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The C-Word

‘I have cancer,” Jonathan said.

Thyroid cancer. A nodule the size of an egg. Jonathan’s primary-care doc found it during a regular checkup. Neither of us could believe we’d never noticed it; now we could clearly see it pressing on his throat when he swallowed. He got hoarse easily, and felt pressure in his neck and shoulder, but he’d assumed he’d pulled a muscle.

The fact that my husband contracted a cancer that’s three times more common in women than in men clearly proves that he’s in touch with his feminine side. (As if you’d doubt that, after seeing the vintage photo of him in a bikini and festive headwrap that illustrated a previous column.) Thyroid cancer is one of the few cancers that seems to be increasing in incidence, with 11% more new cases expected in 2007 than in 2006, according to the Thyroid Cancer Survivors’ Association (www.thyca.org). Luckily, if you’re gonna get cancer, this is a good one to get. It’s usually treated successfully. My best friend Gayle got her husband, a librarian and professional researcher, to collect data for me. (I knew better than to loose myself on the terrifying Internet.) Gayle announced, “It’s the Cadillac of cancers!” I chanted that like a mantra for the next two months.

Immediately it became clear that Jonathan and I were not on the same page. I wanted to tell everyone. (Look at this column. I’m not a secretive person.) He wanted to keep his diagnosis quiet. I wanted to talk to him endlessly about it; he clammed up. I imagine that having cancer is like taking a spirit journey into the desert. You go alone. But it was hard to feel so disconnected from him while he struggled.

Everything happened fast, from diagnosis to surgeon to endocrinologist to radiologist. We told Josie and Maxine nothing until the day before Jonathan went into the hospital. “Daddy’s got a problem with his throat. He’s going to have an operation. He’ll be gone for a couple of days, and when he comes home he’ll have a big bandage on his throat and feel yucky and have a hard time talking so we all have to be nice to him.” I never used the word cancer with Josie, not because of some old-school ptui-ptui anxiety about saying the C-word to her, but because I was afraid she’d chirp, “My daddy has cancer!” to another adult, who’d recoil and blanch and stammer and convey that gee, she should be scared.

Jonathan began judiciously to out himself about his diagnosis. I started to get unsolicited advice. My husband would never be the same! He’d gain a ton of weight and lose a third of his brain cells! I was reminded of the phenomenon of people who love to tell 8-months-pregnant women horror stories about childbirth. Why do people enjoy terrifying other people in the guise of helping them? My friend Margaret made me feel better. “I’m definitely fatter and a third less smart then I was when I was 20,” she informed me. “Maybe someone snuck up on me and gave me thyroid surgery when I wasn’t looking!”

Jonathan’s surgery went well. The surgeon, recommended by my MD brother-in-law Neal, was elderly and hobbit-like, but highly regarded and kind. My mother-in-law made disgusted, horrified noises at the filth and clamor of Beth Israel hospital, comparing it with horror to the Mayo Clinic. When we were allowed to see Jonathan, he squeezed my hand and smiled and looked like himself. For reasons unclear, it took forever to get him ice chips or morphine (I ended up smuggling in a cup of crushed ice from the Dunkin’ Donuts across the street), and he remained terribly under-medicated for pain the entire time he was there.

As part of my usual quid pro quo with God, I donated blood. God seemed receptive, as Jonathan came home a day and a half later (on our wedding anniversary), with adequate painkillers. Josie leapt on him and he straight-armed her off, scaring both of them. A week later, the bandages came off to reveal a tidy yet impressive three-inch scar. I told Jonathan that the minute he saw someone’s eyes flicker down to his neck, he had to say, “Ann Coulter, bar fight.” The first time he tried it, the person’s eyes widened and she gasped, “Really??” Clearly people believe that Ann Coulter is capable of anything.

One frustrating aspect of treatment has been the triangulation among the surgeon, endocrinologist and radiologist. The surgeon and endocrinologist differed about drug regimens, for instance. It was hard to learn definitively how long Jonathan would have to be away from the kids after he was treated with radioactive iodine. Luckily, the kids seemed oblivious to our stresses.

The challenges of having a radioactive guy at home, as elucidated on the thyroid cancer Web site, were daunting: Minimize contact (less than 3 feet for no more than 1 hour each day) with everyone for the first five days, and with small children for eight days. Sleep in a separate room, use separate bath linen and launder these and underclothing separately for one week. Use separate eating utensils or disposable eating utensils. Rinse the sink and tub thoroughly after using them. Males should sit when urinating to avoid splashing for one week. Did Spider-Man do that after that radioactive spider bit him? It wasn’t in the comic book. (My friend Daryl helpfully sent me a couple of comic book pages in which we learn that Spider-Man killed his girlfriend Mary Jane with his radioactive semen. I did not need to read that, thank you.)

My father-in-law offered to let Jonathan stay at his house in Wisconsin. A fisherman, he pointed out that he could hang Jonathan off the side of the boat rather than using customary glow-in-the-dark bait. Ultimately Jonathan decided to stay at my mom’s empty apartment in Rhode Island instead. Being Jonathan, he completely rewired her apartment and grouted her patio. The girls and I, meanwhile, had a lovely, rejuvenating getaway with friends upstate. I didn’t realize until we were on the train home just how tightly wound I’d been. It was wonderful to be away in nature and not think about cancer for a little while. When we rejoined Jonathan at home, that was great too. We did a little gardening (fun until I found the maggot-covered giant rat in the flowerbed I was weeding — whee! Urban horticulture!), then we all had grilled hot dogs outside. (I washed my hands first.) It was a nice glimmer of our former lives. And a promise for the future, we hoped.

For Jonathan, the worst part of the whole experience was the low-iodine diet in preparation for the full-body scan that looks for any remaining cancer. No egg yolks! No dairy! No seafood! Pretty much no packaged food at all because it probably contains iodized salt! Luckily, I like to cook. Dinner felt like a perpetual Top Chef challenge: what can I make that will taste good and not contain any of the eight gazillion forbidden ingredients?

For me, the worst part of everything has been seeing my brilliant husband so compromised. He’s still not on the right dosage of thyroid replacement hormone (they have to inch him up slowly), so he’s sometimes very tired and very slow. It’s always worst at night, when most of the drug has worn off. One evening, his mom left her purse on our kitchen counter. I could not make him understand the problem. “Call her on her cell!” he suggested, lying on the couch with his eyes closed. “It’s in the purse!” I told him. “Wait,” he said slowly, “she left her purse here too?” I exploded, “That’s what I’m telling you!” “Did she leave the cell or the purse?” he asked. It was totally Flowers for Algernon. For a long time he refused to recognize that he was hypothyroid. He still doesn’t always recognize when he’s a bit out of it. Then again, fuzzy Jonathan is still sharper than most people, so we’re ahead of the game.

Jonathan had his first scan last week. It was clear — so clear that the radiologist canceled his second scan, saying there was no need to check again. The endocrinologist agreed. His next scan isn’t for another 6 to 12 months. His Synthroid dosage still needs futzing with, but we’re learning about patience. And gratitude.

Write to Marjorie at mamele@forward.com.

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