Late August, when I saw John Tinker at the cancer support group meeting, I told him, “It has been a privilege knowing you.”
He sat there, looking his usual slim self, with his rosy-cheeked face. His hair was greying at the temples. His eyes were alert.
This was what he looked like ever since Dan and I had been attending these meetings at UCSF in spring 2009, soon after John and his partner Adrian started coming. John just kept showing up, after every creeping back of the cancer into his body. His appearances meant a new day, a new chance at life. Even through pain he was a fixture, one of the main members of this collection of people in various stages of colorectal cancer.
He wore his thick hair a bit longer in the front and short around his neck and ears, reminiscent of the F. Scott Fitzgerald era. The contemporary part of him wore jeans and a button down shirt, and glasses. He and Adrian both seemed like they were from another time. Adrian, skilled in the decorative arts, painted intricate designs on harpsichords, furniture, and walls. He was soft-spoken, humble, with a little pointed beard and twinkling eyes.
They finished each other’s sentences, and when their words would collide, they would ask each other, “Do you want to say it, or should I?”
This was the last meeting I could attend before my semester started, since I was assigned a Thursday night class. We all sat in a circle. The one couch often held either Marsha and RaeAnn or John and Adrian or Dan and myself, couples. Vittorio, the leader, sat in the same chair he always did, but the rest of us alternated. The room was vacated of the usual traffic by our 6pm start time. All the desks were empty, as were the other rooms with tables and chairs. On a shelf to one side were photos of a couple of women who had died of breast cancer, their names inscribed on the frames. On top of another shelf hats were piled up for women who had lost their hair due to chemo. On top of and in cupboards were balls of yarn and knitting needles and crochet hooks for people to make the hats.
John had expressed many times that he was dying, yet this time seemed different. His pain was worse, but too, the cancer was invading further. All of us did our best to respond in some way, and it turned into praising him and showing him gratitude.
“We wouldn’t have met, even though we we’re both English teachers,” I said.
We went in different circles, even though we both helped students with their writing and were both writers. He worked for Stanford and I for Laney. He directed the writing center there, taught literature. When I had looked him up on the internet, I found that he had written papers on a writer I never heard of. The cancer transformed not only his life, but his writing. In between various surgeries, emergency room visits, chemotherapy, and other treatments, he worked on a book written from the perspective of a cancer patient.
It’s not often that one gets the chance to thank someone to their face, to say things that you would otherwise end up saying after their death. But this was a facet of the group, where we practiced the extraordinary.
Three years ago, in fall 2007, John fell down in a grocery store, writhing in pain. He went to his doctor, who did tests and told him he had colon cancer and would need surgery immediately. John balked in disbelief. Cancer? Out of nowhere. He was in perfect health—exercised, ate right, was of sound mind and body, lived daily as a vital person. After the denial wore off the next week he went in for the surgery.
We joined this group as we were doing research around Dan’s own cancer. Dan had been diagnosed with rectal cancer that spring and we had gotten two recommendations for radical surgery from inside Kaiser and one outside, at UCSF, from the new head of colorectal cancer there. The group helped us navigate the terrain. We found people with experience and a leader who moderated the conversation well and with humor. Everyone was frank, which made sense, as we ourselves had already entered into the realm of “too much information” being de rigeur, where bodily descriptions were not tasteless, but necessary.
At first, while waiting for the meeting to start, John and I would talk about our teaching programs. As he vanished from that world, he would ask about my work, and I gladly shared, knowing he understood and appreciated the details of my composition classes, which always benefited from an airing out.
Another connection I had with John was writing. Dan and I were waiting for a surgery date in June 2009 and I could not write. In between semesters, I was drowning in the limbo of not knowing and not having any control. I was anxious that Dan’s surgery would be in the midst of my summer teaching schedule, which was much more rigorous and condensed than a regular semester. We bandied back and forth with Dan’s surgeon about the date to no end, because he would forget what we requested and scheduled a date that had to be pushed back.
