My body, it seems, is erupting. I don’t mean this in the metaphorical sense—like it’s erupting with rage or into paroxysms of laughter—I mean erupting, as in blowing itself up bit by bit from the inside out. It’s been happening for years. There’s not much I can do about it either except, like Yeats, watch for some rough beast to slouch on by and plant another mine somewhere deep beneath my flesh. Then, just wait for the boom.
The eruptions began in my late twenties with a diagnosis of Polycystic Ovary Syndrome. During an ultrasound that was supposed to tell me why I couldn’t get pregnant, my gynecologist picked up a pencil to circle images on a computer screen. Inside each circle, sat a tan colored blob outlined by a white, shadowy line.
“Here, on your ovaries, is what we call the string of pearls. We look for this pattern in cases like yours.” The doctor did not look at me, but at the screen instead. “This will make it difficult to get pregnant, I’m afraid.”
I sat up to examine the screen a little closer.
“Can you point to a pearl?” The doctor took the end of his pencil and struck the sharpened lead along each circled blob. I flinched with each strike, considering each cyst-like pearl a bomb waiting to explode each one of my dreams.
“What do the cysts do?”
“Well,” he said, finally turning from the screen. “Lots of things. Nothing good for you, I’m afraid. They mess with your hormones giving you more testosterone than you need. This causes hair to grow in places you don’t want it to grow, like your back and neck, and hair not to grow in places where you do want it, like on your head. You’ll most likely experience weight gain, acne or dry skin, and more significantly, the lack of a regular menstrual cycle.”
“So bad news for my husband too,” I said. He cleared his throat.
After several quiet moments passed, I asked him about the cure.
“It helps to lose weight,” he said. “But with Polycystic Ovary Syndrome it’s darn near impossible to lose weight.”
“We could try some fertility treatments. Unfortunately, those have side effects too.” Boom.
“You’re still young,” he said, standing up. “Let’s try the weight loss idea and see where we are in six months.”
I knew where we’d be in six months.
After several miscarriages and an ectopic pregnancy where I lost a tube after developing toxemia, I managed to lose some weight. I got pregnant while on a cycle of Depo-Provera and worried the entire pregnancy about birth defects from the drug.
In the afterglow of delivering a healthy baby boy, I almost forgot about the silent bombs waiting to explode inside my body.
Then my father got sick.
My father was not a good man. Let’s get that out of the way right away. Still, when he got sick and they admitted him into the hospital, all of us kids ran to his side. He did not deserve such love. We did it for each other, I think. We did it out of curiosity about what could fell someone so seemingly infallible, I guess. We did it because what else do you do? He was our father.
When the doctor came into the room, we were all cutting up, trying to pull salvageable stories from our youth out of a bag fraught with holes.
“Okay. There are a lot of you in here,” the doctor said, standing by the door beneath a spotlight meant to stay lit in case of an emergency. We nodded in unison like some version of a family choir I’d seen on TV. He introduced himself as the cardiologist and we relaxed a bit. There was nothing strong enough to tackle my father’s heart.
“Is it okay if I talk to you in front of your family?” the doctor said. My father nodded yes. “Your tests indicate you have Stage 4 renal cancer. Your cancer has progressed past the point of treatment. As soon as I leave here, I am sending hospice in to meet with you. The prognosis for conditions such as yours is generally four to six months.”
The doctor dropped his head and stopped talking. I worried for a minute he was going to take a bow—performance over.
“Might as well take me to Vesuvius and drop me in,” my father finally said. “Cheaper that way.”
Some of us laughed. The doctor made his way out of the spotlight and out of the room.
“He’s never even been to Vesuvius,” my mother whispered to me, as if that was the problem with what he’d said.
“He was kidding,” I told her.
“Forse,” she said in Italian. Maybe.
Mt. Vesuvius erupted each year from 79 A.D through 1037 A.D. Then she fell silent for six hundred years. Our family has always had a strange fascination with Vesuvius. I’d guess it’s because our family history mimics the history of Pompeii. Our family could live together in relative calmness for weeks, even months, until something would happen to make my father erupt and shower upon us the pent up anger packed inside of him for ages and ages. In the aftermath of his explosions, there were casualties and scars to deal with, but, like the people who live in the shadow of Vesuvius, my family always came back, eager to rebuild.
This time, there would be no rebuilding.
We took my father home to die. He didn’t go easily. In the last two weeks of his life, when he was at his weakest, he could summon superhuman strength at least once a day to try and escape. He’d take my mother’s car keys, or sneak out the utility room door, or walk into the back yard to squeeze through loose boards in the fence. It got so bad that if the doorbell rang, we’d have to watch him like we used to watch our dog who liked to bolt whenever fresh air hit her face. My brother and I ended up being the ones who chased my dad home just to drag him back to bed so he could die where he was supposed to.
