Cancer killed my close friend Kelly Cosby on Sunday, November 15, 2015. Note the active voice: Kelly did not passively slip away into the night. She fought back at the thing in her body making her sick. Cancer killed Kelly. Cancer took from us a woman who worked with a passion to make the world a better place.
Cancer doesn’t much care what sort of person you are, or what potential might be lying dormant inside of you. It simply sets up shop inside your body, invading your life and the lives of the ones who love you. But cancer is also fickle. Startlingly similar presentations of the disease react in disparate ways to the same treatments. Kelly’s cancer – which, up until nearly the end, she personalized as “my cancer” – had many parallels to another person’s cancer. And as Kelly was killed by her cancer, another person on the same treatment trajectory was found cancer-free.
I said it first on Sunday, December 6, 2015, at 7:33pm, driving west on the Mass Pike. Bitterly, aloud to my empty car and the darkened highway. NPR had just reported former President Jimmy Carter’s announcement that he was cancer free. As I reached down for my phone to text my friend Sharon, an alert from the New York Times repeated the news. I should have pulled over, waited until a rest stop, taken a deep breath and counted to ten. Instead I texted Sharon the Times link: “Isn’t that nice for him. Angry face emoticon.” “I had the same thought.” Sharon’s text was punctuated with a sad face, but I had decided right then and there that I was not going to be sad anymore, I was going to be angry. I drove the rest of way back to Albany in silence; I had turned off the radio to avoid having to hear that news ever again. The idea that I could consciously choose my emotions was about as ridiculous as the idea that my car stereo was at fault for how I felt, but I was angry at the radio all the same.
You cannot, however, turn off the radio of life to avoid news that dredges up negative personal emotions. And the next morning at work, my colleagues were abuzz about the “good” news. Every expression of happiness for former President Carter made the angry ball inside of me angrier and the guilty twinge in my head stronger. Jimmy Carter is “such a nice man”, and he does do “so much good work”. These are very objective facts. A review of his post-presidential life by the Washington Post published alongside the announcement made that clear. The photo spread includes Mr. Carter and his wife, Rosalynn, building homes with Habitat for Humanity and the former President teaching Sunday school at his church in Georgia. He earned a Nobel Peace Prize in 2002 for his humanitarian work, efforts to find peaceful solutions to international conflicts, and advocacy for democracy and economic development. Objective facts. My coworkers were “happy for him”, and “glad to hear it” all before breakfast. I was stewing over my morning yogurt.
The rest of the day felt like an endless parade of people shoving Jimmy Carter’s joy in my face. It wasn’t just my little department talking about it. I heard about it in the elevator on my way to get coffee, passing through the kitchenette hallway to get to the copier, on a conference call about feral cats. My lunch break read of the Times was ruined by his smiling face, by pictures of him giving lectures, speaking in church, literally building someone a home. By the time I left, the ball was consuming me from the inside out. Kelly was also a person dedicated to improving our world. She worked for Amnesty International during college, and spent her first summer of law school with the Global Justice Center advocating for women’s reproductive rights. As a summer associate at Duane Morris LLP she took on pro bono work on top of her regular caseload, dedicating herself to helping survivors of human trafficking through Girls Educational & Mentoring Services. Why cut off Kelly’s potential, and her life, at just 25 years old?
Jimmy Carter, the angry ball inside of me said, is 91. He has had a good run of it, having done incredible and worthy things, while Kelly was just getting started. I prefer not to bring my personal life to work and I knew I would cry if I tried to talk about Kelly, so I let that little angry ball continue to grow. By the time I got home, it was ready to burst. I let the door slam closed behind me on my way in, marched into the kitchen where Mat, my housemate and Kelly’s law school boyfriend, was cooking dinner, and announced it again, for good measure or just to spread my negativity around:
“Fuck you, Jimmy Carter.”
I met Kelly on August 23, 2012, our first day of law school. For those first couple months our biggest worries were understanding Richard Epstein’s Latin at 8:30 in the morning, not confusing Luke and Andy for each other, and the terror of answering an Arthur Miller cold call unprepared the morning after a particularly drink-heavy law school social. Her melanoma diagnosis came the week we celebrated Thanksgiving at a crowded table in my uptown apartment with her mother, Jimmie; brother, Clay; and our friend Melissa. It was the first Thanksgiving dinner I hosted on my own, and I remember so many insignificant details perfectly. The bold blue and white tablecloth, eating in the living room cleared out of most of its furniture, hot cider with cinnamon sticks. Suddenly the looming prospect of our first exams was no longer at the top of our minds. Making a torts outline pales in comparison to developing excellent hat-based style to cover a headband bandage. Kelly took the timing as an opportunity for perspective and to be thankful for all the blessings she had. Her defiance and positivity prevailed. At the end of the semester, Kelly was declared cancer-free.
