Surviving Cancer
Hisham Melhem/Al Arabiya
Saturday, 18 April 2015
The examination was quick but thorough. I was more curious than anxious to know after days of pain, useless anti-biotics and inconclusive local biopsies. I was spent. But I thought that a recent exacting trip in March to Afghanistan, Saudi Arabia and the United Arab Emirates with secretary of defense Robert Gates which left me at times fatigued and almost breathless may have contributed to my exhaustion.
And while Dr. Nabil Yacoub was checking my neck and chest he was asking questions like, how long have you had these lumps in your neck and underarms? Have you experienced waking up at night because you were drenching sweats? I would mumble something and like him alternate between English and Arabic, and give an incomplete or vague answer (I did not remember the drenching night sweats) only to be rescued, as usual, by my wife Rudaina whose voice was being engulfed with impalpable despair. Only then I began to vaguely sense that I am about to enter the capital of pain, where you roam alone and suffer alone. Isn’t April supposed to be ‘the cruelest month’? When Doctor Yacoub was finished he took one step back and said matter-of-factly ‘you have cancer.
It is called non-Hodgkin Lymphoma, and it had spread in your neck, chest and abdomen’. As soon as he finished these words, my wife literally collapsed on the hospital bed, her hands covering her ashen face. I was in rage; not because I was diagnosed with cancer, it took that truth sometime to sink in, and besides the news was not a total surprise, but because my wife had to endure the cruelty of the cold ‘professional’ way my diagnosis was announced. I felt that my right to tell my wife, the woman I shared my life with since I was 22 years old, with my own words and my own cadence and my own touch and tone about my condition, was taken away from me. T.S. Eliot was right, April, the month in which I was born, is indeed ‘the cruelest month’. That day, five years ago I had a glimpse of my own funeral, when I woke up from a brief nap to the muffled weeping of my wife, my son Omar and my daughter Nadia over my hospital bed. Did I say already April is the cruelest month? I remember telling them that I was planning to stick around for a while after I beat cancer. I wanted so much to spare them the pain.
My brother’s keeper
In telling my siblings and close friends and some of my colleagues in the following days I found myself doing more consoling than informing or explaining. My youngest sister Helen, the only one of my four sisters who lives in the U.S. took it hard but tried to project a stoic demeanor. She helped me after I shocked my two younger sisters Claude and Wadad in Lebanon, and my older sister Mounira in Spain, by explaining the treatment and the relatively high ratio of surviving non-hodgkin lymphoma. I conspired with my sisters to hide the news temporarily from my older brother Mounir in Lebanon, because we were concerned that the shock would be too hard for him to handle given his frail health. The following week, burdened by guilt I called him. It was difficult to tell a loved one who – like many Lebanese of his generation- cannot force himself to say the word ‘cancer’, that you have been diagnosed with the damn disease. I think I inflicted undue pain on him by repeating the unspoken word many times to let the reality sink in once and for all.
But what was truly uncomfortable was losing my eyebrows and eyelashes. It took me a while to get along with my new face, and I must admit I was not enamored by it. A hairless face with a baseball cap can be deceptive
He gave me an earful of indignant complaints when he realized he was the last sibling to know. He forgot to mention that he was unable to tell me years ago about the passing away of our two brothers, Elie, the oldest and Michel who like my father Yousef died young of heart disease. Michel was barely two years older than me. When he died I felt that he took half of my life and my childhood with him. For my mother Mariana, ‘Michel and Richard’ were inseparable. From him I learned the love of words and books, and together we smoked the first illicit cigarette (I hated it, though he liked it) and together we had as teenagers our first baptism of fire, when our maternal grandfather Habib Nader, a truly tough mountain man and I am convinced, the handsomest older man I have seen in my life, gave us one of his double barrel shot guns to go hunting telling my brother to be careful and keep an eye on me. Rarely a day passes by without me thinking of my brother. I wanted Michel’s memories and his smile to be my constant companion, when cancer invaded and occupied my body.
‘Bad news; I have cancer, but don’t worry…’
I called my two childhood friends in Beirut Michel Daher and Samir Naimy to tell them the bad news. There were lots of emotions and memories, but only few words. I told them not to worry, that I will have excellent medical care and assured them that I will fight cancer with the same gusto we use to display in our teenage brawls in school. I wrote my editors at Al Arabiya in Dubai and some of my friends in Washington that I felt they should hear the news from me and not through a third person. I titled my email; bad news, then explained briefly the nature of cancer and the chemotherapy treatment I am about to start. I assured them, without a hint of irony or bravado that as a ‘mountain man’ in the mold of my grandfather Habib Nader, I will beat cancer. The outpouring of support was gratifying. It was then I realized that practically every family I know of has someone who was diagnosed with cancer.
