Excerpt: 'Lessons for Dylan'

I learned later, much later, that the surgeon told Imber he would have to make the colostomy permanent, he wasn't sure he could leave enough margin-free tissue to reverse it. Imber urged him to do his best, give it another try, work a little harder. He did. Thank God. It pays to have friends in low places.

Cancer is infantilizing.

You're no longer a grown-up.

You can't take care of yourself.

After surgery, while living with the side-effects of chemo and/or radiation, you need help walking, dressing yourself, even feeding yourself. You lose control over bodily functions you'd learned to control when you were a child. Your hair falls out, your muscles give up, you grow decades older in weeks or months. (I kept thinking of those pictures of FDR taken during his presidency, how old he got from 1932 to 1945 and how he never got younger.) And, on top of all of that, no one can tell you with any certainty how long you have to live.

I don't remember how or when I was told about the colostomy. I was on a morphine drip, felt no pain, and don't remember much of anything. I do remember meeting the colostomy nurse a few days later. This has got to be the worst job in the hospital. Maybe in the world. I remember a moment from a Shaft kind of movie where the tough gang-leader gets shafted, and as they're dragging him, bullet-ridden, into the emergency room he's screaming "Don't give me the bag, doc. Kill me before you give me the bag."

I got the bag.

A colostomy is an ingenious idea. They really do cut you a new opening, called a stoma, somewhere on the right side of your navel. They glue a kind of Tupperware ring around it — they come in a series of sizes in the department of your drug store you've glanced at ever since you were a kid and prayed you'd never have to buy anything there. You glue the ring to your skin, skin-tight, you hope. You attach the bag to the ring, air-tight, you hope.

Before plastics they made the bags of silk, raincoat material, all kinds of things, and tried to hold them in place with metal and bone. They didn't work well, and it wasn't just the smell and the leakage. This is an open wound, prone to infection. They are much safer since antibiotics, the appliances really do work like Tupperware, you press till you hear the "snap." They sell reusable bags you wash out between uses. They also sell, at a much higher price, disposable bags you only use once. I figured, go for broke, I'll allow myself this little indulgence. Hugh Downs tells a story that when he was a page at the NBC radio station in Chicago back in the '40's, Paul Reimer, who wrote Vic 'N Sade, a comedy so big it ran on two different radio networks at the same time, was walking down a hallway one day eating a Milky Way. As he passed young Downs, Reimer saluted him with the half-eaten candy bar and said, "I make big, I spend big." That was going to be my answer if anyone asked about the disposable bags.

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