Pancreatic Cancer

Short Story by Douglas Brouwer

Pancreatic Cancer

“Pancreatic cancer” were not the two words I was expecting to think about today on my long drive home from the university hospital on other side of the state. I knew, of course, that something wasn’t quite right, but always, in the past, the something that was not quite right could be treated promptly and effectively with an antibiotic. A couple of surgeries were exceptions to this rule, but both of those surgeries had been minor. A hernia repair one time and a meniscus repair another. Some aching for a day or two, a few pills for the pain, and then slowly back to normal.

I had been hoping for another repair this time, something relatively easy to fix. I had always told people, as a kind of joke, that I never wanted to be some physician’s fascinating case, a spectacle curious enough to gather the residents around so that everyone could have a good look. No one ever thought that was quite as funny as I did, even though I kept working on it over the years to make it better. Even now I’m thinking about how to set it up for another try. I am determined to get a laugh.

If I had had an inkling, any inkling at all, that “pancreatic cancer” would be the words I would hear today, I would not have attempted to drive home by myself. But here I am, driving along familiar roads, a route I have taken many times, in all kinds of weather. I am not registering any of it. The drive averages a little more than three hours, on a good day, but today on the way home I have no sense of time or place. I don’t know how fast I am driving or what exits I am passing. I might be in a self-driving car, which would be a first for me, except that today I am the one, apparently, who is pressing the accelerator and, when necessary, braking.

I know people who have died from “pancreatic cancer.” I wouldn’t call them close friends, but I knew them from a distance, and from a distance I would learn of their illness and would track their progress, which seems like an odd word to use for a diagnosis which is still essentially a death sentence. These friends would write on social media sites that they were doing well, enjoying life, and spending time with loved ones. Then, these happy, hopeful messages would become much less frequent, and after a silence of a few months a relative, usually a devoted spouse, would announce on the same social media sites that this person I knew from a distance had died. Plans were being made for a memorial service. More to come. In the meantime, we all give thanks for their life.

Except for the numbness I feel in the car as I drive along, the utter lack of awareness of how fast I am driving and where I am, I feel pretty good. I had tenderness in my abdomen, a bit of jaundice, and some fatigue, but I had walked into the hospital under my own power—hadn’t I?—and I was somehow able to find my car again after the appointment. I think of all the people I have seen in hospital parking garages over the years and wonder how many of them could say where they were. The first thing you lose in a cancer diagnosis is the sense of reality. Nothing seems real.

*

This may sound odd, but I was relieved in a way that the diagnosis was “pancreatic cancer.” No one knows, exactly, what causes it, but at least I didn’t feel responsible for it. To tell the truth, I have been concerned about my drinking of late and was afraid the diagnosis might be “esophageal cancer.” That would have been embarrassing, as though I had brought the illness on myself and had only myself to blame. What a loser, people would probably say. Obviously hitting the bottle pretty hard these last few years.

I was never much of a smoker, though I did give it a heroic try for one summer after graduating from college. I think the main reason for stopping was to avoid the shame of “lung cancer.” If I’m going to die from something, I’d like to die without people blaming me for my own death.

I had a small melanoma, a rather serious form of “skin cancer,” removed a few years ago. “Stage zero,” my dermatologist triumphantly said, when he found it and circled it with his Sharpie, so that the surgeon would be able to find it.

But then my dermatologist spoiled the moment and made it sound as though I might have brought the “skin cancer” on myself. “The damage was done years ago,” he said, now in a solemn tone, and I heard it as a reproach for all the loose living I did when I was a teenager. All those days at the beach with nothing but tanning lotion. What was I thinking?

When I die, I’d like to get the right amount of sympathy. Since most men, if they live long enough, develop “prostate cancer,” there’s nothing especially heroic or noble about it. My father died of “prostate cancer” a few years ago, when he was eighty-eight, and I remember feeling sorry for him. I figure, knowing him, that he too would have wanted to die of something a little more interesting than that. In a sense, he died because he was old. But getting old isn’t much of an accomplishment, is it? It’s not usually what people remember about you. Dying before getting old is what’s memorable.

I’ve noticed over the years an inverse relationship between age and how many people attend your funeral. The younger you are, the more people who show up. That always seemed preferable to me. Then I think about how many people might show up to mourn my death. Not as many as I would like.

*

I have always been healthy. When I was seventeen, I took a bus to Detroit, along with thirty to forty other young men, most of whom I didn’t know, for what was called a “pre-induction physical.” The Vietnam War was still dragging on at the time, with no end in sight, and with nine as my lottery number I was certain to be drafted. The higher the number, the luckier you were. But I have never been lucky, at least not in that way.

