In early September Brooke started throwing up. “Just some bad Chinese food,” she said gamely to Dave’s concerned gaze. But the severe nausea didn’t abate, and the food that managed to find its way through her digestive track came out as diarrhea. After three days of this, they scheduled a visit to the oncologist.
Dr. Liau ordered a CT scan of her abdominal cavity and the next day they went back to get the results.
“Your liver is enlarged and there’s a swelling on one node,” he said as if giving the weather report for tomorrow.
“And that means?” Brooke asked when he abruptly stopped.
“Given your history, it may be cancer.”
“May be?”
Dr. Liau took a deep breath. His summary was no longer a weather report. “It probably is. But only a biopsy will determine for sure.”
“And if we know ‘for sure,’ what would my options be?”
“Standard regimen of chemo to attempt to slow the progress of the tumor.”
“But?” This leading on of Doctor Euphemism was wearying the already weak Brooke. She wanted to scream, “Just tell me the truth without being begged!” But the last time she was so direct with the good doctor, he’d clammed up and left the room.
“But even under normal circumstances, chemo is only marginally effective with liver cancers.”
Brooke wondered when liver cancer ever qualified as a ‘normal circumstance’. “And?”
“And yours is not a normal circumstance. This is almost certainly a metastatic spread of your pancreatic cancer.” He paused then continued without further prodding from Brooke. “And if it has spread to your liver, it is probably in other organs and tissues as well.” He looked exhausted at the end of this, for him, long speech.
“If we do nothing?”
“That’s hard to say without more information.”
“Your best guess, please.”
“Single-digit weeks.”
Brooke did the math. Why couldn’t he just say two to three months? “And if we did everything?”
“A few months, give or take.”
If this went on much longer, Brooke would kill her doctor long before her single-digit weeks were up. “I’m assuming the chemo would make me pretty sick.”
Dr. Liau said, “You are already pretty sick.”
“Sicker, then.”
“While we would do all in our power to mitigate the worst contraindications, the deleterious side effects of the medicinal intervention would likely be profound.”
Brooke managed a laugh. “Now that’s the oncologist I’ve grown to love!”
The doctor grinned. “I thought you’d like that.”
That brief lifting of the grim tone freed Brooke to a far-reaching release of her own. “No interventions. No hospitalizations. Treat the symptoms best you can, and we’ll prepare the house for home care.” Through the entire exchange with Doctor Liau she’d not once looked at Dave sitting twelve inches to her right, not because she was ignoring him but because she feared she’d cave in if she met his eyes. But she braved a quick glance at him now with a taut grin locked across her sunken cheeks. “Won’t we, Dave?”
Dave stared down at his shoes just touching the front of the doctor’s faux mahogany desk, still shocked by this news despite preparing for it for months. He raised his eyes to the doctor. “We’ll take care of her at home.”