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The First Dose: A Whole Lot of Gray

This story actually begins long before today. Technically, it began back in 2008. But the story got juicy a few months ago when our baby kicked my husband’s groin and alerted him to the tumor. And now, after months of sleepless nights, thousands of tears shed on pillowcases, a lymph node dissection, a skin infection at the incision site and an international move, we are here at the Georgetown Hospital infusion center where my husband will begin his first of 8 possible treatments for a clinical trial. He was randomized to receive the high dose of Ipi, an FDA approved immunotherapy treatment for stage IV melanoma patients. My husband, having been diagnosed as having stage III melanoma, will participate in this trial hoping to verify the effectiveness of Ipi as a preventative drug. Hoping to ward off stage IV.

The nurse with the perky ponytail and sideswept bangs tells us the drugs have finally been released from the pharmacy and they will begin the infusion now. She has, like all good nurses, mastered the art of happy chatter while performing tasks that would make non-medical folks squirm. She inserts the IV into the port on my husbands right arm, reminds him that his vitals will be automatically taken every 15 minutes by the bright blue monitor attached to his left arm, and then as quickly as she came she is gone. The shift has changed and a new nurse takes her place. My husband is not a number, but he is also not the first cancer patient in this hospital.

I sit, seemingly calm, next to my husband as he watches a show on his ipod, his head phones in, his feet up, seat reclined. If I didn’t know better, I’d think we were sitting in our living room on a Sunday afternoon. But I do know better. I know that only 2 hours prior I was crying at the hospital’s Starbucks, having read and reread the consent form. Every fiber of my being told me to stop the train, to tell my husband this was not worth the risk, to pack it up and leave. My panic rose up from deep within me where it had been buried for weeks. The surge of panic, emotion, fear, it rose up with force, and while my husband ordered two teas, I rushed out of the Starbucks and transmitted my panic to my mother via a harried phone call. “He shouldn’t do this!” I sobbed over the phone, sending my fear thousands of miles away to a small private Catholic elementary school where my mother works. “I don’t think he should do this. I think we should leave. This could kill him,” my tears splashed on the table and I tried in vain to catch them with my worn kleenex. I glanced inside the Starbucks and saw my husband stash his wallet in the back pocket of his jeans and reach for the two steaming teas.

“Your husband knows what he’s doing. He’s pragmatic and well-researched. He would not do this if he didn’t think it his best option. Now, stiff upper lip, he needs you.”

He put the scalding hot teas down on the table and leaned in to take a good look at my tear-stained face. “What’s the matter?” he asked as I slid my phone into my purse, trying to hide the evidence.

“I’m going to ask you this one more time, and then I promise I won’t ask anymore,” I reply. “Are you sure this is what you want to do?” I ask only this small phrase, but hidden behind this phrase are all my fears: The chronic diarrhea, the possibility of lifelong ailments and drugs as a result of the amped-up immune system, the blessing and the curse of this drug. I hide behind this phrase my darkest fear, the possibility of death, higher in the first 12 weeks of treatment, due to inflammation in the body. The question is weighted and heavy but he looks me straight in the eye, unafraid and confident:

“I want to do everything possible to make sure this thing doesn’t come back. I want to do everything I can to be there for you, for the boys. Yes, there are risks, but the risks are greater if I don’t act. I will be monitored here by some of the best melanoma doctors in the country. I’m in the best place possible. This is the right thing.”

Exhale.

I smile through my tear-filled eyes, clear my throat and swallow my fears. He is right, as usual, and although he is the patient, he is also the one leading me through this. His strength is admirable and unfailing. A wonder.

I toss my kleenex into the garbage and smile my best smile. “Let’s go,” I say and take his hand. We walk towards the door, walking out of one phase in our lives together and preparing to walk into the next, a place of unknowns and gamechangers and question marks. A place filled with very little black and white and a whole lot of gray. But hand in hand, we walk forward, knowing we are in it together.

Four hours later we bid the hospital farewell and hope to make it home before the coming snow storm. Waiting to get our keys from the parking attendant, my husband allows the woman behind us to go first — she seemed confused and bewildered and eager to leave. We feel the temperature dropping by the second and he bounces up and down slightly to warm up. He’s holding his hot green tea in one hand and his file of consent forms in the other. His eyes are bright and they twinkle as he leans in for a kiss, relief and joy spreading from his lips to mine. He is happy that his first dose is over and that he still feels normal. I wait off to the side as he steps up to the window to grab our keys and I see it: my husband, the man whose problems are smaller than the rest of the world’s, at least in his eyes. The man who allows an older woman to go before him even though he’s just received his first immunotherapy infusion and has been at the hospital for seven hours. The man who hopes it snows so he can take his boys sledding in the morning. The man I married. The man I love.

Cancer be damned, this man is living. Every second.

Originally published March 6, 2003