Cleanly circumnavigating the globe earns you about 24,901 miles. We say that to be days away is to be halfway around the world, but I only flew 18,676 miles on my recent trip from Jakarta to Los Angeles and back, via Singapore and Tokyo, touching down in all four hemispheres. One evening a few weeks ago, despite feeling a tingle in my chest, I spent an hour at the gym and met friends for cocktails in one of those farm chic restaurants in a marbled Jakarta mall. By 9pm, the tingle had widened and my throat was throbbing. By midnight, I surely had lymphoma all over again. At noon the next day, between important research meetings at opposite ends of the city, I booked a ticket. Instead of flying to Palangka Raya that weekend, I was to going to Santa Monica. While the nurse was drawing nine vials of blood, my oncologist looked down at me slumped in the chair and asked how I was feeling. I feel fine, I shrugged. I really did. Jet-lagged, tired, but fine. I was supposed to be on a river in Borneo today. He raised his eyebrows. We both half-laughed, in the way that our efficient weekly conversations last year about managing drug toxicity, lung damage, and fatigue were punctuated by mutual half-laughter when I gravely asked things like “are you sure the cramp in my leg isn’t leukemia” and “what if my hair grows back blond.” And, “can I ever go back to Indonesia.” He still answers my questions seriously, despite the half-laugh. So, he suggested, "next time you have a cold maybe you can see a physician in Singapore, instead of flying halfway around the world. I've heard their medical centers are world-class, actually."
We met one year ago today. I was wearing a high-collared black jacket. I should have been giving a seminar presentation but instead was sitting very upright in an exam room chair, poking at a grant proposal on my iPad in the bowels of the UCLA medical center. He took my chart off the door and took a long glance in my direction. Oh, hello, he smiled coyly. Then he put the chart back and didn’t return for another hour.
That room was cramped with us, my companion and his resident. Perched on the exam table, I was higher than everyone but feeling vulnerable. His interrogation about my symptoms were an arrow pointed squarely at a diagnosis of Hodgkins lymphoma, though the previous eight doctors had missed that mark. A few minutes in, he asked if I had any pain in my glands when I drank alcohol. I shook my head, not because I didn’t have pain but because I couldn’t remember the last time I had had a drink. I was abstaining from alcohol, I told him. And sugar, and maybe pizza and meat and cappuccinos too, because I’d read somewhere that everything except green vegetables feeds inflammation and I definitely had lots of inflammation for almost a year and though I didn’t quite know it yet, I was also fighting blood cancer, and cancer—especially in the mind—feeds neuroses. I drink a lot of green juice. He raised his eyebrows at me. Then he suggested I have a drink that evening. Are you sure, I said, alcohol is really bad and also, the sugar might be causing all this inflammation in my blood? He made some notes on the chart. "I’m not suggesting you get drunk," he said with an authority that white coats bolster. "But have a margarita." I sensed then that this meeting between us, unfortunately, was not just regarding a diagnosis but a matter of confirming that we were going to get along.
A chemotherapy session is like a long-haul flight. That’s how I thought of preparing for the 12 treatments, and that’s how I talked myself into thinking that once I got where I was going, I’d forget about ever having been in transit. For the plane, I always choose a window seat near the wings; for chemo, it was the first-class lounger in the corner with a view down Santa Monica Boulevard, out to the Pacific. Nurses’ assistants bring water, pillows, blankets. The stack of fashion magazines is appreciated, but rarely touched. I chew gum: it keeps the ears from popping during takeoff, and masks the acrid smell-taste of saline solution used to flush the IV port in my chest. I rub lavender oil on my wrists, put on the eye-mask, and curl up against my buckwheat neck pillow. I’ll entertain small talk, but prefer the Tibetan singing bowl-Japanese flute playlist on my iPod. I used to bring a meal of many components for the long hauls, but now I just as well pick at the plane food and forget it ever happened. Anything I ate during or after chemo might forever be associated with nausea and though I don’t have much recollection of eating waffles and bacon at the IHOP across the street from the cancer treatment center, the seasick feeling I get when I think of those things makes me realize that I did.
I had a practiced but profound cockiness when I walked into the center for my 9am bi-weekly appointments. Not unlike the feeling of knowing that when I disembark from a plane on the other side of the world, I’ll figure things out. I’ll be fine. I ran-walked several miles those mornings, cruised in cheerfully with my bag of travel accessories and my excellent prognosis, and swept past less fortunate passengers to get to my seat. I knew that after the nurse hung the bag of Benadryl, I’d sleep through four hours of slow drip and wake up one checkmark closer to finished. Forever. Like waking up in the next hemisphere over, these are luxuries so many don’t have.
Years ago, during my first ever descent into Tokyo, the plane heaved and lunged so deeply that I threw up and started weeping. The placid Japanese stranger next to me finally turned and said “Oh, you feel... bad?” I wanted to both slap him and hug him. I couldn’t bear to get on my connecting flight to Osaka and took the train instead. At the first chemo session, sequestered in the private room (for amateurs), I cried for several hours before I let them administer anything, fearing the drugs’ toxicity more than cancer itself. But I grip the armrests less tightly now, concentrate on breathing smoothly, and remind myself that I can forget.
I always woke up just as the last of the chemo cocktail was winding its way into my veins, wiping my immune system clean and setting off the beeping IV pole. The nurse hastened to unplug me. Of course, as I struggled to lift myself out of the lounger then, I did not feel fine, or even confident that I would ever feel fine. The last session was no different. I left without saying goodbye to the nurses whose faces had become familiar, without outwardly acknowledging that this long haul was over. No words or gestures seemed appropriate. So I just groggily shuffled out, went home to face the last days of chemo's grotesque side effects, and not three weeks later bought a plane ticket to Indonesia.
As the wheels touched down after last week's stormy landing into Tokyo--also the kind where each drop makes you sit up a little straighter--the Japanese flight attendants folded their hands and gently bowed their heads in unison. It's a gesture of respect and gratitude, and of closure, that is so often practiced in Japan. Even if no one in particular is looking.