Terminal

“Your cancer is at a very advanced stage. At this point, chemotherapy and treatment on the throat lesions would be ineffective, as would removal of the tumors and steroid therapy. Truthfully, I’d be hesitant even to do an exploratory on the growths at this point. As I said, a Grade Four tumor is very aggressive, and you have multiples. Literally dozens, in fact. To be honest, I’ve never seen so many in a patient before. I’m afraid the outlook is terminal. I am truly, truly sorry, Tommy. You have my deepest regrets. Had we caught it earlier—” He shrugged and found something to look at on his blotter.

“Shit,” I said again. “Terminal. Huh.” It felt like somebody had hit me in the stomach. After a few moments, the doctor stirred.

“I don’t understand, Tommy. Why didn’t you come in earlier, at the first sign?”

“I don’t have any health insurance, Doc. The foundry keeps us below thirty-five hours a week so they don’t have to pay for it. State law, you know? And my wife only works part-time at the Minit-Mart over on Eisenhower and Carlisle Street. She doesn’t have any insurance either.”

The doctor nodded and fell silent again.

“Can’t you cut them out? The tumors?”

“It would be futile, Tommy. The success rate is very low and the surgery is quite invasive. The cancer has spread rather quickly, expanding into the rest of your body. Your esophagus is— not good. The tumors in your jaw have sent tendrils into your brain, like roots, if that helps you to understand it better. That’s where the headaches are coming from. Several of the growths have fused with your spine. There is simply no way that we could remove them all, and even if we did, you’d be horribly disfigured. We would literally have to remove your jaw and your nose. There are prosthetics for that, of course, but they are very costly.” He stared back down at the blotter, fiddling with a pen.

There was more, but I didn’t hear it. The doctor showed me pamphlets that I pretended to understand. Even though he already knew the answers, he asked again if I smoked (I did), drank (only a few days during the week, Friday night after work, and on the weekends), used drugs (once in a while, but only weed), worked near radiation (nope, just foundry dirt and molten iron), family history (my mother had breast cancer), or had a father who was exposed to Agent Orange in Vietnam (my father was in ’Nam but came back as an alcoholic). He nodded as I confirmed each one.

The doctor offered me some medication to make the nausea and pain easier, wrote a prescription for something (but I wasn’t paying attention and didn’t really understand what it was for), and asked me to come back in a couple days so we could discuss arrangements.

“What kind of arrangements? What’s there to discuss?”

He explained the difference between a hospital stay and a hospice, and told me that I’d have to make some tough decisions. He’d be there to help me with them.

“Is that appointment going to cost money? ’Cause I don’t get paid again for another two weeks.”

“Well”— he seemed taken aback—“I’m sure we can arrange something, Mr. O’Brien.”

I was Mr. O’Brien again, soon as he saw that he wasn’t getting thirty bucks right away for another office visit.

“I know all about the difference between hospitals and hospices, Doc. Hospitals just fuck you in the ass. Hospices try to make you comfortable first, then they fuck you in the ass.”

“Mr. O’Brien—”

“Just tell me how long.”

“Tommy—”

“How long, goddamn it?”

Outside, the receptionist stopped typing. The office was very quiet, so quiet I could hear my heart beat, pounding like a bass line in my favorite Snoop Dog song.

“Well, it’s hard to be certain of course, Mr. O’Brien, but I’d say you have approximately one month to live. Certainly no longer than three.”

That was it. He showed me to the door.

Outside, the sun was shining, and it felt good on my face. I could smell the honeysuckle growing alongside the building. A bird hopped across the parking lot in front of me. Several more chirped and sang to each other in the trees. A gnat, the first one I’d seen this spring, buzzed my ear. I resisted the urge to squash him, letting him live instead, so that he could fly away and bother someone else.

Winter had come and gone, and now it was spring. The season of renewal. That magical time of year when Mother Nature takes her clothes off, puts on a thong bikini, and shouts: “Let’s party!”

Everything was coming to life while I was dying.

I was terminal.

That was when my knees gave out, and everything got dark.

* * *

I don’t know how long I lay there. A minute maybe, but it seemed like more. Nobody noticed, so it couldn’t have been that long. I skinned my hand on the pavement, and wiped the blood on my baggy jeans.