November and cancer went together for Kelly. Her diagnosis and her death both came in November, and during a November in between, cancer also took her aunt Mona. Law school milestones and cancer also went together for Kelly. She received her first diagnosis just as she began it, and just as she graduated a CAT scan showed lymph node enlargement in her lungs caused by a recurrence of her melanoma.
After her aunt’s death Kelly expressed to me a growing conception of a strong and deliberate life, which would become a pillar for how she spent the next months. Although Kelly dedicated her a significant portion of her professional life to countering injustice, she also made a difference in the world through her everyday interactions. She made time for the people and the activities in her life that brought her joy. And whenever there was a small act of kindness she could do to brighten a day, share a study resource, congratulate a friend, or spread important news she did it. Kelly was positivity personified.
Melanoma isn’t common in someone as young as Kelly was, and stage 4 metastatic melanoma produces some less than comforting Google results. Even with cancer in her lungs, lymph nodes, stomach, liver and brain, Kelly raved to me about her team at Memorial Sloan Kettering and about the treatment she was starting. When her doctor recommended spot radiation on her brain just before the bar exam, she joked that maybe if she brought her books into the room with her the radiation would give her superpowers in knowing the law. As we sat together the morning before the exam, huddling for warmth in the chilly convention center, she told me that if her hair was going to fall out from the radiation, she hoped it started during the exam. She was picturing herself pulling it out in clumps and looking around in horror at the people next to her. Maybe it would throw them off their game and help the rest of us on the grading curve.
Months later we met for breakfast. Her stomach was being finicky and reacted best to starchy carbs. So over a plain bagel and roasted potatoes she told me about how wonderful her new job was, her great clients and pro bono cases. She was enthusiastic about her new treatment plan – immunotherapy – and proudly told me about how well the spots in her brain responded to radiation and the praise she received from the radiology technicians for her ability to sit absolutely still for an hour. After a radiation treatment in September she emphasized that her radiologist had given her a piece of cake to celebrate her birthday with her and she wrote, “I found out I have the tiniest bit of new cancer, and people gave me pizza and cake. I’ll be just fine.”
When I read over our summer of bar study and post-bar break messages they are overwhelmingly the same as the texts we had always sent each other. A complaint about how tights either strangle you or fall down led us to the conclusion we should try maternity tights. One of us would watch a new TV episode before the other and be forced to only send “Have you watched it yet?” messages for days or weeks until the other caught up. When our conversations were about her cancer they found the humor in the situation. Once she sent me a picture of her intake form, which asked, “Do you need help getting onto the table?” wondering if the alternative was needing help to get under the table. It wasn’t that she didn’t feel the weight of the cancer. She did. Occasionally that dark cloud peeked through the aura of positivity we worked hard to create. She said it was like the cancer was trying to do the same thing to her thoughts as it was doing to her body.
In late October, after a PET scan showed that her BRAF treatment was no longer shrinking her tumors and the cancer in her liver was spreading, Kelly made the last update to the blog she had kept since before I knew her. It started as most of her posts did – cheerful, positive. Telling you the story of her life in the best terms she can. But I knew the fear was creeping back in before she said it – her changing appetite and her fatigue were more prevalent in the retelling, cutting through her true confidence in the new immunotherapy. And then she came right out and said it, the thought that had lingered in the back of her mind since her melanoma was discovered during our first year of law school. And she didn’t say it in an off-hand, joking way, as we had so many times before. This was not a playful, “Sorry, cancer, but I’m just too busy for you right now. You’ll have to take a hike.” She simply stated the raw facts of her anger:
“[C]ancer has angered me. I watched other kinds of cancer take two of my very favorite people in the world. And here it is, come for me. And that isn’t OK. Cancer can’t do this to my parents. It can’t do this to my family that has been through the hard parts of this before and who have been there praying and supporting with everything they have. So I’m pretty pissed off that it thinks this is an acceptable time to be messing with us. And I’m not someone you want to piss off. So cancer, LEAVE MY FAMILY ALONE. And leave my body alone. I’m exhausted, and you’ve overstayed your un-welcome.”
