The Origins of a Disease

I.

Nothing pleased Delores more than to sit with her father and listen to baseball games on the radio.  And this afternoon was no different: her pop was due back from the plant at one; the game started at one thirty.
When he walked in, Delores hid.  She crammed herself into a broom closet and could barely ocntain herself as her father pounded around the apartment, his baritone deep, severe:
“Fe, fi, fo, fum.  I smell the blood of an Englishman!”
She squealed when he finally found her, his eyes bright and lively and full of mischief.  He lifted her into his arms.
“I need help setting up chairs for the game.  Can I depend on you?”
She nodded, and as he carried her into the dining room, Delores watched the smoke from his cigarette crawl up his face.
By the eighth inning, her father was leaning forward in his chair, listening closely, the game now a matter of life or death.  And so it was for Delores, too.  She leaned forward and tried to decipher the words her father was so intent upon hearing.  When a commercial came on, he sat back in his chair, lit another cigarette, and blew a cloud into the room.
“Well, we got out of that jam.”
“We sure did,” Delores echoed.
Her mother entered, decked out in white from head to toe.  She worked the second shift as a nurse.
“Look at you two.”  She pulled up a chair.  “Mind if I join you?”
In fact, Delores did mind.  The game was private.  Just her and her pop.
Her mother noticed her reluctance.  “Don’t worry, I’ll be leaving soon.”  She smiled and motioned to her husband for a cigarette.  She lit up.
When the game came back on, Delores watched her mother lean back, relax, cross her legs.

II.

It was crazy, the things her friends did to keep off the weight.  It wasn’t only crazy, it was dangerous.  Delores again focused on the conversation.
“I tried the three-a-week fruit diet,” Jean said.  “I ate only fruit on Mondays, Wednesdays, and Fridays.”
“What’d you eat the other days?”  Rose asked.
“Nothing,” Jean laughed.  “Was I supposed to?”
Delores smiled but inwardly shook her head.  Her two best friends in nursing school were killing themselves with these crash diets.  Didn’t they know what malnutrition could do to their systems?  And they were training to be nurses, of all things.  That’s why Delores followed in her mother’s footsteps in terms of profession: the health of others was important to her.  It just seemed to make sense.
“And what about you, Miss skin-and-bones?  What’s your secret?”  Jean looked Delores up and down.
“I’ve never seen her eat anything but a salad,” Rose added.
“That’s just it.  I eat right.  I exercise when I can.  Girls, those are the keys to good health.”
Jean rolled her eyes.  “Not another lecture.”
No, not another lecture.  That was all.  That was all.  And maybe she wasn’t one to talk.  Her metabolism was excellent.  She rarely gained weight.  The one time she had put on some pounds was when she quit smoking.  For three months, she didn’t pick up a cigarette.  But one morning she examined herself in the mirror: a blossoming double chin.  Thighs beginning to swell.  Even her fingers were getting fat.  She bought a carton of cigarettes the next day and never looked back.

III.

Though the snow fell wet, the size of half-dollars, Delores was relegated to the balcony if she wanted to light up.  One of her daughter’s house rules, even on New Year’s Eve.  So Delores closed the sliding door on the party and stepped into a frosty evening made gentle by the flakes coiling down.
The cigarette warmed her.  She thought about how blessed her life was and thanked her stars.  Her daughter was engaged to a pleasant man, one who showed genuine interest in the people around him.  The hospital had just appointed her to a senior position on the nursing staff, and, more than the promotion and wage increase, she took pride in being recognized for all her years of hard work, all the people she had cared for.  The ones whose pain she could manage and eventually send on their way.  The ones who would never leave the hospital alive: for them, she opened her heart a bit more and tried to fill their sickrooms with cheer.
Shivering, one arm pressed across her chest, Delores inhaled the last of her cigarette.  On hte street, she watched a man walking his dog, the only other soul braving the weather.  The animal darted this way and that, confused by the snow.  When it finally found a suitable patch of land, it stopped.  So did the man.  He blew into his bare fist and looked around, looked up; Delores acknowledged him with a subtle wave.  He took a deep bow, tipping the party hat that was banded to his head.  Then the animal again strained at the leash, and the man obeyed, being pulled into the night.

IV.

     While the M1s streamed eagerly into the anatomy lab, snapping on their rubber gloves, Delores hesitated at the entrance.  She always did.  She glanced at the list posted on a bulletin board describing the cause of death of each cadaver, and again her eyes rested on the same one: Body ID, 52683. Cause of Death, Carcinoma of Lungs.  Age, 57. Table 14.
Knowing Delores’ altruistic tendencies, a doctor and friend had once suggested that she donate her body to a medical school after her death.  “Think of the knowledge you’ll provide those budding doctors,” he said.  Delores had taken his advice seriously.  Over the years, she had seen patients waste away, their eyes blackened from pain and exhaustion.  So many of these people dying from cancer.  And then the families trudging back in, broken, folding their sick ones back into their lives in memory only.  If she could somehow be a link in the chain that would one day prevent this joyless ceremony, she would – without hesitation.
Delores made her way into the lab and stopped, as always, at Table 14.  Today’s dissection was the thorax – specifically, as written on the whiteboard, the trachea, bronchi, and lungs.  She watched herself on the steel table under the gaze of several students, most of them hesitant, but one confident – the leader of the group, a girl.  Earlier in the semester, she had followed along as this girl pulled the skin off Delores’ back and down her arms.  She had seen the care the girl had taken when separating and studying the muscles of her thigh.  And now the girl would be exposing the source of her demise.
A harsh word, cancer.  A monster of a word.  And the pain she experienced in those last few weeks was more than monstrous.  She couldn’t wait to see the fiend exposed.
The girl removed one of Delores’ lungs from her chest cavity and carried it over to a deep sink.  Delores watched as she held the organ under a stream of water, washing away the dried blood and chemical preservatives.  And then the girl did a curious thing:  she gently flipped the lung over, and turned it again, as though she were considering the light reflecting off of the scales of a fish.  Delores leaned in.  Together, they ran their fingers over the cancer: a collection of nodes, nothing more.  This was cancer?  It seemed so….insubstantial.  Almost organic.  The girl returned the lung to its proper home and jotted down a few notes.  And Delores remained, studying herself with the others.

Paul Bergstraesser

English PhD Candidate
Department of Medical Education Writer in Residence