Chemotherapy, Round 5. More than you thought you wanted to know.

It’s a rainy day in Songdo, which means it is now the possibly the wettest place on earth. But I have a penchant for hyperbole.

There are a few things I especially like about living overseas; one of them is being in a place that has an actual rainy season. (Some of the things I dislike include the freakishly complicated banking system, the voracious mosquitoes and the lack of situational awareness amongst people on the subway- particularly those who text on the escalators and stop dead in their tracks at the top, causing pile-ups behind them.)The worst (best?) of the rainy days was during the weeks while everyone else was away, but since the beginning of the new school year, we have had some real hum-dingers. A swathe of black sky creeps forward across the West Sea, thunder clapping off in the distance. As it approaches, the light suddenly disappears, like a drive-by eclipse. The rain arrives in a wall, a relentless and pervasive sheet of water that shifts with the wind and explodes back up from the concrete. Umbrellas are everywhere. There is a whole industry of umbrella distribution, maintenance and support here. Outside all public buildings, one will find not umbrella stands, but dispensers that hold disposable plastic umbrella covers like large sandwich bags. You slide your umbrella into one of these as you enter the building to prevent drippage on the floors. Then, when you leave, you throw the bag away. Environmentalists among you, be horrified now.

The umbrellas are, however, hilariously futile. The water does not fall; it assaults. It comes down and sideways and up and across and through- and many other prepositions- all at once. The only way one could avoid getting wet outside in this rain would be to climb into the disposable plastic umbrella cover dispenser and wrap oneself up in the sandwich bag.

Now, here’s a secret: one of the things that I gently resent about being an adult is the need to behave oneself in the face of such glorious, warm and unrelenting rain. One must stay indoors unless trips outside are necessary, and then one is expected to huddle uselessly under one of the futile umbrellas and skitter between buildings. One must not, under any circumstances, abandon the umbrella and dance in the rain. One must not jump up and down in the puddles, seeing how much of a splash one can create. One must not, ever, EVER attempt to drench passing children or ajimas or colleagues. This is both a great disappointment and a constant struggle. ‘Coz I would if I could. When the rain falls like this, I am struggling with a powerful compulsion to throw the futile umbrella to the skies, and dance maniacally through the onslaught. Be warned: some day I might just do it. You may get wet.

My plan for today, now that I have arrived at the hospital, is to attempt to write this blog entry in something like real time. I could get wifi if I were really keen, but I’m happy enough typing the document up and loading it on the site later.

I am sitting in one of the few public waiting areas, on the basement level where the shops, cafes and parking areas are housed. I have already been up to the International Clinic to see the cranky lady there- though, to be fair, she is much less cranky lately, having been clearly worn down into pleasantness by my relentless good humour and charm. I will have to begin calling her by her real name- Hyunji- since she can no longer be called CICL with any accuracy. I confess a certain disappointment in this, as she was turning into a great character.

Hyunji was all smiles and sweetness. She was speaking to a portly New Zealander when I arrived- and I’m being polite here; the man was enormous- but immediately gave me an update on my insurance status and asked me not to bother going to any of the other tellers when I need to register, but to come back up to the clinic. I do wonder if that’s because she’s so happy to see me, or whether there’s been a complaint about the noisy bald white woman who keeps clogging up the works at the other tills. I suspect the latter.

From there, I went down to the first floor to have me blood taken. The technicians were on good form, probably because I had beaten the morning rush. There has always been a determined focus on the task at hand on my previous visits: no chatter or social niceties. Make fist, clench teeth, endure jab, watch interestedly, khamsa-hamnida, and off I go. Today, they all seemed intrigued by my name, which they pronounce “pah-TREESh”, and the young man who jabbed me told me that it was very beautiful, as he asked where I was from.

I’m not complaining. It’s more action than I’ve seen in almost a year.

The two vials dutifully drained, he gave me an alcohol swab and an instruction to hold it firmly over the needle spot for five minutes. I always ignore this, as I am a scoff-law. I headed to the shop for some Werther’s Originals and a bottle of water, then to the Paris Baquette for a restorative caramel macchiato. I observed the incongruity of placing garlic cheese bread on the same display tray as the triple-berry danish, and brought my drink out here, where I type to you now.

And from here, I head to my oncologist, for her to crow even more about how well my ditty little tumour is doing in the face of the chemotheraputic barrage. I think she is feeling very pleased with herself, and so she should. She saves people’s lives on a daily basis, and all without fanfare or media coverage or wearing her pants on the outside of her tights. She can be smug at my expense if she cares to. As long as she keep howling like Frau Fraubinissa, because that is always the best moment of Chemo Day.

