Cancer Had Me By The Throat
/Originally published in the New Haven Independent
I played the old Rodgers and Hart tune “You Are Too Beautiful” on the saxophone for a downtown crowd last weekend — something I thought I might never be able to do again.
When I played the saxophone last Saturday at a brunch event at the Elm City Market, it was my first actual gig since completing a seven-week treatment for cancer.
The treatment left me, in the immediate sense, depressed, depleted, and doubtful that I would ever return to public performance. My doctors warned me I might not be able to play again — not be able to write or record or perform the music that has sustained me for decades.
It was a chilling prospect.
Strangely enough, in the weeks right after the treatments ended I felt oddly self-confident. During those grueling days of hunger and thirst (I could not eat solid food for almost two months and most liquids tasted like sand), I had been practicing in my head no matter what. I went over old tunes and chord changes, thinking about scales and passing tones, even as I felt like I had to work from the assumption that my musical life was over.
I would on occasion sit down at a piano and spin out a few chord changes, thinking of new songs I could write to new chord progressions, even as I felt that I was in denial.
The weight on my head, the fallout from radiation and chemotherapy, were just too heavy, too much to come back from. Sure, I had played with some of the greatest jazz musicians of the last 30 years, had recorded and composed significant works for significant players. But that was more than just a memory; it felt like a delusion.
I often compensated for my fear at lying on the radiation table exposed to waves of invisible and poisonous rays by treating it as though it was happening to someone else. So I pictured myself on hundreds of stages as though the work had been done by someone else, someone who felt confident and healthy, cognizant of a world outside. (One of the odder side effects of chemotherapy was a faux tunnel vision that cropped out everything outside of my immediate field of vision and consciousness. I could see more, but I didn’t want to.)
The Elm City Market performance last Saturday (a second is planned this coming Saturday) is what is known as a “standards gig.” The truth is that, even before my illness, I hadn’t played one of these in maybe 25 years. (I tend to play original music in most situations.) I love old tunes, I know a lot of them, and it was anybody’s guess at how well my hands and brain would coordinate. Was it like riding a bike? Would I crash and injure myself?
Well, except for a chronically dry mouth, it was relatively relaxed and easy. It helped to have an old friend on bass (the excellent Kevin Ray) along. It helped that this was not a performance in the classic sense.
But from the start I felt as thought my mind was coordinated, even if I forgot the occasional chord or missed the occasional interval. I was ready to, as the late great clarinetist Pee Wee Russell once advocated, play every solo like it was my last.
A Large Lump In My Throat
If you are an athlete, the worst possible injury you can sustain is one to your knee or your arm; for an actor, well, maybe to the larynx or the face. If you are a professional musician (in my case a jazz saxophonist), it’s the hands, particularly the fingers. I never thought about any other part of my anatomy as being particular vulnerable until I was told last summer I had throat cancer.
I have a tendency to always want to avoid clichés and typical, knee-jerk responses to things as they occur in life (and death). I think such reactions are a way of substituting someone else’s experience for our own; they keep us from really looking at life, not just our own but at everyone else’s, through our own eyes. This has made me wary of easy, glib sentimentality. There is an old description used by a great critic to describe modernist emotion at its best as something that is “beyond tears.” What he was suggesting is that instead of appealing to audiences’ most easily-accessed emotions, which are conditioned to be the same-old reactions they have had year after year to the same-old stories, we, as artists, have to challenge and even lead them. We have to make them experience the next and newest emotion they will feel by articulating it ourselves, even before they realize they are about to feel it. (This is a weak paraphrase of an idea expressed by my old teacher, the late, great critic Richard Gilman.)
Faced suddenly with an overdose of reality, I wondered how I would respond to cancer, in both a public and private way.
None of my doctors thought I would die from this disease, but they did assure me that I would suffer greatly from the cure. I was faced with treatments that included the harshest chemotherapy available (something called cisplatten) and seven weeks/35 treatments of high-intensity radiation to my jaw.
I would lose my taste buds, a lot of my salivary glands, possibly a significant amount of my hearing, and be unable to play the saxophone for some time. And there was no way of predicting how weak my jaw would become, if I would lose my teeth or my jaw strength, all of which impacted on my ability to play the saxophone, on the strength and character of my sound on the horn.
My salivary glands would likely suffer anything from impairment to destruction. As I was to discover soon, this would mean horrible difficulty swallowing, badly-chapped lips, cracks in the skin next to my lips, and a regular nighttime sensation of constantly drowning.
All of that, I was assured, would either stop or come back when treatments (seven weeks total) were completed. Or maybe it wouldn’t.
