A scan Tuesday morning, read on Wednesday, showed something in the liver; it is the liver to which colon cancer metastasizes. Wednesday morning I watched the screen during ultrasound and saw the barbell shaped darkness on the liver’s right lobe. No one knows what it is until pathology puts dyed cells under a microscope; but of course it is a metastatic lesion: Fatty tumors do not raise one’s CEA. Today, Monday, a week after the CEA report, we see Dr. Sutton again. The issue now, given what we know, is the extent of the lesion or the presence of others not discernible by ultrasound. It is common that such cancer be pervasive throughout the liver; it is common that multiple metastatic lesions remain inoperable. One undertakes chemotherapy, but the cure rate for this disease is negligible. If I cannot be operated on, I will die fairly soon. A year? Eighteen months? Six months? I speculate; I cannot stop speculating.

But my internist and the ultrasound technician, looking at the barbell shape, claim that the rest of the liver looks clear—as do the kidneys and the spleen. They’re not lying—but they know and I know that an ultrasound may not show everything. Later I discover that the barbell is one of the common shapes that a liver metastatis takes. The ultrasound technician describes it not as a barbell but as an hourglass. Ah, metaphor; do the sands run out? Maybe Dr. Sutton when he looks at the films this afternoon will find more lesions. If he operates, he may find more cancer when he opens me up and applies an operating room ultrasound to the surface of the liver itself. Possibly he can take out several little pieces; one can survive on a third of a liver, and there is something called the Swiss cheese operation. Or he can discover too many lesions to remove. I keep thinking of calves’ liver on a butcher’s tray, not sliced, cellophaned in a bag, slimy and warm-looking, twitching a little.

When I come out from anaesthetic, back in my room after the sojourn in ICU, I will open my eyes to ask Jane what they found. She will not lie to me.

If all goes well, as it were, I will by inches recover the morning Globe, the coffee, work on poems and work on prose, walking the dog, love with Jane, and the continual or recurrent dread—exacerbated every three months by checking my CEA—that a black cell multiplies. It is a common condition, for millions of people, old ones dropping off and new ones entering the mode: the cancer club, the deathwatch. Heaven knows (at moments of anxiety magic thinking knows no let or hindrance; they are reading everything I write on this yellow pad)—I’ll take it, I’ll take it.

The nature of this book alters. Shall I change the title from Life Work to Work and Death? Box office, he said sneering. Oh, let me return to my theme: I have worked all this pre-operation week but not on Life Work: I finished the graveyard (!) essay and the review of Tom Williams that I had almost finished; I finished another piece I had barely started; I wrote thirty letters canceling dates and postponing interviews or giving warnings; I drafted a letter to the National Council on the Arts because I must miss a critical meeting; with my editor’s help I’ve revised phrases in The Museum of Clear Ideas, the poetry book scheduled for March of 1993; at Thom Gunn’s suggestion I’ve added lines to the final section of “Another Elegy”; I’ve proofread Their Ancient Glittering Eyes again, and it looks clean. Like the left lobe of a liver? Absorbedness has helped and absorbedness is incomplete. This morning, as I write this medical report for Life Work, I find that work remains the matter, not only in defiance of death but in plain sight of it. It absorbs me to write these pages; it absorbs me more nearly than anything else has done for the past week or ten days. Writing about cancer allows me to transcend my cancer by the syntax or rhetoric of dread and suffering.