Yet again, I’m in a strange headspace, so bear with me… And if you are claustro or in any way triggered by the description of being enclosed in an MRI, well, you’ll want to skip this post.
My husband and I have been watching Breaking Bad, the Vince Gilligan show about a high school chemistry teacher whose battle with cancer leads him to make some incredibly sketchy life decisions…primary among them, cooking meth to pay the bills. We’d never seen the show before, but it seemed to have earned itself a place in the common American lexicon; we’ve both seen a ridiculous number of pop culture references to it, and yet neither of us had encountered enough spoilers to put us off the idea, so we started just a few nights ago.
It’s a great show, but it hasn’t exactly been always fun to watch.
The writing is at times very close to home. The visuals and sounds of cancer diagnosis and treatment aren’t all that far in my own rear view mirror. Granted, I didn’t have lung cancer, and my chemotherapy was merely a pill, and even then only at half dose, so it’s not as if I was spending quality time face first in the toilet like Walter. I did end up taking far more extra showers and doing far more emergency loads of laundry than I expected (because even the mildest cancer will find ways to humiliate you), and unlike Walter I ended up in the surgical suite twice, but I digress.
One of the ways that the show has hit even closer to home is in the scenes between Walter and his wife, Skyler. For an outside viewer, it’s equal parts hilarious and horrible, knowing what each has been keeping from the other. Skyler has been hiding the fact that she’s smoking while pregnant; Walter has been hiding the fact that he spent a morning shoveling the dissolved remains of a human being off the floor of his meth partner’s house and flushing them down the toilet. Skyler’s hiding what she has been acculturated to believe is the greatest failing of a mother: putting her selfishness and self-destruction ahead of her unborn child’s health and safety. Walter’s hiding what he’s been acculturated to believe is the greatest failing of a man: indulging his pride and his self-destruction at the expense of his living family’s needs. They’re paralleling each other without ever knowing that they have more in common than they think.
For my husband and me, watching them sit on the same couch without sharing it is painful. We wince, not just because we know everything the outside viewer knows–the extravagant self-destruction that’s causing murder and mayhem all around them–but we also know the real-world version of the pain that the characters are each going through. I know what it’s like to be naked on that gurney, twisted into unnatural positions both physically and mentally, forced to give myself willingly to pain and degradation. My husband knows what it’s like to be the helpless spouse, unable to do anything but gnaw at his own wounds, waiting for the next round of news that could be just as bad, or maybe even worse, than the previous unthinkable round.
We also know the biggest pain of all: that we can’t really ever know what the other one is going through. I can’t know what it’s like to have my helpmeet–the one person who was getting me through my hellish job, the one person I could trust to support me if I made the scary choice of changing that job–suddenly slam that door to freedom shut. He can’t know what it’s like to be a tough, fiercely independent woman who has suddenly been reduced to asking for help…and not just once, but constantly.
Like Walter and Skyler, we have been known to sit on the same couch without sharing it at all.
In Siddhartha Mukherjee’s book, The Emperor of All Maladies, he quoted one of his patients as saying, “Cancer makes some families and breaks others. Mine it did both.” The reasons for that are manifold. Think of the wildly disparate positions spouses can take on even the most basic issues, like parenting styles or finances. Then add in attitudes toward showing emotions, physical roles, social roles, etc., and put it all in the pressure cooker that is life-or-death decision-making…and make the cause of that misery the one person who (literally) swore in front of God and everyone to always have your back.
Yeah, that’s a bad, bad recipe for maintaining emotional availability with your spouse.
One important aspect of that problem is coping styles. If the cancer patient spouse copes by studying and encompassing all aspects of the diagnosis in order to come up with a plan of attack (and an illusion of control), but the caregiver spouse copes by wanting to know as little about it as possible (so as to preserve an illusion of normalcy)…oh boy. That’s how you can both sit on a couch and not share it.
Another make-or-break aspect of the diagnosis is each person’s internalized definition of happiness, or even the definition of living. I give mad, mad props to the writers of Breaking Bad for the talking-pillow scene, in which Skyler gets the shock of her life to discover that she might be the only one of the entire family who thinks Walter should treat his cancer. He thinks letting himself die quietly and with dignity is the best route to preserving his family’s future. To Skyler, that same decision looks like giving up on the family’s future. She’s incapable of seeing how the family might be better off if Walter doesn’t fight; Walter is incapable of seeing that the family can’t be better off if he doesn’t at least try to live.
