her. His mother props it on the fireplace mantel, under an old black-and-white family portrait that spans three generations.


How often do I see you? Too often. But how long can that last? I summon an image of you, probably from a photo I’ve looked at recently, and place it in the setting of my choice, and then I watch you move. When excited, you could wriggle your body like a puppy, a brief and gleeful dance. I see you mostly around food. You’d plan a flight around a buffet brunch and get a kick out of watching your brothers stuff themselves. I hear your voice, a forceful voice. Steak, medium-rare. I want to see some blood. And crispy onion rings, very crispy. Fries, the steak fries, and load ‘em up! And I want a Diet Coke, with lemon. Just bring it all at once. Don’t hold back. I hear you leaving a message on our phone machine. Instead of saying goodbye, you say very fast: I’m out. I see you as you’re stung by a bee on a shuffleboard court while we’re on vacation in West Virginia. You tell me you don’t react well to bee stings, and I give you Benadryl. You’re so appreciative as if I’ve given you so much more. I see your joy after Ken has picked you up at the airport and suddenly stops the car, pretending to have a flat, and pops open the trunk where Doug is hiding. I see you at Disney World wearing a pair of Mickey Mouse ears, and in a banquet room, giving your wedding speech: It’s not that I need my bride, it’s that she completes me. You’re in a tuxedo, wearing a red rose boutonniere, handsome, trim, healthy, sober, and, for the moment, complete.


Why is it so important that I make sense of everything I’ve learned about you? Your silence about your work. Your quiet generosity. Your insistence on having Doug, Ken, and N do everything for you during the most painful stages. Think about it: You would have never taken care of any one of them on your own. You would have insisted on hiring a nurse, citing the need for safety and comfort, both of which you weren’t qualified to provide.

Zadie Smith writes about her father’s death, “The funniest thing about dying is how much we, the living, ask of the dying; how we beg them to make it easy on us.”  


At the memorial service, everyone’s mingling. The room is spacious and paneled in oak, and there’s a wraparound patio, a golf course beyond it. Many stand up to tell their stories about you. One man, a member of your tennis team, says that you recently treated several of your good friends to a luxurious golf resort. You’d think the guy was high the way he gave away his money, he says.

Later, a young woman in her twenties speaks. I met her earlier in the evening, and Doug has spent some time with her in the past few weeks. She’s studying to become a nurse. She introduces herself as the daughter of your long-time housekeeper, a woman with whom, at one point, you had a relationship, until she wanted to marry you. The daughter, dark haired, brown eyed, has a wide smile. She calls you a father figure and says she doesn’t know what she’ll do without your weekly talks. You’ve left this young woman a a substantial amount of money in your will, enough to cover most of her graduate school expenses.

Next, a clean-cut man, in his thirties, stands up. He’s poised yet nervous. He says he knows you through bugs—he’s your pest control technician—and he tells about a feral cat who had kittens in your attic and how you were concerned the cats might be harmed. Every time I came over, we talked, he tells the room. He knew about my children and my home life, and he had a great sense of humor.

This young man is also in your will.


After the memorial service, past eleven. The nurse-to-be and the pest technician join us for a late-night snack at one of the few places that’s still open, Waffle House. The restaurant is small—a counter, a few tables—and bright and empty. After listening to so many stories, we’re all punchy and laughing quite a bit. We’re comfortable around one another, talking nonstop, when the waiter shuffles over. Doug and Ken tell him we’ve just left your service and that it’s been a long day. Suddenly we’re all famished. We order far too much. Fried eggs, hash browns, buttered toasts, pancakes, coffee, milk, juice. After the food comes, the waiter lingers by our table. He’s been promoted to manager, he says, but tonight he was back in the kitchen, cooking for us, and he’s waiting to hear how we like it. 

In this suburb, where fast food chains abound, a landscape I first assessed as soulless, I’m beginning to understand why you loved living here. I’ve been missing the point for too long. You were focused on who lived here, on their stories. You didn’t distance yourself from the people you helped. You sat with them, ate with them, listened to them, joked around with them, and, because you understood that no one is ever that far from distress, you gave what you could to them. They deserved a chance, even a leg up. They were you. 


Some time ago, I woke up at dawn to go to the bathroom and found myself staring at a bright star out the window. I realized it was the planet Venus. I’d identified it as Venus before, yet its presence had never moved me, but, in that moment, it was luminous. Many months later, it still is. Why tell you this? To illustrate how I’ve felt while grieving for you. You’ve been gone for a year, and when I talk about you, you continue to appear new to me. I resist sentimentality and don’t discount your shortcomings, but I praise the wide reach of your embrace. You transformed your strong feeling for others into action. How many times have I wanted to do just that and couldn’t?

Start small, I tell myself. It’s working, too. I’ve been able to express my gratitude, admiration, whatever surge of feeling it might be, to a few people whom I don’t know all that well but who have made a difference in my day-to-day living. I’ve managed to show, in one way or another, that they matter to me, and my interest has surprised them. A gift, a note, an effort to be helpful—a call for action—little endeavors, perhaps, but, for me, such steps have never been easy. I think of this as a pact between you and me.

