Hurry Up and Wait

Hurry Up and Wait – The New Cancer

I knew the surgeon would be on vacation when the pathology report came in. What I didn’t realize was that my own GP would be away at the same time. So that meant, waiting and waiting to find out the results from one of those two Doctors. What I also didn’t realize is that neither of them would be able to tell me much. That job, apparently, went to the Radiologist and the Oncologist.

I had the lumpectomy on August 1st and my appointment with the surgeon was scheduled for the first day of his return on the 23rd of August. His response to the pathology report was very non-committal. He was, he explained, just the mechanic, so to speak. They told him where and what to cut out and he did that. He was not an Oncologist or Radiologist and he couldn’t tell me what the next steps would be.

In his round about way he let me know that the pathology report showed that there was a possibility that there were some ‘rogue cells’ that might be outside the ‘parameter’. It sounded very military. His office then scheduled a meeting with the Oncologist and the Radiologist who would be in a position to tell me what the next course of action would be.

It felt like a game of twister. Put your left foot on the blue spot. Spin the wheel. Now put your right hand on a yellow spot. The problem was that white plastic sheet with the colours laid out in a reachable format was missing. And, I didn’t have anyone to play with. Nor did I know the rules and I couldn’t just shout, “I quit!” when I wanted to stop the game.

I told him that my ribs and side hurt but there was nothing to see. I pointed to the location of my pain. “Couldn’t have anything to do with the surgery,” he said and I believed him. A few days later his office called to tell me I had an appointment for September 21st with the Oncologist and the Radiologist. (More weeks with years strung between them.) Finally, the day arrived. It was a Friday.

As always, Dave drove me to the hospital. I went into the ‘cancer clinic’. I had been told my appointment would take one to two hours. Dave and Casey went shopping in Barrie.

I had forgotten to take a book with me and passed my time in the waiting room pretending to read cancer pamphlets. Mostly, I watched the ‘cancer clinic’ patients around me. They were there from all walks of life, from all religions, colours, sexes, ages and all with different kinds of cancer. Many were couples there to comfort each other. I wondered for a moment if I had deprived Dave from providing me with comfort. I decided I had not. I felt stronger alone without the need for uncomfortable comfort; the kind I watched the man across from me give his teary-eyed wife; with a face that said he’d rather be in a Canadian Tire store.

Every once in a while a different nurse would come into the waiting room, call someone’s name and a couple would follow her obediently down a different hallway. Sit, stay, beg and be grateful; like dogs without obedience school they did as they were told out of fear not good training.

I awaited my turn and wondered if I were a dog what breed I would be. I decided I’m a mixed breed. Some sort of odd Jack Russell Great Dane cross with some Terrier and Lab thrown in for good measure. Since I couldn’t concentrate on the cancer pamphlets I gave breed types and characteristics to my fellow waiting room inhabitants.

Then I got up and looked at a map on the wall. Little coloured pins marked the distance some people drove to get to the hospital for treatment and I felt guilty that my trip was only forty-five minutes and I had Dave to drive me.

A perky nurse with ultra-vivid, turquoise-blue eyes called my name. I ‘heeled’ slightly behind on her left side to an examination room. She sat at a computer and confirmed my ‘tombstone’ information; name, address, date of birth, etc. The same as the registration woman for the clinic had confirmed twenty minutes earlier. I wondered if there were identity thieves who stole cancer patients Health Cards. Or, if patients routinely changed their addresses between the registration desk and the examining room.

After the short-haired blond nurse with the only-with-contact-coloured-lenses eyes finished confirming that I hadn’t moved or lied about my age she informed me that the two Doctors I would be meeting with were ‘really nice’. I asked her if she was wearing contacts. “Oh, of course, I am,” she smiled. “It stops men from talking to my breasts.” I couldn’t help myself. I looked at her breasts. They were no bigger than mine. (Maybe she had something there.) She studied my colouring and suggested I look into ‘tiger eye lenses’ that would look great with my hair.

