I find it completely ironic that a dozen or so years ago I struggled with and suppressed the urge to kill myself. Not just for a day. And not just once a day. I dwelt in the land of self-destruction. I breathed poison instead of air. The Shadow of Death consumed me.
So when recent circumstances led me to confront the possibility of Death, you would think I might have - as the Lou Reed song says - "welcome(d) the chance to meet my maker and fly into the sun." This was not the case. Instead, I resisted the notion that death was a possibility.
For the record, resistance for the sake of resistance is a useless endeavor. The oppressive nature of Fear is never any fun. And I decided that even the risk of Death would be better than dwelling in the house of Fear. When I made up my mind to pursue the prescribed treatment of Rituxan, I did so fully and without reservation.
The morning of my first infusion, I made the necessary preparations for my departure from this planet. I packed the important things to have with me in my final hours: a portable cd player with headphones, the requisite death and dying cd's, my journal, my favorite pen, a good organic apple, some havarti cheese, a couple of ciabatah rolls, a jug of water, a lovely shawl brought back to me from Tibet by an old friend, a "magical" broach given to me by my daughter, a rosary from Chartres, and my puffy pink sweater: an artifact of my deceased marriage given to me by ex-husband guy. In a sense, I surrounded myself with as much beauty as I could carry with me into The Treatment Room and as many friends as I could carry without actually having people with me.
Like the biopsy, I felt I needed to undergo The Treatment alone. However, due to the unforeseeable side effects of the first infusion, the nurse told me it would be in my best interest to have a driver. I chose my sister for this task. She offered to stay with me, but I insisted on going it alone.
The hematologist's office is on the second floor of a fairly new medical facility which is a five minute drive from my home. For some reason, I never want to take the elevator there. On this fine morning I climbed the stairs I've climbed weekly for a year, my arms laden with the gifts of relationships in various stages of decay or re-birth.
I walked into the lobby and signed my name on the clipboard queue. I turned to find a space in the waiting room for waiting. I zeroed in on my seat. Laying on the table next to it, larger than life, was one of those Chick pamphlets - badly drawn comics with morose plot lines designed to compel its readers to turn from sin to salvation. The title of this particular pamphlet leapt off the page and into my mind at dizzying speed: "This Was Your Life."
Moments like these cause me to believe in a Supreme Being. Not your run of the mill white-haired guy in the sky, rather a trickster with a perverse sense of humor - one who recognizes fully the way in which I immersed myself in morbidity and who would be amused by throwing an obnoxious Chic pamphlet at me on this particular day.
I picked tucked the pamphlet into my bag. In the event that I should survive my first Rituxan treatment, I would give this pamphlet to my boyfriend. He collects them. Has a whole shelf full. He finds them greatly amusing. Until I met him, I found them greatly offensive and was usually outraged to find them lying in public places. Through his amused eyes, I have learned amusement.
The nurse called my name. Like most official types, healthcare practitioners use my legal name rather than the nickname everyone who actually knows me uses. This formality is always disconcerting. And the sound of that name pierces my heart in moments of extreme anxiety.
I rose, gathered my belongings, and walked back to the little room that is not quite a room - the area where my weight is measured, my blood drawn, my blood pressure and body temperature taken. Then, I walked the long corridor back to The Treatment Room, all the while thinking of the film "Dead Man Walking." Would the chill of Rituxan feel similar to the chill of the three-drug concoction infused into the bodies of death row inmates? One cannot help but think these thoughts.
The Treatment Room looked like a beauty parlor from a Fellini film: your standard issue institutional green walls lined with chairs inhabited by people hooked up to IV's rather than hairdryers. Once told to pick my spot, I wondered if the laws of Feng Shui applied to chemotherapy placement. Would the direction I faced enable efficient healing or cause me to die? I chose a spot that faced South, a row of windows facing West to my right. It seemed somehow appropriate to face, as near as possible, the direction of the setting sun.
Before the infusion of Rituxan, it was necessary for the nurse to administer the pre-treatment of Tylenol - taken orally - and Benadryl- administered intravenously. This is done to counteract the potential reactions to mouse protein: fever, chills, hives, swelling of the throat, to name a few of the milder ones. I downed the Tylenol with water and braced myself for the dreaded insertion of The Catheter.
The idea of having Rituxan flowing into my bloodstream was less objectionable to me than the thought of having a catheter in my arm for eight hours. I simply could not wrap my brain around this idea. So I stopped trying and resolved to deal with it in the moment.
The catheter was inserted via needle into a vein in my left hand. I had all my gear conveniently piled on a table to my right. It really amazes me how quickly the body adapts to discomfort. The initial prick was uncomfortable. The sensation of a catheter was at first awkward. But soon, I became relatively unaware of its presence. Instead, I became aware of the chill sensation of this foreign substance entering my blood.
Upon the administration of Benadryl, I thought, 'This is it.' Now that the process was begun, I had to select my music carefully. I needed something soothing, but not sad. Comforting but not sappy. Inspiring but not upbeat. Richard Buckner. "Devotion and Doubt." The cd that, over the years, helped me survive all manner of Hell. It is one of my oldest and dearest friends. I loaded up the cd player and hit play, adjusting the volume so that the sound of the songs superceded the noise of my brain.
The slow tempo, the low voice, the mournful lyrics, the delicate guitar flowed into my veins simultaneously with the fog-inducing benadryl. I was determined to remain conscious. Yet the soft sweet lull of Buckner's voice drug me down deep, only to be awakened by short, staccato, high-pitched sounds emitted from the machine hooked to my hand.
The Benadryl phase was complete. Time for the real deal.
I kept my headphones on but lowered the volume slightly in case the nurse had any instructions for me. Sensing the internal preparations I was making for my own death, she made no small talk but simply played her part in the melodrama. She switched out one bag formerly containing fluid for another full of fluid. She punched a couple of buttons on the device next to me as if establishing the settings on a microwave, asked if I needed anything and left me alone with my music. My salvation.
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