Garrulous

Do you know how to make yourself feel like a real asshole? Make your mother cry.

Here was mine, silently weeping in the exam room before the surgeon and his nurse practitioner. In glasses and hooded sweatshirt, with pen and notebook, she looked ready for a morning of grocery shopping or lesson preparation – she would tutor children later in the day – but instead found herself here, comforted by the kind nurse practitioner, forced to listen and watch and imagine some unpleasant things happening to her oldest child.

She was there because you’re supposed to bring someone with you to such appointments. As I learned a week earlier in the specialist’s room, it’s entirely possible at these meetings to be told things such as: I think it’s cancer. And: we’ll have to cut out part of your tongue. You want someone with you who can listen, ask questions, and take notes on your behalf since you might find that once you hear things like that, you won’t be able to keep up with the conversation. Not really. If this had taken place just a month earlier, it might have been Gen with me in that exam room. To be fair, she had taken the morning off work some days before to accompany me to the C/T scan ordered by the specialist – the results of which would be read and revealed by the surgeon – and she would spend many days, she later told me, in anxious tears at her desk. But things had changed. As she was to remind me later, if she had been my wife, such responsibilities would have fallen naturally to her. Instead, they came crashing down onto my mother.

And here was my mother, crying. She’d been worrying about me for a week.

I knew what it was to worry about a child, but I didn’t know it well. By the time I met Lilli, her mother had a nearly three-year head start on the worrying game. With much experience in suffering and loss behind her, Gen taught Lilli to stay close and always – and several times – look both ways before crossing the street. Lilli cleaved so tightly to her mother that there didn’t seem to be any need – or room – for any concern from me. For years, she’d grow panicky in parking lots and shriek at any car moving toward her. She insisted on holding hands to cross the street long after a point even Gen thought reasonable. Bright, dour, and suspicious, Lilli didn’t make us worry that she would do something reckless and get herself hurt. Gen grew instead to fear that maybe she’d gone too far, created someone too timid and afraid of the world. Or possibly predisposed to mental illness? She’ll be fine, I insisted. Still, I left my girlfriend to bear the brunt of her daughter’s worst behavior. Working mostly nights, I’d pull a pillow tightly over my head the mornings Lilli threw volcanic tantrums across the hall while Gen tried to dress her for school. She would scream that her socks were too loose or too tight or none of her leggings the proper color. We sometimes feared the neighbors would think we were beating the child, and I sometimes fretted that she might have a difficult time with friends at school, but I never imagined her doing poorly in class, collapsing in an actual nervous breakdown, or lying broken or diseased in a hospital bed. I left the real worrying to her mother.

Growing up, I don’t believe I gave my mother much reason to trouble or cry over me. An oldest child, I sometimes bullied my younger brother and sisters and once pulled my Swiss Army knife on a neighbor girl (I don’t remember the beef), but I got into few fights. At eleven, despairing of life as a tubby fifth grader, I threatened suicide with a butter knife, but never even touched the dull serrated edge to my skin, and that was the last time I flirted with the subject. I didn’t maim or kill small animals and signal a future as a violent sociopath. My criminal career pretty much began and ended with a pack of gum lifted from a grocery store when I was five. As with the neighbor girl, I was scolded by my mother and dragged before the victim to make an apology, and the shame greatly deterred any future misdeeds. I was a good student, a favorite of teachers, but not of girls, overweight through all of high school and never in danger of giving my parents an early grandchild. I didn’t stumble into any vices until college.

My mother always maintained that raising my brother and me was easy and that my sisters caused her the real grief. Neither of them lived an After School Special, exactly, but the two of them butted heads with her and sometimes lied, crept out of the house or smuggled boys in, and caused our mother on occasion to wonder about their whereabouts and imagine one or the other lying bleeding and broken in the road. The younger one was once caught drinking vodka from a Pepsi bottle with friends on school grounds during her freshman year of high school. It wasn’t long after that she decided the whole education thing wasn’t worth her effort and later, that she’d rather finish out her teenage years someplace other than in our parents’ home.

