Wednesday, June 13, 2012

One of These Days: The Other Side of the Curtain

Not too long ago, I went to the doctor for a physical.  Just a check-up.  Something we are supposed to take ourselves to do as Adults.  Blood pressure, hearing test, height/weight, blood work, mammogram, treadmill stress test, the works.   It went ok, as ok as those things go.  I can think of lots of things that are much more fun to do over a three-hour span of time, but it was good to have that check-up behind me, to feel like I was “good to go” for at least another year.

Except that maybe I wasn’t.  One week after my appointment, I pulled the car into the garage at the end of the workday, and, like I always do, I walked to the end of the driveway and checked the mailbox for mail.  Amidst the junk mail was an envelope with a return address of the place where I got the physical.  “Oh, good: results,” I thought.  An envelope, in my eyes, means good news, you’re fine, all clear.  I thought not-good results would warrant a phone call.  Silly me – wrong!

The form letter had three boxes that could be checked to indicate the results of the recent mammogram, like a stoplight with green, yellow, and red indicators.  My checkmark was next to the box for Caution; the comment by the ugly checkmark said, “Further testing is needed.”  Beside that a note was scrawled that read, “Abnormal findings. Call Jamie at number above.”  

And the best part:  it was, of course, after hours.   

The next morning, at 8:00 a.m. sharp, I dialed the number on the letter.  Busy.  I waited five minutes then repeated.  Again.  And again.  On about the tenth time, I got the front desk clerk and asked for Jamie.  The call was transferred, and it rolled over to voice mail.  I left a message and waited an hour then repeated.  Again.  And again.  

About an hour after I had left the third message, Jamie, who never told me what her position or her credentials were, called me back and said, “Uh, yeah, your scan last week didn’t look good to the radiologist so you need to have more testing.  I’ll call and try to get you in to the clinic we recommend, and then I’ll call you back and let you know when the appointment is.”  I stepped into the hallway of the school where I was working, and then I pressed her for more information about the scan, but she either didn’t know anything else or she didn’t care to tell me what it was.  She asked when it would be convenient for me to have the other tests ("Is something like that ever convenient??" I thought to myself), and I told her the sooner the better, that I’d really like to be seen that same day or the morning after at the latest.  I asked if I could call the clinic myself to schedule, but she said she had to do it because a radiologist’s orders are required.  She said it might be several hours or even the next day before she had a chance to call the clinic to see when they could fit me in.  I told her that I didn’t think I could wait that long.  “I know just how you feel,” she said.  

I couldn’t help it.  I know this kind of thing happens to other people every day, but it doesn’t happen to ME every day and I HATE being put in a position of – WHATEVER the position I was in was – vulnerability, fear, endangerment, at the mercy of, out of the loop.   Terrible.  

Actually, you DON’T know how I feel,” I told her as I tried to hold back the terror and the fury I was feeling, “but I am asking you if you will just hurry up and get me the appointment as quickly as possible before I completely lose my grip, out of the kindness of your heart.”  

We’re really busy here today,” she said, “and I have lots of patients.”

Well, I don’t!” I replied, with dwindling restraint, my voice echoing down the school hallway. I was all out of patience for her, the radiologist, and the whole facility of people that seemed to think everyone who went through there was just a number on the page.  The fact that none of this is no big deal to any of the people on the other end of it kept flashing in neon lights inside my head.

I’ll see what I can do,” she said tersely.  "Oh god, I hope I didn't just shoot myself in the foot by talking to her that way," I thought.  But what was I supposed to do - just freaking THANK HER for MAILING me really scary news that could potentially change my life and the lives of those around me, THANK HER for making me call so many times and leave so many messages pleading for her to call me back, THANK HER for being so damn casual about the whole thing, like it was an appointment to get my pants altered?

About an hour later, she called back to tell me the clinic would take me the following afternoon.  And thus began Phase II of the Waiting Game.

Actually, I think some of each are part of life!

