Many of these cells we need, but ideally many of them we don’t. Among its other effects, doxorubicin inhibits the enzyme topoisomerase II, slowing the rapid proliferation of cells. They took the castle soil to Milan, and found Streptomyces peucetius, the bright-red bacteria from which my treatment comes. Two centuries later, scientists harvested its dirt. ![]() In the seventeen-fifties, the Bourbons stripped out its marble. It was built in a rare octagonal shape, and later it became a prison, then a refuge during the plague. The castle had neither a moat nor a drawbridge, so few people believe that it was ever used as a fortress. Scientists discovered the drug known as the red devil near Castel del Monte, built by the Holy Roman Emperor Frederick II, in Italy, in the mid-thirteenth century. Doxorubicin is sometimes fatal to the heart a person can tolerate only a certain amount in a lifetime, and by the end of this treatment I will have reached half my limit. For several days after the drug is administered, my body’s fluids will be toxic to other people. The medicine is so powerful that if it were to leak into the body it could cause my tissues to die. When administering the medicine, the oncology nurse must dress in an elaborate protective costume and slowly push the doxorubicin through the port. Because our urine is full of toxins, the signs in the bathroom instruct patients to flush twice. We have poisonous vaginas and poisoned sperm. Blood from chemotherapy-induced nosebleeds drips on the sheets, the paperwork, the CVS receipts, the library books. Everything we were supposed to keep inside us now seems to fall out. The old seem infantile, the young act senile, the middle-aged find that all that is middle-aged about them disappears. The cancer pavilion is a cruel democracy of appearance: the same bald heads, the same devastated complexions, the same steroid-swollen faces, the same plastic ports visible as lumps under the skin. Because it is decided without ceremony that the doctors will eventually take my breasts from me and discard them in an incinerator, I begin the practice of pretending that my breasts were never there. Then I follow the other instructions I find on the Internet: tell my mother, tell my teen-age daughter, deep-clean the kitchen, negotiate with my employer, find someone to watch the cat, go to the thrift store to find clothes that will accommodate my coming chemo port, worry on the phone to my friends that I-a single working mother-have no one to take care of me. I take a screen capture of John Donne’s first devotion-the one that wonders what use it is to be an earth when earths are subject to earthquakes-and post it to Facebook: “We study health, and we deliberate upon our meats, and drink, and air, and exercises, and we hew, and we polish every stone that goes to that building and so our health is a long and a regular work but in a minute a cannon batters all.” It gets a lot of likes. No one knows you have cancer until you tell them. I hand the knife back to Cara damp with sweat. ![]() After all these theatrical prerequisites, what the surgeon says is what we already know: I have at least one cancerous tumor, 3.8 centimetres in diameter, in my left breast. In the United States, if you aren’t someone’s child or parent or spouse, the law does not guarantee you leave from work to take care of them.Īs Cara and I sit in the skylighted beige of the conference room, waiting for the surgeon to arrive, Cara gives me the small knife she carries in her purse so that I can hold on to it under the table. My friend Cara, who works for an hourly wage and has no time off, drives out to the suburban medical office on her lunch break so that I can get my diagnosis. She won’t give me the initial results of the biopsy if I am alone. The surgeon says the greatest risk factor for breast cancer is having breasts. I’ve just always hated it when anyone suffers alone. I didn’t need to build the temple for weeping, then, having been one. I cried every minute, whether I was sad or not, my self a mobile, embarrassed monument of tears. For months, my body’s sadness disregarded my mind’s attempts to convince me that I was O.K. Later, when I was sick, I was on a chemotherapy drug with a side effect of endless crying, tears dripping without agency from my eyes no matter what I was feeling or where I was.
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