I was very open about having cancer, and I continued my public appearances, but I resisted writing about it then. I thought I needed some time to lapse to gain a better perspective, but I think the main reason for my reluctance to write about my qfight with cancer was my aversion to the thought that I was seeking sympathy and or attention. I was very adamant not to allow anyone to show me even a hint of fake sympathy, and there were few occasions when I did not want some characters to know that I have cancer precisely because I did not want their phony support. As for my enemies, and I made some in more than 35 years of journalism and public commentary, I wanted to assure them by my attitude, behavior and spirit that I am still standing and ready for the next fight.
The cancer vocabulary
My initial diagnosis was followed early next morning by my first operation where a relatively large cancerous lump was removed from my underarm for biopsy. On that day I met for the first time my oncologist Doctor Alexander Spira, a meticulous and lively man, who explained to me that I have to go through six chemo sessions, once every three weeks, and that the day after each session I would have to take an injection to boost my bone marrow. He told me I could continue my work, but I have to take some precautions to protect myself from infections because chemo will weaken my immune system. When he found out that I ride horses regularly, he asked me to desist. I worked every day during my treatment with the exception of the days of my chemo sessions. The session would last more than six hours. Doctor Spira told me he would schedule the first session immediately before they insert a ‘port’ in my chest. By now I was beginning to acquire a new cancer vocabulary. During cancer treatment doctors need access to the patient’s veins to give him/her treatments such as chemotherapy, blood transfusions or intravenous (IV) fluids. To make these procedures easier and to avoid damaging the patient’s veins they recommend (strongly) inserting a special medical device under the skin in the chest called a catheter or a port.
You will not die of cancer
Before my first chemotherapy session, I had to attend a two hour ‘class’ with my wife, along with other patients about to start chemo treatment, to tell us essentially what will happen to our bodies and our minds when they start injecting in our veins what is for the lack of a better word poisonous drugs to kill the cancerous cells. The session was like a horror show, and the lady lecturer was expansive in her explanations particularly of the side effects of chemo. We all knew that we will suffer hair loss. But the list of side effects could include mouth sores, loss of appetite, nausea and vomiting, diarrhea or constipation (What?), low blood cell counts, and an array of other nasty things with difficult to pronounce names. I told my wife if I get only half of these side effects I will be a wreck. On that day I went to my barber to shave my head. He did not do a thorough job, so I had to do it myself. I could not force myself to shave my moustache.
He was dragging his feet so slowly that he seemed condemned not to reach the other side. That young man was ALONE. I could see that he was deep inside the capital of pain. I have never realized that 15 feet can be that long
Few weeks into the chemo treatment, I was pleasantly surprised that the side effects were barely felt (a metallic taste, and some fatigue) and did not affect my work schedule at all. Early in my treatment Doctor Spira looked me in the eye and said; I can assure almost one hundred percent that you will not die from this cancer. I believed him in the absolute, and never felt afterward that my life was in danger. By this time, my conversations with Doctor Spira would start with a brief discussion of the latest treatment, and then he would start asking me questions about the Middle East. I was ecstatic to find out early on that we shared a strong passion for anything that has to do with the American Civil War; the politics, Abraham Lincoln and Robert E. Lee, the Generals, the battle fields and the myths.
A call from Kurdistan
After shaving my head I began to sport a baseball cap, but would wear a more formal hat during my television appearances on Al Arabiya. I did not mind a bald head, but losing my moustache, was unsettling; after all we have been together since my youth and went through different phases of size, thickness and color. My wife had to get used to my hairless face. But what was truly uncomfortable was losing my eyebrows and eyelashes. It took me a while to get along with my new face, and I must admit I was not enamored by it. A hairless face with a baseball cap can be deceptive.
One day I was asked to comment on a developing story during a news program hosted by my colleague Rima Maktabi from Dubai. The producer failed to warn Rima that she will be talking with a cancerous version of Hisham Melhem. I immediately saw the shock on her face; but Rima being the professional that she is, quickly managed to regain her composer. I had a number of awkward encounters with people I deal with professionally, who would not recognize me at first glance, and when they do, they don’t know how to deal with what they see.
