Cancer, a layoff, insurance—and a time to serve

MILWAUKEE -- 56 days . . . 55 days . . . 54 days . . . Chelsea Caudle began signing her text messages this summer with a countdown. At 14 years old, she knew no better way to express what was coming.

Day Zero was to be Oct. 7, the day Dad left for Army basic training in Fort Jackson, S.C. He was moving 950 miles from their home in Watertown, Wis., 950 miles from Mom.

He was leaving, even though Mom was sick with ovarian cancer. Even though he had been at her side through two long, miserable rounds of chemotherapy. Even though she now faced the likelihood of a third.

In fact, Dad was leaving because Mom was sick.

In March, he was laid off from his job as a raw-materials coordinator for a plastics company called PolyOne, where he had worked for 20 years. His severance package provided several months' salary, but by August the paychecks were winding down. Soon the cost of his family health coverage was going to triple, then a few months after that, nearly triple again. They needed coverage so Mom could fight her cancer.

Dad's solution: a four-year hitch in the Army.

So Chelsea counted down the days to his departure. When the countdown reached 49, the text-message signature began to annoy and depress her, so she stopped. High school was beginning, her freshman year.

Mom was working part time at a Culver's restaurant, preparing for more chemo, worrying about how to pay the bills. In less than six weeks, Dad would enter the Army and her care would be covered.

The tradeoff was that he would be far away when Mom needed him home, when Chelsea needed him, too. He would miss all of her high school years. The band performances. Prom.

Chelsea thought of all his absence would mean.

When she sent her next text message, she resumed the countdown.

36 days. Mom and Dad are Michelle and Bill Caudle, high school sweethearts now 40 and 39, respectively. They have three children: Chelsea, the youngest; Alysha, a 21-year-old working at a nearby Holiday Inn; and Little Bill, an 18-year-old ex-high school wrestler.

The Caudles are not fond of politics. Michelle and Bill have paid little attention to the shouting this summer over health-care reform. They have not gone to any of the town-hall meetings. They are well-aware that politicians and interest groups would like to trumpet their story or dismiss it.

"We're not activists," Michelle said.

But this year, the national story of lost jobs became their story. And the saga of families losing health insurance was about to become theirs, too.

Except that Bill wouldn't let it.

True, he had been interested in the Army for years. And he could always request an emergency leave to come home if Michelle's condition grew dire (Army regulations allow this if a family member's death is imminent).

But for weeks before enlisting, Bill had sought other options. He revised his résumé. He answered help-wanted ads. He interviewed for one job that would have paid $13 an hour -- less than half of what he was making at PolyOne. He didn't get the job.

Finally, on May 13, his 39th birthday, he signed the Army papers. Two weeks later, Michelle Caudle sat in the office of her doctor, Peter Johnson, at Aurora Women's Pavilion in West Allis. Johnson has been an oncologist for 13 years, and despite the immeasurable sorrow that comes with treating cancer, he loves the work for the hope in it. He has shared the joy of patients who have lived to see birthdays, anniversaries and the graduations and weddings of their children.

On this particular day, Michelle's latest tests had come back. Just six months earlier, she had celebrated the end of her second chemotherapy treatment. Now the tests revealed tiny "spots," or changes on her abdomen, neck and lungs. Not a good sign. The measure upon which cancer hopes rise and fall, the CA125 number -- please, let it stay low -- was climbing.

"I could lie to you, but I'm not going to," Johnson told Michelle.

Although he could not say for certain the cancer was back, this early sign pointed to that possibility. The doctor compared her cancer to a chronic disease that would never be completely vanquished.

Michelle broke down. For three years she had been nurturing her hope in the face of uncertainty.

"I'm not going to beat this," she said.

Ovarian cancer is a stealth disease, shadowy and overshadowed by breast cancer. Ovarian cancer has garnered just a fraction of the publicity, and the message has been decidedly more Continued on the BACK PAGE
negative.

There is no self-exam. By the time ovarian cancer has announced its presence, the disease often has progressed to the third of the four cancer stages. Once a woman has been diagnosed, her odds of surviving five years are less than 50-50. All told, the disease kills about 15,000 American women every year. On Nov. 14, 2006, the day Michelle first walked into Johnson's office, she thought she had a cyst. Her abdomen felt tender and she was constipated. No one had said "cancer." Still, she had been referred to an oncologist, and she was scared.

A CT scan revealed a large mass, about 8 inches in diameter. Her CA125 level, which measures cancer antigens, was 21 times higher than it should have been.

The next day she went into surgery. Johnson spent more than four hours removing as much of the cancer as he could.

From that day forward, Michelle and Bill had a new job that superseded any other: fighting cancer.

Although the disease was hers, he would assume responsibility for meals and laundry and the things she'd always done but was too tired and sick to do now. Michelle passed some of the days curled up on the recliner, drained and queasy. Bill worked around her, cooking hot dogs and other simple meals. Chelsea made spaghetti and chicken.