It was John who prodded me. He said I must write. John inspired me because of his own writing—not only little essays he was working on in spite of his physical condition, but the book about patients’ attitude and experiences with the health system. He wanted to affect change with this collection. His own positive attitude was the catalyst. The book would be available as hard copy, but also free, online, his gift to everyone and anyone. Thanks to John I put pen to paper, and that grew into writing over 100 pages about the steps and stages from Dan’s diagnosis to his surgery, the hospital stay, recovery period, and beyond, diagramming in words a partner’s experience with the medical system, an arc of a relationship.
John had gone on a leave of medical absence from his teaching position before we met in the group. By the time he had retired for good, a few months into our association, he declared that he did not miss work and did not understand how he could have spent that much time doing it. He was once passionate about teaching, but now a nice day consisted of waking up to Adrian’s touch and a little gardening. His priorities had changed. He and Adrian would have a nice dinner after hearing a new, even more devastating diagnosis, or brunch at the Cliff House.
“What else can we do?” they said to us all, with smiles on their faces.
We were all impressed with John’s attitude from the start—how he had been dealt this hand, yet he was approaching it positively, frankly, step by step. He was not “battling” cancer, as the medical profession wanted him to do; rather, he treated it as much as he could, and then accepted it. This does not mean he was passive. He had undergone surgery and rounds of chemo. When the cancer spread to his sacrum at the base of his spine, John had the new-fangled “cyber knife” treatment, lasers attacking the very spot where the cancer was hitting the nerve. In fall of 2009, he said he didn’t think he would live to the following summer. He took valium to mediate the pain, as the cancer was touching the nerve. Then he tried morphine, but it left him too out of it to pursue his creative outlets, like writing. Then methadone.
He and Adrian were unable to control the actual disease, but they controlled how they experienced the disease. The “we” here is significant, because it means that he and Adrian were dealing with this together. I understood the “we,” having gone through Dan’s cancer, where sometimes the line between patient and partner blurred in the work and emotional investment I put in which involved in attaining the right answers, treatment, and care for Dan.
More than working together to attain an end, because of the recurrences and complications, these two were living more fully than anyone I’d ever known, in spite of setbacks which left John taking the various pain killers, and making an emergency visit to the hospital because of a blockage in the colon. He led a life of laxatatives to avoid further blockage, before he ended up having a colostomy, which deprived him of wearing his nicely-fitted blue jeans, similar to Dan. John’s experience kept turning corners, and we would hear tales of something new all the time.
At the garden party they hosted in September, it was clear that this was a farewell party for John, despite the delectable sheet cake someone brought for his birthday. Adrian explained, as he welcomed us through the house and down the backstairs towards the garden, that John might have to lay down at some point, because he tired easily. Fall was approaching and he only had at most a few months to live since the cancer was uncontrollable and all they were doing at this point was trying to mitigate the pain.
Baroque music from a string trio flowed through the air from under the canvas cover at the corner of the garden, the hire of the musicians a gift from one of John’s friends for the event. A bowl of lemonade stood in another corner, next to the house, along with some chips and guacamole. We were introduced to some of John’s Stanford colleagues, as well as some friends from the Quaker church Adrian was a member of and which they both frequented.
We wandered back upstairs, to the dining room table, where an assortment of French breads beckoned, handmade by another friend who was taking a baking class, along with a platter of Mediterranean finger foods and the brownies I had brought. Then back out to the garden, where at second glace we could take more in.
The variety of growth paled beside the height of some of the plants, such as a couple of olive trees, pink roses climbing a trellis, and the pink holyhocks, in full glory. These mixed with tropical plants and low-lying grasses and flowers in yellows and purples. It seemed like a mad disarray, but the closer you got, the planning became apparent, as you walked on one of the little paths, or sat on a stone wall to enjoy the music more closely, avoiding the prick of a cactus here and there.