*        *        *        *

The appointment has now been and gone, and I am in the cot at the Cancer Centre. I am waiting for the sleeping pill to take effect as I type; it will probably not be long, as I can already feel the surge and wane of sluggishness. The technicians clomp around purposefully, an especially noisy ajima has been hustled away in a wheelchair, and the elderly gentleman next to me snores. There are four others in here with me at the moment- oops, five. A woman in a large straw hat has just toddled in, accompanied by her husband, who ignores the sleeping figures as he talks and rattles papers at full volume. He is now looking around the room, sizing up which bed he wants to choose for his wife.

When I had finished up my earlier entry, I went to the Oncology department to see Dr Moon. The receptionists’ responses to my arrival are always of varying enthusiasm- I am completely ignored by the ones who have not dealt with me before, and the other two immediately start giggling when I roll up to the counter. I take my blood pressure, they look at the results and nod with satisfaction and have me take a seat in the waiting area. There were dozens of other patients there this morning: gritty old patriarchs and doddering ajimas, tense looking mothers and swaggering young men. Today, two grandmothers had a little boy with them, perhaps five or six years old. A hospital worker brought round a tray of rice tea (of which I am a huge fan) for the waiting patients, and the little boy took his drink away from his carers to sit by himself, clearly wanting to be big enough to drink like grown-ups. They kept an indulgent eye on him.

Dr Moon was stationed behind her desk as usual when I was ushered into her office. As always, she half-stood when I entered and made a general gesture towards bowing. (She is in charge of our conversations, so has no need to do even this much.) I bowed in return, and inquired after her health. This inevitably causes her to laugh, which baffles me somewhat, but I laugh with her. She felt glands in my neck for the first time today, before checking the breast. The poking and prodding was definitely less painful this time. She said that it seems to be shrinking still, and again seemed rather satisfied. I expect my gold star in due course.

Then we began the discussion about what happens now. I will be having my next treatment in four weeks rather than three, because of the Chuseok holiday. Then, three weeks after the next round, I will have another MRI and ultrasound. The surgery should be the next week, but she wants to remain flexible, so would not commit to it.

I then asked about what will happen after the operation. I would like to know whether I will have more chemo, for example, and if so, whether I will have it while I am in the hospital. How long does she think that I will need to take off work? When will I be finished treatment?

The short answer to all the about questions was ‘I don’t know.’ This seemed a little vague. When pressed she gave more information, but qualified it all with ‘maybes’ and ‘mights’ and ‘probablies’. One possible answer was on the return time to school: maybe three weeks. The one definite was that there will be more chemo, what she called “maintenance” chemo, and which includes more Herceptin. This treatment could go on for a whole year.

Bugger.

I was really looking forward to NOT coming back here. And to having my hair. And to losing some weight. And to having more than one glass of wine.

The oncologist is, of course, also looking forward to those things. She points out that I cannot do them, however, until the last traces of this pesky tumour disappear, and there is very little chance of it returning.

I’d really hoped to be able to go away at Christmas, though, without treatment hanging overhead. The current timescale she is mooting has me up to the radiation days somewhere around the Christmas window. Hospital, every day for six weeks. The thought of another three weeks here with everyone else flying off on exotic adventures while I sit through a Songdo winter is more than my nerves can bear right now. Am also tired of looking like Mr Clean gone to seed.

However, this is what it is, and getting to the other side of this year is the priority. Sob. Please, please, please, let me go away at Christmas, somewhere that is home or home-ish, or gloriously pleasant, great Chess Grand Master in the sky.

The rest of the conversation was more sociable.

P: So the treatment will last a whole year?
O: Maybe, maintenance herceptin and chemotherapy will be a year.
P: I am looking forward to having beer. A whole year, you say?
O: I stopped beer one year ago.
P: I’m so sorry.

She really won’t know until they biopsy the tumour again during surgery. They need to see how things look in there before the final decisions are made.
Talk turned to Chuseok:

P: Will you be going away during the holiday?
O: No, I will be very very busy, cooking. Much work, much cooking.
P: Ah, I see. For your own family, or for your husband’s family- for your in-laws?
O: My husband’s family.
P: I’m so sorry.

In Korea, the eldest son’s wife generally gets lumbered with cooking for the extended family/in-laws during Chuseok week, which is like a Korean Thanksgiving. It is a huge undertaking, and tradition dictates that she makes pretty much everything herself, setting herself up for judgement and derision from her mother-in-law. Food is a big deal here, as it should be. There is never just one type of dish when one has a meal, though. Even if one orders a single thing at a restaurant, the sides are often enough to make another course all on their own. Dr Moon is, I learned, the wife of the eldest son, so even though she works full time as an oncologist, she is still subject to the tyranny of Chuseok cooking.

