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Dome Is Where the Heart Is: Beren and his sisters during his chemo treatment, with the author showing solidarity at right. We Are the Dead How one MSC staffer coped and failed to cope with her brother's death from cancer By Jessica Rovay MY BROTHER was diagnosed with cancer in April of 2001. He did a couple of rounds of chemo. He dated girls and toyed around with the idea of freezing some of his sperm. He called me sometimes, in the middle of the day, to ask me questions about his love life. "I think I want to get back together with Kate," he said, and like a good big sister I talked to him about the reasons why, the reasons why not. There were parties, during which he kicked all our asses at every board game we played--if you were on Beren's team, you won, it was as simple as that. No cheating; the kid just had an aura. And during one of the parties, in late January of 2002, Beren started complaining about a pain in his hip. "Do you want to go to the ER?" my sister asked. "I don't know." Wince. "I can't decide. You decide for me." So we all packed into my sister's car in our nice clothes and hung out in the Emergency Room at Dominican for four hours. We were a blast, my sister and I. I'd get my sister giggling, and once she cracked up, everyone did; she's got one of those laughs. Beren was in a lot of pain but we had him laughing, too, we had him distracted by what spazzes his sisters were. This was fine by us. Finally the intern came in with his X-rays, and we clustered around while he showed us all these little spots all over Beren's pelvic bone, all down his leg, and that was how we knew it had gotten into his bones. My brother was the one of us who was never sick. Not like me, with my hypochondria; not like my sister, with her pneumonia and bout with the charmingly nicknamed "Valley Fever." Beren just was. People gravitated toward him; his slow, deep drawl, his belly laugh. His friends were musicians, artists, gamers. They all hung out around his hospital bed, chatting with him, draped over each other, watching anime. His cell phone was always ringing, even after he stopped answering it. 'In a Cancerous Manner' Cushing's is almost unheard-of in someone of my brother's age group and gender. It's a disease of adolescent girls and middle-aged men which affects the adrenal system, flooding the body with cortisol (the "fight or flight" hormone). It happens when the pituitary or adrenal glands are somehow stimulated, either directly (by an on-site tumor) or by a tumor elsewhere in the body (usually benign). In Beren's case, this had caused his body and face to swell to balloon-like proportions, his heart to race, his feeling of overwhelming exhaustion. He had developed Geiger-esque stretch marks all over his body; these were caused by the breakdown of his connective tissue. But they couldn't find the tumor. "He's very young," the doctors said. "We'd like to avoid an adrenalectomy if at all possible." The coma changed their mind, even though it only lasted about a week; they did the operation shortly thereafter. "And we've found a tumor in his liver," they said in passing, but no one seemed to be able to tell us much more than that. We placed calls; we did Internet searches. Finally there was a meeting with Beren's doctors. "We originally thought that the tumors in his liver and lungs"--wait, liver and lungs?--"were benign, but they appear to behave in a cancerous manner." "What does that mean, 'in a cancerous manner'? Does he have cancer?" I shaved Beren's head (and my own, for moral support; he said I was a dork) before his first round of chemo. We took turns sitting with him in the hospital while he slept, uneasily, under a drip of chemicals. At first it wasn't so bad--a little nausea for a couple of days, nothing he couldn't handle--but every week he felt a little worse. After two rounds, when the tumors continued to spread, he decided to look at his other options. "I figure, if I get my body really strong," he said, "I'll have more resources to fight this." He joined the YMCA. He started drinking green tea and eating health food. He signed up for more classes at the junior college. He went camping with his friends and got high in the woods. "It's weird," he said, "since my adrenal glands were removed, caffeine and alcohol don't affect me." "I'd have thought the caffeine, but the alcohol surprises me." "Yeah," he said. "It's weird." None of us kids react to things the way other people do. Beren started out unique; the morning after he was born, my sister and I shuffled into the living room in our jammies and blankets to see my father lifting this chubby baby into the air. The baby was laughing. Newborns don't laugh, but my brother did; I was there, I remember. Twenty years later and his sense of humor, pleasantly twisted, was still in full force. Tripped out on painkillers, he'd open one eye and look at us when we'd be talking among ourselves about some strange thing (circus school, Billy Bob and Angelina, inversion tables) and say, "What the hell?" in that slow, ironic way of his, and we'd crack up, same as we always did. He hated his oxygen tube and took it out whenever he thought no one would notice; one night, not very long after the meds made his world into one long acid trip, he was talking to my sister and surreptitiously pulled the oxygen tube up and over his head. He started to drift off, so my sister reached over and put the tube back around his nose. He opened one eye. "Son of a bitch," he said, and blinked at her. "You found it." On a constant oxycodone drip, his conversations resembled nothing more than beat poems. "I need a table, here, something flat. Flat flat, flat flat. And when I have my table, when when, when when, then we can talk, then we can really talk." And you know he isn't talking about a table, you know he means something else, but all you can do is nod and smooth his hair and try and get him to drink some water. He had started grabbing things; the bed, his catheter tube, people's hair--so we all took turns holding his hands. His hands were always the same size as mine, but now they looked huge, his arms reduced to bones visible clearly through his skin. He was so strong. How could he die if he was so strong? He said, "I don't know how to do this." "Yes, you do," I told him. "As soon as it's the right time, you'll know how." Not Just a Number In the year 2002, it is estimated that 1,284,900 Americans will be diagnosed with cancer in some form or other. More than 1,500 people die of cancer every day. Cancer is the second leading cause of death in the United States, causing every one out of every four deaths. With all the advances being made in the medical field, "finding a cure for cancer" remains a tongue-in-cheek, nonsense phrase, sort of like "saving the world." Most people know someone with cancer; many people will lose someone they love this year, or next year, or the year after that. I wasn't there when my brother died; I was at home, watching Zoolander. My sister called me in tears and said, "Beren's gone," and I was pissed, fleetingly, because she couldn't say the word "died." At the house, there were people everywhere; my uncle and my sister had dressed Beren up in his black suit with the smiley-face tie that he thought was so cool. His best friends, Kate and Arturo, were clinging to each other, laughing and crying. "It's good," Kate said, hugging me. "He did it. He was amazing." I looked at them and wondered if I'd have been that together at 20, if someone I loved had just died. I wondered what it was like for him. I wondered if he'd remember. 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