Apparently the urology department had Dad’s prostate cancer medication under control (namely, a shot in the pooper full of girly hormones) because it was six weeks before we ended up in a cancer specialist’s office. Finally, after piles of information with no translation, the oncologist explained Dad’s condition in terms that made it concrete: Dad had “Advanced Stage VI Metastatic Prostate Cancer.” And since, in a cruel irony in the fate of men, it’s testosterone that fuels the fire, the first line of defense against metastatic prostate cancer was hormone (estrogen) therapy, to tamp down production of man’s best hormonal friend. Without testosterone, it was hoped, the cancer would stop growing.
Dad’s oncologist, a polite, aloof man who smiled benignly, gave us a rough idea of what the doctors look at, specifically the numbers that come off the PSA test (“Prostate Specific Androgen,”) which is the map of prostate cancer writ large.
How large? Dad’s first PSA came in at 271; to hear that a normal result should be lower than 4 but preferably undetectable, even without a scale to measure against I could read between the lines: 271 is a lot more than 4.
When I asked the doctor how, in a man with advanced cancer, things would play out over the course of Dad’s hormone therapy, the oncologist explained: were Dad’s PSA to return to an undetectable range, he might have seven years of lively mischief to look forward to. Between 1 and 4, Dad was looking at four years. Anything above that—presumably the higher the number, the worse chance he had of running the Boston Marathon that year. The following year wasn’t looking good at all.
Dad was unmoved by these revelations. So what? Numbers didn’t change anything to him beyond what he already knew: he was sick as hell, felt like shit and he might or might not make it through Proust again.
The oncologist continued to review the possible side effects of his hormone therapy: hot flashes, potential weight gain (including the boobs, which was unsettling), a loss of bone mass and the potential for fractures as a result.
“There’s a potential for short-term memory loss…”
“I promise to make fun of you when your memory goes,” I said.
He shrugged. “That’s okay. I’ll forget it quickly enough.”
Zing! He still had it.
Dad quickly made the necessary mental adjustments to having a catheter. In the choice between exploding like a lobbed water balloon or wearing a bag of pee on his ankle, the catheter seemed the better bet. Still, when we ran errands, or struggled in and out of seats, he felt the catheter tug and he’d wince. Kindly strangers would offer their assistance to this grandfatherly gentleman with a Santa beard.
“Nope,” he said. “It’s just this damned bag strapped to my dick. I’m fine, thanks.”
In the urology office, a receptionist asked him if he needed to use the restroom before his visit with the doctor.
He tapped his thigh genially. “I’m taken care of, thanks. I’ve got this catheter...”
Her eyes widened.
“Christ, my pecker has been about this big since this whole thing began,” Dad said, holding his fingers about an inch apart. “The parts are starting to fall off, kid,” he chuckled.
Bet she didn’t read this in the job description, I thought.
I don’t know why Dad felt the need to share so openly about his wounded goods—not just with me who had come to expect such revelations, but with anyone in his proximity. Once I would have been embarrassed about it; now I was charmed.
And why shouldn’t he feel empowered to share? What man hasn’t had a lifetime love affair with his own penis? As things were unfolding on a medical-go-round, Dad was dragging around apparatus to keep his junk working; it had to be a surprising punch in the gut to have his goods betray him so completely. I might not know how to keep that to myself either.
We weren’t thrilled to hear that treatment might introduce all of these harrowing side effects. As to bone loss—who wants to be frail? Memory loss just seemed like a cruel attempt at humor: if one survived this long with no hint of senility, what a devilish thing to have memory loss introduced as a part of cancer care.
And unless his alter ego had already picked up the habit, no man wants to go bra shopping at 76 years old.
After the initial whirlwind detecting the many parts of Dad’s disease, a slower pace evolved. I had time to adjust to the enormity of what was happening to him, and was realizing that this might just be the “big moment” in both our lives. But I was at an ebb, disoriented and confused.
Perhaps it was the title Dad bestowed upon me after he signed his will and health directives, squaring away his future and laying it in my hands. “That’s it, then. You’re officially the Queen of Me,” he said. “All hail the Queen!”
Initially, there weren’t too many responsibilities attached to my new gig. I took Dad to doctors’ appointments and made sure he had fresh fruit in the fridge. I bought him a new bathrobe to lounge in when he was too sick to do anything else. I watched nervously out of one eye as I helped him in and out of chairs. Even these tasks fell away as the hormone treatment seeped into his cancer-ridden bones: Dad became livelier with a better appetite, and felt liberated if he made it to the grocery store by himself, restoring some of the independence he lost after his initial crash. Being Queen wasn’t too rough, all perks.
But as we went over the ream of papers after our trip to the lawyers, I had the sense of my growing role in Dad’s future. A coronation was fine and good (ours took place over sangria and pork tacos), but the next day all the pressures of state would be sitting there waiting for me. Not to mention all the future crises that would inevitably crop up over my tenure as "Leader of the Free Dad.”
While we read the inscrutable will and medical directives, we cracked jokes. What else can you do? But I was being briefed on my office and it was not a trifle. I wasn’t a goodwill ambassador; not tapped to be a diplomatic envoy to St. Kitts. I had my finger on the button, as it were. Being Dad’s proxy meant that I could be in a position where I had to say, no matter how hard it made me swallow, “No life support.” Or in the position where all of his medical care revolved around my decisions because he was too weak to make them himself.
I would aspire to benevolent rule as Queen of Dadovia, but it was nerve-wracking and heavy crown.