Five years after my younger sister Barbara  died of a malignant brain tumor, I moved from Minnesota to California. I loved the soft tilt of the large round hills, the unfiltered California light, the green Irish spring and golden Italian summer.  Being alone, without Barbara, wasn’t what I had thought would happen. When she died, both of us were in our forties and neither of us had married.I had presumed that the two of us would age, visiting each other’s homes where we would both wash dishes with a sponge, not a rag, use SOS for burned pans, and, like Mother, wrap everything in plastic. Eventually we would end up in a nursing home, eccentric old maids rocking side by side; I imagined her tormenting me with her singing.

Instead I sat in my dusty studio in the Marin Headlands overlooking the Pacific Ocean and just across the Golden Gate Bridge from San Francisco.  It was a 170 square foot garret in an old army quarterhouse with rutted floor boards that caught my chair as I rolled from one part of the room to another, and in the inflated real estate market, I was lucky to have it. In summer my room was often cold and smelled of the spit of the swallows that nested in the eaves. If I opened the skylight, the resident cat jumped out on the roof and attacked the swallows.

In this room for the next five years, I tried to resurrect my sister. At times, Barb’s spirit had given me a friendly wave, and at other times, chastised me as it emanated from one vertical file cabinet, then another, from Minneapolis to San Francisco and places in-between. Now, a yellow folder sat at the front of the file cabinet, luminous against the royal blue hanging file. When I unpacked the files, I felt I was removing a body wrapped in fragile papyrus.

I had Barb’s dresser and desk, I wore her chartreuse harem pants and her red and black striped socks. I had a soft leather purse with her pink plastic comb, boxes of letters, and wads of photographs in rubber bands. I had her sheet music and her scribblings about the voice lessons she took. I drove her 86 Camry across the country and back. I had her eulogy and three-inch thick binders filled with notes and flip chart pages on which I had written “What is the meaning?”

Perhaps our meaning was in singing, maybe even our faith, certainly our hope was. The women in our family had been as one with the Metropolitan Opera as Texaco, which sponsored the Met’s Saturday afternoon broadcasts from 1940 to 2003. My grandmother in Massachusetts sang to those broadcasts and so did my mother in Duluth, Minnesota, turning the volume so high that the basses and sopranos rocked through the oak doors of our house, from the den to the kitchen where, apron tied around her middle, Mother sponged dishes and sang along with Leontyne Price, even though a high school chorus teacher had told her to mouth the words in chorus. Unless the opera were extraordinarily long, broadcasts started unfailingly at 1:00 and my mother refused any invitations for Saturday afternoon.

When each of the three sisters in the family reached fifth grade, our parents took us to the Metropolitan Opera, which toured every year in Minneapolis. Riding in the back seat of the old Buick into downtown Minneapolis, I saw the Pillsbury and General Mills factories stationed like sentries over the Mississippi River. To me they meant, not farming and food processing, but opera and food. In the Curtis Hotel, I walked importantly through the green and red train style lobby, ate in the hotel coffee shop, walked through Dayton’s Department Store with my mother, saw the sunset glow a deeper gold than in Duluth and sniffed grainer, less piney smells. All of this was going to the opera. After I left Minnesota and returned to Minneapolis for graduate school,  by which time the Curtis Hotel had been demolished, my feelings remained the same about the opera and so did Barb’s, who had entered law school in Minneapolis.

That year, the May of opera week was humid and hot and the auditorium wasn’t air-conditioned. Three times that week, Barb and I  joined the opera mavens, their long silk gowns rustling in the soft night breeze, high heels clicking on the stone plaza of Northrup Auditorium. The first night we dressed in black and white and pretended to be ushers. The second night we wore our dress-up hippie clothes, long, pink and black flowered skirts with peasant blouses. The skirts would blend colorfully with the gowns the wealthier patrons wore – we would fit right in, we were sure of it. At the end of the first act, imitating the privileged patrons, we strode to empty seats in the first row. Jittery, we eased into the maroon velvet. A well-dressed matron stopped us and said, “These are not your seats!” We stood up, smiled and walked with injured dignity to the side of the auditorium, where we remained until we found a seat for the next act.

