Poor Margins

Bodies have narratives that can be revised. Souls, it is hard to say. 

The original narrative goes like this: This is endometrial cancer. It looks contained and it is very treatable. We take out your uterus and your ovaries.  Seventy five percent of patients with your stage and kind of cancer do not need further treatment. My body likes that narrative. I am fearful but the diagnosis makes the bleeding and other symptoms part of a story. 

Then, the narrative is revised. The cancer is not endometrial cancer. It is a rare, cervical cancer, so rare that barely anyone has ever had it. There is no data. The tumor has crawled into the ovaries, but (the narrative clarifies) this is not the same as having ovarian cancer. The margins are poor, which means the cancer has tried to get out and comes up against and almost through the uterus and ovaries. A radiation and chemo combo is suggested to eradicate the chance of errant cells. After that, I am to be considered cured.

Second revision. A further scan reveals that the cancer has spread to my omentum, a part of my body I had never heard of, a tissue that wraps around the intestine. My cancer will never be curable. A quick surgery will cut away what they can get. I will have chemo and most likely a remission. But the cancer will recur.

Third revision: And recur.

Fourth revision: And recur.

It is the phrase poor margins that begins to parse my soul from my body. A soul, so far as I know, has no shape and possibly comes with just one story, but my body seeps, spreads, grows tumors. I am told I am going to die. The when of that is a secret from my body, but I suppose, given the nature of souls, the soul knows and doesn’t care enough to tell me. 

I ask my wife to shave off my hair because I cannot stand the idea of the body gradually losing its hair. My wife takes hold of my head and shears and shaves the hair down, so I will not shed for weeks like a dog. My body is an animal, apart. 

My body prepares its defense. I am over-informed and purposeful. My body is resilient. My body deals with cancer when it comes. It knows the routine, when the nausea starts and passes, when the achy-quakes come — what is the exhaustion of chemo versus the exhaustion of life? My physical symptoms are uninteresting and my body handles them like a good secretary.

My soul knows to avoid places like the eyes of my children. The display of five-year calendars. The way my distant brothers cower on the phone and ask, “How is it going?” The soul considers but cannot affirm the idea of longer or more, does not promise a follow through to the incomplete poems, the trip to Hawaii, the novel I always meant to finish.

I may not outlive my father, who is 93 or my uncle who is 100. Every time everyone says I have “good genes,” my face smiles, my neck nods, and my soul says, “What the fuck?”

In the middle of the night, the dog is at my feet. My wife is beside me. Sometimes a moon comes between the slatted shutters. The body says “here you are,” but the soul, wordless and alive at this hour, suggests there is more. Awakened for no reason, the soul scurries back and forth in time. I do not roll over and look at the clock; the soul’s point is that time is senseless. Still, I worry about being tired the next day. I put my hand on the surgery scar, but my soul has moved on. It is knocking around, like a bird in the chimney. The soul shimmies out into the night. I feel deserted and I worry again, when will the cancer come back, what will we tell the children, how will it go, what should I be doing. The soul is silent on these topics, I feel cheated. I thought the soul was there to advise.



Image: Photo by Vlad Kutepov on Unsplash, licensed under CC 2.0.

Elizabeth Crowell
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