Sitting on cast iron furniture under the mid-afternoon sun, Dan and I spoke to a friend of theirs who had a studio near Adrian’s, in the same area, Hunter’s Point. She explained how Adrian drove past the house to his studio and saw the “For Sale” sign. We told her how we knew the couple, and she listened intently as we spoke of the support group experience, of John’s health. Dan, who didn’t readily open up, spoke to her of his cancer.
As this conversation waned, Marsha and RaeAnn from the group appeared. Like John and Adrian, they had lived most of the years of their relationship in separate dwellings and recently moved in together. Marsha said they had visited this house, and explained their joy at the new picket fence at the front which replaced the chain mail one.
He and Adrian had bought the house together a little before John was struck down by the disease. At that juncture, they had already lived together for 14 years, and had been together as a couple for three years before that. Theirs was one of the oldest houses in San Francisco, and a wreck, which they spent considerable time and effort renovating into the Victorian jewel it once was. Adrian used his skills as an accomplished decorative artist to restore the décor. They selected the right furniture to complement the era. They kept all the old pictures that were already in the house, of people they did not know, and propped them. They re-upholstered. John took on the backyard, finding old and new plants and flowers to make a lush, enveloping garden, a legacy for Adrian and John’s friends.
The other connection between John and Adrian and Dan and myself was what cancer gave our relationship. It was a gift. Dan and I realized how committed we were to each other in the midst of the cancer, over lunch down the block from the hospital, during a day of many doctor appointments. We married in April 2010. John and Adrian had their marriage ceremony near the time Dan had his surgery, summer 2009, in Mendocino. These relationships have been the richer for this disease entering our lives, like a secret garden that needs a key.
The meetings I could not attend in September and October, Dan informed me of. He said that John and Adrian were looking into hospice care and discussing the details of John’s death. Adrian so openly talked about John’s death right in front of John, it felt weird and unusual, but it was also mark of their frankness with each other and their openness with the group. Adrian wondered if he could accompany John’s body to the crematorium. John expressed how he had prided himself on his body, and how he had lost control over it.
Cancer has made us seen who are our friends and who are not. It has shed a light on priorities, values, and love, in the same way that death does. When my father died over a decade ago, his absence cast a shadow and made everything clear—my love for him, the balance of my parents’ relationship. Cancer, too, reveals all—what is important in life.
In the face of John’s death, questions come to the front. Why does one person die, while another’s life is spared? Just because Dan’s cancer was caught in an early stage? Why must Adrian deal with this loss? Longing comes up—how I wish I had known John more, better, for more years. Was it enough to see John in group? I picture John’s face and want to hug him as I did the many times after a group meeting.
Knowing someone through a support group is different than sharing their everyday life—it is no better or worse, just more concentrated. I didn’t think of myself as a close friend of John’s because I did not share this everyday life, and because outside of one event they invited us to, we only saw them in group, in a controlled setting with rules, with others around. What the group allows is divulgence of the deepest information—the physical breakdown of the body, cancer cells multiplying and destroying a life. The physical.
In John’s case, the cancer became something spiritual too. His beliefs had helped steer him to a positive outlook of acceptance. His spirituality was, as he told us, something that he went towards to nurture himself in these times. When, however, during one session, he broke down and told us his strength was nowhere to be found, that even his spiritual center couldn’t be found, what could we say? He couldn’t be cured. His optimism failed. He was going to die and was in constant pain. We were there as witnesses to his pain and his struggle to remain optimistic.
As with anyone I love, I found myself wanting to reach out and grasp the pain, removing it for good, along with every part of the cancer, but all I could do was remark on our meeting and knowing each other under these unique circumstances. It was particularly hard to watch someone like John go down because he kept returning to the group, because of the depth which he saw and understood his own predicament, because of his expression of that to us. He was an illusion even before his death.
John’s positive attitude, though it may have waned, was an inspiration, like the garden he left behind to be enjoyed, plants both old and new flowering in the sun and bending to the force of the wind. If there is a way of not “battling” life, but accepting it, recognizing what can be controlled and what cannot, John found it. The garden stands for the connection he felt to the living world, but also his connection to something beyond.