The Oncologist came in first. She was child-like in stature and smiled while she talked in a whispery voice as though smiling and whispery-voicing would make cancer sound nicer. She reviewed the information the registration woman and the nurse had reviewed to make sure I was really me. Then she had me lie on the examination table and touched my breasts with feathery fingers. I wondered what she might expect to feel. “No lumps under your arms,” she smiled and told me I would need to go on an estrogen replacement drug for five years.

I stopped listening to the benefits of the drug. Not that I’m stupid and blacked out but because I knew all of the information and more than I could possibly read would be available to research on the Internet; because estrogen replacement and five years rang a warning bell in my brain; because mostly, I stopped being a dog with no training and let my natural self-defence mechanisms kick into place. She asked when I had first felt the lump in my breast. I told her I’d never had a lump.

After the examination we met back around the curtain in front of the computer. She explained about the uncertainty of the pathology report and repeated her recommendation that I take this drug for the next five years. She said it was important to prevent the DCIS, a non-malignant cancer, from spreading. She said she would arrange for a follow-up appointment. I nodded agreement though I had no intention of ever seeing her again.

The nurse came back in and said conspiratorially, “Isn’t she a nice Doctor?” “Yes,” I replied very Golden-Lab-like, or very polite-Canadian-like, I know there is a difference but I’m not sure what it is.

Next came in the Radiologist from Sunnybrook Hospital. She was my height, straight forward and extremely blunt. She spoke in an adult voice. Immediately, and with no true justification, I liked and respected her. Go figure.

According to her, the pathology report was not good. There was a strong possibility pre-cancerous cells were still lurking in my breast. The ‘mastectomy’ word came up for the first time. After all, at some point, she explained, there would be no point in continuously taking small parts of my breast away. She looked at my chart, according to the surgeon there wasn’t a lot of breast to take away.

Everyone seems to need to get their own feel so she also examined my breasts and lymph nodes. Her hands were firm and pressed deeply into my breast tissue, there was nothing child-like or feathery about her. She’d read my chart and didn’t ask about discovering my non-existent lump. Instead, she began to point out the merits of radiology and DCIS.

A positive plan of action was set out. I was to have my GP arrange for an ‘Urgent’ mammogram to ensure that all of the DCIS cells had been removed during the lumpectomy. We would proceed on the assumption that they had been removed. Her assistant would arrange for a preliminary appointment at Sunnybrook where all the pre-radiation processes would be done. They would put small tattoos on my breast so that the radiation technologist would know where to aim the machine each day, once a day, for five days a week, for a five week period of time.

Alternatively, if the mammogram came back showing that not all had been removed then I would have to make a decision between a further lumpectomy or a mastectomy. In the case of a mastectomy I would not require radiation. In the meantime, her assistant would go ahead and schedule my radiation appointments. While I liked her I wasn’t ready to commit to her any more than the Oncologist without research or discussion with Dave. “Of course,” she nodded understandably when I told her my concerns. Not the least being the time involved in the radiation process in a city a few hours from where I live in the middle of starting a new business venture.

“Take all the time you need,” she said and fished a few of her business cards from her pocket. “Call me on Monday with your decision.” She handed me her cards and added, “Give one to the mammogram department or your GP to make sure I get a copy of the results. Also, feel free to call if you have any questions.”

I left the hospital, called Dave on our cell phone and he picked me up five minutes later. Casey had been riding shotgun. I picked him up and kept him on my lap. “You don’t look happy,” Dave said as we pulled away from the entrance.

“I’m not,” I answered and patted the dog. I told him what I’d been told which essentially amounted to another ‘we-have-to-wait-and-see’ until after the next round of mammograms. I’d do some research on the recommended drug and radiation over the weekend.

“It’s the waiting that’s driving me nuts,” I said. “It’s worse than anything else.”

Dave patted my knee in sympathy then he patted the dog’s head. He patted the dog longer than he patted me. That I noticed this bothered me. I decided that if Dave were a dog he’d be a therapy dog, for other dogs.