The Green Knight & The Red Devil: Choosing Cancer Treatment
A choice was laid before me, not all that dissimilar to the choice of the young Sir Gawain in the 14th century chivalric poem "Sir Gawain & The Green Knight"
It’s Christmas time in the court of Camelot. Boughs of holly adorn the halls, gifts are exchanged, a feast is enjoyed, and a tired King Arthur requests to be regaled by his Knights of the Round Table with tales of their heroic adventures from the year past.
Nearly as soon as his request is uttered, the merriment ceases to a whisper as the party’s attention is drawn to an imposing shadow and his threatening battle axe in the doorway. A massive creature, seemingly organically constructed from verdant branches, leaves, and tree trunks lumbers towards King Arthur and his knights. Filled with unease, the court listens intently to what this “Green Knight” has to say.
The Green Knight proposes a friendly Christmas game (surprise!): someone is to strike him once with his axe, on the condition that the Green Knight may return the blow in a year and a day. The axe will belong to whoever accepts this deal.
Again silence fills the court of Camelot as the deadly implication of this challenge reveals itself to the older, more experienced knights. But Sir Gawain, youngest of Arthur's knights and his nephew, is the sole volunteer who asks Arthur for permission to play the game.
Gawain suits up, preparing for a scrap with this gigantic creature, and to prove himself as a man to his King through battle. But upon Gawain’s entry to the center of the court, the Green Knight calmly descends to his knees, bows his head, and reveals the trunk of his neck in submission to Gawain, waiting to receive his blow.
A knight more secure in his masculinity, may recognize this game as a test of mercy, for whatever pain he inflicts onto his guest will be repaid to him in one year and one day’s time. But Gawain doesn’t recognize this nuance, he only sees an opportunity to vanquish this foe from his court for good, and to escape the delivery of his end of the bargain, not to mention a shiny new battle axe.
With all his might, Gawain swiftly beheads his challenger with one stroke of his sword, and the leaves and twigs of the Green Knight’s head tumble to the ground at the climax of a red fountain of blood. Full of pride, Gawain turns to the court to celebrate his victory, but King Arthur and the Knights regard him silently, wide-eyed with fear.
The Green Knights’ headless body rises from its knees, nonchalantly picks up its head from the floor, and bellows to Sir Gawain and the court the location where he will repay the blow: The Green Chapel
"The head, within his hand he held it up a space, Toward the royal daïs, forsooth, he turned the face, The eyelids straight were raised, and looked with glance so clear, Aloud it spake, the mouth, e’en as ye now may hear; “Look, Gawain, thou be swift to speed as thou hast said, And seek, in all good faith, until thy search be sped, E’en as thou here didst swear, in hearing of these knights— To the Green Chapel come, I charge thee now aright, The blow thou hast deserved, such as was dealt to-day, E’en on the New Year’s morn I pledge me to repay."
In one year and one day’s time, Gawain must seek the Green Chapel, where the knight will behead him to maintain his honor and his promise–embarking on an odyssey he knows will lead to his own demise. But are there even consequences if he refuses the task? There’s of course shame and dishonor, but physical consequences? It seems if Gawain ignored the rules of the game, no physical harm would come to him. But despite this, the rest of the poem, Gawain stubbornly marches towards his own death, despite everyone he encounters on his way begging him to forgo such meaningless suffering.
Sir Gawain & The Green Knight is a tale of shame, cowardice, toxic masculinity, and how cycles of violence mirror cycles of life and death in their ultimate chaotic indifference. Green is the color of the spring, rebirth, new growth, but it is also the color of rot, decay, illness, and toxicity. Red is the color of blood, gore, and anger but it is also the color of lust, passion, and royalty. These dualities don’t speak to a larger confusion in our understanding of life and death, love and violence, but rather the acceptance that these themes exist as two sides of the same coin.
