The Natural Laws of Good Luck (20 page)

I drove to Boston with my husband in the backseat buried in blankets. We had an appointment with Dr. Mayer, an esteemed doctor of gastroenterology and oncology, and his young assistant, Dr. Ngoyen. They appeared to us like two gods in white coats, the taller with white mustache and the shorter with jet-black hair. The two moved as one, at once relaxed, warm, and gently humorous. Dr. Mayer seated himself on a stool so as not to tower over us, and Dr. Ngoyen took notes. Dr. Mayer spoke slowly and concisely, giving each word time to travel through space and translation. He kept looking at my husband's face to see if the words had arrived.

He told us: “Mr. Lu, you have a very rare condition. It is a genetic disease called familial adenomatous polyposis, or FAP, and it
causes precancerous polyps in the lining of the colon and abdominal ducts and sometimes stomach and small intestine. We need to take out your colon and rectum. If we do this, you will live. If we do not do this, you will soon have cancer. We don't know if your polyps will become cancerous in one month or one year; however, we are 100 percent certain that they will become cancerous.” Dr. Mayer paused, again waiting for the words to make their crossing. “You did not have cancer of the gallbladder. You had cancer cells in the duct that leads out of your gallbladder to the common bile duct, which empties into your small intestine. We believe that these cancer cells started in the place where your bile duct joins your pancreatic duct and enters the small intestine. This place is like a traffic intersection. It is called the ampulla of Vater. The ampulla of Vater is often the source of cancer cells that migrate to other abdominal organs besides the colon in people, like you, who have FAP. We want to go in and look at this place. If we can find the source of this cancer, then we can stop it from spreading. We're going to help you, Mr. Lu. It will be very rough for a while, but we are going to take care of you. Do you understand?”

“Understand.”

Dr. Ngoyen was a gentle young man who shared that he had been born in Korea but raised in America. His smooth face was boyish except that it never showed impatience or distraction. We had a Mandarin translator named Mr. Ng. Zhong-hua and I sat on plastic chairs leaning forward while Mr. Ng followed the doctors into the besieged tunnel of my husband's colon. It was as if the three of them—the tall one, the medium one, and the compact, hyperalert Mr. Ng—walked into this tunnel, pointing and peering around the corners and finally crawling on their bellies in the narrowing culverts hung with precancerous stalactites and stalagmites. With their powers of abstraction for headlamps, they reached the ampulla of Vater, the sphincter muscle at the junction where the ducts from the liver and the pancreas converge to enter the small intestine. There Dr. Mayer motioned and
continued liverward. Ng translated everything Mayer said into Mandarin. They focused on the task as if there were no place in the world they'd rather be.

Dr. Mayer felt my husband should be treated at Dana-Farber, since his condition was uncommon and might require a complex surgery with a higher survival rate at experienced medical centers than at hospitals where few of these operations had been performed. Our local surgeon who had performed the gallbladder surgery insisted that there was no need to go to Boston. The primary doctor concurred. I made dozens of phone calls and wrote letters to the insurance company but could not penetrate the system. I begged and then I threatened, but this only encouraged them to dismiss me as hysterical. They refused to approve any treatment in Boston. Dr. Mayer tried calling our local surgeon to explain his point of view and was rudely contradicted. In the meantime, Dr. Mayer had ordered a second colonoscopy in Troy to examine the ampulla of Vater, where he suspected the abnormal cells had originated. The local gastroenterologist came forty minutes late eating a Danish. He wiped his fingers on his gown and performed the procedure. Afterward he came to the waiting room and told me my husband was ready and was cured. He quickly walked away. I ran after him: “Doctor, what did you find? How about my husband's ampulla?”

He waved me away and continued walking. “It's gone. There's nothing there. I took it all out. Your husband has no problem now.” I didn't understand why he was showing me his back as he talked, forcing me to scuttle after him. He lost my trust completely.

At home we lay in bed in the dark, not sleeping, not talking. Whispered words required less effort, but even those felt like unnecessary leaks of energy. I said only, “Are you warm?” Zhong-hua said only, “You comfortable, not?”