The physical was an exam no one was going to fail. A few guys went out drinking and returned to the hotel only a couple hours before the long day of poking and probing began. I foolishly thought their urine samples might disqualify them. I stayed in my room and studied my college Latin textbook before turning out the light and going to bed early. Looking back, neither approach made much sense. As far as I could tell, we all passed the physical and were deemed fit for combat, the drinkers and the students alike. I was about to become a soldier who knew some Latin. I could have been a soldier who knew how to have a good time. A regret, one of many.

No one from that group of young men was drafted, however, because the war unexpectedly came to an end. I was convinced at the time that I had avoided an early death in the jungles of Vietnam, which was not the way I wanted to go, no matter how many people came to my funeral.

*

As I drive along, I realize that I should write some of this down when I get home. Writing has always been my way of making sense of what is happening. If a child can’t express himself, you put a crayon in his hand, you put a piece of paper in front of him, and you say, “Would you draw me a picture of how you’re feeling right now?” And then children, at least in my experience, can often express themselves eloquently. Writing worked that way for me. I always wrote to figure things out for myself. By the time I was finished—whether I had written a paragraph or a book—I knew where I stood. The act of writing allowed me to name what was happening in my world in terms I could understand.

Memories from childhood, I know, can be distorted, with a mixture of what really happened and what was only imagined, but I have a distinct memory of learning to read. And I distinctly remember the power of words on a page. One of the first words I remember learning was “picnic.” At first I thought it sounded funny, as I sounded out both syllables over and over. Pic-nic. Pic-nic. But then I realized that this word had a power beyond the letters and beyond even the sound of it. It called to mind good memories of parks and food and games. I could say the word “picnic” aloud and just about smell the charcoal fire where my father was grilling hamburgers. Learning to read—and then, later, learning to write—gave me a feeling of power. It seemed to me at the time that I had discovered the equivalent of fire.

In fifth grade, Mrs. DeJong asked my class to write a short essay about our most embarrassing moment. My most embarrassing moment, at that point in my life, was being seen by a young girl in my underwear in the changing room of a clothing store. She pulled back the curtain, and there I was. Exposed. It was a painful story to tell, but I told it. And with a few months to reflect on it, I could begin to see the humor in it too. So, I composed my first piece of writing, filled with shame, a dark kind of humor, and (for a fifth grader) surprising honesty. I won second prize in the school’s “prose and poetry” contest that year.

The first-prize winner, Randy Vander Mey, was a year older than I was and later became an English professor at a university in California. He wrote a short story in the form of science fiction, something I didn’t know just anybody could do, and I remember thinking, when I heard him read it at the all school assembly, that his story was really good. Remarkably, though, my admiration for his story only made me feel better about what I had written. I had won second prize! My writing was right up there with Randy Vander Mey’s! I realized, as a ten-year old, that I was good at something, that I could string a few words together, and that readers would respond to what I had written.

*

As I drive along, my thoughts are all a jumble. I knew that I needed to get home and start writing.

A Samuel Johnson quote about death came to mind, not in its entirety, but the gist of it, which is probably how most people remember it. “Death concentrates the mind” is what he is supposed to have said. (The entire quote, which is much better, eluded me in the car: “Depend upon it, sir, when a man knows he is to be hanged in a fortnight, it concentrates his mind wonderfully.”) And what I am thinking, as I think about the quote, is, “No, I don’t agree with that.” Since hearing the words “pancreatic cancer,” my thoughts have been going in all directions. I try to concentrate, but I can’t. Instead I had managed to remember smoking cigarettes and my father’s death and learning to read, among other things, all in the space of who knows how long.

Anais Nin, who spoke in a college lecture series I had helped to organize, once said, “People living deeply have no fear of death.” College students, as a rule, don’t think much about death, unless one of their classmates happens to die, but even then the thoughts tend to be self-absorbed. Death, for a young person, is very nearly unfathomable. So, when I first heard Nin’s words, I thought, “Okay, then I guess the thing to do is to live deeply,” not really knowing how I would do that. But now, as I think about those words again, I realize that I disagree, and I suspect that Nin, as she approached her own death, would have offered a different view altogether.

Am I afraid? A little. More than a little, to be honest. I don’t know how to measure these things, but I know that I am afraid. Does that mean I haven’t lived deeply enough? In this moment, I am more numb than afraid, but numbness is a response to fear. We choose not to think about what we dread.