One day, after I finished an interview on Al-Arabia about events in Iraq, I got a call from someone who spoke with a deep voice with accented Arabic asking for Ustaz Hisham. He told me that Ustaz Massoud would like to talk to me. Masoud Barzani, the Kurdish leader of the famed Kurdish family was watching Al-Arabiya and asked his aide to call me. I was touched by his concern and well wishes and almost had tears in my eyes when he kept repeating: we don’t forget our friends who stood by us when supporting the Kurds was costly. I have always supported the Kurdish struggle in Iraq and elsewhere in the Middle East for self-determination. In the days before the internet and satellite television I would interview Kurdish leaders like Masoud Barzani and Jalal Talabani when they visit Washington on Radio Monte Carlo, the Arabic service, as well as U.S. officials who were in charge of Kurdish affairs (some of them spoke Arabic) when the regime of Saddam Hussein was waging his brutal war against the Kurds. My wife’s reaction: isn’t it interesting that the first leader from the Middle East to call you and wish you well was a Kurd and not an Arab?
The cancer ward
The chemo sessions took place in a large room, with lots of windows, where we sat on large comfortable leather ‘lazy boy chairs’. I did not know if the room had a name, but I found myself referring to it as the ‘Cancer Ward’ and thanking Aleksandr Solzhenitsyn for it. I would sit for hours hooked to my (IV) apparatus, watching the bag of drugs going through my veins one drop at a time, then alternate to reading, watching television or as I did on some occasion writing stories on my lap top, while chatting with my wife. Most of the patients were over the age of thirty. No one below the age of twenty was treated at our ‘mature’ cancer ward. Children and teenagers had their special wards. Not even a mountain man can deal with children suffering from cancer.
The nurses and the technicians were professional and friendly. But from the beginning, I was struck by the dignity and stoicism that the patients displayed. Maybe I was lucky, but I don’t remember any patient complaining; why me. Most patients were laconic, or spoke mainly with their family companions (we were encouraged to have with us a family member or a friend). I wish I could say that the ward was the scene of dramas. In fact there was a certain banality to the place. There were few memorable moments, sights and scenes.
A man my age, sitting on the other side of the ward facing me, was being treated with the same drugs that were given to me. He was the quiet type. All of a sudden his body was flailing violently and uncontrollably. His body was refusing the drugs. The usually dignified man was emitting strange otherworldly sounds. The other patients watched silently, helplessly and probably saying to themselves ‘there, but for the grace of God, go I’.
The youngest patient I saw was a man who did not even look twenty years old. He was emaciated, pale, with a piercing eye and the kind of pained face only generations can chisel. I still remember him shuffling slowly across the ward pushing his (IV) apparatus along his side. He was so thin and haggard that he reminded me of Alberto Giacometti’s Walking Man sculpture. He was dragging his feet so slowly that he seemed condemned not to reach the other side. That young man was ALONE. I could see that he was deep inside the capital of pain. I have never realized that 15 feet can be that long.
It is what it is
A fifty two year old good looking man who was diagnosed, again, with lung cancer was sharing his life experience with me. I don’t recall how we ended up having a conversation and I don’t remember his name, though his face was etched in my memory. I usually forget names, but rarely faces, because I like to read faces, and I like to look at memorable faces. I cannot get enough of looking at some of Abraham Lincoln’s photos. In one particular photo you could read his family’s tragedy and all the horrors and sorrows of the Civil War. Silent faces say a lot.
The man said that at age fifty, after years of heavy smoking he was diagnosed with lung cancer, but he barely survived after treatment and the removal of one lung. Last year he met the love of his life and married for the first time. Two months ago cancer paid him a second visit to claim his second lung. He told me he was dying, but he wanted to spend as much time as he could with the woman he loves, and hoping that the doctors can prolong his life for few months or even few weeks. He spoke slowly and exuded stoicism. Our conversation had a certain rhythm and was punctuated by brief silences, where we would complete sentences or thoughts. I did not say much, I was listening and watching with resignation the face of a dying man.
Then came another moment of silence. Then we looked at each other, and as if on cue we said: it is what it is. I never saw the man again, but every time I hear someone say: it is what it is, I see his face.
When I remember these episodes I feel that they happened to someone else many years ago. I rarely talk about surviving cancer, and still think that the experience did not alter my life. My wife and my sister Helen always remind me that I never complaint or felt sorry for myself. Five years ago I got an early glimpse of my funeral. But that was not meant to be. I am still standing and going through another April. It is what it is.
