Divisadero

She wasn't holding a lollipop and skipping a jump rope, but she could not have been more than 11 years old, the doctor who escorted us into the examining room.  Okay, she was a resident, a fledgling physician, but that doesn't explain why the University of California has taken to running prepubescents through medical school.  Don't tell me I'm old.

She took down Marlou's history, the onset of the cancer, the treatments and surgeries and chemotherapy holidays.  Later, in recollecting the exchange, Marlou seemed embarrassed to have flubbed a few minor points of chronology.  The young doctor wasn't concerned.  I'm sure that in her position at Mount Zion Hospital she has interviewed some of San Francisco's loopiest and most senile.  Marlou, by contrast, presented a coherent and complete oral history of her cancer.  The young doctor, in the time-pressed way of overworked, under-rested medical trainees, moved things along at a brisk clip.  She recorded an answer while asking the next question, simultaneously doing a quick inventory of Marlou's slides, CDs of CAT and PET scans, paper records and assorted clinical evidence.

The doctor would be in shortly.  And short it was.  The cancer specialist delivered a crisp overview of the disease and its progress.  Marlou, he said, needed radiation next.  This wasn't bad, for it would relieve the persistent pain in her hip.  And coupled with a redoubtable bone strengthening remedy, not only would she be safer from falls, but the hip cancer might get beaten back.  One never knew.  One also never knew colon cancer to work its way into bones, until recently.  Apparently this is an unanticipated side effect of the new medications.  As for clinical trials of experimental pharmaceuticals, the issue of the day, well, the radiation would have to come first.  Then we'd see.

I said goodbye to Mount Zion's cancer department without much regret.  But the place did have certain associations.  The crowded waiting room reminded me of large old hospitals in London.  The patients had a more varied, urban look to them.  This was no airy, spacious suburban medical haunt of executives and families.  This was San Francisco, home to Mandarin and Cantonese and Spanish and Filipino cultures, mashed together without enough furniture or leg room, everyone waiting to see the doctor about their cancers.  Marlou offered to pay the fee that accompanies most American medical appointments these days.  Make the check payable to University of California Medical Center?  No, said the receptionist, pay the UC Regents.  This triggered an instant reflex, and I went looking for a spare brick and protest sign.  The regents had this effect on Berkeley students in the 1960s.  Half a century ago.  I am not old.  

The winter day was crisp and Divisadero Street full of perils.  Marlou had driven her new car into San Francisco and was pushing me across the pavement, and up and down the curb ramps, in a manual wheelchair.  The strain, the chance of falling...oh, what the hell.  Within minutes we had driven to Lincoln Park, wedged between the golf course and the museum, and sat munching sandwiches.  It was one of those searingly beautiful San Francisco days.  The Bay water sparkled with blue dye.  The big freighters heading in and out of the Golden Gate revealed every detail of splash and bow, flag and smokestack.  Driving south along The Great Highway, hemmed in by a crush of boxy Sunset District houses on the left, bounding surf on the right, Marlou kept her eye on the road.  Yes, it was pretty, but she had had enough for one day.

Not me.  I was back the next day, on the #2 Sutter bus, heading right back to Mount Zion's next-door neighbor, Jewish Family Services.  The bus was infrequent, but also uncrowded.  In midafternoon, it carried no commuters only people like me, the lame and the halt.  At Laguna Street the #2 docked for a long interval.  At the bus stop, an elderly woman waited with her shopping.  In each hand she carried 24 shrink-wrapped rolls of toilet paper.  Nothing else.  She groaned climbing the stairs, flopped into a bench and eyed the next passenger's progress.  There wasn't much.  The man brandished two forearm crutches, but not very well.  I could tell he did not have decades of practice.  First he got one leg up one step, then one crutch, then the other.  Twenty bus passengers with a destination stared.  Now he had a go at the second step.  First the leg, then one of the crutches, then, what the hell, the other crutch.

'Why don't you lower the lift', the toilet paper lady told the driver.  'See, he needs the lift'.

I was certain this woman was also destined for Jewish Family Services.  The man with the crutches was now on the top step and trying to hand one of his sticks to a passenger.  He needed to pay the fare.  The bus still wasn't moving.  The bus hadn't been moving for minutes.  The woman with the toilet paper held the man's crutch.  He dropped his coins in the box, and we were off.  A few more stops, and I would be off myself.  Already late for my appointment, I glanced at my watch.  At Divisadero Street, I flicked on my wheelchair, just as the guy with the crutches rose.  He was poised to begin his descent, but so was an army of supporters.  The driver ushered him onto the wheelchair lift, the toilet paper lady held his crutches, I held my breath.

Ahead was a social worker and a planning session for life without Marlou.  The woman at the front desk offered me a chocolate pistachio toffee.  I thanked her.  She offered another.  The social worker appeared.  Soon, the young rabbi I had met before.  It was late afternoon by the time it was all over.  The #2 bus was filling with commuters.  The bus driver dropped me at the edge of Chinatown for no good reason.  This bus stop was less crowded, he said.  The driver seemed oblivious to my destination, concerned only with this matter of stops and crowding.  I decided this was fine.  I wove through the late day foot traffic around Union Square, ignoring the conveniently close bus stop for #45 and the #30.  Either would take me to the train station, but both would be packed with commuters.  I knew what I was doing.  Market Street would comb people out of these buses like a flea brush.  All I had to do was cross the bustling thoroughfare and wait on the other side.  Many things were unclear, the future daunting, but for now I knew where to go.