(More) Recent Glimpses of...

...another walk on a rainy day.  This time Daniela has outflanked her trusty security detail, and is on the left.

...silly reindeer games.  Somehow Gabriela has managed to convince her younger brother that it is not a drag to dress up as a reindeer queen.

    

JP Drain Obituary...

Jackson-Pratt Drains. 14 Days, 23 hours, 10 minutes...my best estimation of the lengthy silicone embrace, medically necessary, albeit emotionally suffocating.

Daniela is now, as she exclaimed earlier this evening-drain free! Her last remaining leech deprived of it's hemoglobin nourishment was cast into a plastic wastebasket. Vampiric silicone sealed in a synthetic polymer coffin. I only wish that I could have been a witness to this unceremonious funeral. (One of Daniela's Superfriends accompanied her to the medical appointment today.)

During the past few weeks, I spent many moments ignoring, cleaning, cursing, emptying, and repositioning these drains. Aided by exhaustion, and uninhibited by sleep deprivation, I kept a list of acerbic aliases for these four horsemen of medical artifice. This list could still elicit a wince or two from a drunken sailor, I'm embarrassed to say.

So, the instant this last drain died, I should have sat at my office computer and triumphantly typed its obituary. But I didn't. I waited almost 12 hours...to say farewell. When I arrived home from work, Daniela was basking in her silicone-free status. Since Ari and Gabriela were spending the night with their paternal grandparents, we decided to go out and celebrate at a wonderful Ethiopian restaurant nearby. Hours gone by and with the Amharic aromas lingering in my mind, I finally began to write.

But after saying my peace, I confess that I feel ambivalent about my disdain for the drains. My supercilious schadenfreude seems excessive when I realize their role as conduits, not only of ire and frustration, but of more delicate emotions coaxed from me. These emotions, like the vital fluids syphoned from Daniela, contained a remediating reciprocity, a nurturing and nourishing quality that fortified our friendship. I'm glad the drains are gone, but the memory of those translucent bulbs like the Amharic aromas will linger a bit longer, and that's OK.

Recent Glimpses of...

...Daniela flanked by her security detail during a neighborhood walk.






















...fait accompli, the gifted workbench assembled at last.

Betwixt and Between...Ontology and Oncology

The day after Daniela's surgery, her second and final day at the hospital, I managed to find a wi-fi oasis at the Georgetown University student center. While I checked my email and replied to many well-wishers, I overheard a conversation a few couches away. The main theme of the exchange between the two students was philosophy. The particular context was a debate on free will vs. determinism. If a man is in a room...and the door is locked...but he is not aware that it is locked....does he have free will? I scanned my email. Inbox, 22 new messages. Spam folder, 14 messages. The hypothesis of the causation of actions states that..... After thirty minutes or so, I had replied to most of the emails. The serenade of philosophical postulates continued, and I recall rolling my eyes thinking about the pleasures of the particular, the concrete, and the immediate: negative lymph nodes, validating my parking ticket, Daniela will be home tonight. The argument of abstractions between the apprentices felt so distant, until last night.

Last night, Daniela was scanning her own email's inbox. One message stood out, an email from Dr. Paul Carbone, an oncologist and friend of the family, and the son of her former oncologist who treated her Hodgkin's Lymphoma. This email message had its own menacing ganglial spurs...four attachments...articles from medical journals discussing breast cancer risk for Hodgkin's patients treated with radiation. (At that moment, I had not yet read the articles.) Daniela glanced up from her laptop, and calmly offered, "I may not live much longer...." She went on to quote statistics from the one article she was reading, frustrated that no one had told her, or no one knew about the risks inherent in her previous radiation treatment.  

Statistics. Dr. Cocilovo mentioned a few days ago that Daniela's cancer, classified as Stage I, had a 95-96% survival rate at 10 years. A good friend mentioned in an email that Stage I breast cancer has a 100% survival rate at 5 years. The articles attached to Daniela's email offered other analyses...a risk factor of developing breast cancer as high as 29%, depending on age, for Hodgkin's survivors...a radiation dose of 4 Gy or more delivered to the breast has a 3.2 fold greater risk of developing breast cancer, for Hodgkin's survivors...hormonal stimulation (pregnancy) is a significant risk factor for developing breast cancer among Hodgkin's survivors treated with ABVD Chemotherapy (a chemo cocktail that does not appear to cause ovarian damage).

