At 4:30 p.m. on October 27, 2017, my entire world shatters into a million pieces and I enter a Twilight Zone world that looks like my life but feels like a nightmare. The biopsy confirms what everyone hinted at but were unable to articulate: The bone loss in my jaw is metastasized cancer. Breast, most likely. Stage 4 cancer. Metastasized. Into my bone.
But let me back up.
Two months before, on August 16, 2017, I went into the dentist for a toothache. I was starting to need painkillers, so I figured I should have it looked at. A filling, maybe. A crown? Ugh. I’d neglected my previous six-month appointment because—
Let me back up even further.
On September 30, 2016, my little family of three received fabulous news. Our then-two-year-old would be receiving a sibling sometime in the spring. Then on November 2, 2017, we got a double shock—twins!
That pregnancy was difficult, but no more difficult than multiple pregnancies usually are. All the aches and pains were normal (even if the hemorrhoids felt like they might be worse than actual childbirth at one point). On May 25, 2017, I gave birth spontaneously at 38 weeks to two healthy little girls, Phoenix Corinne at 6 pounds 2 ounces and Calliope Emma at 7 pounds.
Those first three months were tough. So many tears and sleepless nights and a few fights are crammed into that innocent little sentence. As it was when Morrigan was first born, in the beginning, my husband Kevin and I were just surviving.
In the midst of it all, I would think, “This isn’t so bad.” But then, looking back on it, yeah. It was extremely stressful. Extremely. You do what you have to with a baby. You do what you have to with two babies. But it’s a slow grind of unpredictability woven in with a strict routine of breastfeeding and bottle feeding and pooping and napping and crying.
When the babies were about two and a half months old, Kevin went back to work part-time in the evenings at a restaurant he had previously worked at as a cook. We wanted to wait until they’d been sleep trained—so at least bedtime was a routine and they were going down without flipping out—but it was a “now or never” kind of thing. It was supposed to be a few shifts here and there, but it ended up being five days a week.
I didn’t like that, but I survived. I spent hours every evening with two crying babies, trying to get food on the table for my poor three-year-old. Then came bedtime routine, with more crying, and finally bedtime, with more crying.
Calliope especially hated going to bed. She would scream herself red when I put her down, but I was determined to sleep train her. I would pick her up, put her down, pick her up, put her down, so she wouldn’t work herself up too much. But after a while, it wasn’t realistic. I’d have to walk away because I had to get Morrigan to bed, or maybe comfort Phoenix, too.
I gave birth to two babies while I had cancer. I took care of these two babies while I had cancer. How did I not know I had cancer? How did I not know that something was wrong? How did I not know? How did my body do it? How? How? How?
The bitewing at the first dentist appointment was a shock. “Here,” said the dentist, looking a bit baffled. “Do you see on the x-ray? Here’s the left side of your mouth. You have severe bone loss in your jaw.”
Me: “What causes that?”
Her: “I don’t know. I’ll refer you to our periodontist.” She poked around. She scraped my teeth. She measured tooth mobility (several wiggled). She made notes.
The periodontist appointment came too slowly. I was anxious. After all, I’m pretty sure I need my jawbone. I googled “severe jaw bone loss.” I read about poor oral hygiene (I floss every night!) and jawbone cysts. I got into a fight with my mother because she suggested I take herbs instead of having a surgeon fix it.
I did not go onto WebMD and decide that I had Stage 4 breast cancer.
The periodontist scratched his head. He sent me for a CT scan of my head. I read a sci-fi romance novel in the waiting room and waited patiently for my follow-up. When I met with him again, an agonizingly long amount of time later, he told me that they would need to pull at least three teeth and do a biopsy.
I cried a little then because I have grown fond of my teeth. I’ve had them for a while. It scared me. Would I be deformed? Would they be able to give me dentures?
I was supposed to have the procedure done in his office on November 1, but the pain was getting a bit much. He referred me to an oral surgeon in downtown Toronto. I was going to a friend’s wedding in Virginia the next week, so I scheduled it for when I got back.
My dad flew up from Texas to help drive me, the babies, and Morrigan to the wedding. It feels so long ago, even though it was only two weeks. It’s like a curtain has fallen over my life to separate everything I’ve ever known. It’s like looking through a glass bubble. Everything is warped and out of focus. I can never touch it again. It is gone. Forever.
We drove for two days. That was quite the trip. Everyone behaved, but we had adventures. Dad chose a route that took us through the mountains in Pennsylvania, and at one point, we got stuck behind a couple of large tractor mowers that were going five miles per hour. They weren’t even mowing anything. The grass was patchy and the spots that grew were maybe two feet tall. They were cutting it down to one foot tall, and it was on a curving road that was a no passing zone, and Dad cursed up a storm and I laughed hysterically because why not? Why not add another hour to a trip that was already taking fourteen hours to drive because of two babies?
I got into a discussion on Facebook about rape culture on the day that I had my tooth extracted. Not my wisest move. So much stress. I walked away because I just couldn’t do anything more with it. I had to leave it. I had to focus on myself. What was I thinking in the first place? Arguing with people over, essentially, politics, on the day I’m having a tooth pulled.
