Saturday, December 15, 2018

The 60th. BIRTHDAY

When they were young, Jim and Mirium never thought about it. It was all about the fun and frolic. Then came the raising of the children and seeing them grow and prosper. But now as the years ticked on there was the ominous feeling that entered Mirium’s mind and would not recede. It lay on her like a dark heavy blanket, blinding, perhaps even taunting her. She didn’t know what to do with it. She couldn’t talk about it with him to alarm him nor with any other members of his family. But there it was morning, noon and night like a colicky baby, screaming, inconsolable. 



Jim was entering his sixtieth year and she had planned a birthday party for him. Trying to drown her sorrows, she simply immersed herself in the planning phases and threw every fiber of her being into directed attention to the slightest bit of detail; the color of the flowers, the placeholders, the orchestra, the uniform of the waiters, etc. Nothing was left to chance. And yet as she turned every page of detail over, the dreaded thought crept back in like a slithering snake full of cold-blooded venom, forever hissing. 

It was the summer of that year, one afternoon when the hammer hit. Numb with disbelief and fearful of the impending loss that she had anticipated for several years, seemed to be coming true. Jim, her beloved husband had just received news after a “wellness” examination that he had to have a Computerized Tomography (CT) examination of his abdomen and pelvis. She had just nodded. No reply was needed. Even a word of encouragement seemed so futile in its existence that expressing it would be a sacrilege and a betrayal of her carefully crafted inner strength and any weakness would show her inner frailty. She kept the brave face in front of her husband. Her husband meanwhile seemed quite oblivious to all her angst and seemed to take it in stride, “nothing to it, after all I go to the gym 5 days a week and last week I bench pressed 240 pounds. You can’t do that if you are sick. Right? Right?” She just nodded ruefully as she twisted the cloth she was holding over and over again. She knew better. Or did she? There was hope. Wasn’t there? Clutching to straws, she prayed.

Jim’s father had died of a cancer of the throat that caused a “carotid blowout” one day late in the winter. With blood pulsing out onto the carpet and the linen, it seemed like a horror movie playing out in their bedroom. Shortly after, Jim’s mother fell ill with Ovarian cancer. The trauma of the loss was still raw with emotions when the foreboding of yet another malady seemed all to certain. There were multiple hospital visits and many debilitating chemotherapy sessions that laid bare the raw damage of the human body, once the belle of society dressed to the ninth, became the whimper of a human shadow. All dignity that could be preserved, was, until there was none left. Life became a long sleep as the withering frail body left only the skeletal raised relief underneath the freshly laundered linen. Her time grew shorter and shorter until one day when hope left.

Nature’s rebuke of the wonderful life, lived through the lens of pomp and circumstance seemed hard, relentless and outright cruel. But not till their first born, a strapping healthy man in his fifties was diagnosed with a fast-growing lung cancer. This malady seemed to come from nowhere and have total control of him. Yes, he was a smoker of a pack of cigarettes a day but he had not indulged in them for more than 10 years. Now he was left coughing in fits and spells, wishing he had never touched the vile weed. He knew his time was short after the radiation treatments failed to control the growing crab within his chest. He had just enough time to see his estranged child and try to reason with the unreasonable thought that life was a strange torture, painful in its suddenness and ruthlessness. He would never see him grow older. He was gone a few weeks later, having witnessed the horror of the loss of one of his parents earlier.

But he was not alone to suffer the trauma of nature’s cruelty alone. The middle child, a girl who had grown up with nary a desire that remained unfulfilled and always had the world at her feet. A smattering of beaus lining up outside the door testing the angry yet constrained eyes of her doting father. She had been spoiled with the embarrassment of riches she had grown up with, which seemed to constantly surround her even in the darkest of her moods that swung like a monkey on a tree branch. Yet here she was still primed for another 30 some odd years of fun and frolic after the loss of her parents and the enormous wealth that splattered around her like a massive welcome rainfall. Out of the blue the lightning struck and a mammogram revealed a tiny but angry looking whitish crab-like anomaly stuck deep with her bosom. The surgeon had their day and so did the radiation therapist followed by the oncologist, each whispering about the potential of future that was never to be. The crab-like radiological nemesis continued its march, swimming through blood streams and finding haven in places where imaginations of seasoned cancer specialists feared to tread. The once tiny crabby monster made its way to the pelvis, to the ear lobe and even to the bones in both her legs, leaving her bed ridden. Life could not imagine its domicile in that thinned shell for long and decided to leave quietly on a quiet cold fall’s morn. Gone like the breeze, the once vibrant youth who could be found collecting flowers from the flower beds as she did boyfriends from the handsome and striking airline captain crowd. Gone like the orange orchards and the grapevines from the scourge of a deadly virus. Gone were the memories of the ones whom she knew and who knew her. All gone.