I recall a quote by Mark Twain (quoting Benjamin Disraeli): Figures often beguile me, particularly when I have the arranging of them myself; in which case the remark attributed to Disraeli would often apply with justice and force: "There are three kinds of lies: lies, damned lies and statistics." - Autobiography of Mark Twain

Daniela and I both mulled over the sour forecasts...her Hodgkin's treatment plus pregnancies probably gave her a 1 in 3, or greater chance of developing breast cancer.... She is now a survivor's survivor, and she wonders about the consequences of her upcoming treatments...about mortality, about the unknown and unforeseen side-effects of her upcoming chemotherapy. She reluctantly surrenders to the idea of another oncological alchemy. She sighs. I sense her attempts at divination, her faith in the words of the medical journals' actuarial augury visibly shaken. Twelve years ago, her physician also mentioned that leukemia was a possible side-effect of her Hodgkin's treatment. Leukemia, another possibility, another set of worries distracting her. What do the oncology odds makers forecast for this risk? 

I remind her that statistics and probability are just that. She is an individual. She shouldn't dissolve herself in the data pools and acquiesce to the communal fate of chi-square tests, P values, and regression models. Adrift in the sense of the abstract, I try to bring her ashore with images of the concrete by listing some of her attributes:  athleticism, a healthy diet, a resilient Mediterranean physiology....

I think back to the student center days ago and wonder if those two Georgetown students, emerging philosophical sufists, have considered other logic puzzles in their study sessions, examples drawn from an interplay of the metabolic and the molecular, an ontology informed by oncology, molecular determinism vs. cancer-free will. I (re)imagine their conversation. If a young woman has Hodgkin's disease...and is treated with high dose mantle radiation...but is unaware of her severely increased risk of developing breast cancer and leukemia....is she free to consider herself a survivor? I scan my email. Inbox, 14 new messages. Spam folder, 3 messages. The hypothesis of causation of actions states that.... My impatient curiosity wonders how they would have answered. How would you answer?

Translating Pathology Prose

This morning we played a medical appointment double-header.

10:30 am, Surgical Oncologist. Dr. Cocilovo gave us a copy of the full pathology report. In summary, she stated that everything looks great. For those of you fluent in pathologese, here is the unmediated summary:
Tumor Type: Infiltrating Ductal Carcinoma, NOS, associated with a component of Ductal Carcinoma in Situ, High Grade
Tumor Size: 1 cm
Elston's Grade: Poor (Score 8)
% of DCIS: Less than 30%
Margins: Negative
Lymph Nodes: 0/2
ER/PR, HER-2/NEU: Ordered on paraffin block "A11"
pTTNM Classification: T1b N0 Mx
For those of us who are not fluent in the medical sub-dialect of pathology prose, I can offer, after speaking with Dr. Cocilovo, a tenuous translation of the pathology report summary. The Elston's grade score of "8" means that this is one ugly bad-ass type of cancer...it is aggressive. The good news is that they got it all. (There may be a cell or two of metastatic breast tissue left behind, but the chemotherapy will take care of them.) Now, back to the Elston's grade score...the most efficient visual interpretation I can offer is a portrait, in triplicate for emphasis, of the Pale Man.
The Pale Man is one of the characters in the Academy-award winning film Pan's Labyrinth, his fingers an apt metaphor for the ganglial spurs radiating from Daniela's former tumor. If you've had the experience of immersing yourself in this cinematic fairy tale, you will recall that the movie's main character, a young girl named Ofelia, does escape from the clutches of the Pale Man, albeit after a tension-filmed pursuit.

11:00 am, Plastic Surgeon.
After shrouding herself in hospital hijab couture, Daniela decides to look in the mirror. I capture the image of Daniela...looking in the mirror...looking back at me.
Daniela was hoping that today, they would remove the two remaining drains. They removed one drain, the one on the right side. This was the drain that caused the most discomfort. The appointment to remove the solitary silicone leech is this Friday...11:00 am.

Countdowns...

December 13, 2007 (Day of Surgery)
0450 hrs: Radio alarm clock wakes us up.
0453 hrs: I roll out of bed, Daniela tells me she wants to sleep 10 more minutes.
0510 hrs: Done with my shower, I head back to the bedroom. Daniela is staring at her wardrobe deciding what to wear.
0515 hrs: Daniela is still deciding what to wear.
0520 hrs: I am dressed, take vitamins with glass of water. Daniela is asking me what she should wear.
0521 hrs: I check, re-check and check again...the items I've packed in my backpack.
0525 hrs: Daniela is dressed, I tell her I'll meet her in the car.
0530 hrs: Departure Time. Daniela is still in the house. I worry.
0531 hrs: I jog back into the house...Daniela is in the kitchen. She is wearing clogs, prAna pants, her ski jacket, a scarf and a hat, and holding gloves in her hand. The only light in the kitchen is the fan light above the stove. She is carefully cradling a white bowl above the countertop, diligently herding a batch of homemade applesauce into its Ziploc corral.
0532 hrs: I raise my palms. "Take your time sweetie," I tell her.
0533 hrs: I am back in the car.
0535 hrs: Daniela joins me and we are on our way to the hospital.

