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By Sandra A. Miller

We take the tram down Leopoldstrasse to the UBahn station and go thirteen long stops to the end of the line where Klinikum Grosshadern dominates a bland corner of the mostly lively Bavarian city of Munich. We walk approximately a quarter mile down a corridor the width of a swimming pool, past what my sister calls the turban stalls: temporary shopping booths where visitors can purchase knit cancer hats in forcibly happy patterns, as well as painted Easter eggs hung on string, crocheted book bags, and teddy bears sporting ledershosen. It’s like a flea market run by German church ladies.

“Who buys this crap?” I ask my 14-year-old daughter, Addie, as we trot past.

“Apparently a lot of people,” she says.

She’s right. The stalls are thick with visitors and patients in frowsy bathrobes, browsing the handmade wares.

“I feel like I’m in a German Expressionist film,” I tell Addie.

“Huh?” she says and takes my hand, a small comfort for both of us.

“Absurdist,” I explain. “Nothing feels real. Expressionism was this art form that developed, I think, around World War I —”

“Okay, Mom. Okay.”

But it’s more than the metallic abstract art casting shadowy parallelograms across the floor. It’s more than the seven banquet tables inserted into a random dividing wall with nothing on the far side but the other halves of the tables. “Where are the chairs?” I wonder out loud. It’s not even bald patients perched on windowsills — IVs standing guard like sentinels — as they gaze out into the sunny world where they can no longer safely go. It’s where we are going that feels so removed from reality.

We have flown in from Boston to visit my sister in this enormous German hospital. Betsy has ovarian cancer.

Hospital. Betsy. Cancer. Like puzzle pieces that won’t be forced together, those words don’t feel connected, not when I think of my slender 52-year-old sister who eats more vegetables than a rabbit, who actually chews her food well and forgoes dessert, who exercises daily, and who, despite having a BMW because her German husband works for the car company, has driven less than a dozen times in seventeen years of residing in Germany, simply because she prefers to walk or bike.

“If you have cancer, there’s no hope for the rest of us,” I told her on the phone. “It’s open season now.”

Four floors up my daughter and I, still walking hand-in-hand, pass the Aufenhaltszimmer, the family room where people gather to talk and cry. The room is stark white and soulless, bare except for a lone table with two chairs (There they are!), flush against the wall. It looks like the stage set for the kind of probing, existential play that my psychologist husband would object to seeing on a Saturday night. “Feels too much like work,” he would say.

My husband, Mark, is home in Boston with our 17-year-old son. I can picture the pizza boxes and smell the salad greens rotting in the fridge. I like that my boys are asleep right now. I take comfort in knowing that their day lags five hours behind mine, and that by going first, I can — Back to the Future style — avert any danger that might otherwise befall them.

“Crabs,” I joked with my sister after an hour of crying together on her bed. “Such a fuss over pubic lice!”

When we finally arrive in my sister’s room, her blue eyes fire up. “Hey there,” she says, gathering the loose folds of her hospital gown and struggling to prop herself against a pillow. She’s doing okay for someone who just five days earlier was sliced open, gutted, and reconnected with thirty-nine dark metal staples.

Yesterday, while my daughter averted her eyes, Betsy showed me the scar down her abdomen, saying she was going to have a zipper tattooed on it. When Addie heard that, she had to turn and look. “Not so bad,” she said.

“What’s for lunch?” I ask, nodding at a tan cafeteria tray on the swing-arm table next to the bed.

“Gerbil brain soup,” my sister answers and grandly lifts the tan plastic dome from her plate. There is indeed a bowl of broth with what looks like tiny bursts of cerebral matter suspended in a viscous yellow liquid. Partly for entertainment value, Betsy forces down a spoonful and gags. “And this is supposed to make people better?”

My daughter plops on a square corner table with her legs tucked under her, while I sit gingerly on the side of the bed, careful not to squish the various tubes carrying liquids in and out of Betsy’s body. My sister adjusts a blue neck scarf to cover the drainage tube that, like a leash, tethers her to a bag of gunk, something I don’t care to look at. First of all, it’s gross. More importantly, I really don’t like Betsy — always a bundle of spirited energy — being sick.

In the meantime, Betsy hasn’t questioned the diagnosis that I know of. At least I’ve never heard her moan Why me? She just scoffs cheerfully at her soup and asks the nurse with black eyeliner applied like a Nike swoosh when she can start eating vegetables again.

