This October, or National Breast Cancer Awareness Month, I’m finally losing my patience. All the feel-good 5Ks, commemorative pink lipsticks and festoonery of ribbons won’t bring back my dear friend Melanie. She was 33 when she died last month. No one talks about her without remarking how upbeat she was.

But my mother, 64, has some hope of remission by the New Year. As she endures chemotherapy for Stage IV leukemia, I continue to parrot everything that oncologists and nurses have told us about positive attitudes.

Unfortunately for us, we Finns are not a smiley people. What’s to celebrate? Piaa pragmatist and faithful Walmart cashierhas concluded after her third intravenous cocktail of Rituxan and Fludarabine that cancer is big business. Her regular shot of an immunity-boosting drug costs more than $3,000. The diagnosis itself was more than $11,000 (lab reports from California). Health insurance is only some comfort, as her part of the costs could still bankrupt her. Her worried sisters, calling from Vaasa and Hämeenlinna, can’t comprehend that financial ruin is customary in our American practice of medicine.

Keeping vigil in lobbies and waiting rooms, I wonder if she regrets leaving Finland for my father and staying here for me, or if she really did have that déjà vu experience on her first visit. She says she’s a Southerner, and would never give up fall in the mountains. Fittingly, then, Mom splits her treatments between two clinicsone in Sylva, N.C., and one in Asheville, close to where we used to rent a small flat. We joke about missing the grubbier Asheville, the town before cafés and Earth Fare, when the Fine Arts Cinema was just a porn house. Post-renewal, it screens fine art.

Too big for its britches now, this new city dazzles us on trips to what we call The Cancer Spa, its lobby rich with the perfume of hot, locally roasted coffee. The head nurse buzzes you into a long hallway of knotted pine floors leading to a lone grandfather clock. A cocoon of handmade quilts, pink tributes to dead people, lines the path to the ominous timekeeper. After wading through the sad blankets, you land in a vitals bay and wait for a chair.

You see it once you’re admittedan enormous rock waterfall gracing the panoramic windows of the chemo room, half outside the window and half inside, creating the illusion that it’s tumbling right into you. There’s a baby grand piano, where volunteer musicians carefully avoid playing anything gloomy. At the 20 chairs around these falls, there’s a butt in every seat. We never knew how popular cancer was until now.

“Who pays for all this?” Mom once asked. She can only think of the looming tab as she drifts off on a cloud of Benadryl, bracing for her first wave of chemo. One chair over, a Florida woman was quick to answer. “You do, honey!” And then, leaning into me, she counseled, “It’s just business. They aren’t ever going to cure it, but they’ll treat us forever.”