Barefoot: A Novel

“I have children,” Vicki said. Her voice was flat and scary. “I have two boys, a four-year-old and a baby, seven months. You would have a hard time convincing them or anybody else that their mother having lung cancer is good news.”

“Let me tel you something, Victoria,” Dr. Garcia said. “I’m a pulmonary oncologist. Lung cancer is my field, it’s what I do. And if you take al the patients I’ve seen in the past fourteen years—let’s say, for the sake of argument, a thousand patients—I would put you smack in the middle. It’s a chal enging case, yes. To give you the best shot at long-term remission, we’l try to shrink the tumor with chemo first and then we’l go in surgical y and hope we can get it al out. But ful remission is a viable outcome, and that, Vicki, is good news.”

“I don’t want to be a case,” Vicki said. “I don’t want you to treat me like your nine hundred and ninety-nine other patients. I want you to treat me like the mother of two little boys.” She started to cry.

“Many of my other patients had children,” Dr. Garcia said.

“But they’re not me. My life is valuable. It’s real y fucking valuable. My children are young. They’re babies.” Vicki looked to Ted for confirmation of this, but he was stil incapacitated. Vicki wiped at her eyes. “Am I going to die?” she asked.

“We’re al going to die,” Dr. Garcia said.

Just as Vicki was about to tel him to stuff his existential bul shit, he smiled. “The best thing you can do for yourself,” he said, “is to keep a positive attitude.”

Positive attitude? But that, in the end, was how he had won Vicki over. Dr. Garcia was the kind of oncologist who used phrases like good news and positive attitude.

She went for a second opinion at Mount Sinai right after the initial diagnosis, at Ted’s insistence. That appointment was with a female oncologist named Dr. Doone, whom Vicki had immediately renamed Dr. Doom because she wasn’t nearly as upbeat about Vicki’s chances of recovery as Dr. Garcia. Dr. Doone basical y told Vicki that IF chemo shrank the tumor in her left lung such that it receded from the chest wal (which, tone of voice conveyed, was doubtful), then POSSIBLY a pneumonectomy would solve the problem IF THERE WERE NO ADDITIONAL METASTASES.

It’s not the tumor in your lungs that’s the problem, Dr. Doone had said . It’s where that tumor came from. It’s where that tumor is going. She made a comment about Vicki being FOOLISH to pursue treatment in the BOONDOCKS. Dr. Doone felt Vicki should be treated at Mount Sinai—but since Dr. Doone herself had enough cancer patients to fil ten city buses, Vicki should accept as a HUGE FAVOR a referral to Dr. Martine, an oncologist at Sloan-Kettering who also happened to have been Dr. Doone’s roommate at Columbia Physicians and Surgeons.

No, thank you, Vicki had said. I’m sticking with Dr. Garcia.

And Vicki understood at that point that Dr. Doom wrote her off. As good as dead.

Vicki had two days until her chemo started. Two days until the doctors cut into her chest to instal a port through which they would pump her ful of poison twice a week for the next two months. It was, Dr. Garcia assured her, nothing to get frantic about. The problem was, the chemo wouldn’t cure her cancer. It would merely discipline it. Vicki could feel the mean-ass, dumb-shit little cel s throwing a beer bash, doing the bump and grind and drunkenly copulating and reproducing as she lay in bed trying to breathe, with Porter hiccupping at her side . I have a malignant tumor in my lungs.

Lung cancer. She could say it in her mind and out loud, but it didn’t seem true. It wasn’t even a kind of cancer that made any sense. Breast cancer made sense, and Vicki irrational y wished she had breast cancer. She was a thirty-one-year-old nonsmoking mother of two. Give me breast cancer! Lung cancer was for old men, two packs a day for twenty years; it was for John Wayne. Vicki laughed joylessly. Listen to yourself.

The traffic on I-95, a sale on beef tenderloin at Stew Leonard’s, the United States’ involvement in Iraq. Powder-post beetles in the attic. Swim lesson sign-ups. Collecting pinecones for Christmas wreaths. Chapped lips. Uncut toenails. Pollution in the Hudson. Duke, once again, in the men’s NCAA basketball finals.

The chemo regimen consisted of two drugs: gemcitabine and carboplatin. Vicki could barely pronounce the names, but she was wel versed in the possible side effects: weight loss, diarrhea, constipation, nausea and vomiting, fatigue, confusion—and she would, most likely, lose her hair.

She had to stop nursing and she might become sterile. It was enough to bring her to tears—she had cried many silent hours when Ted and the kids were asleep, when the dark house seemed as terrifying as death itself—but the chemo was nothing compared to the pneumonectomy. The surgery blocked Vicki’s path; she couldn’t see over, around, or beyond it. If the chemo worked as it was supposed to, they would operate at Fairfield Hospital in early September. Dr. Emery, thoracic surgeon, Dr. Garcia attending. Two resident surgeons, five OR nurses, six hours, the removal of her left lung and the hilar lymph nodes. Who survived a surgery like that?

Oh, lots of people, Dr. Garcia said. Every day. And it has to be done, obviously. If you want to live.

But it was as though he were asking Vicki to pass through a tunnel of solid granite, or travel into outer space and back. Impossible to come to grips with. Terrifying.

Vicki could have lain in bed al day, obsessing about her cancer, dissecting it until it was in ten or twelve comprehendible pieces, but the curse and the blessing of her present situation was that there was no time. She was in Nantucket with two children to look after, a household to run—and a sister and a best friend who were, after being together for less than twenty-four hours, arguing.

Vicki heard them in the kitchen—strained pleasantries that quickly turned bitter. By the time Vicki wrapped herself in her seersucker robe, col ected Porter, and made it out to the kitchen, she had pieced together the gist of the argument: Peter had cal ed the night before, but Brenda had neglected to give Melanie the message.

“You were asleep,” Brenda said. “You’d been asleep for hours.”

“You could have left a note,” Melanie said. “Slipped it under my door. Because now he won’t answer his cel phone. He’s furious with me.”

“He’s furious with you? ” Brenda said. “That’s rich. You’l pardon me for saying so,