In This Love Together: Love, Failing Limbs and Cancer - A Memoir

By Bob Mustin

The upheavals of modern times can render human relationships difficult under the best of circumstances, and sometimes it takes the ironies inherent in those upheavals to strengthen the most intimate of human ties. In his heartfelt memoir, Mustin lays bare the hopes and fears, the joys and tragedies, of romance and marriage in middle age.
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• Language: English
• Publisher: Gridley Fires Books
• Release date: Jun 1, 2017
• ISBN: 9780692870471

Bob Mustin

Bob Mustin has had a brief Naval career and a longer one as a civil engineer. In the 1990s he was the editor of a Georgia-based literary journal, The Rural Sophisticate, and was later a North Carolina Writer's Network Writer in Residence at Peace College in Raleigh.

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PREFACE

When I began this writing, less than a year had elapsed since my wife Becca’s passing. That may seem too soon to have any true perspective on our life together, or on her nearly two years of cancer treatments and subsequent passing. But I’m at a venerable age now; recently I’ve been laying claim to more years than a redwood tree. While I’ve always been a person in a hurry, forever racing through my time on earth, the fellow with the scythe and black hoodie seems to be gaining on me, and to accelerate the hurry now seems all the more insistent. Even so, and as I suppose is natural, I find myself looking over my shoulder, trying to digest what the years flung at me—at us.

So with Becca gone, how am I to consider the time, place, and condition of my own demise? I can’t seem to reflect on that, however, without knowing Becca’s current state. Is she here? There? Nowhere? These are digressions I’ll grapple with at a later date, although this writing touches on one or two of them. More to the point at the moment, how do I accept her death to the nightmare of cancer when all I could do was feed her, medicate her, and helplessly watch as cancer’s rot set in? It’s certainly nothing we considered in our salad days as we vowed to love and to cherish till death do us part.

Becca and I came of age during the post-World War II years. The U.S. had become the preeminent nation on the planet, and with that came the political and economic spoils of such a national role, meaning a richly rewarding life seemed within the grasp of everyone we knew. Were we to have evaluated with second sight the life choices we made so easily and fruitfully as we grew to adulthood during that era, some of them might have caused our inner antennae to rise. Should I, for instance, question that I didn’t give myself for a decade or two to freewheeling outdoors endeavors—hiking, driving, and hitchhiking across the United States? Or could Becca have given even more time and devotion to the academic abstractions she was so taken with?

In any generational setting, though, you make your choices, admit your errors, change course and move on, or you learn the art of living with the choices made. As you age, however, you realize your way of living is in a practicable sense growing irreversible. Too, you discover that the years remaining to you expose whirlwinds, ghosts you had no sense of in your earlier phases of life. It’s why my father used to say that growing old isn’t for sissies, meaning it takes courage, mettle, to face and sort the consequences the past bequeaths to the present.

Our bodies, of course, are not strangers to consequence. Becca and I each inherited a sweet tooth. Our post-World War II parents plied us with sugar in all its tempting forms for excellence on report cards, as palliatives when sick, and as outright bribery to perform odious tasks such as de-cluttering attics or garages, mowing yards in the sweat of summer, or cleaning a soap scummed and flora-stained shower. The consequence of a lifetime of ingesting sugar? Many in their autumn years, like Becca and me, have learned to tiptoe around sweet foods, hoping its acidic ravaging of pancreas, blood, and liver is minimal.

Besides sugar there are now the so-called weaponized foods, such as genetically modified grains and vegetables, and with age ingesting these carry deeper, more insidious consequences. Our DNA and RNA contain messages that determine height, eye color, resistance to allergens and other invaders, but they can also abet personal habits, the effects of which may not announce themselves until well into one’s years, such as heart disease, diabetes, or arthritis. And cancer.

