CHAPTER 1
Click.
Cancer nurses have kind eyes. Kindness must be their superpower. How else could they continue to smile when most of the time they are treating people who are dying? Because while there is all this talk about survivors, everyone knows cancer is a death sentence. It takes longer to kill some people. And, of course, the good ones like my mother, Sophie Corielli, go down too swiftly.
Click.
Today even the softhearted cancer nurses can only summon up pity smiles for Mom and me as Dr. Chen clears his throat to deliver the dire news.
Click.
Throat cough.
“I’m sorry, Sophie,” he begins.
My mom squeezes my hand, the one she’s held since we sat down. It’s the only thing keeping me from ripping the New York Memorial Hospital pen out of his hands so I don’t have to hear the goddamn click again. A nurse swishes by, her soft shoes’ sweep on the marble adding slightly different vibrato.
Click.
Throat cough.
Shuffle.
It’s a bad Broadway musical beat where the disease is the conductor. It’s the disease—the mutating, killing cells—that directs the players. Today the tone is somber.
The last time we saw Dr. Chen, we were all high-fiving each other. Even the looming medical bills couldn’t diminish the happiness we’d felt when he gave us the all clear three years ago.
“Your MCL is back, and, not surprisingly, it’s aggressive. We’ll need to start an immediate round of chemo. Last time we didn’t need to do stem cell treatment, but I think we’ll have to now, and we should do it right away.”
I stare wide-eyed ahead because I don’t want to see the fear that is in Mom’s eyes at this news. Or maybe I’m hiding from my fear. The first time we were told she had a rare, often undiagnosed cancer called mantle cell lymphoma, she was an endless well of optimism, and for three years, I’d been convinced right along with her.
But while I’ve inherited her light-brown hair and her green eyes, I’ve always been more pragmatic—which she tells me I got from Dad. I wouldn’t know. He died when I was three. My memories of him are dim and incomplete. For twenty-two years, it has been my mother and me.
The Corielli girls. Indestructible. Not brought low by men, disability, or disease.
As Dr. Chen explains about more treatment, including the eight-hour chemo drips Mom will have to endure and the likelihood she isn’t going to be able to work for the next two months, my hand starts to get squeezed as if she is attempting to make lemonade out of my fingers.
In my peripheral vision, I see the skin draw tightly around her skull. Even optimism can’t hide the deep lines illness has drawn on her skin, aging her far past her forty-seven years of life. Her face is closed down, her gaze fixed at some point over Dr. Chen’s shoulder.
My own mind is preoccupied with our ugly financial picture. We’re still trying to dig our way out of the medical bill black hole we found ourselves in the last go-around. The spot I’m worrying in my cheek may ache for days, but that’s better than having a meltdown over the unfairness of the universe. A lament I’m sure sounds too often in these rooms.
It’s not that I don’t have options. I do. It’s that I had been able to successfully avoid those options in the past, choosing an honest struggle with debt over a more lucrative under-the-table career. My foolish pride isn’t going to provide food or medicine. I take a swallow, pushing down the grief and anger, and pulling up my resolve.
“We’ll see you tomorrow.” Dr. Chen wraps it up, and we all stand. “I’ll have Donna call in the prescriptions. Take the steroid and the anti-nausea before tomorrow. And remember,” he shakes a finger at my mom, “don’t forget to eat.”
“Thank you, Dr. Chen.” Mom gives him a wan smile and takes the checkout sheet. As she walks out, he grabs my arm.
“Tiny,” he says in a low voice, “a minute?”
“Sure, Dr. Chen.” My fingers clench the strap of my sling backpack as I brace myself for more unpleasantness.
“I saw on the nurse’s notes that you’re living in a fifth-floor walkup?”
I nod. “Mom and I moved in together when she was sick and the midtown apartment didn’t make sense for the both of us.”
