Diagnosis

Tuesday, August 26

The colonoscopy showed nothing, so they decided to do one more CT scan, just in case. This time they would use a contrast dye, which they hadn't previously, because of my husband Jay's allergy to iodine. To prevent a reaction, they gave him a course of prednisone, which meant another 24-hour delay.

We'd have to wait until Thursday for the results.

***

Thursday, August 28

At ten past eight in the morning, I ran my hand under the antiseptic gel dispenser in the hospital hallway and walked as fast as I could toward the ward. I'd overslept—lying in bed dreaming about buying art and living in a flat high above the river in London, my hometown. None of it made much sense. This was a hospital in New London, New Hampshire.

I found Jay in the sunny room where I'd left him, sitting up in a bed strewn with yesterday's newspapers, which he seemed to have abandoned. A single page, folded several times, lay on his bedside table, near a half-completed Sudoku puzzle. I went to the end of the bed and bent to put down my bag, before giving him a quick kiss. Right now, Jay didn't look as though he was in any pain. He smiled at me.

A friendly nurse, Gail, was standing with her back to the door, tapping at the computer on its stand. She turned around as she heard me come in.

"Just entering the meds." She gave me a smile.

"When's the doctor expected?" I asked.

"Oh," she said, making for the door, "he's already been. About half an hour ago."

"What?"

I wanted to scream with frustration. I'd deliberately planned to arrive at the hospital so as not to miss the doctor, who was to begin his rounds at eight. As I was leaving the evening before, I'd told the nurse on duty I absolutely had to be there when they gave Jay the results of his CT scan the next day.

My husband had always been the type of patient who never bothered with medical jargon, and as a result, never questioned doctors about anything. I, on the other hand, found the antidote to anxiety was information. I was the skeptical one, the one who asked why, and what and how. That was my role. I took a deep breath. I needed to keep calm, on the outside at least.

"So, what did he say?" I asked.

"Your husband will tell you."

The morning sun was streaming in through the window, and beyond a gentle breeze was moving the treetops, making me glad we were in this rural hospital, and not in some urban setting where the view would likely consist of a brick wall.

"They found something." Jay’s tone was neutral.

The sun continued to shine, but I felt a cold shiver run down my back. I tried a laugh.

"You're kidding, right?"

He smiled at me, but I could tell there was nothing funny about this.

"He thinks it's pancreatic cancer. But he doesn't think it's spread," he said.

My voice sounded distant. "Not spread. That's good, right?"

Of course, this wasn't good. It was terrible.

My mind went spiraling down in a jumble of thoughts. Fuck. Pancreatic cancer. So, no hope of a cure. No one to help Jay through it but me. This was so unfair. I saw my chances of returning to my new life as a single woman in Connecticut receding, fast. Might we be able to hire people to give him a hand? Fuck again.

But perhaps he'd recover. In any case, he wouldn't be an invalid, would he? He'd cope. I shook my head to clear it, and moved up the bed to take his hand—warm and dry, as always. It was a hand I had always loved to hold, though we hadn't held hands in a long time.

"Are they sure? How can they be sure?” I asked.

"That little doctor, you know the one?"

I nodded.

"He says they have to do a biopsy to be certain, but he thinks that's what it is."

I grasped at a tiny straw. So, it wasn't definite then. “That little doctor” had been wrong before. He'd done a CT scan a couple of weeks ago and seen nothing. So, whatever they'd found, it must be minuscule.

“They want to do it as soon as possible.”

***

Friday, August 29

I sat in Jay's cubicle at Dartmouth-Hitchcock Medical Center, waiting for him to come back from the endoscopic ultrasound, which had necessitated a general anesthetic. He’d been at the endoscopy unit a month before, when they carried out a similar procedure that hadn't revealed anything. Now they were actively searching for trouble.

I waited, both for him to come round properly, and for the doctor, who'd promised to let us know what he found. I had a cup of coffee and a book with me, but I kept reading and rereading the same page, without taking anything in. The harder I tried not to think about what Jay was going through, the more agitating thoughts intruded. What would we do when the test came back positive? What if it were untreatable? God, how I hated hospitals.

They wheeled him back into the room, groggy but determined to wake up. About forty minutes later, he was sitting up and sipping at some juice when the surgeon slid open the glass door of the cubicle and entered with a file under his arm.

He was young, tall, and slim, and I couldn't read his face. I searched for signs of discomfort, or maybe a cheerful smile, which would give me some sort of clue, but could discern nothing in his warm but non-committal expression.

Jay turned to face him and asked for the news. I took hold of his hand. Clearing his throat, the doctor told us that, based on the pathologist's first impressions of the biopsy, he was 99.9 percent sure it was malignant.

We were silent for a moment. I squeezed Jay's hand gently. I didn't know what else to do. Then Jay nodded slowly. I think part of him had known for a while that he wouldn't be able to tough it out this time.

"What are our options?" he asked, beginning the long journey by talking as if we both had the disease. He was right, of course; this would be our odyssey, not just his. I wouldn’t let Jay face this without me by his side.

The doctor explained that his secretary was setting up meetings as we sat there, first with the oncologist, who would work out a plan of treatment, and then with the team who'd be carrying it out. The chemo, or whatever it would be, would start in a matter of days.

"What about a second opinion?" Though he accepted their diagnosis, I think Jay wondered if there might be more than one way to treat it. Possibly some famous clinic would be able to do a better job.

But when I thought of flying to hospitals in faraway states, and the toll that would take on both of us, I prayed he would decide to stay here.

"You're perfectly welcome to do that, of course," said the young doctor. "We can give you contacts at all the chief places: Memorial Sloan Kettering, the Mayo, and the Cleveland." Jay nodded, doubtless liking the sound of the big guns being deployed on his behalf. He believed in the maxim that one got what one paid for.

"I still think you should meet our team. Some of our doctors are from MSK, and one of them trained under the most famous and respected pancreatic cancer surgeon in the country."

Jay was relieved, I think, to have a diagnosis at last. In a way, I was, too. Now we had identified the problem, we could begin to fix it. Like many men, his favored way of dealing with a disaster was to find a practical solution. He didn't have much time to waste on feelings in these kinds of circumstances. I guess that was my automatic response, too. Only action would help me feel better.

To keep us busy and feeling as though something was happening, they promised to have us meet the medical team as soon as possible. The first appointment, the admissions meeting, was scheduled for Tuesday—the day after Labor Day. They were to explain all the options for treating the disease, and the ways in which they might help with the anticipated collateral shock to friends and family.

The second date was for the week after, when the treatment would begin.

I found one saving grace in this moment. As cleanly as the cut of a surgeon's knife, I stopped thinking about living by myself in Connecticut, and simply accepted that Jay needed me now. And I needed to be with him, too. He was the love of my life, and I wasn’t about to let him take this journey alone.

***

I try to avoid regrets in my life. When major decisions are called for, I make up my mind according to whether I'll regret either doing, or failing to do, something. Luckily, my choices aren't cast in stone. I thought I wanted to be as far away from my husband and New Hampshire as possible. Now I knew I'd regret it if I didn't stay.

And just like that, I stepped onto the path that would change both our lives.

BIO

Gabi Coatsworth was born in Britain, and work brought her to America. Love was why she stayed. She’s an award-winning writer and lives in Connecticut in a cottage that’s American on the outside, and English inside. If she’s not writing or traveling, she’ll be in her flower garden, wondering whether to weed, and holding a cup of her preferred beverage, strong English tea. This is an excerpt from Love’s Journey Home, her first book, and she’s currently working on her second novel.