Death is the Price of Admission

“I prayed for more time, I prayed to be released from the terror I felt.” A story about coming to term with death’s inevitability that drives home the fact that time is life’s most precious commodity..

by: Audrey Levitin

When my son Josh was six years old, he asked me about death. It was bedtime and we were reading Good Night Moon, cuddling among his stuffed animals and Yankees’ paraphernalia. 

He asked, “Mommy, does everyone die?”   

“Yes, sweetheart.”

“Will grandma die?”  

“Yes.”

“Will my teachers die?”

“Yes.”

“Will you and daddy die?”

“Yes.” 

I thought he was taking the somber news remarkably well.

He sat up, looked at me, his big beautiful green eyes filled with tears and said, “Even Nina? Not Nina!” His two year old sister’s mortality was simply unfathomable.

“Honey, there is no need to worry.,” I said. “While this will happen someday, it is not going to be for a very long time. So far away we cannot even imagine it. And then when we die, we see everyone we know in heaven, so it’s okay.”  

Regarding death, adults tend to replace fantasy with denial. At least I did until I landed in that far, far away time and place when a seemingly innocuous dark black spot appeared on the bottom of my toe.  

The melanoma was easy to ignore. Only an emergency could interrupt the steady flow of forward motion known as getting things done. I considered productivity to be virtually sacred. Each morning I awoke without much thought about the blessing of being alive. Instead, I opened my eyes, turned over, grabbed my fully charged phone, checked for email and news, and headed to the kitchen to make coffee. I showered and then watched the news while I surveyed my closet to choose the day’s outfit. 

My husband and I left the house at 8:20 a.m. to catch the 8:40 a.m. NJ Transit train from Orange to Penn Station in Manhattan. The ride to the train takes anywhere from six to ten minutes. Nick and I ranted about the news, laughed, fought, and discussed what to have for dinner. The train arrived, I said goodbye, and along with a throng of commuters, rushed to compete for a seat. 

I arrived at Penn Station at 9:10 a.m. and walked 20 blocks to 14th Street, listening to Queen. I hopped on the 2/3 direct subway line to Tribeca, walked four blocks to get my favorite coffee on the corner of Worth and Broadway from a nice man who ran one of the ubiquitous Manhattan coffee trucks. I waited in line and when my turn came, I said, “light one sugar.” I loved that coffee. I put in eight or nine hours of work in an intense and wildly busy job that I loved, despite or maybe because of its intensity.

After a month, the black spot became a sore and I decided to see a doctor near my office so I wouldn’t miss much work. I took the 1 train, got off at Wall Street, walked a few minutes and turned onto Broadway. I found the doctor’s building, next to a McDonalds, hidden by green scaffolding and silver grated pipes and fences. The street has massive potholes and stores selling over-priced jewelry. The doctor’s building was narrow and dingy. Perhaps I should find a doctor who came recommended, I thought.   

I pressed ahead, pushed a big black buzzer, heard a loud noise, and pulled the heavy door. I walked on a filthy black and white tiled floor to an old clanky elevator and got out on the fifth floor. The waiting area was small and crowded. Placed on the coffee table were laminated articles noting the doctor’s thoughts about comfortable and fashionable shoes. Miniature high heels decorated the windowsills.

I was shown into an examination room and Dr. Jane walked in. She was pretty and tall with long blond hair. I was reassured by her professionalism and our girl talk about shoes. We chatted a while and I described the sore on my toe. I took off my shoe and sock. She looked at the sore and said, “Whoa, does that hurt?”  

“No.” 

“Hmm, it might be an athletic injury.”  

She covered the wound with calamine lotion and wrapped my foot in a large ace bandage. Each week, for four weeks, I went to her office, the bandage was unwrapped, and each week the sore worsened. During our last visit, the sore ulcerated, breaking through the skin. She leaned back in her chair, her face in a frown and said, “hmm, maybe it’s your circulation. My stomach lurched. I realized,she didn’t know what was wrong. I left her office and decided that perhaps I should get a second opinion. 

I made an appointment with Dr. Michael Verdi, a local podiatrist in my town. On a sunny September morning, I made the ten minute drive from my house to his office. I parked my car in one of the ubiquitous two story modern medical buildings that I was so familiar and comfortable with. I sat in the waiting area, looking up at the television placed high on the wall, and watched Good Morning America in silence with the other patients in the waiting area. A young woman came out, called my name, and showed me into the examining room. I sat on the examining table listening to the crinkling sound of the white paper and took in a room that I am completely comfortable with, bright open windows and lights. 

The door opened and Dr. Verdi, sauntered in hand outstretched, young and handsome and full of energy. He listened to my story about the sore on my toe and the calamine lotion. “OK, let me see.” I took off my sock. He looked at my toe, took three steps back and stood silently while I continued talking. 

