A Routine Visit

Every six months, I walk into a Kaiser lab in Los Angeles, where a tech draws four vials of my blood. I’ve been making these twice-yearly visits for the past seven years, but today was my first since the pandemic began. This time, someone with a badge waved a thermometer at my head as I entered the building and handed me a sticker that said I was cleared for the day.

The only other patient in the second-floor lab, a youngish white guy, was joking with a phlebotomist about his frequent-customer status. The gray vinyl chairs in the waiting area were empty of people, and even magazines, which I supposed were germ vectors now. I stood six feet from the reception desk and waited to be called. A woman in pink scrubs approached and asked if I had an appointment. 

I did not. I’d never needed one.

“We’re using this lab for patients who are immunocompromised,” she said. Her voice was friendly, her accent Caribbean. “Cancer patients, that sort of thing. The appointment system is new, because of the virus.”

“This is a cancer follow-up,” I said, hoping she wouldn’t send me home. It had taken so much to get myself here. 

It was a routine visit, but my heart was cartwheeling in anticipation of a test I couldn’t study for. 

Seven years ago, at age 35, I found a tumor in my right breast—as big as my pounding heart, an object that reshaped my body and brain, but which was removed and has not, as far as anyone knows, returned. Statistically and evidentially, it’s so unlikely that I will have breast cancer again, I told myself now. And then the inevitable follow-up thought, the routine that questioned routine: But what if this time is different?

My lab visits are like a growth chart on a parent’s doorway, each pencil marking a different phase of life, even though what they’re measuring for me is (knock on wood) a lack of growth. Perhaps most vivid is the 2015 visit, when I brought my newly adopted son, proudly hoisting his infant seat to show my surgeon: This is a huge part of why I wanted to stay alive. This is what you made possible. 

Now Dash can ride a bike. His dark brown hair has assumed a Beatlemania look during the pandemic. There is a small window in his smile, where his front baby tooth used to be. He devours pizza and loves pillow fights and borrows British phrases from Peppa Pig. He has been folded into my routine, but his presence still feels like an improbable miracle.

The nurse considered, then let me in without an appointment, and part of me felt like I’d forged a handicapped placard to get a good parking spot. Inside the lab, I sat, arm outstretched, watching my blood pool into glass tubes, thick and jewel-colored, full of secrets.

When I think about metastatic cancer—and I am always thinking about metastatic cancer—I don’t worry about death as much as the two to four more years I would be lucky to have and the planning they would require. How would I convince Dash that brushing his teeth and eating something other than candy were necessary when life was nasty, brutish, and short? How would I tell him, Plans fail, and we all die, and I will leave you at an age that will shatter you; but here, take this small broom of my influence and use it to sweep up the shards of your future self? The conviction of our worth, the small daily lies we tell ourselves in order to push our plans forward, are the equivalent of believing in Santa Claus for adults.

And yet we make those plans, anyway. Our son came to us via domestic open adoption. People unfamiliar with the process have asked if Dash’s birthmom was drug-addicted, and while there would have been no shame in that, I want to retort, Do you know how much functionality it takes to make an adoption plan? She had to find us, meet with us, submit to hours of intrusive questions from our agency, fill out stacks of paperwork, and collaborate with us on a birth plan and contact plan. The circumstances that prevent people from parenting may be accidental, but adoption itself requires painstaking intentionality. 

I’ve always been a planner, myself. My parents raised me that way, having bootstrapped themselves out of less-than-stable childhoods, determined to give my sister and me consistency, routine, and a promise that if we got the grades, they’d pay for a public, in-state college of our choosing.

It worked, to a point. They’d kept the white, middle-class myth of meritocracy burning until cancer doused the flame—first for my mom, who died of ovarian cancer in late middle age, and then for me. We learned then what poor people, and people of color, and maybe even a few born-rich people knew all along: it’s all a crapshoot. 

The day after my blood draw, I returned for a physical exam with Dr. Kwan, the oncologist. Today she wore a yellow mask behind a clear plastic face shield. We were far enough into the pandemic that her look was unremarkable. Cancer, too, prepares you for accepting a new normal on an almost daily basis. Sure, take my breasts. Okay, you can have my ovaries too. Take my hair; I’ll pretend I’m Fantine in Les Miserables.

“How are you doing?” I asked, slight emphasis on doing, the acknowledgment that this is all nuts, right?

Could she see my eyelid twitching? Could she smell the fear beneath the floral-alcohol scent of hand sanitizer?

“I’m okay; the thing I’m thinking about now is school. You have a kindergartner, right?”

“Yeah, it’s going to be crazy.” 

The Los Angeles Unified School District had sent daily recorded calls all summer assuring us that they were working on a plan. They’d finally announced that school would be entirely online. Now, a week before the first day of school, all we knew for sure was that I would be able to get a school-issued tablet for my son.

Dr. Kwan’s kids were going into first and third grade. As she pulled up my chart she said, “Their school has an afternoon session and a morning session. I really try not to play the doctor card, but I told them I was a healthcare worker who had to see patients in person, and the morning session would work better for us.”

Did Dr. Kwan have my lab results in front of her? Would she be this chatty if they bore bad news?

“Your labs are fine,” she said. “All your tumor markers came back normal. I’ll email the results to you.”

The anxiety that had coiled like a viper inside me relaxed. I lowered my gown and Dr. Kwan gently pressed her fingers into my fake breasts, my armpits, my neck. 

“Of course we ended up with the afternoon session,” she said.

I thought about the structure of this year, how it seems based on wishful thinking, rather than rational planning. My partner and I can work from home, but that doesn’t mean we can manifest six free hours into the middle of our day. How do single parents manage, I wondered, and those who relied on school and after-school programs, who can’t afford socially distanced daycare? I thought of the summer camp I’d seen at our local rec center. Kids in matching T-shirts spaced across a baseball field to do calisthenics. The camp’s handmade butcher paper sign featured, as its mascot, a smiling red coronavirus.

Kids adjust quickly to whatever is put in front of them. Dash doesn’t complain about wearing a mask, though he’s prone to chewing on it, a wet bloom growing across the middle like a crooked smile.

After a judge pronounced Dash officially and legally ours two weeks before Christmas in 2015, we posed for pictures against the planters outside the Edelman Children’s Courthouse in the thin winter sunshine. Our extended families formed a half circle around him. His face was round and bewildered. I held onto a white bear in a green Santa hat, a gift from the courthouse, and he held onto me.

Kids thrive off routine. It’s in all the parenting books. Lately Dash has been clinging to that bear. But adults also thrive off routine. We counter the terror of cancer and abandonment and the pandemic by reading the same stories and wrapping ourselves in the same blankets each night. 

In a few days, Dash and I will get COVID tests issued by our school district as part of a plan to reopen campuses. Some schools will likely open, only to close again in the wake of outbreaks. We plan. We fall apart. We replan. At the testing site, my heart will race, as it does before every medical test. But I’ll speak calmly and casually to Dash. I’ll hold his hand, pretending he’s the one who’s scared.