Day 1: Diagnosis

November 21, 2011:  Monday

7:30 am

I make the first cup of coffee while Helena checks her email. We’re road-weary but happy—after almost 2 years without a true vacation, we spent the last five days in Parati, our favorite beach town. It rained the whole time, but it didn’t matter. We filled the weekend wandering the cobblestone streets, browsing galleries, eating, and listening to samba.

I am thinking of this when Helena lets out a cry in the next room.

“Amor,” she calls, “Vem cá.“

I will always remember this moment as the dividing line before before and after.

10:30 am

We drive down the mountains in torrential rain, headed for the doctor’s office in Rio. When Helena called his office with the biopsy results, the doctor immediately  cleared space in his schedule to meet with us.

As we navigate the switchback turns through the Serra dos Órgãos, I grip Helena’s leg. We drive in uncharacteristic silence, too numb to speak.

1:00 pm:  First Opinion

Helena hands Dr. Antonio the biopsy results across the desk, and after a 10-second glance he looks at his hands, draws in a short breath, and says,

“Well then. You’ll need to start chemotherapy and radiation immediately. The sooner the better.”

Helena and I glance at each other in alarm. My voice shaking, I ask the doctor in Portuguese, “Isn’t there a possibility that it could be something else?” I know it’s a stupid question, but I ask it anyway.

He looks at me only briefly, and in that split-second I know everything that I need to know. He shakes his head, no. “It’s a very large tumor,” he responds. “There’s no question about it.”

Hot, silent tears burn my cheeks. I brush them away when I see that Helena, too, is crying. She’s in shock, so I clear my throat and ask the doctor more questions about staging and prognosis. He begins writing prescriptions for an MRI, a PET scan, colonoscopy, more blood work.

I ask a few more questions, but the doctor is clearly uncomfortable. Why?

I consider asking him. Instead, I gather our bags. Without looking at us, Dr. Antonio slides a prescription for chemo/radio across the wooden desk. “Call me when you’ve finished the treatment.”

5:00:  Second Opinion

Dr. Roberto comes very highly recommended–a published author and researcher with a high record of treating benign and cancerous tumors. He’s not covered by our insurance, but we’ve decided to pay out-of-pocket for a half an hour of his time to see if we can get more information.

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The office is sleek and chic, situated in a high-rise building overlooking Ipanema Beach. It’s a brilliant spring day, and as we wait for the doctor, I think of the time when I was 16 and I swam from the Vermont side of Lake Champlain to New York. I absently wonder how long it would take to swim from Copacabana Beach to Leblon.

This time when the doctor reads the results it’s different. He looks up from the paper and his blue eyes are full of compassion.

“Do you understand the results?” he asks kindly.

Helena and I look at each other and nod. He talks with us for more than an hour, explaining the prognosis for Helena’s type of cancer, which is a very rare form of anal-rectal cancer. It’s through this conversation that we learn that because of the size and location, the tumor is inoperable.

My heart sinks and my mind goes to a dark place. I will myself to surface.

He recommends a chemo/radio treatment center, but explains that we’ll need to find a place to live in Rio for at least a month. Then he does something unexpected. He calls in a favor to another doctor–a friend of his who he’d recommend to provide the colonoscopy. When he hangs up the phone, he says, “They can take you this week. If you leave now, you can make it before their office closes at 7:00.”

Before we leave, Dr. Roberto hugs each of us goodbye. “Boa sorte.“ he says.

6:45 p.m.

The black and white tiled sidewalks of Ipanema are full of people heading home from work or out for drinks. We scurry through the streets, searching for the number of the office building. “There–number 705!” I call to Helena.

We sign in at the reception desk downstairs and I catch my reflection in the mirror. She looks back at me, hard. “Think you can handle this?”

I mentally flip her the bird. She knows I can.

Within 10 minutes, Helena’s appointment is scheduled: Thursday at 2:00 pm. We wearily walk back to the car to begin the long ride through Rio traffic and back up the mountain.

11:30 pm

When we finally fall into bed, there are no words. When she begins to cry, it’s as though she will never stop. We cry together and I rock her, promising that I will never leave.

It will be more than four weeks before I cry again.

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