The last thing I wanted was to kill my father.

Decades ago, I remember drowning in the murky cesspool of fear — I knew I’d kill him. I convinced my mom to escape the sterilized (makeshift hospitalized) main bedroom where my father lay. “Just go, you deserve it! We’ll be fine, Mom.” She feigned excitement and off she went to the city to see a play with her friend.

Silence surrounded me. Just me and my dad. A deafening quiet filled with noise. The echoes of my childhood home clamored to be heard but there was no competition for the pounding drum beats in my head. The white noise hummed from the oxygen machine. It offered little comfort as I contemplated the magnitude of responsibility. I had no one to blame beyond myself for the predicament confronting me.

I would have to change my dad’s port.

Hearing about changing the port line, and getting detailed updates on required sterilization, fell by the wayside in the emotional turmoil. In my effort to remember everything it seemed as though I recalled nothing. The tiny protrusion from his chest seemed too close to his heart. Why did the doctors put the port there? I wallowed in my smallness as my insides constricted in stifled panic.

“Hi, Dad.”

Our eyes exchanged smiles. He trusted me. Thankful the medical supplies lined up on the bathroom counter were out of his vision, my hands trembled of their own accord. Breathe. No, don’t! Never breathe on the freshly unwrapped line. 

Introducing germs directly into his blood will kill him — As if pancreatic cancer didn’t hold the full rights on that deal.

His eyes watched my movements, seemingly pleased that he was in good hands. A momentary caregiver and a forever daughter. 

The man of few words thanked me. We both nodded and smiled.

“I love you, Dad.”

The elephant in the room was blatantly ignored. We both knew what didn’t need to be said: I hate cancer.

Hello, cesspool of fear, I’m back.

In 2022, as I heard the doctor spit out the words aggressive, Diffuse Large B Cell, and lymphoma, I knew decision time loomed. The speeding train of dread made a furious return.  This time it was my mom.

My mom bore her pleading eyes into mine. Slightly arched brows topped her wide eyes filled with trust, waiting on me. I broke the spell, looked away, and willed divine intervention. A suffocating and immense pressure built, requiring me to perform a dance I never practiced. The vice grip on my lungs squeezed tight while deciphering whether she was pleading to be saved or begging to be let go.

The doctor idled in neutral waiting for my response. I covered my mouth to prevent my mom from reading my lips, “Please tell me, what would you do if she was your mom?” The doctor shook her head and said she wouldn’t put her mother through chemo.

I released my hand and glanced at my mother in the odd and instant role reversal of authority. A faraway voice that must’ve been mine, yet a hushed and higher-pitched version, echoed in the room. “We’re gonna go for it. She wants to live.”

Cancer doesn’t get another chance to ruin our lives.

Did the doctor that day, the one to deny she’d help her mom, know the future? Her eyes have traveled landscapes foreign to me. The pictures the doctor's brain snapped and logged of her patients’ trials and tribulations slowly became my focus. Reality reared its ugly face.

I refuse to beat myself up over that day when I committed to chemotherapy for my mom. She proudly announces at least once a week that she’s a cancer survivor. Mom shakes her head in disbelief when she tells me she won the fight as if it is a brand new revelation.

I pretend it is — I let the proper level of excitement cross my face and then applaud her victory.

The cost of living comes in an unfamiliar currency.

“I’m going crazy, you know.” Her eyes connect for a moment, but the glassy sheen returns quickly. “I have dementia. That explains so much.”

What I never anticipated — after whispering behind her back for months, protecting her from what I considered devastation, was her unexpected relief at such an awful diagnosis. The baton of responsibility was thrust my way. In the increasingly rare times of clarity, she pleads. “Find out how to fix it, Lisa. How do we cure dementia?” I’ve assured her I’ll find out what I can, believing it to be a fruitless task.

True to my word, I stumbled into incredible information. Keep in mind that I possess little medical knowledge beyond the application of band-aids, so my explanation is elementary at best. 

Research has discovered a strong genetic link: Diabetics who carry a gene identified as ApoE 4 are 10 to 15 times more likely to crest into Alzheimer’s disease. The core issue of Alzheimer’s is the build-up of plaque in the brain and insulin disruption. ApoE’s role is to remove plaque from the brain. The variation ApoE 4 is not only the least effective of the ApoE genes for removing necessary plaque, but it may also interfere with the brain cells’ ability to use insulin. The brain cells starve and die off. Unofficially, it’s called Type 3 Diabetes.

Researchers theorized that if Alzheimer’s is a diabetes of the brain, it would be worth trying to deliver insulin via an intranasal spray application. Phase 2 results of the clinical trial show promise.

The intranasal insulin mist directly affects the central nervous system and bypasses the blood-brain barrier. Notably, it has been proven to help improve the cognitive function of diabetics, even patients diagnosed with Alzheimer’s or mild cognitive impairment.

The Mayo Clinic reports positive outcomes. “The patient’s cognitive decline is slowed, if not improved.” 

As with all trials, the intranasal insulin spray has limitations. But it’s something, right?

Explaining any of this to my mom would fall on deaf ears. If she remembers to put her hearing aids in, there is no guarantee they will be charged. Her rapid cognitive decline is hard to miss and even harder to watch.

For us, for our little family, we are grateful for our blessings. My mom can FaceTime from her iPad and proves it some days five or six times in a row.

Initially, an immediate call back prompted my worry. “What happened, Mom? Are you okay?”

“What time am I getting picked up, and who is coming for me? Do I have my earrings? I need to stop at the bank and get money for these maids. Did I tell you my parents are coming for dinner tonight?” 

“Where is your dad? He hasn’t been here. Does he know where I am? Are we decorating the tree for Christmas?”

Many calls involve me “just being there” on her screen as she converses with other residents, eavesdrops on them when she can, and busily scans the room to ensure she isn’t missing any action.

Is this the best-case scenario for my mom? She and I believe it is. Therefore, it is. She’s happily enveloped in unawareness.

She may suffer from diabetes of the brain but…

She beat cancer, you know.

I hate cancer.