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first person

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Illustration by Mary Kirkpatrick

It had been a while since we’d had a family doctor and when we finally secured one, she sent us for the usual battery of tests. My FIT test rang a bell with the BC Cancer Agency and I was scheduled for a colonoscopy. I was relatively unworried. We’re a heart-and-stroke kind of family, I thought, not a cancer family. The doctor and nurses were all pretty jolly as the procedure began, but soon the temperature in the room dropped noticeably. No one would meet my eyes as I was wheeled out.

COVID-19 restrictions meant that we were not permitted to have family members or other support people accompany us in the colonoscopy clinic. It was another sign of the seriousness of my situation that my husband was invited to join me when the resident surgeon came out to deliver the bad news. An MRI later, the news would only get worse. Colorectal cancer. Not the most glamorous of cancers, I remember thinking.

The initial meeting with my oncologist took place, not in his office, but in an examination room at the cancer agency. This must have been to accommodate the mandated space between the three of us. Even my husband and I were seated the requisite two metres apart. We were all masked. The oncologist delivered the news kindly but firmly. Stage 4. Cancer spread to my liver and lungs. Not curable but it was treatable, the treatment aimed at quality of life.

The life expectancy for people with my type and stage of cancer, he said, is two to three years.

In the 21 months since my diagnosis, this is the only in-person meeting I have had with my oncologist. Since COVID-19, telephone consultations have become the new norm.

I began chemotherapy in January, 2021, anticipating that I would undergo six treatment cycles over the course of 12 weeks. Two days later, still feeling pretty lousy, I sat in my reading chair and watched as the mob stormed the U.S. Capitol. It felt like a metaphor.

It was a bit of a shock to realize, later, that my chemotherapy – they call it “chemo-lite” or “maintenance chemo” – will extend as long as I can tolerate it or as long as it keeps cancer at bay. I’m now 20 months into it. All of my symptoms now are the side effects of the toxic chemicals that have been moving through my body.

Cancer treatment has become standardized and it can be hard not to feel that one is a widget on a rolling conveyer belt. CT scan every three months. Telephone consultation with oncologist every three months. Nurse practitioner consultations every four weeks. Chemo treatment every two. The only people I see in-person are the cancer nurses. When I began treatment, at the height of the COVID-19 epidemic, they wore masks and plastic visors over their faces, plastic coveralls over their scrubs and they said it was like being in a sauna, for hours. I have never seen their faces, even now, when they are down to one mask and paper coveralls. They have never seen mine. It surprises and pains me to realize that still, only two or three of the nurses recognize me enough to say a casual hello as they pass in the treatment room.

In spite of these necessary but alienating precautions, we are all unfailingly courteous with one another and the atmosphere in the treatment room is quiet and calm. Once in a blue moon, something unusual happens, like the time I was seated next to a cheerful man in his late middle age, plugged into his iPhone and loudly singing along to country-and-western songs, all in the “she done me wrong” mode.

For a long time, we cancer patients were on our own. There were no visitors and our chairs were positioned far apart from one another. Not too long ago, we were once again permitted to bring companions into the treatment room but hardly any of us have done so. Mostly we prefer to read our books, do our crossword puzzles, check our devices and doze. We don’t feel compelled to have cheerful conversations. We don’t want to play hostess, not even with one another. The nurses tell me this is a change, one they like.

I’ve heard that in the pre-COVID “before times” the atmosphere in the treatment room was different. There were volunteers with tea trolleys and therapy dogs. A coffee shop. A wig-and-hat shop catering to patients who were losing their hair. More visitors and companions. Meeting rooms for support groups and on-site psychologists. Now there are greeters at the door who quiz us about COVID-19 symptoms and ensure that we sanitize our hands and wear new masks as we enter the building.

But here’s what I have to ask myself. Is it better like this? Scaled-down and scaled back. No pressure to join support groups or take up yoga or meditation for people “living with cancer.” No pressure to see a psychologist or to tick items off my bucket list. Cancer has made me realize that my ordinary, daily life is my bucket list. Taking the dog for walks, tending the garden, reading and writing, cracking jokes and watching TV with my husband. For me, at least, having cancer in the time of COVID-19, when there are fewer possibilities and therefore fewer expectations, takes a lot of the weight off.

Something else that takes the weight off is Canada’s Medical Assistance in Dying (MAID) law. I can’t imagine going through this without that consolation. The great inconsolable, of course, is the thought of leaving my husband alone, but in that I have to trust in his inherent strength.

I have developed a handful of mantras that help me negotiate this period in my life. Take one day at a time. Practice equanimity. Live neither in hope nor despair. Live as if I’m going to live while accepting that I’m not. This means, among other things, planting bulbs in the fall. Cancer in the time of COVID-19 has freed me to live my ordinary life, not heroically, not engaged in a courageous battle: just living. After all, I’m alive until I’m not.

Jo-Ann Wallace lives in Victoria.

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