How does that sound to you?


Photo at the top of the page credit: NASA/Bill Dunford (Bright Venus seen near the crescent Moon on July 15, 2018).


Blue Sundays or My Year As a Chemical Eunuch

One thing we can agree on about cancer—there is no great time to be told you have it. I got my good news from a urologist named Alton Fitch. He delivered the results of my biopsy the way a vice principal would teach a miscreant the consequences of his bad behavior. “You’ve got quite a bit of cancer there,” he observed. “Cancer in nine of the twelve cores. Your Gleason score is seven, five being the least aggressive cancer, eight being serious cancer. This cancer is treatable. If you had to get any kind of cancer, this is the best kind of cancer to get.

I wondered if he could say cancer a few more times in case I missed it. But while he droned on about insurance coverage and treatment options, I waited for his nurse to burst into his office, all crinkly and fluttery, waving the fax that just came in from the imaging center that read: Dear Recent Biopsian. Boy, are our faces red! We’ve mixed up your results with some other poor bastard’s, and it is HE, and not you, who must suddenly face the terror of his mortality. We regret any inconvenience this may have caused and sincerely hope you will continue to think of us for all your future cancer-screening needs.

It all started innocently enough. I get my annual checkup around my birthday, so I’ll remember to do it. Who likes to think about maintenance, right? Does anyone remember the last time they rotated their tires?

I always thought it would be my heart. My father’s stopped ticking when he was forty-eight. His father and brother barely made it past fifty. I was not going to let it happen to me. I stayed away from red meat and salt, played a semblance of tennis a few times a week—all the paper umbrellas we hold up against the fifty-ton safe that’s been falling at us from the day we were born.

My GP’s name is Miles Davis (I love that he’s never heard of the other one). He’s affiliated with the medical center at the university where I teach. He’s known me for twenty years. We do the small talk while he pushes and probes and presses and palpates. He asks if I have any screenwriting geniuses this semester. I tell him we give them all the wrong advice. Who needs the competition? But he knows what I want to know, and he tells me right off that my heart looks good. My weight hasn’t changed…he likes that. “And neither has your height,” he adds. The same lame joke every year. But I give him the laugh. Because if he’s joking, it means I’m OK. The waranty is still in effect. I’m cleared for another year. I literally have one foot out the door when he Columbos me. Like the rumpled Peter Falk detective who asks the killer the one innocuous question that crumbles his entire alibi. Davis’s question to me is, “When was the last time we checked your prostate?” Turns out it’s been two years. I’m fifty-seven, young to be considered at risk, but still he suggests we do a digital.

To be clear, the “digital exam” Doctor Davis proposes is not an examination of the digits. It is an invasion by the digits into an area beyond the digits’ easy reach. I can feel his lubricated, rubber-gloved fingers explore their tight enclosure. He intones a brief “hmmm.” It is not a sound of mild interest, but of concerned surprise. It is not a sound you want to hear from your airline pilot, or your auto mechanic, or your doctor under any circumstances. “I feel a roughness on one side,” he says. The room begins to spin. “Was this ever here before?”

“You’re asking me?” I explode. “How the hell would I know if it was there? That’s your goddamn job to know.”

But he knows, and because of the way he’s asking, I know—it wasn’t there before. He can sense my blood pressure rising like a cartoon thermometer.

“Let’s draw some blood and do a PSA before we get all upset.”

At this moment I am so ignorant about my body I have never heard the term: Prostate Specific Antigen. PSA still means Poetry Society of America or Public Service Announcement. When I get home, I do nothing to spackle in the gaps in my knowledge. I invoke my mother’s advice about bees—if you ignore them, they’ll ignore you. Which didn’t even work with bees. But on the alternate weeks when my fifteen-year-old daughter is with her mom, I troll the internet dating scene, where I’ve been doing surprisingly well for a guy who drives a Honda Civic and rents a two-bedroom apartment in (the not yet ultra-fashionable) neighborhood of West Hollywood.

I seem to have found a little niche—a treasure trove of attractive, accomplished, wounded women in their forties and fifties whose successful husbands have ditched them for younger versions of themselves, but left them well provided. They comprise a significant demographic group—The Badly Married, Well-Divorced. BMWDs. Bimwads. Maybe I’m exotic to them. Middle age has forgiven the pudgy foibles of my youth. I have a kind of Yuri Gagarin look—short silver hair, decent enough built. My online moniker is Ageing Astronaut. I’m guessing I’m a 7.5. Patty, the woman I’m meeting tonight is a 9+ and that’s the least of our differences. Looking at our dating profiles is like Battle of the Network Mismatched:

Freelance writer and university professor     Consultant for high-end real estate
Movies, plays, racetrack Charity events, silent auctions
New Yorker/Sunday Times crossword Business Week/Today’s Entrepreneur
Tom Waits/Leonard Bernstein Celine Dion/smooth jazz
Divorced 12 years/15-year-old daughter Just divorced after 20 years/no kids

People will occasionally use an archival picture in the hope that you won’t notice when you meet in person. Patty is better looking that her photo—a blond, intense Catherine Deneuve type—out of my league. But I step up to the challenge. It’s Halloween night, which neither of us had thought of when we planned to meet. I hit her with a stupendous opening line, “I see you came as the pretty girl.” I step back to give her room to fall for me. For the smile to beam across her face like an orchid opening. The smile that says: You have touched me where no one has ever reached. You are the sunlight reaching the deepest recesses of the pyramid on the longest day of summer.  But all I get is a tight little smile. It continues to go that well until we finish our coffee. She does not have an abundant sensor for humor. And I’m really cooking. When she says she has no children, “I tell her two great advantages of not having children are one, you keep your figure; and two, you don’t have children!”