Bill went with Michelle to her doctor appointments, surgeries and chemotherapies. When the cancer returned in 2008, he sat beside her as the doctor discussed what to try next.

He felt he had to be "the strong one," so when she cried, he did not.

Of all Bill's responsibilities, one rose above the others: health coverage. The March 2009 layoff was announced months before it took place. Though the news was jolting, Bill thought maybe it wouldn't be so bad. He wanted a job a little closer to home than PolyOne, 30 miles away in Sussex. Now he could find something better.

After sending out résumés, he got the feeling it didn't much matter. Even companies that had advertised for staff were changing their minds.

By the second week at home, he was struggling to find things to do. He cleaned the kitchen. He vacuumed. He exercised. He logged on to the computer and checked job sites.

The president's stimulus bill was helping laid off workers pay for the health coverage they had while employed. Between this assistance and Bill's severance package from PolyOne, the Caudles initially paid $136 a month for their coverage.

But in September, when Bill's severance package ended, they would pay $497.

In January, when they would be on their own: $1,370.

Bill needed a job. He needed health benefits. And a cursory look persuaded him that the answer would not be BadgerCare Plus, Wisconsin's public health-insurance program.

Besides, he was leaning toward another idea, one that presented the Caudles with a quandary. The Army would solve their health-coverage problem. In years past he would have been too old, but in 2005, the age limit for enlistment was increased from 35 to 40, and a year later it was raised again to 42. The tradeoff would be his absence from home.

In the end, although he risked leaving Michelle to fight cancer on her own, Bill chose the Army. He signed on for a job as a signal support systems specialist, a soldier who works with communications equipment.

"Seventy percent of the reason is for the insurance," said Bill's mom, Marguerite Hemiller. "He told me, 'I've always wanted to do something for my country, and I have to help Michelle.'" The family enjoyed a summer trip to the Great Smoky Mountains, but on Aug. 27 -- 41 days -- Michelle's summer ended. She sat with Bill in a private room in Aurora Women's Pavilion waiting for the official word on her latest blood tests. The doctor's office had called to tell her that her CA125, the cancer measure she hoped to keep low, had risen from 17 to 66.

"Odds are he's going to tell me it's back," she said.

Johnson entered the room and crouched beside Michelle's chair. There was cancer in her abdomen, he said. "There's some areas in the lung, too."

Michelle's eyes went watery. The nurse reached for a tissue.

"You know what? I brought my own," Michelle said, and her smile let everyone know it was OK to laugh. For a moment they did.

Johnson said there was no single area to go after surgically, but Michelle had responded well to chemotherapy. His soft voice outlined the chemo plan. "I'd suggest we start fairly soon," he said. Right after Labor Day.

Michelle bowed her head and Johnson leaned toward her.

"I'm sorry," he said.

35 days.

"I'm going to blow the whistle and you are going to jog."

Staff Sgt. Larry Finefield stood before Bill and a half-dozen other recruits on an empty soccer field in Watertown on a cloudless September afternoon. Finefield called out each new exercise. The recruits shouted back in unison, then went to work.

Bill was surrounded by teenagers, kids who could have gone to school with Little Bill -- in fact, one had. After 10 minutes of pushups, leg lifts and other drills, Bill's face reddened. Sweat beaded along his forehead. The teenagers were straining, too. Each time they jogged, a chorus of panting filled the air. An hour later, they finished by sprinting pass patterns as Finefield hurled the football downfield.

"All right guys," Finefield shouted finally. "We're done."

This was a taste of what Bill could expect at basic training. He was building up his body. 20 days.

Michelle was more than a week into her new round of chemo. The exhausting ritual was familiar, and she tried to approach it with humor.

"They have to draw my blood first to see if I'm healthy enough to be poisoned," she said one morning as she waited to be treated.

Chemotherapy destroys healthy cells as it attacks cancerous ones. That's why nurses had to measure Michelle's white blood cells, red blood cells and platelets to be sure that she had recovered sufficiently from the previous dose and could receive the next without risking life-threatening complications.

And that's why Michelle's stomach churned and her energy vanished. The previous Sunday, she had gone back to sleeping in the recliner for a simple reason: "When you sleep, you don't feel sick."

As she slept, Bill cooked and cleaned. When she woke, he asked what she wanted.

"Who's going to baby me?" Michelle asked, anticipating the days ahead.

Now, as she sat beside Bill, waiting for the next dose of chemo, she still had no answer.

11 days.

The cake was for Bill, but the party was as much for Michelle. In the chemo cycle -- two weeks on, one off -- this was her break from the poison. She was ready to feel good again.

Friends and relatives arrived in the Caudles' backyard carrying dishes. Bill shook hands. Michelle wandered back and forth between the kitchen and the yard, smiling and laughing. She stayed on her feet until just about everyone else was seated.

