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 IOWA AND MICHIGAN News
I. Within minutes, the Iowa River and its tributary Clear Creek, both within two blocks of home, merged with the wall of water from the sky. The intricacies of our human-built storm sewers failed, and our suburban village of Coralville became an instant lake. Susan and I made it back to our third-floor apartment in time, but our jaws dropped and our fears rose as the river at the bottom of the hill joined the geysers erupting from curbside sewer grates. A sudden flash flood, but we all should have known. The swollen riverbanks from many days of summer rains, the volatile recipe of hot, moist Gulf air colliding with cool Rocky Mountain breezes over the Iowa cornfields: the news of the fury of summer waters was there for us all to foresee. The newsflash lasted only moments, but the tragic fallout lingered for weeks, entirely changing the celebratory summer months. We watched our unfortunate basement-level neighbors dislodge waterlogged possessions from the rank pools of muck in their living rooms. We waded through the lake that was the parking lot of our favorite Chinese restaurant, now closed as its proprietors' livelihood was swept away downstream. We observed the ruined nests and beaver lodges along the Iowa River nature trail as the waters slowly receded.
I vividly remember the flash of my bedroom's overhead light at 2:00 a.m. and the wide-eyed, panicked, horrified look on my younger brother's face as he choked, "Grandpa's dead!" I had heard the telephone ringing, but it is the light flash that remains burned in my memory, the sudden change from dark peaceful slumber to blazing illuminated horror. "Grandpa's dead!" Although I was already in my freshman year of high school, this was our family's first major encounter with death, the first time that someone preciously dear, someone who had been an intricate, intimate part of our daily lives, disappeared. Suddenly, it was all lost: the meticulous distribution of a handful of M&M's from the white candy dish, the paper route taxi service with Grandpa and the Rambler religiously waiting at the bottom of Hutchins Avenue for me to finish my appointed rounds, the lusty laughs at All-Star Wrestling on TV after church on Sunday, all irretrievably vanished in one bright flash of the bedroom ceiling light. I do remember the quiet sobs of my mother in the darkness of my parents' bedroom, the eerie stillness of the house as Mom and Dad went to Nina's house (we called our grandmother "Nina"), the stony silence of my older brother who watched me and my younger brother while we waited, and the doleful, agonized wails of Nina on the cusp of a life of unconscionable loss as Mom and Dad returned with her. All the while I remained still, stunned, and frozen under my blankets. All of these images are scars in my memory, but it is the flash, the pronouncement of the news, that remains most stubbornly scored into my being. The flash should not have been a surprise, though. Grandpa had been sick for a long time. The numerous hospital stays, the sagging cheeks, the rattling lungs, the withering frame, the colostomy bag: these are not harbingers of good news, even to a young adolescent. Almost 30 years later, I still have the image of Grandpa sitting on the couch in his pajamas, putting his head in his hands, and, after expelling a defeated breath, muttering, "It's no good." He knew. Even though my mother and father had not told him‹nor my grandmother‹nor us kids. Life was different in the early 1970s‹withholding medical information, even from the patient, was sometimes seen as an act of mercy rather than a violation of rights and ethics. But certainly Grandpa knew for a long time. He must have known even the year before when his doctor urged him and my grandmother to go ahead with their planned trip to Denmark because he was "fine," not because it was his last chance in life to visit his relatives and his native homeland. Deep down, I probably knew all along, too, though I tried to deny it. Cancer can seduce you into denial, because it is not a flash‹a flash flood or a news flash. It is a slowly building, slowly emerging natural disaster. I should have known.