“You don’t like the eire flocken?” the nurse asks.

“Egg flakes?” my sister says in competent German with a teasing lilt. “That’s what this is?” She lowers her head as if ashamed. “I couldn’t flake an egg if I wanted to.”

The nurse laughs so hard she has to stop what she’s doing and collect herself. “Your sister,” she tells me, “she is too funny.”

Our father died of prostate cancer at 64. That was weird because, away at college at the time, I knew nothing about what was happening. But it wasn’t as weird as this in which I am aware of everything, without having any ability to control it. If cancer feels like a foreign thing that unfolds in the strange land of hospitals, try cancer in a foreign culture in a foreign language in a thirteen-floor, barracks-style hospital at the end of Ubahn 6. Add teddy bears forced to wear leather pants and a bowl of gerbil brain soup. Suddenly I don’t know what reality is. Suddenly I’m co-starring in a Fritz Lang film that I never auditioned for.

A month ago on a different visit after my sister’s first surgery, I was sitting with Betsy in her apartment when she got the diagnosis on the phone. She started to sob as she scribbled words on a scrap of paper: Tumoren. Chemotherapie. Nah, I thought as I watched her write. That can’t mean what I think it means. That’s not how you spell chemotherapy.

When it became real, I didn’t know what to make of the diagnosis of krebs. Apparently the tentacle-like appearance of a tumor reaching out to grasp normal tissue provoked Hippocrates to name it karkinos, the Greek word for crab.

“Crabs,” I joked with my sister after an hour of crying together on her bed. “Such a fuss over pubic lice!”

“I know,” she said. “What’s with that?”

My sister, daughter and I joke a lot, laughing throughout the morning in the sterile white room at the klinikum, that I refer to as the klink. Addie and I regale Betsy with stories to distract her from this nightmare, occasionally taking breaks to refill the water pitcher or hold her hand when she starts to tear up. At noon my daughter and I buy lunch in the cafeteria that sells coffee, donuts, pizza, ham sandwiches, and something green that impersonates a salad. My so-called salat is pickled and comes in a paper cup. No, they don’t have forks, the woman behind the counter explains in Germ-lish, and instead offers a plastic stabbing utensil. We all eat together, my sister choking down her gerbil brains, me spearing squares of pickled cucumber.

In the afternoon, back in the apartment, Addie and I wait for my sister’s son and daughter to get out of school then bribe them with pieces of schokolade so they do their math homework right away. Later the children ride unicycles to the park as I trot breathlessly behind them. “We all need exercise,” I say in a vigorous tone dulled by jetlag. But I’m just doing what my sister would do. Really, I’d be happy to sit on the couch all afternoon and binge-watch Germany’s Next Top Model, a show so stupid that I actually understand most of what Heidi Klum is saying.

For dinner, I fry up a package of spaetzle I find in the fridge.

“I don’t think the onions are cooked enough,” my 13-year-old, six-foot tall nephew, says in his halting English. He dangles a half-wilted slice of onion on the end of his fork.

They are fine, his younger sister scolds. “It’s delicious, Aunty Sam,” my niece assures me. She is a spitfire with the face of a doll: straight blonde hair, blue eyes as big and round as coat buttons. She makes me bracelets, pets my head, and takes every opportunity to ambush me with kisses. Without their mother around, I am an excellent stand-in. We look alike. We sound alike. And since I packed too lightly for early spring in Munich, I’ve raided my sister’s closet for fleece, which means now we are dressed alike, too.

“It’s still good,” my nephew says sincerely and lowers the slice of undercooked onion into his mouth. Although I know he means it, I still feel bad about the onions. They should have been browned. I can’t cure my sister’s krebs, but I should be able to make a pan of noodles for her kids.

When my daughter sees me wiping my eyes, she starts, earlier than usual, what has become a mid-meal ritual. Slightly off-key, with no real context other than dinner is about half over, Addie starts belting out Bon Jovi. “Whoa! Halfway there!” she sings in her loudest voice. “Whoa! Livin’ on a prayer!”

Not missing a beat, the rest of us gamely join in, also in voce forte. “Take my hand. I’ll make it I swear! Whoa! Livin’ on a prayer!

