It was violent and it wasn’t.
It was violent because it was the kind of cancer to which people refer as beastly, as pure evil, and though I do not really believe in a Christian god or devil, I was left facing one.
I am a nonbeliever.
Explicit or Imminent [DEATH OR DYING]
I had no warnings only complications.
Due to the low incidence of brain metastasis,
[DEATH AND DYING] there is generally no requirement for an MRI examination [DEATH AND DYING] of the brain and cervical spine of patients with esophageal cancer; Japanese studies have even opposed the routine brain CT examination of patients with esophageal cancer (4). ____(8)
suggested [DEATH AND DYING] that with the rapid development of medical imaging technology, particularly the application of MR and [DEATH AND DYING] the use of enhanced contrast agents in neuroimaging,
[DEATH AND DYING] faster and earlier detection of brain metastasis of esophageal carcinoma
[DEATH AND DYING] has become possible (5,8,9). Currently [DEATH AND DYING] for the detection and evaluation of tumor lesions, MRI is superior to CT.
Therefore, the prompt use of MRI is necessary for the early detection of brain-stem [DEATH AND DYING] and spinal cord metastatic lesions.
Certain DEATH studies have considered the use of adjuvant [DEATH AND DYING] chemotherapy following the resection of esophageal carcinoma [DEATH AND DYING] to increase the risk of brain metastasis (6,12).
Implicit or Imminent [DEATH OR DYING] It has been confirmed that the distant metastasis of esophageal cancer [DEATH AND DYING] depends predominantly on the lymphatic and blood systems.
The most common pathway for [DEATH AND DYING] brain metastasis of esophageal cancer is hematogenous dissemination through the arterial circulation.
In 1940, the Batson venous plexus was proposed [DEATH AND DYING] as a pathway for the brain metastasis of esophageal carcinoma (13).
However, the role of the vertebral venous system in the brain metastasis of esophageal cancers is supported by a more recent study (8).
The present case [DEATH AND DYING] may be more illustrative of the importance of the vertebral vascular system for cerebellar, brain-stem and spinal cord metastases from esophageal cancer, as all three regions are anatomically associated with the same vertebral vascular system,
which is distinct from the venous system of the thoracic and lumbar spine and brain.
Outcome [DEATH OR DYING] Brain metastases are often treated with multiple therapies, including
[DEATH AND DYING] surgery, radiation and chemotherapy. Complete removal of the lesions is the goal of surgical treatment and may improve survival rates. However, this generally only applies to patients with a high KPS score or to those with single, solitary tumors.
Academic journal findings do not have a habit of crying out [DEATH AND DYING] amongst their characterizations of what lies between each hospital visit.
I had no warnings only complications.
I am located further inside of this neural obstacle. It is mentally heavy. I organize the memorial service at which your favorite European meal coats the broad corners of the table with crusts and crumbles and rich spreads, olives and such. There are bounty loaves, beveled-shape cheeses, beef tartare and a filial atonality in the weeping around me. In the speeches. In the stories. So many of our friends, and our colleagues also attend. Museum room alight. One hundred sighs, over and over again. You love it from afar, I think. All occurring within. Family of yours attended. I think with foggy distance of pain: we are a relation through marriage and yet you are the one person of me. We possessed each other, not churched or blocked or fluffed. We were one another: and now, not. Today I believe somehow, with you dead and me alive, that we evaded church and still received its blessings. I am forming a mental image of numbers and the formal space of time. Sometimes you come back to me complete, sometimes I just see a yellowish form. Do you remember that feeble-minded person who wouldn’t speak to you at Worden’s before you died, maybe three months before, maybe longer? You didn’t know you were sick and neither did she. She wouldn’t make eye contact, just gave you sharp stares from her incline. She didn’t like us then. She scurried into her universe, which was not ours. I had wished she were an imaginary number. I wish it now, too. I want her to ignore me the way she likes to. I wish she would. I pray she will. You must have seen us from your distance, when she came up to me at your memorial and apologized for treating us both so badly these last six years. I was moved by it, but then I learned, several months later, she disparaged me in the same hour, under what kind of heart, with what sentience? I wish I could draw you the lines of selves as they spread out in front of me in their inlets, in their narrow channels, in their division. So the apology was not genuine. I thought this treatment was over, but it wasn’t. I was just spared it for a little while. That other friend shorn me from ideas of loyalty. I found this out later. You predicted it. You would’ve felt sad and angry for me but you aren’t here. You are where your distance lives. You would remind me not to feel sorry for myself because there really is an abundance of friends encircling me. There’s no you I say to you. There’s no inter-communication we dilate that is us inside it. I feel you inside but not in space. This is what’s devastating. This has been the injurious landscape from which you fled, skillfully sick, of what you left me with. I know it wasn’t skillful at all, but I want to goad you. I know you didn’t want to flee: life meant much those last months. You and I inside of vital functions, some imaginary, some taken to human forms. Some were the last gasps I heard. There is a neural obstacle of one’s mind to consider, and I now take my scarf of fear and I center it around the bloat of time, of whatever can bring the sequence to the basic character of itself. You might be sitting by me in your distance. I will try to feel the light or manner of this as though you had given me something to put together, a fastening coverlet before we eat or before we go to bed; or to cover your head to feed you what I bought in excess at the grocery store.
