The Return

When I find out what’s going on, my heart doesn't sink to my stomach. I feel like I already knew, like I could already see the signs everywhere. Alma isn’t a good liar, and she knows this. I also know this very well. But I let her lie to me. Not consciously, but in my gut I can tell.

The cancer is back.

It isn’t hard to tell, even though she tries to hide it from me. She starts coughing again like she used to – harsh, dry coughs that shake her from head to toe. Sometimes she has a particularly harsh cough, her throat filling up wet with blood, and she scurries into the bathroom, quickly turning on the vent and running the sink to drown out her noise.

“This cough is awful,” she says wearily when she finally exits, waving away my concern. “I’ll pick up from cough drops from work tomorrow, those will help.”

Soon enough, the next day she has a pack of half empty cough drops on the kitchen table. I look down at them, feelings warring within me on a seismic scale. Just a cough, I reassure myself. It’s just a cough – it'll go away on its own.

The cough stays. It becomes another soundtrack of my life: my dogs barking at the mailman, my children bickering with each other for who deserves the last muffin the most. My wife coughing as she puts her hands to her mouth, trying to muffle the sound so she doesn’t wake me. She doesn’t realize I’m already awake. Or maybe she does, and just doesn’t call me out on it.

When the fit is over, she breathes deeply, raggedly and turns to me. She buries her face into my shoulder blades and her thin arms – thinner than normal – wrap around my waist. Despite myself, I lean into her touch, relying on her comfort even as she breaks me. Soon her ragged breaths slow down, syncing up with mine. We breathe in tandem as she lays behind me, hands grasping at whatever skin she can find.

“I love you,” she whispers to my back after minutes have passed.

The words to reply get stuck in my throat. My vision blurs, and I blink away any tears. It’s just a cough.

Her arms tighten around me, and eventually I fall asleep.

The first time Alma is diagnosed, she is pregnant with our youngest, our little Teddy bear. Our joy to bring him into the world is cut short; our lives are forever changed. Pregnancy alone can be hard enough; hell, cancer alone is terrifying. Together, the diagnoses seems world-ending.

Teddy is three months away from coming into this world. We weigh our options and listen to the advice given to us, but Alma is firm. She will not risk his health in any capacity in order to start chemotherapy. In this case, I agree with her. We will wait.

Visits to the oncologist are frequent and disheartening. He urges us to start as soon as possible. “It’s not getting any better,” he tells us. “Treatment needs to start as soon as possible.”

In front of him, we are a unified front. Sweet, demure Alma suddenly a fierce lioness, unwilling to even consider the risk to her child. I stand beside her, accepting her grip of my fingers quietly. Her anxiety and worry pass from her palms into mine. While I give her strength to make her decision, she gives me her fear.

Fear for Teddy’s well-being. Fear for herself. Fear for both of them, and what we might have to do if things get worse.

In the privacy of our home, I plead for her to listen to the doctor’s advice. I don’t want to lose her is what I tell her. She bites back, keeping her voice low to not wake our daughters, “You would rather lose our son?”

I don’t have a response to her question.

A month later, Alma collapses at the grocery store. She’s rushed to the hospital, and by the time I receive the call, the decision has already been made. She’s going to be induced.

When I make it to the maternity ward, it feels surreal. I can hear her wailing, like every nerve in her body is on fire. My hands shake as I reach the door. I don’t want to go in. I don’t want to see her like this. I’m afraid...

Alma wails louder when she sees me, reaching out with one hand as the other grips the handles of the bed, her knuckles pale and prominent. “He’s not ready,” she sobs, grasping me as soon as I’m close enough. “Tell them he’s not ready it’s too early!”

I kiss her palm, making calming hushing noises at her. “It’s for the best,” I reply. I can’t look her in the eye. She didn’t want this – I betray her by siding with the doctor.

Her wailing stops when she realizes that I won’t stop this from happening. I don’t think I can stop it from happening, but that doesn’t matter to her right now. Her grip loosens for an instant, but then she squeezes tighter. I look at her then. She is angry, but she’s pushed that away. Teddy is coming today, and if she can’t stop it, she will do everything she can to make it effortless for him.

That’s my Alma. Self-sacrificing till the very end. I whisper that I love her but she doesn’t reply. I don’t need her to.

They let us hold Teddy for a few minutes before he is sent away to the incubators. Alma cries again, bittersweet tears of joy and anger. She falls asleep soon after, physically and emotionally exhausted. I step outside, meeting with her obstetrician and oncologist briefly. With Teddy’s birth, there is no reason to stall the chemotherapy any further.

“She won’t be able to breastfeed,” they warn me. I dread giving her the news.

Chemo starts as soon as she’s able to be on her feet again. They transfer down to the cancer ward promptly, and the miserable treatment begins. Alma has always been thin and petite but as the weeks go by, she is skeletal. She can’t stay on her feet for long, and she throws up constantly. She takes it all in stride, putting up a façade of strength for the girls when they visit. We all go visit Teddy the first couple of weeks; I push Alma’s wheelchair as the girls rush us, excited to see their baby brother. We can only see him from the other side of the window, but I lift both girls up into each up so they can coo at him.

“He’s so little and cute!” they exclaim. I agree, but tell them that in twenty years he’ll be bigger than both of them. They protest loudly, laughing and clambering over my shoulders. I pretend that I don’t see Alma wiping her tears away as she gazes at our son.