We must have over one hundred inside jokes between us: Lisa the playful dog from a story my sister wrote in kindergarten; the man upstairs named Herr Butz, but who we call Hairy Butts. Then there are the countless Grandma Betty sayings that we deliver in my mother’s cigarette-rough voice. “Cripes! What did you do, Kid? Comb your hair with a knife and a fork?”

We laugh together until we’re doubled over. We make up ridiculous German phrases, “Where ist ze dishen detergenten?” I ask after dinner. And, every time we say anything at all, we try to find puns in English. No sentence is safe when we’re around. Every word is turned inside out and excavated for extra meaning.

We also laugh before the punch line of a joke, because we likely know it already from so many retellings. “Knock Knock?” “Who’s there?” “Lisa?” “Lisa who?” We’re already in stitches. No need to say the rest, but we do anyway.

“Lisa the playful dog!” We all howl and slap the table.

The hysterical part for us is not the joke, but that we are telling it again. The best part is the easy joy felt by two sisters who grew up with disconnected parents in a sullen household. In our family, my mother and father never laughed together or teased in any but the most hurtful ways. “Don’t talk to me at the dinner table,” my father once memorably told us. “If I’ve had a long day, I don’t want to have to listen to you.”

When my father knew he was dying, he didn’t ask us to come from college to say goodbye. I got a phone call from my uncle at 5 a.m. the next morning. “He died?” I asked. “He’s dead?”

When my mother passed away three years ago, she, too, felt like a stranger. But after the wake our two families squeezed around my mother’s black kitchen table in New Britain, Connecticut, eating take-out Chinese and imitating her graveled voice. “Cripes! You’re spilling that moo shu all over the place!” Or, “Quit you’re complaining, Kid. You’ll eat those scallion pancakes and you’ll like them!”

“I would do anything for you,” I tell my niece and nephew when I tuck them into their high loft beds.

They nod. They know.

But the things I can do are so embarrassingly easy compared to getting your abdomen sliced open and losing every strand of your wavy blonde hair. So I want to do everything extra well, or at least right. That’s why I linger for fifteen long minutes in the cereal aisle at the neighborhood grocery store, hoping the Kokos granola will just materialize. Did she say Kokos? And where are the eggs? Gouda? Is that the right cheese? I carry my groceries home in a fog and unpack them into huge white kitchen drawers. I fill the fridge with the German version of foods that I have no idea how to prepare. Determined to get it right the next time, I also bought two more packages of spaetzel and a kilo of onions.

On Sunday we all cram into my sister’s room and tell her children the extent of her illness, saying the words cancer and chemotherapy out loud to them for the first time. While their father confidently fills in the unknown with pastel-colored promises, my niece sits on my lap, her twig-thin arms wrapped around my neck. Our chests are pressed together so tightly that I can feel her heart beating.

After a while she looks up at her mother who is also crying. “Will all of your hair fall out?” she whispers.

My sister bites her lip and answers quickly. “Yep,” she says, “but then you’ll be able to draw flowers on my bald scalp.”

My niece’s head drops on my shoulder.

When Betsy needs to rest, we reluctantly say our goodbyes. My niece is still crying when we arrive at the long corridor. It is Sunday, so the turban stalls are closed. Save for a mom and her son with a Mickey Mouse balloon, and a chubby German man in a bathrobe walking his IV stand, the quarter-mile stretch is cavernously empty.

The place looks so unbearably sad that I want to sink to the floor, but at my daughter’s prompting, the five of us link arms — my 6′7″ brother-in-law in the middle — and do The Wizard of Oz walk all the way to the end. “Lions and Tigers and Bears, oh my! Lions and tigers and bears, oh my!” We aren’t afraid of the dark woods ahead.

At home the air is heavy in that Sunday-evening-plus-cancer way. As a treat after dinner we all squish onto the leather couch and watch the remake of The Parent Trap, in which a young Lindsay Lohan plays twin sisters separated at birth. The movie is delightfully awful and generates several more inside jokes. (“The reason you can’t tell us apart is that we are the same person!” my niece suggests.)

Later, when I tuck her in, she asks if she can ask me a question.


“When my mother comes home from the hospital will she be bald?”

“Not right away,” I explain, “but after a week or so.” I reach around in the dark for her hand and hold it as she sniffles. “I guess,” I say after a few moments, “we’ll have to buy her a nice wig.”

