The full weight and darkness of a bad diagnosis doesn't hit you right away. 
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        You'd think that you'd have this soap-opera-style crisis moment -- say, a flood of tears in the doctor's office. Instead, it's like a terrific rushing roaring noise, a freight train in your head. It fills your brain with one word or phrase: "cancer" "tumor" "ataxia" "ALS." The word blinks on and off, like a loud neon sign. You're trying to work around it.  To see past the word's enormous, spreading, infectious, blob-like bulk.
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       To do this, you're attempting to form reasonable sentences.  Things like "what kind of time frame are we talking about?" and "what are the treatment options?"  The doctor is giving you answers, and you're trying, you really are, to follow what he is saying but this noise, this incessant rushing noise, the beating of this one word over and over in your head, it's drumming out your ability to hear clearly or think clearly or get your own words out in any kind of coherent rational way, goddammit.
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        In the middle of it, you notice that you're feeling sorry for the doctor.  What a shitty day this is turning out to be for him.  He woke up this morning, maybe banged his wife, maybe argued with his kids about dumping their bikes in the driveway or leaving the lights on all night (again). He's got a really full schedule today, and he's overbooked by three patients.  And tonight he has to eat dinner at his sister-in-law's house, and his sister-in-law can't cook. So he wasn't looking forward to the best day of his life, mind you, but still it was going to be a typical day, a normal day, and now this.  He walked down the hall to pick up the scan results.  He slid the report out of the manila jacket, not seeing what was around the corner, not suspecting a thing, and then wham! there it is, and now he's had to call you into his office, a real office with a desk not an examination table. Man, what a lousy day this is turning out to be for him.
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       So you're keeping it together because we're all grownups here, and there is no reason to make him feel any worse about it. Besides, if you make him uncomfortable, maybe he won't like you anymore.  At this point, he's all you've got, so you're not taking any chances. 
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       You're listening to him go over treatment options. This is a relief to him -- you can see his jawline relax.  Now he's back on familiar turf.  He's using words like "therapeutic agents" and "inhibiting cellular reproduction," and with every phrase he's putting more distance between himself and what he knows to be the final truth, and he's feeling more comfortable. Diseases, he is trained to deal with; patients, not so much. He expects that all these technical words are making you feel better, too. Why not? Why wouldn't what makes him OK make you OK, too? The doctor is grateful that all this structured language is creating a frame, like a ladder that you can use to look down on your disease from a great distance up, like he does. 
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       Only thing is, this word pounding in your head, it doesn't really allow for that.
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       Then you get home. The news starts spreading. Some people you call and tell because you know they'll be offended if they're not among the first to hear. Some people hear it from someone else, and they call you. Some of those people you never hear from again. They vanish, as if the diagnosis was a magic colander that separated out the friends from the hangers-on. It surprises you, which ones take off and which ones don't. Some that disappear, you'd have bet money that they'd stay. Some, you think maybe they stay only because they get off on the close contact with drama, and this great opportunity for gossip. They leech you. They are disappointed on days you are feeling better.
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       For a while, all this talking, all this notoriety, keeps the full weight and darkness of a bad diagnosis from sinking in. You're so busy talking about it that you're not really living with it yet. It doesn't help that half the people you talk to essentially deny it. They tell you of a friend who was diagnosed with a serious tumor but in the end it was only a harmless fatty cyst. They tell you of their own medical crisis -- the kidney stone four years ago, and how much it hurt, and how lucky you are not to be in pain like that. They tell you there's a 1-800 number where you can buy these crystals (or supplements or miracle bracelets) that will cure you, and then they get mad at you a week later when the learn you didn't order anything. That's the last you will hear from them.
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       In a day or two, or three, or thirty, the full weight and darkness of being really, really sick sinks in. You realize that it means you'll never, ever get better.  No point in continuing to think "I'm sure I'll get my energy back once this medical crap is over" because there's not going to be an "over."  Not for you.
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       Here's the thing you need to know:
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       There are only two acceptable plot lines. You've seen this on TV since you began to wear big-kid pants. Get sick; get worse; get much worse; and then either get all the way better or die.
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       You aren't going to get any better, and you'll soon find out that if you don't have the good grace to die within a reasonable period of time, your audience will get bored. They will get sick of all the mini-crises that lead neither to dramatic cure nor to tearful tragedy.  Essentially they will push out your drama and go on with their lives.
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       But rest easy. You'll get their attention back for the key scene. The one that you know from the first half-hour will come only after the last scheduled commercial break. The one where all their waiting for something to happen finally pays off. They might even buy a new dark dress or suit for it. 
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       You doctor won't be there, though.
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       He has more news to deliver.
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