Chemotherapy

8 minute read.

On the morning of my 35th birthday, I found out that I will need chemotherapy.

The cancer center, Epic, is in Emeryville, in a part of town that has been developed within an inch of its life, all personality paved over.  Wide streets with smooth asphalt lead to bland landscaping and office buildings. The cancer center is in a well-kept building with easy street parking.  

Over the past month of visits there, we have developed a routine: my mom meets Brian and I at our house. We carpool to Epic, park on the same street each time, and walk into the office together.  From where we park the car, we walk past the windows of the chemo room.

For weeks, I have looked through the windows at the beige vinyl recliners next to square machines covered with blinking lights, chemo patients sitting resignedly attached to them by long clear tubes.  Each time, I have thought to myself how badly I want to stay out of that room.

I’m so grateful to always have support and company at my doctors’ visits. The crew for today’s visit is Brian, my mom, and my brother David.

I have been in a state of escalating anxiety with each day that has passed without getting my surgery pathology results.  

The oncologist, NM, explains what they found during surgery.  She tells us that lymph nodes are like tiny grapes, growing in little clusters.  The surgeon thought she had removed 7-8, but really she took out 18 all together. Cancer had spread to three of those lymph nodes.  Lymph node spread terrifies me – this is one way cancer moves throughout the body and spreads to other locations. The amount of lymph nodes removed puts me at risk for lymphedema, a chronic and painful swelling of the arm. For the rest of my life, I will have to baby my left arm and avoid cuts and scrapes there.

I am BRCA negative, which means I do not have the gene mutation that causes a very high risk of cancer recurrence.  My invasive cancer is hormone receptor negative, which means I will not be treated with the hormone blockers that put cancer patients into medically induced menopause.  But the cancer may be triple-negative, an especially aggressive form of breast cancer. That test result will take a few more days.

I need chemotherapy, followed by radiation.  Chemo lasts for 4 ½ months and radiation lasts around 6 weeks. Chemo will probably end my fertility. Fertility can return in some younger people, but only sometimes. If I ever want to have the option to bear children, I must do fertility preservation ASAP.  I need to begin chemo within the month.

After our conversation, Dr Marshall escorts us to the chemo room to book my first appointments: a teaching session, and my first chemo treatment.  

Together, Brian and I cross the threshold of the chemo room.  For the first time, I cry during a medical visit.

Somehow, I have yet to cry at doctors’ appointments.  I have observed two modes in myself. In the most frequent mode, I feel strangely calm and alert. I can follow everything the doctor says, and my mind is two steps ahead, quickly forming follow-up questions. At these times, everything seems hyperreal and time seems to stand still.  

In the other mode, I feel dazed, closed off, and numb, without access to my normal thought process. My mind is completely blank, and all I want is for the visit to end.

Up until the moment we enter the chemo room, I have yet to feel tearful during a visit – that usually comes afterwards.  But at the desk in the chemo room, tears come, and I cry. The scheduler is wearing a Santa hat.  They book my appointments: January 8th for a chemo class, January 23rd for my first chemo session.

That night, for my birthday celebration, I have dinner with friends at Camino, the restaurant I have worked at, off and on, for over six years. Camino is the center of a wide community of cooks, waiters, bartenders, farmers, artists, and creative types who come and go, support each other’s projects, walk each other’s dogs, celebrate holidays together, and take care of each other through tough times.  Like many restaurants, it’s an extended family of interesting misfits. But Camino, with its deep commitment to making even the smallest decisions according to the true North of a finely-tuned moral and aesthetic compass, attracts a special group.

I met some of my closest friends, and my partner Brian, working at Camino. Brian and I agreed we would meet at Camino if we ever got separated during an earthquake. The restaurant has been the center of our little world for years. After I was diagnosed with breast cancer, the Camino staff came together and gave me the rest of the shared communal tips in cash: enough to pay my rent for three months.  

After ten years in business, the restaurant is closing on December 22nd.  My birthday falls on the same day as the final Camino dinner, a ticketed crab feast for 130 people.  Russ and Allison, the owners, gave me a ticket as a birthday gift, and seven of my favorite people in the world are with me to eat and celebrate this place.  

Tonight, the restaurant has never looked more beautiful.  30 foot long communal tables cut from a single redwood tree flank a massive stone hearth and the primal glow of a crackling wood fire.  Iron chandeliers are hung with wild laurel leaves and dried orange slices that look like tiny stained glass windows.

The place is packed and everyone in the restaurant loves Camino and all it stands for.  There is a sense of community and joy in the air. Many old friends who have moved on to new chapters of their lives have returned to work at Camino for the final weeks.  It seems like every face in the house is familiar – favorite regulars, farmers, former staff.

The main course was supposed to be crab.  But early that morning, the crab vendor called Russ, the chef, with the news: there wasn’t any crab.  It had been a stormy week and the crabbing boats couldn’t go out. Instead of breaking the Camino code of values and buying crabs from out of state (which might be the obvious choice for other restaurants, but is a non-option at Camino), Russ changed the menu to whole local trout, cooked in the wood oven.  He made early-morning phone calls to wake up the cooks to ask for help. Most of them are not early risers and had worked late the night before. The cooks rallied, came in early, and spent the day coming up with a new menu and quickly prepping ingredients to go with the trout. A last-minute pivot from crab to trout for 130 people who had purchased tickets to what was billed as a crab dinner.  A quintessential Camino story.

The dinner was the perfect Camino meal – beautiful vegetables cooked perfectly, and the celebratory flourish of a huge platter of whole roasted fish, so heavy that several hands were needed to set it down on the table. And cloudy, golden-yellow sparkling wine fermented in the ancient style called methode ancestrale.  

At dessert, the pastry chef sent me a whole Tunisian orange cake, lit with birthday candles.  Brian carried it out to me, smiling. The entire dining room, slightly tipsy and united by the family-style meal and their love of Camino, sang “Happy birthday” to me in unison – all 130 of them.  

The day sums up this cancer experience so far.  The wild rollercoaster, the intense swing from lows to highs.  So strange that one day can contain so much fear and sadness, and so much beauty and happiness.