My niece swallows hard and finds her courage. “We have the curly green one from Carnival,” she whispers.

“Oh good,” I say. “We’ll give her that and save our money.”

My sister is a little stronger the next day, so Addie and I are allowed to wheel her down the corridor. We window shop at the turban stalls, and I decide to buy one of those Easter eggs on a string as a souvenir for Mark.

I make spaetzel again for dinner. This time I start by patiently sautéing the onions until they are lightly browned and sweet. Next I break up two packages of noodles, add a hulking piece of butter and a package of Gouda cheese, and stir it all up.

“This is delicious,” my nephew tells me. He heaps his plate with seconds before the girls and I have finished our first.

“It really is delicious, Aunty Sam,” my niece says.

“But would Lisa the playful dog like it?” I ask.

My niece cocks her head. “Well, I don’t know about that,” she answers. “Lisa is a picky eater. Not like Hairy Butts.”

“Hairy Butts eats anything,” I agree. “That’s why he has such a big hairy butt, of course.”

“Maybe he’s two people,” my nephew suggests with his thick German accent. “Maybe Hairy Butts is twins, like the girl in the movie!”

We double over at the idea of their chubby, bespectacled German neighbor being an identical twin.

The children continue to howl, but I feel myself withdrawing from their cheerfulness. My sister, always the first to crack a joke, should be here laughing with us. Instead she’s stuck in the klink with her gerbil brain soup and five months of chemotherapy ahead. As I picture her bald and puking, I put down my fork and turn away.

My niece notices. “Are you all right Aunty Sam?” she asks, her voice pitched high with concern.

I clear my throat and smile at her. At which point, I realize it’s that time. “You know,” I say, “with your mom’s surgery over and just the chemotherapy left, I think she might be, well….”

But I pause before the next line. I have to think for a moment before I say it out loud. Is it appropriate? Is it okay? I’m not sure at first, but then decide that I have to risk it because we are that kind of family. There is almost never a joke we don’t feel safe making. And if we can’t make jokes, we may as well give up and let the crabs take over.

So I decide to go for it, hoping my voice will break open past tears to the place where laughter doesn’t simply mute the sharp ache of terror in my heart, but transforms it into one family’s communion. Humor is our shared offering that has carried us from the darkness of a long-ago past to a dinner table in Munich illuminated by irreverence and love. Right now, humor is me asking God to heal my sister, to get her well and bring her home, so we can all be together again laughing.

Humor is our grace and our salvation.

And so I pray.

Whoa! Halfway there!” I sing as loudly as possible, shouting at my fear until it withers in the air before me. “Whoa! Livin’ without hair!

My nephew’s face splits into a huge grin, and my niece and daughter start bopping their heads as we all sing together. “Take my hand. We’ll make it I swear! Whoa! Livin’ without hair!

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About Sandra A. Miller

Sandra A. Miller’s articles, essays, and short stories have appeared in over one hundred publications including Spirituality and Health, Modern Bride, The Christian Science Monitor, Literarymama’s Anthology, National Public Radio, and The Boston Sunday Globe Magazine, for which she is a regular correspondent. Ten years ago Sting's wife, Trudie Styler, turned one of Miller’s essays into the short film Wait, starring Kerry Washington.

Miller teaches writing at the University of Massachusetts, Lowell and blogs for several publications, including her own,

She recently completed a memoir called Trove: How One Woman’s Search for Gold Opened Her Path to Hidden Treasure.

You can find out more at


  1. Nuccia
    Posted May 2017 at 2:15 am | Permalink

    Dear Sandie, I’m so sorry about your beloved Betsy’s operation and chemiotherapy. Although I never met her, as your sister she is part of my ever growing sea of daughters and granddaughters and she will be in my thoughts and my heart.
    With love, hopefulness and auguri, Nuccia ??

  2. Maggie
    Posted May 2017 at 5:26 pm | Permalink

    A beautiful essay that captures the bittersweet authentic vulnerability of navigating life with an open heart. I laughed out loud with a tear in my eye.

  3. Susan Curtin
    Posted May 2017 at 6:15 pm | Permalink

    The incredible bond you have with your sister is never more evident than when you talk about her children. Your almost desperate need to keep their world innocent and safe, pre-illness, is palpable. Such a heart wrenching situation but Betsy, and you, will prevail.

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