Calvarium

This is a story about miracles.

It starts in December 2019, a few weeks before Christmas. I had just woken up from minor reconstructive surgery. I remember coming out of the anesthesia, hearing that everything had gone well, feeling relieved for about two seconds, and then immediately worrying about the routine scans I had undergone just two days prior. But I was too afraid to ask anyone if they knew anything, so I shuffled on home with my anxiety to wait.

I received my scan results by email a couple of days later. I was recovering, relaxing on the couch as my daughter napped on my lap, when my phone pinged. My CT results were ready. I took a deep breath, nervously opened the report, willed myself to read the radiologist’s words: stable, no evidence of disease. 

Whew. 

An hour or so later, my bone scan results arrived in my inbox. I opened this document more confidently, sure it would be fine. Eagerly, I scanned the report, settling my eyes on the “findings” section at the bottom of the page:

New focus of activity within the right calvarium is suspicious for an osseous metastasis. 

Uhhhh…what? I’m pretty well versed in anatomy, but I had to look that one up. 

My skull. My fucking skull. Are you kidding me?

I was devastated. For two years, I had managed to outrun my cancer, but apparently it had caught up with me.

I saw my oncologist later that week to determine next steps. The spot was in a tricky area for a biopsy. Radiation might be an option, but we needed to confirm the cancer was really there; there was a chance it was nothing. We needed more imaging. I acquiesced to a brain MRI scheduled for the day after Christmas. That scan was inconclusive, as was the CT of my head that he ordered next. 

We decided to wait and watch. I would have a follow-up bone scan in April—if it was clear, we could call the results from December a false positive; chalk it up to operator error. 

The months went by. I turned 40. Mike and I took a much-needed vacation. Lucy rocked pre-K. 

We started to hear more and more about a novel coronavirus that was moving through the country. We shifted into remote working and learning while sheltering in place. Plans were canceled. Appointments were canceled. Everything slowed down.

Everything except cancer. 

April arrived, with its blue skies and puffy clouds. We celebrated Easter and welcomed the cleansing freshness of spring. I had my follow-up bone scan, hoping desperately for good news. But the scan was not clear. Not only was the spot still there, it was more prominent. I had another MRI, which now showed a faint correlation and all but confirmed the progression. 

More treatment would be in order.

My radiation oncologist went over the plan with me. Thirty-plus sessions of daily radiation to my skull. Skin damage. Permanent hair loss. Possible long-term damage to my brain tissue. My relief at having an “easy” (read: non-chemo) option wavered as we went through the side effects.

But, as I told you at the beginning, this is a story about miracles.

The slow pace of quarantine days had brought my family to a new level of presence. We were noticing the patterns of the birds outside our windows and marveling at ants going about their work in the driveway. We were watching plants grow, observing berries on the mountain ash deepen their shade of red, ever so subtly, from day to day. One morning we saw a coyote loping down our normally busy street. The world was…quiet. Soft and still, full of wonder, even as fear and sadness loomed. 

Our lives had become quiet, too. So much so that I was able to hear the small voice inside that gave me pause—a voice saying, “Maybe not. Maybe it doesn’t have to be so harsh.”

And then one morning, as I was meditating, I had a waking dream—a vision. In it, I found myself in a serenely beautiful forest glade. From my vantage point, I could see a distant, craggy mountain range, domed by blue sky and skirted by evergreens, embracing a tranquil alpine lake. Surrounding the lake’s sides was a group of leafy deciduous trees, filtering the clear, golden sunlight as it shone down. I felt completely content, at peace.

In an instant, it was all destroyed; a violent explosion ripped through the woods, leveling trees, scattering wildlife, leaving charred destruction in its wake. I winced in pain.

As the image faded and my meditation ended, I realized that this perfect place was inside of me; it was me. I recoiled in horror to think of destroying this divine home with a nuclear bomb of radiation. It seemed impossibly wrong.

The next day I had an appointment with my naturopath. We discussed the treatment plan. I mentioned that I had asked about other options, specifically proton therapy, but that my doctor didn’t think it would be significantly better—maybe saving a millimeter or two of healthy brain tissue. My naturopath didn’t hesitate: “I think you should at least have a consult. I care about those millimeters!” 

I’m not usually one for second opinions. I trust my care team, and I love the convenience of the cancer center close to my home. But this time I went for it. Maybe it was the dream. Maybe it was the intuitive nudge. In any case, it felt like the right thing to do. The referral process to get an appointment took a few weeks. In the past, the delay would have terrified me, but my path had already taken so many strange turns that I was more curious than afraid. I had a calm sense that things were working out as they should.

When I finally got to meet (virtually) with the new radiation oncologist, she told me that proton therapy was a possibility but confirmed it wouldn’t be much different from the standard option I was being offered at my home hospital. Side effects and efficacy would be similar. She was not sure about the degree of potential brain damage, though, so she offered to bring me in to run a comparative simulation. 

In fact, she had time later that day. 

Turns out, she was an angel.

When I met with her in person, before going in for the simulation, she told me she had been looking over my scans and believed there was a third option. She had colleagues who performed highly targeted, specialized radiation to sensitive areas. It was high-dose, curative, precise. Instead of 30+ daily sessions, I would be looking at only a few days of treatment. She wondered if I’d be interested in a consultation? There was compassion, kindness, and intensity in the way she spoke to me. I could read her eyes urging me to say yes.

Um…YES.

I had an appointment with the specialist shortly thereafter. With this type of radiation, known as Cyber Knife, I would likely experience hair loss, but it would be temporary. There was no risk of brain damage nor any long-term side effects. The course of treatment would last just five days.

It was an easy decision.

It took another month or so to work through records transfer and insurance approval and scheduling and more scans and simulations, but I was free of anxiety because I knew, with every cell in my body, that I had been guided to the right doctors and the right treatment.

There were also plenty of other things to worry about. It was now late July. We were in the throes of the pandemic. Protests for racial justice had broken out across the country. As a nation, we were deep in collective fear and suffering. The world was no longer quiet or still. It was angry, chaotic, shouting, burning. We had reached a breaking point, and we were breaking. The future was unclear. America’s disease, it seemed, had caught up with it, too.

I began treatment. The first one was not easy; strapped down to the table by a mesh hood that covered my face and held my head absolutely still, I felt panicky, claustrophobic, and intensely vulnerable. I had to will myself: relax, breathe, DO NOT rip this mask off your face and run away. I needed mild sedation to get through the remaining four sessions. 

And then I was done. Nine months and a lifetime since it all began, and over just like that.

My hair started to fall out a few weeks later—triggering some PTSD from my early chemo days and leaving me with nearly half my head bald. I got used to wearing hats. I inspected my scalp daily for stubble. After about two months, I could see a faint shadow darkening the large, pale swath of my head.

On November 2, the day before the election, I received welcome news: my latest scans show that the radiation was effective. My cancer is quiet, healing.

My hair is coming in strong now, growing every day. I have a thick patch of fuzz. I like the way it feels. My husband and daughter drop kisses there often. 

Every day I look in the mirror and am reminded of my miracle.

Every day, I see that I was guided to just what I needed.

Every day, I see my capacity for growth and transformation.

Every day, I see that I am safe, that I can trust, that I don’t have to be afraid.

I don’t have to be afraid.

I see it, and I know it.

This is a story about miracles.