The oral surgeon came in. “Did you get the results of the CT scan?” he asked. He was so calm and collected. I thought, It’s a good thing he’s like this. I’m sure people appreciate it. I do. Going to the dentist sucks. Getting a tooth pulled sucks. How stressful.
“The radiologist said it’s indicative of a rare disease called Langerhan’s cell histiocytosis,” he explained. After he talked a little bit more, I surreptitiously googled it, but they were fairly quick at getting the procedure moving along, and I couldn’t really read up on it. Later, I discovered that it’s a cancer-like disease of the white blood cells. It usually happens in children. It’s even more rare in adult women than adult men.
That made no sense.
“It’s why we’re doing the biopsy,” he explained. “Do you have any other symptoms?”
I feel like I’ve had more boogers lately. I’m a little thirsty sometimes. I stubbed my pinkie toe on the coffee table last night. “Um. No?”
“Unexplained weight loss?”
I looked down at my twin bump that’s only recently started shrinking five months post-partum. “Not really.”
“How’s your pain?”
“Maybe a 5-6 on some days when it feels like the nerve is hurting. Other days, it’s a 3-4.”
He murmured something to the nurse taking the notes. “That’s fine. Any tingling in your lip?”
“Now that you mention it, maybe a little bit.”
More murmuring. “All right. I’m going to numb you now.” He explained about a nerve that he’ll try not to damage. My stomach clenched, but I nodded. It will be what it will be.
I hate having my face numbed for oral procedures, but it’s better than the alternative. Still, it was painful going in. I counted to six hundred while he pulled the tooth and then got bored. I breathed deeply, keeping calm. I didn’t look. I never look. I just… don’t look.
When it was all over, he gave me instructions on taking care of it. “Whatever is going on in there might cause it not to heal properly,” he said. “Just keep that in mind.”
What does that mean?
I had an appointment for two weeks out to get the results of the biopsy. I expected to be trundling back downtown on Thursday, November 2, to hear that it was an aggressive form of periodontitis. What if they find nothing and have to pull another tooth? Langerhan’s seems imminently treatable, especially if it’s one of those one-site things. Hey, I’m a Dr. House episode!
My dad stayed for a few days to take care of the babies while I healed and Kevin worked. Dad left on Monday, and we started to get back into a routine. My nights were getting easier, but bedtime for two babies and a preschooler was still an ordeal.
On Friday, October 27, the worst day of my life–although I won’t know it for hours yet–I’m in the basement writing and the phone rings. It’s the oral surgeon’s office.
“Hello,” says the receptionist, “we have the results of your biopsy. Dr. Kaplan would like to see you today if possible. We have an opening at 4:15 p.m.”
I hold it together. They don’t call you into get the results of a biopsy the same day if it’s an infection. “Let me call you back.”
Kevin is supposed to work tonight. Can I ask him not to go in? To come with me downtown? Do we really want to bring the kids, or can we find a babysitter? I’ve been unsuccessful in finding a babysitter for the appointment next week.
“The oral surgeon called,” I say and burst into tears. “If they want me to come in today, it can’t be good news.” Even as I’m crying, I feel guilty about asking him to call into work. They’re short-staffed as it is, and this puts another burden on them, one that’s last minute. But whatever the results are, I can’t face them alone, especially not with three children in tow.
“I’ll take care of it.” And he does.
We have a playdate setup with three other twin moms. I think about not going, but if I don’t go, I’ll sit around stressed out all day. I go. I watch the clock the whole time. I smile, I tell my stories, I listen. Why is it that every time a group of moms get together, we always end up talking about childbirth? I’m not complaining. It’s just funny.
Neither Kevin nor I enjoy driving on the 401 in downtown Toronto. Everything about going to Dr. Kaplan’s is stressful. We skip the DVP exchange, which always slows down to a crawl, but that means we’re going through town—complete with stoplights. It takes over an hour to get there.
When we get to the offices, the babies have napped, and we’d just fed them, so they’re in a fine mood. I’ve forgotten Morrigan’s LeapPad. I’m disappointed in myself. I’m always forgetting something. Earlier this week, it was a nipple for the babies’ bottles at their five-month appointment.
“Samantha, you can come with me,” says the nurse. She leaves me in a room and comes back one minute later. “Would you like us to watch your children so that your husband can be with you?”
As I follow her back out into the waiting room, I try not to think. I will my stomach not to clench. They’re being kind. They were always kind. Dr. Kaplan followed up to find out how the healing was going a couple times. He’s very gentle and soothing. They’re just nice people. I’m not going to think about it.
I take Phoenix out of her car seat and give her to one of the girls. Kevin and I go back toward the room. No other patients are in the office. Everything up and down the hallway is strangely still. It’s only us, with our kids, and five or six staff members. Is this usual for 4:15 on a Friday night? The drive home is going to be horrendous because of Toronto rush hour. How long will this take? We’ll be right in the middle of it.
Dr. Kaplan comes in. “I have the result from your biopsy.”
Just tell me.
“How much do you know about what’s gone on so far?”
