I see images of black and white and shades in-between.  They are images of a woman, standing.  Now she faces me; now I see her profile.  Her arms are out a bit on the first image, uplifted on the second.  I actually see only part of her - her upper torso.

Briefly, I wonder what she looks like.  But it is too late; she is gone.  Besides, the images I see are not those of a photographer.  Mine are of what lies beneath the surface, hidden from the camera and the eye.  I am reminded of the truism that beauty is only skin deep.  Although few persons look alike externally, there is less variation on the inside.  I sit a moment, gazing, guessing how much body fat there is, before I really look, which is my job.

When I do look, I immediately spot the intruder.  Something is there that does not belong - a stranger who came, uninvited, and stayed.  I see a blot of gray where there should be none, containing a line demarcating fluid and air.  It is enclosed within a sphere the size of a tennis ball.  But the walls of this tennis ball are thick, and the lining is irregular.  I worry.

I also wonder how long it has been there.  I think it is too bad it is on the inside.  Surely she would have come sooner had it been on the outside.  Maybe it will be OK yet, something that has come to stay only for a short while.  I hope.  Even though I do not know her, I would not wish this stranger, this thing, on anyone.  I remember hearing a slight cough from a nearby room earlier.  Maybe the cough and these images go together.

I almost forget about her until her attending physician brings her images to me for review.  I reiterate my concern and wish we could see beyond the shades of gray without invading her further.  This time I do not forget her, but file her in the back of the cabinet of my mind.

Until, shortly thereafter, a surgeon once again brings her images to me, and I sense the nearing of the denouement.  While I fear the knife, both for her (because of what she is about to undergo) and for myself (because I may turn out to be wrong), I am glad this knife-wielder will do the cutting.  His touch is deft and his judgment sound.

This time I learn she is the wife of one of my children's teachers.  At once the sense of community heightens, and my world shrinks a little.  She moves up to the front of the filing cabinet.

She is not able to tolerate removal of a lung, should that be necessary for cure, for childhood infections have damaged both lungs.  The surgeon, skilled and concerned, does his best, but his fingers are crossed when he emerges from the operating room.

Time tells with a vengeance.  A few months later, images of her chest show new gray areas.  The stranger has returned.

Now we meet.  She has declined chemotherapy, having had acquaintances who died despite the drugs, and perhaps made the more miserable for having taken them.  She has learned of an out-of-state physician who treats with ‘natural' methods and wants to know more.  I see the figure behind the images, a still-attractive woman, prematurely aged by pain and disease, nevertheless in good spirits.  I hurt for her and hope we are doing the right thing.  Her family physician, while not enthusiastic, does not oppose her decision.  For this I am grateful.

After one visit to the new physician, she and her husband are convinced that his is the path they wish to follow.  It is not feasible for them to remain out of state, nor can they return to him for frequent visits.  They ask me to assist in obtaining the recommended medications.

I have seen this physician in action and am unsure about his unconventional methods.  Whether they provide benefit I do not know, but I doubt they cause serious harm.  I agree to help her.

The program consists of several medicines, easily obtained.  The mainstay is megadoses of vitamin C, administered intravenously in her home twice a week for weeks.  We improvise: a bent coat hanger secures the IV bottle.  Thoughts of jungle medicine fleetingly cross my mind.  She is ever cheerful and grateful, her husband supportive; both mask inevitable apprehension.

The stranger stays, though apparently content to rest a while before becoming more obtrusive.  Gradually she requires more oxygen, then more oxygen.  Pneumonia develops, which almost finishes her.  But her spirit is strong, and that counts for something.  Nature seems to say, Since you respect me, I will respect you.

She lasts almost a year from the time of diagnosis, leaving us quietly from the greater comfort of a hospital bed.  I sit with her from time to time and wonder why this happened.  She was in her 50's, did not smoke, and had no obvious risk factors for cancer.  I also wonder if what we did was best, given the tough choices.  Then I recall a few things - that this is what she and her family wanted, that she was able to see her latest grandchild born a few months before her death, and that she was at peace throughout her ordeal - and I am able to sleep at night.