II. For two or three summers in the late 1980s, our daily ritual of flipping on Denny Frary, our favorite weatherman from Cedar Rapids, Iowa, added one more brick of news into the firmament. We didn't really need Denny to proclaim the double h's of Midwestern summer: Hot and humid, we know. Another day of sweat and languor, when even reading for my doctoral exams soaked my shirt with sweat, my body trying to adjust to the tropical, almost alien atmosphere. Each day drew the curtain back a little further on the official proclamation‹"heat wave." But we still flipped on Denny Frary to confirm the emerging news‹through the jolly cheeks and thinning blonde hair made crisp as straw by the burning Iowa sun, Denny would recite the numbers, legitimize with Fahrenheit figures what our saturated pores already knew‹high of 99 degrees, current temp at 5:12 p.m. Central Daylight Time of 97 degrees, low this morning of 85. Next a map with the humps and swales of the jet stream, usually curving beneficently through the upper Midwest, often bringing promise of cool, dry breezes, the hope of respite for our armpits working overtime to produce human coolant. But the jet stream on Denny's map was flatlined over Canada, forcing Southwestern fire and Gulf water to mix and set, stagnant, over the Iowa prairie. So, OK, we figure out we're in a heat wave. It's not really news anymore. But the seriousness begins to sink in. This is no simple scorecard. Sportscaster John Campbell tallies the numbers for the Hawkeye victories. Denny Frary's numbers translate, gradually, but assuredly, inexorably, inevitably, into new headlines‹of withering crops, dwindling water supplies, peak electricity days, desperate farmers staring blankly at acres of powdery dirt and limp aborted corn and soybean crops, old men and young children collapsing from heat prostration. Heat wave‹anticipated by no harbinger, announced by no atmospheric violence, realized when it's too late, devastating in its cruel imposition of stubborn and debilitating and relentless dissipation of life energy.
My father phoned me during one of the final heat waves of the three-year drought. It was the Fourth of July, 1990, and Susan and I had spent most of the sweltering day playing sloth. The unforgiving heat caused waves of air to ripple off of our apartment parking lot, creating the illusion that even the concrete was melting into the atmosphere. The height of our ambition for the day was to make a pizza delivery order. We languished prostrate on the floor waiting for it, letting some college kid suffer the furnace outside. I knew it was the end the second I heard the shakiness in my dad's voice, the defeated and sad announcement that "your mother is really bad." God damn it. This had been going on for two to four years, depending on which symptoms we wanted to mark as the beginning. Four years prior, my mother's collarbone snapped as she opened a window. From there, her right hand became more and more immobile, her slight frame gradually bent and twisted. All sorts of pokings and proddings led to many answers, none conclusive, none convincing. Osteoporosis. Nerve damage caused by scarring from the mastectomy twelve years previous. The x-rays and scans revealed masses in what remained of her chest muscles on her right side. Scar tissue‹but let's remove it. Her hand and arm never got better, though. Her handwriting got progressively worse, her fingers more and more debilitated, her hand becoming limp and twisted. Two years of tests, scans, X-rays‹radiographic attempts to peer inside her body, to isolate the mysterious force or substance rendering her most vital limb worthless. Eventually, two years later, the doctors' X-ray vision circled around to her back. "Hot spots." In her bones. The period from 1986 to 1990 was a gradually unfolding nightmare of scans, tests, and hospitalizations, none of which offered respite or assurance of an end, good or bad. But the heat wave was about to break. After my dad's phone call, our pizza only half-eaten, we threw together some clothes and toiletries. "I'd better pack my suit for a funeral." God damn it. We gassed up the Escort for the three-hour drive from Iowa City to Rockford, Illinois. As the flat miles of interstate, baking in the Independence Day heat, unribboned beneath our wheels, my thoughts unfolded backward‹to sixteen years prior. It was summer again. I was at band camp, the summer after my grandfather had died. Several dozen high school band geeks had taken over a church camp in bucolic Green Lake, Wisconsin. We were devoting a week or two of our summer to daily marching drills and music rehearsals, with visions of taking the Virginia Beach Music Festival by storm the following year. The pleasant Wisconsin summer zephyrs, matched with the camaraderie of making music and marching in lockstep with friends, went a long way toward clearing the occluded front of sadness that had