Courage to change the things I can,
And the wisdom to know the difference.
Grace had been exposed to the Serenity Prayer at her first AA meeting more than a decade ago but had never paid it more than lip service until, with Dr. Will Grant’s help, she finally connected with people who helped her get honest with herself about her alcoholism. Now, although her life was in remarkable order, it wasn’t unusual for her to recite the prayer to herself every ten minutes when she needed to get through difficult situations.
Mark Davis took his wife’s arm and guided her into the building.
“You’re doing great,” he whispered.
They both knew how fearful she was and always had been of doctors and hospitals. And although the cancer center was a glittering, modern outpatient clinic, with comfortable furniture and dazzling artwork on the walls, it was more of a hospital than she would ever care to see.
Only Mark would ever fully appreciate how anxious she had been about having her surgery done by a doctor she didn’t even know. It was such a blessing that day to have run into Dr. Grant the way they did, and later such a terrible blow to learn that his license had been suspended because of drugs. But Dr. Hollister had helped soften the blow by being kind and patient with both Grace and Mark, and best of all, she unabashedly supported Dr. Grant’s claim that he was innocent.
The receptionist, a prim young Hispanic woman with
“I already filled these out,” Grace said, “when I came here to meet Dr. D’Antonio.”
“Oh, I remember who you are,” the woman said, “but these aren’t our registration forms. They have to do with transferring your insurance from Steadfast Health to Excelsius Health.”
“Transferring my insurance?”
“I guess you hadn’t heard. Excelsius has taken over your insurance company. We were told that the change has been in the works for a long time, and that Steadfast Health had sent out a mailing.”
“We had heard there might be a change when we were initially sent here for Grace’s mammogram,” Mark said, “but we had no idea Steadfast Health had actually been taken over already, and we certainly didn’t get a mailing. You didn’t know anything about this, Grace, did you?. . Grace?”
“Huh?. . Oh, no. No, I didn’t know Steadfast Health had actually been taken over already. We had heard there might be a change.”
Grace, battling a sudden wave of anxiety, was unaware that she had used her husband’s exact words. At three that morning she had been awakened by a similar episode of panic, but after half an hour or so, she was able to fall back to sleep.
She tried to ignore the perspiration in her groin and soaking into her dress beneath her arms. No big deal, she told herself. Dr. D’Antonio had given her medication to help her relax for her treatment. Phyllis, her AA sponsor, had assured her that taking the sedation was definitely the right thing to do. If this was as bad as her anxiety was going to get, she could handle it. Nobody told her getting chemotherapy was going to be pleasant.
“Well, that’s what we’ve been informed,” Carla was saying cheerfully. “As of today, Steadfast Health is part of Excelsius. We have lots of Steadfast Health clients here. All of them are being given the choice of switching to Excelsius or changing to another company. If you choose to go to another company, your chemotherapy will be turned over to whatever doctor your new HMO allows you to select.”
“Thank you,” Mark said.
They retreated to seats in the waiting area and filled in the form authorizing the transfer of their coverage to Excelsius.
“Good thing we checked into this last week,” Mark said. “I would have hated to have to change doctors. . Hon, are you all right? You don’t look good.”
“I’m fine, fine. Just a little apprehensive.”
“You should tell the doctor.”
“He already told me to expect this first day to be frightening.”
“I still think-”
“Mark, please! I know you mean well, but I just want to get this over with. Besides, they have a nurse practitioner in there or nearby while the drugs are going in. There’s absolutely nothing to worry about.”
Her husband, generally not at all demonstrative about his feelings, merely nodded that he understood and, after an appropriate pause, looked at his watch.
“You go ahead to work,” Grace said. “Phyllis will be here later on to take me home and fix dinner. I’m fine, honey, really. Don’t worry. Here, gimme a kiss for luck. Not one of those pecks on the lips; I want the wet, juicy kind you’re so good at. Mmmmm. Now, be gone. The students need you. I’ll call you when I get home.”
Grace watched as her husband hesitated at the doorway, then left for his office. Of all the unmerited gifts made possible by her sobriety, he was by far the greatest. She returned the clipboard to the receptionist. The worst thing about all this, she was thinking, was that she wasn’t the least bit sick when this whole nightmare started. Logically, she was grateful for the early detection of her cancer and the fact that the tumor was small and there was no evidence for spread. But emotionally, all she could think about was that she was feeling fine when she was called into the radiologist’s office for the bad news. No symptoms whatsover. How could anyone improve upon no symptoms?
“I know you’re feeling fine,” the radiologist, Dr. Newcomber, had said, “but trust me and this X-ray here, you’re not.”
Grace scanned the waiting area.
“Grace Davis.”
The sound of her name startled her. It was Judi, the nurse she had met during her orientation to chemotherapy. They had sat together in a small, windowless room while the woman outlined all of the effects and side effects of treatment. It had not been a heartening conversation. She had started with hair loss, the most dreaded and expected side effect of the drugs. There was no doubt, she said, that Grace would lose her hair. It would probably occur about two weeks after her first treatment. Most women got their hair cut very short before it happened, but, even so, she should be aware that the short hairs would be annoying when they fell out, getting in her mouth and nose.
It would have been okay if the nurse had stopped at hair loss. But there was a litany of side effects to review. Nausea was of course a major topic. Grace would be given an arsenal of drugs to help alleviate that symptom. Judi had patiently reviewed each pill and its potential side effect.
“Ativan works quite well for anxiety but will make you drowsy. Vicodin is good to take if you have pain, but it is addicting if you take it more often than prescribed, and it may make you constipated.”
It seemed like there was a potential side effect for every part of Grace’s body. Her fingernails might become discolored and break easily. Urinating could burn and bowel movements would be painful. Finally Grace just looked up from the myriad of papers Judi had given her.
“Tell me there is at least one upside, please; tell me that my skin will never look lovelier or it will make my eyes shine brightly.”
Judi responded with a weak, ironic smile. No, there was no upside. At best, Grace could anticipate four months of malaise and an assortment of disrupting discomforts.
“Oh I forgot,” Judi had added, “you’ll be extremely sun-sensitive for a while after your therapy.”
So much for the celebratory getaway with Mark to Aruba after all this was over. Maybe Greenland.
Finally, after Judi had pushed back in her chair, her arms folded, her expression indicating that the number of times she had done this might be getting to her, Grace had screwed up her courage to ask the big question.
“How will you and Dr. D’Antonio know that this is working?”
“What?” replied Judi, as if Grace had asked the single most stupid question in the world.
“The chemotherapy-how will you know that it works, that I am getting the expected result?”
“Well, there is no way of knowing. We can certainly tell that it
