Fundamental Truth

We don’t get to carry the memory of being born; others do that for us. Our mothers, fathers, midwives, doctors, nurses. They bear witness to the miracle of life, the beautiful entrance that is leaving the womb to become a single entity—human. We aren’t allowed to carry this moment with us, those feelings we experienced as neonates, so primal and instinctual that by the time it’s over, we have no way to implant the experience into our existence. This experience is a fundamental truth for all beings existing on this planet. No matter their background, their livelihood, their generation—everyone has been born. The only other truth besides birth that connects us on a greater scale, is the fact that one way or another—everyone will die.

           I sit on the examination table, waiting for the doctor to return with whatever results and clinical discoveries he is going to make for me this time. Then, there will be a lecture—there’s always a lecture: “cut down on your smoking, reduce your alcohol intake, monitor your blood pressure…” Blah, blah, blah. At this point, I don’t even know why I keep coming back. I begin to wring my hands together and remember very suddenly why I’ve come back… the pain. The dull ache and utter stiffness of my fingers have become unbearable and impacting how I’m able to work. You need two functional hands to successfully operate an auto body shop, that’s a given. There’s a soft knock on the door.

“Yup,” I say, a little bit louder than I intended.

The doctor enters, closing the door behind him, “Mr. Jones, I have your paperwork to go over.”

This doctor is young, he could practically be my grandchild—if I had grandchildren, or children for that matter. I just nod and wait for him to cross the room and take a seat in the chair facing me. He clears his throat. Great, that’s always an excellent sign.

“Mr. Jones, I understand that you originally came in because there was some concern regarding the discomfort in your hands… I’m concerned you may have developed an autoimmune disease known as Rheumatoid Arthritis. I can’t be one hundred percent certain as of right now, so I am going to put in a referral for you to see a rheumatologist—someone who specializes in this issue.” He pauses, watching my reaction to see if there is anything I’m going to ask, I just shrug and offer up my hand for him to continue, “In addition to that, I am also severely concerned about your smoking history and the status of your lungs,”

Here comes the lecture, I think

“You mention having an ongoing cough, sometimes coughing up blood,” he continues, again pausing for my not so valuable input.

“that’s been going on for a while, nothing to complain about there, I can still work and function… I’ve tried all the mumbo jumbo cramp on quitting and trust me—it makes my life far worse than smoking. I promise you that.” I reply. I feel myself getting defensive, I need to tone it down.

The doctor clears his throat again, “That’s exactly why I’m concerned. Some of your lab tests we ran today, as well as the fact that you’ve lost fourty pounds in the last couple months without changing your lifestyle, has me concerned that you may have lung cancer.”

This throws me, and I don’t even know why. It’s not like I should be surprised. Like they say, I smoke too much, drink too much and don’t take care of myself. All that has ever mattered to me was keeping my pop’s shop running from the time he died ten years ago. I don’t even know how long we’ve both been silent for, until I hear that annoying clearance of the doctor’s throat. I make eye contact with him; he wants me to say something.

“Cancer? Uh okay. Yeah, that wouldn’t be too great,” I chuckle trying to offer some comic relief. He doesn’t laugh, and his eyes continue to pierce into me.

“Mr. Jones, I understand this is a lot of information for you to digest all at once. This is not something I throw around lightly, but we do have to cover our bases and have you follow up with some imaging tests to be absolutely sure.” I nod, and he continues.

“I’m going to have Amy at the front desk schedule you for a CT scan of your chest today at St. Mary’s Hospital down the street, I’ve already made some calls and they’re able to get you in for the scan today if you’re willing.”

Now I clear my throat, fuck, “Yeah, that would be fine. Thanks doctor.”

“In the meantime, I’m going to give you a prescription for some corticosteroids to help with the inflammation in your hands—that should help with the symptoms until we can get you into a specialist and gain more insight on what’s going on with this cough.”

I nod. He slowly gets up from his chair, I reach my hand out to shake his, but he doesn’t take it. Instead, he places a firm hand on my shoulder, gives me a light squeeze.

“We’ll be in touch,” he says, and hands me a stapled packet of papers with my name, information on rheumatoid arthritis, and you guessed it: 5 steps to smoking cessation. Wonderful. I could really use a cigarette right now.

