It had to become completely dark in her life
so that she could recognize the light
that still shone on her in the dark alleys of life ?
it had been there all along.
In a row, their backs to the wall, they all sit ? in thin, yellow gowns, half-naked and uncertain. Most of the women are of Mexican origin, overweight, covered in tattoos and looking totally unkempt. The floor is dirty, the air conditioning is turned too high, and the stench of disinfectant hangs in the air.
For Lilian, it is strange and frightening to be forced to wait for her examination in a so-called “homeless hospital”. Back in Switzerland, she had never even heard of such a thing. The social system in Europe is, after all, so very different. With her long blond hair, blue-green eyes and always carefully groomed appearance, she attracts glares from the others in the waiting room. Everybody here knows: whoever comes for treatment in this run-down hospital is either living on the streets, locked up in jail or can’t afford health insurance.
Seated on the bench with her lips pursed, Lilian’s daughter Johanna scoots in very close to her mother’s slightly trembling body. The place is very unsettling for her too, but she couldn’t change Lilian’s mind about coming here because even she knew how tough things were financially.
Since the family had been living in the States, they’d never bothered to get health insurance since it isn’t mandatory here. After Lilian’s husband had left her, she wanted to put an end to this carelessness, no matter what, so she took out a policy with a local Californian insurer. The premiums were affordable, $75 per person, but she thought the $4,500 deductible per claim was too much. That’s why, when she heard about free treatment, she mustered all her courage and drove here, to one of the most dangerous areas of Los Angeles.
For a long time already, she’d had a feeling that something inside her simply wasn’t right. There was the constant exhaustion and the weight loss ? she kept blaming it on all the stress of the past eighteen months. Surely it was nothing serious; for a native of the Swiss Upper Valais, it was hard enough just making ends meet with two teenagers in a city like L.A. Lilian’s tired eyes fix on a large metal clock on the wall across from her. Two hours and nine minutes have passed while the two of them wait in the cold hallway on the first floor. Downstairs is the technical equipment, including machines for x-rays, ultrasound and so forth. Upstairs is the entrance where the patients with no appointment wait. The smell in this hall is awful. Many of the patients are disfigured beggars, grimy and penniless, or injured, blood-crusted Mexicans sleeping on the floor; and then all these screaming babies! On the upper levels are the operating rooms alongside the shabby, dilapidated patient bedrooms with open doors where patients recover from their treatments.
Lilian’s gaze sways gently toward Johanna, who is lost in her thoughts, watching the relentless action of this department. She has just turned fifteen and Lilian can’t stop worrying about how it might affect her to be sitting here in this place with no way of knowing what is going to happen next. Johanna’s father should have been the one to come here with Lilian. They were still married after all and, by rare coincidence, he happened to be in the city right now.
It has been almost a year since her sister and her husband were visiting the States and Lilian had confided in Ralf that her right breast had often started to bleed from the nipple. He laughed and asked her if it was some kind of a trick to win him back. Ralf is the personal trainer for an actress with whom he’s also having an affair. He is always on the road and impossible to reach if there’s ever a problem. At the moment, he’s at least meeting his financial obligations to the girls, although that won’t last for much longer.
Lilian’s name is called. She asks Johanna if she’ll be alright to wait here alone and stands up. Stiff from sitting for so long, she moves slowly in her high-heeled sandals through the open door into a surprisingly clean room with a cot in the middle. She is quickly told how to lie down so that the doctor’s assistant can take a biopsy from her right breast as easily as possible, without wasting any time. Again she waits, but this time she’s lying down and can no longer hear the loud Spanish chattering of the other women. The silence is so pleasant! Lilian’s thoughts drift back to Park City, Utah.
In the late summer of 1995 when the four Ks ? Ralf, Lilian, Johanna and Margrit ? moved from Europe to the States, they were all so hopeful: they’d bought the cutest little restaurant on Main Street in Park City and Ralf was working on the side as a ski instructor. “Swiss Corner,” as they called their fondue place, got off to a good start in the first winter and its authentic Swiss decorations with bells, Alpine scenes, a life-sized stuffed cow, as well as Lilian’s handsewn outfits for the staff, were a big hit with the Americans. Even the family dog was Swiss ? a St. Bernard called Barry.
