I am a creature of habit. I count on routines and rituals to know that all is well in the world. Like breakfast – always the same – poached egg, toast, berries of some sort, an orange. Coffee from my favorite cup. Whenever I wave goodbye to my husband, three things always happen: he’ll blow a kiss, flash a peace sign, and watch until I disappear from sight. Predictably perfect. Let the day begin.

On vacation, one set of routines is temporarily traded for another, our days devoid of hot weather and work, traffic and junkmail, air-conditioned cars and offices, of medical appointments and more to schedule. On the coast, living is easier and outside. Living happens without looking at the time. Days eventually begin with idle conversations over good food at Good Tides where breakfast is served all day and a scan of the local newspaper for news about people we don’t know. The only schedule of any import is that of the local Farmer’s Markets so my husband can make his annual pilgrimage to Atascadero for his favorite avocados. On an afternoon, I might be sprawled on a beach ostensibly reading a book I’ve been meaning to read since 1997 but in fact staring over the pages and out at the ocean, delighted to realize the shimmer atop the rocks is the glistening pelts of six seals basking in the sun at low tide.

This year’s vacation is different in that it is my first with cancer, qualifying it as some sort of milestone. Seven months ago, I would not have envisioned our little trio ensconsed by a bay in a Bed and Breakfast the decor of which reminds me of a little house. On a prairie. Oh, it is quaint. Quiet too, with a cosy fireplace and a view of the water that inspires the kinds of daydreams that make time go by too quickly. Cancer does not enter my thoughts too often –  you couldn’t have paid me to think about it during that moment when I discovered the seals. Still, I can always count on cancer to be there when I’m not looking for it.  When I realized I had forgotten to refill a Tamoxifen prescription, I needlessly panicked. It was so simple. All I had to do was go to the pharmacy (no longer a nameless vacationer looking for sunscreen) but as a cancer patient whose information is in their computer, and if they’ll just check, they’ll see I need more Tamoxifen. The young pharmacist was very kind as she asked me questions about whether I had any questions about the medication. (She could not know I have countless questions about Tamoxifen and what I think it’s doing to me, but I’m on vacation.) She was very earnest and had that prescription filled in less than fifteen minutes. I remember wondering if she felt something like sympathy for me, understanding better than I perhaps that cancer does not take a vacation.

I don’t know if I was thinking about any of this as I scrolled through my Twitter feed yesterday, but in between Tweets about Syrian President Bashar al-Assad and Tom Cruise’s divorce, I noticed from Elizabeth Whittington, this:“What a loss. Heartfelt condolences to u all @FightCRC: It is with great sadness we report Pat Steer passed away yesterday.” I do not know Elizabeth Whittington, nor did I know Pat Steer. I was not familiar with the acronym CRC. I know more today.

Last night, after the kind of sunset that brings out lots of people with cameras, I found myself thinking about Pat Steer.  I went back through the day’s tweets and eventually found Elizabeth’s condolences. Then I found Pat’s blog and read about her. In her own words. She was a dog trainer, a writer, and a really good cook who loved exploring Syracuse to find new foods. She had been diagnosed with Stage IV rectal cancer in 2004, stopped active treatment on March 28 2012, and on May 7, 2012, she wrote a guest post No More Room in the Bucket for the Fight ColoRectal Cancer website.  Her friend, Janet, had wondered if there were still some unfinished “bucket list” activities that might make Pat’s wishes come true. I suspect Janet expected a request for something grander, but Pat’s wish was only for enough strength and mobility to go upstairs and do a load of laundry by herself. Strength and mobility.

Like most of us, I imagine, Pat had not created a formal bucket list; she had long-term goals that were not written down but fulfilled nonetheless – paying off credit card debt and a mortgage, retiring from corporate life at 55, training her dogs, experiencing the vastness of North America by train. Following her diagnosis, she traveled to New York for consultations and treatments, and she took advantage of the Amtrak points she earned. From coast to coast on sleeper train, Pat took her time to savor America and Canada and visited relatives in various states along the way. She described the travel as leisurely and enjoyed creating wish-list routes for the future. She was soon all set for another cross-country trip in 2011, to Denver for the English Cocker Spaniel Club of America national specialty, but because Amtrak prohibits dogs, she would forgo the train and drive in her Jeep. Everything was coming together perfectly for a dream trip, until one of those consultations in New York revealed an inoperable recurrence of her stage IV rectal cancer. Now, she had tumors in her lung and in her lower spine. Her oncologist confirmed metastatic cancer in her spine and hipbones, and a weekly chemotherapy regimen abruptly ended those plans for a six week cross-country road trip.  She cursed chemo for ruining her summer vacation, but found consolation in learning that the tumors were shrinking. Her strength was returning, so much so that she felt strong enough to travel to New York for treatments. Her routines of writing and lunches with friends were once again part of her life. And, she had all those Amtrak rewards to use later.

Cancer’s ironies are infinitely cruel. Throughout her treatment and in her advocacy work, Pat had always cautioned other patients to be prepared for the speed at which things can change with Stage 1V colorectal cancer. She was prepared in all the “official” ways with a will and an advanced directive; her family knew her wishes. But she was wholly unprepared for the rapidity of cancer’s final, painful assaults on her own body. In No More Room in the Bucket she writes that it took not even one month for her “to morph from full-time functional adult who could drive herself around to full-time cancer patient who is mostly bedridden.”

I was done.

Pain control became paramount, and in consultation with her team, Pat decided to stop treatment. She blogged about it too, at Life out Loud: Surviving Cancer Living Life where I found out she had, like so many of us, been held up by virtual connections and the sheer kindness of “strangers” including a woman she had never met who created a virtual tour of Seville, Spain for her, complete with well-wishes from Spanish waiters.

So as I go about my vacation today and all the simple things that make it perfect, I will be thinking of Pat Steer and her bucket list. I hope you will too: 

“There is no more room in the bucket for big dreams like cross-country train trips. I feel a pang watching tv shows set in NYC, knowing that I’ll likely never visit my favorite city again. It aches to see puppies and kittens and know I’ll never own another one. I’ve never tasted foie gras, or truffles, or uni. I never got to visit the Food Network. I’ll never meet my friend Shawn in person or visit her in Seville, Spain.

And perhaps the hardest thing – I ran out of health and activity before I ran out of treatment options. My body quit on me before my brain has … In the greatest cancer race, hanging on until the next new thing becomes available, I didn’t quite make it to the finish line after eight years of trying.

Simple things are my goals now – and simple things are what I miss most. I miss spontaneous restaurant lunches with my friends. I miss being able to shop for fresh food every other day. I miss being strong enough to walk outside. I miss my dog, Madison, who I sent back to Virginia to be with her co-owner because I’m no longer healthy enough to care for her.

It’s frustrating to have to ask someone else to do laundry because I can’t safely climb the stairs to get it done. Knowing that I may never be independently mobile again – that’s what I miss the most in this phase of non-treatment. More strength and mobility – that’s what’s on my bucket list these days.

That and, well, I decided that at the very least, I could take care of a little desktop aquarium and a betta. Petsmart is delivering the aquarium, filter, gravel and betta food tomorrow. A friend has already agreed to pick out my new fish…and maybe my sister and brother-in-law will take the tank when the time comes. Until then, it’s a small goal that I can reach, one that will remind me every day of brightness, and color, and movement – even when I can’t always accomplish those things.”

Rest in Peace, Pat Steer

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