December 23, 2007 (Ten Days Later)
2115 hrs: The homemade applesauce is still in our freezer, enjoying its cryogenic siesta.

Even Superheroes Have a Bad Day...

Maybe it is was the frustration, swelling steadily for the past week, unnoticed until today, the awareness of limits on everyday tasks.

Tea in a to-go mug...because her favorite mug is too heavy to lift.
Wearing a nylon belt when showering...because the two remaining drains cannot hold themselves up.
Another night sleeping in a mummified pose...because sleeping on her side is too painful.

Daniela manqué...this unwelcome fabrication colonizing her sense of space (silicone hosiery leeches) and time (calendars mottled with medical appointments), she cried this morning for no particular reason, and for every other reason imaginable.

I may (over)dress Daniela in Supergirl metaphors, but her crying, that form of emotional dispensation made intelligible to the onlooker by a script of facial contortions as unique as fingerprints, is my kryptonite. When she cries, her lips tremble with the intensity of a newborn yowl. The reflex is innocent. The effect is paralyzing.

I sat down to finish my breakfast listening to my own breathing hoping, wondering.... Within the hour, a triumvirate of close friends, Supergirls in their own right, came in succession to visit. Their presence was the simple antidote to the tearful tremors. The rest of the morning went well, so did mid-day.

By late evening, the discomfort has crept back into her mood. The drains need to be emptied. The ritual itself has become a variant couvade...instead of mimetic labor pains for the husband, I ape her sense of exhaustion...emotional and physical. Surreal...I have become mid-wife to my own wife's nightly natality of grumpiness. The drains will expire sometime before noon on Monday. I can weather the tempest. Daniela has overcome much, much more.

A few minutes before I go to sleep recalling what happened this morning, not the crying but the visitors, I smile. Imagining her as a Superhero may be cool, but knowing that she has Super friends is better.

A week-old vignette: An Everly Brothers Farewell

The evening before her surgery Daniela opted to take a long shower, a bit unusual since her preferred method of aquatic repose is a warm bath. (The pre-op instruction sheet ruled out bathing and showering the morning of surgery. The taboo was not related to the water, but pertained to fragrances and unguents veiled by soaps, body-washes, shampoos and conditioners.) While she showered, I busied myself inspecting my packing list...p. 136-137, The Breast Cancer Husband, by Marc Silver. I read silently..."What to bring. Stuff to pass the time: a laptop, a book".... The sirenic tune, vaguely familiar, drew my attention away from my list. I placed the book on my lap. I mused to decipher the lyrics. Journal in hand, I reached for my pen, found a blank page and wrote what I heard: Bye Bye Breasts | Bye Bye Sweet Caress | I Think I'm Gonna Miss You || Bye Bye Breasts | Bye Bye Sweet Caress | Hello Emptiness || I Think I'm Gonna Cry.

This refrain played a few more times before the water stopped running. A few minutes later, I still had not heard the bathroom door open and hesitated wondering if my new field guide, The Breast Cancer Husband, covered this particular scenario. Doubtful. No time. A deep breath, a small step into the hallway and a few more to the bathroom. I didn't even think of knocking as I both quailed and turned the knob.

No tears...only water drops rappelling from her hair onto the terra cotta tile. No frown...only a sensible smirk punctuated by that cerulean stare, her gawkish terry cloth figure resembling an oversized albino she-bat (with a pedicure) in self-embrace. If there was a hint of sadness, mourning or grief emanating from this comical chimera, it was clouded by an aura of acceptance, an ethereal sense of peace.

"Are you OK," I offered.
"Yeah. I'm fine," the response.
"I like your song. Cute, but morbid...," I parried with a wink.
"I know," she ended with another wink.