Later than evening, I find myself sitting at my desk in the shop looking at the dusty framed photograph of my father and me. I can’t be much older than sixteen in the photo, my dad has his arm around my shoulders as we stand smiling at the camera in front of his light green 1970 Cadillac Deville convertible. The hood is up, and naturally, there are motor oil stains all over my white t-shirt. A pang of sadness and guilt comes over me. I love this photograph, and the memories of working on that beautiful piece of machinery with my dad every day after school. But now, I can’t shake the feeling that I’ve done the one thing I feared the most: failed him.

After the doctor appointment, chipper Amy scheduled me for an appointment at St. Mary’s for the CT scan,

“Great news! They can take you in an hour,” she whispers to me as she covers the receiving end of the phone.

She finishes up the conversation and grabs a scratch sheet of paper. On it she writes the time of my scan and where to go when I enter the main lobby of the hospital.

The drive isn’t long, and I arrive with 15 minutes to spare before my appointment time. I’ll be darned, but Amy’s handwritten directions were literally spot on. I find the imaging department and check in. When I’m called, a less than enthusiastic technician gets me checked in. He starts an IV and tells me I’ll feel like I’ve pissed myself when the contrast is infused during the exam and not to worry, it’s normal. He’s right. I thought I literally pissed myself. When all of that is finished, I am told to go home, and the radiologist will have results for me by the end of the day.

           I got the call about an hour ago from Dr. Clears-His-Throat that the scan does show masses engrained in both my right and left lung, and that he went ahead and made me an appointment with his colleague who is an oncologist… I’ll meet him tomorrow. Since then, I’ve been sitting at my desk, staring at the photograph. It’s at that moment, I grab the pack in front of me and light a cigarette. Because honestly, it’s not like I can really do any more harm with smoking.

My father was my best friend growing up, he was never an authoritarian like some of my friends’ dads. He was confident, skilled and he loved to teach—about automobiles especially, but he wasn’t limited in that area of expertise. At the dinner table he would tell me stories and talk about historians, politicians and philosophers. My mother would always roll her eyes when he would get on a roll, but I would absorb every second of it. He was brilliant, literally brilliant. He had a full ride to Harvard and spent a year there studying law but left to come back home and start up the shop. He said his heart wasn’t tied up with all those other academics, that as far as he was concerned, he would live a much happier, healthy life working on cars. And frankly, he did. Sure, we weren’t financially rich, but we had everything we needed—and my father was always so full of life, so vibrant. I wanted to be him when I grew up and I figured taking on the shop was what I needed to do to fulfill that. Looking back at it now, maybe the shop wasn’t what my heart was tied up in, maybe it was just my father’s passion that fueled me and later left me feeling obligated to keep his dream going.

           My father’s death was unexpected, not like the way I am going to die. Nothing terminal, nothing he could have prevented with a good diet and quality exercise. He didn’t drink, he didn’t smoke, he said his prayers and ate his green leafy vegetables. He was in amazing shape for an older gentleman and was working in the shop up until his untimely death. A freak accident really, he was wearing worn down gym shoes and didn’t think anything of it walking past the wet floor sign. He slipped, those who witnessed his fall at the grocery store said, he slipped and smashed the back of his head on a shelf of avocados on the way down. Leaving behind fresh blood and pieces of his hair. When the paramedic came, he still hadn’t come too, and the pool of blood around his head grew only larger. They placed a breathing tube in him right there on the grocery store floor and rushed him to St. Mary’s. When I met with the doctors taking care of him, I was given the news that my father suffered a massive intracranial hemorrhage, a massive brain bleed, so extensive they were not able to operate, and care was ultimately futile. Brain dead. I held his hand when they removed the breathing tube, and watched my father’s lifeless, flaccid body struggle to take in air until eventually, he didn’t breathe at all.

