Walking to Gibraltar, Chapter 13: In Which Dr. Cowboy Rides Again

Surgery. Outpatient surgery, of all things. Maybe breast cancer could kill you, but zip, zip, in and out, here's your hat, what's your hurry?

They sat in a tiny, dark room. Walls the color of Pepto Bismol. Frank on a plastic chair. Astrid on the gurney in her surgery gown. She'd put on a little makeup that morning, but it couldn't hide her fear.

Dr. Kartes strode in smiling. "We're gonna inject the dye and see where it goes. Then we're gonna go in and clean up around the first biopsy," he said. "We're looking for clear margins--no cancer cells at the edges of the tissue we remove."

Local anesthetic. Dye injection. General anesthetic. "Couple of hours at the outside," Dr. Kartes said. "Then we'll keep you quiet until we're sure you're coming out of anesthesia okay, and your husband can take you home."

Frank sat next to her on the gurney and squeezed her hand. "You're going to be okay, Astrid. You're going to wake and it's going to be over and you're going to be okay."

"You don't know that," she said.

A nurse wheeled her away, and Frank's stomach flipped. The loneliness rushed to envelope him. He alone was here for her. Where were her mother and her sister? Where were her friends? Did she not have one other person who cared enough to be here? How had it come to this—that the husband she professed to not love anymore was the only person in the world at her side?

He settled in a corner in the waiting area, away from the families and Good Morning America. The place smelled of french fries and vending-machine chicken broth. He pulled a paperback copy of The Stories of John Cheever out of his jacket; he'd read them all, but he wanted them now. Wanted something luminous and familiar. The naked women walking out of the sea. "Oh, what can you do with a man like that?" He burrowed into his chair and remembered the ocean.

Two hours. No sign of Dr. Kartes. Two and a half. Three. Shit. This was not good. Something had gone wrong. They'd cut her open and found her riddled with cancer.

Or maybe it hadn't been cancer, after all. Maybe it was all a huge, fucked-up mistake. Maybe—

"Mr. Carey?"

Dr. Kartes wore his blue scrubs, still had his head covered. "Well," he said, "she was interesting."

"Interesting?" That wasn't exactly the outcome he'd hoped to hear.

"We didn't find much of anything you'd think of as a tumor. It's likely Dr. Dresser got the whole thing with the first biopsy. You know, it was damn small to begin with. But we removed some tissue and we'll check the margins.

"The interesting thing was the sentinel node. Most people don't consider that you also have lymph nodes in your chest. Well, the dye traveled to one under her arm and one right in the middle of her chest. So we had to make two incisions—one here and one here—to get the nodes we needed for biopsy."

"So you'd never have known about the other lymph node if you'd done a traditional procedure?"

"Correct. If we'd done a typical axillary dissection, that lymph node would still be in her chest, and we might have tested all those other nodes and found nothing. But if the cancer has spread, it's just as likely to have spread through the node in her chest. We'll find out soon enough, in any case."

Astrid slept in the recovery room. If "sleep" was what you called it. Drugged into unconsciousness. Not yet aware of her three new scars. She looked so tiny, so vulnerable, wrapped in blankets.

And he realized he wanted to take her home—get her out of there to someplace soft and quiet and safe. Maybe she hated him. Maybe he had given her cancer. But he was all she had, and she was all he had. Maybe cancer would be the thing that saved them. When the student was ready, the teacher arrived. Maybe cancer was the world's most sadistic marriage counselor.