Trigger Warning - A heads-up that this chapter (and the next) will deal quite intimately with what it is like to have a close family member be diagnosed with terminal cancer.
January 2001, Everett, Washington
"Stage 4 adenocarcinoma... palliative care recommended..."
It had all started with a simple dentist's visit, apparently. They'd found a growth in Grandma's jaw, and after a battery of medical tests, the report was out. Nobody at home understood any of it; not even Mary with her habit of Googling every little symptom she thought she had. Of course - despite all her hypochondria, Mary was still at the age where she believed herself to be practically immortal, so she'd never be morbid enough to fancy herself to be dying of cancer. How Mary expected Anne to be able to translate the medical-ese was beyond her, but in any case, it was enough that Anne understood the two most important words in the report: "Palliative Care."
For as long as Anne had understood the meaning of life and death, she had dreaded this day. As a little girl, she used to make Grandma promise that she'd live to be 100 years old. Every time she saw senior citizens in wheelchairs on the street, she'd give thanks that Grandma was sprightly, healthy and young for her age. Grandma was the one family member she loved and respected the most, so naturally she wanted to hold on to Grandma for as long as possible. She was determined that it wouldn't be so easy to seal Grandma's fate with just that one report. It couldn't be.
Within days, Anne booked her flight to Detroit, taking three days' vacation from work to go home and investigate the situation. After she'd talked to the doctors at the local hospital where the tests were done, her conclusion was that the situation was not that good, but not totally bad either; the cancer had started in the lung and spread to the jaw but both tumors were relatively small and the good news was that the cancer was believed to be slow-growing. Cancer is an ambiguous disease, Anne told herself. Nobody can ever tell you how much time you've got left because everyone is different. and so even though the official prognosis was six months, Anne believed there had to be more hope than that, if only she could wipe out those two fateful words: "Palliative Care". She hated the finality of those words.
There was one certainty, though: Anne knew that she would have to move home. Hope didn't create itself; it had to be built through careful research and action. Even if the others had gotten more involved, Anne would still have wanted to take the lead because of how much Grandma meant to her; but now that it was clear nobody really knew what to do, it was even more imperative that she should take on the main role as a caregiver and advocate for Grandma. Actually at 22 going on 23, Anne had no more idea of what to do than Walter, or Elizabeth, or Mary; but where she lacked in experience, she more than made up for it in will. The only way to move ahead was to do whatever appeared like a no-brainer, and just build up from there, one step at a time.
The first no-brainer to Anne was to tender her resignation once she returned to Everett. Boeing didn't have a major operation in Michigan, so even though Anne hadn't figured out whether she'd be able to work or not after she moved home, it was pretty clear that she couldn't stay with Boeing. Anne found it hard to believe that after six short months, she was walking away from her dream of a lifetime to face the nightmare of her lifetime; yet, she supposed, having just those six months of her dream job at Boeing were better than not having had them at all.
With the whirlwind of activity she faced - the administrative work of tendering her resignation, handing her work over to her colleagues, packing her belongings, and managing the other logistics of her relocation home - Anne had hardly any time to think about Frederick at all for the first week after she got the news. It wasn't until Frederick called her over the weekend that she realized how delinquent she'd become in her communications to him, wrapped up as she was in this unfamiliar new world.
"Hey, stranger. What's up? I haven't gotten any email from you all week, baby."
"Yeah," Anne wished there was a playbook for life, especially life after cancer. Something, or somebody, to tell her how to navigate all this uncharted territory she was facing, like how to tell her absent fiancé that her entire life plan and priorities had changed literally overnight. But there wasn't, and so Anne was left with only her instinct. At this time, her instinct was to choose flight, rather than fight. "I'm just tired, I guess. There's this urgent project at work, and I've been pulling all-nighters to get it done. I'm sorry about being so tied up Talk to you more next weekend? I guess I'll have more sanity time after this whole project is finished." She was making it up as she went along, but at least she could buy some time to think.
"OK then, I won't take up your time. Take care of yourself, yeah?"
To tell, or not to tell? When to tell? The questions haunted Anne like a shadow, clinging to her day and night. Writing about it in an email was the first option Anne eliminated - by now, she knew just how tough military pilot training could be and springing this type of news on Frederick after a long day of training and study would be tantamount to planting a bomb in his inbox. That left the phone, and face-to-face communications. Anne tried to visualize his reaction if she were to show up at base to tell him - which was out of the question anyway because she'd have too many things to do when she got home to afford the time for such travel. Just imagining his shock was enough for Anne to throw out the entire idea of telling him now. In the middle of pilot training, he didn't need this kind of problem to distract him; especially when there was nothing concrete he could do to help her as long as he was still stuck there on base. She'd tell him when they were next planning to get together, at the end of summer after he completed his training. It would probably be easier to tell him then, too, when she had a better idea of what lay ahead for her. For us, Anne hastily amended in her mind.
Us. Ever since the cancer diagnosis, the word "us" in Anne's vocabulary had become synonymous with her and Grandma; or perhaps if she wanted to generously expand the meaning it could refer to the Elliot family at large. Her priority now was to bring the Elliots to band together against the dreaded disease, like gathering a football team in a huddle before they faced an unknown opponent. In this jigsaw, Anne just couldn't see where Frederick would fit. It was an unsolvable puzzle that constantly played in her head, but since she had to focus on the immediate action items to be done, she used all her effort to keep pushing it to the back of her mind every time it surfaced.