I was away at college for much of this drama, so most of what I knew about my mother and weeping I had learned from sentimental films and television shows and even commercials – they could pull tears from her effortlessly. Just show an estranged father and daughter reconciling, a pair of reuniting lovers, or a stricken child in a hospital bed and my mother’s eyes would instantly moisten. Whenever she caught me grinning as she wiped them after a particularly affecting coffee ad or scene of Touched by an Angel, she would tell me to “Just shut up!”

In the exam room, the surgeon gave her a different set of pictures to consider.

The first weren’t so terrible, maybe even a little comic. The surgeon peering intently into my mouth, help open as wide I could. Me sticking out my cancerous tongue. The scope. Like the specialist, the surgeon produced one, but it was not, he noted, a neat little battery-powered number like the one belonging to the other doctor. Apparently the specialist was known – and possibly envied – for his scope. The surgeon let his nurse practitioner do the honors with this instrument. I had already described this process to my mother, but I don’t think she cared for it; she made a small cry, and I saw her cringe and close her eyes just before I shut my own as the tube began to creep up my nose. For me, the second time around wasn’t so bad. I thought of people flossing their nasal passages with limp spaghetti noodles, and imagined this spectacle of the scope might be sort of funny for people who could bear to watch, with me exhaling in a girlish pitch the various “eeeeees” and “oooooohs” necessary to open my nose and throat to the tube. And the nurse practitioner had little to report other than a small clot of mucus. “The clinical term for that, I believe, is ‘booger,’” said the surgeon. He was that kind of doctor. Before we met in the consult, he called me at home to introduce himself and began by asking about my tumor: “Hey, so just how big is this thing?”

Then next image was less slapstick, more medieval. The surgeon was going to cut out part of my tongue. He, and the specialist before him, might have said “remove” or “excise” or “resect,” but I always heard “cut out.” We had to picture a sharp blade slicing into muscle, in this instance the one lying in my mouth. It seemed a punishment straight from the dark ages. I imagined some poor, trembling peasant hauled before the village court, accused of slandering his neighbor or speaking ill of royalty or conversing with a goat, a sure sign of satanic collusion, and the king loudly proclaiming: “Cut out his tongue! The knave shall be dumb the rest of his days!”

I’m not sure what my mother imagined.

Then came the mad scientist bit: after the cancerous piece was carved out, another surgeon would harvest tissue from my left forearm and sew it to the remaining tongue. (The forearm because it is rich in blood vessels, like the tongue, and the left one because, well, I’m right-handed.) The surgeon assured us this reconstruction would offer me continued speech: “You won’t sound exactly the same as before, and you won’t be entering any tongue twister contests, but you’ll still be able to talk.”

My tongue’s fate was certain, but there were other contingencies to consider.

A transfusion, should something happen during surgery and I lose a lot of blood.

A tracheostomy. Should it appear, after surgery, that the trauma of the operation caused serious swelling in the throat, the surgeon could decide to open a hole there so I didn’t suffocate overnight.

My jawbone being sawn apart at the chin and opened up like the mouth of a crab or the creature in Predator. The surgeon told us this was a real possibility should he decide, come the start of the operation, that my mouth wasn’t wide enough to accommodate the maneuverings of his fingers and scalpels and everything that would be needed to remove the offending portion of tongue and reconstruct it. For the three weeks between consult and surgery, I had cause to picture a bone saw coming at my face and blood spraying and bone dust flying and my jaw pried apart like a peanut shell.

For those three weeks, my mother must also have envisioned and replayed these horror film scenarios.

For the week before the consult, she must have considered, at least for a moment, that she – nearly a grandmother, indifferent to exercise, diabetic – might outlive her oldest child.

We had to consider that I had done this to myself.

