Stepping into the void: Richard Crouse's experience of chemotherapy

6.

The first day of chemotherapy feels like walking into a void. Despite the training class, conversations with doctors and anecdotal advice from friends and family it is impossible to know exactly what to expect or how you're going to feel when it's all said and done.

How long will the needle be? How will I feel afterwards? Will my appetite disappear? Only time would tell but it makes for a long night — Chemo Eve — when those questions race through your mind in an endless loop, making it impossible to sleep.

Magazines, books and iPads were packed and Andrea and I jumped on the subway. Four stops later we transferred to a bus that dropped us at the cancer ward front door. I've been taking the subway in Toronto for thirty-five years so that part of the trip didn't register as strange or ominous, but for some reason I attached bad feelings to the bus ride. I began to realize that cancer and chemo was going to readjust my relationship with everyday things. I suppose because the bus dropped me right at the door I began to feel anxiety every time I walked from the subway to the bus platform. Subway good, bus bad.

The first line (of many) took so long I almost forgot why we were there. "Yes?" said the receptionist. "I'll have a grande, iced, sugar-free, Vanilla Latte with soy milk," I said. She didn't laugh and stared at me until I handed over my health card and hospital identification. After typing for an eternity she directed me to the blood work area.

In truth she didn't type for an eternity, otherwise I'd still be standing there with a bad joke hanging on my lips. It felt like forever but was actually just my first lesson in the rhythm of chemo days. In your head you're racing toward the finish line — the sooner we start the sooner I can get out of here — but everyone you interact with seems to be moving in slow motion. It's a methodical process with many steps and all the fun of cutting an apple in half and watching it slowly turn brown.

There's something science fiction-like about the whole thing. "You're going to be touched on the cellular level." That sounds like something that you'd read about in Dr. Frankenstein's notebook.

The building is very modern, all sleek lines, metal and glass but the process begins with some old school blood letting. Vials of blood are taken, whisked away to a lab for testing to ensure your cell counts are high enough to handle the massive injection of drugs you're about to receive.

Step 1: Blood Work.

This will make or break your day. You drop off your hospital card and wait until your name is called. One poke and three or four vials of blood later you're sent to cool your heels in the waiting room while tests are run to make sure you're strong enough to receive chemo. I imagined they had a room somewhere in the back with a large Rube Goldberg-esque plasma machine to analyze my fluids. I pictured a white lab coated nurse pouring my blood samples into a large sluice and after some elaborate swirling and shaking the machine would spit out a chit reading either HEALTHY or NOT HEALTHY.    

We sat and waited, watching the sea of faces around us. Tired faces, anxious faces, people trying to make the best of a bad situation. It's impossible not to note that cancer is all-encompassing, welcoming everyone regardless of age, social standing or race. The waiting room is a cross section of society bonded by one thing, an insidious disease. Hardly anyone speaks to anyone outside of nurses or family members, but there's a shared unease among us, a tacit understanding of how we all ended up sitting here, waiting.

At this point in the process, like the residents of the mysterious Village on The Prisoner, we all now have numbers rather than names. Eventually these digits will flash up on the screens that dominate the room when your number in the Chemo Lottery is called. A quick visit with a nurse determines how the rest of my day will go.

Step 2: Blood Test Results.

It's like being called into the principal's office. Your number pops up and you slowly walk to the office, head bowed, unsure of what is to come. In fact it's a straightforward thumbs up / thumbs down situation. A friendly nurse looks at your paperwork, asks how you're feeling and either allows you to get stuck with the chemo needle or sent home. I was never refused treatment but saw lots of others who were sent away because the medicine that should have been healing them would actually harm them. Better luck next time, rinse and repeat next week.

Step 3: Waiting Room Redux.

Once green-lit there's more waiting around. Chemo drugs are usually used in combination as each one attacks cancer cells in a different way. While I waited technicians went through my data and mixed a cocktail of drugs based on my kind and stage of cancer, my weight and height. It takes time. Lots of time. You want them to be precise… but giddy up. I imagined handlebar mustachioed Gay Nineties-style bartenders shaking the chemicals, preparing them as though they were Whiskey Sours. Anything to pass the time.

An hour or so later I was called into the inner sanctum, the Chemo Ward.

My first visit was comforting and unsettling at the same time. I pictured something out of Hieronymus Bosch, with writing bodies topped by gape-mouthed faces but was greeted by bright, airy rooms with rows of hospital beds on each side. Alongside each bed are IV poles so heavily laden with clear plastic bags full of toxins they look like medicinal chandeliers.

As with all my appointments Andrea was at my side for all of this. A smiling, steady presence, she skipped work, packed a lunch — more on that later — and passed the time squeezing my hand as we moved through this unusual day.