I closed the door behind me and walked back to my packing list...a music headset, snacks.... The sirenic tune returned for an encore, the lyrics joy-riding atop the steam that swaggered down the hallway: Bye Bye Breasts | Bye Bye Sweet Caress | I Think I'm Gonna Miss You || Bye Bye Breasts | Bye Bye Sweet Caress | Hello Emptiness || I Think I'm Gonna Craa-ay, Craa-ay.

__________

After drafting this post, I thought it would be appropriate to share a photograph taken almost six months ago in Sicily by Daniela's cousin Marcella... ...Sirens in the Sea, mother and daughter.

Yeya's Yoga a-go-go...Six days after Surgery

Daniela's friend Liz arrived at noon, eager for a play-date with her convalescing comrade. Liz brought the lavender yoga mat, and a bag of pistachios. They traded stories with an enthusiasm reserved for young boys bartering baseball cards in the playground. They laughed and giggled like adolescent maidens scouring a Judy Blume novel for details of teenage sexuality. They also turned a fragment of our bedroom into a provisional yoga studio. I made eye contact with Daniela and paused. She smiled, and then added "Yes, you can take pictures for your blog." Here is the slideshow:

Seamless...

Earlier this evening, Daniela asked me, "What is the female Frankentstein called? It took me a few seconds....

She had quite a bit on her mind after we returned in the early afternoon from today's doctor's office visit. Dr. Nahabedian, her plastic surgeon, removed two of the four drains, and removed the gauze bandages atop the fledgling scars. The plastic surgeon, with his predilection for symmetry and his attentiveness to aesthetics, noticed her muted frown. His reflex...to reassure her that everything would look great in the end...did little to ease her impression of the sutures. After many afternoon glances in the mirror...after many hours eyeing this new surgical font inscribed upon her, an impersonal cuneiform lament...she probably began to translate what she saw and how she felt. And I began to translate what I saw and how I felt at that moment. So, I created my own clumsy photo-mutation. The picture above is an alternative construction...my version of more manageable Frankenstein worries.

Gabriela's Bricolage

Both Gabriela and Ari are back at home with us having enjoyed a few days at neighbors' homes. Daniela's sister, Steffi, arrived from Holland to help out. The kids were delighted to see their aunt this morning as we all enjoyed a frenzied breakfast punctuated by laughter, giggles, and smiles. After breakfast, the kids went off to school and Daniela took a shower. But before sliding out of bed she showed me something Gabriela had sketched a few days ago:

(double click on the picture to enlarge)

Sleep deprivation. My first reaction was to scrutinize her artwork, and wonder why she had drawn breasts on our (male) cat. I tried to recall texts from long ago...grad school...Freud...projection. I blinked again, and realized they were paws. I need to sleep. Interpretation of Dreams.

Chez Brancaforte-Marty...

Yesterday afternoon, we were able to settle back into our home with the aid of two amazing helpers. Our two friends transported Daniela in the comforts of a mini-van. Pillows, and blankets kept her company as she was lying in the back seat...this 21st Century sedan chair trotting back across the Potomac River into Arlington.

Before we could enjoy the familiar surroundings, I had flashbacks to my days in the military...decontamination exercises aimed at vanquishing biological agents. Our friends orchestrated a swift and well coordinated para-military assault on each and every item returning with us from the Hospital. Clorox disinfectant towelettes buzzed around me like a swarm of papier-mâché locusts. Our friends, co-Consuls in earnest, led the effort and declared a "cease wipe" after thirty minutes.

When the fog of Clorox lifted, I was able to focus more clearly on the myriad of flora, the cornucopia of books, magazines, letters, cards, and ribbons crowded around the house. Daniela and I were overwhelmed with emotion, yet traded the temptation to gaze at these gifts for a few hours of sleep. Before surrendering to narcotic-induced slumber, Daniela whispered, "You should only get this much attention if you have a quadruple mastectomy," always the self-conscious patient eager to deflect the attention focused on her.

We slept for a few hours, Daniela's biorhythms calibrated to Percocet Standard Time. So at 2:30 am last night, she awoke (not because of pain, but because she was) craving a pear. For Daniela, a pear is not just a fruit. It is a repository, a music box of memories. More specifically, memories shaped twelve years ago, memories of her father pealing her a pear as he nurtured her appetite after chemotherapy. The melody of her father's Italian phrase, audible in the empty kitchen, as I peeled the pear for her...Vuoi una pera? Ti la sbuccio, figlia bella. She gingerly consumed it all...the pear, and the memories released by the mending morsel.

Another Percocet...another period of rest. Five hours of sleep, a bounty of relaxation for both of us, and she was up and walking around this morning. She insists on challenging the limits of her own constitution in ways that would make the current Presidential administration jealous as they challenge the limits of another Constitution.

