Guilt of the Patient

Genuinely, I sometimes wonder when I hear stories of other cancer patients who are suffering so much worse than me with their treatments, whether I should feel guilty about how well I appear to be doing, comparatively. It is an irrational reaction, of course, as I am not responsible for how other people respond to their chosen treatments, nor do I have any level of control over their physical health either before or after their cancer was discovered. Yet it pains me to hear these stories and realize that there is so little I can offer to ease the suffering.

In many of these cases, the patient remains upbeat, even happy, throughout the story. Tougher than I, these characters. Stronger of will, because they endure more by choice, determined to lick their adversary. And lick it they shall, because these are cancers that, even far along, can now be cured or, more practically speaking, be diminished to the point of near eradication. And this, in spite of the heavier toll paid for the intense beat down of the chemo cocktail, makes me feel a little jealous. And that jealousy makes me feel guilty, too.

And then along comes my friend, Carlos. A refuge from El Salvador, Carlos came to California with the hope of finding some treatment for his leukemia. He is a slight fellow, but only on the outside.

When I think of inner strength, Carlos is the standard by which I measure. I met him shortly after I moved into our house some years ago. He looked wan, weary, almost like he was wasting away, and he addressed me with slight confusion, seemingly unsure of where he was. Apparently, he had been coming by the house sporadically for a while, getting some handouts from the previous owners, whether food or old clothes or recyclables. He spoke of how kind the previous owners had been to him, then launched into his story.

I felt bad for him. He sure had it rough, no question. And at the time, I actually thought that maybe if I gave him some cash he would go away and absolve me of his history of struggling to get to the North, crossing potentially hostile borders, being taken advantage of, beaten, robbed, left to fend for himself on the unpaved road. At the same time, I didn’t want to set up a precedent that would keep him coming back. But I could not get past the fact that I was struck by his story — and moreover by the sincerity of it in his broken English. And the kicker was that he had come by to show the previous owner how he had gotten some official paperwork to apply for legal alien status. He was so proud that he showed it to me, transferring the relationship he had hoped to continue with the family we replaced into my hand. I could not help being happy for him, and my initial pity dissipated in lieu of a growing admiration.

Carlos had left his home country for various reasons. He was escaping violence. He was looking for a better life and a way of sending money home. But his health had demanded the migration. Here, in Los Angeles, he was a statistic. An illegal, mostly homeless migrant with few prospects, taking advantage of state-covered health care through the city hospital’s emergency room, where he knew he would not be turned away. I was living in a nice-enough house on a pretty and peaceful street, where trees formed a canopy over the road and children played outside without much concern. At the time, I wasn’t worried about much of anything beyond whether the gardeners would do a decent job on the hedges without clipping the amaryllis I had been fostering. I had to give him something.

Then I never expected to see him again, really. I had almost forgotten about him when he showed up to tell me some good news, that he had a place to live: a garage, where he was even allowed to keep some of his stuff outside, for only $20 per week. He was so happy to have a roof, and not be subjected to the whims of other transient figures who had bullied him. Over the coming months, he returned occasionally, each time with a new story of his trials or successes. Sometimes he was out of medication, needing a blood transfusion, and it was readily apparent that this was no lie. He would be weak and frail one month, then bright and energetic the next time I would see him. I would listen to his stories and offer an empathetic ear. His world was beyond mine, slightly terrifying and clearly not as distant as I would like to believe when I fall asleep at night.

When he came to me with a story about being beaten for emptying an already near-empty beer can that he thought had been left as trash, he showed me the bruises still visible from his broken ribs. When he came to me with the story about how he had been hired to break apart glass without being offered protective eyewear and asked what he could do about a fragment lodged in his eye, I offered my best advice and a proper eyewash, and admonished him for doing a job he knew wasn’t safe even though we both knew he really had little choice because he still had to pay for his medicine, for the bus, for that shelter in the garage… More often, though, he comes with an air of excitement rather than misery. He comes to tell me that he got a bicycle (later stolen), or that he had been given a new pair of shoes (two sizes too large, but comfortable and sturdy). He comes with the good news of his treatment, or the prospect that his legal status will be granted. He always comes, even when the news is not so good, with a smile and hope on his face.

I was out washing my car yesterday and he came by just to see if I had anything he could recycle. Turned out that I had one beer bottle in the bin, which I gave to him with a shrug, and he said maybe he would see me next week. I put my hand on his shoulder, something I had never done before, and I told him that he looked really good. He said he felt good. He smiled and told me to “say hi to the angel,” referring to my golden-haired daughter who he thought looked like the image of an angel when he first saw her so long ago, staring at him wide-eyed through the window while we spoke outside. Part of me wanted to say, “Carlos, guess what, I have cancer now!” But I couldn’t do it. I didn’t want him to feel sorry for me or worry about me or feel that he could not come by to tell me of his troubles.

Part of me needs Carlos to come by, to balance my perspective and to remind me of how I should be facing the world. He has never given up and he has asked me for remarkably little beyond a glass of water and a banana. What he really wants from me, I think, is to matter to someone. Granted, yes, I am someone who has sometimes helped make up the difference in the cost of his monthly bus pass, or who has given him an old shirt, but that is not the reason he visited me yesterday and will not likely be the reason he visits next.

We are from vastly different worlds, Carlos and I. He identifies strongly with a statue of St. Francis that sits on our front porch, an image from his strongly ingrained Catholic upbringing that to me is just a quaint piece of art. I have seen him once or twice, when he thought I wasn’t home and he was preparing to leave, take a moment to kneel and pray to St. Francis. And he has told me more than once that he says a prayer for “the angel” and for my family; though I have never felt that I particularly deserved his prayers, I appreciate knowing that someone cares enough to single out my daughter if for no other reason than that she is my daughter. It’s weird to me, but a reminder that there is something good in this world and good in people even when the odds are so stacked against them. So while I do not want the life that Carlos lives, and I acknowledge that I would not want to trade places with him, even that I am scared for him, I also recognize that in many ways he is a person I want to be more like. I admire him, though my own guilt will probably always keep him, usually at least, at arms length.

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