“Come on. You don’t get material like this at the real estate round table.”

She says, “I have an early meeting.”

Outside, her Lexus is parked alongside my Civic. I give it one more try. I point to a high rise in Century City and mention that I own it. She says she has never dated creative types. But after 20 years in a squelching marriage, her therapist has advised her to try someone outside her comfort zone. She asks if I have a tuxedo. Before I can say no, she puts her fingers over my lips and tells me to get one. And I do. To my immense surprise and delight, the next several nights are a sexual banquet. She expands her creative and comes to a poetry reading and the racetrack. I expand my Republican side and go to her charity fundraiser.

I have no illusion that this can last, and I doubt that she has either. Smart horseplayers tell you if there’s no horse in the race that you love, you lay off that race. Conserve your capital. Gamblers say, someone’s gotta win. If there’s no one you love, bet on the one you like. Stay in the action. But everyone agrees that no winning streak lasts forever. And when Doctor Davis calls a week later, there is no small talk. “Your PSA is 11.8,” he says. I strain to hear relief in his voice. Like, Phew we were worried for a minute, for a second but thank goodness it’s only 11.8. I ask him what’s normal? I prepare myself to hear ten. Maybe nine. He says normal is anywhere between two and three. Above four we might be a little concerned. Words start falling out of my mouth like teeth or mahjong tiles. “Do I have cancer?” My voice sounds like an unoiled hinge. Again, he tells me not to get upset—until we get the results of a biopsy.


The word itself (like a stroke) sounds like something nice. A ride at Disneyland. Or something you’d say to make a baby giggle. Biopsy daisy. When I call the Urology office to schedule an appointment, the nurse says they have no openings until after the first of the year. I tell her that’s fine. There’s no urgency. I feel quite magnanimous, deferring my place to men with greater need. She asks what my PSA is. When I tell her, she asks me to hold for a moment. When she returns she says Doctor Fitch can see me at three-thirty tomorrow. Now I know how it feels to have clout in a fancy restaurant.    

The four other men in Doctor Fitch’s waiting room are WAY older than me. At least they look older. At least I hope they look older. They’re all with their wives. One woman smooths her husband’s collar. Another points out a picture in a magazine they both recognize. I feel heroic being on my own. I don’t need a damn buffer. I AM the buffer. A plump nurse with a clipboard and tight kinky hair takes me to the exam room. The shelves are lined with the tools of the urology trade: rubber gloves, finger condoms, K-Y Jelly. Why would someone even become a urologist?

I park my car in the same spot every morning. Reserved for Doctor Alton Fitch. I take the long walk down the hallway that I think of as The Great Hall of urology. Twenty-four majestic portraits behind glass. Doctor Ernst Prater, inventor of the flexible catheter. Doctor Maurice Younger, King of the Kidneys. I was a young man when I first arrived, with grand urological ambitions of my own. I’ve squeezed ten thousand prostates in my twenty-seven years. Some small and juicy as a kiwi. Some stringy like ball of rubber bands. Some grown to the size of a cantaloupe. Some hard and noduley like a handful of marbles. I remember every one I’ve ever touched. But not all the women I’ve known. We take twelve tissue samples. A needle at the end of a slingshot shoots three centimeters into the prostate while I watch through a computerized digital camera. The camera is Doctor Milton Freedman’s invention. His portrait is in the great hall. You’ll feel a little pinch, I tell them, like an electrical shock. They curl into fetal position on the table. I always wanted to deliver babies. Oh, well.

Afterwards there’ll be some blood in the urine, blood in the stool. Blood in the semen is the one that gets to them. Some of them can’t pee when it’s over. It won’t come. It’s like a full ketchup bottle on a winter day. You read the panic in their eyes, that something irreversible has happened.

You don’t tell them that the results are nearly always positive. Two hundred thousand new cases of prostate cancer every year. Basketball coaches. Leaders of nations and great cities. Your Uncle Phil. Forty thousand die. We still don’t know what causes it. It’s the younger guys you don’t want to tell. Like this one here. Seems a nice enough person. You know what’s going on in their brains. You’ve seen it hundreds of times. They have bitten into the fruit of knowledge. They know they have been marked. That the angel of death has not forgotten them. That even if it is not this, that something will get them. That the meter’s running down and nobody’s going to put any more quarters in. It’s that. It’s the knowing. It’s that now they know. And that you’re the one who has told them.

