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Life and Other Near-Death Experiences
Camille Pagán


It was all supposed to be very Eat, Pray, Die, but I promise I’m not spoiling anything when I say it didn’t quite work out that way. Take my diagnosis, for example; Dr. Sanders couldn’t even bring himself to say the word.

“I’m afraid it’s malignant,” he said from behind his desk.

“Malignant?” I asked blankly. It had been a long day and I’d had trouble convincing my boss to let me out of work early, even though the nurse who called said it was absolutely necessary that I see Dr. Sanders today.

“Cancerous,” he said, his thin lips all but disappearing into his mouth.

“You’re not saying I have cancer, are you?” I asked, attempting to help him clarify—as surely this was not what he meant. After all, just before he cut the golf ball–size lump out of my stomach, he said he was certain it was a fatty tumor. The surgery was just a precaution.

“Um. I’m afraid so.” He peered cautiously at the paper in his hand, as though he didn’t deliver bad news for a living.

“I don’t understand,” I said.

“Elizabeth,” he said, reaching forward to take my hand—which I quickly jerked back, as I’m not big into people invading my personal space, not to mention he had more or less just told me via body language that I was a goner. “You have subcutaneous panniculitis-like T-cell lymphoma. This type of cancer is extremely rare, but when it does come up, we see it most often in individuals in their thirties, such as yourself. I’m afraid it tends to be aggressive. You’ll have to—”

This was around the point at which I stopped listening and started going through a rapid-fire version of the Kübler-Ross model of grief. Denial: No one calls me Elizabeth; my name is Libby. Dr. Sanders is obviously talking about someone else. Anger: He said he was sure the lump was nothing! I’m going to give him a reason to be grateful he’s been paying through the nose for malpractice insurance. Bargaining: If I run a marathon to raise money for cancer orphans, not only will I live, I’ll become such a raging success that Oprah herself will promote my memoir. I’ll start a movement, complete with races for the cure and rubber awareness-raising wristbands in turquoise, which will become the national color of—what the heck was my cancer called again? Depression: I can’t race for a cure because I don’t run. I don’t even exercise, which is probably why my body is riddled with overproducing disease spores. I’m going to bite it before I see forty. Acceptance—

Unfortunately, acceptance was essentially identical to depression.

I was going to die. Just like my mother.

Dr. Sanders kept yammering, oblivious to the fact that I was looking right through him. “So, chemo. I’d like you to—”

“No,” I said.

“What do you mean, no? Elizabeth, your best chance for survival is to try to zap this thing as fast and hard as possible. I am sure you’ve seen the worst-case scenarios for chemo, but today, particularly for lymphomas, treatment is manageable. And, if I may say so, the difficulty of treatment is preferable to . . . well, not getting treated.”

“I’m not going to do it,” I said. “I don’t want chemo, or radiation, or any of it. How long will I live without it?”

“I’m sorry?”

“You should be; you just handed me a death sentence. Now, how long will I live without treatment?”

He looked befuddled. “I’d like to run a CT scan to see if the cancer has spread to other areas, but given the cellular activity in your tumor . . . well, prognosis can range from six months to . . . um, it’s difficult to say. Although certainly there have been some successful cases . . .”

“Okay then,” I said, grabbing my bag off the back of the chair. “I’ll be in touch.”

“Elizabeth! I’d really like you to meet with a counselor—”

I left before he had a chance to finish, the taste of cold pennies on my tongue, as though I’d consented to chemo and already started injecting liquid poison into my bloodstream. Oncologists, nurses, radiologists, palliative care specialists: I was all too familiar with the cancer routine, and I wasn’t interested. Not one bit.

My twin brother, Paul, once told me that there’s healthy denial, and then there’s LibbyLand. His theory is that in order to function, most people have to ignore reality, or at least most of it. Otherwise, all of the horrible things in life—child slavery, acts of war, the pesticides jam-packed into every other bite of food you put in your mouth, knowing that you’re a day closer to dying when you open your eyes each morning—would be so overwhelming that no one would ever get out of bed. “But for you, Libby,” said Paul, “the whole world is filled with kittens and rainbows and happy endings. It’s very cute and probably helps you sleep at night. I just worry about you sometimes.”

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