The last night of the opera there were no empty seats in the front rows. We stood at the side and as soon as the curtain went up, Barb beckoned me, then walked across the first row of seats, crossed the few yards separating the audience from the orchestra, and casually walked towards the seven steps on the far left that led to the stage. Praying that I was invisible I followed. There we sat, on the fourth and fifth steps, nearly on the stage, twenty feet away from the silver streaked hair of Cesare Siepi, who was singing Mephistopheles in Faust, his tall lanky body packed into a red jacket threaded with gold and silver. The dimension and timbre of his bass voice slid into every cavity of our bodies in the same way a morning jump into Lake Superior cuts to your vital organs and makes your body tingle until nightfall. My ears reverberated and my heart beat – in part I was afraid we would be asked to leave but Barbara wasn’t perturbed – she hummed along with the music. I  heard the music note by note, the melody almost fragmented, each note becoming both more and less than it was alone as it joined up with the others and strolled or marched or leapt toward the end of the aria.

It was certainly possible that we would be kicked off the stage steps and tossed out of the auditorium, but I went with Barb year after year because to hear Violetta die in La Traviata and Lucia go mad in Lucia di Lammermoor from six yards away thrilled me. Concentrated in one night were all the bliss and fear I had yet imagined. I felt proud going to the opera with Barbara in the same way I had felt special when my parents took me in fifth grade. I was going with  someone who cared. It was my good luck to be with her.

After Barbara passed the bar exam and joined my dad’s Duluth law practice, she took voice lessons in Duluth and kept written vocal instructions in a booklet lined with bass and treble clefs, as she practiced arias from the operas we had seen as children. She did breathing exercises every day and learned how to support the voice and how to locate the place where the sound comes from, behind the bridge of the nose, deep in the sinus cavities.

Eight years later, Barbara was diagnosed with a brain tumor that started in her visual cortex. “If I hadn’t identified so strongly with Violetta when I was a little girl,” she cried as I sat with her in the hospital, “do you think this would have happened?” Violetta, a young courtesan, is Alfredo’s lover in Verdi’s opera La Traviata. Alfredo’s father begs Violetta to leave Alfredo so that Alfredo’s sister can make a good marriage. Violetta, sick with tuberculosis, is reluctant to leave the man she loves, and during the duet, you’re not sure what will happen, she could go either way. Finally, generously, she  forsakes Alfredo and moves to the country to die of tuberculosis. Believing himself abandoned, Alfredo rages. When at last he learns of  Violetta’s sacrifice, he rushes to her bedroom and they are reunited. Minutes later she dies. Barb and I grew up listening to La Traviata as my mother played it on the old mahogany record player in the front hall. We both thought it could be the most beautiful opera ever written. Verdi’s combination of tragedy and score – the troubled relationship of father and son, the family pride, the illness-crossed love of Alfredo and Violetta, the courtesan who sacrifices so another woman can marry in an almost feminist gesture – all of this thrilled us. Oh, to be so grand, to love so well, to sacrifice so nobly. To die so beautifully. Barbara had always identified with Violetta, I think because she felt things wouldn’t work out in her own life, and because Verdi’s flowing melodies express a bittersweet longing for all that is unattainable.The story would be melodrama without the music. The despairing “Addio” is filled with longing and the melody searches. Why do we enjoy wallowing in sad music? Because the song’s end promises, not joy, but the knowledge that others have felt what we feel. If you know an aria, you silently join in that place at the top of your soft palette where music soars. You feel it in your chest and throat and lift your rib cage, involuntarily breathing as though you were singing, and climb over and under, up and down, your pleasure in the melody and the search propelling the aria forward. The music of “Addio del passato,” which Violetta sings at the end of La Traviata, melds a sublime musical line with an earthly story, guiding you from loss, to rage against that loss, until, eventually, over the course of the aria, you are able to reflect on what happened. After she got the tumor, Barb couldn’t see well but she could still sing while I played. She sat scrunched against me on the piano bench, so close that my arm couldn’t move. Then she stood. “It’s better to sing standing and better to see too,” she added.

“I can’t see either, Barb,” I said.

“You act like you don’t believe I can’t see.  You don’t want to admit what is happening to me because it makes you unhappy.  You’re trying to make me feel better, but it doesn’t.” I was lucky we continued. I stilled my back and shoulders so they didn’t betray contradiction. Only my fingers moved. She was so close I could smell her if we hadn’t smelled so much alike that I smelled nothing. Would she sulk? I couldn’t see very well but who could say how well I saw compared to her or what made it dark – the light or the angle or the blindness caused by the tumor? We had really believed, Barb and I,  we could burrow inside each other’s skin or behind each other’s eyes, that we knew what the other was feeling. Now I couldn’t make the leaps of understanding that came so easily before. I couldn’t be inside her head. I was careful not to look at her in case that made her angrier. I couldn’t see what she saw. I could only see how to find the keys in her purse and open the door to the porch, how to put bright lights in her lamps, and when to shut the windows because it might rain. I could only see that she wanted to sing and I waned to play. A match. Rejoice!