Zhong-hua was forced to quit the bread company and the natural food grocery because he could neither stand on his feet all day
chopping nor lift heavy juice boxes to shelves above his head. The grocer missed him for his strong back and fastidious floor mopping. The bread company manager said nobody could chop so many tomatoes in an hour. My husband was pleased that his worth was noted.

Between appointments I continued to support us with small jobs modeling, gardening, and cleaning. Sometimes I worked side by side with others who had more experience and counseled me to slow down, hold back, take longer breaks. My nature is never to hold back, but they were wiser; aware of the toll the manual work was taking on their muscles, tendons, and ligaments, they projected the fortitude needed for a lifetime. People helped us through this time, including Da Jie, my parents, and friends who bought multiple teapots even though they probably could not use more than one. Landscaping work we had done together I found I could not do without my strong partner and reluctantly left a small mountain of stones and five cubic yards of mulch right where the truck had dumped them on one employer's driveway, saying only, “I'm so sorry, but I cannot do this.” She was very displeased.

I posed for painting classes at Bard College as a collapsed heap of bones and felt gratitude for the first-year students who turned my naked exhaustion into lovely penciled sand dunes. The professor urged them to pay attention to the “geometry of Ellen.” This was in contrast to the “fluidity of Sara,” the other model. Where was my fluidity? I used to lie under the Norway spruce and gaze into the blowing branches. I used to swim in the river with my kids and climb onto the ridge in back of the waterfall, gasping in awe behind the heavy veil of water. I used to be a part of what moved and dreamed, but now had crystallized into geometry. I was like angled rocks on a scree slope. Down underneath there was still audible a thin tinkle of water on its way to the ocean.

We lived inland, and I longed for the ocean, but when I thought of its frigid saltiness and wounding debris, I asked myself what this longing was really for. I envisioned each wave rolling in, thinning
out into foam upon the sand, and sliding back to the deep. The ocean never forgot to breathe. I forgot. At the modeling job, I remembered, not who I was or what I was doing on earth—those questions seemed irrelevant—but how to breathe. I lay with an empty mind like a piece of driftwood on the beach or stood like a tree in the pasture. The scratch-scratching of charcoal on paper, the small sniffling and coughing and shuffle of feet, was as relaxing as wind in the trees and small birds jumping branch to branch. It was hard to imagine how a person could be an outcast at Bard. The students adhered to a peculiar fashion fad. They looked as if a Salvation Army plane had dumped rejected thrift store donations on the common and each student had donned whatever fell on or near his or her person. They wore slips on top of trousers and sweaters two sizes too small. They maintained serious, stony looks of concentration that I deeply appreciated.

Every day I called the insurance company and was transferred to a different office in the bureaucracy, only to be snidely rebuffed. Armed with statistics and medical jargon, I must have sounded like a possessed madwoman. Then, at last, from one of the dozens of offices where I had left messages, a person named Sherri called me back. She listened and said she would try her best. Sherri arranged for Dr. Mayer to conference by phone with the medical director of the insurance company, who quickly agreed with Dr. Mayer that my husband must be treated at Dana-Farber Cancer Institute. Dr. Mayer was a great man willing to use his power to save a life. I will never forget Sherri, whose face I never saw, as the person who was the crucial link in the communication that furthered my husband's treatment.

We traveled to Boston for a third colonoscopy, and the doctors found a precancerous polyp on the ampulla, exactly where the local gastroenterologist had assured me there was nothing. This was removed, and now Zhong-hua was ready for a dual surgery. A team of surgeons would remove my husband's colon, his rectum, and the vagabond cystic duct. I told Dr. Mayer that the Troy
doctor had said this small thing could never be found. He smiled wryly. “Believe me, we will find it.” The surgery was scheduled for the end of the summer, and we returned home to plant our garden.