settled over me since my grandfather's death that past February. "What's wrong?" I said into the telephone receiver one night, even though my mom was simply exchanging pleasantries. "Nothing," she said. "Sure," I thought. She didn't want to worry me‹just as she didn't want to worry us kids, or Nina, or Grandpa himself these last couple of years. So I get home from band camp, and sure enough: "I found a lump. I'm going into surgery to have my breast removed. It's cancer." In 1974, they were pretty aggressive about these things, which is good, for the radical mastectomy seemed to be successful at staving off the deadly creep of cells gone awry on a metastatic killing spree. But once your body has betrayed you by having your own defense systems turn traitor on you, you never feel 100% "clean." Five years go by, and the doctors tell her things look pretty good. But Mom had been lucky only in the sense that, somehow, the break in the weather had gone fourteen years until the doctors finally had to admit that there were "hot spots" in the bones in her back‹exactly where breast cancer often makes its next stop. We arrived in Rockford at about 9:00 p.m that Independence Day night, the fetid humidity enveloping us as we stepped out of the air-conditioned car, the crickets chirping in disharmony with the cacophony of other insects that buzz and hiss more intensely on hot, humid Midwestern summer nights. We dropped our luggage off in the silent house I grew up in, and then it really hit me that Mom wasn't coming home. We made the pilgrimage to Swedish-American Hospital, a journey I had made all too often a decade and a half previous in the years my grandfather was ill and my mother had had her surgery. I knew this was another terminal journey. As we rolled down Charles Street and the hospital came into view, we could see the explosions of green and pink and red and white and blue fireworks from downtown Rockford bursting over the trees in the distance. It was almost funny at the time, but I will never see and hear a fireworks display in the same way again. In the dark hospital room, the contradictory odors of hypersterility and acrid mortality clashed like hot and cold fronts over the prairie. My mother lay on her back, almost motionless, her mouth gaping open, her filmy eyes staring blankly toward the ceiling, her head wrapped in a tight turban. I didn't know whether to be sad or angry as my father bumbled about the room, announcing that her blood pressure had gone up a couple notches‹"the right direction!" Dad, 80 over 40 is not good, and why have you been whitewashing this on the phone for the last month? "I didn't want to worry you," he claimed, repeating the misdirected cant practiced so well in 1974 during the sonata of Grandpa's death. The cancer had spread to her spinal fluid, and my mother was becoming a vegetable before our eyes. I really hadn't known that she was deteriorating so quickly. The last time we had seen Mom was, appropriately, Mother's Day, and although she was clearly ill‹her frame hunched over from severe back pain, her gait halting‹she was sharp and in good humor. As her hair gradually dwindled from the chemo treatments, she had jovially dug out an old wig bought on impulse 20 years ago at a downtown Rockford wig shop we had passed on the way to one of my orthodontist appointments. But since Mother's Day, she had returned to the hospital a couple of times. I remember one eerie phone call in particular, when, between long, awkward pauses, she would repeat the same question in a slurry, breathy voice about the used car we had just bought. At one point, I had asked my dad whether or not we should visit for Memorial Day, and he told us to stay in Iowa: "She's so tired. It's the drugs. She needs her rest." In retrospect, I can see how bogus, how misdirected, and how wrong that prescription was. I knew in my bones that the heat wave was intensifying toward an F5 tornado of family destruction, yet I let the false forecast of the paternal meteorologist dupe me into ignoring the sweat on my brow. Even my father was whacked into reality the next morning when the doctor examined Mom. He stood next to her bed, his hands in the pockets of his white coat, staring at her and speaking softly. "It's going to her brain. Maybe 48 hours. We're in a zone now where, really, we don't know anything." The moment was sad, even shocking‹the official pronouncement of what most of us already knew‹yet it was also eerily transcendent. The vigil, in the end, lasted about five days, and in that time the heat wave broke. It actually got downright cold. In our flight to Rockford, we had taken only shorts and T-shirts, and the crisp, almost autumnal air bit into our bare legs as we trotted through the dark late-night hospital parking lot. We had been visiting Nina, reporting as sensitively yet as honestly as we could that cancer, after killing her husband, was now setting its