On examination, the gynecologist noticed a “fullness” to Little Ray’s lower abdomen and pelvic areas. An exam revealed “bulkiness” and “nodulation” in the “adnexa and tubes,” and one of her ovaries seemed to be “notably enlarged and irregular.”

“What does all that mean?” I asked Molly, who’d been quoting the gynecological findings.

“Don’t beat around the bush, smarty-pants—you know what they think it is,” my mother told Molly.

“At Ray’s age, a show of blood could be uterine cancer—it’s usually treatable. That’s not likely, but that would be better,” Molly said.

“Better than what, Molly?” I asked.

“Tell him, smarty-pants! I’ve got eighteen months—two years, tops, sweetie,” my mom said.

“They’re thinking it’s ovarian cancer, Kid—it’s insidious, and slow to show symptoms. You probably don’t have eighteen months, Ray—that would be a long time,” the trail groomer told her.

A subsequent CT scan showed “a complex ovarian mass with both solid and cystic components, as well as widespread lymph node enlargement with nodulation and stranding throughout the pelvis.” That didn’t sound good; I refrained from asking the old ski patroller what all that meant. There was a blood test, too—the cancer antigen 125 blood test, Molly told me. It returned at 413—an abnormally high level, compatible with what was now an almost certain diagnosis of ovarian cancer.

CT scans of my mother’s lungs, abdomen, and brain showed there had been spread to her liver, her spleen, her brain. My mom would be told not to blame herself for the delay in seeking treatment; most ovarian cancer patients, as in her case, don’t get the diagnosis until the cancer has progressed considerably.

The doctors would describe the treatment, the chemotherapy, and possibly the “debulking” surgery—to remove the ovaries and the pelvic organs. She was told that radiation wouldn’t be used because of the widespread distribution of the cancer. Molly knew the chemo would make my mom lose her hair, and vomit, and become very weak—prone to serious infections.

Once treatment began, Little Ray wouldn’t be able to manage by herself; she would need what Molly called “a fair amount of care.”

“What do you mean, Molly?” I asked the old ski patroller.

“Ray realizes she’s not going to get out of this, Kid. You know her—if she’s going to die, she’ll do it on her own terms,” the trail groomer told me.

I knew what Molly meant. My mother would refuse all treatment; the treatment might prolong her life, but she knew the treatment would make her suffer and wither, with no hope of a cure. Her doctors advised her against this decision; almost no one refused all treatment, the doctors told her, although they admitted there was a less than fifteen percent chance of a cure. “Zero is less than fifteen percent, you know,” was Little Ray’s response.