Probably unfortunately and also probably weirdly, I know lots of facts about cancer.  (For some reason, this peculiar category of knowledge never comes up in a trivia contest.)  For example, I know that there are around 300,000 new cases of breast cancer diagnosed in this country every year and about 40,000 deaths from breast cancer in the U.S. annually.  I know that breast cancer is the second most common type of cancer among women (skin cancer gets first place) and that it is the second most deadly type of cancer in women (lung cancer is the most deadly).   The chance of a woman having breast cancer at some point in her life is around 1 in 8 in our country.  Fortunately, death rates from breast cancer are declining, but it’s terrifying stuff, especially when one has a family history of breast cancer like I do and especially when something “abnormal” has been identified on a mammogram.

I couldn't decide if I wished that the next appointment would hurry up and get there or if I wished it would never come.  When it did, I walked into the waiting room, and I signed in, sat down, and - you guessed it - waited.  The pounding in my ears as I waited was almost deafening.  After 30 minutes, I was called up to the registration area where the clerk took my insurance card.  When she told me the name of the physician to whom the results would be sent, I told her I’d never heard of that doctor before.  She said it was the radiologist from the other facility.  I asked her how this person whom I’d never met was going to follow-up with me, should some kind of follow-up be needed, and she looked at me as if I’d asked her how gravity works.  “I guess you can call him or her,” she said.  “How?  I don’t have his or her number! I don’t even know this person’s first name or if it’s a man or a woman!” I said.  “Well, I guess he or she will call you then,” she told me, obviously wishing I would just go away and be quiet.  Hmmmm.  I was trying to be nice; I know more flies are caught with honey, but I was so nervous, and I just wanted someone to be nice to me.  I wanted to feel like this clinic was handling things ever-so-competently.  I wanted this whole thing to be over with.  I asked her if she could also send the results to my primary care doctor and my gynecologist, both of whom I DO know and know how to make an appointment with.  “That’s not usually how it’s done,” she said, “but I guess we can do it.”  She gave me my insurance card back and told me to sit in Waiting Area #2.

After about 15 more minutes, I heard my name being called again.  A person (Nurse? Technician? Volunteer?  Escort?) introduced herself to me as Theresa and motioned for me to follow her.  She was very nice but didn’t tell me what her title or position was and that made me even more nervous.  (The more educated the person who escorts you back into the exam room is, the worse off you probably are, I was thinking.  I really hoped she isn’t a Radiologist or worse, a Surgeon.)   She led me to a dressing room with lots of lockers.  No one else was in there at the time, but I got the idea that even if they were, the procedure and the conversation would go exactly the same anyway.  It didn’t seem like the most private of venues, but I thought maybe that was good – I certainly didn’t want to go into the Room of Doom where they give bad news in private.  

Theresa told me that the official report they’d received said that there are two areas of concern on the left, changes since the previous scan the year before.  Standing there in the locker room, she asked me if I have children, if I breastfed them, and how old I was when I started my cycle.  Then she asked, “Have you ever had cancer before?” I felt bile rising in my throat, and I said, “Before when?  Do I have it now?”  (People often don’t realize how very literal of a person I am.)  She just half-laughed, and for some weird reason I laughed too, even though I didn’t think anything about anything that was happening around me was the least bit funny.  She told me to undress from the waist up and then to put on one of the robes on the shelf by the lockers.  "And then come sit in Waiting Room #3 around the corner until your name is called again.  And bring your purse with you just in case,” she said.  (“In case of what?” I thought.) She didn’t, however, tell me that if I have on deodorant I should wipe it off because it will obscure the view on the mammogram, which I knew she should have mentioned and which made me think she might have beeb forgetting to tell me something else I should really know.  

