El Regreso Del Pinché II

 Entry 1   2:22 p.m.

It's true. But I am getting in front of the story.  

This afternoon we met at the UW Liver Center.  We parked in the Triangle, and it brought forth memories of the days my mother struggled against death in futility -30 days seemed so long and it wasso many years ago now.  It made me nauseous, as if this was day 31 of my mom dying, instead of a meeting for Jenny.  I steeled myself. 

The Liver Center is located in the surgical center complex with its massive atrium covered waiting area. It has huge windows in various sizes of rectangles and squares to brighten the room with the sun, but they did nothing to lighten the mood as we waited.

After being led to the room by an M.A. at 12 on the dot, we sat and worked on a crossword puzzle together.  Jenny, since leaving home, was almost sick with nerves.  We finished the crossword puzzle, and she took my arm and told me she was scared.  I was scared too, because I had no hope this would amount to anything, and was worried about the imminent disappointment.  I hate for her to be heartbroken repeatedly.  Johns Hopkins, Seattle Cancer Care Alliance, MD Anderson and Sloan Kettering have already told her there is nothing more  they can do.  I went in expecting the same today, questioning why we were here, but kept it to myself.  Jenny wanted to come because a friend of hers who had colon cancer was treated by the Liver Center, received a transplant, and is cancer free as a result. Jenny pinned her hopes on the idea that this would be the solution, that this would present a cure.

A few moments after finishing our crossword puzzle, two residents entered the room, the chief resident and her wet-behind the ears resident shadowing her. He must have been all of 25.  They explained that they were going to ask a battery of questions, and then when complete, they would go consult with the Attending, and the three of them would return to talk about what was next.  They collected her medical history, and then asked specifics about her lab results with regard to her liver and pancreas.  The chief resident then had Jenny lay on a table while she and the new resident palpated her liver.  Completing that, they left.  

We were alone long enough for Jenny to again grab my arm and tell me she was scared and also to tell me how thankful she was I was there and said how glad she was to always be able to rely on me. That felt good, heartening even.

The doctor came in with the residents almost immediately .  He didn't make eye contact.  He was incredibly uncomfortable. Walking to the corner of the room, he began to speak.  I took notes.

"We met this morning as a team, and reviewed your radiological exam records and your chemical markers. It seems like the disease is slowly progressing. The progression is not in one location more vs. another location. [In other words, the progression is happening equally in the pancreas and the liver.] So, that means both your liver and your pancreas are showing signs of the cancer progressing. 

Here at the Liver center, we wouldn't be focusing on one area versus another. That wouldn't work. Our approach has to be systematic to work.  Even after resection in pancreatic cancer [where the cancerous portion of the organ is removed and the digestive track rerouted], therapy for the liver alone, after resection, at best produces marginal results.

Where there are only 2-3 lesions, the risk/reward ratio is very low, and we could consider surgery. But here the lesions are too diffuse in your liver. Anything we would do would not be good in terms of increased survival. There is not much we can do."

Jenny told the doctor the story of the friend with colon cancer who had a liver transplant.  He told her that pancreatic cancer is a tough cancer.  He said colon cancer is much easier to treat than many cancers, and pancreatic cancer much harder. He noted they have made great strides in treating it in the last 15 years. 

Jenny began to sob. I put my arm around her and held her, trying to protect her from the unprotectable. She rested her forehead on my shoulder. The doctor and residents scrambled to find Kleenex. Handing Jenny tissue, the doctor, searching for words, began to suggest clinical trials. When I told him that all the trials from 2019 were shot down, and that there really are very few trials for people with metastatic stage IVb pancreatic cancer, he concurred.  I wasn't trying to be a dick, but don't get her hopes up again, if in fact there is nowhere to go.

The residents and doctor tried to offer solace. The doctor told her she should be grateful she is so healthy, which is true. But that is cold comfort when you have a terminal illness no one can stop.

They left. Jenny resumed crying on my shoulder for several minutes as I rubbed her back.  She stopped crying long enough to gather her things and put her coat on, and then sobbed all the way to the pay station in the Triangle Parking Garage. I was a wreck, sad for her disappointment.

