It began with her annual physical, prompted by a side comment - almost an afterthought - to her doctor. “I plan to cut back the amount of wine I drink.” Linda’s target goal of only one glass per day must have exceeded her doctor’s recommendation - clearly one of them is more in tune with recent medical guidelines. Unbeknownst to Linda, her doctor added a liver panel to the more routine blood work that would follow the exam. (We now refer to her doctor as her Angel.)

The following few weeks remain a blur. The liver panel suggested an abnormality, but the potential causes were many, prompting additional tests; an ultrasound, an MRI, an endoscopy. As each step added new information, it was my responsibility as researcher-in-chief to Google the results and summarize the outlook in the best light possible - without misleading, but with heaping doses of optimism. We really really wanted it to be a wayward gallstone on a field trip. We really really knew it was cancer. (Putting lipstick on a pig is the modern equivalent of making a silk purse from a sow’s ear; that was my job.)

The surgeon gave the cancer a name; duodenal. He drew a diagram for us on the back of a hospital brochure, a childish sketch of the organs surrounding the tumor in the small intestine (the duodenum). He drew straight lines across the organs and ducts showing where he planned to cut, excising parts of the duodenum, the pancreas, the stomach, and just for good luck, the whole gall bladder.

Duodenal is a rare cancer; the overall 5-year survival rate is less than 30%. But the odds I reported were better than that, benefiting from my optimism: they found the tumor early; Linda is young and in very good shape, among the 20% or so who are candidates for what’s called Whipple surgery; the UCSF Medical Center is one of the top 10 cancer hospitals in the country; we have good health insurance. And we recycle.

The surgery was textbook, Linda’s recovery remarkable; the nurses and doctors were all impressed (and not unjustifiably proud). Exactly one week later, preoccupied with needier inbound patients, they all but pushed her out the hospital front door. After another couple of weeks, the oncologist surprised us with more good news; the lymph nodes were clear, and there was no evidence of metastasis. Somewhat stunned, we were free to go, sans chemical warfare. Jokingly, I commented that Linda was being deprived of the complete cancer experience. I quickly learned that her sense of humor had not yet fully recovered.

Statistically, more than one in three will develop cancer in their lifetime. At some point, that statistic becomes personal for each of us. Those who are called to provide support get to observe and, to a small degree, to feel the emotional and physical tsunamis that accompany multiple chasms of uncertainty. That’s partly why I suggested that “we” have cancer. But ultimately, the patient is the one who confronts their own mortality, steeped in the immediate and the personal.

We’re left with now thankfully fading nightmares, unshared but parallel cauchemars that for months awakened us fitful and drenched, peppered with dark places the mind insists on visiting. As close as I held Linda, I experienced true powerlessness. As supportive as my extended family was, I felt more alone than I imagined possible. As optimistic as I always am, I felt our future dissolve, ashes into a great stormy lake. Together, we practiced how to forget, savoring a fleeting normal for the few moments we could make it last.

Now we’re the lucky ones. Linda continues to recover, and will start quarterly screenings. Of course these will be negative! I continue to affirm.

And we’ll again get busy making other plans even while life happens.