Chapter 1: A Small, Innocent Lump
It was the summer of 1976 and I was a slim, pale, baby-faced 31-year old woman. I was sitting comfortably in the living room, reading in the company of my two daughters. Inbal, my 11-year-old, doe-eyed, slender and serious-looking, sat next to me on the couch, her head buried in a book. Hilit, my 6-year-old, lively and vivacious with blonde, curly hair, was sprawled on the rug, surrounded by the toys she had ceremoniously carted out of her room earlier.
The sounds of Hilit playing did not disturb the pleasant calmness of the room, and I continued reading while the thumb of my left hand, which supported my chin moved inadvertently under my jaw, occasionally coming across a small bump that hurt slightly upon touch. What could that be, I wondered, without much concern, as yet. In the days that followed, I found myself touching this spot quite often and soon discovered it swelled and became more sensitive. I started to wander how serious this thing could be, and so a few days later I went to see our family doctor.
Dr. Gordon is an elderly man, pleasant and smiling, despite his serious professional behaviour. On the wall of his room hangs an elaborate drawing of fruits and vegetables, which he points to frequently, insisting, in his South American accent, "If you want to be healthy, eat lots of fruits and vegetables." I would often swallow a hidden smile; he was known as a sworn vegetarian, and therefore was suspected of trying to convert others to his ideas, and was not to be taken too seriously. Little Hilit, who could never reject any sweets whatsoever, loved him so much that she often pretended to be sick just so that she could pay him a visit, in spite of his sweets’ “embargo”.
Dr. Gordon carefully examined me and said he thought an infected tooth needed extraction. He explained that the tooth infection had caused the lymph gland beneath it to swell; after the extraction, he reassured me, the swelling would no doubt disappear.
I hastened to follow his advice and made an appointment with my favourite dentist, Dr. Tuvis, a plump, motherly Russian woman. She took an x-ray of the tooth and confirmed the fact that it had to be pulled. I sighed and leaned back, resigned to my fate and ready for the narcosis and the pain that will surely follow. But no, Dr. Tuvis washed her hands, a sign that the visit was over, and told me that before she could pull the tooth I would have to take antibiotics for a period of one week to reduce the infection.
Antibiotics were a common commodity at my home, as I frequently suffered from bouts of tonsillitis. I did as I was told without a second thought. It never entered my mind, or my dreams, that suppressing the infection could cause any harm to my health. On the contrary; I was sure I was doing the wise and responsible thing. Even my husband, who always used to joke about my devotion to medications and doctors’ orders, believed there was no other choice.
The following week I returned to the dentist after having finished my antibiotics. My good-hearted dentist performed the extraction fast and skillfully, as she always did. I went home in some pain, but happy that the problem had been solved.
I carried on with my life. Days and weeks passed, but the small bump, which no longer hurt, did not disappear. Eventually I bothered to ask my doctor when it would go away, and he reassured me, saying that occasionally it takes a long time before a bump disappears. I stopped worrying and ignored it.
More than two years went by, and gradually the bump continued to grow. It did not hurt. At a routine check-up, the dentist noticed the bump and asked with a concerned look, "What's that?" I reminded her of the rotten tooth of two years earlier. She was shocked, "Do you mean to tell me that it's growing?" I shrugged by shoulders, wondering what she wanted of me. "I want you to have it checked at the hospital." Even in her soft Russian accent, the order sounded so decisively compelling that it left no doubt in my mind and I immediately made an appointment with the Ashkelon Hospital’s Oral-Maxillary Department.
One always has to wait a long time for appointments at the hospital, but eventually my turn came. The physicians in the Oral-Maxillary Department suspected a stone in the salivary gland and x-rayed my jaw from every possible angle, but to no avail. After a grave consultation, the doctors decided to operate, to find out the core of the problem. The operation was due to take place a month later. In my naiveté, I believed it to be a minor procedure and was not too nervous about it.