Clearly not understood by Dr. Chen was that we could no longer afford the midtown apartment with its lobby and elevator access to the upper floors. He had to know that many of his bills from three years ago, during my mother’s first bout with cancer, were still unpaid. Medical bills are astronomical even if you have insurance but if you didn’t, they were crippling. Every little luxury had to be excised, so Mom lives with me in a tiny one-bedroom apartment that has no doorman and no elevator and sits over a greasy-spoon restaurant.
He shakes his head and frowns. “She’s never going to be able to make it up a flight of stairs, let alone five flights, after her chemo treatments. You really need to do something about your living arrangements.”
I laugh but it’s a hollow, ugly sound because nothing about today is funny. “I’ll get right on that.”
“I know times are tough for you and Sophie, but I’m serious.” He shifts on his feet and clicks his pen a couple of times. “Maybe you can talk to public housing assistance. I don’t know how that works, but perhaps there’s some kind of exigent circumstances clause. I’m giving you a handicapped worksheet for Sophie. Use it.”
There’s no point in telling Dr. Chen we’re broke. From the look of his Hermès tie and his hand-stitched Italian loafers, he’d think that meant shopping at Macy’s and carrying your own bags instead of having Barney’s deliver your purchases to Ralph, your doorman.
“I’ll go down to the City Housing Authority tomorrow,” I promise and tuck the doctor’s handicapped note into my backpack.
“She’ll beat this,” Dr. Chen says and pats me on the back. “Don’t let her get down. You need to be the voice of optimism at all times. Mental well-being is as important as physical well-being.”
We catch the bus because the subway stop is too far away. Mom is swaying and looks exhausted even though she doesn’t start treatment until Monday. The mere thought of IV drips, surgery for ports, and long needles constantly stuck into your most painful places is crushing. I want to pick her up and carry her the short distance to the bus stop, but I know better.
“We should cancel our trip to Vermont,” she says as we ascend the three stairs onto the bus.
“If you want.” I’m not sure if she really doesn’t want to go or is saying that for my sake. Our stilted interaction pains me. It’s as if the cancer is now eroding our ability to communicate as well as killing her healthy cells. Already she is withdrawing. Her arms are folded against her sides, her lips are pressed flat and thin, and tension is visible in every line of her frame.
“It doesn’t make sense to go. We’ll need the money.” Her voice is curt and final.
“I never liked Vermont anyway.”
No one in her right mind is against taking a tour of a world famous ice cream factory. But we aren’t in our right minds any longer. We’re straining hard, trying to keep the tide of disappointment and despair from flooding our minds and bodies. Or at least I am. I sit up straighter because if Mom needs me to be the shield for her, I will. I’d take every last drop of her cancer inside me if I could.
I can’t help but make more comparisons to last time. Three years ago, when we made this same ride after similar news, she was fierce and determined. “I’m going to kick cancer’s ass,” she told me. The only time I saw her cry was when her hair started falling out.
Today she has no pithy fight words nor does her expression show anything but defeat. My heart stutters, and Dr. Chen’s words follow each ragged beat.
Mental well-being is as important as physical well-being.
“We’ll go when you feel better.” I pull her against me and try to avoid the sharp ache of anxiety at how frail she feels already. “I’ll let you eat all the ice cream you want.”
It’s not a very good joke, but usually she’d give me a little poke in the side to acknowledge my effort.
To my dismay, she turns her face into my shoulder to muffle a big, watery sob. Sunny Sophie has no happy thoughts today. Tears prick my own eyes, and I close them tight in an effort to try to keep all the worry and fear inside me. I get as close as the scooped seats of the bus allow and hold her trembling body for blocks, the cacophony of passengers getting on and off covering the choked sobs of my mother.
Cancer survivor.
Cancer sufferer.
“What did Dr. Chen say to you?” she finally asks, breaking away from my embrace. She wipes her face with a tissue and looks out the window, avoiding my eyes.