Naivete, misplaced trust and a still-shaky command of the English language all resulted in a series of invalid contracts and, within a year, the dream was over. In the months that followed, as the case was going to trial, the four Swiss immigrants moved to a remote farm in the mountains of Utah. Although their lawyer quickly reached a settlement, the pressures of these difficult times away from their home country had taken a toll on the marriage. In the winter of ‘98–‘99 when Ralf met another woman and wanted to separate, Lilian moved with the girls to Los Angeles, California, to the “City of Angels”.
Slowly, very slowly, she tried to accept the things that she could not change. It never occurred to her that things first had to become completely dark in order for her to recognize the light in the dark alleys of life. A loud knock at the door and the quick footsteps of the young doctor jolt Lilian abruptly back into the present.
While he assembled what they called the “gun,” Lilian opened the yellow gown, baring her right breast. The round bulge is unmissable ? two fingers’ width above her right nipple. Unlike the other lumps or hardenings that had occurred in her mammary glands from time to time in the past, this lump is hard as a rock. Still, Lilian is convinced that her prolonged breastfeeding and heavy mastitis are the causes for this change. Without any local anesthetic, the needle punctures the thin skin in three different placed around the bulge. The sharp pain strikes her like a snakebite, followed by a light burning sensation. The doctor informs his patient of the process of the further testing in which the results are to be directly analyzed, right here in the building. Lilian adjourns to the technical room next door where the mammography machine is located. This is her first experience with such things, which, at age thirty-six, seems to her to be fairly normal. Again she opens her gown and, following the nurse’s orders, positions herself in front of the machine. The nurse is clearly in a hurry and places the first breast, then the other onto a cold platform and then mashes the breast tissue extremely hard. Lilian felt as though she were being squeezed in a vice. Four pictures are needed ? two from below and the other two from the side ? to make a diagnosis. After she gets dressed again, Lilian is led back to the hall where the others are still waiting their turn.
Johanna’s patient smile and her knowing look encourage Lilian as she is called back to repeat the mammography because one of the images is unclear. The hands on the clock point to 6 p.m. and Lilian is becoming a little tired. Meanwhile her breast aches from all the prodding and the needle marks have started to bleed. After four more pictures are taken, she is allowed to go directly to the ultrasound room without having to wait any longer. A nurse, the same age as Lilian, enters the room, introduces herself and instructs her to lie down on the bed and undress her upper body. The thick liquid that the nurse smears onto the bulge is a little cold but other than that it feels nice. Also the fact that she is familiar with the process is reassuring to Lilian. Slowly, the nurse glides the ultrasound probe along Lilian’s skin in all directions, her gaze fixed constantly to the monitor. The nurse is troubled by something and repeats the entire examination then sets down the probe and rushes out the door. A few minutes later she returns to the darkened room, followed by a doctor. The doctor takes one look and says out loud, “It’s cancer,” and calls for the physician’s assistant.
The terrifying word “cancer” clangs through the entire room. Like an echo, it drowns out the assistant’s quick entrance. The oncologist explains in short sentences that another biopsy is necessary ? this time, directly from the tumor.
Cancer, tumor ? never before had Lilian given any serious thought to these words or to illness in general. It is just so unexpected. Lilian had never been a smoker or a drinker and, apart from the pill, which she regularly took, she practically never took any medicines; on top of that, no one in her family had ever died of cancer except for one person: her mother’s mother.
Her thoughts are interrupted at that point as she is asked to stand up and move to the examination table in the biopsy room. As she passes by the waiting room, she sees that no one is left waiting except for Johanna. She looks deeply into her daughter’s eyes. How in the world can she ever tell Johanna and her sister, after the turbulent times they’ve just been through, including the loss of their father, that now their mother may be dying of cancer?
Once again the skilled assistant stands over her to take the biopsy, but this time Lilian is first given a local anesthetic. He pricks her five times and now he collects noticeably more fluid than earlier that afternoon. The entire process lasts ten minutes at most, after which Lilian finds herself waiting in the hallway once again. Unable to think clearly, she simply stands there and waits for the test results. Time passes, minute by minute, and her head begins to drone. As though she is looking through a haze, she sees the doctor coming toward her. With a stern look on her face, the doctor informs Lilian that her suspicion has been confirmed and that the results indicate breast cancer. The doctor continues to speak but her words hardly register with Lilian.
Emergency surgery is necessary; also something about “spreading,” “chemotherapy” and “radiation”. Lilian murmurs a word of thanks to the doctor and says goodbye, then, as though in a trance, she starts toward the dressing room. In robotic motions she slips her clothes on, walks back into the hallway to find her daughter, puts her arm on Johanna’s shoulder and together they leave the building without a word.
