Cancer 1, Doctor 0 (Part 1 of 2)

The doctor leaned in to study the lesion on my forehead. I could see his easy demeanor fall away into a frown, his brows now tightly knitted in concentration. The air was suddenly sucked out of the room. I was afraid I’d vomit on his pristinely ironed white coat. I recognized the expression on his face. It was the same one I’ve worked to control before breaking bad news to my patients. I took a deep breath, bracing for the doctor to substantiate the diagnosis I had already suspected.

I had watched the pimple transform into a friable, uneven mark. The day after my 35th birthday, I decided that enough was enough. I felt stupid as an oncologist-in-training to stare at it day after day and continue to ignore the obvious. Clearly, it met all the criteria for lesions that should scare you to take action. So, I had ended up at the doctor’s office, determined to put an end to my denial.  

Finishing his examination, my doctor launched into a knowledgeable discussion about my options. Clinical language is pleasantly distracting when facing huge amorphous entities like c-----. I swallowed my thought. I still couldn’t mouth the word, even as it started to encircle me like a boa constrictor. The doctor emphasized that I could go the more aggressive route, a biopsy, but that would most definitely result in a permanent scar. I nodded silently, but was outraged that he would even mention such a trivial cost of the procedure. Why would I care about a blemish when it could be c-----? I gulped for air.

“I want to be certain of what it is as soon as possible.” There was a pause. For a moment, I wondered if I had said that out loud. Then, I was given a consent form. Eyes glossing over the fine print, I dutifully signed where the “X” was, thankful for the hint. Who can read legal documents in moments like this? My brain was awash in a messy torrent of emotions. My doctor had excellent surgical technique. I barely felt the scalpel against my skin.

Walking outside into the world afterwards, I immediately cringed in the powerful southern California sun. The rays no longer felt warm and inviting. In fact, those rays had probably morphed my skin cells into relentless monsters, growing and perpetuating out of control. I ducked into the underground parking structure and counted off the seconds of life lost to waiting for the valet – 378 to be exact.

The first thing I wanted to do when I got home was walk the dog. I didn’t want to talk to anyone. What I craved more than anything was an instance of peace amidst the war in my head. My sensitive, furry dog was as much as I could handle. Watching him frolic nonchalantly in the hills, I thought about my great grandmother. What would she do? She’d cook a pot of gingery, sesame chicken with bamboo and medicinal herbs, with a side of long-life noodles to soak up the broth. Then, she’d insist that I eat it while it was piping hot, so the soup could free up my obstructed “chi.” What reason did I have to doubt her tonics? She lived well over 100 years.

I headed home and started cooking. My mind fixated on folk remedies, even though I have devoted myself to Western medicine. Fear took hold, and I needed something, anything weighty, like millennia of ancient Chinese wisdom, to keep me grounded and comforted. I read the National Cancer Institute’s literature on the cutting-edge treatments for all my potential diagnoses, but the science felt cold and inadequate. Instead, I was calmed by a large bowl of sesame noodles and gingery cabbage that I devoured ravenously. I washed it all down with a pot of green tea for good measure.

I suffered through two weeks of vivid warrior nightmares. Battle-worn and injured, I tried to beat back insidious cancer cells. They had the latest stealth technology, but I could only throw sticks. I spent a lot of time staring at the ceiling at night, resenting pathologists. Seriously, how long does it take to write a two-line report? Time was too precious to waste. The cells were dividing and replicating unchecked, while the health care system creaked along its inefficient ways. There was nothing rational about the way my mind waded through this time of waiting. I started to hug people longer. I talked to my family more frequently. I celebrated my birthday, surrounded by friends.

I was being forced to look at Cancer in a different, more humbling context. For me, Cancer had stopped being an exciting area of medical research. It could very well be a physical part of me, intimately attached and unwelcomed. I wanted to run away to a silent retreat. But that was the problem exactly. There would be no more running away. When the pathology report came out, it could confirm that Cancer had invaded my body -- my personal, private sanctuary. It would no longer be at a safe, analyzable distance. I could not contain it neatly at work. There would be no leaving it behind to go on vacation. I couldn’t turn off my pager and hand off care responsibilities to a trusted colleague. Realistically and statistically-speaking, this Cancer wouldn’t threaten my life. But merely the prospect of having it had shaken my way of life, and wantonly collapsed the compartments I’d so meticulously set up to maintain order.

Just minutes before I learned of my diagnosis, I was working in the shady hospital courtyard, cramming to meet a research deadline. A Chinese man approached and asked me, in Chinese, to translate his English prescription. I looked at the prescription and saw that it said, “Mr. Chen has leukemia and should receive chemotherapy.” In alarm, I thought, does he know how sick he is or am I going to be breaking bad news in my grade-school-level Chinese? Mr. Chen looked at me expectantly, with trust and friendliness. I marveled at this man’s courage, venturing to this hulking institution to seek treatment, relying on the kindness of strangers. I translated the best I could. Then, he excitedly pulled a letter out of his bag, another mystery to him. This one read, “Mr. Chen has finished chemotherapy, and needs a bone marrow transplant.” He bowed with gratitude and chatted with me about Taiwan. “I knew you were Taiwanese. I could tell by your accent.” His eyes twinkled, enlivened by a touch of familiarity in an unknown place.

As Mr. Chen walked confidently towards the hospital’s entrance, decoded papers in hand, I felt like the universe was sending me a message. I still had so much left to do here. In connecting with Mr. Chen, I finally stepped out of my own head and experienced the peace I had been searching for in two weeks of waiting.

My phone rang. It was my doctor.

“I would usually have you come in to talk, but I figured you’d want to know without delay.”

I heard a huge gong being struck, too close for comfort. Round 1 goes to Cancer.