The Wrong Side of an Illness: A Doctor's Love Story is a non-fiction novel based on the memoirs of a general hospital psychiatrist whose life is turned upside down by physical signs of his wife's silent illness. What follows is his extraordinary account of their journey through her battle with ovarian cancer. His ability to translate emotion into prose allows him to share with his reader the subtle nuances of the narrator's altered role, the family's experience, the complexity of medical interactions in the setting of tragic illness, and the hope that follows from a loving marriage and a fulfilling career of patient care. Her fatal illness is the subject of a candid narration of love, loss, and recovery.
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THE WRONG SIDE OF AN ILLNESSA Doctor's Love Story
By Owen Stanley Surman
iUniverse, Inc.Copyright © 2008 Owen S. Surman
All right reserved.
Chapter OneSUBURBAN SWEEPSTAKES
Here is a picture of the four of us in March of 1994. There is Kate at the far left. (She is also the most politically liberal.) Kate is a month past her eighteenth birthday in this photo. You can see her gentle smile, blue eyes and shoulder length brown hair against her oval-shaped face. Her expression seems to say, "Well, here we are. This is the group!" She is tall—about five foot, eleven inches—and graceful. Her equestrian activities have spared her the round-shouldered slouch so common in young women of her height.
Craig is next to Kate. As you see, his right hand encircles his sister's shoulder. He is four years older and very loving. Craig is the family archivist. He has traced his mother's genealogy to the seventh century and mine through three generations from Eastern Europe. Craig has a sinewy build like his English Canadian grandfather, A. Bruce Humber, Lezlie's dad. We lost him to cancer two years before this picture was taken. Bruce swapped track shoes with Jesse Owens at the 1936 Berlin games and later helped a number of fine young athletes develop their running skills. "I hope you'll name him Bruce," he said when Craig was born, so we added the name and called him Craig Bruce. Lezlie's dad was the kindest man I ever met. Craig is like that. You can see it in his expression. Craig is the one in the family who rescues moths and sets them free on summer evenings. He is six foot in height and has big ears like me. Craig, too, will be a psychiatrist. I know he will be good at it. He is very perceptive and nurturing.
That is a good likeness of Lezlie standing between Craig and me. Her eyes are full of joy. There is the smile I fell in love with when we first met. I knew right away that her capacity for love was boundless. It is funny to say but I also loved that classic oval chin that the children later inherited. Lezlie is aged fifty-one here, plus a couple of months, but one of my patients will see this picture in my hospital office and ask if Lezlie is my daughter. I always think of her as the world's greatest mother. That was her fulltime job when she left nursing after giving birth to Craig. She taught at Children's Hospital while I trained in psychiatry at Harvard Medical School. We used her salary to pay the rent while my income supported our weekend skiing. She never did go back to nursing. When Craig and Kate were older, Lezlie taught knitting to earn some extra money. After that, she tried her hand at cosmetic sales and became a NuSkin representative. She had five customers and counted on me for a monthly order of hair restorer. Kate still insists that the Nutriol keeps my hair from thinning.
I'm at the far right, most conservative of the group and the only Republican, although I am liberal by Republican standards. Craig insists that my political affiliation is a symptom of ethnic rebellion. I am outgoing and friendly but you would never know it from my stiff expression in the picture. Actually, I am camera shy, although, among the four of us, I am probably the most open. One time Lezlie called me at the hospital to tell me we were overdrawn at the bank. I told her that one of my affluent patients owed us a fair amount of money.
"Did you call him?" she asked when we next spoke.
"Yes," I said. "I told him we're overdrawn. He lives nearby and brought a check right over."
"Why did you tell him that!" she said.
You can see that I am tallest of our bunch—six foot two—and the only overweight person. "When you get older, your metabolism changes," Lezlie warned. "You used to gain weight, then lose. Now you just gain." I tend to work late and forage about the kitchen when I get home, but when this picture was taken, I could bench press 220 pounds, and in the summers I swam two miles around the lake. Lezlie would watch from the shore and work at her knitting. Sometimes on a summer morning we made love standing out of view in the water near the boat landing. I tended to fall over because I am not coordinated.
