Homeostasis

Homeostasis

Homeostasis—the tendency of interdependent elements to form a relatively stable equilibrium

***

Summer mornings and evenings, in the back meadow, this was where my sister’s husband could be found. An ardent communitarian, for two decades he’d tended the public land that extended from the back of their property to the bike trails that were once railroad tracks. But the year of Jim’s cancer diagnosis he could not mow or trim, weed or pull, plant or water. And this grieved him.

I remember how Jim's story began. One moment, so blessedly normal—the next, a whisper, a shift, and suddenly all reference points were speeding away.

On the late afternoon of July 5, 2008, the phone rang. It was for Sara's husband. She walked the cordless up the stairs, then returned to where we’d been starting to cook dinner. “That was weird,” my sister said innocently enough, “Jim was meditating, but he seemed so disoriented.”

A neighbor knocked on the back door. He needed Jim. He needed help moving a three-story ladder. Now Jim got up from the place of his meditation, and his gait was off. Oh, he helped the neighbor with the unwieldy scaffolding, but upon his return to the kitchen he could not walk straight. Something was clearly wrong.

In retrospect, we know that that something was likely a grand mal seizure during a Sunday meditation turned nap. It was the first sign that rogue cells were on the loose, setting up home base in Jim’s right parietal lobe.

At the time, seeing Jim so unsteady, I did not wait for my sister’s instructions—rather, pulled my station wagon into their driveway, and off we went, to the very hospital where Jim worked as a doctor.

***

In the 1800’s, Rhamnus Cathartica was brought from Europe to Minnesota. Also known as common buckthorn, the plant was used as a fencing material. It grew rapidly. When trimmed into hedges, buckthorn demarcated lot lines and kept animals confined. However, eventually the problem with this shrub was realized: it out-competes native plants, leafing early, dropping leaves late, stealing moisture and nutrients, and eventually light. It is a selfish plant. At some point during the 1930’s Minnesota nurseries stopped selling buckthorn. But to this day, eighty years after realizing Rhamnus Cathartica's invasive nature, the Department of Natural Resources runs buckthorn eradication programs.

***

Jim was raised in a family of seven, four boy children and one girl child, Jim’s father, an entrepreneur, his mother a nurse. John Victor, the father, had many ventures—they shifted depending upon opportunity: December wreath-making and selling morphed into burrow-rides at the August State Fair. No matter what, though, John Victor’s sons were always part of the family busyness.

A landscaping business grew. Jim, the youngest of the first three boys, planted trees in clumps, usually three saplings in one hole (so that, to this very day, it is easy to spot Young Jimmy’s fingerprints on the land). Eager to be helpful, he mixed herbicides, hauling garden hose to white powder. Papa John Victor bought government surplus, often surplus destined to be banned, 2,4’DDT, strychnine, Agent Orange. His little boy filled and stirred fifty-gallon drums until the contents, fine, dusty particles, spashed with water, then turned into a thin milky mixture. Afterwards, Jimmy washed his hands and ate the bologna sandwich his mother had packed, noting the odd taste and the powdery residue still on his fingers.

***

To create a language of cancer, prefixes are added to the root-word, plasia.

Plasia—the normal physiological formation of cells

Anaplasia—cells formed backward—essentially de-differentiated, losing specialized characteristics

Hyperplasia—“normal” cells overgrown, as in too many

In tumor pathophysiology, this is what transpires: There is this moment no one sees; the moment happens in secret, reasons for its occurrence guessed at later; mathematical equations are calculated, narratives applied. One cell goes anaplastic, then becomes two, four, eight then sixteen, thirty-two then sixty-four. Anaplastic cells, now grouped, call for support. Tiny blood vessels become hyperplastic, over-develop, branch and weave; this blood vessel highway speeds nutrients and oxygen to cells gone mad. The death of healthy tissue, necrosis, happens when normal cells are crowded out, starved, and ignored.

Under the microscope, tumors resemble a hub, swirled and blanched, surrounded by dark and unevenly distributed dots; they look askew, cockeyed, out-of-balance, like drawings made by two-year olds—impulsive, illogical, raw, curious, and frighteningly beautiful.

***

Jim was diagnosed with glioblastoma multiforme stage IV (GBM), a malignant brain tumor. Prior to this he had had no feeling of foreboding, no body-full-of signs and symptoms. So how could this be? Jim, vital Jim, with cancer?

Jim’s doctors, friends and colleagues, had the pained task of telling him. GBM is the same tumor that took Ted Kennedy, Carl Sagan, Gene Siskal, and George Gershwin. After surgical resection, radiation, and chemo, give or take, for most GBM patients the disease grants an eighteen-month lead-time to death.

***

Two weeks after Jim’s diagnosis, a small group of friends and relatives gathered and celebrated his fifty-fifth birthday. He had had surgery, but had not yet begun the next step, radiation. My brother-in-law was tired, but seemingly in good cheer. In fact, if you’d been at Jim’s party, except for his half-shaved head, you might not have guessed at the story unfolding. There was the inevitable staple of all Sara and Jim's parties, good food and wine, and on this day, cake, too, with candles. There were decorations, balloons and streamers and flowers, funny cards and tearjerker cards, and special gifts. There was singing, and of course, stories—stories, always stories with Jim—these things comprised my brother-in-law’s birthday celebration.

After the exceptional meal, we pulled Jim through his backyard, down the hill, and into the meadow. For this dear man a community of friends and family had come together so that during his enforced absence from the meadow the lawn had been mowed. Weeds around Jim’s St. Francis statue were pulled. Freshly sown flowers, annuals and perennials, were recently watered. And a ginkgo tree, with ancestry dating back to the age of dinosaurs, its fan-shaped leaves fluttering in the wind, was about to be planted.

***

Twenty months post-cancer diagnosis, Jim is doing well; he has no new tumor growth. He works in his meadow, and this spring, which has come unusually early, he has been especially focused on one project. I point to Jim’s forearms, the long and deep scratches, some scabbed over, some fresh, angry and red.

Jim shakes his head, and utters the hex I’ve heard him exclaim before, “That darned buckthorn. I call it Satan’s Spawn.”

Briefly I feel him step back into himself, “I’ve told you that before, haven’t I?”

I look out the window, in the direction of Jim’s labors, and am disappointed to see it is already dark outside. “I’m going to come back in daylight to see what you are doing back there.”

“The neighbors can’t believe it,” Jim adds. “With all the buckthorn gone, how the meadow has opened up.”

I offer to bring native plants, to hold space made by the disappeared invader. But Jim replies, “I think the trees, the trees already there—the elms—are going to do a fine job filling in.”

He pauses, quiet now, his head tips down, yet he continues to look me in the eye. “You know, the back meadow is my battlefield.” Jim smiles, “And if you want to come over and pop out some of Satan’s wee roots, well, that would be just dandy.”

“Next time, Jim. I’ll be back." We hug, and I recall, as I do every time, how melancholy goodbyes can be.

"I’ll see you soon.”

Elizabeth Brenner