Unless he is already doomed, fortune is apt to favor the man who keeps his nerve. The maxim from the ancient Anglo-Saxon epic Beowulf reverberated in my skull repeatedly, like a mantra, until the words no longer made sense and were simply a collection of sounds. My breathing slowed and deepened; my mind felt calm. I felt far away from my gurney in the isolation room in the bone-marrow-transplant ward, though high-dose chemotherapy drugs dripped through IV tubes into a catheter implanted in my chest.
Minutes ago I’d been anything but serene; anxiety had welled up inside my chest like a giant palm pressing on my diaphragm.
I watched the nurse open the plastic levers on the IV lines and prepare to exit the room. She stood briefly to give me words of encouragement when she noticed the small stack of books on the wheeled tray near my gurney.
“Beowulf?” She picked up a translation of Beowulf with a photo on the cover of an ancient Anglo-Saxon war mask, iron mouth smiling, spaces for a warrior’s eyes hollow.
“God Almighty, you should be reading something lighter, like War and Peace.”
“I can’t help it—Beowulf is my soul brother. You see, we’re both born monster-killers.”
“Oh, I see.” She shook her head. I forged a smile on my face, hoping it looked grim and determined like the mouth on the iron war mask. As she closed the steel door to the tiny isolation room, signaling the beginning of the month-long transplant process, I scanned my surroundings.
Fifteen years ago the room was state-of-the-art, built specifically for the transplant procedure. At that time, medical experts thought that any hint of a germ would be fatal to the patient after his blood counts dropped to ground zero, so they designed the room to resemble something out of the space program, a combination of the sterility of a NASA “clean room” with the roominess of an Apollo space capsule.
The walls and ceiling were composed of aluminum sheets joined by riveted metal strips, all painted hospital white; the room itself was about 12’ by 12’ and perhaps 6 1/2’ high. The gurney dominated the workspace, leaving room only for a single chair, medical monitors and equipment, and the portable commode with its high back and arms for comfort (useful when diarrhea struck every 15 minutes).
A single window provided a view of the outside world: the hospital parking lots. Its double-paned glass slightly warped the vista and was dense enough to be bulletproof. Terrific—no assassin’s bullet would find me! I was really worried about that possibility.
Those were the old days; today human contact is slightly less antiseptic—the nurses and doctors condom themselves with disposable gowns, gloves and filter masks, bypassing the screen entirely.
Panic. Shallow, quick breathing and thoughts of death pinball through the mind. It’s that door—once the door clicks shut and the air no longer flows naturally into the room, panic sets in. The noise of the compressor blowing filtered air into the chamber increases the sense of claustrophobia and constriction in the chest. Is this how the gas chamber feels?
Quick: rip the tubes from your veins and escape into the corridor. They can’t hold you here! From outside you hear the sounds of the workmen’s tools as they modernize other rooms on this floor to accommodate future transplant patients.
Steal a hardhat and a pair of coveralls and escape into the working world. It’s Friday, and you imagine returning home after a long workweek. Your sons meet you in the driveway, riding circles around the car on their bikes as you pull up to park.
Then the scene switches. Several boys ride bicycles, including your two sons. They seem oblivious to my presence. They are talking to each other.
“What happened to your father?”
“He died,” the older boy answers, while the younger rides his bike in ever-tightening circles.
“Was it in a war or an accident or something?”
“No, he got sick and died in a hospital.” Your wife comes to the screen door; face puffy, eyes empty, like the hollow sockets in the Anglo-Saxon war mask.
“This is agony! I don’t want to die in this place!”
Keep your nerve, man...yeah, easy if you’re Beowulf, the hero of my long-gone Anglo-Saxon ancestors, a superman who could tear the arms off monsters with his bare hands. But what if you’re me, Corporate Bob, a word-weaver, a man who might be clever with people but can barely tear the arms off a Barbie doll? How do you keep your nerve if you have lymphoma cancer? Huge biceps and a washboard waist won’t help you here.
Damn. I’m in for a screwing this time. This is my second transplant, so I have the dubious advantage of knowing what to expect: Over the next few days, the chemotherapy will destroy my bone marrow and, with luck, all the cancer cells in my body. It also could destroy me by causing a heart attack, damaging my organs, allowing infections like pneumonia to arise, or killing me in numerous other ways.
The less lethal but uncomfortable side effects of the chemo could include rampant diarrhea, nausea and vomiting, fevers and chills, as well as complete fatigue and depression. In short, I am facing what amounts to three or four weeks of a simulated cheap red-wine hangover—one that could prove fatal.
If I survive the chemo, they’ll pour my stem cells (baby white cells harvested from my blood) back into me. These little buggers are smart: hang them off an IV pole from a bag that looks like watery tomato sauce and they swim back into the bone marrow to recreate my immune system.
Of course, something could go horribly wrong, something mentioned in sterile print in the release form I signed before the doctors began the treatment. Sometimes the stem cells refuse to take or engraft properly, and you are left without an immune system. But not for long.