My oncologist told me she had one saxophonist/patient who managed to start playing four months after the treatments ended. This concerned me, though not as much as the possibility of hearing loss (30 percent of patients experienced this) and neuropathy in my hands, which could, if it got bad enough, end my musical life. Since I already have varying degrees of carpal tunnel in both hands (from nearly 13 years of corporate torture, otherwise known as a day job), this seemed like adding injury to injury.
Of course there was not much choice in all of this for me. The diagnosis was clear; I had a rather large lump that had grown in my throat, and the alternative was a near-certain death, and not necessarily in the far future. These things progress in their own time, which is sometimes slow and sometimes fast.
I had moments of complete terror. Though I am retired from my former work, my entire life is currently centered around work as a composer, saxophonist, and historian. I am married with two grown children, and I was distraught at the thought of abandoning them.
On top of all this, though I am no longer a musician-in-his-youth (I am 65), and though I have felt myself being aged out of the social contract, I am playing better now than I ever played before. I am still composing, and I have a new book planned and a number of musical projects in the works.
What would I do?
I would of course get the damned treatments. But I was also determined not to define this as a great moment of tragedy.
I would (try and) fight the urge to descend (or ascend, I guess) into the typical philosophical dead ends of attempting to determine how all of this impacted on the Meaning of Life, of how it impacted on the meaning of my life in particular, and what my life meant in relationship to the universal condition of life as it negotiated the terms of this irrational sickness. I already had an answer to all that. The impact was clear, the meaning obvious: I would do virtually nothing but get treatments for tw months, followed by a period of recovery, and it would be a miserable experience. Nothing about it would be edifying in any existential way, and the best thing about it was that it had a finite ending. It would definitely stop at a certain and clearly marked point, and there was a good chance I would recover well enough to resume “normal” life — which of course was dependent on what I defined as normal life.
But there was also a chance that things would go wrong: my throat, which was being radiated, might close up, I could end up with a feeding tube and/or in excruciating pain. And, like some of the patients I saw passing through the Smilow Cancer Center where I was treated, I might end up as a walking ghost, weak and defeated and ready to surrender without resistance to whatever odd fate awaited me.
Fast forward seven weeks: I will spare you all the raw details, but nothing in my previous life prepared me for the darkness that descended over me for the duration of my cancer treatments. Every week post-chemo a cloud came over me, like one of those sudden storms in which the sky first turns a hopeless shade of black and is followed by torrents of unstoppable rain. The difference was that these were my personal clouds, and remained for three or four days at a time, and never really receded. They only withdrew temporarily like an enemy engaged in guerrilla warfare steeling itself for another attack (or, in my case, the next chemo).
It is hard to describe the deep and near-irreversible pall of being under the influence of chemo: Nothing seems worth doing. Time floats over and around you in an endless loop of sadness and hopelessness. This is fate, you think, an illness that has stalled like an endless front of bad weather, and blocked you from ever moving forward and away, free of the grip of its cold, cold hands.
There were times when dying seemed a reasonable alternative to the weekly assault of chemotherapy and the daily blitz of radiation. And radiation was a strange and awful thing. Each time, I was strapped to a table – well, my face was strapped, restrained – with a mask that barely allowed me to breathe. For eight long minutes each morning I felt like I was being baptized to the point of drowning. For three months, in reaction to this, I was unable to fall sleep while flat on my back. I still wake up three or four times a night to a sense that I am sinking slowly into a drowning pool.
The Other Side
I decided early on that I was through with music, with writing, with basic human interaction. It was all too difficult and too risky. I had trouble talking on the phone with people. I did not want to see anyone other than my wife (keep the children away; they did not need to see me like this), though I have to say that the much-maligned social media kept me from completely sinking into myself.
So here I am, about 10 weeks after my final treatment. My taste buds are about halfway back. My salivary glands are significantly better, though I sip liquids constantly and wake up in the morning with a feeling that a family of moths has, overnight, nested in my mouth.
I have been playing the saxophone consistently for about a month. I am composing music, writing my book, and have even gotten a few gigs, including a few Saturdays at Elm City Market at State and Chapel in New Haven (the next one is this Saturday, Dec. 14, 10:30 a.m to 1:30 p.m.), and a concert Jan. 5 in Brooklyn at the concert hall Roulette.
I still hate the music business, but jazz is like an addiction from which there is no recovery. I am playing as well as ever, with maybe even a bit more conviction and desperation. I am also determined to keep annoying the people who have grown a little tired at my complaints about the arts world both here and around the country.
Though I was ready to do so at many points throughout this whole ordeal, I will not surrender. When the end comes they will have to pry my saxophone from my cold dead hands.