deadly sight on her only child. Even though it was late, we wanted to go back to the hospital and check on Mom one more time. Death watches do not obey hospital visiting hours. The heat wave had not ended with a slam-dunk thunderstorm as the cooler air mass intruded its way into the soppy Illinois atmosphere. The heat, the humidity, the oppressiveness had simply stopped, ushering in some breathing room. My mother died on a comfortably cool, sunny July Friday morning at 11:00 a.m. It was one of the quieter moments of the whole ordeal, really. We were acclimated to the idea that we were conducting a death vigil. We were all as much as we could be, comfortable waiting for the end, for respite for all of us. Even my nephews, my mother's three grandchildren, had stopped having nightmares about zombies rising out of hospital beds. I felt fortunate that through the fog that was my mother's mind, through the drugs and physical devastation, over the last few days she knew I was there, had managed a very weak but powerfully palpable squeeze of my hand, and had taken advantage of her few precious moments of lucidity to mutter as well as she could, in a voice barely audible and through facial muscles hardly able to function, some important things she wanted to say to me: "I love you," and "Have a baby." On this quiet, sunny morning, my older brother Paul and I were quietly chatting about old times, when I stopped in midsentence and looked over at Mom. It was actually an absence that had caught my attention. The quiet, shallow suspirations that acted as an obbligato to our increasingly subdued conversations around Mom's deathbed were noticeably absent. I stood up and walked over to the side of the bed and bent my head down more closely. I saw one more brief intake of breath, and I saw a flutter of the carotid artery in her neck. And then all was still‹a stillness in her body that had never been seen before. The heat wave was over.
III. As I sit in my office in Bessey Hall on the Michigan State University campus in the spring, I know from the rough grumbling of the sky that it's time to check my late afternoon mail. Time to start packing away my scholarly thoughts and my sheafs of papers to grade as the room gradually darkens and the contrasting round glow of my desk lamp intensifies. I know that I'd either better head for the bus before the sky becomes water or get another cup of coffee and settle in to watch the view from my window be slowly obscured by pelting rain. The Michigan summer thunderstorm‹predictable, gradual, and gloomy‹can be an event to be ridden out through its violence, but more often it is a gradual unfolding to be embraced for the time of enclosed reflection that it offers in the afternoon.
I woke up from surgery in St. Lawrence Hospital, Lansing, Michigan, in the late summer of 1996, my vision blurred, hearing only the subtle patter of nurses in the hall. I knew I no longer had the left testicle that I went to sleep with, though it was intellectual rather than physical knowledge. Nothing really hurt "down there," but I definitely knew that I had had a knife sliced into my left side just above my hip. "He's awake," I heard the nurse say as Susan and the kids treaded softly to my bedside. Through the fog of anesthesia, my first question to Susan was the one I already knew the answer to: "Was it cancer?" "Yes." A couple of moments of silence. Susan continued. "But it was the seminoma, it hadn't spread, and they got it all." At least that was the news I wanted to hear. The definitive news of the cancer came with rumbling predictability. It had been gradually gathering with episodes of grumbling thunder for a month or so. Shortly before the Fourth of July of 1996, six years after that horrid Independence Day trip to Rockford, the hardness in my testicle sent some sharp warnings to my brain. I first learned of this deadly transformation in my body while in the bathtub, transforming my legs into the walls of underwater tunnels for my three-year-old son's plastic shark. I placed my hand over my groin to protect myself from the eight-inch Great White shooting its jaws and fin under my legs. It's different there on the left‹it's hard. Maybe those sharp pains of the past months when Nathaniel would kick me in the groin while roughhousing were not the expected price of fatherhood. Rumble. I have an appointment for an annual checkup with a new doctor in a month or so, but I know it can't wait. The earliest appointment is with the staff physician's assistant. Fine. Soon. Now. Dale, the P.A., gives me some antibiotics‹could be an infection. Sure, that's it. I had been poring over my home medical book, optimistically self-diagnosing an infection of the epididymus. "But we worry about testicular cancer, so we'll order an ultrasound." Rumble. I'm lying on the table in the cold, darkened, antiseptic room, my legs spread apart, my groin gooey with sticky fluid, the