When poet and essayist Kenneth Sherman was diagnosed with cancer, he began keeping a notebook of observations that blossomed into this powerful memoir. With incisive and evocative language, Sherman presents a clear-eyed view of what the cancer patient feels and thinks. His narrative voice is personal but not confessional, practical but not cold, thoughtful and searching but not self-pitying or self-absorbed. The author's wait time for surgery on a malignant tumour was exceptionally long and riddled with bureaucratic bumbling; thus he asks our health-care providers and administrators if our system cannot be made efficient and more humane. While he is honest about what is good and bad in our system, he is not stridently political or given to directing blame. His narrative is interwoven with engaging ruminations on the meaning of illness in society, and is peppered with references to other writers' thoughts on the subject. A widely published poet, Sherman helps the reader understand the deep connection between disease and creativity-the ways in which we write out of our suffering. Wait Time will be of special interest to anyone facing a serious illness as well as to health-care providers, social workers, and psychologists working in the field. Its thoughtful observations on health, life priorities, time, and mortality will make it of interest to all readers.
Kenneth Sherman is the author of ten books of poetry and two collections of essays. His most recent books are the highly acclaimed long poem Black River (2007) and the award-winning book of essays What the Furies Bring (2009). He lives in Toronto, where he conducts poetry writing workshops.
Tuesday, March 16
I can hear myself breathe.
I can hear the examination paper crinkle under my back as my general practitioner, Dr. Sidney Nusinowitz, presses down repeatedly on my abdomen. His friendly banter stops. I know something is not right even before Sid says in a low voice: "I can feel your spleen." He follows with an aside, almost as if he were speaking to himself: "I shouldn't be able to feel your spleen." His eyes-usually bright and playful-narrow with concern behind his dark-framed glasses. He presses again and again along my lower abdomen, then in one swift motion sits down on his swivel stool and picks up the phone. He says-in a low voice as he dials-that he is booking me an ultrasound appointment, but I am too frightened to ask what he suspects might be the problem. He reports that there is an opening at the ultrasound clinic the next day, and I tell him that I am scheduled to administer a test at the college where I am teaching. Of course, I ought to take the appointment and ask someone to substitute for me, if only to limit the wait time and the worry I will have to endure. But duty is in play-or fear of knowing-and I ask Sid if it is all right to postpone the ultrasound a few days. He nods and books me an appointment for later in the week.
There is tension in the tiny room as Sid sits and types into his computer, making notes on my file. I study his pursed lips, his furrowed brow, his concentrated gaze at the computer screen. I study his muteness. Psychologists consider the moment of diagnosis for a deadly disease to be a traumatic event; the trauma starts early and builds as you pick up body signals and interpret silences.
Without looking up, Sid requests a urine sample. I walk numbly down the hall to the washroom, and then return with the warm container into which Sid drops a test strip and reports that my urine is normal. When I finally do work up the nerve to ask what he thinks the problem is, he tells me he doesn't know, but he's sure it is "nothing serious." Do I believe him? I trust him as a doctor, but I do not believe him. There is an ever-so-slight note of apprehension in his voice, and I am too distressed to press him, to find out what list of possibilities he is running through in his mind. In any event, what would I gain by hearing his conjectures? There is nothing to do, really, but wait to have the ultrasound and wait for the results.
Waiting, as I am about to discover, is what being a patient is mostly about.
What do you do after leaving a doctor's office when there has been an unsettling and unresolved discovery?
Drive home, crawl into bed, and pull the comforter over your face?
Marie, my wife, has given me a list of grocery items to pick up after my doctor's appointment. I drive a short distance to the Metro supermarket, and as I take hold of the rattling buggy I call home on my cellphone. I tell Marie-trying to sound my usual self but likely failing-that the appointment has not gone well. When she-concerned and sympathetic-suggests that I drive home, I respond that I will do the shopping first.
"Are you sure?" she asks.
I am not sure, but it seems best to try and preserve normalcy. As I put the phone back into my pocket and grab hold of the buggy, I wonder if my actions are a sign of good mental health-the ability to maintain routine in the face of adversity-or a means of denial. I pull a folded piece of notepaper from my back pocket. It is from one of those notepads that charities send out. Marie's name and mine are blazoned on the top in bold blue script and underneath, in Marie's elegant cursive, is the list:
Greek low-fat yogourt
Bob's steel-cut oats
Hardly a list for a couple courting ill health.
In the dairy aisle I pick up a tub of yogourt and then, as I make my way to the fruits and vegetables, I halt.