The day she had to tell Harriet, Anne still couldn't find the wherewithal to string the words "Grandma" and "cancer" into the same sentence. Mutely, she handed Harriet the printed medical report. The clothes, books and other personal items were piled up in their living room, waiting to be placed into moving boxes, and stood as silent witnesses to Anne's impending departure.
"I've booked my air ticket to Detroit already, and I'll be flying off in a week. The stuff I'm bringing with me will be just whatever I'll need on an immediate basis. As for the rest of my things, it'd be great if you could help me to arrange for shipping, and for my car to be transported back as well. Just tell me how much it costs, and I'll pay you back pronto. Please?" Anne begged. Then she added, "And one more thing. Please. Don't. Tell. Fred."
"Of course not!" Harriet would never presume to interfere with the couple, both of them were her dear friends and she respected their privacy. "That's for you to tell him - in fact, I can't imagine for the life of me why you haven't told him already."
"How could I? What can he do, even if I told him?" Anne shrugged and spread her arms in a gesture of resignation. "He can't come, that's for sure. I can't ask him to abandon his pilot training. And if he knew, it'd drive him crazy thinking about it, on top of all the studying and other stuff he has to do already. It wouldn't be fair to him. As far as this is concerned, I've made up my mind - I won't tell him until after UPT is done. That way, he can focus on his training with complete peace of mind."
"Anne, do you really think Fred will have more peace of mind if you wait till summer to tell him?" Harriet wasn't in the thick of it, and maybe that was why she could see clearly where Anne couldn't. "Just imagine - it's the biggest thing in your life right now, and he finds out you went on for more than half a year without telling him. If you were in his shoes, would you be happy about that? Fred has stood by you for four years now. He'd want to stand by you when you're going through the biggest challenge of your life."
"That's exactly it," argued Anne. "If I told him, he'd want to stand by me, but I'm not sure that would be good for him, or for us. You know how my whole family feels about Fred, Grandma included. If Fred shows up in Detroit, it won't do anybody at home any good. It'd kill Grandma, for me to disrespect her blatantly like that in her current state of health. And what would it do to Fred? Or for that matter, to Fred's plans to become a fighter pilot? He's already so close to getting there, and I can't ask him to throw it all away for me. It's not a good idea. Really."
"You're treating Fred like a baby. Come on, he's a grown man - and he has to be one heck of a hero to handle all the crap of military life. He can make his own decisions. Tell him - he can handle it."
"No, and I mean no. I can't solve this problem, and I don't have time to solve this problem. I just need more time to think."
"Well, if you wish. But if you ask me, I think you're making the biggest mistake of your life."
Battling the two words "Palliative Care" took up all of Anne's time and energy once she touched down in Detroit. She made her rounds of hospitals - not just limiting herself to hospitals within Michigan, but also making the rounds of Memorial Sloan-Kettering, the Mayo Clinic, and MD Anderson Cancer Center, to get second, third, fourth, fifth opinions. What she was after was a treatment plan that didn't have the word "palliative" in it; someplace which would be willing to give treatment that could keep the cancer somewhat at bay. No matter how many people told Anne that the realistic goal would be to control rather than to cure the cancer; and that palliative therapy aimed to do just that, somehow Anne felt better if they just didn't use the word "palliative" altogether.
Meanwhile, Anne made sure to keep up with her schedule of emails and phone calls with Frederick. Luckily for her, he always called her cell phone, so she didn't have to explain a change of phone number to him. Somewhere along the way, she fell into a pattern of fielding his questions about her life with vague answers, and encouraging him as far as possible to continue jabbering on about life on base so that she didn't have to talk too much. Like an automaton, she went through the motions time after time, until one time she found herself nodding like a china doll, not even realizing that Frederick couldn't see her and couldn't hear her on the other side of the line.
"Anne? Are you listening?"
Anne returned with a jolt to the conversation and tried to pay attention. It wasn't that she didn't want to talk to Frederick; rather, she was too caught up in her own world, the cancer world which she refused to share with him, to really engage in what he was saying. Their college days and aviation dreams seemed like a childhood fantasy long past; while in the present, Anne found it hard to fathom that she was still just turning 23 years old that spring. To her, 23 years old felt too young to have to deal with problems as big as this.
Anne's current world consisted entirely of tumor markers, radiotherapy, chemotherapy, side effects, and a whole slew of drugs and dosages to remember. For the most part, The Elliots vs. Cancer was a battle fought by an army of two, though Anne also shamelessly capitalized on Walter's name to gain access to top specialists when she needed it. Eventually, they settled on MD Anderson; it seemed strangely ironic that she was physically nearer to Frederick than she'd been in months, since MD Anderson was also in Texas, yet she couldn't be farther away from him in spirit.
And she had to figure out what to do with the Pontiac, too. Like all the other issues pertaining to Frederick, she found someplace safe to stash it away, waiting for her to have the time and energy to think about it again.