Meanwhile life’s trauma had gnawed at Mirium slowly about the “what ifs” until the request for a diagnostic CT scan was made. She knew then, the serpent was near. She kept up the stoic exterior in front of her four children and silently cried herself to sleep in the darkness of her bedroom, where her only love, Jim breathed comfortably, oblivious to the growing darkness that was to arrive soon enough and overwhelm him.

“Why,” Oh God, why?” But there were no answers. It was in the stars or in the genes or somewhere in-between the heavens and the earth. Jim had just turned 60 as his father had and his mother and his older brother and his older sister, who had all succumbed to the vagaries of this awful and ruthless monster called cancer. And now, right on-cue just like the rest of them he would be faced with the enormous task of living through the infamy of the constant indignity.  The answer seemed to arrive as Jim’s health declined. He had, had a coronary bypass graft surgery for the “widow-maker” successfully until it was revealed that he had developed a case of an inflammation of the liver. The hepatitis symptoms after an acute phase seemed to abate and for several years only “minor blood tests” were done to determine the viral activity in the liver. Yet one day, the virus triumphed over the liver creating the wayward cellular multiplication and ensuing liver cell destruction leaving in its wake the crabby monster!

There were a spate of experts and specialists alike who opined about the best care. Jim was wealthy in his own right as well as the beneficiary of his parent’s fortune. Everyone thought the best mechanism of cure was a liver transplant. They brushed aside the CT scan findings of enlarged perihepatic lymph-nodes. “No,” the experts said, “During the abdominal surgery for the liver transplant, that he,” the able surgeon “would also do a thorough lymphadenectomy (removal of the lymph nodes) and that would result,” as the surgeon said, “in an R0 state.” 
Jim was all for it. As the preparation for the liver search grew with a fervor. Soon the liver was acquired from an unlikely source; a Chinese young man killed in the service of humanity by a freak motorcycle accident. Lo and behold the liver was grafted and all rejoiced. But shortly after the immune-suppressive therapy with Cell-Cept was begun another shadow appeared on the follow-up CT scan of chest and abdomen then another and another till all hope was thrown to the wind. Another of the misfortune family member shriveled into a ghostly apparition. It seemed that the cure of the transplant required immune suppression and suppressing that, caused the cancer to grow with abandon.

Mirium’s worst nightmare had come alive like the fire breathing dragon, which consumed her life, leaving in its wake the charring remains of tattered dreams.

Jim died in her arms surrounded by his four daughters. No sooner had his blood turned cold, did the youngest son, the angry rebel filed a law suit to gain all his brother’s fortune for himself. Ruthless like nature, he preyed on the father-less four children with a team of pin-striped suits parading through the court houses. Like leeches they sucked on every possible loophole in the will and like vermin they trolled poor bereaved Mirium. This human monster of a child, the last born of this once wealthy family had a penchant for money squandering. He spent and spent and spent to console an emptiness within that could not be satiated. Yet he persisted. 

He would turn 58 that summer.

Epilogue:
A fault in their stars was the causal determinant of the malady that was to befall them at their birth. A multi-gene mutation on one allele of the chromosome? A shortened tandem repeat of the Telomere?  Whatever the abnormality it sat quietly until smartly and quite purposely the second hit took place at the approximate appointed hour of the sixtieth birthday. Meanwhile the youngest one still awaits as the hours and minutes slowly tick away time into that dreaded 60thbirthday. He refuses genetic testing, because, “it is unnecessary.” 

That dread is something that only the medical-knowledge naïve, Mirium realized, but could not do anything about.