Unlike so many children, I didn’t give my mother cause to worry about me during high school, my teen years: I gave it to her after. I never tried cigarettes and alcohol until college, well away from three younger siblings who could follow my lead, a father for whom such things weren’t merely advised against but divinely prohibited, and a mother who had the regular earthly maternal concerns about these behaviors. She always thought I was too self-possessed, too in need of control, to be tempted by drinking. I wasn’t, until my freshman year, when I tried some wine in a friend’s dorm room and understood almost immediately the wonderful release it provided someone who could deliberate and agonize long and hard over the proper order of arguments in a thesis paper or the correct kind of deodorant to buy. Around the same time, someone had me try a cigarette as a means of masking the smell of marijuana (a drug that never quite took like the other two). Smoking, I learned, offered a quick, convenient, and regular reprieve from the stresses of any given hour. At home during breaks and for the year or so I lived there after college, I walked around the block to sneak cigarettes and tried to time my return home after nights of drinking with friends so I could steal into my room unnoticed by my parents. Of course my mother knew about these habits. She was disappointed, concerned about the smoking and furious that I had driven drunk. I sometimes agreed to stop, and meant it, but then I persisted, furtively.

Here with the surgeon, it was all in the open. As with the specialist, he began the appointment by asking questions, and here, in front of my mother, I had to admit to admit how much I smoked (half a pack a day, pretty consistently) and drank (about once a week, usually, and almost always to excess).  The surgeon duly noted my answers and, as with doctors before and after, didn’t comment or assign blame. Even though I felt I deserved it: “Just say it!” I thought, “C’mon, just say it! Tell me. I did this.” The closest I ever came to satisfaction on this point was when my radiation oncologist, after explaining that researchers had linked HPV and other viruses to oral cancer, concluded, chuckling, “So this may not have been all your fault.” I figured that over a decade of drinking and smoking and six years working in a busy, smoky bar made it mine, but I understood that there were probably a host of other factors to take into account – genetics, personality, environment – and that no one could hope to diagram what had been responsible for what, exactly. The case against me would be circumstantial, and there was no utility in pointing fingers, so they didn’t. My mother never did either. Still, if I were to die, I thought, it would be on me.

Dying didn’t seem to be on the table, though. After reading the C/T scan and checking me out in person, the surgeon said he believed my cancer to be stage 2. The tumor appeared to be self-contained, not yet leaking out and threatening to colonize other organs.

My mother started crying. I could only nod dumbly at the surgeon and left it to the nurse practitioner to move over and comfort her, offer further assurances. Both of them clarified and expanded on the message of the specialist: “This is fixable. Don’t worry, we will fix you.” Then they told us what was still to come, none of which, despite its graphic, possibly painful nature, seemed beyond our ability to handle, now that we learned I was to live.

In the car ride home after the appointment, I had to ask my mother to recount some of what had just been said: “Wait, so I’ll be in the hospital for a week after the operation? Is that a week exactly, or like six days? Eight?”

“I don’t know. They just said a week.”

“And the feeding tube – how long do I have that for?”

“Well, the whole week you’re in the hospital, and maybe a week after.”

“And, um, how does that work again, the tube?”

“Through your nose, down your throat, and into your stomach.”

“Oh.” But I remembered one detail clearly. “And they might saw my jaw open!”

She shuddered. “They won’t have to do that,” she insisted.  “He has to tell you everything that could possibly happen, just in case, but I’m sure they won’t have to do that.”

“Yeah, but imagine the scar,” I said, running a finger from the middle of my lower lip down my chin. “It would be badass. I’ve never seen one like that.”

I offered to take her out to breakfast, which seemed the least I could after what I had put her through, would put her through. It also seemed like a good thing to do while my jaw was still in one piece.

This entry was posted on Friday, August 21st, 2009 at 4:06 pm and is filed under The Big C. You can follow any responses to this entry through the RSS 2.0 feed. You can leave a response, or trackback from your own site.