Becca fell prey to cancer in her sixty-fifth year. This memoir is in part a chronicle of our attempts to vanquish her disease and, later, to mitigate its discomforts. However, in committing her descent into squamous cell carcinoma to writing, I’ve set that time into a grander context: the wonders and worries of marriage in one’s middle years, of a love that, like a wind, blew strong and steady at times, at others gently and tenderly, and at still others raging with the passion of two persons trying to understand one another and live as one. Still, we knew the love was always there in one form or another.

Including the ghastly effects of cancer, of trying to make sense of why this infirmity was visited on us, has been difficult. Still, there’s been much happiness to write about. This then is our story, as best I can reproduce it through the imperfections of memory. But to understand our time together, I also include a brief history of our lives preceding the two decades we shared, and of the effect our careers’ final years had on our marriage, although my thoughts resist the linearity of chronological order. And so our story begins with the onset of this awful disease.

FROM A HARMLESS-LOOKING SPOT

June 2012—March 2013, Asheville, NC

Our evening meal was over, the dishes done. This was the time I usually drifted to my computer and the virtual golf game that occupied much of my evening down time. Becca normally spent those evening hours downloading strange new pieces of electronic music. But this night we sat in our recliners, I watching TV, Becca leafing through catalogs and dog-earing pages.

Damn! she said, index finger about to probe her mouth for the source of her irritation.

I rose, flipped the wall switch for our ceiling fans, and the summer night humidity began to cool. I noticed Becca shiver but, preoccupied with the oral irritation, she didn’t complain.

What’s going on, bite your tongue again?

Yes, she said, drawing out the sibilant ending and loading it with irritability. It’s not bleeding though. Then more probing. I think there’s a lump on the right side.

Want me to get the penlight, take a look?

She shook her head. I have a dental visit tomorrow. I’ll have Dr. F look at it.

The next day was a dank, rainy one, as gloomy a day as the summer would offer. While Becca was gone, I forewent a trip to Lake Louise for my daily walk and instead performed a loopy inside-the-house equivalent: circumnavigating all the upstairs rooms, then taking the stairs down, pacing the periphery of both rooms there, jogging back up and repeating the whole thing until I was sweating. Then I settled down below our living room’s ceiling fans to read that week’s novel. I had barely set my attention on the book when Becca returned.

I met her in the kitchen. Her gaze had fallen to the gray, faux-tile linoleum—to shield her too-sensitive eyes, I supposed. It was the hour when afternoon sunlight crept underneath the deck awning and turned to a glaring cubist structure as it passed through the kitchen window. She was frowning.

What did Dr. F say?

That the question seemed to irritate her wasn’t outside the norm; she had an occasional mistrust of doctors, and that included dentists. Nothing, she replied curtly. He just looked at it, and that was that.

I tried to interpolate between her reply and what I imagined the dentist might have said about her tongue, but I came up with little to arouse suspicion. I ran my tongue along the inside of my own right jaw, where a length of scar tissue lay, the result of biting the inner lining of my mouth. For the rest of the day neither of us said anything more about the lump.

January 2013—Asheville

Becca complained more and more over the subsequent half-year about biting her tongue on that right side, and from what she was telling me it was growing sorer. I suggested she make a conscious effort to draw her tongue toward the rear of her mouth and away from her teeth. She tried it, but habits are habits, and the biting continued. She did allow me to peek at it a few times, and it did seem slightly swollen, but I saw nothing with my unpracticed eyes that I could say was amiss.

Finally the day arrived for her next semi-annual dental appointment. She returned home in a pensive, I-don’t-want-to-talk-now mood, so I tromped down the stairs to my office and a story I’d been writing. A half hour passed. I returned to the main floor, intent on a piece of applesauce cake. I cut a wedge, offered it to her. She shook her head without looking up from the newspaper she was reading at the kitchen table. Melt from that morning’s meager snowfall dripped from the upper deck just outside the kitchen, creating a continual soft staccato below. So I set the cake on a paper towel and munched at the wedge’s sharper end. We’d used black walnuts this time, and their rich, bittersweet taste filled me. Before I could initiate conversation, she looked up. For a second a glint of anger peeked out from those almond colored eyes of hers.