Zhong-hua was frightened of surgery. It wasn't the Chinese way. It particularly bothered him that the surgery would cut from the breastbone down, all the way through the seat of his body's qi energy to stop a few inches below the navel. He said if this energy center were cut through, he could never be well again. It had to be just as disturbing to envision clusters of headless polyps wagging from the walls of his entrails. I read surgical statistics on the Johns Hopkins Web site. What did it mean that a given surgical procedure had a 50 percent survival rate if 80 percent of those 50 percent died within five years of the surgery? Only one certainty emerged from the statistics: patients had a far better chance of not dying in or around the time of surgery if they were able to go to a medical center that frequently performed the complicated surgery my husband needed.

We each tried to keep our balance in our own way. A qi master breathed in through the heels, moving energy with his mind into the body's center, where it collected. When needed, it was moved from there swiftly back out the hands and feet or mind. Outside in the moonlight, my husband did Tai Chi, then stood holding the qi ball to his stomach. I read the Taoist philosopher's praise for the master who lives in such a way that there is no place for the rhinoceros to sink his horn:

Appearing means life

Disappearing means death

Thirteen are the followers of life

Thirteen are the followers of death

But people living to live

Join the land of death's thirteen

And why

Because they live to live

It's said that those who guard life well

Aren't injured by soldiers in battle

Or harmed by rhinos or tigers in the wild

For rhinos have nowhere to sink their horns

Tigers have nowhere to sink their claws

And soldiers have nowhere to sink their blades

And why

Because for them there is no land of death

—L
AO-TZU, TRANSLATED BY
R
ED
P
INE

I wanted to find this land of no death, but everywhere I looked, I saw life slumbering unguarded and exposed to danger. The burdocks grew up by the kitchen door as high as a man, prompting our old dog Socrates to pee on them as invading species. His tail gathered so many burrs it looked like a beaver tail and threw him off balance. He tottered past the kitchen window and lay down in the dewy grass belly up, exposing gigantic black balls. Zhong-hua and I both stared.

“My God.”

“In China, this dog already eat. When somebody's dog get old, he invite his friends: ‘Come over. Let's eat meat and drink together!'”

“That's not our way.”

“Dog old. Why not eat?”

“I don't know. I don't know. We just don't do that.”

Socrates' tail got bigger and bigger, and he spent more and more time turning around and around attempting to bite the burdock seeds, which then stuck between his teeth. Socrates' tail upset the ecosystem. I followed him around and tried to pry the outermost burrs loose, but Socrates eluded me by heading deep into his honeysuckle grotto to a hollow of cool earth, where I couldn't reach him. I had adopted this dog from some people who had kept him on a short chain for six years, and he didn't appreciate being restrained for any reason less urgent than having porcupine quills removed from his nose.

At midnight I sat upright in bed. Something horrible was happening in the pasture by the barn. A demonic chorus sent chills up my spine, like a hundred dogs being thrown on a bonfire—coyotes. Socrates barked hoarsely and unceasingly, but when I went downstairs, he and his beaver tail were pressed against the screen door. He was entreating me to silence the eerie cries, which he had no intention of investigating himself. If the screaming coyotes hadn't already awakened our neighbors, then the barking dog would. I got in the car and coasted down the grassy hill to the barn. The headlights shone on a half dozen tails disappearing into the dark pitch. I returned to bed.

After a short time, the howling roused me again. I jumped up again and this time started for the barn on foot. As I waded through the thick mist of dawn, I saw a row of people sitting on the old wooden benches and on hay bales along the west wall. They looked at me with disinterest from under languid, oily eyelids. They wore farm clothes but were oddly misshapen. Their skin had a damp pallor, and their sneering lips curled back over small, sharp teeth.

“What do you think you are doing?” I demanded. “You can't have a meeting here.”

“Oh, I think you are wrong,” said one man, stepping forward off his hay bale. He grabbed for my throat, and I kicked him. His bloated overalls popped like a water balloon, and sickly green smoke exploded in my face. A coyote ran for the woods. I awoke in the bed.

“Zhong-hua, wake up. Wake up! There were coyote spirits gathered in the barn. Come on, do something! They're not friendly. They are not really coyotes. They are not people. They are like demons or something. What should we do?” I was shaking him, but his sleep had been behind the thinnest veil. He was lucidly awake.