“He’s running away from death,” my mother whispered to us. We nodded solemnly, as if somehow that made sense.
At night, we took turns sleeping at my mother’s house. The hospice folks placed my father’s final bed in the living room where he rested like a body already in state. At night, watching my father’s restless sleep, I waited for the boato—the enormous roar a volcano makes when it blows. I wanted a dramatic moment before my father turned cold. I needed to feel the heat of his apology for the shattered lives he’d left in the wake of previous eruptions.
His restless sleep told me he was still roiling inside, but when he left this earth it was soft, like ash that can still suffocate long after the event is over.
Had my father simply been a bad guy his death might have been the end of him. It was more complicated than that. As often as he terrorized us, he also loved us. He was the parent who liked to play board games, ride the rides at theme parks, and find out-of-the-way diners where we could eat onion rings and drink malts while he told silly jokes. My father loved us unconditionally even though he could have killed us in his hottest moments of rage. His anger was one of those random things, like the path a lava flow decides to take.
A few months after he died, my mother noticed a pimple growing out of the corner of my nose.
“I need to biopsy it,” my doctor said. This was one of his last procedures as he had Parkinson’s disease and was retiring at the end of the month.
As soon as he took the scalpel and cut the bump off my nose, I felt like the cartoon roadrunner when he realizes the trap door has been pulled out from under his feet. Pain. Sudden and intense. The numbing shot to my nose either hadn’t gone deep enough or missed the mark completely.
I held my breath until my nose was patched, then ran to the sink in the little operating room and vomited and vomited, then vomited some more. My husband and the doctor stood back like victims on the news who later say, “We never saw it coming.”
On the ride home my husband said, “I’ll bet he’s glad to be retiring now. That room looked like the set from The Exorcist.” I sat in shame and turned on the radio to drown out the memories of the day. Somewhere, I felt the familiar rumblings of Vesuvius.
When the doctor called to say it was cancer, I wasn’t surprised. The bump on the side of my nose had erupted like a small toe on top of my nostril.
The surgeon explained the Mohs operation to my husband and me. He planned to remove the cancer, run a biopsy of the remaining cells, scrape more skin if necessary, and repeat the process until he was satisfied there was nothing bad left in the margins.
It sounded great in theory.
After the first run, the doctor stood at the procedure room door to tell me they needed to take more skin from my nose.
“No,” I said.
“No?” the doctor repeated. He had already turned to walk down the hall.
“No,” I said again. “I think I’m done. I want to go home now.”
The doctor came into the room and rolled his stool toward me. “You have a large hole in your nose. I can’t send you home with an open wound. Let’s just finish this off today, huh?”
“I can’t,” I said. “My father died.”
The doctor sat up straighter on his stool. “Oh. I’m so sorry. Did you just find out?”
“It happened a few months ago.”
The doctor looked to the nurse, who shrugged slightly. How had that even come out of my mouth? Maybe it was the smell of the hospital or the desire to run like my father had wanted to, but in that moment I had a clear understanding of the futility in having the bad cells cut from me when there were so many layers and layers of memory that needed to be removed first.
I cried until the doctor went to get my husband from the waiting room.
With my husband by my side, I let the doctor finish the procedure and sew me up. I always wondered if the next series of scrapings really got all the cancer or if they just wanted me sewn up and out of there.
In a few months, I would see my surgeon on the news, arrested for molesting patients while they slept.
“You were never out,” my husband said, reassuring me. But my concern was about what they’d done with the cast they made of my nose. Had it been left behind when the office was closed forever?
In Pompeii, there were many people caught by surprise when Vesuvius exploded in 79 AD. Their bodies, smothered in hot ash, are preserved today in plaster casts. You can read the expressions of pain and shock and horror on their faces as easily as you can read a tattoo.
Somewhere, in some disgraced surgeon’s office, there is a cast of my nose on a shelf, maybe even waiting to tell its own kind of story.
My body’s newest eruption begins in my heart. In an instant, my pulse will go from a resting heart rate of fifty-five beats per minute to over two hundred beats per minute. Once my heart begins to run its private race, it simply will not stop.
“Paroxysmal Supraventricular Tachycardia,” the ER doctor told me. “It’s commonly known as SVT.”
I had been at Target looking at patio furniture the first time my heart went wild. My husband ran me to the ER where they quickly did an EKG.
“We are going to use what we call a chemical paddle,” the doctor said. “It’s a way to reboot your heart using the drug Adenosine rather than an electrical current.”
I pictured a person standing over me rubbing two paddles together and yelling ‘clear,’ but it’s not like that at all. Instead, the small ER room quickly fills with medical folks because this is an unusual procedure and medical personnel are curious. They also need several nurses and a doctor to mix the drugs and then administer them. With so many people involved, it feels like an emergency.
