Last Updated on February 7, 2020, by eNotes Editorial. Word Count: 1024
Part 2 (titled “Cease Not till Death”) opens with Paul and Lucy in a hospital bed together, both weeping at his CT scan results: Paul’s lung cancer has reached Stage IV and invaded multiple organ systems. He assumes that there is no hope and that he will never return to his practice. When his brother Jeevan tells Paul to take solace in the fact that he’s “accomplished so much,” Paul fails to appreciate the remark; he feels his future has been “firebombed” and the things he truly wanted to accomplish will never be his.
That night, Paul sees his oncologist, Emma Hayward. Their first proper meeting is scheduled for later that week, but Emma insists on introducing herself before picking up her children that evening. She says the lab is running a test on Paul’s tumor sample, and the result will determine if he has to undergo chemotherapy or not. Paul asks about the Kaplan-Meier estimation on his case, but Emma refuses to discuss it. This angers Paul, as it implies that she sees him as more a patient than a colleague (when he had appendicitis eighteen months previously, his doctors treated him more like the latter). However, Emma’s compassion and skill as an oncologist endear her to him, as does her implication that he might be able to return to work.
Paul grows more ill: even going to the bathroom requires “effort and planning.” He walks with a cane and takes multiple pain medications. These changes affect not only his body but also his sense of self: his pride in work and physical fitness no longer apply in his new state as an invalid. Looking at an image of himself and Lucy dancing, he is reminded of Laurie and the fiancé she left behind after her death.
Paul’s family does their best to help him adjust to his new situation by setting up an account with a mail-order pharmacy and modifying his sleeping arrangements with a bed rail and ergonomic mattress. Paul’s lack of income puts massive pressure on Lucy. Despite his father’s proclamation that Paul is sure to beat the cancer, Paul thinks of all the times he has heard patients’ families say the same thing, only to lose the battle anyway.
Paul and Lucy meet with Emma. She says that they may start chemotherapy the following week, depending on the results of genetic testing. Emma warns Paul that certain medications could have a permanent negative effect on his nervous system, affecting his ability to resume work as a neurosurgeon. Paul replies that he does not mind having to find another profession should his hands become damaged by the chemotherapy; however, Emma insists on using carboplatin over cisplatin, as one is not more likely to be more successful in killing the cancer cells than the other, and the carboplatin has less chance of ruining his surgery career. Once again, Paul asks about the survival chances, but Emma refuses to discuss it.
The following day, Paul and Lucy go to the sperm bank, because Paul’s treatment might have unknown effects on his ability to father a child. (They had originally planned to start a family after Paul finished his residency.) After they return home from the sperm bank, they learn that Paul has a treatable genetic mutation, which means he can take a pill instead of undergoing chemotherapy. The Tarceva medication allows Paul to put some weight back on, though his skin develops blemishes and bleeds easily.
Paul also starts biweekly appointments with Emma. During one session, she asks him if he wants to quit his job or go back to it. Many cancer patients retreat from the world to spend more time with their families, while others dedicate themselves to their work even more. Paul is unsure how to proceed and says if he had a general idea of how much time he had left, he could better choose a course:
(The entire section contains 1024 words.)
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