Before I got sick, I’d been making plans for a place for public weeping, hoping to install in major cities a temple where anyone who needed it could get together to cry in good company and with the proper equipment. It would be a precisely imagined architecture of sadness: gargoyles made of night sweat, moldings made of longest minutes, support beams made of I-can’t-go-on-I-must-go-on.

When planning the temple, I remembered the existence of people who hate those they call crybabies, and how they might respond with rage to a place full of distraught strangers—a place that exposed suffering as what is shared. It would have been something tremendous to offer those sufferers the exquisite comforts of stately marble troughs in which to collectivize their tears. But I never did this.

Later, when I was sick, I was on a chemotherapy drug with a side effect of endless crying, tears dripping without agency from my eyes no matter what I was feeling or where I was. For months, my body’s sadness disregarded my mind’s attempts to convince me that I was O.K. I cried every minute, whether I was sad or not, my self a mobile, embarrassed monument of tears. I didn’t need to build the temple for weeping, then, having been one. I’ve just always hated it when anyone suffers alone.

The surgeon says the greatest risk factor for breast cancer is having breasts. She won’t give me the initial results of the biopsy if I am alone. My friend Cara, who works for an hourly wage and has no time off, drives out to the suburban medical office on her lunch break so that I can get my diagnosis. In the United States, if you aren’t someone’s child or parent or spouse, the law does not guarantee you leave from work to take care of them.

As Cara and I sit in the skylighted beige of the conference room, waiting for the surgeon to arrive, Cara gives me the small knife she carries in her purse so that I can hold on to it under the table. After all these theatrical prerequisites, what the surgeon says is what we already know: I have at least one cancerous tumor, 3.8 centimetres in diameter, in my left breast. I hand the knife back to Cara damp with sweat. She then returns to work.

No one knows you have cancer until you tell them. I take a screen capture of John Donne’s first devotion—the one that wonders what use it is to be an earth when earths are subject to earthquakes—and post it to Facebook: “We study health, and we deliberate upon our meats, and drink, and air, and exercises, and we hew, and we polish every stone that goes to that building; and so our health is a long and a regular work; but in a minute a cannon batters all.” It gets a lot of likes. Then I follow the other instructions I find on the Internet: tell my mother, tell my teen-age daughter, deep-clean the kitchen, negotiate with my employer, find someone to watch the cat, go to the thrift store to find clothes that will accommodate my coming chemo port, worry on the phone to my friends that I—a single working mother—have no one to take care of me. Because it is decided without ceremony that the doctors will eventually take my breasts from me and discard them in an incinerator, I begin the practice of pretending that my breasts were never there.

The cancer pavilion is a cruel democracy of appearance: the same bald heads, the same devastated complexions, the same steroid-swollen faces, the same plastic ports visible as lumps under the skin. The old seem infantile, the young act senile, the middle-aged find that all that is middle-aged about them disappears. The boundaries of our bodies break. Everything we were supposed to keep inside us now seems to fall out. Blood from chemotherapy-induced nosebleeds drips on the sheets, the paperwork, the CVS receipts, the library books. We emit foul odors. We throw up. We have poisonous vaginas and poisoned sperm. Because our urine is full of toxins, the signs in the bathroom instruct patients to flush twice.

Ten days after my diagnosis, doxorubicin will be infused into my body through a port surgically implanted in my chest and connected to my jugular vein. Its name is derived from “ruby,” because it is a brilliant and voluptuous red. One brand of the drug, Adriamycin, is named for the Adriatic Sea, near where it was discovered. I like to think of this poison as the ruby of the Adriatic, where I have never been but would like to go, but it is also called “the red devil,” and sometimes it is called “the red death.”

When administering the medicine, the oncology nurse must dress in an elaborate protective costume and slowly push the doxorubicin through the port. The medicine is so powerful that if it were to leak into the body it could cause my tissues to die. For several days after the drug is administered, my body’s fluids will be toxic to other people. Doxorubicin is sometimes fatal to the heart; a person can tolerate only a certain amount in a lifetime, and by the end of this treatment I will have reached half my limit.

Scientists discovered the drug known as the red devil near Castel del Monte, built by the Holy Roman Emperor Frederick II, in Italy, in the mid-thirteenth century. The castle had neither a moat nor a drawbridge, so few people believe that it was ever used as a fortress. It was built in a rare octagonal shape, and later it became a prison, then a refuge during the plague. In the seventeen-fifties, the Bourbons stripped out its marble. Two centuries later, scientists harvested its dirt. They took the castle soil to Milan, and found Streptomyces peucetius, the bright-red bacteria from which my treatment comes. Among its other effects, doxorubicin inhibits the enzyme topoisomerase II, slowing the rapid proliferation of cells. Many of these cells we need, but ideally many of them we don’t.

In the United States, doxorubicin was widely approved for use in 1974, the year after I was born. It is probably the same treatment that Susan Sontag was given before she wrote “Illness as Metaphor,” one of the first books someone mails to me when I fall ill. Treatment with doxorubicin can cause infection, leukemia, heart failure, and organ failure, and will almost certainly, for me, cause infertility. Because doxorubicin is a generalist in its destruction, it is also harmful to the central nervous system. The damage it unleashes cascades beyond treatment, and is often sustained for years. As I sit in the infusion chair, a drug cocktail pouring into me, the white and gray matter of my brain is under attack. There is no particular way to know how this will change me.

Doctors at first did not believe patients who described doxorubicin’s cognitive effects, or minimized the patients’ complaints as cancer-related unhappiness. MRIs of people who have had this chemotherapy for breast cancer indicate damage to the premotor and prefrontal cortices. Patients report that they lose the ability to read, to recall words, to speak fluently, to make decisions, and to remember. Some lose not just their short-term memories but their episodic ones—the memories of their lives.