1

There’s occult blood in the sample.
I talk it down, I tell the proctologist
it might be hemorrhoidal. He gives
me a second test kit. Six weeks later
there’s occult blood in the sample.

2

The tech’s a skittish twenty-year-old
who can’t find a vein for the anesthetic.
He keeps sticking me till I yelp. A nurse
takes over and instructs him: thin veins,
thin gauge needles.
When I come to,
she tells me the colonoscope was blocked
by a constriction at forty centimeters.
Polyps were taken for biopsy.

3

My doctor calls. She says it’s not
good news. There is a moment
when the floor gives way
taking my stomach with it. But I ask
in a normal voice, what happens now?

You always knew your world would end
forever, but not how, not when; you thought
your heart would fail, like your father’s,
who died in his sleep. There was comfort
in that: a soft lapse into painless dark, no time
to think or pay back or regret. But this
is a minefield of exploding hopes and guesses.

4

I climb onto the platform bed. The team
of two covers me with a blanket, asks me
to unbuckle my belt, unzip my pants
and push them down to my knees. (The CT
is allergic to metal.) I hold out my arm,
watch the hypodermic needle ease
iodine contrast dye into a vein, feel
a slow fever swarm through my body.

The machine sucks me into a giant,
enameled donut. Electronic whirrs
and clicks work with due diligence
then I’m regurgitated out.

5

They said they would read the scan and call me
tomorrow. It’s already tomorrow. All morning
I sit on the porch in the sun. The hedge
has opened its thick, shiny leaves
and the Russian elm has new shoots, heavy
with seeds, ready to launch in the wind.

I try not to get lost decoding
a collection of googled info-bytes
blurred with medical Latin,
as if they could tell me
how many days I have left.

But how bad could it be? I feel fine.
They can probably catch it before . . .

It could be everywhere by now.
You shouldn’t have taken so damn long
to send in that first sample;
you shouldn’t have downplayed the blood.

6

I’m reading the CT report.
There, in the last paragraph,
the dreaded word, the death sentence:
Metastasis, to the peritoneum.

Mortality is no surprise, but you
have stashed it in some future far away.
Now it’s come home, and it’s changed
the entire world into death row.

7

The surgeon is short and stocky, middle-aged
wearing a plaid shirt and jeans.
He has an upbeat smile and quick fingers
on the computer keyboard. He’s examining
the CT image, says what he sees
doesn’t match the written report.
The mesenteric lesion may not be metastasis.
He decides to wait for better data. His main
concern is blockage. He asks if I ever feel
bloated and if I have regular evacuations. I tell
him half-truths, no, and yes. He’ll order a
fast-track PET to scan for abnormal cell growth.

8

A letter arrives from Health Services.
They’ll do the PET in six weeks.
Six weeks! It feels like six years.
My wife, Annette, tracks down a private clinic.
They can do it in a week for a thousand dollars.
We discuss this, then book a flight.
The weather is great, and the restaurants
and the parks. We almost forget why we’re here.

9

When we get back we call
for an appointment, but the surgeon
won’t be available for three weeks.

Have we wasted our money?
The best we can do, now,
is get our family doctor to read the PET.
We call her. She’s on vacation.

10

Uncertainty has become a physical
tension, with brief adrenaline rushes, spurred
by the pressure of unfinished tasks,
deadlines, promises, loose ends.
Otherwise, life goes on, wastefully
indolent, as though there’s nothing
much going on. I mow the lawn, play
iPhone word games, watch TV
sports, and breaking news from the war.

Time’s running out, fool.
Get off your ass, do something.
Why? it’s too late now.
Nothing I can do will change
the life I’ve already lived.

11

I can’t sleep. It’s not death that looms
like an axe at the edge of panic, it’s dying:
the body wracked with chills and fever,
in excruciating pain, deaf, half blind,
and shrinking relentlessly, helplessly
toward what has always been there.

And what is that, exactly?

If I no longer exist, I can’t be
dead. But what if consciousness survives?

It would have to go on without the body, without
sight, sound, taste, touch, smell.
There would be no sensory “world”
in which to feel or think, pure awareness
of nothing in the endless dark.
What about memory? It’s not stored
in consciousness, it’s in the hippocampus,
in the brain cells and they’ve gone off with the body.
Give it up. You’ll know soon enough. Or not.

12
My belly’s bloated, tight as a basketball.
I can’t eat, feel seasick. There are cramps,
and a pressure drives shards of pain like
shattered glass through my insides.
This goes on all day, gets worse.
I tell myself it’s a bad case of indigestion,
but I know what we feared most has happened.
My colon’s blocked.
Annette’s on the phone.
She locates the hospital
where our surgeon’s on call.
When we arrive at Emergency, they won’t
let her in. I hunker down for an hour, waiting
till the triage nurse asks why I’m here. She checks
me in and I rock myself on a hard plastic chair,
doubled over with small grenades going off inside me.
Minutes stretch into hours as the pain climbs
from eight to ten, no sleep all night, and I’m walked
to a cloth room like a cell with a chair and a bed.
A health worker throws me a hospital gown
and disappears. I change and shiver,
naked under thin cotton, waiting, waiting,
for an orderly who wheels me down to CT.