A bit past midday, she is sipping her tea. She continues to read Funny in Farsi: A Memoir of Growing Up Iranian in America by Firoozeh Dumas....the music of Squeeze playing in the background...the lyrics resonate with her recent experience...She goes for her medical | She's passed, it's a miracle | She's up over the moon | She whistles nonsense tunes | She wants drinks for everyone | She's found a chord that she can strum.... Our cat, delicately nestled beside her, purrs as she turns the page.

The Day After Surgery...

We are both exhausted, and will go home in a few hours. Here is a compilation of images from our last 24 hours or so.... Thank you all for sending us your good vibrations, visualizations, and digital incantations. :)

[If you click on the lower right hand point/corner of the image below...you will see a new format. Click on the "album name," and you will open a new webpage were you can view the images in a larger format.]

Great News!

Dr. Cocilovo, Daniela's surgical oncologist, informed me this morning (after she was done with her part of the surgery) that Daniela's lymph nodes were negative, i.e., cancer-free. Her double mastectomy was a success according to Dr. Cocilovo. A few hours later, Dr. Nahabedian, Daniela's plastic surgeon, informed me that his part of the surgery was also a success. The surgery was almost five hours long.

It is now, 1:40-something p.m., and Daniela is in the recovery room, still sleeping.

Gamma Camera Images

Daniela had an appointment earlier today, the day before surgery, at Georgetown University Hospital. I accompanied her to the Nuclear Medicine section...nuclear medicine...two words in apparent errant juxtaposition. Here a very nice technician, thrice injected Daniela's right (it ryhmes with viola) with a radioactive imaging agent...no topical anesthesia. Now, I know this had to sting, because Daniela has an insanely high threshold for pain, and she was cursing under her breath--a patois of Italo-Germanic obscenities that would've made Asterix and Obelisk flee in a state of panic. A few minutes later, the technician slid Daniela in front of what appeared to be a faceless Apple Computer from the early 1980's. This box was in fact a Gamma Camera. Daniela closed her eyes and asked for her New Yorker magazine. She calmly turned the pages using only her left hand. I couldn't resist capturing the image:

The camera is the "box" to the right of Daniela. While I was taking my photo, the unstylish artifact was capturing its own image of Daniela. The Gamma Camera (Its name alone manages to conjure miscellanea from the realm of science fiction and comic book lore.) took the following image:
The dark spots on the lower left are the sites of the injections. The radioactive syrup will slowly make its way to the underarm. In a few hours, the lymph nodes, their jelly-bean forms satiated with imaging agent, will await the inspecting glance of the surgeon. Tomorrow during surgery, they will dissect the sentinel node(s) marked by radiation in order to better stage the level of metastatic activity. This Gamma Camera silhouette, more wispy apparition than photograph, has an eerie aesthetic. It also has an intriguing simplicity that betrays the reality of Daniela's physiology. I can not decide which of these two pictures is the greater distortion.

Tomorrow, we will be on the way to the hospital by 5:30 am. Surgery should begin on or about 8:00 am. To all of you who called and left voicemail messages, text messages, emails or simply thought of us today...your presence was felt, appreciated and welcome.... Thank you.

Ari's Antics

In my family, not so long ago-a generation or two ago, children were aggressively shielded from discussions of illness. Children were kept at a distance from relatives who were ill, often literally sequestered. Other times, they were inoculated with heavy doses of silence on the topic. Illness and disease were analogous to "the birds and the bees." The kids will figure it out later...no need to tell them anything. Whether born of custom, or culture, this approach is not the one we have taken with Ari and Gabriela. Daniela and I have both discussed, in age-appropriate terms, the details of both processes and procedures that Daniela will face. We made a conscious choice to enlist our children's aid in the process of healing.

In conversation, one day, both Ari and Gabriela volunteered to make tea and pumpkin bread (from a box of Trader Joe's mix) when Daniela came back from the Hospital, their faces resonating with pride as they realized their new role as helpers. They are both aware and proud of themselves as part of the community contributing to ease the unpleasantness of days to come. In contrast to these conscious efforts, there are other moments, literal eruptions of childish exuberance that create unexpected junctures of rejuvenation. For instance, this past Saturday evening, we shared a festive meal at the home of wonderful neighbors. After the Latkes, the kids decided to engage in a bit of theatre, and put on a performance. During the show, Ari came running onto the "stage." He lifted up his shirt to reveal a hand-drawn face across his abdomen. (His level of detail included a unibrow above his belly button.) He then proceeded to pinch the sides of this belly face and move them back and forth. His staccato monologue, which lasted for minutes, or so it seemed, began.... Hi! I-am-Bob. I-live-in-a-log. We all laughed. Daniela laughed a deep therapeutic laughter, as we all did. And I smiled. For a moment, even though he did not known it, Ari and his seraphic silly-ness, managed to doctor our sense of anxiety about the days ahead. Ari is in great spirits these days, and so is Gabriela. Their resilience is remarkable. Their presence is indispensable.

