Pretend burial.

Earlier this week, hurtling along I-40 on one of my final daily trips to radiation, I heard this thing on the radio about a teambuilding exercise that an employer in South Korea is using to raise worker morale.

During the exercise, employees dress in long robes and sit at low desks. Each writes a letter to a loved one as if it were their last correspondence. Sniffling and even outright weeping is acceptable.

Next to each desk is a big wooden box. But not an ordinary wooden box. The kind of wooden box that is a coffin.

When the workers are done with the letter, they lie down in the coffin and someone pretending to be the Angel of Death comes around and hammers the top shut. They lie in the dark inside the coffin for about ten minutes. The idea is that when they re-emerge they will have a new perspective on life, one that will make them more passionate about their work and appreciative of their lives.

This Christmas week was supposed to be the last hurrah of 6 weeks of radiation—my last day scheduled for the 23rd, and then one whole day to pull Christmas together. Overall, despite the challenges of the last few months, I was feeling pretty hopeful and festive—beloved family coming in to town, the magic of internet shopping/wine drinking after kid bedtime, class parties, piano recitals, baking, the culmination of this whole mess of treatment seeming to be almost slipping into the rearview mirror. The only thing that was getting me down was my nagging back, which just seemed to not really be improving as quickly as I wished. I was feeling a little 90-year-oldish, but hanging in there—pushing through it when I could.

I thought about the Korean work burial a number of times. Intriguing, but the mandatory-ness felt kind of heavy handed. And I was skeptical about the boss’s clear expectation that his workers would reemerge with renewed vigor to work harder.

Still, it resonated with me that a serious, vivid envisioning of one’s own death could be a rewarding and enriching experience—a chance to take stock in that way we sometimes try to do at New Years but it gets all clogged up with booziness and roman candles and overpriced meals.

The Korean boss—who used to work at a funeral home—also has his employees engage in a rousing exercise of forced laughter before they sit down at their desks in the morning. Supposedly it stimulates the system, and if done regularly and convincingly enough can replicate the benefits of genuine laughter.

The night before my second to last treatment had been a particularly rough one—lots of spasms, hard to stand up and use the bathroom. At one point it took me around 45 minutes to summon the strength to walk down the hall to the office to get a roll of tape for present wrapping.

John drove me in to my radiation appointment that morning, and I needed a wheelchair, as I sometimes have these past few weeks. The receptionists slapped the yellow FALL RISK bracelet on my arm as they have done a number of times since early November. Radiation went well, as normal—Motown Christmas carols over the speaker—but when I mentioned to one of the techs that my pain was bad again and I was having a hard time peeing because my muscles were so tight, someone paged the doctor.

I already had an orthopedist appointment scheduled for the next day, but someone said, The quickest way to check this out is to send you to the ED and get an MRI. They were apologizing, but I was relieved. My biggest worry was that we would be there so long I would miss some of my afternoon commitments and I’d still be in pain.

An hour or so later—down a quiet hallway of rooms of gowned patients lying flat like me on their backs inside tight loud tubes, silent patients in their beds being wheeled to and from these sterile basement rooms, the pretend burial exercise came back to me again. As the machine clanked and buzzed and zapped all around me for about an hour as I lay impeccably still there in my hospital gown I thought Forget the angel of death. The angel of medical imaging is loud and terrifying enough. I would have six more similar scans in the coming days.

I did emerge with some euphoria. That machine reminds me a lot of what it feels like to stand inside my son’s room during ‘band practice.’ I said to the techs. I felt very at home. Thanks so much for that retreat.

 I’m not half bad at the forced laughing thing, either.

Now you just need to wait an hour or so for the results, which we will try to expedite, the ER nurse said, and we can get you out of here. So, John sat in the little chair in our little room eating gross hospital food and fussing with social media. I think I had some naps and maybe some pain meds that made the world of metaphorical dying simulation quite lovely and ethereal.

When the results did come back (very quickly!), it turned out it was the sucky job of the ER attending—who I hadn’t met yet—to remove the word “metaphorical” from the whole situation.

He was so young and cheerful and decided to start on a bright note: Good news—your labs look mostly normal. Ok.

But one thing to note—seems that you do have a significant fracture in your spine, at the L2 vertebra. And the way it is broken is very worrisome. It’s not a trauma break. It’s a pathological break, likely caused by a tumor that has metastasized from your breast.

I am so sorry, he just kept saying, I hate telling people these things and I’m not very good at it.

The world kind of broke open right there—or maybe the reverse is truer. Maybe the wooden box lid slammed down kind of hard on our heads.

We’re going to admit you up on the oncology ward. You will probably have surgery right away.