13
I wake to a flood of sunlight. Mine
is the only bed in the large room.

Nothing happens. It feels
like time has stopped, trapped
by the IV’s drip, drip,
and the night-long pain is gone.

14
Out of the darkness beyond the door
a woman, a man. It’s my wife, my son.
They are cheerful. They are trying hard
to be cheerful. The surgeon’s told them
I’ll be all right, but I’ll have to wear
a temporary colostomy bag. As I take this in,
I remember a friend of Annette’s. Yvonne,
thirty years ago. She hauled hers on a hiking trail
all the way from the Basque Coast to Bilbao Bay.

15

A young woman, hardly more than a girl
comes to my bed. She’s smiling. She says
her name is Shelley and she needs my permission.
I nod. She lifts the hospital gown, frowns
and ponders my distended middle. She
is thinking. Can’t make up her mind. “I’d like
some help with this, can I bring in a friend?”

Her name is Ashley. They could be sisters.
Or priestesses from the temple of health.
They whisper. They poke and prod.
They ask, “Are you able to stand?”
I am. And I do, gingerly. More whispers.
They’ve made a decision. They ease me back
on the edge of the bed, uncap two Bic pens
and draw a cross on either side of my navel.

16

I’m on a gurney, in a hallway, waiting.
To my right, a backlit screen displays the day’s
schedule. Dr. Hochman is in surgery
for the next half hour. I while away the time
thinking of everything I won’t want to do attached
to a bag of shit. When Hochman arrives, he’s
friendly but serious. “I’ve seen the PET
and CT scans. It looks like your bag won’t be
temporary. At your age, your body won’t tolerate
being opened again when the colon’s healed.”
An orderly explains that operation has a mortality
rate of fifteen percent then hands me a clipboard.
I scribble my name on the release.
As they wheel me into the OR’s white blaze
I’m thinking of the eighty-five percent
chance that I’ll spend the rest of my life dying slowly.

17
I’m sitting up. There’s a woman, standing
next to me. She’s talking. “You’re awake.
Do you know where you are?” I turn to see
where I am and that half of the room
is a cascade of black lines and broken images
like an old TV with staticky reception.
When I turn back, she’s still there. I try
to tell her what I’ve seen. She smiles.
“No worries, it’s the anesthetic wearing off.”

I slide my hand down to see which side
the colostomy bag is on, but it’s not there.

18

I’m back in a plasticized-cloth cell.
One of the shower-curtain walls opens.
It’s Annette, and Evan. They’ve been waiting
all afternoon. They’re excited. Dr. H
has told them he took out the entire colon,
removed a lesion from the small intestine
then hooked it all up. My GI tract
will be almost normal in six months.

I have questions. Almost? How almost?
And what does that mean? I blink
and stare, but don’t say a word.

19

The night nurse asks “How would you like to go
for a walk?” I don’t understand. I’m connected
to an IV tree with sagging plastic bags
that hang like transparent papaya: She sees
that I’m confused and explains. “The sooner you
get out of bed, the sooner you get to go home.”

She helps me up. When I stand, I’m light
headed. My knees feel like they’re going to melt.
One step, then another, without lifting my feet
from the floor. We walk the wheeled IV
across to the other wall of the hallway, and back.

20

There are two of them.
They take off my hospital gown
to inspect the incision. It’s the first time
I’ve seen the long white tape spotted with blood.
They peel it down, uncovering a column
of glittering staples that stand astride
the seam from sternum to pubes
where a scalpel has sliced down through my navel.

OMG. It looks like a sword wound
from the thirteenth century! Hard to believe,
but there’s almost no pain. Maybe the excruciating
death I fear can be softened with opiate snow.

21

I’m shouting at the nurse. “I can’t breathe!”
There’s a hiccup, stuck halfway, in my windpipe.
She leaves to find a doctor from the surgery team.
When he arrives, he can see I’m at the edge
of panic and he looks worried. He palpates
my abdomen. He nods. “I know what’s happening
here. Your GI tract has been traumatized
and it’s frozen like a deer in the headlights.
Your stomach won’t release all that water you drank
to stay hydrated and it’s jamming your diaphragm.”
He pauses, then adds, “We’ll have to insert a tube
through your nose to drain it.”

22

Five times a day they unhook the tube in my nose
from the stomach pump so I can take my walk
steering the IV-tree down the long hallway
past the nurses’ station to the storage space
with its picture-window view of the river.