technician moving across my testicle the microphone that will bounce rumbling sounds off any tumors and translate them into fuzzy black and white, telling images on her little screen. "I'm going to have the doctor take a look at the films, and he may want to come in and take a look for himself. He likes to do that sometimes." Yeah, especially when there are cancer songs playing on your little instrument there. I wait, shivering under the cold white sheet, waiting for the rain to come. The doctor and the technician stare and point at their little screen, turned away from me. At least they stare and point at that instead of my crotch. "Hmmmm." "There." "Yeah." The rumbling is getting louder. "OK," says the radiologist. "I'll send the report to your doctor, and he'll explain what to do next. I'd rather let him explain it." Sure‹as if that doesn't tell me what you won't in so many words. With my family history, the news is predictable. Delusion is a powerfully seductive tonic, and one side of me drank deeply. After several days of skittish staring at a silent phone, I convince myself, just enough, that no news is good news. Everything's fine, and the doctor will tell me so at my checkup appointment in a couple of weeks. Sure. And there is no quiet thunder rumbling in the distance. I'm in my office, and the phone rings. "Hi, Tom, it's Dale." The physician's assistant who ordered the ultrasound. "How are you feeling?" A warm flush rises in my cheeks. "I'm feeling fine. Shouldn't I be?" "Well, I got the ultrasound report, and we want to set you up with a urologist appointment this afternoon." "This afternoon? Is it cancer?" "Well, we don't know that. But the ultrasound report is cause for concern." He reads off the cold clinical language to me: "'There is a well circumscribed solid mass within the left testicle measuring 2.8 x 2.6 x 2.0 cm. This demonstrates a slightly unhomogeneous internal echo texture which is in general slightly less echogenic than the remaining testicle. The appearance is consistent with a neoplasm.'" Ah, so that's how "Hmmmm" is translated. I wait in the examination room of MSU Urology, looking out the second floor window, across the Hannah Plaza parking lot toward the Michigan State campus. The grey clouds of a Michigan afternoon are gathering in the sky. At this moment, eloquence escapes me. The only word going through my mind is, "Shit!" The doctor walks in. Thankfully, he does not ask me how I'm feeling. "Do you want it straight?" Yes, please. I want the clouds to open so it will rain and be ended. "You have a mass in your left testicle that needs to come out." He goes on with further rumblings about size, location, sudden growth patterns, and the need for surgery tomorrow. "Is it cancer?" "We don't know that for sure, but if it is, we need to get it out of there as soon as possible, because these things have a tendency to take off." "But you think it's cancer." "Yes." It's raining.
The nurse says I can get up and sit in the chair. I'm still fogged, and fortunately numbed, but I have difficulty moving my recently sliced body. As I manage to plop in the chair, the nurse is putting my socks on my feet. I'm going home. Modern medicine. Isn't it wonderful? You can have cancer surgery and leave two hours later. (Or perhaps that should be "modern health insurance.") It takes me several minutes to get out of the wheelchair and into the van for the ride home. That night, anesthesia still making my brain swim in the murky post-surgical waters, I pass out while trying to urinate before I go to bed. I knock the toilet paper holder off the wall, waking our sleeping baby. Susan rushes into the bathroom. I'm lying on my back, revived, staring at the ceiling. I say, "I'm fine. Go take care of Sylvia." Five minutes later, I manage to turn my body over and crawl into bed. "Simple outpatient surgery." I won't be able to bend my body comfortably for at least a couple of weeks. But it's gone, and in many ways that's refreshing. I feel violated, I feel damaged, I feel incomplete, but I do feel cleaner, and perhaps reinvigorated with life. Sometimes after a thunderstorm, there is some damage to pick up‹sticks, branches, maybe even loose shingles that blew off your roof or a cardboard box that blew into your yard. Sometimes you discover a surprise from the fallout‹some water in the basement, some baby rabbits washed from their nest. In the weeks after my surgery, news of alterations in my life continues to rumble in. One week after my surgery, I have a CT scan. I still get dizzy when I walk, my incision still bites me, and my stomach continues to do somersaults. Yet only seven days post-op, I drink half a gallon of acrid contrast fluid, unsuccessfully masked by orange flavoring; I receive an enema; and I have iodine pumped into my veins, which flows through my heart, delivering a metallic taste to my mouth and a hot flush to my cheeks. I feel like my body has