The blue eyes are my best feature, and that nubbin of a chin is my worst. You can see from this frontal view that the Nutriol is actually preventing hair loss. To be honest with you, my head is a bit bald at the back.
Photographs migrate—like Canadian geese. For a long time, this one found its home on our old avocado-colored Frigidaire. Lezlie and I focused on the children but did a poor job of keeping up with the appliances. We covered the worn places with memos, receipts and pictures. In this picture, she and I were with the children by the side of our house. In the background you see a line of overgrown yews and behind them a stand of scotch pines that separate our property from the main road. The previous owners had planted fifty seedlings and I added three dozen more in the mid 1970s when we moved from Pearl Harbor after I completed three years of active duty as a Lieutenant Commander in the Navy Medical Reserve. I was born in 1943, in case you too think that Lezlie looks like my daughter in this picture! I liked to tease her that she got to try out all the new ages first.
You cannot see the house here. It is a simple eight-room barn red Garrison Colonial on an acre of land—mostly lawn. This picture is set on a flat rectangular expanse of green, a good place to play ball when the children were young. We called it the "North Forty." Craig was three when we moved to Sherborn. I well recall his look of awe when he confidently carried his sand pail out into his first New England snowfall. Kate was born a month after I began work as a staff psychiatrist at Boston Hospital. I often think of her running in the North Forty when she was six. She never did learn how to play catch. Every time I threw the ball to her she ran away with it. I was sure that she learned that from our unruly golden retriever. When Craig was older, he tried valiantly to snag the high flies I threw him. He was never any better at catching a ball than Kate was at bringing it back. Like me, the children proved better athletes in the water. Grandpa Bruce's track and field genes obviously passed them by.
After leaving its home on the Frigidaire, the picture found its way to the side of a filing cabinet in my clinic office. I suspended it with scotch tape next to a printout of Desiderata. I was never much at blank screen psychiatry and wanted my patients to know that I was a real person with a beautiful wife and two kids that I was proud of. It was a happy time. Craig received his acceptance to the University of Massachusetts School of Medicine, and Kate was beginning to hear from colleges. In March, the pressure of college applications was behind us. Kate had a place at either Vassar or Bates and was about to hear favorably from Haverford.
Our family life in Sherborn was idyllic. I was a board member at the Unitarian Church and Lezlie taught Sunday school. Craig was an Eagle Scout and Kate was president of the Wild and Woolly Shepherd's Four H Club. She had her own horse, Funny Girl, part thoroughbred and part Welsh pony. They were best friends as only a girl and a horse can be. It alarmed me only slightly when I once overheard their conspiratorial discourse. "Let's trample Daddy," Kate said.
We were not rich, just lucky. As a Navy psychiatrist in Hawaii, I took our five thousand dollars in savings and bought a condominium in Waikiki. When we shipped back to Boston, the condominium became an entry level house. The house appreciated fivefold and we drew out the equity to pay for independent schools and colleges. Our lives were child-centered as were the lives of close friends and neighbors.
No matter how busy we were, Lezlie and I talked for two hours every evening, reviewing the day's experiences. We talked about the kids, the extended family, the neighborhood, and events in my practice. On weekends, I carted my academic work about as we attended to household chores and family events: the swim meets, the downhill ski races, the soccer, the baseball, the museum trips, the 4-H fairs, the Christmas wreath sales for Troop 1. It was a joy and in a subtle way a kind of suburban competition—like a sweepstakes. There was a loving sameness to our lives that neither Lezlie nor I expected to change.
That same March, I photographed a cardinal that built her nest in an open area that was clearly visible to us from a second story bathroom window on the north side of the house. Cardinals are beautiful for their color and beautiful in a spiritual sense because they mate for life.
Mornings before leaving for work, I peered through the portrait lens of my old 35mm Minolta—a relic of the Navy years—and watched her retrieve food for the newly-hatched chicks. I did not save the photos because it ended badly. One night we heard a brief and malignant commotion. In the morning, the nest was empty and a trace of Mrs. Cardinal's plumage was all that remained.
I never shared that story with anyone, but I am a mystic by nature, and the incident made me feel that something was not right in our lives.