I can’t count the number of fights my husband and I have had over two completely opposite ways of viewing the exact same solution to a problem. I could understand how we’d argue over having opposing solutions, like Walter and Skyler; but somehow, IRLWC (in real life with cancer), my husband and I have managed to have some terrible moments while agreeing with each other.
If that’s not a sign you’re in deeply difficult emotional territory, I don’t know what is. The fights you have with your family when you have cancer have very little to do with cancer, and everything to do with the issues you brought with you into the diagnosis. Those fights are about the separateness you’ll always feel, no matter how good times are. When times are bad…that separateness becomes aloneness, and then it becomes feeling abandoned and bereft while still being expected to share a life. That’s where the resentment begins.
Now here comes the part where I twist the works.
Courtesy Buddhism and cancer both, I’ve learned something kind of shocking and counterintuitive about pain: the harder I pull away from it, the worse it gets.
Yeah, that’s a mindbender to think about. It’s even weirder to live it.
You’d think that pulling away from pain would make it lessen. Well, it might if we’re talking about something as simple and primal as getting away from a fire. But when the pain is non-optional–when you have no choice but to live with it, to seek it out and force yourself to endure it, as you do with cancer treatment–it’s worse if you aren’t there with it fully.
It makes no sense, but it’s true.
Take, for example, what it feels like to be claustrophobic and contrast allergic and suffering a raging medication headache before you’re shoved into a small bore MRI for two hours.
After 30+ contrast procedures in less than three years, I am terrified of small spaces. I feel as if I’m being buried alive when I’m in a small bore MRI, as if at any moment the machine might collapse on me. Rationally, I know it’s safe in there. I’m inside a giant honking electromagnet weighing hundreds of pounds, for God’s sake. That thing is tuned to spin at a bazillion miles an hour and not wobble so much as a hair. That’s a feat of engineering that should reassure me. Hell, I might actually be safe in there even if the entire building collapsed on top of it; it’s that beefy.
But my claustrophobia isn’t actually about small spaces. Like Walter and Skyler, the fight isn’t about what’s going on right that moment; it’s about the baggage I’m bringing with me. In the case of MRIs, it’s not the small space, but the knowledge that I’m getting into that small space in order to find out whether or not I’ll be dead in six months.
Aggravating my mental situation is the fact that I also have to be NPO for four hours previous to any MRI. That process leaves me physically sick and dehydrated and hollow-hungry on three different medications for claustrophobia and contrast allergy. And that’s before they shove me into the bore and pump me full of gadolinium. (One radiation tech marveled that I was even able to walk after the cocktail I have to take; as she put it, “I’d be passed out or throwing my guts up or both, and here you are like, ‘This is just Tuesday'”). And that’s for the short MRI, which lasts only about a half hour or so.
On one particularly memorable day, I was going to be stuck in a small bore MRI for two solid hours. Unable to move, unable to pee, for two straight hours, lying there with the bore of the MRI less than a hand’s breadth from my entire body, so far into the machine that I literally couldn’t see light past my feet anymore, in an area so tight my shoulders were forced closer to my head. And did I mention I was going to have a Hannibal Lechter cage installed over my face, in the already impossibly small space between the bore and me? And did I mention that I can’t sleep in an MRI, especially if I have to do breath holds?
And with just a few minutes remaining before I was to get into the machine on that particular day, as I was sitting there waiting in my hospital gown and adult diaper (to handle the two-hours-unable-to-pee problem) and with an IV stuck painfully in one arm, I developed a pounding headache.
For you lucky souls who’ve never encountered an MRI, you can hear them long before you can see them. Even from the outside, they have a sound that resembles somebody’s really bad dance mix: bump-WHEEZE bump-WHEEZE bump-WHEEZE. From inside, it sounds like you’ve somehow gotten stuck inside the world’s biggest (and loudest) copy machine. It’s so loud you feel the sounds in your bones as much as hear them with your ears. Generally you’re given earplugs or headphones, but even with ear protection it sounds like you’re the unlucky first to turn the TV on after your grandfather’s been watching. Some places manage to pipe music in to the patient through the headphones, but many don’t; on this particular occasion, I had no music to distract me. All I had was the sound of the blood pounding horribly in my head without painkillers, and the sound of the machine scraping the insides of my gray matter right alongside the pain: EEE BRR CHICK-CHICK. Pause… EEEEEEEEEEEEEEEEEEEEEEEEEEEEEEE brr-brr-brr-brr-brr-brr-brr-brr-brr BAAH BAAH BAAH BAAH BAAH BAAH BAAH BAAH brr-doop brr-doop brr-doop brr-doop UHUHUHUHUHUH…
…like someone tumbling a hammer and at least two different alarm clocks every direction in a copy machine, right in front of my face, for the next. Two. Solid. Hours.