Undressed, uncomfortable, and even more tightly wound, I took a seat in Waiting Room #3 which was filled with women in robes.  The women all seemed older than me, but some didn’t seem that much older.  One woman reeked of cigarette smoke, and the smell permeated the room so much that I actually looked around to see if somebody was puffing away in the midst of all of this.  I overheadr one of the employees telling a fellow Robe Wearer that this waiting room is for “The Re-checks.”  At first, I thought she said “rejects,” which I considered protesting, but when I realized what she had actually said, I couldn’t argue so I just went on listening to the noise in my head.  I also couldn’t help thinking that they should really call this the Russian Roulette Room.  Statistically, some of us were probably going to get good news that day and some were more than likely going to get bad news.  I tried not to think too much about my Cancer Fact Bank.  I didn’t know the other women in there or their situations, but I didn’t want any one of us to be one of the 1 in 8.  We sat there together in Purgatory, each of us with no idea which way things are going to go that day, that year, or over the course of the rest of our lives.

After a few minutes, Theresa reappeared and took me into the mammogram room, where she showed me the films from last week, which were not very clear except for two black spots on the left amidst the gray and white background. I looked at the spots and felt the world start to melt away.  Or maybe I felt like I was melting; I’m not sure.  Theresa informed me that the scan I was looking at was radial, which didn’t really mean anything to me, especially given the fact that I was hyperventilating at the moment.  “Our machine is digital, which will show things much more clearly,” she said.  OH, ok, I thought, and I mentally tied a knot in the end of my emotional rope so I could try to hang on.

I’m pretty sure I didn’t want to see things more clearly, certainly not those two black spots ("Can’t I just wave a magic wand and have this whole thing go away?" I remember thinking), but I mutely followed her directions as she scanned my left breast from two views and then told me to come over to the computer.  I floated over and looked at the screen.  In my total-layman's opinion, I thought it looked good, nothing glaringly tumoresque, but then Theresa said, “They’re going to want to do an ultrasound on that area, too.”  

"Oh god why? That sounds bad!” I thought.  I floated on over to the ultrasound room.  The technician or whatever her title tried to make small talk about the upcoming weekend.  I hung in the conversation with her until I glanced over my shoulder at the screen and saw two black dots.  They looked like black marbles.  The melting thing started happening again, and this time there was some chest pain involved, and not from the wand that was going back and forth over the gel on my chest.

Surely this chick is CPR certified, and they’ve probably got some of those paddles around here in case she needs to shock me back to life if I have a freaking heart attack,” I thought.  I decided I would hang onto my sanity long enough to direct them to stick the biggest needle they had into those black spots and suck them out or at least do whatever it took right then and there to find out definitively what they were.  And, if the results weren’t good, then I could drift off into the Deep End for a while if I still needed to. 

Ultrasound Girl went back and forth, side to side, with the wand, and now the small talk was over.  I was busy again listening to the sound of pounding in my head.  After a couple of minutes that seemed like a lot longer, one of the spots appeared on the screen again and I said, “What the hell IS that?”  I think it was only then that she realized I had been craning my neck so that I could watch the screen.  Maybe she thought I was asleep or meditating or just being really quiet for no reason before that question, but she picked right up on the terror in my voice once those words tumbled out.

Looks like a cyst to me,” she said casually.  She threw out some factoids about normal fluctuations in hormone levels and transient cysts, took some more measurements of the black marbles on her screen, and then told me she was going to talk to the radiologist to see if he needed "anything else” and that she’d be back with my Results in a few minutes.  

After she left, I sat up on the table.  I considered looking through the drawers in the room to see if they had any huge needles or sedatives or anything else of interest but decided I’m wasn't sure if my legs would work if I tried to stand up right then.  One of the voices in my head said that the tech or whoever she was seemed upbeat, and then one of the other voices pointed out that she does this kind of thing every day and she probably had some acting classes as part of her training for cases just like this. 

And so I sat there, teetering on the edge, until she popped back in and said in a cheerleader voice, “All clear!  You get to go home with good news!”  She handed me a piece of paper that looked a lot like the one I’d gotten two days before in the mail, except this one had her clinic’s letterhead at the top and this time the box next to “Normal Findings” was checked.  I got dressed and went back through the maze of waiting rooms, and Life Marched On.

Do you have a false-alarm medical story?  If so, did the way you handled it surprise you, and do you think your initial thoughts and reaction were clues as to how you would handle a real crisis?  Did it help to give you perspective, or did it just make you even more uneasy about what could happen in the blink of an eye?

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