I saw Dr. Fo instead of Dr. F, she said, and I asked her about the spot. She said she thinks it might be a tumor.

My jaw tightened. My only familiarity with that word summoned the image of an ugly, dangerous growth.

It might be cancer, she added. Including that word brought a lump to my throat. I went to her, bent, and we held one another. Becca’s taciturn nature never left much opportunity for emotional displays, but this time she cried for a while, and when that passed she gently pushed me away.

Well, we need to have it checked out, I said. Talk about lame responses. But what else could I say, other than the obvious?

She nodded, held up a leaf from a prescription pad, a phone number scribbled on it. Dr. Fo recommended an oral surgeon. She said we couldn’t know whether it’s a tumor for sure without a biopsy.

I reached for the phone, but Becca rose, took it from me and dialed the surgeon’s office number. I retired to the living room and my recliner. It can’t be that bad, right? I thought. Cancer’s not the killer it used to be; they’ve made so many advances. We knew a couple in Atlanta, had a regular noshing Friday night meal and beer with them. The wife had breast cancer, had undergone treatments for it, and was in remission. Surely a tumor on Becca’s tongue couldn’t be that bad. And what if it isn’t a tumor at all? No, it’s probably a misdiagnosis, a false alarm. But Dr. Fo was right; we did need to have it checked out for our peace of mind.

Two weeks passed. During that time we hardly spoke of the lump, but once every day or so I would see Becca examining it in the bathroom mirror. I remember thinking if we could just ignore the lump’s presence and leave it alone, it would shrink and go away. Those two weeks passed with glacial slowness, both of us weighted down by unspoken concern.

The suite of doctors’ offices resides in a converted, early 1900s house off Asheland Avenue, near Asheville’s Mission Hospital. We announced ourselves to the receptionist, and after a brief wait a nurse summoned Becca to an examining room. I wanted to go with her, but for reasons unknown to me even now, the nurse would only allow Becca in. I settled into a waiting room armchair near a hissing, crackling, wood-burning fireplace and passed the time with a book. A half hour or so later Becca emerged to tell me the doctor was going to take a biopsy of the spot. Once more she was to return to the exam room without me. The surgeon promised to send the biopsy sample to a lab for evaluation, and Becca was to return in three weeks to discuss the lab report.

During the three-week wait, we convinced ourselves once more that the issue would amount to nothing. Becca was about the cleanest liver I’d ever been around, eating only a fiber-rich diet—organic foods, organically fed chicken and pork. (She would almost retch at the thought of eating beef, even refused to handle meat she was to cook. Which meant the cutting, handling, and prepping of meat for our meals ended up with me.) She drank sparingly, an occasional beer or glass of wine. She exercised fairly regularly, and while she stayed up late, she always managed plenty of sleep.

I don’t now recall whether I offered to accompany her on her follow-up visit with the surgeon, but however that transpired, she went alone. When she returned, she dropped her purse on the kitchen counter, turned to me, and said, I have cancer.

I reached for her. She pressed a hand against my chest and pushed me back, her face screwed into an angry pout. That’s twice you weren’t with me when I heard bad news.

She was such an independent person; her anger over that perceived slight flummoxed me. I didn’t know what to say. I reached out again, and this time she let me hug her. I’m so sorry, I said.

She let out a long sigh and the anger ebbed. Me too, babe. She turned a wistful look to some far off place. They’re going to make an appointment for me with another surgeon, and he’ll take the tumor off my tongue.

Thoughts and memories cartwheeled though me. I thought of my splenectomy years earlier, of a fledgling doctor’s improper diagnosis and that of another who was eventually censured for all but ignoring my situation. I could only hope Becca’s surgeon would be a good one. I’d had other surgeries since the splenectomy, and my recuperation from each had been just this side of gruesome. But, I thought over and over, the removal of a small tumor on her tongue couldn’t be a big deal.