Chapter TwoWEAVERS BLEND
Joy and Woe are woven fine, Clothing for the soul divine ... —William Blake
It started in April of 1994.
"I'm feeling bloated," Lezlie said. We were dressing together. Lezlie had a certain modesty and deftly covered her breasts before turning her side to me as she slipped into a skirt and blouse. Her waistline looked different. The strong inward curve of her lower back normally gave her belly a subtle protuberance. Now something in her profile looked misshapen.
"Let's have a look at your tummy," I said. I thought how I used to examine her when she studied nursing and I was a medical student in Montreal. Those were our new-love years. Lezlie hesitated for a moment—it was only a slight hesitation—then positioned herself on the bed. It was the same bed that we had purchased when we first came to Boston.
Self-consciously I percussed her belly with the technique doctors learned from old-time brewers tapping at their barrels to find a fluid level. Physical examination has always seemed absurd to me.
The percussion note was dull. "Lie on your side," I said. "This way...." The dull sound shifted to the side of her that was not pressed against the bed. Shifting dullness. That's ridiculous. You're finding things that aren't there. There was fluid in her abdomen—ascites.
"Hmmm, that's strange," I said. "Why would you have fluid in your abdomen?" There was an empty feeling in my chest as if I had discovered something horrible and wanted desperately to unfind it.
"What does it mean?" she asked.
I was silent for a time and sorted through my thoughts like tangled string. When there is no immediate answer between lovers, it is answer enough.
"I'm not sure ... a lot of things ... maybe some kind of inflammation." Some kind of inflammation? It's cancer, damn it ... You might as well yell it through a megaphone.
She looked frightened. Secrets were not a part of how we were together.
"I suppose ... at the worst ... it could be some kind of lymphatic tumor ... maybe even a cancer. I'm not saying that's what it is ... I could just be imagining it ... but if that's what it is, you can treat it." I thought about a colleague who had been diagnosed with Stage Four Hodgkins disease more than five years before. It was terrible, but the radiation and chemotherapy took care of it. I remembered his fear that we talked about in my office. I taught him to do self-hypnosis. It didn't seem to do much good, but that didn't matter because they cured it. Nothing matters when you cure a cancer—but when you don't cure it, it's lousy.
Lezlie waited most of the week before calling her gynecologist. She was too scared. The delay troubled me but I said little about it. As a psychiatrist I annoy my patients by energetically repeating the same advice—then I blame it on my Eastern European Jewish ancestry. Lezlie had never put up with that nor had she tolerated my obsessive queries. "I say it once," she would say.
On Sunday, April 17, 1994, the day before her first appointment with Alex Godley, I struggled out of bed against a feeling of invisible weight pressing against me like a bad case of flu. I was aware of a pulsing sensation in my face. Lezlie was already downstairs making coffee. I was glad not to see her and tried to wash my face into a brighter perspective.
"Let's go for a walk," I suggested. I wanted to be busy with her. It was a Lezlie kind of strategy, like the time after the big blizzard of 1978 when she kept all of us active during days of school cancellation and lost work.
"Sure," she said.
Our house faced a quiet child-populated street that ended in a cul-de-sac bordering on woodlands and a network of horse trails. "Just in case," I muttered while sliding a canister of Mace into my jeans front pocket. There is no leash law in Sherborn and two unruly German shepherd dogs routinely terrorized passersby. One of the delinquent canines had recently nipped menacingly at Lezlie's heels while she retreated to a neighbor's porch. I was angry about the incident but she asked me not to intervene. The owner was a single man with a large family.
"He has a hundred and twelve children," she liked to say.
"You don't need that," she now admonished, nodding toward the Mace. "Put it away."
I shrugged absently and found another pocket for the licensed weapon. A long-time patient routinely brought me an unsolicited supply. "You never know when I might need you," he would say. He was an out-of-work middle-aged man with the expression of a boy trading baseball cards. Lezlie knew about him as she did about many patients whose stories she shared thoughtfully and with dependable confidentiality.
We walked silently, ponderously, to the top of our street. Shadow, our timid black lab tugged at her leash beside us. "Shadow the Friendly Dog," as I liked to call her, seemed to understand about fifty words in English and one, sientite, in Spanish. Leash training was another matter.