And here I start to lose the fight against sleep. More later.


*      *        *        *

Later arrives. I have slept for about an hour and a half, despite the best efforts of the two elderly ladies in the beds to my left, who have carried on a conversation at full volume and are only now settling into a tired quiet, interrupted occasionally by additional questions and comments. The technician and the man two beds down on the other side have now taken up their noisy mantle. The desperately thin woman whose treatment  is so painful has just arrived, and is preparing to take her place immediately next to me. Her upper arms are thinner than my wrists. I note that the women climb foot first into the beds, rather than sit on them and swing up their legs. Random.

So to sum up, the oncologist has scheduled the next events as follows:

final round of chemo before surgery- September 26th.
MRI/ultrasound- October 14th.
appointment with surgeon/oncologist for them to not have consulted with each other or  reached a decision about when my surgery will be or whether I am the Russian or what all will be removed or whether I will need reconstruction- October 17th.
Probable surgery date- Lord knows.
What post-op treatment will look like- don’t get me started.
radiation therapy- h’aint got a clue, now.
whether I’ll ever be finished treatment- your guess is as good as mine.
when I’ll be myself again- Sigh.

I left her there, wishing her well for the Chuseok holiday and the judgement of her mother-in-law (I didn’t actually say that, but I think we both knew it was implicit) and set off up the stairs to the International Clinic again. Hyunji also started laughing at me when I asked after her health, which continues to bemuse me a bit. I think that the common ‘How are you?” greeting translates as ‘Have you eaten well?’ See, I think that’s hilarious and brilliant. It may explain why ‘How are you?’ doesn’t work well. Hard to say.

Hyunji was comforting about the length of time that it seems I will have to wait to be the other side of treatment:

H: You need to be strong and keep fighting. It will be over eventually.
P: Yes, I know, I know. And in the meantime, I have this impossibly symmetrical head...

Having run through the total lack of a plan with her, I wished her a happy Chuseok (at which she laughed at me again) and headed to the pharmacy to collect my meds.

As I turned the corner, I happened past the orthopedics unit, where I saw my friend/colleague Ginger Puffer, getting checked out after an unfortunate episode with fluid on the elbow. Now, Ginger and I get along very well, but see each other only rarely during term time. Our greeting ritual is therefore flamboyant and noisy, and unfortunately, now engrained in my conditioning:

P: Puuuufffffeeeeeerrr! (Excited hand waving and feigned palpitations)
G: Pattiiiiiiiiiiiiiiiiiiiiii! (Similar gestures, limited by presence of cast, bandages and sling
Korean Passersby: Startled stares, stern disapproval.

We passed a pleasant few moments updating each other on hospital experiences/appointments/food, etc, before she set off to see Hyunji upstairs (P: Tell her I said ‘Hi, how are you?’) and I accidentally stumbled immediately upon the pharmacy without my usual aimless wandering around the corridors looking woe-begone and foreign and waiting for someone to help me locate it.

The pharmacist knows me by sight now, and grinned at me as she handed over yet another ridiculously and unnecessarily large supply of painkillers and blue bombers. I grinned back- they may come in handy on long-haul flights. For the next seventy-five years.

The cancer ward was relatively quiet when I arrived. It is located on the same floor as the International Clinic, off in a still corner where no one will stumble upon it by mistake. There are three technicians in attendance: one is tall and thin, the one who answers the phones is what my dad would politely deem ‘husky’ when he is endeavouring to be polite- which isn’t too often, to be honest. The third is a little slip of a thing who looks like she’d blow away in a good, stiff breeze. They all three of them manage a difficult job with unflinching unflappability- they have just changed the soaked bed of an elderly lady in the same smiling calm with which they greet their patients and share gentle jokes with each other. There is no fuss, no drama- not from them, at any rate.

During a lull, the small one- and I really need to learn their names if I am to be coming back here for a year- manfully tried to have a conversation with me by using the translation app on her phone. She would type questions in and show me the translated phrases, ascertaining my job, my nationality and the progress of my cancer treatment by doing so. How lovely. She is now sitting on the chair next to me, ministering to the impossibly ill thin woman, whose husband is wearing the same orange shirt that he wears every time they come in, holding vigil like a sentinel next to her bed. He reaches a steadying hand down to her as she flinches and whimpers. His voice is smooth and quiet. I envy this poor woman nothing but the strength of his presence.