Becca did accept the appointment with a head, neck, and ear surgeon, Dr. R, for an assessment. On the appointed day we sat waiting in a pale, monochromatic examination room barely large enough for the exam chair Becca sat in, a tiny sink, and the small bench I claimed for a seat. Dr. R, a studiedly casual man of gangly proportions, finally entered and introduced himself. Then he took a look at the spot on Becca’s tongue.

It’s definitely a cancer mass, he told us in his matter-of-fact way. The best course of action is surgery to remove it.

We were expecting that, I said.

Can you tell me what you’d be doing exactly? asked Becca. And will I be able to talk afterward? She absently took her right hand in the left and squeezed, a mannerism I’d long since realized was for her a physical expression of anxiety.

Oh, I think you’ll be able to talk, but you might want to have speech therapy if you have difficulty forming certain words.

But the surgery, Becca insisted.

Dr. R scooted his stool to a nearby wall and leaned back. I’ll remove the obvious tumor, and then I’ll be able to confirm whether the cancer cells have jumped from the tumor to the tongue’s tissue. If they have, then I’ll remove the diseased portion.

If you have to do that, Becca asked, how much of my tongue will you take?

I’ll just have to see, Dr. R replied, but my gut feel is it won’t be much.

It would be outpatient surgery; we could expect Becca to return home by evening. A few days later we reported to Mission Hospital for the surgery.

True to Dr. R’s word, the glossectomy, or tongue surgery, didn’t take long. I had brought my laptop so I could work on a writing project while in the waiting room, had finished that day’s work, and just opened a book when Dr. R sat beside me.

The surgery went well, he said. I took the tumor out and found some cancerous tissue on the right side. Had to remove some of the tongue on that side. She’ll be fine. He commented too that he had sealed the incision with a piece of cadaver skin.

So Becca came through the surgery in fine shape. The hospital’s operating arena had been busy that day, though, and she had to wait a long while before she was assigned a post-op bed prior to release. By the time that happened and I was able to see her, evening had crept in to replace the day. Patients were slowly disappearing, and so was the O.R. staff. Finally, only Becca, I, and an older man remained. By then Becca was fully alert and understandably fuming at the delay. At long last someone completed the paperwork and we took off for home.

A week or so later, we attended a follow-up visit with lanky, youngish Dr. R. in the same tiny room. He examined his handiwork, said everything looked fine, and asked if we had any questions. Becca had lost her ability to taste, and he reassured her that in most cases the taste sense would return. Foremost, however, we wanted some assurance that the cancerous tissue had been completely removed. But that wasn’t to be.

I took out all I could see, he said. I went as far back toward the root of the tongue as I felt was safe.

But you took all of it out? Becca asked. You were able to get all of the cancer?

He took a deep breath and exhaled. I can’t say that, not with any degree of certainty. I didn’t want to impair your ability to speak, and if I’d gone back farther toward the root, there was danger you’d lose the use of your tongue.

What if you didn’t get it all? I asked.

He shrugged. Let me talk to Dr. Co, an oncologist. She can schedule a scan as soon as you’re healed. If there’s more cancer, then she and I can decide whether you should have more extensive surgery, or maybe radiation.

Becca’s tongue healed fairly quickly, but the glossectomy left her with a mild speech impediment. I wanted her to have speech therapy as soon as possible; I didn’t want her to end up like my mom, who had nearly died from a stroke sixteen years earlier, leaving her without an ability to speak. Specialists held out hope that Mom would recover her speech, but only if she worked assiduously with a speech therapist, something she proved unwilling to do. I realize I was projecting Mom’s situation onto Becca, but it had been one of the deeper sadnesses of my life to watch Mom go mute. Selfish perhaps, but I didn’t want Becca, the woman I considered the most loving and beautiful I’d ever known, to lose her voice.

CONFRONTING A DELICIOUS SIGHT ON A TRIP THROUGH THE PAST

Mid-1940s to 1994—Louisiana and Mississippi to Atlanta, Georgia

I came of age in a man’s world. My father retired from the U.S. Air Force as a senior non-commissioned officer, and during his working years he dominated Mom and