Suddenly, one of the shepherds burst growling from our neighbor's unfenced yard and nipped aggressively at Shadow's retreating hindquarter. We struggled to separate the dogs. Shadow squealed.
"Owen!" Lezlie shouted as the neighbor retrieved her beast, "Get your Mace!"
We reached the trails, and Shadow recovered from her fright. There was no sign of physical injury. Freed from the leash, she sniffed frantically for the local woodland news. The deer tracks piqued her interest. Lezlie and I walked along the trail. I felt weighed down by sadness as if we were doing this together for the last time.
We sat down beside the well-marked path and leaned side by side against the trunk of a large maple tree brought down by the winter's storms. I could see the bulge in her abdomen. It was bigger than it had been only a few days earlier. I felt it again carefully. She did not object. We had always been playful together—but not this time. We sat together in silence and I felt her warmth against me. She seemed weary.
For me it was a tragic moment as much as I tried to mute its intensity. I felt the pain as if testing a hot burner. I remember the odd mixture of horror and rationalization. As we sat against the log, I thought to myself that my life with Lezlie would soon be over, but the thought, gripping though it was, yielded intermittently to self assurance, to a preferred conviction that I was overreacting, that the swelling making Lezlie appear pregnant was an explainable phenomenon that would soon be set right. She could have a curable cancer, a lymphoma like Hodgkin's disease. I knew, however, that this was bad ... very bad. I knew and yet I dismissed the thought. Then the process of recognition and denial recycled ... like a nightmare.
We walked back to the house in the silence that comes when there is too much that needs saying. Our minds have a built-in editing process that frames experience to make the tough times manageable. From that time in the woods together, Lezlie took refuge in denial as though it were a form of psychological Mace that one could spray at the intolerable. I understood, better from instinct than education, that she needed that haven.
After a light dinner, we sat together in our family room. The walls are paneled with a cherry-stained pine. One of my patients, a primitive artist, had sold us an antique fireplace screen on which he had painted a country scene. The room was full of warmth. Lezlie knitted in the winged back easy chair that she and the children had given me at Christmas one year. I perfunctorily completed some office work and tried unsuccessfully to read my journals. I could not focus. My mind was filled with thoughts of Lezlie and how we first met at McGill University in the cold Montreal autumn of 1965.
Excerpted from THE WRONG SIDE OF AN ILLNESS by Owen Stanley Surman Copyright © 2008 by Owen S. Surman. Excerpted by permission of iUniverse, Inc.. All rights reserved. No part of this excerpt may be reproduced or reprinted without permission in writing from the publisher.
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Table of Contents
About the Book....................xi
Prologue—Questions for the Sphinx....................1
Chapter 1 Suburban Sweepstakes....................5
Chapter 2 Weavers Blend....................9
Chapter 3 A Doctor's Wife....................16
Chapter 4 The Janus Mirror....................20
Chapter 5 Informed Consent....................25
Chapter 6 The Other Side of Yesterday....................29
Chapter 7 Random Thoughts....................35
Chapter 8 A Cancer War....................41
Chapter 9 Positive Thinking....................46
Chapter 10 Grapes of Wrath....................52
Chapter 11 He Never Had a Chance....................56
Chapter 12 The Apple....................62
Chapter 13 Little Lezlie....................67
Chapter 14 Handcuffs....................73
Chapter 15 To Haverford and Back....................80
Chapter 16 An Arabian Princess....................88
Chapter 17 Pain Relief....................95
Chapter 18 In the Valley of the Shadow....................101
Chapter 19 Coming Home....................106
Chapter 20 Origins....................112
Chapter 21 Holding Hands....................118
Chapter 22 Don't Stick Out Your Tongue!....................122
Chapter 23 The Weirdest Dying Person....................129
Chapter 24 In the Spirit Passing....................134
Chapter 25 The Doorbell....................141
Chapter 26 Movie People....................151
Chapter 27 In the Highlands....................159
Chapter 28 Flightless Birds....................164
Chapter 29 Flaming Arrows....................171
Chapter 30 A Sufi Tale....................175
Chapter 31 Tour Guides....................182
Chapter 32 A Mystic....................189
Chapter 33 Thanksgiving....................193