“Shhh,” I whispered, meaning, “Sing softer.”

“Were you telling me to be quieter?  I haven’t sung in over six months. I am lucky to get out anything at all much less the variances necessary to do it At the piano I kept silent, breathed slowly, acted calm. I loved playing and hearing her sing the arias from La Traviata, Un di felice – A happy day, Sempre libera – Forever free, and Addio del passato.

Ten years after Barbara died, I walked down a sandy hill to the Pacific and felt the familiar tears welling up as I thought about Barbara’s lengthy and violent dying. I had cried almost every day, sometimes several times, from loss, guilt, anger, all the usual emotions of grief. Startling myself, I thought, “I don’t have to cry.” I felt some guilt, as though I were choosing to ignore Barb. I smiled anyway. It was a windy afternoon softened by warm moisture from the sea. The hills were blossoming with bushes of lavender lupine and on the sand were unruly spreads of fuchsia iceplant. I heard the brown pelicans’ wings tapping softly against the water in Rodeo Lagoon when they landed. In 1962, Rachel Carson wrote Silent Spring, for which I imagine these brown pelicans, nearly wiped out by DDT then, flap their wings in gratitude. Carson herself died of breast cancer in 1964, but not before visiting Rodeo Lagoon in a wheelchair to witness fifty brown pelicans gliding to the ocean on their huge floppy wings and splash-landing in the water. Before that day, I hadn’t known that one could choose not to be sad, not to cry, that one could move around in the mind like a chessboard, taking a pawn and sliding it to a safe place instead of placing it directly in the path of  the queen. At the turnoff on Coastal Trail, I started singing. I had begun singing lessons nine years after Barb died and I breathed through my diaphragm and tried to flare my nostrils and smile, as my singing teacher had instructed me. In classical singing, you pull your chin down, push out your diaphragm, let your stomach flop, flare your nostrils, flatten your tongue, make fish lips and smile. When I neared the east end of the lagoon, nostrils flaring and stomach flopping, I thought I was singing well.Addio, dorati sogni, cari fantasmi, addio. . . .  (Farewell, golden dreams, dear spirits, farewell. There is no room for you in my heart anymore.) My teacher picked this song for me, along with Come Away Death by Sibelius, Dido’s Lament by Purcell, and several other death-oriented arias. It troubled me that she thought I was suited only for death. The music of Addio has an agitated marching rhythm and an acrobatic melody but the lyrics are angry and depressed: “Woe is me, in the strife of the world sorrow cannot be forgotten. Death is the only true farewell and that pleases me.” It pleased me to sing the song, but I didn’t understand its emotions until I remembered Barb saying she needed distance from me. By the time she said that, I had thought things would be peaceful but they weren’t. I saw that it was wrenching for her to pull away from the living and when Barb pulled away, I felt like she’d socked me in the stomach.

Suddenly, in front of me in Rodeo Lagoon, a Great Blue Heron lifted its terrific wing spread and flew to the next cove. My body on the shore seemed utterly unimpressive and finite. I walked to the bridge over the lagoon and she did it again, flying back to where my singing had disturbed her. She landed on the grey rocks and was still. After a few seconds, I couldn’t make her out. Perfectly camouflaged. I began to sing again.

Mardith Louisell has published essays, profiles, and book reviews in Italy, A Love Story, The House on Via Gombito Street, The Best American Erotica, and in journals and magazines. She writes about music, color, obsession, the WWII Holocaust, feminism, food and relationships. She lives in San Francisco where she works in child welfare and just finished singing the Mozart Requiem.

After I was diagnosed with breast cancer, I couldn’t help but notice circumstances that, when they arose, seemed to strike me as blatantly unfair.  To each I would respond with a dramatic sigh and state emphatically to anyone who would listen, “There ought to be a rule against that!”

Now as the self-proclaimed Menopausal Warrior Queen, I decree that the rules that follow are hereby effective immediately and across the universe.
Okay, so I don’t really have that kind of power.  But if I did, here are the ones I would implement with the snap of my noble fingers.

