I heard from Ryan again late that winter. Ryan and Jan were
visiting Scottsdale, Arizona. “Howdy,” he said. “I had some tooth
pain, so I stopped in to see a dentist here. He says that one of my
lymph nodes is enlarged.”
“Oh, Lord,” I said, trying to control my emotions, trying to
keep an even keel. I knew by the tone of his voice what he was
getting at. I had worked with too many patients in hospital cancer
wards, and their common denominator was cigarettes and alcohol.
“Now don’t get too far out into your future until you get it checked
out first, okay?” I advised.
“Yeah, I know. I’ll have a biopsy done when I get back to North
Carolina. There’s a doctor in Asheville who I see,” he replied.
“Okay,” I said, with an uneasy feeling. “Let me know what
Before too long, bad news came over the phone. “Tongue
cancer,” Ryan said.
I felt numb as he shared with me the prognosis from his
physicians. I gave him support, saying, “We’ll fight this together.”
But the words fell short and sounded hollow. I already knew the
usual prognosis. All those years of drinking and smoking had at last
exacted their toll upon him, in a tragic and ugly form. Finally, he
ended the phone conversation saying, “Well, I’m telling ya, if the
tongue goes, I go.”
Like finding a four-leaf clover on a New York freeway, he could
not have been any luckier. They would not have to cut out his
tongue. Chemo and radiation were options for his grade of tumor,
but it would be a long and arduous slog to the end. We agreed that
I should keep working and not visit much because there would
probably be extra expenses that the insurance did not cover. I
picked up some extra hours of work to help with Ryan’s medical
expenses. Erika maintained her position of not forwarding any
monies in order to protect the legal status of the trust that was the
bedrock of Ryan’s corporations. So it began that Ryan started his
therapy of chemo and radiation with its associated pain and side
effects. The tongue, a delicate and sensitive organ that is so often
taken for granted, now became his central focus. He withdrew
into a protective boundary, keeping the rest of the world at bay as
is to be expected in a life-and-death struggle. I kept our calls to
a minimum, allowing him some space and privacy while only
visiting him once during this ordeal.
While staying in Asheville, North Carolina, we went together to
the cancer treatment clinic. I watched as he sat in an overstuffed chair
and received his intravenous medication, watching it flow into his
veins. I reflected on the many times that I had mixed such solutions
under the hood. Now it was personal, closer to home. He introduced
me to his oncologist, a woman in her late thirties who was well credentialed
and equally well-spoken. I do not know what role
Erika might have played in her selection if any. I wanted to call the
doctor into a back room for a discussion, explaining to her who
Ryan really was and letting her know why it was so important that
he received the best care. I quickly dropped this idea, knowing that
Ryan would be furious if he ever found out. He was not the type to
garner special favors for himself. Rather, he merely sat in the room
among the other patients taking his turn. Besides, how does one
explain Ryan to someone else without looking exceedingly strange
or delusional at best? In the end, I imagine that Ryan’s oncologist
simply knew him as one of her many patients, nothing more and
nothing less.

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