If the stem cells do engraft properly, you’re not home free. No, those nasty mouth sores prevent boredom from setting in. Once a patient’s white blood cell count dips into the nether regions, the mouth sores appear: raw, leprous wounds covering the tongue, the inside of the mouth, the throat and sometimes the esophagus. The pain is so intense that you cannot talk or swallow—never mind eat—without the help of a morphine derivative constantly dripping into you.
Control. I can’t lose my nerve. Okay, Beowulf, let’s step away and observe what is happening. My mind is a tangled jungle canopy. Thoughts careen through the foliage like frightened monkeys chattering and swinging from the vines. I am under heavy stress, in a state of fight or flight. If this continues, the adrenal glands atop my kidneys will continuously flood my bloodstream with adrenaline and other hormones.
Short term, this hormonal boost is positive: it gives humans the energy to handle extraordinary situations, like fighting a monster or escaping from its claws. But suppose the monster is within you, and you can’t fight or can’t run away? The hormones inundating you will overload your body’s systems and eventually burn you up.
Can’t have this! The combination of the cancer and the chemotherapy is enough to wear anyone down. Must seek a state of stillness so my immune system will let the treatment work without interference from my body. How? You know how.
Seize the monkey. The monkey in Chinese philosophy is the emotional mind that chatters unceasingly, cluttering the brain with questions, thoughts, fears and judgments that prevent a calm mental state. This monkey can be dangerous if you’re ill: if the mind is in a state of panic, the body responds and triggers its panic systems.
How to center the mind? With the breathing. The breath is the bridge that links the mind and body. Regulate the breathing with slow, deep inhalations from the bottom of your lungs, seizing the monkey, calming the emotional mind by removing the chaos of irrational thoughts. As the mind calms, so does the body, from a state of alarm to a state of neutrality.
Fortune is apt to favor the man who keeps his nerve: the formula for survival. That is what my Anglo-Saxon will tells me to do. But how do I maintain my nerve over months and years of continuous battles, when fatigue and world-weariness wears me down? What is the mechanism to keep the will strong and prevent it from faltering?
Breathing, again, breathing. When the will falters, when we’re at the breaking point, let go. Don’t quit, that’s different. Let go. Breathe. Let things happen, don’t try to make things happen. As a wise mystic once told me: stop thinking and permit. Permit. Easy to say. Hard to do.
Despite my fatigue I stand near the edge of the gurney, the tubes in my chest connecting me like umbilical cords to the IV bottles hanging from the metal pole. Gently I bend my knees, sink my body and raise my arms in an arc in front of my chest, fingertips a few inches apart, my spine straight, the top of my head pressing lightly toward heaven.
My arms embrace the image of a tree, drawing its clean oxygen into me as it pulls dirty carbon dioxide, cancer cells and toxic chemotherapy from my body. The bottoms of my lungs fill with air, expanding my abdomen and the area in the small of my back between the kidneys.
Focus on breathing, the intermediary between mind and body. In and out, inhale and exhale, no pause, a continuous cycle. Gradually fear dissipates as my mind shifts to the action of my lungs. Beowulf’s formula for survival echoes in my mind and quickly condenses itself to two words: fortune as I inhale, nerve as I exhale. After twenty or thirty breaths the words lose meaning and become mere sounds. The pressure within my chest disappears.
Slowly a ghostly serpent of energy arises within me and spirals its way up my spine. It entwines itself in the intricate web of bone, nerve, muscle and tissue that ultimately connects to every part of my body, preventing it from collapsing to the earth into an accordion of lifeless flesh.
This snake penetrates my brain and drifts upward through the top of my skull into the puzzle of bony plates that seam together in infancy. I exhale and the serpent gathers mass and structure and slithers downward over my forehead to slip through a vagina of skin that seems to open between my eyes. It descends down my throat, behind my sternum, and settles in a coil below my navel, liquefying into a molten, spinning ball of heat that sends tiny, stimulating currents of sunlight into my penis and testicles.
My lungs fill and this tiny sun reforms itself into a great, diaphanous cobra that again winds its way up my spinal column. Now it’s no longer a snake but a spiral staircase of swirling gases, a fragile molecule of DNA, its atoms held together by the opposing forces of electrical attraction and repulsion. Eventually its head catches up with its tail, engulfs it, and it changes into a continuous orbit of energy revolving within my torso and arced arms...
The snake disappears, the image of the tree dissipates, the hospital room dematerializes. I too depart, along with the threat of lymphoma cancer that has dogged me for five years. All that is left is a pulsing of energy that coordinates itself with the action of my lungs, of which I am barely aware. Corporate Bob is no longer an entity, he has melded into the earth and sky.
I’ve seized the monkey. Monsters half-heartedly stir from their corners, moving through me and evaporating harmlessly. Stillness descends like a great, pealing crack of silence. What a paradox! This sensation of peace is not absence of feeling; it’s as though a quiet energy pulses uniformly within me and around me, as though the very molecules of the air are positively charged, alive.
I am still, and this electric tranquility also vibrates in the walls, ceilings, medical equipment and portable commode that constitute this isolation room. It is now my room, my space, my place to heal. Monsters cannot survive here, only heroes.