The Coral-Colored Coffee Cup

There’s a travel coffee cup in the kitchen cabinet that catches my eye frequently. The outside is finished with a smooth polymer in a striking coral color and is embossed with a subtle logo. The inside is polished stainless steel and the cup is vacuum-sealed to provide good insulation. It has a black plastic screw-on top with a flip top covering an opening from which to sip. This particular travel cup stands out from the others in the cabinet in quality and appeal, and it holds special meaning because it was given to me by a research student some years back. I really like this cup but I haven’t used it often out of pure laziness since it is one that I do not put in the dishwasher. These days, I see the cup and remember the time when I used it daily.

In March of last year, Chris’s tumor progressed and grew rapidly, displaying the cruelty of the dreaded glioblastoma diagnosis. Over the course of a few days, his seizure activity worsened significantly turning into hour-long episodes of strange partial seizures or altered consciousness. At the same time, his reading/writing skills deteriorated with alarming rapidity. At the beginning of an awful week we were deep in the logistics of a clinical trial using immunotherapy followed by high dose radiation, but on Friday because Chris’s condition had declined so precipitously the plan was immediately abandoned when the nurse practitioner took one look at him. She ordered a dose of dexamethasone for Chris right then and there to treat brain swelling, and called the infusion center to arrange for an Avastin treatment that afternoon. Just an hour after that appointment, Chris was downstairs in the infusion center hooked up to an IV pump sending the drug into his vein.

In fact, Chris was already receiving the infusion by the time I met him in the infusion center, because I had stayed back to speak with the nurse practitioner. It was the first time the medical team needed to deal with me instead of Chris; they saw that he needed a caregiver and they had to make sure I understood the situation and would manage the details. So, they sent him down for treatment and kept me to make arrangements. When I was done with that business, I was walked into Chris’s infusion room by a receptionist. It was one of the few times he had a private room during a treatment. Chris was calmly reclining in a bed and speaking with his nurse. I was extremely relieved to see him looking like himself and wondered if either the steroid or Avastin could already be working. It had been quite a week of being worried about Chris and seeing him be not quite himself during elongated partial seizures. I had been rattled by the sudden change in medical plan and flustered by making hasty calls to arrange care for the kids. Moreover, the significance of Chris receiving Avastin was not lost on me since this treatment is essentially the last resort in the treatment of GBM. Being back with Chris and seeing his serene, kind smile gave me comfort.

When medical situations devolve into this level of urgency, any control of your life disappears. You have to give your trust over completely to the providers as there is little time for questions to fully understand the landscape. Moreover, you are at the mercy of an already packed schedule in the oncologist’s office, the infusion unit, the radiation suite. The radiation piece of treatment was expedited and early the next week Chris had a mapping appointment. Within days of that, less than a week after abandoning the clinical trial, Chris was started on a course of daily radiation. I’m convinced that Dr. S. used a superpower to accelerate the wheels of medicine to help Chris and get him started quickly. If memory serves me correctly, Chris received a list of radiation times a day before he started treatments. The first was on a Thursday in the afternoon, then most of the rest were early in the morning, like 7:45 or 8:00. Possibly earlier. Looking at that list, I didn’t know how we were going to get through. My parents came to the rescue once again – someone had to be able to get the kids off to school so they flew in to provide that stability for the kids.

Once those morning appointments started, we fell into a routine. We woke before six, started the coffee, ran through minimal getting ready tasks, poured the coffee and hit the road just as the sky was beginning to lighten. It was a slog, and we were bone tired. Chris wasn’t able to drive for the last year of his life and so this meant that I piloted us through the traffic to the hospital and back. In better years, Chris would be the driver, confidently maneuvering through knots of traffic. He was never rattled. When it became my job, I was nervous for a long time. Boston traffic is unforgiving, nobody wants to give a driver an extra millisecond if she doesn’t know exactly where she is going. During this radiation period, I knew what to do but it was still stressful. Every day I selected the coral-colored cup to hold my coffee. Something about the bright color and smooth feel in my hand was soothing for my jangled nerves and calming for my buzzing mind. It immediately became part of the radiation routine to use the cup.