A stream of doctors after that—one crouching down to eye level with me, gripping my hand and not pushing away her tears. Another—Dr. Rosenblum—standing over me with the face of a mother whose daughter is very late for curfew. She kept patting my hair. John’s eyes from the visitor chair reflecting my own face back to me again and again: WAIT, WHAT? We kept asking each other, WHAT?

I don’t know what exactly will happen next, but you know that metastases put you at stage four, the crying doctor told us. This is clearly an aggressive cancer. It recurred before we even finished treating it. It’s probably time to put your affairs in order and make a bucket list, as hard as that is to hear.

A fuck-it list, John quickly started calling it—kind of the opposite I guess. What can we just say “fuck it” to and send splashing off into some sewer and not bother ourselves with anymore?

Turns out not many things!

It’s early days still, I know, but there is not a lot of ambiguity in the diagnosis. I will die of this someday pretty soon. But if lying in the wooden box—or the clanking metal tube—or under the hands of a weeping doctor—has underscored anything it is that there is no real fuck-it list.

I want all of it—all the things to do with living—and I want them to keep feeling messy and confusing and even sometimes boring. The hospital transporters bitching about their insane holiday hours. The Queen sitting on my bedside looking me in the eyes and admitting she’s scared. The sound of my extended family playing an improv word game downstairs around the dinner table. My weird chemo hair growing in suddenly in thick chunks. Light sabers cracking Christmas ornaments. A science fair project taking shape in some distant room. The drenched backyard full of runoff, and tiny, slimy, uncertain yard critters who had expected to remain buried in months of hard mud, peaking their heads out into this balmy Christmas air, asking WAIT, WHAT?

 

 

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Found on Level 00.

Most of radiation is about waiting. The actual zapping takes about 15 minutes.

After you check in (name and birthday, have you fallen in the last 30 days, have you traveled outside the country in the last 3 weeks) you wait in the big lobby, then you get pulled down the corridor to change in a little booth—it’s kind of like the opposite of Superman: you go in your normal human self, you come out hospital-gowned and feeble looking.

Then you sit and wait some more in the Gowned Area.

It’s mostly the same people every day, so you can really get to know some folks. Sometimes you feel pretty social, and other times you retreat into your feeling-pretty-poorly shell and are more of a listener.

Sometimes you listen with a notebook in hand and are a little bit of a thief (and HIPAA violator?):

Ms. Sutton, the doctor would like to speak to you immediately.

This morning he wouldn’t even eat ice cream.

Love you darlin’.

I’ll shut up when I’m dead.

I’m just so worried.

Ooh, this place rocks—they have hospital ice!

Hi Crystal—it’s me. I’m down here with the nukes.

I’m sure I’m not the first person to tell you that you look just like Prince.

The radiation team loves to dance—they play the Motown/funk Pandora station every day over the speakers in the radiation chamber (name and birthday please), bopping around, getting down on it, all while they threaten you with your life if you move a smidge. You take them pretty seriously, even though they are all 24 years old. You ignore the hell out of Marvin Gaye.

Daddy’s fine, Mom—he just went to the bathroom. 

Love you.

Well, I guess all we can do is hope.

It isn’t nearly as obvious in this light, baby.

There’s donuts over by the scale at the nursing station if you want one.

Jesus is the only doctor who knows it all.

 

Usually people like to talk about The Lord back in the Gowned Area, but yesterday it turned to politics.

That moron really needs to shut his mouth and go back to just being a trillionaire.

$65 dollars to see Dr. Cook—forget it! Who can afford that?

You stay strong.

Love you, sweetheart.

Is the sun shining out there today?

 

One thing that’s kind of crazy is that despite the multi-million dollar machines, the whole radiation protocol feels a little MacGyver-ish—they mark where the lasers should line up on your body with paint pens and sharpies, they make a mold of your torso out of foam and duct tape, they increase the radiation to the chest wall by wrapping a rubber mat over the place where your breast used to be with masking tape.

I like thinking about the scheming, practical mind that came up with all this.

You need some help with that? 

The good news is we made it through another day.

Be blessed.

I’m going to miss you.

Behave yourself.

Love you.

 

Twenty-one treatments down, twelve to go.

You got you a nice tan going, says one of the techs this morning as she examines your chest. Looks like that part of you has been to the islands.

Aloha! You say when they’re done, floating in your gown out of the nuke room, back toward the Gowned Area.

Aloha! the techs call, the three of them clustered in the hallway outside the command center in their light blue scrubs, two of them waving slowly like your cruise ship was just pushing off, the other looking past you, beckoning back the next patient.