"She's a strong woman," said her mother, Sharon Hutchins.

Both Hutchins and Bill's mother, Marguerite Hemiller, have accompanied Michelle to her cancer treatments. Hemiller, a nurse for 27 years, remembered that during the first months of chemo, Michelle would stand in the parking lot crying, not wanting to go inside. Now, Hemiller felt conflicted about her son's decision to join the Army.

"One half of me says, 'Go.' The other half says, 'You'd better stay,'" she said. "I know he's got to do it. He's got to get that insurance."

At the party, Michelle wore her birthday present from Bill: a Green Bay Packers jersey with the number of her favorite player, defensive end Johnny Jolly. Her birthday was still a few weeks away, on Oct. 20, but by then Bill would be gone.

After dinner, friends and family sliced up a "Farewell Bill" cake decorated with an eagle clutching arrows and a shield. There were no songs, no toasts.

6days.

Oct. 1, Chelsea's 15th birthday. A balloon and flower bouquet waited for her on the dining room table. Chelsea was at a football game.

In the living room, Michelle lay in her recliner, huddled under a blanket. She had turned the television way down, but the glow from the screen flickered over her, the only light in a dark room.

The chemo, administered two days earlier, had hit full force, nausea overwhelming her. During earlier rounds of chemo, Bill had tried to talk with her, to distract her. Now he knew better. He left her alone.

Posted on the door of the refrigerator were the doctor's orders and the date of her next appointment: Oct. 6. The same day the recruiter would take Bill to Milwaukee before his flight to South Carolina.

"It doesn't seem real yet," Bill said, coming in from the garage where he had been cleaning. "I don't know if I feel anything yet."

In the dining room, he had the list of things to bring: comfortable clothing, socks, underwear, shampoo, soap, deodorant, toothpaste, disposable shaver, $50, Social Security card, birth certificate and marriage certificate.

"I'm scared for when you leave," his daughter Alysha said.

Bill knew how the family felt. To help them prepare, he had written lists of the tasks they would have to pick up when he was gone. Weekly jobs, such as vacuuming. Biweekly jobs, such as cleaning the shower. Monthly jobs, such as cleaning windows. And seasonal jobs, such as switching the furnace from summer to winter.

Day Zero.

The separation came sooner than Chelsea had expected.

Her dad was not scheduled to fly to basic training until Oct. 7, but a day earlier he had to report to the recruiting office where a van would take him to Milwaukee. The recruits would be driven to a hotel in the city so that early the next day, they could be processed, sworn in and flown to their base.

Bill's family would not be there on the 7th. Hard enough to face one farewell. No one had the stomach for a second.

Besides, separation wasn't the family's only misery scheduled for Oct. 6. Hours before Bill left, Michelle was to receive her next dose of chemo. Bill planned to accompany her to the hospital. Chelsea, too.

This time, however, Michelle's blood tests were not good. She was not healthy enough to be poisoned. She would have to skip a week.

So, on a rainy morning, everyone, including Bill's mother and stepfather, waited in Watertown, watching the clock tick closer to 1 p.m. and his appointment at the recruiting office.

Less than an hour remained. Bill hooked up the camera to the TV and they watched a slide show of images from the past year. Here was Little Bill at his high school prom and graduation, and Chelsea at confirmation. Here was the Fourth of July parade, Chelsea marching with the band and holding the flag. Here was the trip to the Great Smoky Mountains.

When the slide show returned to Little Bill's prom, the family stood up to go. Bill grabbed his backpack. The long goodbye moved to the recruiting office. The van was late. Michelle straightened her husband's jacket and hugged him. She talked about the last few months, how strange it had felt to have him home during the day instead of away at work. It would feel stranger still not to have him around at all.

"I'll find out how many times I say, 'I don't know. Ask your Dad. That's your Dad's department,'" she said.

Just before 2:30, the van arrived.

"Butterflies are coming back," Bill said, excusing himself for a last trip to the restroom.

The driver checked IDs, consulted his clipboard, then eyed Bill and the other recruit.

"You ready?"

Chelsea and her Dad hugged. It happened so quickly; all she could say was: "Bye."

In the parking lot, tears streamed down Michelle's face. She held Bill near the van, unable to find any words at all.

"I love you," Bill said. "I'll call."

And then he was gone.

On the ride home, Chelsea texted her cousin and her best friend.

My Dad just left.

No signature this time. The countdown was over.

Early the next morning, Bill Caudle learned that he would not be going to Fort Jackson, S.C. He was headed to Fort Knox, Ky., instead. He would be half as far from home -- 475 miles instead of 950.

The moment he was processed at Fort Knox, his Army health coverage kicked in.

If all went according to schedule, Bill would finish basic training in mid-December. Michelle would still be in the midst of chemo. She hoped to make it to his graduation.