I didn’t ask many questions in the consultation room, as my doctor soberly explained my situation. He even drew a confusing little sketch of my pancreas which I took with me, determined to study it later. The only question I remember asking my doctor was what dying from “pancreatic cancer” would feel like. He hesitated at first and seemed uncomfortable with the question, preferring to talk at length about a treatment plan and the promising clinical trials he was conducting, but finally he said, when I asked a second time, that I would be weak much of the time, that I would probably lose a great deal of weight, and that I might experience some pain toward the end, though there were medications to control this. I nodded as though I was taking in this information, but the truth is that I couldn’t fully absorb any of it. Even now the words have little meaning.

My question was, What does dying from “pancreatic cancer” feel like? And the answer is, this is what it feels like, what I am feeling right now. I didn’t need a doctor to explain it to me.

*

I think of people I should tell. My wife, course. She would be waiting for me, as always, offering me a martini, dry and only a whisper of vermouth. She would have bought me a pack of cigarettes too if I had asked. I will tell her the news first. I will practice all future conversations about my illness by having this first conversation with her. My words, I know, will be raw. She and I will cry a little. And then, I assume that after I tell her, after I get the hang of saying the words, I will be able to tell others with more confidence—and fewer tears.

Next would come my daughters, both of them grown now, both of them living far away, both married, both with children. It was a mistake to encourage them when they were young. It was a mistake to tell them to dream big dreams. When I asked, “What do you want to be when you grow up because, you know, you can be anything you want to be,” I had lost them. I didn’t know that at the time. But when they left for college, they were gone, never to return. An important chapter in my life, the best chapter as it turns out, had come to an end. When they come back now, it is only for a few days at a time. It’s a big deal, so we try to cram as much as we can in those few days. We laugh and talk, we eat more than we should and drink the trendiest cocktails. We used to go for long runs together, which I know I enjoyed more than they did.

I look at them with such wonder. I never imagined myself as a dad. I don’t think boys do that, but I could be wrong. Once I became a dad, though, once I held my infant daughters in my arms, I knew I didn’t want to be anything other than their dad.

The day my older daughter left for college was the worst day of my life. Until today.

I’m not sure who else I need to tell. My mother, I suppose. She is in her nineties now. I realized last week when we talked that she is counting half years now, like a toddler who says she is “three and a half years old.” My mother is ninety-three and a half years old. And she is proud of it.

Telling her will be hard. Children are not supposed to die before their parents. I’m not sure where that’s written, but it’s got to be a rule. There’s an order to these things. And I am not supposed to die before her. She will say this before I do.

Then who? Who else needs to know? I can’t imagine going to social media with my news, but people will be hurt, won’t they, if I keep the news to myself? They’ll tell me I was selfish. How is it that I am dying and I still feel the demands other people make on me?

I won’t miss that.

*

I might have prayed in the car, but I didn’t know where to begin or what, exactly, I should pray for. My illnesses and other complaints over the years never seemed as though they merited God’s close attention, so I seldom mentioned them when I prayed.

What about “pancreatic cancer”? Would God find that disease somehow more concerning, a reason at last to get more directly involved in my life? I don’t plan to ask for a rescue. So, what should I pray for?

I grew up learning about God. I remember going to Sunday School and learning from a white-haired Mrs. Peterson that God loved me which, I must say, made quite an impression on me. I’ve never forgotten it. I’ve learned a great more about God since then. I even felt compelled at one point, early in my life, to get a graduate degree in theology, which turned out to have little practical use. If my understanding of God has progressed much beyond what I learned from Mrs. Peterson, it’s that God’s love is far more complicated than I first thought. God loves not me not so much for who I am, but in spite of who I am, in spite of all the ways I fail to be better than I am.

I am loved. And this is something—I am capable of offering love.

I have been loved by my grandparents, who showed me what unconditional love looks like. I have been loved by my parents, though their love always had a more conditional quality about it, and I know I gave them reasons along the way to wonder about me. And today I am loved by my wife.

At the beginning of our relationship, her love reminded me a bit of the love I felt from my grandparents, which is one reason why I responded to it so earnestly. Now, more than forty years later, she still loves me and will continue to love me as I get weaker and thinner and gradually disappear from her life. I would do the same for her. It was the pact we made when we were married. I was only dimly aware at the time what I was agreeing to, but I see it more clearly now. This is what love means. I am loved, and I am able to offer love. Imperfectly.

It is still light outside, as I turn down our street and press the button to open the garage door. I know where I am. I am home. I am not sure how I made it, but here I am. And I am glad to be here.

About the Author

Douglas Brouwer

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Douglas Brouwer was born in western Michigan, then moved and lived away for more than 40 years (in the the U.S. as well as in Europe), and has now returned for what will be the last leg of the journey. He lives with his wife in a house they built a few steps from Lake Michigan, which has the best sunsets in the world.