Five times a day a nurse comes by and asks,
“Have you passed gas?” For six days the answer is no.

23

My stomach still doesn’t work.
I’ve lived on ice chips and sips of broth
for a week. Sugar water from the IV is not enough
to keep my body from eating itself so they’re
going to feed me by inserting
a peripherally inserted central catheter
through a vein in my arm to my heart’s vena cava.

A middle-aged woman and a very young man
wheel in an ultrasound and its bag of tools.
She explains the procedure and the risks,
infection, pulmonary or coronary thrombosis,
arrhythmic heartbeat, tachycardia.
He reassures me, nervously.
We watch the screen as she pierces a vein and
slides in the tube. It worms its way upward.
Then it stops. They stare in shocked surprise.
This is not supposed to happen.
He looks at me as if I know what to do.
She avoids eye contact,
concentrates, draws out the tube and inserts
a new one. This time it gets where it’s going.
I have a plastic pipe in my heart
and a bloody bruise on my arm that
will last for weeks.

24

I’ve finally been to the bathroom, fluently,
releasing a deluge interspersed with bursts
of methane. Every two hours, twenty-four seven.
The surgical residents are celebrating.
The nurse brings in a stack of Huggies.

Is this is what they mean when they say
old people become children again:
Living the rest of your life in diapers?

25

Wild dreams break up my sleep, then I sleep
too deeply. When the orderly shakes me
awake I’m half off the bed and the tube has been
ripped from my nose. He doesn’t reinsert it.
A nurse comes in, reads my chart and smiles.
“Today we’ll take you off the IV.”

26

Breakfast on the soft diet. Oatmeal
with brown sugar, an omelet, a dwarf pancake
with syrup, a carton of ice-cold milk, a sausage
patty and fried chunks of potato. Three
meals a day. Baby burger or roast beef
with green beans for lunch; Mediterranean
haddock, succotash, veal stew, scallopini
with penne or meatloaf and rice for supper.
Also, nausea, acid indigestion, and punctual
every-two-hour junkets to the head.

27

A and E are taking me for a ride
outside. The first fresh air I’ve had in weeks
is brisk and bright with sun. A breeze comes up
and I can smell the river. The concrete sidewalks
are cracked and jar the wheelchair; at times
the grade is steep and I have to hold on.
I remember myself as a boy, with one leg
in that red wagon, the other pushing hard, faster
and faster, flying and bouncing down the street.
On the way back to the hospital,
Evan points out a falcon, high on the evergreen.
Shade of the park across the water.

28

An assistant physiotherapist stops by
to assess my mobility. He accompanies me
on my walk down the hall. He has a suggestion:
Slow down or you’ll knock someone silly.

Tomorrow, they’ll give me one last test
before they let me go home. I’ll have to climb
and descend four stairs on my own.

29

When I wake up there’s a burning sensation
in my left ankle. As it touches the floor
a knife-edged cramp shoots to my knee.
It’s an attack of the gout.
I can’t walk, can barely limp to the head.

30

Five days of naproxen and the disease of kings
has finally eased off about halfway. I can make it
to the nurse’s station and back using a walker.
But my ankle is still too weak to climb four stairs.

31

It’s pathetic, really. Four stairs,
when the stairway to my bedroom has twelve.
But did it, and I have been released.
I shed the hospital
gown, pull on an adult Huggie,
get dressed and begin
civilian life without a colon.

32

Convalescence. I get out of bed and feel
faint. The home-care monitor shows
BP too low, pulse too high.
Irregular heartbeat. Nausea. Shortness of breath.
I’m referred to urgent care for an EKG.

33

I’m lying on my back. The tech
is attaching electrodes to my chest.
Two minutes later we’re done.
I can’t believe that’s enough time
to detect arrhythmic tachycardia
which may result in ventricular
fibrillation and cardiac arrest.
So where am I now, rescued
from cancer and quickly delivered
to the death I thought would surprise me?

34

I’m up to three walks a day
from the front door to the back door,
but I still have to climb one step at a time.

I find the cane I bought years ago
when I had three cervical vertebrae replaced
with rods and screws. It helps me ascend
and descend like a third leg or a chrome angel.

35

A week later, BP’s up, heart rate is down.
I can walk to the small park above the river.

I’m happier now with things as they are—tasks
and errands I used to delay for days, for weeks;
staid routines and mindless repetitions. Even
my toothbrush has become a subject of interest.

I know it won’t be long before something
somewhere in my body starts
to take me apart, slowly, painfully, as I dwindle
for months, for years, wishing
time had run out on the table
or all at once in my sleep, but the present
moment seems inexhaustible, as though
I have climbed up, onto the surface of time
which doesn’t flow by, but takes me
wherever it’s going.