I am three months shy of sixty; I am at an age where things, medically speaking, might start going awry, though they aren't supposed to happen to me.
I run five kilometres three days a week.
I do yoga.
I have no symptoms.
Where I happen to be shopping is a supermarket in the Lawrence Plaza, a place I often walked as a boy in the mid-1950s. I have no hard evidence that I am near death or even ill, yet my life at this moment seems poignantly bracketed by this L-shaped plaza of unremarkable stores. The building housing the supermarket where I am standing was once Morgan's, a department store. My mother took me there to buy winter mittens and a wool hat to protect me from the cold. It's no coincidence that I'm recalling a time when I was protected from the elements, since I'm feeling vulnerable, defenceless. The Morgan's store is long gone, as is Jack's Restaurant across the parking lot. On nights when my father worked late, my mother would take my younger sister and me to Jack's. I would order a butterscotch sundae for dessert; it came topped with whipped cream and a maraschino cherry. I had my first haircut at the Lawrence Plaza barbershop. My barber's name was Vince: he wore a greased Elvis Presley ducktail and had a deep scar running down from the corner of his mouth. I first heard Elvis's "Heartbreak Hotel" on the radio in Vince's shop, Vince softly echoing the words in his Sicilian accent; I was unaware at the time that Elvis's hotel was a place where, sooner or later, we all spend time.
I step outside the entrance to the supermarket and turn left and walk a few steps so that I can see the tiny bungalow on Glengarry Avenue into which my family moved as part of the Jewish exodus from Toronto's densely populated downtown core. Our former home is one of only two bungalows left on Glengarry, a street dominated by monster houses. My former house, too, is destined for teardown, but at this moment it still stands as a shrine to my childhood with its broad-branched maple on the front lawn. There was a pear tree in the back, a fragrant arched rose trellis, and huge pink and white peonies on which ants marched assiduously back and forth, attracted to the buds' sweet resin. That was my first garden, and I surprise myself wondering if the garden Marie and I planted in the front of our own house last spring may be my last. It's a fleeting worry, with no medical proof thus far to give it solidity, yet there it is.
I look around the plaza and note how many of the stores bear unfamiliar names, yet it is the same plaza that I walked through as a boy of six, two steps ahead of my mother and my little sister.
From six to sixty in the blink of an eye.
Thursday, March 18
Cloudy. Bone-chilling damp. In Ontario, the month of March engenders impatience. You want winter to be done, but the season is tenacious and holds on, reminding you that warm weather, when it comes, will have something of the miraculous about it.
I arrive at the ultrasound clinic half an hour ahead of my scheduled appointment in the hope that I will be taken early. I'd been fretting since the day of my checkup, and a subsequent call to Sid, who reassured me that "it" was likely "nothing serious," failed to calm my nerves. I had spent some of my time scouring the Internet for causes of a swollen spleen, and nothing I came across seemed too disconcerting. Other than the occasional episode of atrial fibrillation, a common irregular heartbeat, I am in good health. And there are no hereditary markers to suggest the possibility of cancer. No one in my immediate family has the disease. My parents are in their mid-eighties and fully functioning. My sister and brother are in excellent health. None of my four deceased grandparents had to deal with malignancies. My parents come from large families: my mother had eight siblings, my father five. I have close to forty first cousins. One of the uncles on my mother's side has, in his old age, prostate cancer. Not so unusual. One of my many cousins has colon cancer. Given my genetic odds, I am fairly sure that I will live out my life cancer-free. I think this even though I've recently read an article by a research doctor pointing out that after the age of fifty our DNA becomes unpredictable. After fifty, he suggests, we all operate on an equal playing field called Uncertainty.
There is another, less rational reason for my feeling that cancer is unlikely. Six years ago, Marie was diagnosed with breast cancer. What are the odds of a husband and wife both being stricken with the most dreaded disease? It happens more often than one would imagine. A parent, a child. A baby can be born with a malignancy. There are households that live under a cancer cloud.
The ultrasound clinic is in the basement of a medical building. I sit on an uncomfortable hard-backed chair in the waiting room and take in the low ceilings, the indoor/outdoor carpeting, and the slime-green walls that are in need of painting. The technician who glances at her clipboard and calls my name is tall and middle-aged, her blonde hair perfectly straight and unusually long for a woman her age. There is no name tag on her white lab coat, though her accent suggests to me that she is Polish. She possesses the world-weary demeanour that I associate with East Europeans. I lie down on the examining table and attempt to make small talk, but she doesn't respond; she is concentrating on her screen where the images of my internal organs are about to show up and she...