When the strength leaves her legs, she sits back into the wheelchair, where the girls are quick to leave my side and climb into her lap. They are gentler and more subdued in showing their love to her.

“Are you okay mama? Are you tired mama?” Alma gives them both kisses and waves off their concern, but we’re heading back to her room soon after.

A little while longer, Teddy comes home. I am wholly unprepared for the responsibility of taking care of a newborn baby and two toddlers by myself. I manage somehow, stumbling through the days filled with exhaustion from sleepless nights. I yearn for Alma more than ever.

She’s released later – Teddy is about five months when she comes back home. She isn’t herself yet, still weak and sick, but she can stand on her own two feet and she is sick and tired of the hospital. So they release her back to us, with a firm condition to stay on track with her chemo sessions.

Our little family has been put back together again, finally. Our house feels like home again. I don’t let Alma out of my sight – just as she doesn’t let Teddy out of hers. She holds him every moment she can, obsessing with him fanatically. She takes over feedings and diaper changes and she even goes to him on nights he can’t sleep, even after her chemo sessions. She makes up for their lost time completely.

When the cancer is finally announced as in remission, Alma cries once more. I hold her as she cries in relief in her doctor’s office and when we get home, she kisses our children happily, face still wet with tears. The girls are a bit older and protest but allow the affection nonetheless. Teddy babbles happily, smiling back at her reaches out for her hair.

That night, we celebrate by eating all our favorite junk food and having a movie night. The girls crowd their mother on the couch while Teddy and I lie at their feet. It feels like a whole weight has been lifted off our home.

We all stay up late that night. The girls don’t really understand what’s happened, but they understand their mother isn’t sick anymore and it fills them with delight. Their excitement is contagious and we ride the high of positive emotions till the children crash, hours into the night. Teddy is first to go, naturally. We put him to bed together in the nursery, cooing at his cute cheeks and fingers. Our daughters fight valiantly, but eventually they start to doze off too.

I carry them both to their room as Alma leads the way, stroking their curls gently. I unconsciously mirror her soft smile as I study her. It all seems so idyllic; it’s the perfect night to commemorate a perfect day. Basking in it almost feels like a stolen moment.

The activities and excitements of the day finally catch up to me as I get into bed myself. I pull Alma closer to me, my eyes closed and my mind drifting into the soft embrace of sleep. Alma pulls me back into the land of wakefulness when she lifts herself up, propping her head up with her arm and looking down at me.

Dreamily I admire her features. Her curls are thinner and shorter than what I’m used to but they still curl down into her eyes, framing her round face beautifully. I can’t help myself when I reach out to tug on one gently. My mind is finally processing what’s happening – our nightmare is finally over. My lips curl into a small smile.

Alma lets me play with her hair, but her countenance differs from mine strongly. "Marcus,” she begins, her brows furrowing and her lips arched into a downturn, “I need you to listen to me.”

She has my attention immediately. Alma hardly ever calls me by my real name; she has always preferred some sort of sickening pet name or inside joke. Even when we’re in disagreement, she addresses me as “Marc”. Everyone does.

She sees that I’m listening, and continues, “If the cancer ever comes back – no, listen to me.” My mouth clicks shut, stunned by the ferocity in her voice. “If it ever comes back, I’m not treating it. I’m never putting myself through this again.

“I know it’s selfish and I know you’re going to tell me we should discuss it or not to worry about things like that but this is something I have to tell you now. While everything we’ve been through is fresh in your mind.

“This has been,” she pauses her to gather her words, and a short laugh bubbles up from her lips. It’s a laugh full of pain and exhaustion, and the words that follow carry the same cadence, “the scariest thing I’ve ever gone through. All I wanted was to be by your side, with our wonderful children. All I wanted were days like today: warm happy days where I’m surrounded by the people I love the most. Not to be stuck in a hospital with toxins dripping into my veins, surrounded by strangers who don’t know they’re fighting a battle they’ve already lost.

“We all die eventually Marc,” she says to me softly. Sometime during her impassioned declaration I’ve started crying and she wipes the tears from my cheeks, leaning in to kiss me. “I’m okay with that. If it takes me, I want to be with you all. I want to spend all the time I have left by your side, by Teddy’s side. I want my girls to remember how beautiful I was, I want to be that role model for them when they go through that phase all girls do. I just – I just want to be my whole self when it’s time for us to say goodbye.”

Alma’s face goes blurry in my sight as I fail to hold my tears back. She pulls me closer to her, her frail arms holding me as tightly as I sob into her chest. I can’t process the words she’s telling me - how can I? She wants me to just accept that she’s not willing to fight? She wants me to watch as it consumes her entirely, watch as it tears her away from the people who love her most. And do nothing. I just can’t process it.

The conversation doesn’t come up again. We both tuck it into the back of our minds, and it becomes something like a looming shadow over us. The cancer is gone but it becomes my greatest fear. I have nightmares of her death, of aggressive and malicious tumors taking over every inch of her body. I dream of my children, motherless, staring up at me with accusing eyes.

“Why did you save her?” they ask me. “Why didn’t you fight?”

I wake up, shivers running down my spine and heart racing frantically. I reach out for Alma, gathering her up in my arms. I reassure myself over and over again. The cancer is gone. She’s fine. She’s safe.

And then it comes back.