CHAPTER 1

March 2003

I feel compelled to go through Tammy's things over andover again, to touch and smell the things she lived in and with.Each object, whether it's an earring or a book or a sweater,still holds the essence of her, and I want to hold her essencejust a little while longer. I don't want time to steal it from me.

Here is one of her trophies—Lokahi Canoe Club, MostInspirational Crew, 1987. She was a senior at the Universityof Hawaii that year. She and Terri were seniors in highschool when we moved to Hawaii. Wayne (their dad and myhusband) worked for the US Department of Agriculture, andin those days, if he wanted a promotion, he had to accepta transfer every couple of years or so. By the time Tammyand Terri graduated, they had attended three different highschools in three states. Their older sister, Cindy, was tired ofmoving when Wayne transferred to Honolulu, so she stayedbehind in San Antonio, Texas, to work on her bachelor'sdegree at the university there.

Though most of the kids in the Ts' classes at McKinleyHigh in Waikiki were very short Orientals and the Ts werevery tall—nearly six feet tall—Tammy and Terri got alongjust fine. Their buddies called them the Redman Trees andquickly introduced them to island ways. For example, theTs played clarinet in the marching band, and after footballgames, everybody went for saimin instead of hamburgers orhot dogs. And everybody hung out at the beach instead offast-food joints. In short order, both girls learned to bodysurfand to paddle an outrigger canoe.

Terri and Tam are mirror-image identical twins, so Terri,the oldest by one whole minute, is left-handed, while Tammywas right-handed. They loathed being referred to as thetwins, but they didn't mind at all being called the Ts. Eachstruggled to find and maintain her own identity, separate fromthe other, yet they both liked the same things, had the samefriends, and wanted to do the same things at the same time.Maintaining the peace could get a bit tricky at times.

When they were babies, Terri and Tam seemed to needto touch each other before they could go to sleep. They bothslept in the same crib, crossways instead of lengthwise.Later, they learned to sleep in separate cribs, but they stillneeded to be able to see each other before they could relax.By the time they earned their bachelor's degrees, they weredetermined to finally go their separate ways.

Here's a second-place trophy for the Brookwood Run10K in 1993. Tam lived in Birmingham, Alabama, then. Shehad come to Albuquerque from Hawaii to attend graduateschool at the University of New Mexico. When her programwas downsized, she transferred to the University of Alabamaat Birmingham, where she earned her PhD in microbiology in1995.

Here are several trophies and medals from herBirmingham days. This one is a participation medal for amarathon. I didn't know she ever ran a marathon.

The medals are wrapped in a red T-shirt she got forparticipating in a 10K run in Hawaii in 1983. Oh, and here,underneath several pairs of shorts, is a small chess set withquartz chess pieces. I had no idea she played chess. Shemust have learned in Birmingham.

At the very bottom of the box, there are a couple ofChristmas tree ornaments. One is a tiny wooden lobster, andthe other is a tiny mandolin. Nothing ordinary for my Tammy!

There are yet more boxes. Those with clothing haveother things tucked in them too. This one has a small wickerbox with a lid on it. The box is about four inches across,and inside there are all sorts of odds and ends—a pair ofearrings made to look like tiny evergreen wreaths, anotherpair of small round glass Christmas tree ornament earrings,a bottle-cap opener, a small Swiss Army knife, a motleyassortment of key rings, and a tiny pair of scissors.

There are boxes and boxes of papers, each with folderslabeled and filed alphabetically. Most of them are aboutthings I've never heard of before, probably information shecollected while she was in graduate school. And then thereare the files about cancer. I don't want to look at those. I putthe lid back on the box and put it away.

Tammy has an eclectic collection of books: JamesMichener's Hawaii, several books by Arthur Clarke andRobert Heinlein, and even a collection of Shakespeare'sworks. Here's Viktor Frankl's Man's Search for Meaning,the National Geographic Photography Field Guide, Cats ofthe World, and All I Need to Know I Learned from My Cat.My curious daughter pursued information about all sorts ofthings, it seems.

All these CDs, and to think these are what's left aftershe sold most of her collection to get some much-neededcash. I remember this one by Mary Chapin Carpenter. Tam'sfavorite track was "The Bug", especially the part that said"Sometimes you're the windshield, sometimes You're theBug".

CHAPTER 2

Our family scattered across the country once all three ofour daughters were grown. Tammy started graduate schoolat the University of New Mexico in Albuquerque. Terri wentto graduate school at the University of Miami in Florida,and their older sister, Cindy, lived with her husband andtwo young daughters in San Antonio, Texas. Wayne andI lived in Hawaii. When he retired from the US Departmentof Agriculture in 1987, we moved to Albuquerque to be nearour parents and siblings in Arizona and still be within drivingdistance of our girls.