been turned inside out and hot, dirty laundry water poured into it‹yet I make it through the eerie white tube scanning for deadly microbes. I submit myself to similar torture once or twice a year for the next five years. The CT scan shows no metastatic disease. The pathology report reveals my tumor was anaplastic. Although seminoma, the weakest yet most common form of testis cancer, the growth was virulently aggressive. "You had a nasty tumor. Two more weeks and it would have spread," says the urologist who performed the surgery. As it is, it had doubled in size during the two weeks between my ultrasound and my surgery. A month-long course of radiation is recommended. "We just would like to be sure," says the urologist. "We can't see every microscopic bit on a scan." The radiologist maps my stomach with blue and red crosses, reminding me of how our children love to draw on themselves with their magic markers. Every weekday for a month, I take the bus to Sparrow Hospital in Lansing, chat with the pituitary tumor guy in the waiting room, then lie on the table with the huge dome over me, pull down my pants, have my penis and remaining testicle encased in a lead cup, and submit myself to waves and rays of radioactivity. The aftermath of my prophylactic radiotherapy is worse than my surgery. My stomach hair grows back strangely, painful intestinal distress plagues me (so severely on one occasion that I take an ambulance ride to the emergency room). The radiologist tells me I may have perpetually sensitive skin in the target area. Since they're unavoidably zapping my kidney, I may suffer from hypertension as I age. The thunder and rain from this Michigan thunderstorm will never quite roll completely out to Lake Huron. During my first appointment with the urologist, he had tried to comfort me. "Once this is all over, it really amounts to a big scare." My cancer is 98-99% curable and is one of the great success stories in oncology. But I am now and forever will be a cancer patient. I know it is possible that this violation of my body and threat to my life can happen, because it has. My numbers are different from what they were before. I'm pretty safe in the fact that I have only a 1 out of 100 chance of reoccurrence. But before, I had a 1 out of 15,000 chance of ever getting testicular cancer in the first place. I was the one. Still, I'll take my new, post-surgery and post-radiation odds. One percent chance of a thunderstorm is better than 30%. Still, I think back to the drought of 1990, the cancer death of my mother, the unusually warm winter we had just experienced in Michigan, my unexplained tumor, and I wonder how much those odds have been manipulated by human intervention. Today, though, for the most part, my body functions normally. I will never have children again, more from the risk of birth defects from the radiation, but I may in fact be sterile. It really doesn't matter. Susan and I have brought our two lovely progeny, Nathaniel and Sylvia, into the world already, and we know that our love and family will last, manifested as we had hoped before all this happened. I do think about how the joys of my life, those wonderful children, sprang from the body that had ultimately betrayed me, and how in fact our daughter may have been conceived at the same time my reproductive organs were trying to send me on a trip to oblivion. But their entrance into the recovery room, Sylvia close to Susan's body in the sling, Nathaniel holding her hand, was the fresh air and sunshine that helped break the storm clouds. Since my cancer summer, we have experienced many storms. In Minnesota, the wind of an early morning Fourth of July boomer sheared off the main branch of a stalwart elm along our house, tossing it onto our backyard fence, smashing it to splinters. Our second winter back in Iowa cocoons us in the heaviest snowfalls in decades, the icy mountains of snow causing the torrential rains of a freak February cloudburst to slide off and invade our walkout basement with sopping ruination. A tornado skirts the edge of Iowa City, taunting our community with twisting devastation. During that same awful summer of 1996, Susan's mother suffers a heart attack, and my father has a benign brain tumor removed. Thankfully, both recover well, as do I. I also continue to scan the reports of hottest decades on record, glaciers breaking free of the Antarctic shelf, cancer clusters, and the race between better oncology treatments and increasing incidence. So the atmospheric news continues to announce itself, with drama and with subtlety. The bodily news of our loved ones continues to laugh darkly at us at times. Today, anyway, I am happy to report, that the Doppler radar scanning the landscape of malignancy continues to show no metastatic fronts. That is the best news of all, and I hope the forecast remains clear until a timely sunset. 
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