Casual Cancer

There is something shockingly casual about the process of chemotherapy.

“Good morning Scott”, the receptionist said as soon as I entered the office, as if she had been waiting on me all morning. The familiarity with which she said my name caught me off-guard, but I feigned the same level of familiarity and replied, “Good morning! How are you?”

Admittedly, this familiarity was a little disconcerting. If there is any place I don’t want to be recognized and my name thrown around so casually, it’s the waiting room of the oncology center.

“Scott”, the nurse routinely called out into the nearly packed waiting room air, all the patients noticeably older than myself.

I got up and walked to the back room where all the patients getting their infusions sat complacently, some balding or completely bald, some not. Divided only by chest high walls, the brightly lit rectangular room contained approximately 15 stalls adorned with nothing more than a comfortable lazy boy type chair, another chair for a companion and a “tree” to hold the medicines that will drip into our bodies for the next few hours. A couple plasma screen TV’s were mounted to the wall, the sound off, but the annoying over exuberance of game show expressions continuously pulling my attention away from the passive surroundings.

Donuts brought in by a patient sat on the nurse station counter top for everyone to share, which I thought was an amazingly kind gesture. Everyone spoke in tones so friendly they seemed to undermine the seriousness of the situation we were all experiencing. Frankly, everything was so pleasant…so casual…that I didn’t trust it. I was waiting for the ruse to show itself. Almost as if everyone was being so pleasant to lessen the blow of an incredibly harrowing experience that was about to begin, or as if we were all trying to deny the emotional weight of our individual realities.

I was unnerved. I was worried. I was somewhat afraid.

After my last treatment, at a different location, I had a horrendous post-chemo experience at my parents for the next three days, brought on entirely by the fact that I wasn’t given any nausea medication, which meant I spent the night violently vomiting in the toilet, then unable to eat or move for the following three days until I finally met with my oncologist who prescribed me the necessary medication. With that awful experience still in my memory, I was very very very apprehensive about this next infusion and what was to come.

The nurse, a familiar and friendly face from an earlier office meeting greeted me with a minor pin prick through my chemo port and a pull of blood for testing. She hooked up the tubing that would pull the meds into my system for the rest of the day and then sent me with some papers back into the waiting room to hang out before meeting with the oncologist.

A few minutes went by and they called me back again where we had a pretty basic discussion about my past experience, ran through my blood counts (“good”) and made sure I was not having any drawn out negative effects from the treatment (I wasn’t).

I was sent along with the nurse again who handed me some yellow papers, brought me back into the infusion room and gave me instructions in such a simplistic, but necessary, manner that I felt like I was being instructed on how to act at my first day of kindergarten.

“You’ll come in here, put your yellow papers into this slot, then find a chair to sit in and wait for us to come over and start your meds.”

I picked out one of the few remaining stalls left, strategically away from the bathroom and any high traffic area for minimal distractions, and got to waiting.

I was still nervous. Still concerned. But maybe a little less afraid now.

The whole experience was still far too casual for my liking. I don’t know what I was expecting or wanting, certainly not some morbid environment where the lights are dimmed and everyone walks around with their heads hung low, but also not this common routine that takes place all day every day, so frequently that for most people, nurses and patients alike, it’s just going through the motions. Everyone around me was older, which was to be expected, and in various states of degeneration or regeneration, but no one looked to be on their last leg so to speak. Yes, some were balding, looking more ravaged than others. Some walked across the room with a little less bounce, but nothing that the normal ravages of aging doesn’t already create. For the most part, everyone looked and acted quite healthy, as if we were here being infused with nothing more than gatorade instead of the poisons that actually filled the clear plastic bags that hung above.

This was just too common. It felt like this whole cancer thing is something we all just do now.

Soon enough my poisoning began. Because this was my first time at this facility the nurse began explaining in detail the types of drugs I was getting, their potential side effects and a whole slew of information she had memorized from performing this routine over and over again with countless other patients. And for the next 4, 5, 6 hours (I don’t know, I stopped paying attention) the fluids dripped into my body and began attacking the cancer cells and, unfortunately, the healthy ones too. I kept busy reading, checking social media, and absorbing the casual atmosphere that surrounded me.

Patients came in and had to head right back out into the waiting room as the stalls had become filled to capacity. An old man walked in cracking jokes with the nurses he now knew by their first name. Patients completing their last infusion were offered jewelry as a parting gift. Another man answered a call on his phone in the stall next to me,

“Oh yeah, things are good. I’m just sitting here. Yeah, actually I’m getting an infusion as we speak”, he flippantly explained to the person on the other line.

And all this went on, as if it was our jobs. Just clocking in and clocking out.

My last bag drained into my body and without so much as having to check in for another appointment I was unclipped and sent on my way, out the door and back to my parents for a few days of relaxing and letting the worst of the chemo effects subside, fortunately nothing like the time before, the vomiting never showing itself and the nausea kept at bay.

2 down. 10 to go.

And I’m STILL not comfortable with how routine this all is. But at least I’m not concerned anymore. Or scared. I’m actually falling in line with it all, bringing oatmeal cookies in for my 3rd treatment, knowing where to put my yellow papers and getting on with the business of poisoning in stride, maybe even cracking a few jokes of my own. But despite my discomfort with how casual and easy this whole process is, there is still the unavoidable seriousness of everything going on around me. Some of these patients won’t live to see their final treatment. Others will walk away cancer-free and undeniably changed from the whole experience. And, for me, I don’t know what is to come. It’s still too early and, should everything go well, the worst (a second extensive surgery) is yet to come, which might be the factor hiding in the shadows of my thoughts that keeps me so unnerved about this casual atmosphere. It feels almost wrong to enter chemotherapy (what’s so therapeutic about this anyways) so cheerfully knowing the outcome is both unwritten and, in my own situation, not the most pleasant regardless.

These are all internal considerations, however. On a daily basis, these nurses will go through the motions so many times they could do it in their sleep. Ultimately, their job beyond all that is to make something so dark and potentially depressing just….not so bad. They are here to make the process of poisoning seem nothing more than hooking a tube up to a bag, which is exactly what they do. Because no matter how serious this all may be, each one of us considering the weight of our own mortality, we must go through this process regardless, and there’s no reason to make it any worse than it already is.

As I type this, the poisons drip into my system. The TV flashes on the wall. Donuts and cookies line the nurses station countertop. Someone cracks a joke. And although all of us go through a process of degeneration or regeneration, silently wondering if we’re going to make it out alive, we are quite fortunate that in this very moment, at least, all is no more difficult than laying down to take a nap.

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