This gesture of the overbalanced, the solitary of which I see things lined differently in front of me now, because it had been stitched from your mouth and gone so I trudged to look beneath and found I trudge. It’s trudging we all do between sighs, I think.
How is it that I settle on these feelings as he disappears?
All my life I waited to sing-holler in the bathtub to my own pure dewdrop fury but it only came with your death and my aching to live out the adequacy of a seventies narrative all the way to its heart-probe pique and loss. I was a margin-cord rammed with storytelling, and with a susceptible palpitation to a sentimentality in search of a piston: I was sounding out each coarse tangled lyric, unladylike but finding comfort in its seam.
What is explicit now is that I had been a defenseless dependent for those years. I wasn’t hedging a bet with a life then. I was just helping myself to it and to the party of coupledom in its normalcy, in its rewording of intimate interferences, and to this one person I loved. I ground life to a powder underfoot, with the dominion of freedom in front of me. We both did, carelessly, then. We shared a living grief of what disturbed us about others but it lived only in a grievance and in the exterior walls. But then this, and I stopped being in those perceptual truths, of the mind’s eye seeing who was where; this was a kind of luxury of living in knowingness. I gave that up without understanding I had to. When it does come back I will know I am healing.
I was struck back up, bent forward and sprung from my dry hapless complacency. You see, I was sitting for too long; but at a certain point—I see—I just buckled and then he quickly slipped into a part of himself that became part of the hospital. Memories curved and then sounded: were sibilant and jest, and from not-his-mouth, and not-his-teeth, and the breath grew so sharp and he grew so thin and gaunt that he was buried in a slander his body made of him and I could only spurn cancer as an enemy; nonetheless, it overtook: was inside his brain, his chest, a tumor catching the lymph nodes; and did he tell the doctor he didn’t love me anymore and that’s why I wasn’t allowed into those conversations? Did he want to end with his end and not share it with me? I was a nobody outside of his illness as was he, but there was no togetherness in there except for something I craved of him and he of me. Perhaps we couldn’t do stouthearted with too much talk or we must have really believed we had time: there was not the send-off of which we held each other in the deepness of ourselves, the kind with dramatic northeasterly consciousness. No. It was a disaster of insufficiency that now I learn is what death does with you, if you watch it take out what it needs. It’s the power outage with a powdery starch, granules trailing the floor. One foot in front of the other, I have said now to a nobody with me in the laundry room.
Because I am the kind of nonbeliever who believes in the culture around me I was watching for fragments to arise out of habit. Self-destruction from self-annihilation—pinhole pains.
I am returning to the photographs.
What they do is sting the inside with nettles of feeling.
I will try to feel my way through them as if they are still unburdening me with stereo drift because I have to let go of all the literary shapes for truth, and what we had of real love with its grip, an ice-hold.
I am here above the suburbs, where you hold your ears tight.
To get outside the noise of falling inside, of getting away.