Kelly was right when she said that cancer is unfair, and she was right when she said that the cancer was un-welcome. And three weeks later she was gone.
How does the universe decide who lives and who dies? How can one person’s melanoma never spread past the initial lesion once removed, and another’s quietly invade their liver, stomach, lungs and brain? Why does a treatment that began by shrinking tumors and slowing cancer growth suddenly stop working? What makes a particular treatment work tremendous results on one person, and completely fail when put to work against essentially the same cancer with the same spread in another person? What about when those people are 91 and 25? A person with a full lifetime of memories and accomplishments, and one just starting out in their vocation? Jimmy Carter and Kelly Cosby?
It is easy to focus my questions on why Kelly’s treatment didn’t work, why cancer took over her body the way that it did, and on why Jimmy Carter enjoys such a positive health outlook. These are questions that smart, talented, ingenious researchers are churning out studies and papers to answer. Sometimes cancer’s cause is identifiable – pollution exposure, tobacco consumption, severe sunburns even, and sometimes it strikes randomly in the otherwise healthy who have followed all the advice to lower cancer risk. It was this randomness – the empty gap between what science has taught us and what actually happens in the world that angered me.
In the aftermath of my outburst directed at President Carter, I poured myself a vodka, snuggled into my footie pajamas and sat down on the living room floor. The angry ball had grown up and pushed its way out of my mouth and into the world. Unfortunately, it didn’t do much to get me back to acting like a functional and rational adult. One who could listen to other people’s treatment success stories without hating them a tiny bit; who could listen to news reports about cancer without needing to pull over to text stops and rest areas to sob silently against the steering wheel; who could enjoy The Mindy Project without crying because my watch-buddy wasn’t at her apartment watching also; who could get out of bed to face days in a world that is unfair. Being angry at cancer for killing Kelly didn’t make any of those small tasks easier. Anger rarely does. All it did was make me pour another drink, snuggle deeper into my pajamas, and question.
A childhood friend’s father, J.Y. Smith, once wrote that, “People try to deny painful memories. In this way death is the enemy of common sense and, unless one is very careful, death always wins. Denying painful memories is to deny part of life itself.” As I sat on the floor I began to consider that I was using anger to deny pain. Being angry with Jimmy Carter meant a break from being sad. Being angry at cancer meant freedom from small empty space in my soul that Kelly used to fill with her joy. It would be easy to stay in that angry vodka-and-pajamas place because it is hard to face the inevitable question of how to live after Kelly.
My common sense has been lacking since November. I left some important tasks undone for far longer than I should have for my job and for my health. Kelly was the first person to know my bar results. When she found out I had waited half a day and still not opened my results she was first incredulous, and then amazed at what she saw as self-control. Finally she wrote to me, “ Whatever it says. It will be okay,” so I opened them, and it was. Until the notice of my admission to the bar in New Jersey arrived with the date of my admittance: November 15, 2015. It doesn’t make sense, but the coincidence that I would become an attorney on the day of Kelly’s death stopped me from filing the paperwork for my New York admission for three months. In December I was supposed to see my doctor to follow-up on abnormal results on a cervical cancer screening. But when she told me she didn’t accept my new health insurance, I canceled my appointment and have spent the past three months inventing excuses to avoid finding a new doctor. It doesn’t make sense that I am as dedicated as ever to my yearly dermatology exam, which has never revealed anything of note, while I studiously ignored my actual low-grade precancerous cells. I was doing exactly what I have been warned against; I was denying what is painful.
Since I started writing this I have submitted my application for admission to the bar in New York, and I have picked a new doctor and scheduled an appointment. I think next I will buy maternity tights. It would wrap up Kelly’s and my last brilliant scheme and also be a tangible step I can take forward. We had hoped they would be game changing. And perhaps they will be. I am not ready to put down the vodka, change out of the fleece-y cupcake pajamas and stand back up off the floor all at once. But I need to figure out what will get me from here to there: how do I want to live and what do I want to do that reflects who Kelly was as a person and what she meant to me?
The first step is this apology: I am sorry, President Carter. My reaction to your cancer-free news was far from ideal. I know that you are not at fault for the success of your treatment and the failure of Kelly’s. I know that just as Kelly did not deserve what cancer did to her, neither do you. Your long, good life does not make you less deserving of excellent medical care and positive results. I know that her death is not the result of your survival.
I am grieving in a way that makes sense to me. I am being very careful so that death, so that cancer, does not win.