Tick Tick Boom

On January 29th last year I woke from a colonoscopy to the news that they found cancer. On the 30th my GI doctor called to say it was metastatic. “Well that doesn’t sound good,” I said. “It’s not,” she responded. “I’m sorry to be the one to tell you.”

This year, on January 29th Billy and I woke up early and lit a fire in the small fireplace of our cabin at Costanoa. Billy went to the little restaurant on the property and brought me back a coffee and a fistful of wildflowers which he picked, put in a drinking glass, and placed on the mantle. We went for a hike that morning along the path that weaves through a grove of Eucalyptus trees and up the hills of coastal scrub and Monterey pines above the property.

There are a few places along the 3-mile path around the property where they’ve built little wood platform landings and set out benches so you can sit and enjoy the view. I have walked this path many times. Costanoa is an equal parts fancy and rustic camping type place. You can set up your own tent on the property, stay in canvas tent cabins that have beds, heated blankets, and electricity, the lodge itself has lovely rooms. But I prefer the actual cabins.

Located a few miles south of Pescadero, Costanoa is halfway between Half Moon Bay and Santa Cruz and sits just across the road from the Pacific ocean. It’s been my go-to escape for twenty years. Twenty years I’ve been coming to the benches above the ocean behind Costanoa to chill out, to grieve, to pray, to petition for a life that felt softer, easier, something more like a life I could wake up and love, a life I don’t need to escape to find myself.

On our walk we stopped at the bench at the top of the ridge. We sat quietly for a long time. My legs draped over Billy’s, my hat pulled down over my face which burns even more easily now. I was prepared to take stock, to process, to somehow mark the passing of this year. But I wasn’t in a particularly somber mood. That morning, exactly one year to the day of my diagnosis, Billy received the contract on the space he’s going to rent for his new shop. He’s always wanted to open his own sign shop. When I woke up that morning, I didn’t have to first check my email. I didn’t have to do anything, call anyone, respond. I sat on the porch swing and drank my coffee.

Billy and I went to dinner the other night. We put our name on the list and waited outside along with all the others. Eventually it was just us and one other couple left waiting. When the host finally poked his head out the door he said, “We can seat one couple now and the other will need to wait…or if you’d like to share a table, we can seat all four of you together.” Before I was even done rolling my eyes Billy enthusiastically agreed that we should all sit together. We all made an effort to make the best of a strange situation. After the other man and Billy had talked for a bit about work, the other man turned to me, “and what do you do?” I hesitated. What do I do? Is cancer something I do? Does taking 4-hour baths count? I just finished George Saunders’s new book Vigil, does that count? Does scrolling TikTok count? Walking with Annessa? Napping? I do a lot of doctor appointments, I give a lot of blood. I do lots of things. But like, I don’t have a job if that’s what you mean. Do I tell them I was let go from my job? Do I say I’m in between jobs? Am I? Will there be another job? I legitimately was stumped and not knowing what to say was making it weird. So, with all the grace I could muster I said, “It’s complicated.” Which made it even weirder. I quickly retreated saying, “well, I used to blah blah blah,” and hoped no one would ask why I don’t anymore or what was so complicated about that.

I wouldn’t say that cancer is a softer, easier way (like ever). I wouldn’t say getting cancer and losing my job and selling my little cottage and then Billy losing his job were answers to prayer. Like ever. But without those things, we wouldn’t be here now spending our days doing the things that make us our best selves. I watched the waves.

I turned to Billy, “Imagine, if last year at this time someone said - One year from now, Kirsten, you won’t be working. You’ll be spending your days writing and going for walks. Sometimes you’ll just take a bath and read. And Billy, you’ll have your own sign shop and you’ll both be happier together than you ever have been. But there’s a catch…”

I will never say I’m grateful for cancer. Cancer is not a moral issue. I don’t believe it is sent as a lesson or a test. Cancer is biology. One cell divides when it shouldn’t, then another, and another. Controls fail. Cancer is a reactor going unstable in the dark. Tick, tick, boom.

