Year One. “I think I’ll call her Millie, after my mother,” my mom said as we drove south on the BQE toward Coney Island to pick up the twelve-year-old breast cancer survivor dog we were co-adopting. At seventy-seven, adopting a dog—any dog, even a senior—wasn’t easy, so it became a joint venture. Between the nerves and excitement, neither of us was thinking about the week before: Thanksgiving 2024. I had been on edge waiting for the Abbott Boston Marathon lottery results. I hadn’t received the email saying I didn’t get in—but I hadn’t received the one saying I did, either. I’d worked so hard the past few months completing all six half-marathon challenges for extra entries, Boston was my 6th star in the world marathon majors. The odds felt stacked in my favor. Weren’t they? My mom, meanwhile, wasn’t feeling well. She asked my brother and me if we’d mind moving Thanksgiving dinner to Saturday. She had a strange pain in her side. We assumed it was anxiety about adopting Millie—or maybe a Crohn’s flare. She’d had her annual colonoscopy just a month earlier and received the all-clear. December passed in a joyful blur, carried by the chaos and comfort of a new dog. “Maybe I just don’t like holidays,” my mom joked on Christmas day, mentioning the pain in her side again. “Let’s go to urgent care,” I said. “They’ll just send us to the ER.” “Then let’s go to the ER.” She declined. After hours of Googling, she decided it was diverticulitis. “I’ll call my gastroenterologist tomorrow,” she said—forgetting, as we all do, that nothing happens between Christmas and the New Year. By mid-January, the mystery had a name. Incurable stage IV gallbladder cancer. Stage IV because it had spread—four sizable tumors had taken up residence in her liver. We sat wide-eyed in the oncologist’s office as he explained how resilient the liver is, how it can function almost normally while being ravaged by cancer. Cancer isn’t always treated as an emergency, but this was. The disease had likely been growing for at least a year, possibly two. How many colonoscopies had she had in that time? Mammograms? Doctor visits? My mom was otherwise healthy, diligent about her care, how did this sneak up on her? “What did I do to cause this?” she asked. “Bad luck,” the oncologist said. Did we have a family history of gallbladder cancer? My grandparents hadn’t lived long enough to know. Would that knowledge have changed anything? Too many questions. No useful answers. January blurred into February. I ran along the East River in brutal winter cold and cried. I cried and ran until I couldn’t do either anymore. Was my mom going to die? How long did she have? She was still too healthy to die. The weekend before her first chemo was the worst. What if she couldn’t tolerate it? What if her Crohn’s flared and ruled out immunotherapy—the very treatment shown in clinical trials to add years to her life? I made the mistake of Googling survival rates. Every so often my mind would drift to Boston, first thankful that I didn’t get in, how could I possibly train while going through this. Immediately followed by the thought… “What if my mom isn’t around to see me finish Boston, my sixth star?” I stopped running when the crying got so bad I could no longer breathe. I confided in two people. One was a close colleague I met every Friday for yoga and drinks—the safe, dim corner of a dive bar where I could say the things I wasn’t ready to say anywhere else. The other was a friend who had survived cancer in her thirties. From her, I learned that you can be positive and terrified. Incurable cancer is still incurable—but that doesn’t mean life immediately ends. Winter became spring, and we settled into a routine. On chemo days, I’d pick up Millie from her apartment, while my mom went for labs and bloodwork. I’d meet her in the waiting room before her oncology appointment, quizzing her relentlessly. “Did you bring snacks?” “Do you have something to do?” “How do you feel?” Gemcitabine. Cisplatin. Durvalumab. IV hydration. Often, a blood transfusion. Hours later, Millie and I would wait eagerly in the hospital courtyard for my mom to emerge from the quiet, nearly empty building. --------------------------- “So your mom has cancer, and you have a dog?” a friend asked as I walked over to a table at our local brewery carrying a beer for myself, a soda for my mom, and Millie tucked into a bag at my side. It was Memorial Day weekend, the unofficial start to summer. I laughed. Somewhere along the way, my mom stopped treating cancer like a secret and started blurting it out to people. “She asked how my winter was, I didn’t want to lie”. By Fourth of July my mom completed eight cycles—sixteen chemo sessions. The side effects piled up: nausea, exhaustion, alarming weight loss. But the chemo was done. Treatment would continue with immunotherapy alone. Immunotherapy gave her some relief. Her energy returned. She carried Millie down the beach at sunset each night, surrounded by friends. Life felt—almost—normal again. But “almost” doesn’t last long with incurable cancer. Four months later, we sat with the physician’s assistant at a routine pre-infusion appointment. It was mid-November and I had just been accepted onto the Dana-Farber Boston Marathon team, an end to my 10-year World Marathon Majors endeavor was in sight. The weight we all felt earlier in the year had dissipated. “I have that pain in my side again,” my mom said. My head snapped up. She hadn’t told me. Her next CT scan was moved up. Most tumors had continued to shrink. One grew. At a boarding gate in the Atlanta airport, the day before my 44th birthday, I got the text I’d been dreading: The doctor called. I’m starting chemo again on Wednesday. I spiraled. I wouldn’t be in New York. By the time I boarded a plane to Tulum, I was fighting back tears while texting my brother to coordinate the appointments. That night as the ocean waves crashed just feet away, I cried and shuffled a deck of tarot cards. The fool. Had I been the fool on this journey all along? Wednesday came, I camped out at the beach side restaurant with the good Wi-Fi until 2 p.m., waiting for the call to listen in on the appointment. How many sessions this time? The same drugs? What if side effects were worse? Are there options? How were we here again? It was on that beach in Tulum that I finally accepted the truth of what lay ahead: this is a rollercoaster. Highs, lows, loops that feel cruelly familiar. And I’m left with two truths. First: you can’t control what happens to you. My mom didn’t cause her cancer—no matter how much she believes she did. But being healthy when the unthinkable happens matters. Second: every extra day, month, or year comes from research—people who studied, participated in trials, and pushed medicine forward. These treatments exist because others went first. And because of them, my mom is still here.