“He, ah . . .” I clear my throat because my feelings are blocking my ability to speak. “He said we needed to move. That you’d have a hard time with the stairs.”
When she says nothing, I continue. “I’m going down to the Housing Authority tomorrow. Dr. Chen wrote me out a note that will help us get into a building with an elevator—exigent circumstances.”
There’s another muffled sob and I can see in the window reflection that she’s pressing her fist against her mouth. The other passengers are beginning to notice and look away, not wanting to catch whatever grief we’re not handling well.
“We make too much money,” she finally chokes out.
“What’s that?”
Her head swings toward me, and in her gaze I see guilt. Lots of guilt.
“I already looked. Because I worked this year, we make too much to get public assistance and not enough to move.” She presses her lips together but they tremble with the effort.
“When did you . . .” I trail off. If she looked, then she must have had some inkling she was sick again. “When did you know?” I ask accusatorily.
“A couple of months ago,” she admits.
“A couple of months?” I screech, bringing curious glances our way. I lower my voice to a hiss. “You’ve been sick for a couple of months, and this is the first time you’ve gone to a doctor?”
“I hoped it would go away,” she says defensively. “The last thing we need is more medical bills.”
Hearing this makes me crazy angry, and I know that it is not the right emotion to be expressing right now, so it’s my turn to avoid her eyes. If I open my mouth now, I’m bound to say something I regret.
“I’m sorry, Tiny.” Tears flood her eyes, and she begins to weep again.
The sound and sight of her grief destroys my anger. Be her shield. I gather her close, ignoring her struggles to push me away. “No worries, Mommy,” I whisper. “We’re going to be all right.”
She says nothing but continues to cry, and no matter how hard I hug her, her tears won’t quit. By the time we arrive at our stop, she seems to have run out of water and all that is left are dry, shaking heaves. I help her off the bus, trying to shut out the pitying glances that are cast our way as we exit.
By the time we walk the half block to our apartment complex, she’s already breathing heavily. As I unlock the exterior door, she stares at the staircase as if it is some giant mountain, too big for a mortal to ascend. The stairs between each level are split in half so that there are six stairs and then a square landing and then six more to reach the next floor. That’s sixty in total that we walk twice every day. Sixty stairs that must look like Mount Everest to my mom.
“Come on,” I encourage. “We’ll take it a few at a time.”
She smiles wanly and takes my hand. We walk up to the first landing and she’s leaning heavily against me. The next twelve steps are taken with determination, a spark of the Mom of old. But at the midpoint between the second and third floors, she collapses and I barely react quickly enough to keep her from tumbling backwards.
Heart racing, I sit my butt on the edge of the second floor landing and pull her against me. She’s trembling and crying.
“I can’t make it, Tiny,” she sobs out. “I’m not going to make it.”
I pretend she’s only talking about the stairs. Only the stairs. My eyes are wet too, but I’m going to get her upstairs to the apartment. And when she’s lying down and resting, I’m going to make a phone call. I crouch in front of her. “Climb on,” I order.
“No, Tiny,” she protests, but after a moment she realizes that there are no options for her—I’m not leaving her here in the stairwell. Her slim fingers curl around my shoulders, and I begin the laborious task of carrying my five-foot-six, one-hundred-and-forty-pound mom up the last three flights of stairs. I’ve never been more grateful than at this moment that I’m a bicycle messenger because if it weren’t for the fact that I bike dozens of miles a day, I never would have made it to the fifth floor.
By the time I reach our apartment, my thighs are burning and I’m gasping for air like I’m on the last mile of a marathon. “See, easy peasy,” I tease her when I’m able to catch my breath, but it’s not enough to generate a smile. She looks defeated and stumbles into the bedroom to collapse.
She’s asleep before I can tug off my shoes and get her a glass of water. After setting the full glass by her nightstand, I pull out my phone and dial up a number.
“Hey, it’s me, Tiny. You still need someone to do that special job of yours?”
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