After crossing the garbage-strewn parking lot, they huddle into their old English car. Lilian quickly pushes the button to lock the doors, turns the key in the ignition and drives away. It takes about thirty-five minutes to get from L.A.’s inner city back to Studio City. The entire time, not a word is said. Only after they are parked in the underground garage does Lilian turn to her beloved daughter and start to speak, carefully and factually, about what has happened. Johanna bursts into tears right away, asks many questions and seems terribly helpless. Understandably, the teenager has no idea what to do in a situation like this. Things have already been so hard for her ever since the three women have been living on their own. Johanna always feels as if she has to fulfill the father’s role in the household and that she carries the responsibility for what’s left of the family on her shoulders.
To a large extent, this was Lilian’s own fault, as she had been so open with the girls about all of her worries and fears over the last months. With a brave smile, the mother tries to soften the impact of the terrible news by telling Johanna, her firstborn child, that the sickness is part of her destiny and that the suffering would be different from the kind of suffering people inflict upon one another. The memory of the countless tears and sleepless nights after her separation have left terrible permanent scars, some permanent, along with the senseless attack that Lilian had suffered two months ago on the way to the beauty school where she was studying makeup. She didn’t just lose her money and expensive books that day ? no, she also lost something much more important: trust. After the two dark figures had left her beaten and lying on the ground and she held her bloody face with both hands, Lilian sensed a fear that she had never experienced before ? a fear of people.
No, the disease cancer is something different: a struggle that Lilian may even be able to win; she has no idea how, but she is prepared to face it. She does not yet know what is in store for her, or how the aftershocks from this event will continue to shape her destiny and that of her girls.
Our situation today is based on our thoughts and decisions from yesterday ? our current thoughts and decisions determine our lives of tomorrow.
Back at their apartment, they are greeted by Margrit, who has been waiting rather impatiently for the two of them to return. As Lilian throws together a simple dinner, the three discuss the disease and the necessary steps that lie ahead. None of them is even prepared to speak about the fact that the disease could even cost Lilian her life. Later that evening, the worried mother calls Ralf who, at the time, is staying with his girlfriend in Marina del Rey.
As promised, he shows up at the apartment the next morning when the girls have already left for school. The two parents talk at length about the new, life-changing situation, the coming surgeries and treatments which they can only guess about at this point. As usual, Ralf shows little emotion and his girlfriend calls him again and again during the conversation, which puts Lilian on edge. When the girlfriend insists that Ralf fax her all the documents that Lilian received at the hospital yesterday, Lilian feels sick: after all the lengthy treatments from the day before, the shocking results and a sleepless night, does she now really have to answer to the girlfriend of the man she’s still married to?
Humiliated, she cries in the bedroom as Ralf obediently feeds the papers through the fax machine. After that, there’s total silence for hours and Lilian uses the time to look for a hospital where she can get the surgeries, chemo and radiation therapy she needs. The fact that her insurance won’t cover all the treatments is a source of grave concern. Hoping for a miracle, she calls several different oncologists in the area. She gets lucky with the third doctor and is given an appointment for the following day.
After a long search, Lilian finally finds the clinic in Encino. Although she’s been living in this area for two years
already, finding her way along L.A.’s enormous streets remains a struggle. The clinic has an underground parking lot where she parks her car. Once she arrives on the first floor, the receptionist explains which papers she needs to fill out ? Lilian thinks to herself, there are always a hundred different things you have to sign in America, much of which she can’t even understand since everything is only in English or Spanish.
After having some blood drawn, Lilian has to lie on a white bed in the next room so that the surgeon can examine her. After a moment, the doors open and a man in his mid-forties with an unbelievably sweet look on his face reaches out his hand. With his eyes closed, the doctor feels her body and then explains in detail what comes next for her and in what order. Because Lilian’s English isn’t good enough for her to fully understand the medical jargon, and since the doctor is very moved by her case and the circumstances surrounding it, he spends a long time talking to her.
Gently, he tries to explain to her that he probably will not be able to save her breast and that it will only be clear after the surgery how far the cancer has spread. Without any tears and very calmly, Lilian listens to the doctor and trusts his decision to proceed with surgery as soon as possible. For this he will need the pictures from the homeless clinic and only Lilian can request these ? for privacy reasons.