By: Camila Rodriguez
She arrived at my dorm room at 7:45 p.m. She knocked on my door twice with a light hand. I opened it and there she was— a 5’3 sunny brown eyed woman with thick curly brown hair, a tan complexion and a wit sharper than a paring knife. She was wearing her favorite shoes at the time—low cut Nike Air Forces in the color white and her green parker on top of her blue jeans and UC Merced t-shirt. She came in, sat at the tip of my bed and whispered, “Look at it with me…please.” I wanted to say no. My natural instinct was to say no, but I couldn’t. I gave her a little nod of affirmation, which signaled her to bring out her CAT scan out of its envelope. She held it above my window, letting the sunlight seek in and one by one, each firefly, a flicker of cancer’s light on the film, glistened.
If you look at it long enough you can see the beauty those fireflies had, the different shapes and sizes they were— how they danced all together as if they were in a hot summer night. They moved up and down, left to right, top to bottom, and each one, each and every single firefly that was there was lymphatic cancer.
Intense fever, night sweats, severe itching, persistent fatigue, and unexplained weight loss are all symptoms of Classic Hodgkin’s Lymphoma. Mia had been diagnosed with Stage 3, which signified a lot of things. These fireflies come in two distant types of lymphatic cancer: Hodgkin’s or Non-Hodgkin’s. In Hodgkin’s Lymphoma Reed-Sternberg cells are present. In Non-Hodgkin’s they do not. Reed-Sternberg cells are what physicians look for when they evaluate patients. Those fireflies are abnormal white cells that have developed to have one or more nucleus and are larger compared to normal white blood cells. They take on different shapes and forms but at the most advanced level they start to look less like fireflies and start to take the form of huge bulk of cells being glued together.
The division of stages that are used to diagnose patients is based on where those fireflies, or cancer cells, appear in the lymphatic system. If they have affected only one lymph node region or organ, it is diagnosed as Stage 1. If two or more lymph nodes are affected and are either above or below the diaphragm, it is diagnosed as Stage 2. If it affects lymph nodes on both sides of the diaphragm, it’s Stage 3. And if the cancer cells have moved beyond the lymph system into other tissues and organs, then it is diagnosed as Stage 4 (“Staging of lymphoma”).
To be tested for lymphatic cancer, one enlarged lymph node is removed from the body through a surgical procedure called lymph node biopsy (Staging of lymphoma”). Those samples are then sent to a local laboratory and are evaluated under a microscope for any possible Reed-Sternberg cells. Mia’s biopsy took five hours from start to finish. We arrived at the University Surgical Center at six o’clock a.m. and left there around 1:00 p.m. I remember us holding each other’s hands before she was prepped for her surgery. We looked at each other and silence took up the room. In that silence there lay our affirmations and our “I love you” without having to say the words. Mia was being taken in for surgery when we had talked and before that we said our goodbyes not knowing what the future held for us.
My friend Mia had an enlarged lymph node protruding like a ball in her neck that had developed over her internal carotid artery. It took precision and patience to remove it, and the surgeon, a white male in his fifties with solid white hair, had to stop multiple times to make sure her artery remained intact. The artery was my friend’s life, and we were both trying to keep her sanity intact from being buried by something that seemed too real. It is highly unlikely a person can die from a lymph node biopsy; it is the diagnosis and its presence that affect patients.
Seeing the physical presence of cancer causes a psychological reaction, making it a thin place that divides between the real and the fake, the experiences you face internally or externally or what sets lives in the fortune or unfortunate. At that moment, I felt the thin places, dividing the living and dead and the seen and unseen, open and close rapidly as if they had changed the tone and the manner of our lives. I had feared this thin place between Mia and me – the one that was going to divide what I wanted to do from what I needed to do to help my friend through this difficult time. I knew she was going to come out alive. I just didn’t know whether, once she came out, I was ready to embark on a journey that ultimately made me sacrifice a piece of my happiness to contain hers. I was afraid even of telling her that I was scared. That’s the thing of all of these thin places – they’re hard to talk about since the encounters we face are with the “ineffable” (Kisner 125).
Situations happen– they happen out of luck, out of odds, and the chances we have to experience something life changing is always near. I knew something was coming before Mia’s diagnosis, I felt the water coming in near my feet, the sirens going off, but not a tragedy was on site. Our inner consciousness plays a part when it comes to tragedies and the reactions that we give to them. There is a difference between “something is wrong” to “I know something is wrong” it’s the feeling, the emotion, the recognition it takes to recognize the “homeostasis gone amiss” (Sacks). When a general feeling of disorder entices you, it doesn’t feel like pain, it doesn’t feel like numbness either—it feels like our inner and external scale is off by one, a small but pivotal number that alerts anxiousness.
When the thin places that Mia and I formulated in our minds became physical outside of our consciousness, the tension and questioning of reality and courage were on a loop. The pain and discomfort we felt in our heads and our hearts were like wounds that bled out of our mouths and into our laps. The issue with Mia and me was that the thin place we felt were not in our heads anymore but in our day to day life, where the thin place started to echo with loudness and discomfort. Mia was someone who always was courageous and continues to be, but a general feeling of disorder where “homeostasis has gone amiss” (Sacks) had made us question what her story entailed. We weren’t living in the same pain but being in the vicinity of her made it feel like I was. I wasn’t the one going home with the diagnosis, but I was the one who saw her go through it, and especially the one that was on the other side waiting for her. It’s incredible when we talk about life no one says that our existence is real outside of our perception and how these types of challenges make us recognize how we are. Before we had both started our undergraduate studies it was repeated to us that the most memorable events would happen to us, but no one said that the things that question our morality, our courage, our or existence would be. I had always thought what happened to her was a tragedy but, in reality, what happened to her was nothing but life picking and choosing where the fireflies appear.
Kisner, Jordan. “Thin Places.” The Best American Essays 2016, by Jonathan Franzen, Houghton Mifflin Harcourt, 2016, pp. 117-138.
Sacks, Oliver. “A General Feeling of Disorder.” The Best American Essays 2016, by Jonathan Franzen, Houghton Mifflin Harcourt, 2016, pp. 242-249.
“Staging of lymphoma.” Lymphoma Action, Mar. 2019, lymphoma-action.org.uk/about-lymphoma-tests-diagnosis-and-staging/stages-lymphoma.