Cancer treatment brings big picture to forefront

Richard Schuetz

Monday, May 11, 1998 | 10:06 a.m.

Jan's surgery was scheduled early in the morning. The afternoon before, we went to a show with her parents. That evening, it was a quiet dinner and early to bed. Neither of us slept particularly well.

The next morning we arrived at the clinic and were ushered into a changing area. Jan gave her valuables to me and changed into her surgical garb. We then sat and waited. We were having conversations with each other, but neither of us had the slightest idea of what they were about. I tried to keep talking, to provide a distraction to this whole scene.

A nurse entered the room to place Jan on an IV unit. Struggling to find an appropriate vein, she hurt Jan somewhat. Jan began to cry. This was becoming all too real. A nun then entered the room, offering Jan a blessing. Then came the gurney to wheel Jan into the operating room. Jan wore a green surgical head-cover. She looked beautiful and terrified. Her concern was not about the surgery per se, but what they might find. I walked to the operating room holding that beautiful right hand. At the operating room doors, we parted.

We were told her operation would take about 1 1/2 hours, and that the doctor would visit me afterward to explain his findings. While the breast tissue would take several days to evaluate, the lymph-node report would be given to me by the doctor after the surgery. Jan would return to a hospital room if the lymphs were positive or a recovery room if they were negative.

The wait was hell. The clock would simply not move. Every time the door opened, I jumped, only to find it was another doctor there to explain to another family what he had found. It seemed that this was a particularly bad day in the waiting room. You can tell by the way the doctors enter the room and approach the family, and by how the family reacts afterward.

After one hour and 40 minutes, I was getting afraid. When you are expecting a 90-minute surgery if all goes well, you get alarmed at the 100-minute mark. At 110 minutes, I began to prepare myself for the worst. I was terribly upset.

At the two-hour mark, Jan's doctor, Armando Giuliano, entered the room. He walked directly to me and, in very hushed tones, said, "The surgery went well, and the lymph nodes were negative." I heard the words, but they didn't sink in. I asked him, "Did you say the lymph nodes were negative?" His response was, "Yes." I shook his hand, and he returned to the operating room to work his art on the next patient. Jan's mother, sister and ex-husband were with me. All were thrilled with the result and left to tell the world of the great news and get back to their lives. I sat there alone, waiting for Jan to return from the operating room, and I realized I was as tired as I had ever been. It was a contented tired, like after skiing, but it was a very tired tired. I couldn't wait to see Jan.

When Jan left the recovery room, I was immediately by her side. She was awake, in a loosely defined way, and I told her the great news. Because of the aftereffects of the anesthesia and the pain medications, she didn't seem to get it. I told her everything was OK, and she dozed off to sleep. She then awakened and asked me again. I just sat there, holding that hand, feeling more confident than I had in weeks that I would get to hold that hand for many years to come. Now we simply needed to wait three days for the pathology report to see whether Dr. Giuliano had been able to secure clean margins.

He had. I was now married to a woman who had a 90-plus percent chance of surviving five years and an 80-plus percent chance of surviving 10 years. Not an ideal scenario, for sure, but the very best we could expect.

In her recovery from the second surgery, Jan was typically Jan. In very short order, she was back to work and I missed her tremendously. For eight weeks I had spent essentially every moment by her side. And now she was gone. I felt lost, as if my best friend had gone off to college. But I got her back quickly. Jan, being Jan, had tried to do too much. As a result, she had caused fluids to accumulate around where the tumor had been. Not only was this incredibly painful, it could complicate the chemotherapy schedule. There was even talk of additional surgery.

Since Jan had been back to work and did everything in her power to convince the world that all was well, this was a difficult time. I almost had to duct-tape her to the bed to rest so that the fluids could dissipate. Her public felt she should be at its disposal. After all, the public had seen her at work and she looked just fine.

After four days of bed rest, the fluid problem had been significantly eased. Jan was again back at it, at full force. This time I was really left alone, and I didn't know what to do. It seemed that my whole life had been spent taking care of and trying to protect Jan from whatever I could protect her from. All of a sudden, it seemed like I was alone in the world. When you go through an extended period where every thought and every action are focused on one person, and that person leaves you to re-enter the real world, it is tremendously alienating. Since I had nothing to do, I decided to get sick. I simultaneously got a cold, the flu and tonsillitis -- a bit amazing because I had my tonsils taken out as a youth. And I behaved in typically male fashion, which means I did more whining and complaining during my week of more minor illnesses than Jan had done through her entire battle with cancer.

Our next stop on the Cancer Express was Jan's first chemotherapy session. Chemotherapy is used, in cases such as Jan's, to kill any cancer cells that may have migrated from the tumor to other parts of the body. It's like a group of bounty hunters are unleashed in your body to root out and kill cancer cells. Unfortunately, it is an undisciplined group of bounty hunters that, in their recklessness, ends up killing all kinds of things -- and can even kill the patient. My friend Frank, who knows about these things, explained to me that at some future date we will view chemotherapy with all of the reverence we now feel toward the old medical practice of leaching. Chemotherapy is a poison that's poured into one's body. It's nasty stuff, but it's the best we have now.

Jan was more concerned about chemo than I was, and with good reason. I had just spent several months not knowing whether my wife would live, so the fact that she might now lose her hair or be tired and nauseated was a big step down on the worry chart for me. Jan, however, was the one who was going to have this poison dumped into her system. She was the one who would lose her hair and suffer the nausea. So Jan was a bit traumatized as we approached chemo.

Chemo is administered through an IV. Medical personnel start on a vein near the wrist and move up the arm in subsequent treatments. That's because the chemo drugs may damage the vein at the point of entry, and plenty of good vein must be left to administer the remaining eight treatments. The treatments are separated by three-week intervals so they won't kill you. Your body needs three weeks to recover from the damage chemo does.

The emotional fear of anticipating chemo is worse than the chemo itself. Jan felt a bit of nausea for several days and was quite tired at times. But over all, it wasn't bad. It amounted to a very unpleasant experience. There are excellent drugs to mitigate the nausea associated with chemo. The worst part was that the treatments reminded us Jan does have cancer.

We have to look forward to eight more chemo treatments. After the fourth, we begin six weeks of daily radiation therapy. It should be completed in September. Then there will be thorough checkups every six months. Jan is now at a substantially enhanced risk of experiencing further problems with cancer.

I'm back to reality, whatever that means. Not a day goes by when I don't think about Jan's cancer. I look to see whether she's tired, how she is eating and what her emotional state is. In many ways, I almost miss our time when we were dealing with the disease on an hour-by-hour basis. While it was a harrowing reality, it was a reality that filtered out the normal nonsense in both our lives. It was a reality that caused us to focus on the critically important things in our lives. It also was a reality that demonstrated to the whole family that there are deeper dimensions to love than we had ever experienced.

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