August 31 2023

I remember the date

August 29 was our anniversary. Nina and I had celebrated with a wonderful dinner at Sababa. But looking back at the photographs now, I can see something I didn’t completely understand then.

Nina wasn’t feeling well.

She had bought a dress for our anniversary dinner, but she wasn’t comfortable in it. Her stomach didn’t feel right. There was discomfort, but nothing that told us our lives were about to change.

Two days later, on August 31, we had our annual physicals in the morning.

Afterward, we had lunch reservations at Le Diplomate in Washington, D.C.

And somewhere between the doctor’s office and that lunch, MyChart began showing the results of Nina’s blood tests.

I saw a phrase I had never seen before:

Essential thrombocytosis.

I looked it up.

Then I looked at Nina’s numbers. Her white blood cell count was very high. So was her platelet count. Our primary-care doctor had referred her to a hematologist, but there was apparently no reason at that moment to go to the emergency room.

I was frightened. Why hematologist! Why? What is ET? Blood cancer doesn’t make sense, why? Mind raced at a million miles an hour and landed at scary diagnosis like MPN (Myeloproliferative Neoplasm): hungry for answers. The nearest appointment with hematologist was in November! How would we know what’s going on?

But I didn’t tell Nina.

We went to lunch.

She ordered seafood. I remember her complaining afterward about discomfort in her stomach. We thought perhaps it was indigestion. Maybe something in the food.

And I took a photograph of her.

She looks so happy in that picture.

Even now, that photograph stops me.

Because while Nina was sitting across from me smiling, the first clues to what would eventually take her life were already appearing on my phone.

We just didn’t know it yet. I kept a track of symptoms as November approached. It was scarily lining up with MPN symptoms!

Something Was Wrong

The symptoms continued.

Not dramatically at first. They rolled in slowly enough that each one could be explained away.

Bloating like feeling.

Less hunger.

Feeling full after eating very little.

Abdominal discomfort.

Numbness in fingers.
Numbness in feet.
Ringing in head.

Trying to fast because perhaps that would help.

Medicines for indigestion.

Natural remedies.

Nothing worked.

On September 13, Nina had her mammogram.

I remember something that sounds almost impossible to say now: Nina hoped it would show breast cancer.

She was hurting. Something was clearly wrong. Breast cancer at least had a name. It had treatments. It was something we could understand and fight.

The mammogram didn’t give us that answer.

Nina cried.

Not because she wanted cancer.

She wanted an explanation.

And we still didn’t have one.

Waiting

Despite the continuing pain, we waited for the hematologist appointment.

The first available appointment was November 6.

The hematologist took a detailed history, examined Nina and ordered what seemed like an endless series of tests—CBC and differential, flow cytometry, inflammatory markers, mutation analyses including JAK2, CALR and MPL, and others.

Again, we waited.

Again, the tests failed to explain what was happening.

Meanwhile Nina’s body kept telling us something was wrong.

Her abdomen was uncomfortable. She was retaining fluid. Her weight was increasing, although she wasn’t eating more.

We didn’t understand why.

Then came December 1.

December 1, 2023

We were returning from lunch when Nina began having significant abdominal pain.

By then I wanted her to go to the emergency room.

Nina didn’t want to go.

So we called the hematologist’s office.

They told us:

Go to the ER immediately.

We arrived around 2:30 that afternoon.

And then the tests began.

Bloodwork.

X-ray.

Ultrasound.

Something appeared.

Then came the CT scan.

Her ovaries were massively enlarged.

I remember the middle of that night—the strange unreality of being awake in a hospital while the rest of the world slept.

At approximately 3:30 in the morning, a gynecologist gave us the diagnosis.

Ovarian cancer. Stage IVB.

Her CA-125 was approximately 5,700.

There are moments when life divides itself cleanly into before and after.

For us, this was one of them.

December 2

The next day was one of the hardest days of my life.

And strangely, Nina seemed almost peaceful.

The pain medication had finally relieved some of her suffering. She began calling people. Friends. Family.

She was saying goodbye.

And I remember watching her and wondering:

Why is she so happy?

I couldn’t understand it.

Then Nina told me.

She believed there was no cure for the cancer she had. She believed she was going to die, perhaps very soon.

And she was ready.

I wasn’t.

Eventually she looked at me and understood.

“You’re not ready to let me go.”

No.

I wasn’t.

How could I be?

How do you let go of the person with whom you have shared thirty years of marriage?

How do you suddenly accept that the person who has occupied almost your entire adult life may simply disappear?

I couldn’t.

And Nina could see that.

We spoke with her gynecologic oncologist, Dr. Bicher, about what treatment could realistically offer.

What we heard was devastating. Even with aggressive chemotherapy and major debulking surgery, the prognosis we were given was measured not in decades, but roughly 15 to 18 months.

Nina had a choice.

She could decide that she had suffered enough.

Or she could fight.

And Nina chose treatment.

But this is the part of the story that matters most to me.

She didn’t choose it only for herself.

Nina knew I wasn’t ready.

She agreed to the brutal chemotherapy, the surgery, and everything that would follow in part because she wanted to give me something I desperately needed.

Time.

Time to understand.

Time to love her.

Time to begin saying goodbye.

I didn’t have a word for what was happening to me then.

I do now.

My grief did not begin on May 25, 2025.

My grief began in that hospital room in December 2023, while Nina was still alive.

It began the moment the woman I loved looked into my eyes and realized that although she might be ready to leave this world—

I was not ready to live in it without her.