June 12th arrives on schedule and we begin treatment in the afternoon. We start with a trip to the lab for a blood draw to check my levels, my red count, white count, platelet count, and more. This will be used to confirm that my levels look good today and will be used as a baseline for comparison with future tests throughout treatment to ensure that my levels aren’t falling off too much. Before the blood test, I comment to the technician that I have a pain in my arm at the sight where the IV line went in during the liver biopsy. He acknowledges it, feels it, moves a few inches away, and uses the same vein for the blood draw and the IV line. I mention the pain in my arm an hour later to my oncologist. Again, he acknowledges it, feels it, and moves on. (This will come up again four days and four paragraphs later.) He asks if we are ready and I tell him, “It seems weird to say because who wants to go on chemo? But the two weeks since you told us that I can take Tagrisso has felt like a long time and we can’t wait to get started.” I also tell him that well over a hundred people are praying for him and his combination of art and science as he manages my care. I can’t say for sure, but I think he smiled under his COVID-19-health-care-worker mask.

Kath and I head upstairs to check in where I will receive chemo. I show up full of energy and good spirits so the front desk can tell we are new. They give us a primer on how it’s going to work and they tell us to sit anywhere we like as long as it’s close enough that we can hear them call for me. Because I’m going to eat again, Kath and I want to be as socially distant as possible from everyone else. We choose a location that’s bordering on anti-socially distant and we head toward a bench down the corridor. Before taking our seats, I visit the restroom, because who wants to go through chemo with a full bladder? (That will come up.) Time to take our first dose of Tagrisso. At long last. Kath pops it in my hand. We join hands, say a reverent prayer over the pill, and I swallow it down. Game on. The fight begins with medical science finally joining in. Because it seems like an important moment, I make a Facebook post. All I write is “Êtes-vous prêts … Partez!” The international command for rowers to start racing. Everyone seems to understand. At this point for whatever reason, I stand up to stretch my legs. Kathleen notices that the fly on my pants is open … and reaches over with both hands to zip it up … in plain view of about 8 other people. Not weird at all. We have a great laugh, which is good medicine. I eat and they call my name.

I am taken back to a nice little chemo suite with a great view of the south and the west. There’s just enough room for me, Kathleen, a nurse’s workstation, and one nurse. It’s a beautiful day. The sun is shining and I am, as always, cold. The nurse offers me a warm blanket and I accept because I never turn down a warm blanket. It’s one of the very few perks of being a patient at a hospital. There is a lot of preparation. I receive IV fluids, followed by a steroid, followed by an anti-nausea medicine. Then they bring in the first IV bag of chemo. This stuff must be serious because they work with extreme caution. It takes two nurses, one to do the work and another to check her every move. They are covered from head to toe. Face shields, gowns, gloves, the works. They set up the bag. Kath and I say a prayer over it and they start the drip. We let it do its thing in relative silence. I read and eat. Kathleen watches. 15 minutes later, it’s done. Time for the next bag. Now the nurses double gown and double glove. This stuff must be really dangerous. Thank heaven they’re putting it directly into me. We pray over this bag too, which under the circumstances is probably a really good idea and they start it. 30 minutes later it’s done and we are free to head home. I feel no different.

Let’s talk about side effects. Nausea. Vomiting. Diarrhea. Those are the side effects we’ve all heard of. All of them are controlled by the steroid and the anti-nausea medicine. But those too have side effects and I get hit with them. The steroid has me jacked up. I have plenty of energy for the next two days and I can’t sleep at night. And the anti-nausea med shuts down my GI system. But I consider these the chemotherapy version of first world problems. If I’m not curled up in a ball on the tile floor of the bathroom, I think I’m doing ok. Saturday, Sunday, Monday are all the same. I don’t feel normal. I don’t feel awful. I do the best I can.

Tuesday the 16th, I have this sharp pain in my left arm. I couldn’t sleep and this time it wasn’t the steroid’s fault. It’s really tender. It hurts to straighten it. It hurts to bend it. In the afternoon we call the nurse’s hotline to let them know. The doctor orders an ultrasound, which I have later that afternoon. The ultrasound technician works silently with her wand and her gel and scans my left arm from the shoulder to the middle of the forearm. She stops occasionally to tap data into her keyboard. Then she says, “Have you ever had a blood clot before?” “Do I have one now?” “Unofficially, yes, but I can’t tell you that.” The head radiologist comes in a little while later to officially tell me that I have an 8” blood clot in my basilic vein. There’s nothing they can do for it and it should resolve itself within … wait for it … two months. “Two months? You mean to tell me I can’t sleep for two months?” I give the radiologist my best I-am-not-happy-with-you stare and Kathleen and I leave, with me trying to not swing my arm. Later that night when Kath and I walk the dog and the arm is throbbing I make a comment about this being a good thing. It can help me harden up and it’s surely time for that.