Before administering the chemo the nurse ran saline through the port, priming the pump and answering the first of my many questions. How big is the needle going to be? Called a Huber needle, it's a fearsome-looking beast that looks like a prop from Game of Thrones. Slender and sleek enough not to hurt on the way in, it would still strike fear into the heart of trypanophobiacs. Wiped with rubbing alcohol and taped into place, the needle is hooked to a pump that chugga-chuggs the drugs into your system with a sound that soon becomes a hypnotizing rhythm.

Across the room a woman was having a worse day than me. Her IV pole heavy with bags, the nurse was asking questions. "Do you have pets? Yes? Then if you throw up at home don't let the animals near the vomit. It will kill them." Yikes. Even worse, when the patient left the nurse said, "See you tomorrow." In moments like that I felt relieved that I wasn't there everyday ingesting enough drugs to kill a beloved pet.

As the chemicals slowly dispersed throughout my system I imagine the chemo is like Pac Man, hungrily gobbling up the bad cells in my body. It's a singular sensation, feeling the drugs make their way. I feel the spread and pinpoint where the drugs are. It felt like a cool blanket being pulled across my body until I'm covered head to toe. It's not entirely unpleasant but during this first treatment I still wasn't sure how my body would react.

For lunch Andrea made sandwiches. I was determined to treat this day — and all the subsequent chemo days — as normally as possible. That, in part, meant eating lunch. With the chugga-chugga of the chemo pump providing light background music I ate a ham and cheese on — and this is important — a triangle bun.

Delicious, made just the way I like it with pickles and the perfect dressing of mayo and mustard. "Why the detail?" you may ask. I bring all this up because I quickly learned that chemo is not only a cancer treatment, but it's also a kind of aversion therapy. Those sandwiches are delicious for the first two or three sessions but as the side effects of the chemo really start to kick in I find myself repulsed by the mere sight of my once-beloved triangle bread. Even today as I sit and write this my stomach flips when I see the geometrical bread in the supermarket. Had I known chemo would put me off certain things I would have taken beer, cheese and every other unhealthy snack I could think of with me instead of my favourite sandwich.

Post-lunch hours tick by slowly until it's time to leave. Released from the machine I was then hooked up to a to-go bottle about the size of a venti coffee at Starbucks. I'd carry around this bottle, complete with a skull and cross bones on the label for two days until my body had completely absorbed all the liquid medicine. That and a handful of steroids dulled the effects of the chemo for a few days.

At first the bottle was an inconvenience but eventually I got used to it and made it part of my routine. I hosted the Canadian premiere of "The Hunger Games: Catching Fire," complete with cast members and hundreds of rabid fans, hiding the bottle in my back pocket. Later at a Simple Minds concert the bottle fell out of my pocket and rolled around the aisle until I noticed a pulling at my chest. It's true, you can get used to almost anything, including having a take-out bottle of toxic drugs tethered to your body.

Leaving the hospital after the first dose of chemo gave me the first hint of the side effects to come. Six or seven hours after arriving I left, loaded to the gills with a drugstore full of chemicals, including one that made me extremely sensitive to cold. The doors opened, the fresh air hit and it felt as though I was sucker punched in the throat. For me it was the first sign of the neuropathy that would soon spread to my hands and feet, making them numb and, conversely, making them extremely sensitive to cold. Over the coming weeks it would become painful to be outside unless I was wrapped like a mummy and at its worst, made it difficult to touch anything cold. Even taking milk out of the fridge became a challenge.

After the first dosage of chemo, however, the feeling quickly passed and I was able to catch my breath. In the cab ride home I felt pretty good. I survived without throwing up all over the taxi and left thinking that while chemo sucks, it's better than the alternative. Later in the treatment, when I didn't feel as chipper I thought the same thing, but compared it to jumping from a burning building. It seems like the only alternative, but one way or the other, you're going to get hurt.

The next days passed without much incident. The sensitivity went away and other than having the to-go bottle as a constant companion, life went back to normal. Just 30 more treatments to go.

The to-go bottle usually emptied on Wednesday, two days after my treatment. I began to look forward to my standing appointment at a nearby clinic to have the needle taken out, the bottle disposed of and fresh dressing applied to the port. For weeks the same man would silently motion for me to come in and take off my shirt, while he put not one but two pairs of latex gloves on. After some weeks of this I realized he didn't speak English fluently, but I had to ask, "Why do you wear two pairs of gloves when you disconnect me?" "Poison!" was his succinct answer. Great. I'm a walking, talking skin bag full of poison. After that I handled the bottle a bit more gingerly than I had in the past.

In previous instalments, Crouse shared the life-changing moment he first heard his diagnosis, the challenge of talking about his diagnosis with colleagues at work, the indignity of hospitalization, his struggle to keep the faith in cancer care. and the difficulty of feeling kicked when you're already down.  In a week, we'll have the next instalment in his series on surviving colon cancer.

Richard Crouse shares a toast with celebrity guests and pundits on the talk show Pop Life on CTV NewsChannel and CTV. Catch up on all the entertainment news, reviews and interviews at the Pop Life website.

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