Re-entry

 The French have a word for this time of year; they call it la rentrée. For the long summer break, including the whole of August, everything revolves around les vacances. Schools are empty of course, but so are offices, and forget about trying to find anyone resembling a plumber to fix your drain. Then comes September, and normal life returns, and everybody has to find a way to respond to the sudden change of pace once again.

 

It is less extreme, but even New York has une rentrée. For many of us, the summer is a time to dread rather than embrace, because the humidity is unrelenting and the noise of air conditioners a constant nuisance, yet we are still expected to function. Now, in September, all my choirs have restarted and the routine of the week has resumed. Yet for us, this year, our rentrée has assumed an exaggerated significance. I did not expect to be embarking on this season in such good health; indeed it always felt that this might be the season when things started going downhill fast. Yet a chance remark by our oncologist last week has helped to create a very different atmosphere, one of unexpected optimism. Of course that is very welcome, but it has created its own challenges. Bring them on.

 

I can’t fully explain how it came into my head that this period might turn out to be a milestone of decline. When I first received a preliminary diagnosis last October, I still recall the words of the surgeon after he had breathed dreaded words including “aggressive” and “high grade”. “Sometimes we are looking at years, and sometimes months” certainly came across to me as a warning to prepare for an early demise. The hope offered by the discovery of “unusual features” never amounted to much, since they were obviously not so unusual as to warrant any sort of unusual treatment. I avoided Google, but still could not avoid discovering the statistics of an eighteen-month median life expectancy after diagnosis and a five year survival rate under 10%.

 

Then came the operation and a period my family still describe as a temporary insanity, backed up by a series of quickly arranged visits which told their own story about what family members expected. Even when the intense treatment seemed to have suppressed the cancer and the MRI reports started to lead to medical smiles, our hopes were still cautious ones, and it spoke volumes when the oncologist encouraged us to visit Europe but warned us to “have our affairs in good order”. All of this led to what I characterised as “bonus time”, a period to enjoy as something of a last hurrah.

 

I am not sure that very much has changed now, except in our heads. Finding myself still healthy at rentréetime, with its resumed choirs and other routines, and seamlessly passing the halfway mark in the chemotherapy, were perhaps surprising enough to reset some expectations. But my wife and I surely sat up and took notice when the oncologist reacted to the latest clean MRI scan by starting to wax lyrical about patients of his who had thrived for ten years or more after a diagnosis like mine. Now, talk like that would be irresponsible if he did not feel such an outcome was a realistic possibility, and this general is certainly not irresponsible. 

 

We both decided very quickly not to go overboard with our reaction, and after a long cuddle and some tears we have not had much further discussion so far. But it was clear immediately that the remark, together with the other hopeful indicators, has had some influence on us. We will remain hopeful but also remain ready. After this treatment phase will end, all being well, in February, there will be a period without treatment, standard practice to allow to body to recover from months of well-intentioned poison. The most likely scenario is probably that the remaining cancer cells will remain docile for a while after that, but will then use the treatment lull to begin to reform into clusters and eventually regain their potency.

 

Still, the change in tone feels like a clarion call to convert hope and vague intentions into action, and not to waste too much time in going about it. Our intention remains to return to Europe next spring, but now the many complications involved have to be worked through rather than used as a reason for procrastination. Further, those plans have to somehow remain valid for a longer time period. As an example, until now my heart has not really been engaged in the plan to upgrade the villa. Perhaps a part of me doubted it would ever happen or felt that the project would surely no sooner be executed than become outdated by adverse medical changes. That is still quite likely, but we are now much more likely to find the energy to advance the plans. The mood will still be one of holding our breath and hoping and handling as many contingencies as we can, but that is no longer a reason to put things off.

 

So this September rentrée somehow feels especially poignant now, and in a different way to how I contemplated a few short weeks ago. True, it is a return to the old routine, albeit punctuated by some nausea and plenty of medical appointments, and that return would have been a source of immense gratitude anyhow, signifying a milestone I did not expect to arrive in good health. But now the return somehow feels rather more than one more extension of bonus time or one more section of an elongated coda. Now, even though very little has really changed, it almost feels like a temporary reprieve from the coda altogether, perhaps more of a da capo section to the piece. And da capo sections can have a propensity to be longer than the orchestra anticipated, to demand a renewal of orchestral energy, and offer an opportunity to discover something completely new in the music.

 

Our oncologist is indeed an accomplished orchestral player, a talent held in abeyance while his work is so demanding but something he frequently muses about restarting when he hears my wife and I banging on about our choirs. Perhaps he is ready for a more poignant and more fully encompassing rentrée as well? After all, I imagine he could almost see France across the Rhine from his college campus. No doubt this journey has many surprises to reveal yet, some of which will surely be devastating, and we will remain as ready as we can. But we are grateful to have been alerted to the possibility of an altogether more welcome surprise. Danke schön, Herr Doktor.