Lost Woods: The Discovered Writing of Rachel Carson - Rachel Carson, Linda Lear (1999)

Part IV

Chapter 29. Letter to Dr. George Crile, Jr.

[1963]

CARSON’S CANCER along with its attendant heart disease entered a more virulent phase early in 1963. This letter to her cancer surgeon and friend, George “Barney” Crile,* of the Cleveland Clinic, was written barely a month after her triumphant appearance at the Garden Club and just shortly after the death of Crile’s wife, Jane, who had been Carson’s longtime friend, and who had herself fought a desperate battle against breast cancer. Carson describes her latest symptoms to Crile and courageously asks for the truth from a physician for whom she had great respect and affection.

There is great irony in the fact that as she was battling the economic power and secret influence of corporate America, Carson was having to fight the medical profession to tell her the truth about her own illness. Even more tragically, Carson correctly understood the need to hide the truth of her cancer from all but a handful of friends, lest the chemical industry use her illness to discredit her scientific objectivity. In the hope of achieving a greater good, she kept silent.

image DEAR BARNEY,

You have been much in my mind and it was good to have a talk with Kay recently, to hear some of the things I wanted to know. I am glad you have the book [Crile’s book on diving treasures More Than Booty (1965) with Jane Crile] to work on, and above all, glad you and Jane had those months to work on it together, giving it form and substance. It may be emotionally hard in some ways for you to carry it through to completion, and yet I think it will be a satisfaction.

Jane meant many things to me – a friend I loved and greatly admired, and a tower of strength in my medical problems. When she wrote me, after my visit with you two years ago, that she shared my problem, it was as though a great tide of courage flowed into me. If she, so vibrant, so gay, so full of the love of life, could live with the problem so fearlessly, I could at least try to do the same. Over the months since then the feeling I’ve had could best be explained by an analogy. Once, years ago, my mother and I were driving at night in uninhabited, unfamiliar country near the North Carolina coast. For the 50 or more miles through those wooded lowlands we were able to follow the lights of a car ahead. As long as it progressed smoothly I knew our way was clear. Jane was that kind of reassuring light to me. Now, without that light to follow, I admit my courage is somewhat shaken.

But you, Barney, for different reasons, are also a great source of strength. So now I’m writing you of my current problems. I didn’t want to bother you while Jane was ill, and for that matter the more important ones have just happened, or at least have just been noticed.

First: I finally saw a cardiologist, Dr. Bernard Walsh, about three weeks ago. I definitely have angina (even the cardiogram is now abnormal, but he said the diagnosis was perfectly clear from symptoms alone) of the less common type in which the pains come on without physical provocation, the worst ones during sleep. Dr. Walsh said frankly the implications are serious and it is most important to get the situation under control. So – I’m virtually under house arrest, not allowed to go anywhere (except as you will see later), no stairs, no exertion of any kind. I had to rent a hospital bed for sleeping in a raised position. I’m taking peritrate. For the first ten days or so there was a big improvement, but I must admit the pains are sneaking back, though not in the night.

The second problem is in your department. About two weeks ago I noticed a tender area above the collar bone on the left (operated) side, and on exploring found several hard bodies I took to be lymph nodes. Dr. Caulk was just going out of town for several days and said he would come to the house on his return. By that time I was so sure I was going to need treatment that I just had myself taken down to see him. (This was last Wednesday.) They are definitely lymph nodes “gone bad,” some lying fairly well up in the neck. This is the side opposite last year’s trouble spots and is an area never previously treated. So we have begun – 5-minute treatments 3 days a week to keep my hospital trips to a minimum.

Now there is a further complication. At the time I went in about my back in December I kept making remarks about having “arthritis” in my left shoulder, but no one paid much attention. It has been increasingly painful, and now there is some difficulty about certain arm movements. I had begun to have suspicions, so now I’ve tackled Dr. Caulk about it again. They took a picture Friday and there does seem to be trouble. He let me see the x-rays. It is the coracoid process of the scapula – the edge of it looks irregular and sort of eroded. For some reason Dr. Caulk seems rather puzzled – says he wants some of his associates to look at it and may want a picture from another angle, but on the whole he does feel it is a metastasis.

Well, all this brings questions in my own mind, which leaps to conclusions that may or may not be justified. Oh – the back trouble cleared up, but so slowly that Dr. Caulk had about decided it wasn’t a metastasis. Treatment was begun just before Christmas and completed December 31. I was still in considerable pain in mid-January. Then rather rapid improvement set in and now it’s OK. But now this bone deterioration in the shoulder makes me think all the more I had a metastasis in the spine. Dr. C. says not necessarily, but I think he’s just trying to reassure me.

Barney, doesn’t this all mean the disease has moved into a new phase and will now move more rapidly to its conclusion? You told me last year that it might stay in the lymph nodes for years, but that if it began going into bone, etc., that would be a different story. If this is the correct interpretation I feel I need to know. I seem to have so many matters I need to arrange and tidy up, and it is easy to feel that in such matters there is plenty of time. I still believe in the old Churchillian determination to fight each battle as it comes (“We will fight on the beaches – ” etc.), and I think a determination to win may well postpone the final battle. But still a certain amount of realism is indicated, too. So I need your honest appraisal of where I stand.

Jane continues to give me courage. Kay told me of her question to the doctors: “Which of you is in charge of not giving up?” How like her! Well, I nominate you to that post. [ … ]

*George Crile, Jr., was an internationally famous surgeon who specialized in breast cancer at the Cleveland Clinic. His nickname was Barney. Carson also refers here to Kay Halle, who was Jane Halle Crile’s sister, and to Dr. Caulk, who was her radiologist at the Washington Hospital Center.