And now, one week later, I am sitting across the desk from him and he has been droning on about—what? I’ve completely tuned him out. Wanting me to have a bone scan done…right now? What, is he kidding? I’m six days behind on what I’m supposed to be doing right now. I’m a divorced single parent raising a fifteen-year-old daughter, and I haven’t bought anything to make for dinner. Plus I have my screenwriting class and a rewrite on a script that’s due this weekend. I know he means well, but he has to understand: “Doctor Fitch. I apologize for interrupting you. You have to understand. I DON’T HAVE TIME FOR THIS.” I wish I had my schedule book. I could open it up to any page.

“No!” he says. It’s possible that he grabs me by the shoulders. “It’s you who don’t understand. With your high numbers, there is an even chance your cancer has already metastasized. You will take the elevator to the sub-sub-basement and follow the orange signs to NUCLEAR MEDICINE.”

The sub-sub-basement is like a bomb shelter. Thick concrete walls. All painted orange. I have the grim understanding the concrete is not meant to keep radiation OUT, but to keep it enclosed. In a blind trance of obedience, I follow rather than flee from the signs pointing to NUCLEAR MEDICINE. I am met by a lab technician with a bony head, thick glasses, and eyes that blaze like a man hatching plans for world domination. I am rammed up against a cold flat slab of glass. He ducks behind a wall of sandbags as thousands of roentgens are sent through my body.

He tells me the migration patterns of prostate cancer are as predictable as Ospreys. They seek out the femur, the rib cage. Their vacation isles of the Pacific. He says he’s seeing a lot of hotspots. I catch a glimpse of the x-ray plate. Good Christ, it’s all over me. I look like Van Gogh’s Starry Starry Night.

It’s 5:30 of a late November afternoon when I return to the outside world. Everything looks alien, like I have been to another galaxy and returned a hundred years later. The sky is cobalt blue with streaks of orange, and I have cancer. Normal people walk across the promenade chatting about weekend plans and real estate prices, and I have cancer. Their kids run, erratic and thoughtless. Are their parents unconcerned by the railing the kids are climbing, the lawn sprinklers, and sense meas the only danger? Do they shield their kids from me? Am I marked?

I remember being the age of those kids, walking down Ocean Parkway in Brooklyn on cool fall nights. The streets, filled with men coming home from work, wearing overcoats, carrying brief cases filled with adult concerns. I wish I were still a child again among them, comfortably ignorant of my future, a loaf of warm bakery rye bread under my jacket, cool fresh air with the smell of burning leaves in my nose, knowing that when I get home there will be a hot bowl of soup waiting for me.

Patty calls that night to see how it went. It feels just a twinge obligatory. Like this was not on my dating profile. We’ve seen each other nearly every night but as the novelty wears off, it’s hard to ignore the obvious. This relationship has more red flags than Moscow on Labor Day. I make a spontaneous decision I’m sure I’ll regret. I tell her not to come over tonight. “You have to walk away from this right now. From me, from this, from it, from us. No, listen to me! You’re just out of a long stifling marriage. You didn’t sign on to be an oncology nurse. You should party and dance and sleep with and as many management consultants as you can! Listen to me. I’m being Bogart for you at the end of Casablanca. Take the exit visas!”

A moment after I hang up, my daughter surges into the room like a pit bull. She’s fifteen, too smart, too perceptive, too strong for my primitive parenting skills. She bludgeons me with a question. “Are you going to die?” I sputter and spatter and assure her that no. Of course not. “Oncology nurse? Who needs an oncology nurse?” Of course. She eavesdrops on my phone calls. I fumble for a plausible lie. I don’t want her to know. A parent’s job is to be their child’s external kidney, to filter trouble OUT of their lives, not to be the cause. I tell her it’s a safe word Patty and I have when we’re fighting. I assure her I’m fine…that she’ll have me to abuse for many years. She seems placated. I feel like the lousiest of louses. How easy it is to lie to her. And what a violation it is to the one consistent purpose, the steady foundation I am for her life, that when she asks, I will always tell her the truth.

I will never forget her coming up to me one day when she was five and asking me if all men had penises. We were up in the garden staking tomatoes. It was a beautiful spring day. Everything was in blossom—peas, beans, three kinds of squash. But when your daughter asks about penises, the way you answer is going to shape her life. You have to hit the right balance. You can’t underplay it, like oh, just this little thing boy’s go peepee with. Because it’s more than that, and later in life you don’t want her to get freaked out. (Holy shit, this is artillery. I expected small arms fire.) On the other hand, you don’t want to overplay it and make it sound like the hammer of Thor, so that when she sees a perfectly adequate one on her husband or boyfriend she won’t think, Is that all you’ve got? Most important, you can’t be lazy and tell her to ask her mother! You’ve got to man up. Be strong. Take the bull by the horns. So I knelt down to eye level and said, “Yes, honey, all men have penises. In fact, the males of all species have penises. Dogs, cats, squirrels, goats. Having a penis is what makes a man a man.” I could see my answer playing on a PBS special on Great Moments in Parenting. But as I thought of the millions of viewers watching me, I wondered if what I had just blurted out in a moment of elevated sincerity was true in a deeper way than I had intended. Or not true at all. IS having a penis what makes a man a man? Are we nothing more than carrying cases for our genitals? The male ego rears up on it hind leg and shouts, NO. We are so much more than that. We are born to higher purposes—to cure Ebola or invent Post-its. But if we take the ego out of it, our one purpose is no more elevated than any other species. It is to propagate. Once we pass on our genes, as far as nature is concerned, all our accomplishments are hobbies to pass the time—write a book or two, conquer an empire.