Rule 1: Bad behavior on the breast cancer patient’s part should not be held against her by others, at least not permanently.  Actually, this rule was in effect for me although I wasn’t badly behaved all the time.  I was at my worst when I was recovering from my mastectomy and breast reconstruction surgery and my husband was my primary caregiver.  After a week in the hospital, he drove me home and bundled me off to bed,   then set to the design and execution of a well-documented system of round-the-clock checks, meds, and drain line cleanings that would have impressed Florence Nightingale.  He made sure I ate on schedule.  He arose every hour on the hour, night after night, to lead me to the bathroom since I couldn’t walk without wandering because of the pain medication.  He was the model of loving efficiency.   Since I was unable do much by myself, I really did need his help.  But his unlimited cheerfulness made me want to smack him, so I soon dubbed him the “Nurse Nazi.”  

Luckily, he remained steadfast through my emotional outbursts and did not hold them against me.  His explanation was that my temporary lack of gratitude was the result of exhaustion, pain, medications and fear which sounded plausible enough to me.  Therefore, I dictate that this rule is now in effect for all, henceforth.

Rule 2: Anyone who accompanies you to a diagnostic test should be prepared to dress you once the test is complete.  I took a doctor-prescribed Xanax prior to my MRI biopsy and it did the job because I don’t remember any pain or discomfort.  The tricky part came when the procedure was finished.  I was so out of it that I couldn’t dress myself, so the nurse called my husband from the waiting room to help me.  The jeans I wore had slipped off quite easily when I undressed to change into a gown.  But getting those same jeans back on proved to be about as difficult as stuffing sausage meat into a casing, only without the spiffy machine.  Ed was able to place my feet into the leg openings while I sat on the bench, but when he tried to stand me up my rag doll posture made it difficult for him to pull them up around my waist.  His military training served him well as he draped me over his shoulders in a modified fireman’s carry, propping me up so he could slide the jeans over my hips.  My giggles over Ed’s groans coming from behind the dressing room curtain caused the nurse to check to see if everything was okay.   In retrospect, I was grateful that I hadn’t asked one of our male neighbors to drive me to the test.  That would have made the rounds of our neighborhood at lightning speed!

Rule 3: You should not be held responsible for breaking basic fashion rules when coming home from the hospital or at anytime
during treatment.

This rule can keep you off the fashion hook for four or five months, at a minimum.  For example, although it was not a combination I would normally wear, drawstring sweat pants, a blouse that buttoned up the front, and pink Crocs on my feet were all I could manage when I left the hospital.  Since it was chilly that day, I layered my white terry cloth robe over it all for an attractive finish to the outfit.  The good news is, no one cared because everyone leaves the hospital looking like hell anyway.  And I didn’t care because… I was on pain meds.  Thank God my oldest daughter, ever ready with her camera, was not there or I would certainly have shown up on the back page of Fashion Don’ts in a future Glamour magazine with a black rectangle over my eyes.

Then there are the days during treatment when concocting any outfit, much less a fashionable one, is just too overwhelming.  One afternoon after a chemo treatment I answered the doorbell looking a bit green while wearing my trusty terrycloth robe over pink knit pajamas, slippers, and a pink terry turban on my head.  A Victoria’s Secret ad gone terribly wrong.  The FedEx man, polite but wide-eyed, had me sign for the package, then literally sprinted back to the safety of his truck.  Note the common theme of the robe in both anti-fashion examples.  Maybe I should decree that runway designers need to elevate the style status of fluffy terrycloth robes in next year’s collections!

Rule 4: As a cancer patient, you should not be embarrassed to admit to the use of unorthodox methods to solve unexpected annoyances. I submit the example of what to do with your head after you shave it, that is, if you choose to shave off your hair prior to it falling out during chemotherapy.  A week or so after you shave, some hairs will not fall out readily, won’t come out when rubbing your head in the shower, and are also not growing.  They feel like little needles and can be pretty uncomfortable under a hat, scarf, wig or crown.  

I presented this dilemma to my husband, ever the willing problem solver.  He suggested the typical male answer to most all of life’s problems – duct tape.  My first instinct was to snap back at him: “Are you crazy?  It isn’t enough that I am bald?  Now you want me to rip the skin off my head??”  (This was a holdover from the bad behavior highlighted in Rule #1.)  But I managed to hold my tongue and, after conceding that this stuff was used in wartime to patch bullet holes in helicopter blades until repairs could be made, decided that I didn’t have much to lose if I was careful.  And I had to face the cold reality that none of my ideas had worked.