On a sunny January 1979 day (like most winter days in Ashkelon) I went in for the operation. Yossi, my husband, was in the Reserves (in Israel, husbands are always in the Reserves when you relocate or when the children are sick), but anxiously asked whether he should request leave. In a heroic gesture I replied that there was no need for that, as it was going to be a minor operation and I would probably be returning home that same evening.
On the day of the operation I left my daughters with my mother. They were big girls - Inbal, a delicate, serious 14-year old, immersed in her books and her drawings, and my sunshine, 9-year old Hilit, playful and busy as a butterfly. Yossi and I, who had married young and were nearing 34, had begun thinking of having another child before it would be too late. The operation had postponed that for a while, but we did not consider it as a real reason to be concerned.
I entered the hospital with no worry whatsoever, preparing myself for a day of leisure, and had taken along a good book. I sat in the corridor waiting patiently, concentrating on my reading. An acquaintance who passed by asked in surprise, "What are you doing here?" "Waiting for an operation," I replied nonchalantly. He looked surprised and concerned but said good-bye and went away. Every once in a while I was informed of a brief postponement, due to urgent operations that had to be performed first. I began to feel hungry, but was not supposed to eat. Never mind, I went on reading.
It was close to noon when I was given the hospital garments and a bed. Then a physician came to explain the nature of the operation. He said that after it I would have to try to whistle, to make sure they hadn't harmed a certain nerve in the jaw. The latent warning in his remark, combined with the long wait and the irritating pangs of hunger, made me feel tense and slightly worried. I found it difficult to concentrate on my reading. Two more nerve-wracking hours had passed when the nurse finally arrived, and without much ado gave me an anaesthetic, placed me on a mobile bed and noisily wheeled me into the operating room. I felt relieved that at long last things were moving. I was not afraid of the operation itself, because I did not have the slightest idea of what it entailed.
I was left near the operating room, surrounded by the commotion of people running about, busy with their own activities, skirting around my bed when it got in their way. I felt my breath weakening and suddenly I was filled with fear that they might have given me too strong a dose of anaesthetic; after all, I was a featherweight. Had they made a mistake? Everyone around was so busy, it seemed as if no one had noticed me. To whom should I turn? My breathing became weaker and weaker, the fear had increased and was pressing on my heart like an iron fist. A terrible thought entered my mind - What if I am going to die this very moment and I'll never see Yossi and the girls again. I wanted to embrace them and say good-bye before I died, but was so weak, I could not even cry.
A sudden move had rocked my bed and I was shifted into the operating theatre. Several pairs of hands grabbed me and rolled me onto the operating table. I was surprised to discover that, after all, I was still alive and that someone was paying attention to me. Rachel, a good-hearted nurse with whom I was acquainted, smiled at me with her eyes - the rest of her face was covered with the operating mask - as though promising me that from now on everything would be O.K. I wanted to believe her encouraging look, and I was still watching her when the anaesthetist gave me an injection, at the same time trying to joke with me. I heard him count to three and then sank into oblivion.
When I woke up, there was an excruciating pain in my neck. Had it not been for the pain, which made it clear that the operation was behind me, I would have thought I had fallen asleep for a minute or two (the operation had lasted three hours). Consciousness came and went. One moment I was awake, in agonizing pain and nauseous, and the next I had dived into a black hole of unconsciousness. I did not understand what was going on. After an hour or so the delirium and nausea passed, leaving me with the irritating pain.
I managed to get up and look in the mirror - a very foolish idea, because what I saw was frightening. My neck was swollen like a balloon; a transparent plastic tube was hanging from it, to drain the blood. I could not bear the thought that this image was once slim and delicate me. The pain in my neck was agonising and in helpless desperation I pleaded with the nurse to give me a tranquillizer, but she refused, insisting that it was not the right thing to do after an operation, without explaining why. For several hours I paced back and forth like a lion in a cage of torment, until the pain began to subside and at long last became bearable.