Angie was not interested in squirrels or goats on that day. Something deeper was troubling her. She said, “Does Mister Rogers have a penis?”

“I’ve only seen him on TV,” I told her, “Same as you. And he was wearing all his clothes. But, yes. I’m going to say Mister Rogers has a penis.” My answer did not surprise her. I think my limited understanding of the world disappointed her. She said, quite thoughtfully and not to hurt my feelings, “I think Mister Rogers is too nice to have a penis.” I just wanted to hug her. Think of the qualities she had felt in Mister Rogers that were absent from the other males.

Maybe cancer has made me sentimental, but she’s still that five-year-old girl who trusts me, and I’ve just lied to her face. Is this what it means to be a man?

The day after the biopsy is a day like any other. Go for a run, pick up the laundry, find out if the cancer has metastasized. Patty pays me a surprise visit. She looks vulnerable and undefended. The hard professional mask is gone. “I know you think I need my life to be predictable,” she says. “But you have to admit. I couldn’t have predicted you. I want us to be in this together.” The phone rings. It’s the lab calling with the results. “Maybe we’ll be lucky, and it’ll be a short-term relationship,” I say. She smacks me. I kind of like it. The voice on the phone tells me I’m a lucky man. All the hot spots on the x-ray were old sports injuries.

“All of them?” My voice is weak with disbelief.

Tears flood Patty’s eyes. She squeezes my arm, thinking the worst. When I hang up, I tell her the cancer had not spread. It is confined to the capsule. A smile radiates from her, an orchid blossoming. She says my name like she’s meeting me for the first time. It feels the way I met my dog, Norton, through the bars at the animal shelter, how at first glance we both thought: Oh. There you are. I’ve been waiting for you.

Patty said, “I never seen anyone so glad to have prostate cancer.” I am flabbergasted. “Patty, did you just make a joke?” Breakup sex and makeup sex are great. But the cancer has not metastasized sex? Not for amateurs.


Euphoria fades fast. I have to decide on a course of treatment. I have armloads of material I can’t bring myself to read. And every day I delay, I picture the thing like Pac-Man biting off chunks of my organ meat. Like my tumor is Popeye and my prostate is spinach and the more he eats the stronger he gets. I need someone to tell me what to do. This is a job for my friend, Big Paulie.

Paulie has the absolute definitive opinion about every possible subject, whether he knows anything about it or not. He’s right out of The Sopranos. Big mug of a face. Voice like a triple-decker sandwich. But a total sweetheart. If he had to break your legs, afterwards, he would drive you to the hospital and water your plants. I dump the crate of material in his lap. “Paulie, I prostrate myself at the temple of your wisdom. Tell me what to do.”

He leafs through the material like he’s tossing crap out a dead relative’s closet. “Dja read any of this shit? Of course not. You can’t figure out your electric toothbrush. Awright, ya gotcha Door Number One. Your radical prostatectomy. Meaning they cut it out and throw it away. Sounds good except that they have to cut YOU open to get at it. Side effects Incontinence and erectile dysfunction.” Meaning you can’t fuck and you wear diapers. So that’s out.”

“Beautiful,” I say. “So I do radiation. Thank you!”

Not so fast. They microwave your ass. Side effects—? Here we go again. Limp dick and diapers. Throw in exhaustion and puking. Oh, and this is a nice touch. After all that, if any of the cells have escaped, you gotta do chemo anyway. So forget that shit too. What else ya got?”

“I think that’s everything.”

That can’t be everything. They both suck! This is like when we were seniors and we took the freshman up to the roof for THE QUESTION, and if they gave the wrong answer they’d get thrown off. D’ya remember the question—? If you’re buried up to your neck in a vat of wet horse dung and somebody throws a pail of vomit at your head…Do you duck?”

The thought of jumping off a roof doesn’t sound too bad. Thankfully there IS a Door #3. The older brother of a longtime friend. He had gone through hormone blockade for his prostate cancer a year ago, and he looked great. A few pills every night. A shot once a month. Some radioactive seeds injected after a year. And that’s it! No surgery! No radiation, except for the implanted seeds! Doctor Calvin Ramsey is tall and lanky with the manner of a well brought up country boy. He talks about my life after cancer. He sees me as a human being, not an array of symptoms. And for the first time, I think maybe I’m going to come out of this OK.           

I’m excited to tell Big Paulie about it. We’re at Hollywood Park racetrack the next day. His enthusiasm is more muted than I had hoped. “Are ya outa ya fuckin mind? A couple of pills every night are supposed to cure cancer? They wouldn’t cure hemorrhoids.”

