A Super Bawl

I intended to write this post, musing on my return home to Hawaii, from the comfort of my couch yesterday. However, did I mention that my couch is comfortable? I made the dubious decision to close my eyes rather than open my iPad, and — boom! — an hour and a half had passed by, and it was time for yet another meeting about the house we are building.

So, I find myself writing on Super Bowl Sunday, which feels appropriate enough. When patients asked when I might be back from Seattle, my stock answer was: “I hope to be home in time for the Super Bowl.”

We made it. I can say that the journey home, and my first week here, was not exactly what I expected, but I hardly knew what to expect.

For starters, I had been well-warned that stopping chemoradiation does not equate to chemoradiation stopping. By last weekend, as we tried to pack up from nearly two months of life in Seattle (including Christmas and a 14th birthday!), despite being several days out from my last treatment, my mouth jockeyed to exist as the epicenter of my felt universe. Pain levels spiked to new heights as I had to abandon all solid foods for nearly a week, and even smoothies were a sweaty, painful task. Speech became overwhelmingly painful, as having to move my tongue to talk was unbearable. With more of the lining of my mouth stripped of proper epithelial cover than ever, secretions seeped forth even more disgustingly than before, with coughing fits, drool, and hoverings over the sink far too common.

True, everything else was improving — my appetite started to re-appear, the skin around my neck quickly began to heal, and even fatigue lifted a bit — but the silver linings were hard to appreciate from the vantage of my oral misery. This, then, was my existence as we jammed six suitcases and four daypacks into our loyal friend’s Subaru and drove off on a cold, rainy morning from our north Seattle home to the airport. I cannot say I was “happy” or “excited;” simply relieved to be leaving the place where I had undergone this torment.

The plane flight was hard, long, and made no easier by many periods of sustained turbulence, holding us within our seats. Then… we approached the runway, and the abrupt sight of the barren lava surrounding the Kona airport struck me with a greater force than I could have imagined. This is a rather homely site for a runway on a tropical island and yet — it almost moved me to tears. After an interminable wait, at last we deplaned, right into the Hawaiian sunshine on the mobile ramps still the custom in Kona. I immediately began to bawl.

I’m crying even as I write this. So much suffering, so much doubt as to what would come next, all mixed with a strange resentment towards everything in Seattle that was not Home — lifted, totally, in a moment. It was over. The worst suffering was over. I was home.

It literally hurt to cry, but felt so very good on an emotional level to release all that pain. I will never forget the moment in which I caught up to my wife outside the terminal. We were both crying, joyfully. My sense was that for the first time in 2 months I could shed this feeling of being a sick, whining man reaching for his overburdened wife, herself doggedly blasting through endless responsibilities. No, we were just Us again. The woman who had to drive me to treatments I didn’t want to receive; to remind me to drink smoothies I didn’t want to consume; to ask me my weight when I hated how low it was dropping — that woman could remain in Seattle, and this was my wife, here. I will never forget, and never lose my gratitude, for all that she did for me through that dark Seattle winter, with a remarkable amount of cheer and grace. But, I hope to never need to ask so much of her again, and have so little to offer back.

Coming home was no less sweet.

Our landlords had helped, by painting, mowing, mulching and trimming our house and land into a particularly handsome version of itself, but truly nothing could diminish my appreciation for the serene beauty of upcountry Hawaii after that time in Seattle. I can’t say I could experience anything quite like bliss with a mouth so dismal, but my mood was immediately uplifted to be home. Everything was better. That first night, rising from my own bed with a full bladder and a painful mouth, I stepped out onto our lanai and heard the tree frogs, felt the gently swirling warm air on my legs, and knew: the hard part is over.

Indeed, it is. My mouth is slowly healing, day by day. My appetite is back to normal. I ate two hot dogs (organic, of course) Friday, an open-face cheeseburger for lunch yesterday, and a modest hunk of salmon for dinner. Yes, the meals are still quite painful, but in a week or two I expect the “meal sweats” to be over. I am talking again as of the past couple days, and sometimes it hardly hurts at all.

Reading an email yesterday, in which someone commented on my treatment in the past tense, the realization struck me for the first time: my treatment really is over. I am healing now.

I now face the welcome decision of how to bring this skinny, grateful, easily-tired iteration of myself back into the world. I’m self-conscious of my appearance, unusual for me, and rather dread seeing anyone outside of my family (note to friends and patients: “You don’t look half as rough as I expected” are golden words; “DAMN you are skinny, man” — not so much). I lack the stamina to do much of anything for more than an hour or two without needing to lie down. I expect to start to do a little bit of in-person medicine in the coming weeks — vaccinate a few kids due for immunizations who have never had anyone else but me put a needle into their arm, do a house call for a nearby patient with a recent confounding cardiac diagnosis whom I’ve been seeing for the past fifteen years — but it’s strange, not knowing what my limits are and will be.

Such decisions feel like the ultimate of luxuries to me right now. I’m on the mend after a life-altering cancer scare. I’m home. I’m in a place to begin to serve and care for others again, after two months in the unwelcome role of having to accept care.

I’m so happy I could cry.