Sunday, January 25, 2009

What Trickles Through Us

Inspired by the short story, “The Things They Carried” by Tim O'Brien, Esquire 1987. The numbers come from memory.

Drip, drip, drip. Etoposide, a clear liquid, 365 milliliters infused over 60 minutes. Ifosfamide, another clear liquid, another 365 milliliters infused over 60 minutes. Each day 730 milliliters, over 5 days 3,650 milliliters, over 8 cycles 29,200 milliliters. 29.2 liters, 7.7 gallons.

Drip, drip, drip. Vincristine, a clear liquid pushed through a small syringe. Doxorubicin, brand name Adriamycin, an orange-red liquid, 30 milliliters pushed through a syringe over a 15-minute period. Cyclophosphamide, brand name Cytoxan, a clear liquid, 200 milliliters infused over an hour. 2 days, 6 cycles, 2,760+ milliliters, 2.76 liters, 0.7 gallon.

The drips come from the bag of anti-tumor drug known as chemotherapy hanging on the pole next to us, and then enter a tube fed through an IV pump and sent to our hearts. We count the drips and study their pace. Some stagger, clump together and form one large drip. Some are smaller and follow one after the other, impatient, striving to reach their final destination: those mutated cells that grow uncontrolled.

Zofran, Benadryl, Ativan, mesna, dexrazoxane, vancomycin, morphine, Valium. We can keep going.

Fludarabine, Cipro, propofol, Phenergan, pamidronate, cyclosporine, Abelcet, hydrocortisone, Decadron, fentanyl, Versed. We can't remember them all.

All drips of different densities, chemical structure and purpose. The drips become part of our blood, momentarily, and reach every vein, artery and capillary. The brand-named Cytoxan, which should have been named Cytoxican, is said not to pass the blood-brain barrier, but we have difficulty believing that—chemo brain and fogginess don't come from nowhere. We sweat the drips out, pee them out, poop them out, breathe them out, puke them out. Some drips exit slowly, some quickly, some with an odor, some odorless, most colorless, one exiting our urethras orange-red.

What trickles through us even more are the thoughts about those drugs that trickle through us. Drugs that make us sleepy, like Benadryl: 1 unit of mental energy. Drugs that make us elated, like Valium: 5 units of mental energy. Drugs that fuck us up now, like Cytoxan: 50 units of mental energy. We have no energy to think about how what trickles through us will fuck us up in the future. Maybe we don't have the capability to begin with.

So years later, we change our lifestyles to counteract what trickled through us. We cut the fat from our diet and bodies, and eat fresh fruit instead of processed snacks. We steam our vegetables because less nutrients are lost that way. We buy organic when it makes sense to, like celery and apples, because those retain the most pesticides. We try not to use the microwave and talk on a landline instead of a cell when plausible to limit radiation exposure. We drink water out of a BPA-free Nalgene, and lots of it, and wear sunscreen anytime we're outside past our minutes-to-burn. We exercise our hearts, muscles and minds, and are well-rested.

We do this to prevent ourselves from having to worry about what trickled through us, all those drugs and milliliters and Cytoxans. Some may say we're not living spontaneously, or that we're living in fear, or not really living at all. They say we’re obligated to ourselves to let loose. We say we're living smart, and healthy, and that we're obligated to ourselves, and others, so that what trickled through us stays in the past tense.