Jenny suggested we go to Starbucks in U-Village. She needed a hot apple cider to buoy her mood.  So, to U-Village we went.  On the way there, and on the way back to the car from SBUX, Jenny again was telling me how grateful she is that she has me, how much I mean to her.  Yadda. Yadda. Yadda.

Jenny, ever busy with social plans, is going overnight with her friends Jennifer and Marianne to Sequim.  In fact, we left SBUX and headed to TOPS, where Jenny was to meet them.  Now, in the Honda, Jenny's phone hooks up automatically to the radio for music and hands-free calls.  We are riding along, getting on 520-W to go to Roanoke, when her phone rings. I look down and whose name do I see flashing on the radio?  Yep. El nombre del pinché motherfucker.  She hangs up.  It immediately begins ringing again. el pinché motherfucker. She  hangs up again. It rings for a third time, she hangs up again and says to me weakly, "I am sure he is just calling because he wants to know what happened."  I say, "Well, that makes it all better."  She looks baffled.  I ask, "So, is Eric  el pinché going with you?" She is flabbergasted, shocked even.  We are at TOPS moments later. She gets out of the car and grabs her gear, and goes to stand with her back to the gymnasium wall.  I leave. I don't go around the block and wait for them to meet. I know they will. I instead test the 0-60 speed, burn rubber and hit I-5 South feeling like the fucking rube I am.

Entry 2     8:47 p.m.

Therapy was wild.  I was so steamed I waited 5 minutes before I called in to the Zoom meeting.  Jenny was there, calling in from Sequim.  I was full scope angry.  I told her I was angry.  She said she didn't cause my anger.  She said, I swear to God she said, she didn't cause my anger. She said it again.  I noted that if she wasn't being unfaithful, the call wouldn't have happened. So, yeah, she was the cause of my anger.  Also, it was clear she had talked to her enabling counselor friend who helped her come up with that defense. For fuck's sake, get better friends.

 If I was mad before the call, estaba llamas ahora. ¡ Busca el exinguidor de incendios! I mean, on fire.  I had just spent a harrowing and emotionally draining day with her, comforting her, trying to be the balm to make it all less painful, less terrifying. The tandem therapist, as useful as tater tots in a tool box, tried to calm me down, I pushed her out of the way and continued my jeremiad.  I pointed out that every thing I do is for Jenny. That I do everything she wants, that I attend to her every need. That I have been doing this for the last year or better. Despite this, she has no regard for me, no respect, she doesn't really love me. I said, "love isn't words, its actions, and you are unfaithful through it all. It doesn't matter what I do, you are still unfaithful."  The use of the word unfaithful was a conundrum for her. Normally, I accuse her of having an affair, which she thinks she has been glibly contradicting by saying she can't see el pinché motherfucker anymore because I told his wife and he has decided to work on his marriage.  I suspected (and, in fact knew) it was bullshit. But hearing unfaithful, she looked perplexed. I said, and I paraphrase, "Despite everything I have done in the last year to make you happy, and still you have no respect for me, you still carry on with this schlub.  You don't love me. If you loved me, you wouldn't be doing this." She protested, of course, that she does love me, and I pointed out again that love is action not words. She started to respond, but she had nothing, or thought better of propagating bullshit. I continued on, pouring my anger out like she was a Windows 95 dump file. At some point she tried to tone police me, and I pointed out I had a right to be angry and suggested strongly that she not tell me what emotions were appropriate.  She had had enough, and said she was going to hang up.  I said to her, its ok, I will let her go and tell her story, such as it is, because I have nothing else to say. I hung up.  

At some point in the therapy session, the therapist, now less useful than a carpet layer's ladder, tried to intercede. Also at some point, I asserted that Jenny talks to el pinché every morning, asing isn't that true? The tandem therapist said, "You said earlier you wouldn't believe anything she says."  "That may be true," I said in retort, "but Jenny is cagey." She volunteered to me that she doesn't talk to him every night.  When dealing with such bullshittery, one has to listen to the things she says paying particular attention to the interstitial, to what she doesn't say. She answers questions like she was prepped by a lawyer, and not a very good one. So, she didn't deny speaking to him every morning, and so I know she does. Whether she answered yes or no may be irrelevant, but that wasn't the point. The point is she is maintaining her infidelity, her unfaithfulness. and well, fuck the therapist.

I ask you, seriously, am I insane?