A year after our move, Tammy transferred to theUniversity of Alabama at Birmingham to finish her PhD inmicrobiology. Meanwhile, within a couple of years, both Terriand Cindy and her family had moved to Albuquerque.

After she finished her PhD, Tammy continued workingas a postdoctoral fellow in Birmingham. Though she workedlong hours, she was diligent about keeping up with what wasgoing on with the rest of the family and letting us know whatwas going on with her.

"Hey, Terri," she said during one of her regular phonecalls. "I've been thinking about this a lot lately. With all themoney I spend on phone calls and trips home to see youguys, I think it would be much cheaper and better all aroundfor me if I just move back to Albuquerque. I shouldn't haveany trouble finding a job there. What do you think?"

The year was 1997.

Overjoyed, Terri bought an old—over fifty-year-old—housenear the University of New Mexico campus for her and Tamto share. Tammy paid rent, but as far as each of them wasconcerned, the house belonged to them both.

The house had been a rental for years, and it wasrun-down, but it was in one of those old-fashionedneighborhoods where everybody knew everybody else. Allthe neighbors got together for picnics in the park down thestreet on the Fourth of July. They exchanged small gifts atChristmastime. They brought food if someone was sick. Andthey were seldom too busy to stop and chat.

Terri and Tammy loved the neighborhood, and they lovedthe old house.

They painted and repaired and updated it until it wastheir own. They turned the badly neglected yard into a greenrefuge.

They both loved plants in general and gardening inparticular, and their yard showed it. They trimmed and fedand coddled the row of ancient rosebushes along one side oftheir front yard. They hauled out trash, and they cut down thedead cottonwood tree in the backyard. They contoured andthey planted. One side of the backyard had apparently beena vegetable garden, so they cleaned it out and planted theirvegetables there. But not in neat straight rows—that wouldbe too regimented, too ordinary for them. The tomatoes wereplanted in a cluster, and the cucumbers wound around attheir feet. So it went with the rest of the garden: two rowsof flowers, one yellow calendulas and the other bright bluelobelia, twisted and turned in the shape of a double helixthroughout the vegetable garden. Sunflowers lined thesidewall.

Terri and Tammy spent hours sitting in the cool shade intheir backyard, just watching things grow. I had my doubtswhen they decided to live together. True, they were bestfriends. They even had their own twin-speak, as many twinsdo—they made it up first even before they learned to talkso the rest of the world could understand what they weresaying. They were both fanatic about exercise, especiallyswimming and running and cycling. But Terri was like aSuper Ball, always in motion, always in a hurry, while Tammymoved at a much slower pace. She was more methodical,more laid-back. Terri was a neatnik, while Tammy was a bitmessy sometimes. I was worried about them getting alongtogether in one house again after living apart for so manyyears.

But they got along just fine.

Then, in 1998, Tammy was diagnosed with cancer.

Nine years earlier, almost to the day, I had beendiagnosed with leiomyosarcoma, a fast-growing type ofcancer that attacks smooth muscles. But I was fortunatebecause my tumor was growing on the lining of the commonfemoral vein in my left groin, and it made its presence knownearly on. It made my left leg swell, and the search for thecause of the swelling led to the discovery of a golf-ball-sizedtumor.

It was surgically removed, and when the biopsy confirmedthe diagnosis of cancer, my doctors rushed me througha series of scans and tests and started my treatment rightaway.

At first I was angry—not at anyone or anythingspecifically, but just generally angry. The first time I went tothe oncologist's office and saw a partially completed jigsawpuzzle on a coffee table in the waiting room, I saw that as anominous sign that somebody expected me to be spending awhole lot of time in that waiting room, and I was not pleased.

I was absolutely obsessed with maintaining the statusquo; I was not going to let cancer control my life. But whenmy hair started coming out in clumps and I ended upbald, my anger turned to bewilderment and sorrow and areevaluation of my priorities.

After three sessions of chemotherapy (one a month), Ihad a series of radiation treatments followed by three morechemo sessions. During the interruption in chemo whileI had radiation, my hair had come back curly (it's naturallystraight—this was a great bonus!), but when I started thefinal session of chemo treatments, my hair fell out again.This time it wasn't such a shock. And I came to actually enjoyplaying with those jigsaw puzzles in my oncologist's office bythe time all my treatments were finished.

I had all sorts of scans and tests on a regular basis after Ifinished the treatment regimen. Each time, I expected direresults, but each time, there was no sign of the cancer. I justknew every strange bump and each unexplained ache or painmeant that the cancer was back, but it never was. Long after Iwas declared cancer-free, I still expected it to pop back up again.But eventually I came to believe that maybe it really was over.

