***

“I couldn’t do what you’re doing,” we hear frequently, referring to my husband’s decision to forgo cancer treatment.  It’s not been too hard so far because Marv’s been “normal.” But that changed last week when he sprouted his first new nodule since the one removed on January 23 that led to his diagnosis of Stage IV Small Cell Lung Cancer. He found it and asked me to check it. Sure enough, a small, round, hard, and movable “marble” under the skin, with no pain.

We’ve known all along that the cancer is outside his lungs, traveling around and deciding where to land. In my mind, that landing would be internal, most likely in the bones or brain where lung cancer usually metastasizes, but here we are with a palpable bump.

Not until evening did I ask him how it felt to have external evidence of the disease’s progression. As we sat in our usual places in our living room, he in his recliner, me on the couch, he said he felt, “Nothing really.” And I admitted I didn’t either.

I wondered why I didn’t react and came up with that I’m probably in some level of denial that the cancer is a reality. I remember studying Kubler-Ross’s stages of grief in college: denial, anger, bargaining, depression, and acceptance, stages that can occur in any fashion, not necessarily linearly.

When we learned of Marv’s cancer in January, we were in acceptance mode from the beginning. It did not come as surprise; we’d had his lung scare in 2010, and he’d smoked most of the time since he was fifteen (with so many attempts to quit that I long ago lost count). I never felt any need for bargaining with God—if only you do this, I’ll do that, and I’ve never felt depressed—sad yes, but not in any clinical sense.

I did feel tremendously angry for a few hours early on, but aside from blaming tobacco manufacturers for making such an addictive product, I could not muster up any feeling of anger toward God and certainly not for Marv.

I’ve lived Marv’s addiction for our courtship of three years and our marriage of fifty-five. I’ve seen him try to quit; I’ve seen his successful attempts of up to three months. But mostly I’ve seen how cigarettes and coffee have worked together to calm him. He’s always been on the go, never been able to sit for long, even his mind is constantly creating innovative ideas, and his thoughts are usually larger in scope and miles ahead of anyone else in the room. A therapist we consulted recently for his “can’t sit” state concluded after extensive testing that his brain is wired differently than about eighty percent of the rest of us. And that different wiring is okay; the world needs energetic, creative types like he is. Like, she said, a Gates, Bezos, or Zuckerberg.

So, do I wish that he’d never smoked and maybe we wouldn’t be here today? Of course, but I can’t fault him for dealing with his “can’t sit” personality with what worked for him. And I accept what he said right away upon diagnosis: “I’m not going to beat myself up for smoking; I know why I did it, and I don’t expect others to understand.”

Now, with this new nodule, our first external evidence since the diagnosis of the last one, I must confront that the cancer is indeed real. That even though he’s still running circles around us (he did three hours of yard work the other day), I’ll have to work on my level of denial. Sooner, rather than later, as yesterday we think we felt another one starting to sprout.