“Tengo una puerta aquí,” I said, tapping the knob that pokes out of my body above my right breast.
“Ah, estas bien,” said the TSA agent at the San Juan airport, kindly overlooking the fact that I’d just told her I have a door in my chest. “Adelante.” And I whisked on through.
I’ve had a port implanted in my chest since June of last year. Both the point of access for chemotherapy drugs and the means of egress for my blood on its way to the lab, the port is a domed hemisphere about three centimeters in diameter, smaller than the tumor that impelled its arrival. The flat side lies against my ribcage, the dome juts out about a centimeter, protected by a thin layer of skin. The full name, port-a-cath, speaks to both this hard plastic lozenge and the piece of tubing that laces out of it and up over my clavicle, where it threads into the jugular vein and disappears.
The knob itself is covered with a thin layer of resilient silicone that can be punctured repeatedly without losing its structural integrity. When a nurse wants to access it, she (it’s always a she) swabs it with disinfectant, then takes a small IV needle attached to a syringe and with a 1-2-3-GO, stabs it through my skin and into the silicone case. When I was having chemo I was careful, as part of the pre-chemo prep, to coat the port site with a thick layer of lidocaine. The nurse said I should pretend I was frosting a cupcake when I did this; that I should use enough of the numbing agent that it remained visible. By the time I got to the hospital, the site was usually numb enough that I barely noticed the needle going in, beyond a moment of pressure and then gentle release. These days, I keep forgetting the lidocaine, and it hurts when the needle goes in. But it only lasts a moment, not painful enough for me to remember to frost the cupcake the next time around.
I wrapped up chemo in October, and people are confused sometimes when they see that I still have the port in, months later. “Aren’t you done?” they’ll ask. “I thought you were done.” And that’s the rub: I am done, but yet am not, exactly, done. I’m still going to the hospital every three weeks for infusions of the monoclonal antibodies trastuzumab (brand-name Herceptin) and pertuzumab (Perjeta). These two are holdovers from the original four-drug chemo cocktail, but have far fewer hangover effects. I’ll be done with these targeted therapies in June, at which point, they tell me, the port will be removed, in an outpatient procedure I hope to be as mild as the one by which it was installed.
Until then, though, I have a door in my chest – and I don’t mind it so much. Here’s what it looks like:
I often find myself mindlessly tapping it, or working it between my thumb and forefinger like a worry stone. And in situations like airport security, it actually can be a door of sorts, through which the TSA agent may glimpse my secret identity as a sick person, veiled as it is now by my fast-growing hair and (I’m told) glow of health. On the way down to San Juan a few weeks ago, the agent at O’Hare saw the lump before I could say anything and kindly asked me if I was tender anywhere, before sending me away with the gentlest of pat-downs and a knowing look.
Like the death of a parent or the birth of a child, getting diagnosed with cancer is often said to open a door to a new realm of previously invisible knowledge, to Sontag’s kingdom of the sick. But to call it a portal between two distinct realms – the healthy and the ill, the “nightside of life” – is a misnomer, because we all know, don’t we, that that threshold is unstable, fluid, oblivious to our desire for binary clarity.
In addition to the tri-weekly infusions, I’m also getting prophylactically treated for lymphedema, and to address the ongoing stiffness, swelling, and cording around the surgical site on my left side. The occupational therapists’ suite is a liminal space – a darkened room between sickness and health in which I lie on a table while the OT ever-so-gently massages my armpit and my scars, her fingers brushing my skin, delicately working the fascia and tendons with the lightest of touches. The embodied experience of this treatment – its laying on of hands-ness – is not far removed from that of receiving acupuncture and reiki. It is the closest I have felt to pure healing within the context of the medical establishment – in this case a boring professional building across the street from the main hospital and adjacent cancer center.
In the twilight of the lymphedema room I float between sickness and health. I can drive myself there, I can afford to pay the $4 to park in the garage, I have the latitude to still, nine months later, leave work early to tend to my healing body, no longer in acute crisis. I am feeling good, and yet here the therapist listens seriously to my lingering concerns: the cording that pulls, the swelling that disfigures. I mention that I went on vacation and that while it was wonderfully restorative I am still perpetually exhausted and I don’t understand why. It’s not that surprising, she says, and reminds me that the fatigue of radiation usually peaks four to six weeks after the end of treatment – another invisible country.
Lying on that table, a kind, no-nonsense woman gently soothing my unhappy scars, I understand all over again that being a cancer patient means learning to straddle these two worlds. I have to get better at shifting my weight, one foot to the other, between the bright sun of health and the dusky shadows of illness, and learn to linger in a liminal state like that fostered by airport security or my loose command of Spanish, neither here nor there, speaking neither quite one language or the other.
Thanks for writing and sharing your experience. I’ve been working with people with ports for a while now and they really fascinate me. Practical, yet invasive, they are always there and remind me of that when I forget and accidentally touch one. I’m glad you’re on the other side of the regular use of yours. It’s amazing what we can get used to.