Chapter Six: Here It Comes

Undeniable: The Second Time the Universe Spoke to me.

Part I: Her bus

Up to this point, I’ve been careful with language. Intentionally so.

I’ve used words like journey, hope, rhythm, living while uncertain. And all of that is true. But there’s something I need to say plainly now, before we go any further.

What we were doing — through diagnosis, treatment, recovery windows, travel, maintenance, and the careful choreography of living — was something else entirely. It was partnership under pressure. It was vigilance. It was love with logistics. It was standing close to the edge without stepping over it.

Caregiving, in its truest sense, had not yet begun.

I didn’t understand that then.

From the outside, it would have looked like we were already there. We managed appointments. We tracked medications. We spoke fluently with doctors. We made contingency plans. We adjusted our lives around scans, infusions, and recovery windows. We did what capable, responsible people do when something serious enters their home.

But here is the truth that only shows itself later: as long as the person you love is still choosing — still directing, still deciding — you are not yet caregiving.

You are accompanying.

She was still herself. Fully. Decisively. Even when her body betrayed her, her mind did not. Right up until the moment we finally saw the bus coming, I had not yet begun caregiving at all. Not really. I was on the journey, yes — but caregiving had not arrived.

She knew what she wanted. She knew what she didn’t. And she was clear about the difference. Rational choices were still being made, and we still had one more choice left. I wasn’t leading her life. I wasn’t managing it. I wasn’t carrying her.

I was walking beside her. That distinction matters more than I knew at the time.

But then things began to show themselves.

Cancer did not take her life in the way people imagine. There was no single dramatic moment. No clean line between alive and gone. What took her life was quieter and far more instructive, and it matters that I say this carefully.

What ended her life was not the diagnosis. Not even the disease.

It was the accumulation of decisions — made correctly, responsibly, and humanely — until the body could no longer carry the load those decisions were meant to protect. Decisions that once extended life eventually forestalled the decisions of the present, until the road narrowed and the bus finally had a clear path.

Treatment bought us time. Time bought us life. Life demanded more time than the body ultimately had.

And eventually, the math stopped working.

That moment — when the math breaks — is still not caregiving.

It is the moment before.

I used to think caregiving began when illness entered the room. I was wrong.

Caregiving begins when agency begins to leave. When decisions shift from we to you must know when. When conversations change from what do you want to do next to what did we already decide. When love stops being expressed through support and starts being expressed through restraint.

That is the line we reached.

And Donnie did his thing again. This time, the first read had been done by one of his partners. The all-clear was still given. It was late August of 2013. We didn’t know it then, but if you are counting days, there were about four hundred left. The bus had been seen.

Donnie wanted to review the scan himself because that’s who he was. He was going to see this through, no matter the direction. He asked us to come by and take a look.

“I think there’s something there that shouldn’t be,” he said.

There it was — small, very round, sitting in the adrenal gland.

We made some choices.

We had previously had success with stereotactic radiation on the spine nodule. There was nothing else active. So we asked the obvious question: what about this? The doctor agreed it was worth the effort.

I’ll spare you the mechanics of stereotactic and gamma-based radiation — how it’s more precise, how it tries to spare surrounding tissue — but imagine a target deep in the body, not fixed, subtly moving with every breath.

What other options did we have? Plenty.

What would they have gotten us?

And here is the part people don’t like to hear: she would have died anyway. You just don’t know that yet when you’re standing there. You still believe, for a while longer, that one more correct choice might change the ending.

Yes, you can live without one adrenal gland. In fact, you can live without either. Surgery would have been clean. Quick. The nodule was clearly contained in soft tissue — very different from bone. These are things you learn when you are forced to learn them.

But this is not a story about illness.

Readers sometimes assume that what came before was caregiving. They think the hardest part must already be behind us.

It wasn’t.

This is a story about what happens after illness stops being the central problem.

The caregiver’s journey does not begin when someone is sick. It begins when someone you love can no longer carry themselves all the way through what’s coming.

And for us, that was the moment the bus arrived.

Looking back, I can see the signs now. The questions that lingered a little longer. The fatigue that didn’t resolve. The way conversations shifted without announcing themselves. The way doctors began saying when instead of if — without ever saying it outright.

There were about four hundred days left.

But at the time, we were still living. Still choosing. Still planning. Still laughing.

And the caregiving — the real journey — was about to begin.

We saw the bus.

We thought we could cross the street.

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Part Two: Configurations

So now we will just go through it.

We spent 6 weeks on radiation in an attempt to clear the spot.

After that time, as we approached mid to late October — now just inside 365 days to go — we imaged. It was HOT as fire on PET, and yes, that is because it should be. It had just been radiated in that zone. Other imaging was a bit inconclusive, but it seemed we did not get the entire growth.

The next step was to schedule surgery. We were not aware at the time that we probably needed to move faster. It was now around November 1, and we scheduled the surgery for early February of 2014. It seemed reasonable then. They wanted some cooling-off time, more clarity, and a final determination of exactly what we would be dealing with.

The second time the universe spoke to me was in January of 2014. The exact day is not perfectly known to me, but it was certainly before surgery.

I was there and it was me in the dream. Maybe this was not the loudest the universe would speak. Perhaps this was maybe just a little reality jolt. In January of 2014 I was 51 years old and about to turn 52. There I was in a clear dream and it was before my birthday and she was gone. The exact day was not given or necessarily hinted, but I knew it was before November 25, 2014 that she would be gone and I would be a 51 year old man again on my own.

And so it was the ice storm of the century in Florida. Oh yes. I didn’t tell you. Brenda was depositing me into my new life already and I think she knew it. We had bought a lot in Sugarwood and started building a house around June of 2013 at a time when they would still finish em in 9 or 10 months. And there we were about to leave for Nashville and surgery and just like that Tim, the supervisor who I still know today, was meeting with me and no one could get to work. This is how I remember the dates. More or less the last day of January everything stopped. No one could drive. I mean it is Florida and there was Ice on the roads. There was no work going on and before I left we had a chance to meet as work was about to begin. I recall it being about February 7th 2014. I knew the universe had spoke. “Tim, I am going to Nashville so she can have this operation but please complete the home as fast as you can she is dying” and I knew what it meant. Soon.

I spoke to Annie who was decorating it and wrote her a check and told her to finish it. We would be back one more time. It was done.

There was no apparent emergency in late December, but by January there was a bit of discomfort in the abdomen. It was time. We were off to Vanderbilt to get some good work done and take out this adrenal gland.

It is a less invasive procedure through scopes of course. They would go in the front and dissect their way to the gland and remove it. Then the realization after the fact that maybe radiation is not a great choice if the surgical option is ok. Was it a mistake? Probably. Should we have operated early on? Probably. Were there more dandelions in the field? Certainly. Did it take me years to overcome that “caregiving” guilt that she might have lived? A few.

The doctor came out and gave me the early read something like this: “We went in and we were able to dissect the adrenal gland, but I am afraid the growth was outside the margin. There was just too much outside the gland to recover, and the pattern of the growth is less contained and more free in the abdomen along the scar tissue of the radiation.”

There it was.

I knew then what he was saying.

And I knew we were out of “good configurations.”