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A husband's vigil
Tuesday, August 21, 2001 By Bill Heltzel, Post-Gazette Staff Writer
"Do you have anyone with you?" a nurse asked.
"No," I said, I was alone.
"The doctor wants to talk with you," she said.
With those words I knew something had gone terribly wrong.
My wife of not quite nine years, Betsy, was undergoing surgery. Fibroid tumors, we had been told, were responsible for the incessant pain she had endured for six months. The hysterectomy was expected to take a couple of hours, but her surgeon also suspected ovarian cancer and had scheduled extra time for exploratory procedures.
Now, 14 months later, I wonder if we could have summoned the courage to proceed if we had known what we were about to face. Ovarian cancer -- any cancer -- ravages its victims and devastates the patient's family. But the flip side of catastrophe is discovery. Betsy's ordeal taught us ways to cope with adversity
Really, what choice did we have?
Dire diagnosis
Five hours after I had left Betsy in pre-op, the surgeon finished the exploratory phase and interrupted the operation to meet with me.
"She has an extremely advanced case of ovarian cancer," he said.
I tried to comprehend what he was saying, but more details slammed into me: He would try to spare the colon. ... Without surgery, she'd live only a couple of months and she'd be in extreme pain. ... If she were much older, or not so strong and otherwise healthy, he wouldn't even try. ... With surgery, she could have some quality of life for a few months. ... If he could get at least 99 percent of the tumor, chemotherapy would give her a 20 percent chance of survival.
The floor seemed to move and I slumped against the wall.
"I'll call you when I get out," the surgeon said. "I'll be in there all day."
He called at 11 p.m., nearly 15 hours after surgery had begun. We met outside the surgical overflow unit. He had been unable to salvage the colon but he believed he had gotten nearly all of the tumor. He seemed euphoric, as if he knew he had accomplished something extraordinary. His confidence bolstered me.
I went to Betsy's bedside. Her eyes were lifeless. She kept mumbling, "pain," and asking again and again, "Is it over?"
Lean on them
The first lesson I learned was to lean on family and friends.
I was supposed to call family members by mid-afternoon, but now I had to deliver news while the outcome was still uncertain.
First, I told Betsy's mom. I worried that it would be too much for her. Her sister had died of ovarian cancer, and she was still grieving the loss of her husband. When the moment came, it was I who was weak and she who was strong. Her steadiness and compassion braced me for the rest of the day.
My parents adore Betsy and I couldn't bear to tell them what had happened, so I asked my brother in Ohio to deliver the message.
I was tormented by thoughts of two equally horrible possibilities. Betsy would live only a few more months and in excruciating pain, or she would die in surgery and I would never see her again.
My brother drove to Pittsburgh. He told me to remember what the doctor had said. If he could get 99 percent of the cancer, Betsy had a 20 percent chance of survival. Focus on the 20 percent.
That ray of hope steered me through the unthinkable.
Lean on me
Once Betsy got out of surgery, her needs were all that mattered. She was helpless, bewildered, wracked with pain. If someone barely touched her bed, she gasped. When the telephone rang, she winced.
Her large family kept a constant vigil. We swabbed her lips, caressed her gently and kept her company nearly around the clock. We became her advocates.
Helping was easy, but one must also become hardened.
Thirty-six hours after surgery, she was moved from intensive care to a semi-private room. The transfer was jarring. When she arrived, she didn't understand where she was. She wanted to die, she sobbed.
My heart sank but I concealed my despair. This was the pain talking, I told myself. I ignored her anguish to focus on the longer battle.
She improved remarkably every day, but she didn't believe us. As she become more aware of the enormity of her condition, she struggled with depression. Family kept her focused on recovery. We rejoiced in every triumph and offered encouragement at every setback. On day four, she walked 100 feet without the physical therapist's assistance. Her grin was as wide as the corridor, and my eyes welled with tears of pride. A few hours later she made a second attempt. This time the exercise was grueling; she felt defeated and fought back the tears.
The truth is, all the attention we lavished on her probably made little difference medically. It was Betsy who set the goals, Betsy who did the work, and Betsy who paid with pain and exhaustion. But I believe we did make a difference. A kind of momentum was building, a determination, that together we could overcome this crisis.
Heal thyself
For me, Betsy's illness was the worst thing that had ever happened. That's quite a conceit, considering what she was going through. Yet, it was true, and it was important to take care of myself so that I could remain strong for the months, if not years, to come.
Surprisingly, performing household chores calmed me. The routines gave me a reason to start the day before visiting her in the hospital, and they seemed to impose a semblance of normality.
Watering the garden and feeding our two cats had always been Betsy's job, and I didn't want her to be disappointed when she got home. I gave special attention to the window boxes. The snapdragons had failed to thrive, and even before she went in the hospital they seemed emblematic of Betsy's season of illness. I pruned them back to a few green buds and watered and fertilized them diligently.
Changing Betsy
On day 12, Betsy was discharged. She went to her mom's Oakland condo for a few days, to take advantage of air-conditioning and no stairs, before returning to our home in Point Breeze. In the hospital she had no choice but to accept help. Now as she regained strength and mobility, she reverted to her usual stubbornness and her way of putting other people ahead of herself.
Friends and relatives responded in every imaginable way. Food baskets, meals, flowers, books, videos, and visitors arrived at our door. One friend stopped by to weed the garden. Betsy was put on prayer lists at churches, a synagogue and two convents. Relatives paid for a professional house cleaning before her homecoming, and for a beach vacation in North Carolina that refreshed us between chemo treatments two and three.
I kept thinking of ways to comfort her, peppering her doctors with questions and sitting by her side through chemo (fleeing only when overcome by squeamishness when nurses repeatedly stuck her trying to find good veins).
Communication
Good communication is essential. But that truism says little about timing.
In the hospital I tried to conceal my anxiety, because I didn't want my fears to impede her progress. She, too, had hidden her darkest thoughts. Gradually, we revealed our thoughts and concerns. But I withheld one thing. I didn't tell her that the surgeon had estimated survival at 20 percent.
Then, a couple months after surgery, she asked her oncologist, "What's the prognosis?"
"Do you really want to know?" he asked.
"Yes," we both said hesitantly.
"Sixty percent."
I was ecstatic. I had hoped that her odds had edged up, but I hadn't expected that much.
But Betsy was shaken.
On the way home, I revealed the surgeon's mid-surgery estimate. Her response was characteristic. Rather than think of herself, she understood how that number had burdened me, and she poured out her heart for me. The truth is, no one knows the individual odds. But talking about the numbers, and facing mortality, we have come to terms with this horrific disease.
We decided that whatever time she has left, we would make the best of it.
We also knew that we had been lucky. The medical bills were astronomical, but health insurance paid most of them. Our bosses were accommodating; the Post-Gazette's sick leave policy was generous. And Betsy's doctors, nurses and therapists were extraordinary.
We have discovered that we can adapt to whatever comes our way.
The snapdragons, by the way, rallied. The window boxes got so thick with blooms that they became the talk of the neighborhood.
Betsy, too, is flourishing.
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