While I was sitting out on the tailgate of her husband's truck, my sister in her smoking spot -- her walker pushed to the sidewalk and turned around so that she can sit on the little cushioned seat provided for this purpose, all while lighting up outside the limits of the property on which smoking is verboten -- I was momentarily dazzled by her sparkly ring finger. It was hard not to be, since it was a gorgeous sunny morning and since her ring finger, with its engagement and two wedding bands, is pretty loaded with diamonds.
I wish I'd taken a picture of her ring finger, actually, of her hands altogether. It's the little things like that that I know I'll want to remember. The big strokes I will never forget. It's the details that I'm already mourning, even now, as they start to slip.
Sitting there, her rings flashing in the sun, wreathed by her own smoke, my sister told me that she doesn't think she'll last until Christmas.
My sister is on no drugs at all right now for the cancer. During a recent visit to the ER for a seizure they thought might be a stroke, the doctors made the determination that the latest chemo cocktail was harming her more than helping. One of her white blood cell counts had dropped to the feared AIDS threshold, so off she came. As a result, the only thing my sister is taking now is the usual pile of HIV pills, Ativan for anxiety and pain meds for the headaches which, when they show up without warning, are excruciating. As of Friday, she's in hospice care which means, as far as I can make out, that the medical team have made the call that the time for curative care is over. It's palliative care now, keeping Carla comfortable. For as long as it takes. Until Christmas or beyond.
It's a mercy, I suppose. Off the chemo, Carla seems steadier than a month ago. But still, she talked about how scared she is, how easily depressed. The doctors don't have definitive answers about anything -- least of which about The Big Question: how much longer?
Can you imagine if that were you, sitting smoking just past the end of your driveway, knowing the end was coming in just a matter of time? Leave aside the cigarette if you need to, but for a moment, turn your walker around and stare that fact in the face. How would you feel?
We sat out there together while my sister smoked and talked, and I was struck by how normal our conversation felt. Except for the subject matter, we were just two sisters, hanging out in the street on a beautiful late winter morning, talking. It might actually have been the most -- the only? -- normal adult interaction we've ever had, unfettered by the old sibling baggage, unsullied by a lifetime of resentment and oneupmanship. I kept my eye on her flashing finger and on the fact that I have this time with her at all. No regrets (ok, small regrets) about the past and some nerves about the future, but relishing the sparkly moment in the sun. Together.
As it turns out, it could be a while. Although I had a freak-out last week about hospice, about what it might mean for my sister's mortality, hers is a slow-growing cancer. The doctors, who appear to be learning as they go, theorize that the cancer took three years to cause the hydrocephalus that landed my sister in the ICU three years ago. And she's been in treatment for the three years since then. All told that cancer is probably 6 years old. It's not like the end of chemo will mean a sudden burst in growth for the cancer. It may just keep creeping along, extending its nasty little tendrils deeper and deeper, wrapping tighter and tighter around her poor brain. It could be a while, and it could be awful.
Once she'd smoked her Malboro Light to the filter and soaked in enough of outside, my sister got herself up, rolled over and sealed her cigarette butt inside the ziplock bag they keep in the truckbed for that purpose. I opened the gate and stayed close as she made her way to the back door of their apartment where lunch and a nap were queued up next
All its sparkle aside, the square-cut diamond in Carla's engagement ring is long gone, sold a long time ago, she said. The two wedding bands -- I'd be remiss if I didn't point out that one is really a one-year band, something I just learned from Carla on Saturday (of course she knows these things and I do not) -- still have their diamonds. Their life together sure has not been an easy one for my sister and her husband. Diamonds have come, some diamonds have gone. But even so, the hands sparkle just the same.
I'll see Carla again this coming weekend when I take her to her neighborhood place, Pinkie's, for a mani-pedi. It seems like just the right kind of pampering girly fun -- a little outing, a little massage, a little color -- just the thing to make hands prettier, a more fitting vehicle for all those rings. When she's sitting out on her walker in the sun, I hope it'll be something that makes her look down at her own self and be glad, even just for a moment.
I'm hanging on to every interaction, driving, going, baking, texting, waiting -- trying to make the most of every opportunity that's offered, to give some comfort or only some change-of-pace entertainment, to be present, to be helpful. I'm keenly aware that I've only recently been allowed access, and so trying not to fuck it up, bringing the tall decaf peppermint mocha with extra whip and no sprinkles from Starbucks, even though I think it's stupid to spend $3.75 on a coffee drink. So what? Who cares about stupid? This is life and death, for reals. This is the end, coming slowly, but coming just the same.
So let it come and we'll be waiting on the sidewalk, nails pretty and rings flashing. We'll be ready.
Monday, April 29, 2013 at 10:38AM 
One week ago today, my youngest sister passed away after years of cancer and illness. She was a brilliant person who changed dramatically in the final years of her life, away from the person we knew into some other creature with a different family and a desire not to know us.