I can hold that cup and close my eyes now, more than a year later, and see our pattern clearly:

Get up and out the door while the neighborhood seems to be asleep. Merge onto the Pike, stay in the middle lane until 128, then bear left to keep going toward Boston. Get all the way to the left lane a while before the dreaded Cambridge/Allston exit. The exit traffic will split into two lanes, keep in the right. Take a breath and get all the way to the right to turn on Storrow Drive, cross that lane of drivers trying to merge the other direction. Don’t get off Storrow where it says “To Downtown” but instead follow the signs for 93, go through a short tunnel, then get to the right lane for the Cambridge St exit to MGH. The exit will turn into two lanes, stay in the left of these. Turn left onto Grove Street but watch for pedestrians ignoring the red Don’t Walk light. Drive around by the ER and loop back toward the Yawkey Center, avoid the valet parking lane if possible. Turn down into the Yawkey garage watching for people who are in a hurry. If there aren’t any spots available by the third or fourth floor down, drive in the direction of the exit and there will be spots on the way up and out. Park. It’s plenty early for the appointment.

Take the elevators to the Yawkey lobby. Pick up a bagel and breakfast sandwich at the cafeteria and, if still early, sit at a table for a while. Talk about this bizarre situation, talk about important things, talk about worries, be together. Be together.

Walk up the stairs to the second floor, follow the skyway across to the Lunder building, take the Lunder elevators down to LL3. Head down the hall to the right, then left, to the restrooms. Nobody is ever in there except you. Meet back in the main waiting area. Mentally note the unique décor of the radiation suite, airy leaves or maybe they’re birds suspended from the ceiling. Go back to the patient waiting area and try not to think about how sick people look, don’t imagine how long the patients have left to live. Don’t wonder how long Chris has left, the answer would be shocking if knowable.

Then, our paths diverge. Chris is called back and he walks alone toward a member of the treatment staff to endure what he must in order to have a little more time. He never complains, he is always polite and pleasant to staff. He has to do this alone, I cannot do it for him. I am relegated to my individual path on which I numbly wait. Do not look around, give others their privacy. Block out the optimistic “beat it” messages dangling on a wire hope tree. Don’t think too hard about the benevolent atrocities being carried out on Chris’s brain for the gain of maybe a few months. Try to quell the panic rising in your chest by sipping from the coral-colored coffee mug.

He returns from the treatment room, with a small smile or nod and we are reunited. Without saying much, we leave, our paths entwine again like vines. Retrace our steps through restrooms, elevators, and walkways, go back to the car, swipe the laminated patient parking pass. The return trip is a breeze, just a little over half an hour in the light reverse commuting traffic. Chris may doze next to me during the ride because there is no choice, he is tired. Return home. The children are already off to their schools and my parents leave us to nap. We fall onto our bed and sleep deeply for an hour or more, sometimes I snuggle into his side and hold his arm. It is the sleep of the exhausted and desperate, but it is also peaceful. We are together. It is more precious than anything.

Now as I hold that coral-colored cup in my hands and trace the embossed trademark symbol with my thumb, that intense and now treasured period of time in which we made our daily treks to the hospital feels so close it could be the present. Chris feels near such that he could be just down the hall. But, he’s not. He is gone. That time has passed, the written tense should be the past tense, not the present, nor should it use an active voice. Chris is nowhere to be found now – thankfully he is not at the hospital and he is no longer suffering losses, but he is not down the hall in our bed, his dear profile is not next to me in the car, he is not dictating messages in the rocking chair, he is not joking at the dinner table, he is not lovingly putting our children to bed, we cannot be together.

Chris is nowhere to be found except in my mind. All that is left are memories, but thank goodness for those. I’ll continue to use the coral coffee cup from time to time and remember Chris deeply. Even in the hardest times he was a magnificent being. I loved him then, and I love him now.