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It was soon the Ides of March and I was showering. No, this is not a tawdry attempt at Roman erotica.

I'd felt like shit for weeks going on months. Insomnia, night sweats, gut issues. I'd recently moved to Vancouver and I wasn't happy about it. I attributed it to depression and skimping on food and water. I also pride myself on my high tolerance for pain. But when I've been compelled to write, it's been about friends and artists who got sick and died young. Tragic, infuriating nonsense, often related to living fast and being poor.

Something is up.

The soap slid around my arm pit, and, lo, a lump. Obviously, this thing, the size of a baseball, had been around a while.
"Well, what the f***."

And so started my life on cancer. It's been a month of sudden calls - "Your urgent PET Scan is tonight at 6pm. Don't eat anything. And avoid contact with all children for 6 hours afterward. That requires me figuring out how to not see my child and make sure she is well cared for. I booked a hotel.

It makes you insane, and it makes you sicker. The stress, the lonliness, the uncertainty, the medical system's bureaucracy and specialization and patronizing and stench of fluids, alcohol swabs and death.

Advanced breast cancer usually hits younger women - I just turned 40. And because ladies are not covered to get mammograms until age 40, and in some places it's 50 - if you are an unfortunate, the cancer silently grows and grows and grows until you feel bad in far-off places, not your breast. I've got it in my breast and lymph nodes. The radiologists are still conferring about my liver and lungs. There are tumors in both of those organs, but are they bad or good? And so we wait. I'm looking at Stage 4 cancer - that is really rare for an initial diagnosis. Only six percent of women with breast cancer are in my situation from the get-go. But metastatic breast cancer is the number one killer of women in the United States under 50. And the United States has some of the best cancer research institutes in the world.

In my family, we have a lot of heart disease, lung cancer, mental illness, and alcoholism - all problems my parents and grandparents created themselves because of how they lived. Right? Well, they are also diseases of the poor, people who cope one way or another with their choices and their heavy histories. But there's no breast cancer on either side of my family.

I grew up on the banks of the Missouri River, the second biggest sewage pipe in the Midwest, a conduit of all the Big Agriculture runoff for a third of the United States. That thing stinks, it's big and it's fetid. The Missouri joins the Mississippi at St. Louis, and the Delta near New Orleans is now a Dead Zone, according to NOAA, that now covers 5,840 miles in the Gulf of Mexico.

When I was a kid, I used to go down to the Missouri River banks, hold my nose and sit among the Poison Oak and Sycamores, swat mosquitoes, pick at ticks, and soak up the closest thing I could get to a wild experience. The Missouri was obviously long dead to nature, levied to the hilt. It resembled more of a canal, but I'd never seen mountains or the Pacific. That was my secret spot. I drank water out of that river until I was 17 and left home.

I can't help but think of that river when I think about the cancer inside me. It's also a known, and stoically Midwestern, avoided fact that my home town is a thyroid cancer cluster. The story goes that the winds of nuclear testing in New Mexico in the 40s and 50s blew over my Mid-Missouri, rained down, and, for one, my mom lost her thyroid. Three of my guy friends were diagnosed with thyroid cancer in their 20s and early 30s.

Science doesn't like to make connections between environmental health and disease. Blame the smokers, drinkers, and stress. St. Louis-based Monsanto has donated so much money to the University of Missouri science research centers that it really should be renamed the University of Monsanto.

But big environmental groups are probably even more culpable. They fret and spend money on fighting the Keystone XL pipeline, and determining which large carnivore is the most photogenic for the grant report, but they've forgotten Love Canal, Karen Silkwood, and Rachel Carson. "Public health stories are too complicated, too hard to tell," I've heard in the past. That translates into: "Environmental grantmakers don't care. So we don't care."

But there are reporters out there doing it. Investigate West - run by one of the good environmental reporters in the Pacific Northwest, Robert McClure, is my local source. Environmental Health News has quietly been publishing a succinct daily newsletter for years and years. These sources are concerned with the facts, not framing and messaging and win-win.

Still, we have hell to pay for how we've treated The Big Muddy and everything else. And I'm grateful that there are people publicizing these issues.

I have cancer, but it's not my fault. The fault lies on those who choose to ignore the environmental crises reckoning.

As Rachel Carson wrote: "Why should we tolerate a diet of weak poisons, a home in insipid surroundings, a circle of acquaintances who are not quite our enemies, the noise of motors with just enough relief to prevent insanity? Who would want to live in a world which is just not quite fatal?"

Or maybe "quite" is a reasonable revision of this quote, decades later.