I spent the first few minutes fighting the need to writhe in pain. I knew that this MRI had to be performed, sooner or later; I knew that the more I moved, the more likely I would have to repeat this awful situation. But my head was killing me. If it was this bad now, what would it be like after two straight hours of loud noise and stress? Would it kick over into a migraine? Would I be days stuck in this kind of pain? I began to panic, feeling almost like I was being held down, except I was the one doing the holding. The panic voice in my head got louder, instead of remaining comfortably behind the sound-muffling wall the anxiety medication provided. I knew that if I didn’t get myself under control fast, that I would have to do this whole thing again, with an even bigger fear load the next time for having failed it previously. But every piercing alarm-clock EEEEEEE right over my face and every bone-deep BRR-BRR-BRR felt like they were clawing through my brain with scalpels…
…until I permitted myself to realize that they didn’t feel like scalpels. Not really. It felt more like…hmm, how could I describe this to myself? As if somebody had warmed their hands and they were pawing through my brain. Well, not pawing, either. It was almost kind of delicate, actually–like parts of my brain were being pried apart in time to the pulsing of the MRI, as if to allow someone to look at the folds of my brain more closely. Yes, it wasn’t pleasant–it really hurt–but it wasn’t the frantic ripping-and-slashing pain that I’d previously thought. It was warmer and broader than that… Then it suddenly wasn’t again, and went back to the slashing. I managed to hang on through the panic, which allowed the change to intrigue me. I eased into the sensation, unpleasant though it was. I began to play a game with it: did the brr-brr’s give me the same sensation as the BAAH-BAAHs? Yes, yes they did. But the EEEE was a different sensation altogether. Ahh, it’s the EEEE that gives the sensation of sharpness, but there’s no real pressure behind it. The sense of pressure comes from the brr-brr and the BAAH-BAAH. Hmm. I wonder what it is about them that causes the sensations to feel so different…
And I permitted myself to notice that part of the reason my head was hurting was that my neck was locked, and that I could control. So I let my neck muscles relax. And that made me realize that my shoulder muscles were tight. So I let them relax. And so on, all the way down to my toes.
Yes, for brief moments the panic would wash over me. I would remember how close the bore was to my face, or I would lose control enough to think about what it would physically take for me to worm my way back out of this goddamned thing if it quit working…
…but then, once I ran out of ways to ease my body’s pain or to analyze my brain’s throbbing, I forced myself to remember the fact that wide open blue sky existed just a few short feet away from me. I pictured the MRI and the hospital above it becoming invisible and falling away. I breathed the moving air of the little MRI fan as if it were the same breeze that ruffled the trees. And I was still okay in that stupid little tube. Yes, I was hurting a lot, but I was also comforted enough to live with it. I had given myself the emotional room to recognize that I wasn’t as overwhelmed as I’d first thought.
My situation had very little to do with what was immediately going on, and everything to do with what I feared was going on. And even the pain…that grinding pain…became something I could almost contain just by describing it. By being honest about what it was, I could rule out everything it wasn’t. In being precise about the depth and breadth of that difficult place, I could allow space to experience relief alongside the pain. And once the procedure was over, the comfort I’d found for myself allowed others to successfully comfort me, too, without resentment.
Because if I’ve taken the exact measure of what I’ve been through, I don’t need anybody else to know it. I’ve witnessed it enough for myself.
My success in going toward the pain rather than away from it–toward that man on the couch, and not away from him–has been hit or miss. At times I’m very successful with it. Other times, I’m just grimly hanging on for the ride. It’s my personal version of “fake it til you make it.”
As far as we’ve gotten in Breaking Bad, Walter and Skyler are still a world apart on that couch, not even looking at each other. But even though my husband and I have days like them, we have many more days that we’re closer together than that. We’re learning how to sit together on that couch even when our significant other is the source of our most significant stress.
I have to be willing to get closer to the pain I hold within. I have to encompass that silent enormity and dissolve its presence off the couch, so the two real people in our marriage have room. Because when I do, I leave enough space in my head and heart for me to inhabit myself…and for my husband to sit with me.