Hektoen International

A Journal of Medical Humanities

Last Chemo

Paul Perilli


Today’s the day. The last IV drip of oxaliplatin into my arm. The fifth of five sessions done at three week intervals. There’s still the pills called capecetibine to take for two more weeks, but those aren’t as bothersome or debilitating as the fearsome drip. The pills merely dry the skin on my hands and bottoms of my feet, otherwise I don’t feel much of anything. The IV though is another kind of poison, giving the feeling of taking me closer to death than away from it, as poison does; doing the job it’s meant to do. I do not at all like the wiped-out days after it. The nausea and upset stomach. The bed-ridden afternoons I’m incapable of sustaining anything that might be deemed productive, such as stringing words together on a flat screen. I hate the tingling sensation my fingers get at the slightest contact with anything south of room temperature.

“Tingly Tips,” my wife Geraldine calls me after each treatment.

There’s the fingertip business to deal with and there’s also the chippy, broken glass feeling that makes me gag whenever something cool comes into contact with my throat. Which means that tea and coffee and warm water are all I can take in for a week or so after each injection.

“This is your insurance policy,” Dr. C., my medical oncologist told me in her office before this final phase of treatment began.

I’d been through a previous stint of radiation and chemo that shrank the tumor in my colon 90%. There was the four hour minimally invasive robotic surgery that cut it out and re-sectioned the separation. Before all that, and in the spaces between, I’d been poked, scoped, scanned and tested, and so far the results are all good. There’s been no spread to my liver, lungs, stomach, or anywhere else. The examination of thirty-eight lymph nodes removed during my operation all came back clean. So I should be grateful. I’ve had a pretty d–n good life and there’s the promise, or rather the implication, of more of that ahead. I’ll take it. I’ll take anything. The enormous tug to want more and more of it is as inevitable in me as in any other living creature. To want to be instead of the opposite. And I want to be.

And yet, I know I’m a little closer to not being. Maybe a lot closer. I don’t know and I don’t want to. Percentages, projections, don’t tell me any of it. The day up ahead when I won’t be, when the spin of the wheel stops at my number, will remain unknown, and if I see it getting close, well, nothing I’ll be able to do about that. For sure I’d been close before this. More than a few times. But the closest, I suppose, came when I was eighteen and riding in the passenger’s seat of a Volkswagen Beetle that crossed a solid white line and crashed head on into a station wagon. My friend Luke, the driver, was killed instantly, as was one of the three unfortunate female students we had picked up hitching a few minutes before that. Another was maimed, in a wheelchair for life, I believe. The third female hitchhiker, the one sitting behind me, was cut up and bruised but okay, as I was. Twelve stitches in my face and a few broken ribs was all. Not much damage, considering…

“A miracle you weren’t injured more seriously,” I still remember the words of the doctor sewing me up. “You were lucky. You were very lucky.”

Too young to appreciate my good fortune, I’m not sure how much I replayed those moments in my head or how deeply I thought about them. I’m unaware of even any subtle, long-term affects it might have had. As far as I know I got over it. Or that’s the impression I have, though I understand I might have never gotten over it. I’ve been living in society as another functional, psychologically damaged person avoiding a therapist’s keen analysis and understanding.

Nevertheless, many lucky years later there’s this, colon cancer, a much less dramatic strike than a head-on collision on a dark central Massachusetts highway. Nevertheless, it’s an experience that has changed my life and outlook in a fundamental way. A strike leading me to who knows where? Not me. Not the doctors. Their continuous testing tells me they’re as unsure about what’s up ahead as I am. Though they have the knowledge and curative tools, and if not that, then the ability to delay the inevitable a while longer. One day I’m in a gym running seven miles on the treadmill, going to a job, writing every day, the next I’m in the medical system full on “stage 3” due to a situation that is likely to be with me the rest of my time. Like it or not, there’s no retracing my steps, no rewinding time in a kind of reverse reel that would take me back to age fifty to get my first colonoscopy and the chance, the very good chance, I could have avoided all this.


In the private, curtained space I sit in the beige recliner with a pillow behind me and another pillow in place to rest the arm the IV will be attached to. Geraldine sits across from me poking the iPad. My nurse, a lady in her thirties with a bright personality, blonde hair, and a marathoner, I know from my last time here, is fast with the checklist of questions that need to be asked before we can continue with the chemo business: Do I have any allergies? Any lasting sensations in my throat or fingertips? How’s my appetite? Any constipation?

All’s okay, I report, and she finishes setting up the metal pole, hooking the clear bags of fluid in their respective places and poking a few buttons on the infusion pump. All set up, the prep work done, the anti-nausea medication and steroids come on first. Then the oxaliplatin begins its slow, two hour drip that will make my arm hypersensitive to the touch in the days ahead. This last mixture isn’t the killer dose I’d been getting blasted with. It’s a bit diluted, as I had requested with the hope it won’t have the same incapacitating affects as previous ones had. I’d told Dr. C. about an incident after my last visit. Back home I’d started coughing, and then, unable to catch my breath, I began hyperventilating, long, deep sucks that failed to fill my lungs. Geraldine watched me as if wondering whether or not an ambulance might be needed? Fortunately, one wasn’t. I stretched out on the floor, relaxed my body and took a series of short, measured breaths until, in a few minutes, I was all right, back to breathing normally.

Later on, out on 53rd Street, Geraldine says, “How about we get a cab home. You need to save your energy.”

“I’m fine with the subway,” I say, recalling the twenty-five icy winter nights riding the trains back to Greenpoint after radiation treatments even though it was suggested I might be so compromised I’d need a taxi. “It’d be admitting I can’t take it anymore.”

“It’s a treat,” she says. “Nothing more than that.”

“I haven’t taken one yet and I’m not starting now. I’d rather writhe around on the sidewalk than do that.” It’s not meant to be a joke but I laugh anyway.

“That’s not funny,” Geraldine says as we start down the steps on the way to the E-train. “It’s not funny at all.”



PAUL PERILLI’S recent writing appears in bioStories and volume 3 of The Transnational.


Summer 2015  |  Sections  |  Personal Narratives

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