One of our wonderful hosts, quick on his feet, had the presence of mind amidst the mirth and merriment to reach for his camera. He was able to capture the last few seconds of Ari's comedic eruption. Enjoy:

Daniela's Inner Strength

Many friends and relatives have called in the past few days asking, "How is Daniela doing? How is she feeling?" I can elaborate an answer in a roundabout way.... I don't always dwell on coincidences. I am not one to extrapolate multiple meanings from ordinary events or objects. And then, some coincidences have to be seen as and probably are perfect metaphors. Here is the card I found attached to a gift I received this week from Daniela.Yes. She actually decided to gift me a workbench. I was speechless. I was confused, perhaps in the same way many women (and some men) react to receiving kitchen appliances, lumber, or the like as gifts during the holidays.

I know Daniela has watched hundreds of hours of Seinfeld episodes during the past decade. And if she didn't learn it from this TV comedy, she should've reached into her anthropological archives and anticipated my confusion. This gift...this Trojan Horse (The ideas for future home improvements dormant not within the workbench, but Daniela's imagination.)...this "honey-do list" monument...sits in our basement awaiting assembly.

After dwelling on when I could assemble the workbench and what I could do...once it was built, I realized the workbench had to be seen as an unintended metaphor. I haven't figure out whether it is a metaphor for the strength, the tenacity, and the sheer mettle Daniela has always displayed and will deploy once again. (This is the woman that cross-country skied to radiation treatments during winter... in Wisconsin...and then skied back home...during her bout with Hodgkin's Lymphoma more than 12 years ago.) Or, perhaps, the gift was Daniela's way of telling me that piece by piece, and plank by plank, I too can create a structure, a platform to build upon....and from which to draw strength.

Daniela is at her best marshalling ideas and dreaming of projects. This gift was not only an indication that she is "doing well," but also an indication that she is well enough to draft a list of things to do while she recovers from surgery. That is comforting and reassuring, and it also means that I should get off my blog and start assembling....Chazak, chazak, venitchazek. (Be strong, be strong, and let us strengthen each other.)

Pre-Surgery Visit

A few minutes before 9:30 am this morning, Daniela and I walked into the Georgetown University Hospital Surgery Center. Her appointment mainly dealt with the banalities of insurance paperwork. A nurse also took a blood sample.

I have to say.... I was impressed with the warm and cozy, and small, waiting area. The intimacy was palpable, evoking the charm of some Vermont coffeehouses. The nurses and staff were personable, attentive and friendly. A glance around the room revealed many patients and family members, and they seemed at ease. Daniela reappeared in the waiting area a few minutes after 11:00 am. Time to head back home. Seven days until surgery....

Beginnings

Daniela is scheduled for surgery on December 13, 2007 at Georgetown University Hospital. Her medical team informed us that she will have to stay overnight, but if all goes well she should be allowed to come home on December 14.

[If you'd like to know more about her medical team, here are links with information about Georgetown's Lombardi Cancer Center, her surgical oncologist, Dr. Costanza Cocilovo and her oncologist Dr. Minetta Liu.]

We have been extremely fortunate. Dr. Cocilovo has been an incredible source of information and support. She has an exceptional bed-side manner, and is a warm and down-to-earth physician. Dr. Cocilovo shared with us that her father is from Sicily. And with that bit of information, she and Daniela were trading family stories, in Italian. That initial office visit was a good omen. Daniela's smile projected a soothing elegance and a renewed energy. It is hard to describe, and even harder to imagine how this medical encounter...the first of many...instilled a much needed sense of optimism.

Ten days until the surgery.... Daniela and I have been planning, organizing and scheduling for the days ahead with the help of our friends. And here I have to single out two dear friends whose penchant for precision and skill for scheduling has orchestrated a remarkable symphony of support. These two muses and their musicians are diligently working with us to make this journey more bearable. To all of our friends and family, near and far...Thank you.