           After that was when my own life didn’t matter to me, and it really hasn’t for a while. I’m not surprised that I have cancer, not in the slightest. I treat my body like shit. I eat fried food, smoke more than your average chain-smoker, and drink at night to fall asleep. If the shop is running smoothly, I let myself do whatever the hell I want. I’ve been dying a slow death since I watched my father reach his. To be honest, I know my cells have been actively decaying inside of me. Revolting my lifestyle and the choices I make, but I don’t care. I’m too proud to point a revolver to my head, and a slower death while operating mechanics seems more plausible to me. Cancer may be the best thing to ever happen to me in a while. I don’t have many regrets, and if I did, I would have worked those out ages ago. I know my father would have wanted a different alternative for me, but I couldn’t mask the pain any other way. He would have wanted me to do something I was passionate about, to find love and start a family, to teach my children the same way he taught me. I tried, I really tried. I dabbled in dating, some women I really felt a connection with, few I could see myself spending my life with and starting a family. When I could feel that moment start though, the moment you know your life will never be the same without that person—I ran. It was too painful. Why start a family and have children when I couldn’t even live with the loss of my dad? I had too much shit to deal with to put that on another person, let alone a kid. With no siblings, and my mom leaving for a younger man shortly after my eighteenth birthday—it was only me and my dad. And he left me.

           I make my way upstairs to my personal loft and living quarters inside the shop. On the countertop is half a fifth of Jameson. I turn the television on to infomercials and drink straight from the bottle until I fall asleep.

           The next day I find myself sitting on yet another examination table, this time in one of those patient gowns that’s an awful shade of green with a horrible design. What is the irony of arriving to your oncologist appointment hungover, and smelling of cigarette smoke? I wonder if I’m the first. The oncologist is friendly, empathetic and goes over my scan results and blood tests. He then ventures into the overwhelming topic of treatment options; all of which include quitting tobacco use and drinking—all of them sound rigorous and painful. When he has finished talking, he looks at me to decide on which direction to take. I don’t know how to say what I’m about to say, so I just say it,

           “Doc, I appreciate everything you are telling me and the time you’ve taken to go over all this information… I just, I just don’t see this going well for me—and I know you want to save me and cure me and give me a second chance, but I’d be lying if I said that’s not what I want.” He looks at me without saying anything, I think I’ve broken him. I continue, “I just don’t want to go through this extensive therapy, if there was an option for me to go home and continue to be in my shop—I’d take that.”

“If you choose that,” he says, “You’ll die. Soon. Without treatment, your body will not sustain this way much longer.”

“I understand, I know that. I don’t have a death wish—but I don’t have a desire to go through this treatment either.”

           He looks at me, really looks at me, “Mr. Jones, I can’t force you to do anything you don’t want to do. But I don’t want you to make any rash decisions just yet. Today has been overwhelming and confusing for you, I’m sure. Why don’t you take today and tomorrow to think about your options? We’ll meet up again in a few days and see how you feel about going forward with, or without, treatment. It’s your right to decide which direction you would like to go, but it’s my responsibility to make sure you have given your options a fair and honest thought.” Damn, he’s good. I agree with him, and I schedule my next appointment with him in two days.

Instead of driving back to the shop, I detour and find myself at the local lake. A fishing spot my father and I would go to frequently. There’s a bench right before the pier, and I find myself sitting there looking out onto the water. It’s not that I don’t want to live, it’s just that I don’t have anything to live for. I didn’t ask to be born, and I’ve loved the life I’ve lived up until my father’s passing. Even after, I’ve had everything I needed, nothing to gloat over—but I wasn’t in shambles either. I made my choices, and now I must live with them. It is inevitable that every single person on this planet will die. Everyone. Dr. Clears-His-Throat, Amy the receptionist, the unenthusiastic CT technician, and the lifesaving oncologist will all one day perish from this earth. What they leave behind is up to them: family, loved ones, legacy, their careers. Nonetheless, they will all go. There is nothing anyone can do to stop that. No matter your health, economic status, or job title. My father always said there were two fundamental truths that connect all humans on earth: that we are all born, and that we all will die. I know my truth. I’ve known it for a long time. I don’t need two days to think about my decision, but I’ll take them anyways to validate choice. I’m scared, but a little fire has lit inside of me. Not a fire to save myself or my soul, but a fire that there may be some chance, some way—I’ll see my father again. For me, that is worth dying for.