It was September 5th 2021 and I was in a small plastic tube listening to the whirrs and bangs of the MRI machine spinning around me. I had finished three months of Taxol, a weekly chemotherapy distilled from the poisonous compounds inside the bark of the Pacific Yew tree. Knowing this, I would often joke to my friends that during my infusions I would pretend I was an ancient druid receiving my elixir of life under the bowers of a Yew grove. Anyways, it was a more romantic thought than the reality of sucking on ice chips under several dozen stiff blankets in a fluorescent hospital room.
I had entered a special trial of a new chemotherapy regimen that was supposed to be easier on the body for younger patients, with less long term side-effects. This all with the promise that at the end of the three month regimen, I would be scanned and it would be determined whether or not I had a complete response to the Taxol and immunotherapy. I was receiving my MRI on this day to see if enough of the cancer had been killed so that I could complete chemotherapy and proceed to surgery.
Everything was riding on this scan. It felt like a test that if I passed, it would mean my freedom, and if I failed it would mean my agony. If any cancer lit up on my scan that would mean I would need three more months of a more intense chemotherapy called Adriamycin and Cytoxan (AC) More colloquially known among cancer patients as “The Red Devil”, not only for it’s bright red color, but it’s propensity to cause heart toxicity, acute nausea and vomiting, total hair loss, severe bone pain and permanent neuropathy.
As I went into the MRI tube, I felt like Gawain in the immediate aftermath of the swing of his sword; like I had vanquished my challenger, smiling and preening as its head rolled to the ground. Everybody else at this cancer center receives bad news, but not me. Not today.
My knights of the roundtable, (my family) were the ones wide-eyed with fear as we sat down in my surgeon’s office waiting for the images to pop up on her computer screen and for the headless foe to rise from its knees and issue the ultimatum. I remember the words clear as day:
“You had a response to treatment.”
Okay…but what does that mean for me?
“There’s still a large amount of cancer left. We cannot clear you for surgery.”
I had failed. My body had failed. My gamble with a less intense treatment had failed. Three months of a weekly dose of poison all for a small response to treatment and the prospect of a much harder three months ahead.
I originally made this decision with my future self and long-term enjoyment in mind. Could I go through cancer treatment and then be lucky enough to just be done with it?
Would I suffer with hands and feet that are on pins and needles endlessly, or a heart that can’t pump blood, or hair that never grows back, or, or, or… the list of long-term potential side effects from AC goes on and on. But here was the cancer, promising to return to the blow to me in three months and three days.
In shock and incensed, I told them “no”. I won’t do it. I won’t face The Red Devil in the Red Chapel like I had promised when I signed the trial’s consent to treat. But realistically, I couldn’t speak through my weeping. I was a blubbering coward, determined to continue risking my life for the vague and non-binding promise of a future without side-effects, but maybe no future at all. People think Gawain’s choice to continue his quest to seek the Green Knight at the Green Chapel is either evidence of his honor and dignity, or evidence of his stupidity. I contend that it’s both.
The true wisdom of Gawain’s quest is revealed to him in the potentials of the choices he does not make. His choice to meet the terms of his agreement or to not, is not a choice between life or death, love or violence, because all roads lead to all outcomes. His only choice in this matter is his conduct through his quest and whether or not he chooses to accept his death or to deny it until it demands an audience. Which path will leave him fully satisfied?
After a few weeks of thought and regaining my composure (and a lot of daily therapy), I decided to face the Red Devil on a few conditions. First, that I have the rest of the month of September to regain my strength after Taxol, and enjoy a bit of my life before I lose it to my illness once again. Second, that my onco-psychologist be present with me during my first infusion to support me and my panic disorder that had developed rapidly during my time in the hospital. But eventually, my “one year and one day” came, and I walked into the hospital ready to receive the blow.
My boyfriend held my hand as the infusion went in, and my onco-psychologist led me through breathing exercises to calm and soothe me. All roads led me to here: learning to breathe through the fear and embracing living without knowing what was going to come next. Sleeping through the night knowing I did everything that I could.
"And wonder, dread and war have lingered in that land where loss and love in turn have held the upper hand."
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