The Emperor and the Hierophant
The same week my daughter was born, my dad was diagnosed with pancreatic cancer. Siddhartha Mukherjee referred to cancer as the “Emperor of All Maladies”. Emperor: one who controls an empire; Empire: a collection of kingdoms; Malady: disease or ailment; this can refer to a small infection or the common cold, but as we climb the hierarchy of sickness it’s hard to top cancer, appropriately called malignant.
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As my daughter slept under a heat lamp, I floated around in the hospital wondering about her future: how many surgeries? What disabilities? We’d have to sell the house. And then came the news of my dad. The Emperor holds power over his Empire, and my father’s last journey began.
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It wasn’t until I was in college that my father became a lay preacher. We had always been a religious family: praying before meals, church on Sunday, vacation bible school, after school youth group, the small town church influence; even students and teachers in school talking about the Bible and Jesus. It wasn’t until I separated myself from those habits that I realized how devoted my parents were. I found myself asking, had my father always been like this? Or was it some symptom of old age that some people became more devout once they got on in years?
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The doctors said it was good they found the cancer early. My dad thought it was just indigestion, but when he went in for a scan they found it: a tumor, millimeters in diameter, attached to his pancreas. They were hopeful, or at least that’s what they told us. Statistically, there is a 5% survival rate within the first 5 years of diagnosis for pancreatic cancer, but usually it’s because they don’t find it until it has spread. My dad went through chemo and radiation and all the while stayed positive, as did everyone else, trusting in his God and accepting the prayers from his congregation. Hard to say if his faith stayed the same, or if it grew like the bundle of cells that might slowly kill him, because certainly neither had diminished.
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My dad was always a larger man, thick in the middle and burly. Even as he turned 65 he maintained his weight with a mostly sedentary lifestyle, although he was proud of his daily morning walks. Shortly after treatment began, his walks ceased and he started losing weight. The pounds melted off him like paraffin wax and his skin turned the same pale color. His skin became loose and deflated like a fluid drained IV bag.
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After chemo and radiation, they decided on surgery to remove the tumor. It had stopped growing and there were some hopeful options for the near future. In the hospital he had many visitors, friends and family alike. Waiting always feels longer in hospitals, like there’s some weird vortex that slows time down. Eventually they wheeled him away. He was all smiles and waves and so were we.
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My dad had a history of bizarre medical diagnoses. Once when I was in high school he was showing signs of a heart attack; it turned out to be gas. He had a benign tumor removed from his back the size of a grapefruit. He always had back problems, but a VA doctor said he had suffered a fracture long ago probably when he was still in the military, so he got an implant with a remote control that could almost literally turn off the pain. As he was wheeled away, to surgery to remove this malignant tumor, I thought maybe this was another one of those times where something turned out to be nothing, where they could fix it, and it wasn’t as serious as it seemed.
The surgery was a long one. He went in in the afternoon, and it wouldn’t be until evening when they were done. The sky outside began to darken, the sun ducked behind the city skyline and the light through the windows became soft. Most of our family and a few friends were still in the waiting room. We knew it could be anywhere from a few minutes to another hour before they were done. I had my son with me and we decided to go to the cafeteria to eat.
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When we returned, everyone was standing. Some people were embracing, but the room hinted at quiet sobs. As I approached with my son, my mom saw us, she held a crumpled tissue in one hand and heavy tears ran down her face. My brother stood some distance away with his wife, his hands in his pockets looking down at the floor. Immediately, I knew something was wrong. The hope had been drained from the room, as if the setting sun took it away. A thousand thoughts hammered my brain - was he dead? Just a few minutes ago everyone was cautiously optimistic, but now as my son and I returned, I knew I had missed some bad news.
My mom embraced me and through her choking sobs she said, “They found it on his liver, Stage 4 pancreatic cancer.” She had to excuse herself and went to be alone.
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My brother explained later that when they opened my dad up, they found there was cancer in his liver that would not have shown up on scans. They decided to leave the tumor alone because it would be too traumatic for him to recover. They would have to treat the cancer as it was, but it was already in his bloodstream and the clock was ticking.
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My son looked at a book as I was told this. I knew he was too young to comprehend, but as he looked at everyone standing around in their suspended grief, there was an understanding in his face that something bad was happening. I sat next to him and read him his book, he pointed to pictures and I said what they were. In time I stopped and he looked at his book in silence.
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My dad was in recovery and eventually a nurse came to tell us he was waking up. We weren’t sure where my mom went so my brother and I went to the post-op ward to see him. The double automatic door opened up to a long dim hall. It was now night, but there were no windows in the ward anyway, just yellowish lights glowing bright enough to illuminate the air. There were no white glowing fluorescent lights. It was like entering a crypt and torch-light was guiding the way.
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Our dad was all the way at the end. Our quiet footsteps echoed down the ward and faint whispers surrounded us as other people were sleeping or waking. They were all old and white haired, wrinkled and freckled with sunspots. When we got to my dad, I realized how much he looked like the others as he slept with tubes and tape on various parts of his arms. He took a deep breath and opened his eyes. “Hey guys,” he said. “Where’s your mom?”
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“She’ll be here in a sec,” I said. He exhaled, closed his eyes and paused as if he was going back to sleep. He took another breath and opened his eyes again.
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“Did they get it?” he asked. My brother and I looked at each other, not really sure what to say. Should we lie to him? Tell him the truth? Would he even remember anyway?
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“We’ll tell you later,” my brother replied. My dad let out another deep sigh and again seemingly went back to sleep. My brother and I stood over him as if in vigil in the quiet yellow haze as he drifted in and out of consciousness. I thought of my son who sat in the waiting room and wondered if he was making connections between his grandfather who was cut and his sister who would have to be.
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