When I finished, he said in a low and serious voice, “There is no reason for you to have a sore like that on your toe. I think it might be cancer. I’m going to do a biopsy.” 

I said, “When?”

“Now.”

“Oh.”

He numbed my toe, took a sample and removed the sore.

I was relieved. The horrible ugly sore was gone and I comforted myself with the thought, Okay skin cancer, how bad can that be? 

A week later, I was in my office when the phone rang, my green reading lamp emanating a low, warm light, papers piled high on my desk. I took the call and heard Dr. Verdi’s voice. “Hi Audrey, I’m sorry but it’s melanoma.” 

I went online to find out what I had been avoiding. Depending on the stage of the melanoma, it was possible I could die within seven months. Productivity now seemed ridiculous.

I prayed all the time — when I woke up, when I went to sleep, when I was on NJ Transit, the subway, or sitting at my desk. I prayed for more time, I prayed to be released from the terror I felt. 

At the time of the diagnosis, gratitude for being alive was not the first, second, or third thing on my mind. Instead, I had festering conflicts at home and at work that interfered with the productivity I so valued. Nick and I were fighting. Our fights were about housekeeping. Nick recently retired and I was working. We agreed he would keep things running at home. We just didn’t agree what that meant. I was referring to cleaning, food shopping, and cooking dinner. Nick meant diving into do it yourself home repairs including finishing the basement and building a photography studio.

I was especially attracted to Nick when he transformed into a home repair guy, exuding blue collar competency in spite of my resentment about unequal gender roles. On weekends I woke up, looked over, and Nick was putting on his jeans, t-shirt, blue work shirt, and brown work boots. He has big green eyes and a great nose. He has a beard, is bald, and is about 5’10”. If I didn’t know him and saw him on the street, I would think he was a plumber, electrician, or contractor.

I said, “Home Depot?”

“I just need a few things.”

He left and returned early in the afternoon. The red van pulled into our driveway next to the side door leading to the basement. He unloaded the planks of sheetrock, hoisting them onto his shoulder, then carefully and methodically he slid them down the stairs. I asked, “Wow, how do you do that?” He said, “Audrey, it’s all about leverage.” I followed him into the basement where he ripped out the old dark paneling and with great abandon, flung the discarded wood on the floor. He hoisted the newly purchased sheetrock screwing each piece into the studs with an electric screw gun. 

Seeing himself as an enlightened guy, Nick couldn’t admit that assuming what had traditionally been a woman’s role was unacceptable. So, I came home and instead of dinner waiting, I heard “Wow the day just got away from me.” This drove me crazy, and we fought all the time, for months. 

At work I was involved in a demanding project which included a power struggle with a colleague. I was furious and upset all the time. 

My ability to hold everything together collapsed in a meeting with my boss. We were sitting around her small round table, talking about the troubled project and my conflict with Bob. 

“You and Bob need to find a way to work together,” she said.

 “Yes, I know. I’m doing my best, but Bob isn’t interested in supporting me.”

“Can I sit in on a meeting to help the two of you get on the same page?”

“Sure.”

Unexpectedly and suddenly, I put my head in my hands and started crying. I said, “I have cancer.”

Silence.

I went on, “It’s melanoma, it’s very aggressive. I wasted a month going to a podiatrist who didn’t know what she was doing. I am going for tests to determine how far along the cancer has spread.”

After a long pause she responded. “I’m so sorry you are going through this? Do you want to go home?”

“Yes.”

And with that, I left the office and didn’t come back for two months. I received lovely notes from my colleagues and life at the office went on without me. 

Without work to distract me, I was left to sit with my possible death sentence and came face to face with the realization that I love my life, it is going to end, and time is life’s most precious commodity. Not money, not work, not success, but time. 

For my salvation I turned to doctors. I grew up loving my pediatrician Dr. Robert Kaplan, a large, burly man whose office was in his home. He was wise and fatherly and made house calls. When I was a little girl, I needed a shot of penicillin. Scared, I ran from room to room in our family’s apartment. Dr. Kaplan threw a toy in front of me. I bent over to pick it up and he gave me the shot. “See,” he said, smiling, “that wasn’t so bad.” My mother put me on her lap and gave me ice cream.

I was hoping my oncologist would be like Dr. Kaplan.

I imagined he would say, “Don’t worry. I’m the best, I’ve done this a thousand times. I’ve got you.” Instead, each visit was an encounter with the Angel of Death.

The hospital looked like a college campus, with brick buildings, trees, and flower beds. Nick and I parked and walked, holding hands to the building where I would have my first meeting with an oncologist. I was looking for reassurance, hopeful information and conversations about new treatments. We walked through the quiet hospital lobby and took the elevator to the second floor.  

I opened the door to his office. The waiting area was packed with about twenty-five people at 9:00 am, some in wheelchairs, some with oxygen masks. A pretty teenage blond girl was holding a stuffed giraffe with a stricken looking grandparent by her side. After forty-five minutes, my name was called. Nick and I jumped up. 

