Appointment in Radiation Oncology, November 1992

by Jane Meyerding

The doctor has the CT films up on a lightboard for us to look at: cross-sections of my mother's body, from the top of her breastbone to the pelvis.

Now here, he says, you can see that everything looks fine. Here are the lungs.

His capped pen makes two symmetrical loops north and south.

And here again, and here.... But here, here you can see something that doesn't belong.

The pen taps at a gray-brown mushroom blooming in the southern lobe.

Do you see that there is nothing to match it in the other lung?

We nod our heads. Yes, we see. We are good students, sitting alert in the chairs allotted to us in the small, bare office crowded with just a desk, three chairs, and fear. When I look at the doctor, I see a professor. He looks like one of my English professors, in fact, I realize with a shock -- and then feel guilty for allowing part of my mind to leave the room.

It's bigger here, and here, and then in this film we see that it has spread here, to the lymph nodes. those are the white circular areas here.

The pen spins two or three small, impatient circles before jumping back to the previous film.

So this is where the tumor started -- tap, tap on the swelling mushroom -- and then it spread here and here, but then we're out of the lungs. the rest of these--

these cross-sections, these pieces of mechanical art, these filmic representations of my mother's liver, stomach, womb,

-- we take in order to check whether the cancer has shown up anywhere in the abdomen. But as you can see, everything looks fine.

He flips a switch and cuts off the light behind the glass. When the films lose their hard-edged clarity and blur into ghostliness, I can drop my eyes at last. Those films are my mother's ghost, sliced for convenient pre-death display. Every night for the past three weeks I have seen lungs glowing red and agonized gold in the darkness over my bed. But now here they are, the real thing, in ghostly black and white and the gray-brown of mushrooms.

As I told you, by the time lung cancer is diagnosed you can be almost certain it has spread elsewhere in the body.

The blood carries it cell by cell, he had said.

But we're lucky here to get such an early diagnosis.

My mother sits back in the chair with the toes of her black orthopedic shoes tapping silently, absent-mindedly on the linoleum. With her right hand she turns and turns and turns, the wedding band that for many years has not passed over the jutting knuckle without a soap or lotion assist. You recommend radiation, she says.

Yes. It's not a cure. It won't make the tumor go away. But in my opinion, without it you'll be in serious difficulties within a month. Two months at the most. Bleeding. Blockages of the bronchial tubes -- which would cause a kind of pneumonia almost impossible to treat. And with the tumor so close to the spine....

My mother looks at me and I see again how the blue of her eyes has faded over time. For so long she was stronger than I was, as she has always been bigger than I am, five-ten to my own five-two. The tree of life.

My mother looks at me. You think I should go ahead with it, she says. I try to imagine my father here, but I fail. When he died, he was 42, the age I am now. I can almost hear his voice in my mind sometimes, but not now. He has nothing to say to her, to me, about this moment 31 years after his own death. After your skull splits open on the sidewalk, there are no decisions to be made.

We don't recommend chemotherapy for this type of cancer.

The doctor leans back in his chair but looks intently at her, at me. Measuring, judging, deciding how much we need to hear. The judgment made, he launches into a well-practiced lay-person's guide to the world of lung cancer. Squamous cell versus small-cell, that's the gist of it. With one of them, chemotherapy has been shown to be...but with the other time -- the kind we're dealing with here, with our kind of cancer....

Should I tell him that her first reaction to confirmation of the tumor's malignancy was: Not chemotherapy, it's not worth it. But I can't seem to get the words out. I see her sitting there, contained and patient, trying to guess what choice will allow her to die without destroying her life. Because that's what it amounts to.

What is the procedure like? I ask him after he stops speaking.


The decision is made. She will return tomorrow for the preliminary work. Radiation to begin on Monday.

Do you have any questions?

We are standing now, ready to leave. My mother has her raincoat folded over her arm, but her hands are plucking at it as if part of her had decided to put it on. We turn to each other, repeating his question with our eyes. There are two questions I know we both want to ask, questions he probably could answer to some extent.

What will it be like to die of this? What will this kind of death be like?

And second: When will it come? The death. When will it happen?

We don't ask either question. Instead, we say Thank you, no. Instead, because it is not his fault and he has done the best he could, we smile good-bye and walk out into a corridor of frozen light leading to the desk where the appointments will be made.


There is an espresso cart by the elevator that will take us back down to the parking garage. I think I'd like a latte, she says. A celebration: the appointment is over. Now we can begin to go on again. The coffee warms her hands through the paper cup as I drive us home.

Back to home.