The title of today’s installment of Julie’s Story comes from Julie’s rueful observation made a couple of weeks after our wedding while she was recovering from her mastectomy at Michael Reese Medical Center.1
After starting and scrapping a dozen drafts of this installment of Julie’s Story, I have decided to forgo, at least for now, the notion of continuing a narrative about the life Julie and I shared during the period after our marriage and her diagnosis of breast cancer. Instead, I plan to post, on a sporadic schedule, vignettes drawn from the period beginning with our marriage and ending with Julie’s death, in the conviction that this will provide a more accurate sense of who we were and what happened to us than would a biographically organized chronicle.
Today’s post contains background information, primarily about Julie’s disease and our response to it, to provide a context for those individual vignettes.
The Disease
A prime element in our lives was Julie’s pathology, specifically her prognosis. After Julie’s diagnosis of breast cancer and her initial mastectomy, we talked at length to the surgeon and a consultant as well as doing our own research. All the information we received was congruent, and the arithmetic was grim:
- 50% survival rate at six months
- 20% survival rate at 12 months
- 5% survival rate at 18 months
As it turned out, her cancer was significantly less aggressive and more manageable than the histology and staging predicted. Over the ensuing years, the disease waxed and waned. At some points, her symptomatology simply disappeared for months and even years at a time, only to exacerbate, bringing on another set of physical problems and triggering another round of treatment.
The Treatment
Julie underwent multiple operations, chemotherapies, and bouts of radiation treatment and experienced the treatment side-effects that were expected (e.g., nausea, vomiting, hair loss, weight fluctuations) and some that were in the “rarely occur” portion of the adverse effects listings (e.g., kidney failure). When the cancer was inactive, she faithfully followed a schedule of testing, scans, and sessions with her oncologist to monitor the illness. Julie’s Story, however, is not a medical textbook and few of the specifics of the surgeries or medicines, for example, will be discussed.
The Patient
And, we also dealt with the hassles of the healthcare system although it is clear that our difficulties were only a fraction of what others endured because we had the advantages of adequate insurance, some money of our own, and my own involvement in the healthcare business. A surprisingly large number of problems in the healthcare arena were resolved – or dissolved – by executing tactics based on the simple strategy I’ve summarized as “I’m a doctor and I’m willing to be a jerk about this.” And, yes, I’m a little embarrassed about that now, but not embarrassed enough to regret using it to good advantage.
While Julie and I casually despised the implicit (and sometimes explicit) admonitions to be a brave little soldier, she was brave – sometimes to the point of nonchalance – in dealing with her cancer. Many years after her initial diagnosis, I read, in a feature story about Christopher Reeves after he was paralyzed, a psychologist’s notion that chronic physical impairments can be devastating, yet individuals, such as Mr. Reeves, who were fundamentally happy before such impairments are most often fundamentally happy individuals afterwards as well. That was certainly the case with Julie. She didn’t pretend the cancer and the treatments were trivial and she had more than her share of suffering, but for an extraordinarily large proportion of the time she was routinely, unambiguously happy.
I once wrote that Julie spent many years of her life either dodging bullets or biting on one. While that is passably clever and absolutely true, it is incomplete. I should have added that she did it so gracefully that the rest of us almost never noticed.
The cliché is that the diagnosis of a terminal illness changes ones perspective, causing one to appreciate life and live each day as though it’s the last. And, I suppose that was true for Julie and for me as well, but there was no dramatic epiphany; the disease, the treatments, the prognosis, and the rest were just more stuff we managed. In retrospect, I’m proud enough of the efforts I made to take care of Julie, and I’m profoundly proud of her courage in the face of her disease, but at the time, neither of us felt heroic or brave or self-reliant or steadfast; we didn’t even see ourselves making difficult choices. The gift we had was seeing clearly the path that we should follow. Then, it was just a matter of trudging on, day after day.
While it sounds odd and perhaps indulgent, I believe that we were able to manage a wonderful life despite Julie’s cancer and all the other problems we faced, simply because, every day, we were still so startled and fascinated to find ourselves waking up in the same bed together that everything else was overwhelmed.
Julie Showalter
Julie Showalter was the fiercely intelligent, sexy, and loving woman with whom I had a outrageously wonderful marriage that ended with her death in late 1999 from cancer diagnosed the week of our wedding nearly 20 years earlier. She was also a brilliant scholar, the mother of our two sons, and a prize-winning author. Many posts on this blog are about her and still others consist of her writings. Julie’s Story is the account of our unlikely romance, Information can be found at Julie Showalter FAQ.
Julie’s Story
- Next Installment: 16. The Hospital Epistles: May 1998
- Previous Installment: 14. Vows
- First Installment Of Julie’s Story: 1. This Is How A Love Story Began
Note: Originally posted July 7, 2006 at DrHGuy.com, a predecessor of Cohencentric
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- I completed my psychiatric residency and was later a member of the private staff at Michael Reese. Julie’s doctors at this point of our lives were also on staff at Michael Reese. Reese is now extinct; see Last Exit From Michael Reese – The Final Days [↩]