There is no purpose in the blast. Only impact. But that impact sets off another chain. One decision leads to another. One hard conversation forces the next. You keep going because, as we all learned from Jeff Goldblum in Jurassic Park, life finds a way. In this case, that way is in the dark, lit with only the dim light of the glow stick in your hand. When you get scared you keep your eyes in front of you, give the glow stick a good shake, and decide to take the next step.

“I’ll never say I’m grateful for cancer,” I said to Billy, But sitting on the bench that morning, watching the waves, I told him, “but if I had to do it again, I’d chose cancer.”

It’s easy to say things like that, sitting on a mountaintop. Harder from the bed in the ER with a morphine drip in your arm, which is where I found myself the very next night.

Early January I had a pretty cool procedure where they injected radioactive microbeads into the largest lesion in my liver. The spot had been tender over the weeks, but I’d had no other complications. As we drove home from Costanoa the following day, I felt a band of pain just below my ribs. As if the tender spot spread, then got really angry. As the day wore on it got worse. In bed that night I tossed and turned and struggled to get comfortable. We finally went to the ER. There they stopped short of a CT scan but ruled out the worst of things. They eventually sent me home with a prescription for Pepcid and Mylanta.

Neither Pepcid nor Mylanta helped. The pain got worse. Monday my surgeon sent me back to the ER for an urgent CT scan which showed the pain was the result of swelling and inflammation resulting from the earlier procedure. The cancerous tissue was aggressively dying. That’s great news. Not so great news is that they found a new fast growing tumor in my liver. I was admitted to the hospital where I stayed for 4 nights for immediate chemo and pain management. I spent the next week at home in bed, largely unable to move from the pain, alternately either sleeping or waiting for the pain meds to kick in so I could go back to sleep.

Two weeks later I’m up and around and feeling almost back to normal, but these last two weeks, back in bed, back on chemo, have been hard. Would I really still choose cancer? And, the news of James Van Der Beek’s and Katherine O’Hara’s deaths, both colorectal cancer related, make news of the new tumor all the more sobering. I can’t help not going all the way there sometimes. Like, what if this the beginning of the end? And from here out it’s gonna just be pain management and hospital beds and surgeries, only to die in the end?

But then, maybe it’s a good thing that this pain hit. A small miracle even? I got the CT scan a month earlier than was scheduled. They caught the tumor a month early. See? It’s all very positive. Life will find a way.

Sure, but James and Katherine both died due to colon cancer complications. So did Chadwick Boseman, so did Kirstie Ally, so did Audrey Hepburn.

Tick, tick, boom.

I pause. I remember to pray Wren’s prayer; “Please make everything go the way it’s supposed to.” I remember the great things about this year: watching Bracket graduate college, celebrating Cash’s graduation from High School, my friend Serin inviting me to Hawaii for a week in August where I recovered from my surgery on the beach and she made sure I had adequate protein intake. My birthday party with so many of you. It was a hard decision to sell my little cottage, but my neighbor Gemma happens to be a realtor and held my hand at every step. The weekend it went on the market, my best friend Steph took me to Disneyland and at 4pm on the first day, pretended she was too tired to continue and took the blame for us going back to the hotel early. We promptly took off our shoes and crawled into our beds and binged Below Deck. We promised each other that we’d head back to the park in a few hours. Instead we grabbed food at the hotel restaurant and went to bed early. And I remember again that it’s always ok. Even when it’s not.

There’s a newly approved procedure called Histotripsy which is a focused ultrasound treatment for liver tumors. It uses ultrasound to basically break the tumor apart using sound waves instead of cutting or burning it. It’s been shown to be 95.5% effective. At the moment there are two hospitals in the Bay Area that have the machine. There are very specific parameters that tumors must meet to qualify for Histotripsy. So far everyone agrees this new tumor is right for this procedure. I’m meeting with the team at CPMC this Friday.

I give the glow stick a good shake and once again find myself with just enough light for the next step.