A physician and friend cautioned, “There are two types of doctors. Those interested in you and those interested in the disease.” Dr. Johnson was squarely in the latter group. I was sitting in a chair and he walked up to me, leaned forward, and shook my hand, up and down three times as if he had to practice being with people. He was tall, had a long face and double chin. He wore a suit. He looked at my chart, asked his assistant about my tests, and finally looked at me and said, “Okay, let’s see it.” 

“What?”

“Your toe.”

“Oh.” 

He sat down on one of those small medical stools with wheels. I took off my shoe and sock, putting my foot on his knee. He took my big toe in his hand and squeezed it, feeling around for the melanoma, his eyes closed. He was deeply interested, like Ahab encountering the white whale. He saw me take out my notebook with my long list of questions. He looked at me and said, “Audrey, let’s not get ahead of ourselves.” And with that, he left.  I was shattered. 

The results from the scan came back. The cancer had spread to my lymph nodes. My chances of survival beyond five years were 50 percent. At this point, I found that statistic to be hopeful. I continued an attempt at having my questions answered including what he thinks about my prognosis, a euphemism for “when will I die?” He shrugged and made a face that said, “Who knows?” Anytime I asked for reassurance or had a question, he would lift his hand, palm forward, as in, “Don’t talk.”  

I hated him. It was strange to hate someone charged with saving my life.

Nick believes a good filing system can make anything better. He organized all my doctor’s reports, test results, and resource materials. I was drawn with horrified fascination to the American Cancer Society’s large white manual. Each morning I rose from my bed, went to our office, picked up the manual, stared in disbelief at descriptions of tumor size and thickness, ulcerations, lymph nodes, and life expectancy. I put the book back in its plastic wall file, left the room, heart pounding, stomach churning. In dramatic fashion, I threw myself on the bed, my face in the pillow, crying. And then, I got up, went back to our office, re-read the bad news and repeated what had become a very nutty ritual.  

I had surgery and Dr. Johnson saved my life. He removed sixteen lymph nodes and a part of my big toe. I went home to recover. There was nothing to do but wait until my follow-up scan in January, ten weeks later. It became apparent, no matter how bad the situation, that terror is unsustainable. I finally thought, If I was going to die what was the point of being upset all the time? I decided to fight for my sanity. Reason is a powerful ally in all great emotional challenges. I reasoned if everyone dies then everyone should all be upset, all the time, every day. I came to understand the obvious — dying comes with the territory of living. 

I needed help and found Vincent, a counselor who specialized in issues related to death and dying. In his mid-60s, Vincent had long grey hair worn in a ponytail. I felt a sense of anticipation as I walked down the steps to his basement office, passing by a rock garden and fountain, my boots making a crunching sound as I stepped on the snow. His office had incense burning and various sized statues of the Buddha placed throughout the room, along with one of those gold eastern drums with a sound that vibrates for a long time. 

The experience of re-emerging from the crisis happened in the cold. In my reoriented relationship with time, I learned to love autumn and even winter, a season I previously dreaded and endured. There was Thanksgiving, the holiday season, football, and dinner out with Nick on New Year’s Eve — holidays, work, family, sports. I became reoriented to the world of the living. 

By December I was back at work. In my new appreciation for virtually everything, I realized how much I liked the commute from New Jersey to Manhattan. The crowded train put me in Essex County’s melting pot and the daily drama that unfolds on a packed train. I was happy to be back in the office where life was all around me.

The January scan came back with no evidence of cancer but it took several cycles of tests, about two years, for me to finally believe the cancer was gone. I spent that time in therapy talking with Vincent about life and death’s inevitability.

It has been six years and while life has its normal day to day hassles and aggravations, I also know that I am going to die. That hard, cold, inescapable fact changes nothing while changing everything. My life has a new dimension. Being aware of death’s inevitability offers a layer of emotions ranging from fear and sadness, and at times relief knowing that my problems are temporary. I live in two worlds now, and death is no longer in the background, but right there, all the time. I work at accepting its presence. And as for that fairy tale I told Josh, I believe in it. I hope for happy reunions in heaven. 

I have also come to appreciate how much love, work, partnership, achievement, happiness, joy, exhaustion, frustration, and failure go into an ordinary day. I continue to try to make peace with the forward march of time, keep in the front of my mind that to be alive is a blessing, that each day is a gift, and that death is the price of admission. 

 

Audrey Levitin is Senior Counsel at CauseWired, a firm working with human rights and social justice organizations. For 15 years she was the Chief Development Officer at the Innocence Project. Ms. Levitin is an essayist and her work has been seen in the Star Ledger, The Weekly Forward, and Cape Cod Life. She has also written about criminal justice reform in Occupy Wall Street and the Innocence Project. She and her husband, photographer Nick Levitin, live in West Orange, New Jersey.

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