When we had a scare with Phoenix’s health when she was three weeks ago, they just fucking told us. “Um, severe bone loss,” I stumble over an explanation, “cyst or something, maybe Langerhan’s, you guys did a biopsy.” My brain isn’t working. My tongue isn’t working.
“Yes,” he says some things that I don’t hear, and then, “I have the results.” He holds out the paper. He explains as he points to it.
Sections show fragments of collagenous fibrous tissue with interspersed irregular islands of round to oval epithelial cells. The cells have hyperchromatic, irregularly shaped nuclei with dense chromatin. Occasionally, the lesional cells appear to form duct-like structures. As well, some of the tumor cells are vacuolated and there are pools of mucoid material. In addition, there is abundant atypical bone matrix with calcification.
Immunostaining was negative for CK 20, CDX, PT TTF-1, ER, Pr, PAX8, P63, and positive for CK7, GATA3, HER2.
The histopathology is consistent with a metastatic adenocarcinoma and the immunostaining suggests a breast primary. Clinical correlation and further investigation is required.
“It’s cancer,” he says, or at least, I think he does. I can’t remember the words. “Metastatic” was in there. “Secondary site.” “They think it’s breast cancer.”
But it’s not in my breast. It’s in my jaw.
It can’t be.
I can’t have metastatic cancer. I am whole and healthy, and I have given birth to two babies five months ago. The Venn Diagram, where there’s a circle for Samantha and a circle for cancer, do not overlap. The Venn Diagram, where there’s a circle for Samantha and a circle for Stage 4 metastatic breast cancer, aren’t even on the same fucking page.
I start crying. I ask for water. They ask if I want juice and I don’t but I’m polite and I say yes. And they bring me this cup of blue stuff, and I laugh because it’s Koolaid or some shit, and if I didn’t want juice, I really don’t want this fucking shit. But it’s funny because they just told me I have Stage 4 cancer and they’re bringing me blue juice.
“Call my parents,” I croak out.
Kevin calls my parents. He tells them. He’s crying. He doesn’t cry very often, and it’s not a lot, but it’s enough for me to know that he loves me and he’s going to miss me when I’m gone.
Because I have Stage 4 cancer. I’m going to die.
One of the nurses comes in and stands in the middle of the room and looks at me with this forlorn look on her face. She’s not even saying anything. She’s not even comforting me. She’s not gawking. She’s telepathically absorbing the pain of my news, feeling all the things that are going through me, feeling them and channeling them outward using the super power she has that no one knows about, thrusting my emotions into the ether so that they scare away a passing bird. Buffering them. Removing them. Shielding me for a small window of time until she must leave and I must be alone with my new reality.
They give us chocolates. I don’t think they’ve ever had to do something like this before. I don’t like Lindt chocolate, so I politely eat one and reaffirm that I do not like Lindt chocolate. Morrigan appears out of nowhere and asks for one. I give her one, but I don’t let her have a second one because I am a good mother and good mothers, even when they’re told they’re going to die, do not allow their daughters to eat too much chocolate.
We leave. I almost leave the chocolate on the city planter next to our car. Kevin gets it and hands it to me.
I do not want this chocolate.
I do not want this news.
I want to leave their shitty chocolate and their shitty news on a Toronto city planter, where some other poor motherfucker will come along and pick it up and take it along home with him and then he can deal with it. Not me.
I can’t say the c-word. It is the word that must not be said. It is He-Who-Shall-Not-Be-Named. It is voldemort, with no capital, because it doesn’t fucking deserve a capital letter.
Calliope is crying because she’s hungry, and Kevin is trying to navigate through traffic. I’m texting a close writer friend of mine because I don’t know what else to do. I suppose I should tell people that I love that I’m going to die. That’s what you do, right? When you find out that you’re going to die.
The traffic is horrible. It’s rush hour in downtown Toronto. I look at Google maps and tell him there’s a fast food place and another fast food place and another one, but he can’t get through the traffic. But then suddenly we’re at Subway and we’re parked and we’re inside and I’m crying, sobbing, feeding a bottle to Calliope that I managed to mix up myself.
I wonder what everyone in the restaurant is thinking. I also don’t care. If they ask, I will fucking tell them, and they will say meaningless words and maybe apologize for intruding.
No one says anything.
I can’t eat. I drink some water. I cry. Calliope doesn’t want to be in her car seat. Phoenix needs a bottle. Morrigan needs to stop making a mess on the table. Now she’s done and getting down. Now she needs to stop running around. Did she just take some food off that homeless-looking guy’s sandwich? No, she picked it up off the floor.
I take her to the bathroom with me. She tells me she doesn’t want to go to the potty. Why would I make her use the potty? We’re not potty training.
I call my brother.
He tells me I’m not going to die, and I don’t believe him.
I call my dad.
He tells me I’m not going to die, and I don’t believe him.
I google t-shirts that say, FUCK CANCER. I like the ones that aren’t censored by the ribbon in place of the C and the K. I don’t buy one. I see one that says, Cancer picked the wrong diva. I start sobbing.
“What’s wrong, Mommom?” comes a tiny voice from the backseat.
“Mommom has an owie,” says Daddy. “The biggest owie.”