Heartbeats of Chemo

As I pulled into the parking lot in March 2020, I noticed how empty the clinic was. Only a few cars freckle the spaces, most in the employee section off to the right. At the door, I am greeted by a woman wearing a surgical mask and holding a thermometer.

“I’m going to give you one of these,” the woman says, handing me a homemade mask with white fabric and little purple flowers. I tuck the mask’s thin bands around my ears and under my light brown chemo beanie. The straps are elastic and dig into the backs of my ears; I’m not used to wearing these masks yet, but I will soon adapt. A cancer patient in a pandemic is prepared for anything.

“Do you know where you’re going?” she asks.

“Cardiology.” My chemotherapy drugs are notorious for causing heart issues; I’m due to receive my first of three echocardiograms that will determine how well my heart is functioning despite its monthly dose of toxins.

The woman runs the thermometer over my forehead, telling me that everyone needs to check in downstairs. She points to another staff member, also masked, waiting behind a desk about a hundred yards away. The hospital is almost empty; these two people are the only ones in sight. My last visit to this previously bustling lobby, only weeks ago, may as well have occurred in another lifetime. The pandemic has shut down restaurants, schools, and health care in rapid succession.

Two weeks ago, my chemo nurse was giving my arm a gentle squeeze before she prepared me for the IV stick. The TV behind her wore the distant whisper of some new disease halfway around the globe, but we didn’t even blink. Life was good. You know, except for the recent cancer diagnosis.

As the woman finishes taking my temperature, I take in the empty lobby. Tall ceilings with high windows let mid-winter light sweep across the floor in slanting patterns. In normal times, the coffee shop tucked beside the pharmacy creates long lines that tangle with those waiting to pick up prescriptions; old people tell stories as they are wheeled about by people in scrubs; staff, patients, and family members of all ages bustle and chat near the door.

Where has everybody gone?

“Do I check in upstairs, too?” I finally ask.

“No, just down here. Nobody’s up there,” she says.

“Nobody?” It sounds ominous.

I check in and ride the quiet elevator to the third floor. The lights are dim, and the waiting room is entirely empty. I glance toward the check-in area, where I would normally be greeted by a couple of smiling faces wearing headsets. The two chairs sit empty, the computers turned off, the elevator music absent.

“Hello?” I call softly toward the hallway where the nurses usually appear.

There is no answer. Beneath my mask, I bite my lip. I don’t want to sit down. This whole situation seems unnerving. Does anyone actually know I’m here? The eerie silence seems to hum around me. Pacing, I debate whether or not to return to the first floor.

I glance at my phone, then take a quick selfie to send to my mom, who is at our house watching the kids while my husband is at work. I am wearing a mask and a beanie, effectively covering most of my face and bald head. Behind me, you can see the empty chairs, the dim lighting. “Nobody’s here!” I send it with a surprised face emoji.

After I hit send but before I can make my way back toward the elevator, the technologist steps into the waiting room. “Sarah? Come back with me.”

As we walk down the silent hallway, she adds, “We’re the only ones up here.”

“I was beginning to think I was the only person on the entire third floor,” I say to her, with a little giggle. Maybe the only person in the world, I add in my head.

“These are unusual times,” she says, leading me into the room.

“You can say that again.”

As we enter the room, she looks at me face-on, or as face-on as you can while wearing masks. “How are you holding up? I heard you had a baby right around your diagnosis.”
“It was tough enough before the world started ending these last couple of weeks,” I joke. Then I nod, more serious. “It’s been hard, but I’m doing my best. I’m fortunate to have a great support network beside me.”

She bobs her head. She might be smiling. “That’s important.”

She gives me instructions for changing into a gown and positioning myself on the hospital bed. I’m made to lean particularly close to the edge so that it feels like I’m nearly falling. She reaches out to me when I slip a bit too far forward, but then quickly pulls her arm back. “Oh, sorry!” We’re not supposed to touch anymore. We don’t yet know how dangerous the illness waging outside is, if we can spread it with a simple handshake, or the reassuring touch from caregiver to patient. It’s safer not to risk it.

It’s okay; I catch myself on the table’s edge. I am still safe.

The technologist places the wand against my chest, and the screen fills with images I don’t understand. Cobalt blues fight with orange-reds in the different-sized chambers. She rolls her wrist and makes a slight adjustment before clicking a few keys on the keyboard.

The heart is such a strange organ; it pumps blood throughout our bodies, essentially the powerhouse of our entire life, but we also place such a metaphorical meaning on our hearts: the place of love, the place of our cares and our joys and our passions.

She walks me through the echo, complimenting me on my “beautiful heart.” I laugh but she insists that she spends most of her time looking at hearts ravaged by years of smoking or other abuses. “It’s unusual that we look at a healthy heart.”

I’m grateful to hear that my heart looks healthy despite the chemo. She asks about my children, the one born just after my diagnosis and the two older ones, all of whom are keeping me a little too busy at home.

“I can only imagine,” she laughs, “with three boys!”

“They have a lot of energy,” I say, my usual qualifier.

She tells me about her own children, and how she feels for parents at a time like this. “Everything is uncertain.”

She makes me laugh, too, though, with the way she describes the heart, this magnificent organ, with its “beautiful chambers” and surprising strength.

Looking at the grainy images, I obviously cannot pick out the ventricle that holds my husband and children inside, or maybe the valve that stores my passion for writing or desire to travel the world or to see my students succeed. I see only a powerful fist-sized muscle, ignorant to any of my desires or intentions. It beats on because that’s what it is meant to do.

The next two years would not be easy. For my first three rounds of chemotherapy, my oncology team greeted me with a mixture of playful teasing and comforting smiles. I then spent two years and sixty-five hospital visits without seeing another healthcare worker’s smile, without their usual comforting touches.

But this visit is the first of many when I realize that a mask, a mysterious threat, an illness doesn’t have to separate us or push us apart. We are still ourselves, and we are still strong, encouraged by the pumping of our beautiful hearts. I will go on to share jokes and gifts and hopes through the rest of my hospital visits. I grow to identify the wrinkles around my oncology staff’s eyes that mean they are smiling back at me, even if I can’t see it.

Despite stage three breast cancer, despite a global pandemic, despite all the worries of work and kids and treatment, my heart is holding its own. That’s what it had been doing for 32 years before my diagnosis. That’s what it did for a year and a half of treatment. And I have faith that it will continue pumping on for much longer.