While the medicine is quickly plunged into my IV, everyone else checks the monitor that shows my pulse. When the IV was first inserted, the monitor showed my heart rate at two hundred and twenty beats per minute.
“Okay,” the doctor said, standing up and holding my shoulder. “You are going to feel like a door opened beneath you and you are falling through it, but you won’t fall.”
And it feels exactly like that. If you’ve ever been on a ride like Tower of Terror at Disney, it’s like you are standing on firm ground one minute, then free-falling to earth the next. But there is some chest pain. And lots of muscle contractions. Actually, it sucks.
In the meantime, people all around you are counting down. One seventy-five. One forty.
One ten. Ninety. Seventy-four. It’s like being a human New Year’s Eve countdown ball.
After my heart rate is stable and the lab work comes back, they release me into the world. It only takes a couple of hours to stop and reboot a heart. Once home, exhaustion from the hours of two hundred plus beats per minute, and the muscles spasms, and the fear sets in.
There are some tools I can use to avoid a trip to the hospital. I can bear down like I am taking a big poop to see if that will reset my heart. I can plunge my face into a bowl of ice water to see if that will shock, then reset the rhythm of my heart. I can pretend to blow into a balloon, which seems sillier than the other two ideas, but I’ve done them all. Mostly they work. Four times they haven’t.
The thing about SVT is that you can have mini-episodes quite often. I’ve had a couple dozen. I’ve read that it’s a good idea to avoid caffeine, sugar, and white wine. I’ve also read that it’s an “electrical problem” and you can’t help how you were wired so nothing really works except for an ablation if it happens too frequently. I’ve read and read and read about SVT because it’s scary.
When I was diagnosed with PCOS, I blamed myself. It was my fault my body was messed up because I was fat. Because of my messed up body, there would be no children. And even after we were fortunate to have one child, that child would be all there would ever be. My fault.
I took the blame for the skin cancer too. The sun. The tans. All my fault.
But the SVT is different. I didn’t do anything to get here. I don’t think.
I worry about my heart racing whenever I take a plane, go out of town with people I don’t know well for conferences, or hike deep into a mountain trail.
What will I do if my heart erupts into the wrong rhythm?
When will it happen next?
What is it I have lodged so deeply inside my body that it is trying to run away from me?
Boom. Boom. Boom.
I guess I do take some blame for this too.
After the first chemical paddle, my GP sent me for a nuclear treadmill stress test just to make sure all was well. My appointment was scheduled at an old hospital in downtown San Antonio on the forty-something-th floor. I am not a believer in ghosts, but that hospital was filled with them.
Waiting for my name to be called, I thought about how they would insert an IV into my arm, then insert radioactive material into that IV while I walked on a treadmill. I felt the building swaying. Looking out the window forty-something floors below I saw a car that reminded me of the family car we’d had when I was a child.
After moving from Italy to the United States, my father joined the military where he made sure he had a job where we had summers free to travel. During the summer months, we drove across the United States and when it was good, it was the best. My father loved to sing and if he was singing Dean Martin, we would sing along. When Hank Williams Jr. came out of his mouth, I could see black clouds beginning to form in the car.
I’ve heard that some volcanic eruptions are soft with oozing streams of lava dancing down the side of the volcano like a Las Vegas chorus line. My father’s eruptions were quick, like bricks being thrown through a window.
“I’m sick of this family,” he yelled, out of nowhere, while we were driving on a mountain road without guard rails in Colorado. “I’m going to drive us off this road. Swear to God. All of us. None of you assholes deserves to live.”
My mother would cry gently as if the ash had already suffocated and rendered her useless.
Over the years my father would threaten to drive us off many roads and bridges, burn down our house, and poison our family. And though he never did, we lived in the shadow of the possible eruption.
“Ms. Tolan,” someone dressed in white said from the hallway. “Are you ready for your stress test?”
“Sure,” I said. “Can I use the restroom first?”
“Of course.” When she went back inside, I bolted to the elevator and to my car.
I never went back for the test.
Even the memory of a car can remind me that shadows never die. I can’t go back in time and escape past eruptions. I can’t go ahead in time to predict new rumblings. But on the day of the stress test I saw an opportunity to avoid a minor eruption, and I took it.
These days, well over a million people live in the shadow of Mt. Vesuvius. Ancient Pompeii is now a modern city spelled with one “I.” People probably call Vesuvius a mountain instead of a volcano to make themselves feel better or maybe even to forget.
Experts say Vesuvius will erupt again. Some say it is past due for a cataclysmic eruption. In the meantime, the people who live near the volcano go to work each day and shop for groceries and possibly even go bowling from time to time.
Will this generation take the hit? Will it be the next?
When you live in the shadow of a volcano, no one is safe. Nothing is predictable. Things eventually erupt. Things eventually go boom.