11. “Closing rituals” — Chemo, Round 6

Have you ever had huge expectations from an event, only for them to be crushed?

That is what I felt like at the end of my last chemotherapy treatment on January 20, 2021. The day had begun in the usual fashion. I had listened — one last time — to the pre-chemo meditation (and managed to get through it without crying), eaten breakfast, and checked the contents of my bag to take along to the hospital. Once there, I stepped on the scale and took a deep breath when I saw the number. It was 15 pounds above what I had weighed in late September 2020. “Oh well,” I thought. If nothing else, my blood pressure, pulse, and body temperature were perfectly normal for which I was grateful.

“We have got a ‘business class chair’ for you today,” the nurse announced as we walked down the hall and entered, for the last time in 2021, the treatment centre part of the cancer clinic.

“That’s perfect,” I said, happy to be using a remote control instead of struggling with levers. Taking a deep breath, I took off my winter jacket, sat down, and put my feet up.

“Is it true that you get to ring a bell when you have finished chemotherapy appointments?” I asked the nurse. I had read about that tradition on the internet. Apparently, it had started in 1996 in the United States, when a navy officer brought a brass bell with them and rang it at the end for a job well done.

“I have never heard a bell on the days I have been here,” I remarked.

“It gets rung,” the nurse assured me. “Would you like to do it today?”

“If it’s not too much of a bother, yes, I would,” I replied.

“Not at all,” she said.

She began to insert the IV needle, going higher up on my arm to give the back of my hands a break; they had bruised badly the last two times. That was a mistake: my veins refused to cooperate. After four failed attempts, she tried the other arm and was immediately successful. “Finally,” I thought and closed my eyes. Surrounded by a multitude of guides and angels, I travelled to “the land of healing” one last time, albeit only in my head.

No rest for the weary

Five minutes later, my cell phone, which I had put on silent, started buzzing. It was the oncology radiologist. According to his voice mail, his nurses would call me with assorted details tomorrow. “Fine,” I thought and closed my eyes.

Ten minutes later, the phone buzzed again. My GP’s office wanted me to call back. “Will do,” I thought and shut my eyes.

Fifteen minutes later the nurse asked me for my full name and birthdate — for the 500th time since I had first taken a seat in a hospital chair — and announced that the first of two chemotherapy drugs was about to be administered. “Can’t a girl get some rest around here?” I muttered to myself. I grabbed my German ear plugs, donned a funny (and appropriate!) sleeping mask (“leave me alone”), and closed my eyes for the third time.

Two hours later, the social worker dropped by.

“I am sorry I did not get to visit last time, Barb,” she said.

“You missed all the excitement before Christmas,” I replied. Then, I told her about my hospital stay, stretcher and all.

“How are you doing today?” she asked.

“I have been quite anxious,” I admitted to her.

“The monthly gynecological cancer support group Zoom meeting is on Monday, Barb — did you want me to give you the information?” she asked.

“Yes, please,” I answered. The timing was likely not a coincidence.

Then, I closed my eyes again, intent to make myself invisible for the next few hours.

“It’s time to wake up, Barb, and take your diuretic pills,” a nurse said, gently touching my arm. “Does that mean that it will soon be time to ring the bell?” I asked, eyes wide open.

I had been pondering this closing ritual in detail for weeks now. Did it really mean that I was beating cancer, as others in the same situation had proudly announced online? I concluded that maybe trying to scare it away is more accurate in my case. After all, I had been cancer-free ever since the surgery in August of last year, and the CT scan from early January proved it.

At the same time, I had wondered whether these chemotherapy treatments would really help prolong my life. Would I ever have to repeat them, especially over the course of the next five years when the oncologist would keep a close eye on me because the recurrence rate was comparatively high?

“Give your head a shake,” my guide with the top hat had said to me whenever I conjured up another new episode of my award-winning series Gone with the Chemo Wind in the middle of the night. “Focus on the now, not the future.”

For whom the (chemo) bell tolls

I followed his instruction when the nurses declared, “We are ready for you, when you are, Barb.” Handing one of them my cell phone, I put a big smile on my face.

“Okay, let’s do this!” I announced boldly.

Then, I rang the heck out of the medium-sized bell I had been given. The nurses cheered and clapped loudly, drawing the attention of patients nearby, who either joined in or looked annoyed. After about 20 seconds, I bowed for the nurses. “Way to go, Barb,” they shouted happily and turned their attention back to the other patients.

After grabbing my stuff, I stopped at the nurses’ station on my way out. “Thank you from the bottom of my heart for taking care of me since late September, ladies,” I said. “And I hope to never see any of you again!” I declared jokingly. Everyone chuckled and waved goodbye as I exited the clinic in tears.

“Congratulations, Barb — you did it!” my trusted neighbour said when I got into her car.

“I don’t feel like celebrating at all,” I replied.

“Did you ring the bell?”

“Yes — in fact, I had great hopes that marking this milestone with a closing ritual of sorts would help me officially cross the finish line of the ‘chemo tunnel’,” I explained. “But all I feel like now is numb and exhausted.” My inner child was nodding vigorously.

“Give it some time, Barb,” my neighbour recommended and pulled into the parking garage a short time later.

My relatives and close friends were thrilled with the “Barb ringing the chemo bell” video I had sent them. “We are so proud of you for making it this far,” they said. I thanked them for their vote of confidence. “I aim to please” was my standard, somewhat cheeky, answer.

Nevertheless, I felt a huge sense of disappointment on the evening of my last treatment. Why? Because I blamed myself for not having been more present during — that is, enjoyed, if not savoured — the act of ringing the bell and acknowledged its significance as a closing ritual. As far as I was concerned, I had wasted an important opportunity to move on to a new reality that did not involve receiving chemotherapy drugs.

In hindsight, I realized that I had desperately wanted this ritual to be more meaningful and memorable than those “Life is good” moments I had been experiencing. “Oh well,” I thought in the evening. “Expectations are there to be crushed.”

Maybe a good night’s sleep would do the trick.