Nearly through a bottle of Taxol, which my reading informs me is responsible for my sore mouth and hair loss. And good things, too, of course. The tall technician has just attached my IV to some sort of monitor, which beeps angrily if I bend my arm too much and limit the flow of chemicals. It might be forcing the juice into the vein more quickly, as I can feel a chill running up my arm now that it has been connected. A bit disconcerting.

A calm has settled over the ward as the afternoon has moved on. Six of the beds are now empty; just the Russian woman and I are alert. She is reading on her Kindle; I am typing this. It is the first time I have had the presence of mind to bring in headphones and a charger so that I can block out some of the noises of the room- KC and the Sunshine Band are uh-HUH-ing in my ears. Few new patients arrive this late in the afternoon. The usual pattern will have me out within an hour or so. Tamarisk and Shelly are coming to fetch me home, via Macdonalds’ drive through for an ice cream.

The machine just started beeping crazily, bringing the small techie running. Nothing seems to be too amiss; I adjust my posture to straighten my arms out a bit, and the beeping stops. She leaves briefly, and comes back to check my now sleeping neighbour, cautiously raising the sides of the bed so as not to disturb her.

The very elderly woman whose bed needed changing is now snoring prodigiously. The machine beeps again, the technician comes back and scowls at it. She removes the IV tube from it, wags her finger at it (wonderfully universal gesture) and leaves the room again.

And the hours pass.

 *        *        *        *
Back in the flat now, tying up the loose ends of unravelling the day. Shortly after the last installment, the very ill woman next to me attempted to get up to leave, her session completed for another day. She was far too weak to manage it, nearly collapsing before getting even a yard away from the bed. Her husband caught her, and with the techie, helped her lay down again for another quarter of an hour. She then slid back out to try again, and he helped her hobble frailly out of the clinic.

I was packed off shortly thereafter, far more robust than I had any right to be. As I headed for the stairs, I saw the couple waiting by the elevator. The husband was staring at the numbers on the screen as they ticked down to our floor; his wife was sitting on her haunches next to him, head in hands.

I stood outside for several minutes, waiting for Tamarisk to arrive. She soon pulled in, without Shelly for a change. Despite being ready to load up and head out, I still fumbled with my bags as I clambered inelegantly in and grappled with the door. Tamarisk threw one of my bags into the back seat, bringing her arm forward just as I was leaning back to fasten my seatbelt. SCHMACK! Elbow, square in the back of the head.

T: (Trying vainly to suppress laughter) You survive a day of chemo just to wind up back in hospital with concussion!
P: (Giggling, feigning tears, rubbing the back of my head hard) You just smacked a woman with cancer?? That is cold, Tamarisk.
T: The one day I don’t bring Shelly...
P: ... and I get assaulted!
T: (mad, sheepish laughter)
P: Stop laughing. I think I need stitches.

We headed for Macdonalds, the Big Mac meal of conciliation awaiting. There was no parking immediately available, so we went through the drive-through and immediately found spaces to park around front. Had a very pleasant half hour there, scowling disapprovingly at the two able-bodied men who parked in the clearly designated D space, and hoped fervently that karma would come along and bite them both on the ass.

Then we wondered whether karma ever actually does that. And if it does, why it doesn’t let its ass-bitten victim know why s/he has been bitten:

K: Good afternoon, I am Karma, and am here to bite you on the ass for that time in August 2013 when you and your colleague parked your minivan in the Disabled space at the Macdonalds near Inha Hospital in Incheon. Please stand still.

It tends not to work that way, which is a shame.

We also noted and discussed the difference between parking in the Disabled space, which is clearly wrong and using the disabled toilets when going to public restrooms, which is clearly not wrong because they are simply accessible to those with disabilities, and not designated especially and solely for them. Because that would be silly. I will happily let anyone who needs those commodes to have them ahead of me, because I’m sweet like that. But woe betide anyone who tries to tell me to queue up for ten minutes for the able-bodied loo, when the disabled one is sitting there empty. Someone who parks in the spot meant for those who need it simply through laziness? Come here, Karma!! Come now! He’s over there! The guy in the minivan! There are DOZENS of other parking places. There are inevitably only one or two other toilets available, and twenty women waiting, some of them with squirming children. And no one with a cane, a walker, a wheelchair or a seeing eye dog anywhere to be seen.

Rant, pant, rant, pant.

You can see that I have given this some thought. And that chemo brain is walloping my internal monologue, making me have imaginary arguments with imaginary people over imaginary toilet facilities.

Which means it is time to close. If only my dissertation would write itself so readily.