After a whole week in that depressing place called hospital, in the company of sad and suffering people, I was happy to return home, despite the fact that we were in the midst of moving. I did not think my husband would be able to manage the move in my absence, but friends had helped him and I was brought, like a royalty, to a clean, tidy new home. My neck was very stiff and every movement hurt, but despite the remaining swelling, I could now look in the mirror without alarm.
When I left the hospital, the doctor said I would have to come back a week later to get the results of the operation. I did not understand what "results" he was talking about, but if he said I should come, it was clear that I would.
It was the middle of winter, but the sun stubbornly continued to warm the earth as though it was still summer. The sea was calm and deep blue, up to the sharp line of light blue of the western horizon, where the world seemed to come to an end. Throughout that first week at home, I had been occupied with the effort to get back to routine, despite a stiff and painful neck; now I once again found myself in the Doctor’s reception room after a long wait in the corridor.
Dr. Neder, the surgeon, was a broad, thickset man with a square face framed in grey hair. The wrinkles in his face expressed a good-hearted man. "Sit down, Sara’leh," he said warmly, and for a split-second I noticed a shadow cross his face. "What's the matter with him?" I thought to myself, still without the slightest inkling that his concern had anything to do with me.
He pulled himself together and said: "Well, we took out a lymph gland the size of a nut. We sent it to the pathology lab and found that the gland is not good." There was silence for a moment and at once my heart fluttered and sank in fright. It was clear to me, I don’t know how, that "not good" meant cancer - as simple as that. Comprehension mingled with shock was undoubtedly reflected in my face, and before I had time to regain my composure, he quickly continued: "I sent the gland to another pathologist, just to be certain. In a few days we'll know for sure. I don't think there is any need to panic, because it seems to be a local tumour that probably hasn't spread."
I allowed his words to calm me, and the panic gave way to a sigh of relief. What did I know about cancer? If the doctor was calm, why should I be alarmed? I enveloped myself in the naive certainty that "it would not happen to me," and spent another relatively calm week.
At the next visit, I was once again amazed to find Dr. Neder looking sad. This time he was brief and clear: "The second test confirmed the diagnosis of the first one: a non-Hodgkin lymph gland cancer of a particularly malignant type called "Hichiocitic Lymphoma". My heart fell. Tears of fear and self-pity burst forth and could not be stopped. My naive confidence had turned out to be a straw I was clutching in the face of a tidal wave. Now, in the light of the bitter reality, I felt small, vulnerable and terribly frightened facing something large and terrible. This time, the doctor's pacifying words to the effect that it was possible to live with cancer for quite a long time, did not offer any consolation. Like every young and healthy person who never thinks about death, I wanted to live with no time limit until I was old and grey - until . . . until I was tired of life. I could already imagine the kind of life that was now waiting for me. Up to that very moment I had seen myself as a healthy woman, and then, all of a sudden I had become an invalid, about to be kept alive through all kinds of artificial means. My world fell apart.
Yet, through the tears, and in spite of the awful feeling, I managed to pull myself together a little and asked the doctor to always let me know the whole truth about my condition, as painful as it might be, no matter how much I cry. Indeed, he promised and I felt that he, too, preferred it that way. Somehow, this promise restored the little hope and faith I had in myself; and, perhaps, offered a certain sense of control over my own destiny.
After I had somewhat calmed down, Dr. Neder began to tell me what to expect in the next few days, step by step. First I would have to take a number of tests to see whether the ailment had spread to other organs. If that was indeed the case, local radiation treatment on the neck, designed to destroy the remaining cancerous cells, would not be sufficient. This means that I would have to undergo chemotherapy, which would affect all the living cells in my body, the healthy as well as the unhealthy ones. Now the only thing I could do was to hope and pray that the cancer had not spread.
I returned home in a state of shock. Yossi was as frightened as I was. I could see the fear in his eyes - I have cancer - that terrible disease that had killed his mother a few years earlier. He had seen her suffering and watched her die, and now his wife! The only thing that the girls understood was that something terrible had happened to Mummy. Even today, as adults, tears come to their eyes when they remember their emotions back then.
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