“Don’t let one cloud obliterate the whole sky.”–Anais Nin
We now had until the 5th of March before we had to be back in Minneapolis to meet with Dr. Carson. The news we had received from Dr. Thomas yesterday had been troubling, and I wasn’t sure, but it looked to me as if it was a watershed in her battle with this disease. However, true to her form, Joanie refused to dwell on it. Instead, she went back to work with new energy.
Her calendar was filled by lunch one day with Tara Holt and Patsy Thompson, two of her good friends, on another day with Vicki Melchoir, also a good friend. She had meetings with Mikey Hoeven, events to be coordinated, walks with Betsy Dalrymple to be taken when weather allowed and life to be lived. She was living each day as we had talked about that long ago day in 1998 when she was in the hospital recovering from the pelvic exenteration. She was doing her best to not let the disease dictate her life anymore than it did.
She filled her time as best she could, right up to the weekend before we would have to leave. Since her appointment was for early Monday morning of the 5th, we would leave on Sunday. On Saturday night, we didn’t do a thing. As always, she would get quiet prior to these trips. She wouldn’t talk about what was coming, but I always knew it was on her mind.
On this night, whatever she wanted she got. I asked her about what she wanted for dinner, and all she wanted was a good loaf of French bread, and some olive oil. I tried to talk her into something a little more substantive, but he just shook her head, and told me that was all she wanted. Bread, olive oil and wine had been an integral part of our lives since before we were married, and they were representative, I think, to her of all of the best times in our lives. So, that’s what Joanie got for dinner that night.
Sunday morning, she dawdled, as she always did, and I never minded. I knew she would be ready to go when we needed to be gone, after all, we couldn’t miss our stop at Mabel Murphy’s. And we didn’t.
Monday morning, we met with Dr. Carson. She had gone over the discs we had brought of the CT scans along with the notes. In one way, Joanie was glad to see Dr. Carson again. It wasn’t hard to understand, since she had been there with Joanie through some of the darkest days of her life. I know that doctors are not supposed to get attached to patients, but Joanie couldn’t help but form some kind of attachment to a doctor who had been such a part of her life for so long. That’s the way it was with Dr. Carson and Joanie. Joanie had complete confidence in her from the beginning, and today that confidence was as strong as ever, especially since we were embarking on another journey into the unknown.
After she had done an examination of Joanie, her suggestion for further treatment was that we go to see Dr. Kathyrn Dusenbery next, and look at the possibility of radiation. She told us there weren’t any Stage II or III clinical trials she would qualify for, and none that would have been appropriate. She told us Katie had already been briefed on the current situation, and would have a recommendation.
Joanie’s confidence in Katie was the same as it was for Dr. Carson. It had been from the first days after we met her in 1996 and Joanie had six weeks of radiation. Now we would find out what Katie would recommend as an option this time considering the circumstances were different.
Katie was recommending a radiation regimen consisting of what she called “conformal radiation therapy” to be delivered once a day, five days a week for three weeks. She had talked to us about the area to radiated, and that it would be very near the lung. She said they could deliver the radiation and spare the lung with a new machine they had. It was called a TOMO Hi-Art machine of which there were only 20 in the country at that time.
We were told this machine was basically a marriage of the ability of a CT scanner with a radiation delivery device which can more precisely identify location and measurements of a tumor and aim the radiation beam accordingly. This capability minimizes damage to healthy tissue, and is especially valuable when delivering radiation in the area around what is left of her right lung. Lungs do not take kindly to radiation. Also, the beam could be delivered from any angle in a 360 degree range, which was different from devices that could only attack tumors from limited angles.
Katie did call back to Bismarck, and talked to a doctor with the Bismarck Cancer Center, to inquire if the same type of radiation might be done there. He told her that for what Joanie was dealing with she was in the right place at the U of M. They didn’t have the same machine.
Katie didn’t waste any time. She wanted to get Joanie ready to do a simulation, which meant they wanted to get her on a table, take measurements, and do treatment planning CAT scan. The treatments would begin next week.
When Joanie and I left Katie’s office that day, we got in the car and headed back to Bismarck.
Even with this new chapter in her battle, uncertain as it was, Joanie sat, staring out the windshield as the miles clicked by, remained determined to not let the cloud obliterate her sky.
Without even looking at me, at one point she said, “This is going to work.”