Calculating God

10

Susan had come with me last October when I’d gone down to St. Michael’s Hospital to meet the oncologist, Katarina Kohl.

It was a terrifying experience, for both of us.

First, Dr. Kohl conducted a bronchoscopic examination. She passed a tube ending in a camera through my mouth into the airway subdivisions of each lung, in hopes of getting at the tumor and collecting a sample. But the tumor was unreachable. And so she performed a needle biopsy, pushing a fine needle through my chest wall directly into the tumor, guided by x rays. Although there had been no doubt, based on the cells I’d coughed up with my phlegm, that I had cancer, this specimen would nonetheless confirm the diagnosis.

Still, if the tumor was isolated, and we knew where it was, it could be surgically removed. But before opening my chest to do so, another test was required: a mediastinoscopy. Dr. Kohl made a short incision just above my breast bone, cutting down to the trachea. She then passed a camera tube through the incision and pushed it down along the outside of my windpipe to inspect the lymph nodes near each lung. More material was removed for inspection.

And, at last, she told Susan and me what she’d found.

We were devastated by the news. I couldn’t catch my breath, and even though I was sitting down when Kohl showed us the test results, I thought I might lose my balance. The cancer had spread to my lymph nodes; surgery would be pointless.

Kohl gave Susan and me a few moments to compose ourselves. The oncologist had seen it a hundred times, a thousand times, living corpses looking at her, horror on their faces, fear in their eyes, wanting her to say she was just kidding, it was all a mistake, the equipment had malfunctioned, there was still hope.

But she said none of that.

There’d been a cancellation for two hours hence; a CAT scan would be possible that very day.

I didn’t ask why whoever had had the appointment had failed to keep it. Perhaps he or she had died in the interim. The entire cancer ward was filled with ghosts. Susan and I waited, silently. She tried to read some of the outdated magazines; I kept staring into space, my mind racing, eddying.

I knew about CAT scans — computerized axial tomography. I’d seen lots of them done. From time to time, one or another of Toronto’s hospitals will let us scan an interesting fossil when the equipment isn’t being otherwise used. It’s an effective way to examine specimens that are too fragile to remove from the matrix they’re encased in; it’s also a great way to see the interior structures. We’ve done some wonderful work on Lambeosaurus skulls and Eucentrosaurus eggs. I knew all about the procedure — but I’d never had it done to myself before. My hands were sweating. I kept feeling like I was going to throw up, even though none of the tests should have made me nauseous. I was frightened — more frightened than I’d ever been in my life. The only time I’d been even close to this nervous was while Susan and I were waiting for word about whether we were going to get to adopt Ricky. We had sat by the phone, and every time it rang our hearts jumped. But we’d been waiting for good news, then . . .

A CAT scan is painless, and a little radiation could hardly do me any harm now. I lay down on the white pallet, and the technician slid my body into the scanning tunnel, producing images that showed the extent of my lung cancer.

The substantial extent . . .

I’d always been a student, a learner — and so had Susan, for that matter. But the facts and figures came in a dizzying flurry that day, disjointed, complex, too much to absorb, too much to believe. Kohl was detached — she’d given these lectures a thousand times before, a tenured prof, bored, tired.

But to us, to all those who sat in the same vinyl-covered chairs Susan and I sat in then, those who had struggled to take it all in, to understand, to comprehend — to us it was terrifying. My heart was pounding, a splitting headache; no amount of the warm water the specialist kept offering would slake my thirst; my hands — hands that had carefully chiseled embryonic dinosaur bones from shattered eggs; hands that had removed limestone overburden covering fossilized feathers; hands that had been my livelihood, the tools of my trade — shook like leaves in a breeze.

Lung cancer, said the oncologist in even tones, as if discussing the features of the latest sport-utility vehicle or VCR, is one of the most deadly forms of cancer because it usually isn’t detected early, and by the time it is, it has often extensively metastasized to lymph nodes in the torso and neck, to the pleural membrane lining the lungs and chest, and to the liver, adrenal glands, and bones.

I wanted her to keep it abstract, theoretical. Just some general comments, mere context.

But no. No. She pressed on; she made her point. It was all relevant to me, to my future.

Yes, lung cancer often metastasizes extensively.

And mine had done precisely that.

I asked the question I’d been dying to ask, the question I’d been afraid to hear the answer to, the question that was paramount, that defined everything — everything — in my universe from that moment on. How long? How long?

Kohl, at last a human being and not a robot, failed for a moment to meet my eyes. The average survival time after diagnosis, she said, is nine months without treatment. Chemotherapy might buy me a little more time, but the kind of lung cancer I had was called adenocarcinoma — a new word, a handful of syllables I would come to know as well as my own name, syllables, indeed, more defining of who I was and what would become of me than “Thomas David Jericho” had ever been. Even with treatment, only one in eight adenocarcinoma patients are alive five years after diagnosis, and most were gone — that’s the word she used: “gone,” as though we’d slipped out to the corner store for a loaf of bread, as though we’d called it a night, turned in, gotta get up early tomorrow — most were gone much sooner than that.

It was like an explosion, rocking everything Susan and I had ever known.

The clock had started on that autumn day.

The countdown had begun.

I had only a year or so left to live.