In retrospect, I see that I was extraordinarily lucky. Mytumor was found early, before it spread. Tammy wasn't solucky. She was diagnosed with cancer, angiosarcoma, on thesame leg, only hers was on her buttock. I saw my oncologistin a restaurant not long after Tammy's diagnosis, and I toldher about Tammy.

"Oh my gosh!" she said. "Did you know your diagnosiswas changed from leiomyosarcoma to angiosarcoma? Yourdaughter has the same cancer you had, and it's a really,really rare one."

After a while, Tammy started keeping a journal of hercancer odyssey, detailing events as well as her impressionsof what was going on now that her life revolved aroundcancer. At first she didn't post entry dates; she just wrotewhat was on her mind.

This is what she had to say about her first encounter withcancer, with hash marks marking the end of each entry:

"Hey, is there a bump on my butt?"

In the beginning I thought it was an innocuous bug bite ora splinter. I asked Terri to inspect the back of my left thigh.

"I don't see anything," she said.

Jokingly, I responded in a lame impersonation of ArnoldSchwarzenegger, "It's probably just a tumah on my ahss."

Several months later, it turned out that I truly did have atumor on my butt. It wasn't funny.

I first noticed the bump on the back of my leg inNovember 1997 after helping Cindy clear weeds out of herbackyard. At the end of November, I went to see my doctorabout the bump. She thought it may be an abscess andprescribed antibiotics. I took the antibiotics and went on withmy life.

In March, I noticed that the damned bump was still there,so I went back to the doc. She said that sometimes theinfected tissue gets walled off from the healthy tissue and theresulting bump can last for months. She decided to try to doa needle aspiration. The bump was solid—nothing came out.So I got more antibiotics and went on my way.

Now the bump began changing. It grew larger, and thesurface grew flat and red, and it began to feel warm to thetouch. I went back a third time to the doctor. She said she hadnever seen anything like it, and she felt strongly that it neededto be removed. She said that another physician in her practicewas more experienced at these small in-office procedures.

He thought it was probably a benign lipoma, and laterthat afternoon, he removed an ugly mass from my buttock. Anurse carefully cleaned and tightly bandaged the wound, andI went home.

The next day, I felt pressure building under the skin wherethe "lipoma" had been removed, and later in the afternoon,the wound opened up and began bleeding again. I went backto see the doctor, and he drained as much blood as he couldand reapplied the bandaging.

I went back to the doctor every day that week. By theweekend, it looked like the wound might be healing. Butwhen I took a shower Saturday evening, I saw a trickle ofblood from my leg. It soon turned to a horrifying river ofblood. I screamed for Terri—thank God for a sister who'sa physical therapist with training in wound treatment.She calmly helped me out of the shower and stopped thebleeding, then bandaged me up.

Monday morning, I called the doctor about my recurrentbleeding problem. He agreed that something needed to bedone, so he referred me to a general surgeon. The nextWednesday, Mom and I went to see him.

Meanwhile, the pathology report finally came back sayingthe mass was a benign hemangioendothelioma.

When I saw the surgeon, he ordered a CT scan beforehe scheduled surgery to remove the mass, which was rapidlygrowing back. The scan showed it localized to the fat justunder the skin of my buttock.

The surgery was no problem. I went home with somestitches to be removed by a physician's assistant in a coupleof weeks.

Just a few days later, someone from the surgeon's officecalled saying I needed to come back and speak directly withthe surgeon. That's when I knew the mass was not benign.

My life moved in very slow motion, but time sped by. I leftmy office and went for a two-hour walk in the desert to tryand sort out my thoughts.

I realized I knew nothing about the kind of cancer I had orthe treatment options. So I decided to focus on my immediatecomfort.

It was June in New Mexico, and my car's air conditionerdidn't work. I figured it was going to be a rough summer,and I wanted to at least have a comfortable car to ride in.My car, a stunning, classic old Saab, was getting expensiveto maintain. I decided to trade it in and get a brand-newSubaru Impreza Outback Sport. That afternoon I looked atsome—and drove one home. I bought the car on absolutelyblind faith that somehow things would work out and I wouldbe able to keep it.

I met with the surgeon after work last Friday. He told methat I had an angiosarcoma, a rare soft-tissue sarcoma. Hesaid I needed much more extensive surgery to remove anyremnants of the tumor.

I also talked to a plastic surgeon. I'm to have a wideexcision to remove the lower half of my left buttock andany remaining cancerous cells, followed by reconstructivesurgery using tissue from the back of my thigh to fill in thehole. The incision will extend from midbuttock to just abovethe back of my knee.

I felt numb. I walked out of the clinic feeling so differentfrom everyone else. I went home and took a three-hour walk,trying to get used to the idea that I have cancer.