“No! Listen! They stop your body from producing the hormone that the cancer feeds on. The tumor gets starved! Isn’t that the perfect irony? The treatment does to cancer what cancer does to your body. It gives it a taste of its own medicine!”

“What are the down sides?”  

“Paulie, why are you being so negative? Why do you think it has downsides?”

“Because when you lose your stupid hunch bets at the track, all you lose is your money. I’m not gonna let you pick a cancer treatment that way. Let’s hear the downsides.”

“Ok. The treatment only shrinks the tumor down. It doesn’t kill it. After a year I go to Seattle where they’ll inject little radioactive seeds into what’s left of the tumor. But I’m in and out the same day.”

“That doesn’t sound too bad. What else?”

“Who are you, Perry Mason? Why do you think there’s more? OK, there’s one little bump. It turns out that the hormone the cancer feeds on, the one that the treatment stops your body from making, is testosterone. So I’ll kind of be—stop laughing please—testosterone free for a year. No sex drive. No libido. My body chemistry will be like a woman in menopause. Will you please stop laughing, please?”

“You’re gonna be a chick!”

“They call it a chemical eunuch. But think about it. It’ll be good for me. I’ll be like Dustin Hoffman in Tootsie. He came out a better man.”

“Except he just put on a dress, he didn’t have cancer. Plus he got paid eight million dollars to do it. Plus it was a fucking movie.”

“Anyway, but also the doc says one guy in ten keeps his sex drive through the whole thing and you know I’ll be that guy.” I drop the laughs and get serious. I’m exhausted and at my wits end. “I’m doing it,” I say. “I need you to tell me it’s the right thing.”

“Hundred percent you’re doing the right thing. Just answer me this. If you grow tits, can I date you?”


I hate routines of any kind. I hate regimens. I hate patterns. I hate anything predictable. But if I’m going to be a cancer patient, I’m going to be the best patient in the history of cancer. I impose a rigid discipline on myself. Soy shakes every morning to counter the estrogen. Exercises to prevent muscle atrophy. Calcium pills to support bone strength. None of it allays the effects of the slow steady slide. Illness is measured in milestones of loss. As my testosterone level drops, physical changes occur. One day the hair under my arms is gone. Then it’s gone from my chest and my legs. A glob of fat accumulates around my middle. One night at a restaurant. my whole body breaks into a sweat. Patty’s friends take a shared delight in this—my first menopausal hot flash. Desire diminishes. The mechanism gets sluggish. One day I jog past a workout center as a group of young women in leotards comes out: their young birchy bodies crackling with pheromones. Perspiration glinting off their skin. The way their hands move, their arms, glimpses of exposed flesh—! Old me would have been hooked through the nose and dragged across the street to them. But now, for all the effect they have on me, they could be nuns at prayer.

Even worse than the physical changes are the emotional changes. I’m becoming soft and sallow. Sickeningly sereeeene. Nothing bothers me. I WANT things to bother me. One day I’m driving. I grew up in New York and what Los Angelinos call “road rage,” we call courtesy. A woman in an SUV is putting on makeup while she drives, talking on her cellphone, completely oblivious. She zaps into my lane, like an inch on front of me. And when I give her the horn, she gives ME the finger. Old me would have rammed her into oncoming traffic. Instead I smile and wish her a nice day. What the hell kind of man am I becoming? I want to be Jack Nicholson, but I’m turning into Mister Rogers. A man too nice to have a penis. It’s not going well with Patty. Our differences are growing inversely to our frequency of sex. I’m finding her humorlessness less charming. She has the same feeling about my humor. She buries herself in her work. I try to badger her into having some fun.

“I’ll tell you what isn’t fun,” she snaps at me. “The other night at the party, I did not appreciate your telling my business associates that I was a pole dancer when you met me. No, I do NOT think it was ironically funny. Yes, I DID see the looks on their faces. Maybe you think that was theater. My friends don’t go to that kind of theater. Why would you ask me if they know you have cancer? Does every minute of your life have to be the Oprah show. Damn it. Stop badgering me! I have a deadline.”

When I come into the bedroom that night, she is asleep on top of the covers. As beautiful as a fawn in a moonlit glade. The bottle of pills is on the nightstand. Not the cancer pills. The purple pills that rhyme with a certain waterfall. Our ritual has become that I take the pill on Saturday night and Sunday mornings we do the dirty deed. They have a funny side effect. They create a blue haze in your field of vision. When it first happened, we called it our Blue Sundays.

But as I reach across her beautiful, available body, the thought of sex makes me slightly nauseous. I realize the unthinkable happened. My libido is gone. I will not be that one guy in ten who keeps his. I feel like a dead rock. What am I without my sex drive? What kind of man am I without the thing that defined my manhood? In junior high I used to ask these weird questions. Like where does light go when you turn off the switch. And now I wonder where mine has gone. And if it will ever return.