Per his instructions I cut a 9” length of tape, wrapped it around my palm and the top of my hand, sticky side out, then slowly and gently rolled my covered palm across my head where the needle hairs were.  Sure enough, many of them came out without any pain while my skin remained intact.  As I performed this exercise Ed sat in the bedroom anxiously awaiting the results.  I walked out and stated ruefully, “As much as I hate to admit it, this actually works.”   After a few more duct tape treatments, I progressed to my Sheltie’s pet roller for the less stubborn hairs.  These two techniques got me to the point where I had no more needles and no more hairs falling out and sticking to my pillow or turban.  Therefore, I order that we will no longer be embarrassed to share our unusual (okay, weird) solutions with others who might benefit.

Rule 5: Staying with the hair theme, wigs need to be cooler. I don’t mean better styling, although President’s wives must be popular /images for some wig designers because one made me look like Mamie Eisenhower while another channeled Pat Nixon. The wig I finally selected was a stunner and was comfortable enough when I bought it in mid-October.  That is, until my first serious hot flashes began after I started chemotherapy.  Then, all I wanted to do was strip off everything – my clothes, the wig – and do it fast.  Since that kind of behavior can get you arrested out in public, I sucked it up until the flash was over.  But over a period of four months I went through several packages of batteries for my personal hand fan.  That sweet little device saved me from becoming bald jail bait.  So forthwith, wigs will help us look terrific while containing a cool gel lining in the net cap so we can survive climate change, both personal and global, while staying on the right side of the law.  

Rule 6:  Steroids and adjuvant hormone therapy should not result in weight gain. Here’s another one where the drug universe really sticks it
to us.  Although I didn’t have a weight problem before, once I started my second round of chemo accompanied by steroids, I packed on 13 pounds before I could bat my skimpy-eyelashed lids.  It didn’t help that I was moving less because of bone pain, fatigue, and winter weather, and my steroid-induced appetite evaporated any attempts at portion control.  But the appearance of my ballooning alter ego was definitely unwelcome.  And, for the record, I was still bald.

As the effects of the chemo drugs faded, and the weather started to turn warmer, I began an exercise regimen to strengthen my body, doing a little bit at a time, and progressing as I felt stronger.  Just about the time I started to feel like I was hitting my stride, my oncologist initiated a one pill per day hormone therapy which will continue for five years or more.  One of the most common side effects is – yes, you guessed it – weight gain.  You have to love the irony here.  It’s not like we need help gaining weight as we mature and our metabolisms downshift after menopause.  I am dutifully exercising and watching what I eat, as well as how much, and am feeling 100% better and looking fitter and firmer but really, this rule needs to happen – NOW – before I gain another ounce!

Rule 7: When you ask for the curly hair chemo, then you should get curly hair on the regrowth. I spent my entire life begrudging my two brothers their curls, while my hair was stick straight.  That’s another rule that I should have taken care of long ago.  (Did I mention I am the oldest, and had to put up with them both, so they owe me?)

But I digress.  When I heard that many survivors’ hair grows back curly, I saw my chance.  I explicitly requested the curly hair chemo mix from my oncologist, who appraised me with a puzzled look, nodded, and said vaguely, “Aha.”  Now as I examine the current quarter inch regrowth that nominally qualifies as my crowning glory, there is not one curl to be seen.  The hairs are baby soft and delicate, and there are many more silver representatives than before.  What is that all about?  But not a damn one is curly.  So let’s revise this evolving rule: Curly hair chemo, if requested, means you get curly, non-gray, luxuriant tresses as your regrowth, and this goes double if you have two ungrateful brothers who have curly hair and the gall to complain about it in your presence.  Now that’s a kickin’ rule!

In summary, I don’t mean to be a complainer.  But if these rules were effective today, coping with breast cancer surgery and treatment could be rendered significantly more straightforward and certainly less maddening.  Alas, until that time comes, we just have to hunker down and fight our way through it, day by day.  To those untouched by breast cancer I say, good luck, annual mammograms all around, and keep ‘em coming!  And to my brave, survivor sisters: Fight on, Warrior Queens!  We can’t back down now and we can’t let the Evil Breast Cancer win!

Tana Suter is a recent cancer survivor who, fed up with illness memoirs crammed with drama and pathos, used her idle time throughout treatment to document how a serious illness muscled its way into her previously well-organized life.  She is finalizing a book entitled The Menopausal Warrior Queen Slays the Evil Breast Cancer where she collects her non-medical frustrations and observations into a funny, sad and often cranky call-to-arms for warrior queens and those who love them.  Her website, menopausalwarriorqueen.org will go live in May 2009. Suter lives with her husband, Ed, in the picturesque foothills of northern Virginia.