With my trip to Seattle a month away and the finish line in sight, I have a setback. It is decided that my initially high Gleason and PSA numbers “support the possibility” that some cancer cells might have escaped the prostate capsule and begun to migrate. The decision is made to err on the side of caution, and I am to have 30 doses of “conformal beam” radiation. The idea is to create a kill zone—a ring of fire—that will vaporize any cells attempting to escape. A solid plastic sheet is placed in a vat of hot water and made pliable and then molded to the contour of my body. Six holes are cut on each side that match a series of bolts on the table, so I’ll be in the same exact position every time X’s are marked for the coordinates where I’ll be blasted.

With each session my internal temperature builds up. After two weeks, my plumbing becomes inflamed. I wake up every hour with the ferocious need to pee…walk like a zombie to the bathroom. Wait for the deluge. Get a dribble. Stagger back. I make the mistake of looking at myself in a mirror. My skin is the color of a used bandage. Driving is the worst. One day I have to pull over on the freeway to pee. I don’t even see the cop car. He leaps out of his Black and White. “Hey You. PUT THAT THING AWAY.” I feel my neck bowing in submission. “I have prostate cancer,” I mumble. I take a card from my wallet to prove it. He doesn’t want to touch anything my hand was on.

The encounter takes me back to a day when I was twenty. One of my dad’s clients got us tickets for a New York Giants football game. The Bronx was foreign territory, and we got a little lost finding the Stadium. All the parking lots were filled. He’d already had two heart attacks, and he couldn’t walk far. We pulled up to a lot a few blocks away. A chain was latched across the entrance. The kid in charge was maybe nineteen, hair slicked back. “Sorry bub. All filled.” My father was a CPA, not a ‘bub’ kind of guy. He wore trousers and dress shirts on weekends. He rolled down his window. I thought he was going to slip the guy a twenty. Instead he said very quietly, so I wouldn’t hear, “I have a weak heart.” After we parked, I walked deliberately faster than he could and made a big ceremony of slowing down for him. I resented his weakness. I didn’t want to be a genetic casualty of his faulty manufacture.

When the game was over, I took the keys from him and told him to wait inside while I get the car. I had never driven in the city or at night. I felt like I was making a run through enemy lines. I negotiated the one-way streets and got back to where he was waiting. He expected me to slide over but instead, I opened the passenger door and said, “Get in bub.” My back found a space in the indentation worn by his back. He fell asleep crossing the Throgs Neck Bridge. Like I used to fall asleep in the back seat to the murmur of adults talking. I kept the car at a steady speed and changed lanes very slowly, so he would sleep all the way home. Only now, as I feel my own terror, do I realize how he must have felt every day, not knowing how far away that safe was from crushing him, but knowing it was there.


At last, the day that seemed so far in the distance has arrived. I am flying to Seattle where the radioactive seeds will be implanted. My Bangladeshi cab driver finds the Princess Hotel easily. The carpet smells like something cooked in the 1940s. The couple checking in before me are half deaf and have to repeat everything five times. And yet they seem bonded. Maybe that’s the secret to sustaining relationships. Lesscommunication. I don’t really know why I didn’t let Patty come with me. I know why I said she couldn’t come. “We’d have to get a nicer hotel. You’d pack too much.”

There’s an hour of daylight left after I check in. I wander the city. I don’t know how I should walk. Hunched in a C-curve of surrender, conserving my strength, or defiantly using it all up. I find myself at a supermarket and when I get to the checkout, I see that I have a set of dishes, a plant, and some wall decorations in my cart. And a painting of George Washington on his horse? What am I thinking? Am I going to decorate my room at the Princess Hotel? I leave it all there, go outside with a fifty-nine-cent Bic pen and a spiral notepad. I start to write, and all the thoughts and feelings I’ve kept bottled up come flooding through me. A paramedic ambulance passes me, siren howling. It’s heading toward my hotel. The first line I write is: The angel of death came looking for me today, but I was out.

Morning comes to the Princess Hotel, and I am up before the alarm. I am greeted at the hospital by a nurse with a psychotically cheerful smile: “Good morning, sir. Have we had our two fleet enemas?”

“Yes we have!” My sarcasm at trying to match her cheer is unnoticed.

“And did they have their desired effect?”

“They did, indeed.”

“That’s good. The doctors don’t want to have any cloud cover.” She winked.

And now it’s all business. I’m brought into a prep room, given a hospital gown, told to undress, strapped down onto a table, given an epidural that will numb from the waist down and a shot to put me into twilight sleep. I’m rolled into the operating theater and now, everything goes into waltz time. I hear murmurings of conversation as the doctors go to work. I think I hear one of them say the tumor is so small they only need 70 instead of 90 seeds. I think I ask if I get a discount. I think they say yes. A long, thin needle is inserted into my rectum. One by one, the rice-sized radioactive palladium seeds are inserted into my now shrunken prostate tumor. I encircle myself with images of friends, their arms linked, all of them smiling at me. Patty is outside the circle, trying to look in. When am I going to learn to be a human being? I want to leap off the table and apologize for not letting her be here. Of course, that would be a huge mistake as I am on a table with a catheter up my dick.

An hour later it’s over. The first time I pee it feels like I’m giving birth to a porcupine through hot barbed wire. I call Patty and get her voicemail. I take the night flight back to Los Angeles. The moon hangs outside the window like a glowing earlobe. I read the post-op instructions I was given at the hospital: Sexual intercourse may be resumed. However, initial ejaculations may be discolored brown or black or red. This is normal. This is normal?? I have clearly moved into a new dimension of normalcy. I realize that after a year of diagnoses and treatment, I am no longer a cancer patient. My treatment is done. All I can do now is wait and see if it has worked.

I must have dozed in the taxi because I find myself at home. My lights are on. I open the front door. A warm rich aroma permeates the house. Patty has made me hot soup. She has also packed her Louis Vuitton valise with the few things she keeps here. Her contact lens solution, a French sweater, a pair of glasses, her hair dryer. “Really? Now?” I say. “The hard part is over.”

“You’ll find who you’re looking for.”

“I wanted it to be you.”

“No…you wanted it to be someone like your friends who looked like me.” She wishes me well, nods goodbye with a rueful smile.  


With the treatment over, the manic of doing is replaced by the wallow of waiting. The thousand pound gorilla crouched just over my head is the PSA test six months down the road. Any reading over 1.0 means that the implants haven’t worked, and the cancer is still alive. I’d have to go on another cycle of hormone blockade or something more radical. Men aren’t wired for waiting. Men are linear. We think in outward extensions. Unbroken streaks. We would never have imagined the cycle of seasons. It must have been a woman who first knew the world was round.

I write Patty a few letters she doesn’t answer. One thing hasn’t changed—my futile belief that if I can find just the right words, I can penetrate the heart of an unreachable woman. Either that or cure Ebola. To kill time, I make another foray into online dating. I run an ad with the headline: OLD. RICH. DYING: Terminally ill man looking for a woman whose personality is so obnoxious she will make death a pleasant alternative.This is LA. Three hundred women answered. Maybe this is a milestone of recovery. I don’t call any of them back.

Six months finally pass. I go to Doctor Davis and have blood drawn for the PSA. It comes back 0.005! The seeds have done their job! I am cancer free. There are people who will want to know. I call Patty first. We haven’t spoken since the night she left. It’s Halloween tomorrow. The second anniversary of our first meeting. We meet at the same restaurant. She looks stupendous. There is so much I need to say. I don’t know how to start. “I had cancer,” I say. “I’ve had cancer.”

“I was hoping you’d say ‘you came as the pretty girl.’”

“You remember that?”

“You don’t hear material like that at the Real Estate Round Table.”

I’m surprised and a little bit turned on that she remembers. “I never got to thank you. You went beyond the call of duty.”

“You think you’re easy to be with, but you’re not. You inflict pain with your humor. Cancer is no excuse.”                               

“I understand that now.”

“The next girl will be lucky.” 

She preempts what she senses I am about to say.

“It wouldn’t have worked no matter how much hard work we did. Maybe it takes knowing you’re with the right person to make all that effort possible, because that’s the one person you can’t afford to lose.”

She tells me she’s getting married. It takes me a few moments to be happy for her. And then I am. “Another writer?” I smile.

“You’ve cured me of that. He’s in upper management.”

I walk her to the parking lot. We hug one last time. It still feels good. She gets into her Lexus and drives west. I get into my Honda and drive east. And that would be the end of the story, except that Angie is waiting for me when I get home. She charges like a rabid wolf. “I hate you! Asshole Jason broke up with me.”

I am dumbfounded by her ferocity.

“He’s just like you. He wouldn’t know love if it hit him in the face. No wonder I choose misfits. Look who’s been my role model. You should have died. I’d be better off.”

I am left in tatters. Is this why I fought so hard for my life? To have the person I love most in the world wish me dead? Strangely, the answer is YES. I realize I’d rather be alive hearing her wishing me dead than dead and her wishing me alive.        

A moment later she comes back. She throws her arms around my neck and says she’s sorry. I multiply the gesture by its weight on Jupiter. Men live in a hard world. A mother has a child’s love whatever she does. A father has to earn every moment of his by explaining and making safe for his child a world that still frightens him and that he’s never understood. It’s weird to think of cancer as a gift but maybe that’s what it took for me to understand an obvious basic truth: You don’t choose a woman to sleep with, but to be awake with. And if there’s no one running that you love, you lay off that race.

We never know when someone is going to say, “Hmmm, I feel a roughness on one side,” and everything we thought about the rest of our life changes. We are, and then we aren’t. All that light? Who knows where it goes? But growing old doesn’t scare me anymore. I want to keep doing it as long as I possibly can. It’ll take six months for my testosterone to return. I hope I’ll retain some of this understanding, and that we are not merely products of our chemistry.

The first night in Seattle, on the walk back from that drug store to my hotel, I stopped outside a small café where a singer songwriter named Annie Gallup was performing. I still remember a line in her song. “I’m looking for that one bright and shining choice, so clear and compelling it makes every other possibility irrelevant.” I hope I haven’t missed my bright and shining choice. I hope she is careening through the maze toward me, and that we’ll recognize each other and say: “Ah. There you are. I’ve been waiting for you.”