I left work after my
dermatologist broke the bad news that I did indeed have cancer. He had said that
my type of cancer wasn’t so deadly that I should drop everything and find the
nearest qualified surgeon; however, he added he wouldn’t wait too long. He gave
me two names to look up, experts he’d trust with his own face. I appreciated
how he fed me the information in digestible bits, and then gave me a
straightforward task. It distracted me from thinking about how we don’t really have
a cure for cancer.
At home, my partner and I
set to work decoding our insurance coverage. We searched through hundreds of
network physicians and learned that none of them performed the surgery I
needed. In fact, none of the health plans available through my employer – HMO,
PPO, POS, union-run – would cover the treatment. So, we called up the two
specialists recommended by my dermatologist and asked for quotes. Would it be
hundreds, thousands, or tens of thousands of dollars?
At the university hospital,
no one could answer the question. One friendly nurse philosophized that our
hospital should be offering comprehensive insurance for its own providers. I
wish one could assume, but I wasn’t in the mood to ponder the capitalist,
for-profit nature of our health care industry. Imagine going into a store and
being forced to buy something for the sake of your life. What incentive do
suppliers have to keep products accessible and prices low, when consumers have
to make a purchase regardless? I just needed to be cancer-free, ASAP. I didn’t
have time to wait for health system reform.
The private office we called
next connected us to their billing person, who briskly listed the costs, line
item by line item. Encouraged by the office’s efficiency, I requested the
earliest available appointment...four weeks away. A good friend of mine confirmed
from people who had worked directly with this surgeon that he was among the best
in his subspecialty. My parents agreed to help me with the bill.
I attempted to relax as I
counted down the days. In preparation for my treatment, I reviewed the latest
literature on my cancer and informally consulted colleagues to make sure I was
making the right decision. I wrapped up loose ends at work. I purchased a
wide-brimmed hat. The weekend before, I stocked the refrigerator with fruits,
vegetables, and ice cream, and cooked a large pot of chicken soup. I bought the
recommended list of wound care supplies. All in all, I was ready. The goal was
to stay in control, keep everything predictable. My cancer didn’t have to be
any more disruptive than getting my car washed.
My surgeon good-naturedly
obliged my need for order. While I laid stiffly on the operating table, he gave
a detailed timeline of how the surgical site would change over the next weeks.
Even when the affected area turned out to be much larger than expected, he
explained that the gaping wound could be hidden with a special skin closure
technique. I stole glances at the vital signs monitor and was pleased to see my
blood pressure and pulse remain normal. My surgeon finished by commenting with
satisfaction that my case was done on time. I liked him precisely because he
was a skilled technician who didn’t get too caught up in the emotional
messiness of illness. He affirmed my desire in that moment to believe in “magic
bullets” – cancer => cut => cure.
My cancer experience thus
far had been running like Swiss clockwork. So, it was an unwelcome surprise when
my methodical façade broke down only hours after the procedure. At home, resting
with an ice pack on my face, I found myself spooning rum raisin ice cream into
my mouth as if I were in an eating contest, all the while fighting back tears.
What is going on, my brain raced in confusion. The cancer is gone. Everything
went smoothly. Why the drama now?
I replayed the events of the
day in the doctor’s office. At one point, a nurse had come in, put her hand on my
shoulder, and stated that my surgeon was confident he had gotten all the
cancer. I should do “just fine.” Her smile was warm and sincere. I wanted to
believe her, but I had seen healthy women almost bleed to death from routine
vaginal deliveries. I had dealt with minor office procedures that turned into ICU
stays. I have had to admit to patients that we have no explanation for their
diseases. Doctors can’t give guarantees. Most of the time, we don’t have cures,
just symptomatic remedies. Rather than comfort, the nurse unwittingly reminded
me that science, technology, and medicine have more questions than answers.
So, it was not in the
doctor’s office, but at home when my healing truly began. Twice a day, I cleaned
and dressed the incision that started in the middle of my forehead and ran into
my hairline. I carefully washed over the small stitches with saline, applied
antibiotic ointment, and taped down the large white bandage. The wound started
off angry and inflamed, causing swelling down to my cheeks until I looked like
the cross between a Klingon and Frankstein. I hid from the outside world,
mortified by the blatant sign of illness on my face.
But in the quiet and in my
embarrassment, I slowly came to acknowledge my physical limitations. I sought calm
in daily rituals. I sipped nourishing stews and ate fresh fruit. I napped on
the couch with my dog at my feet. I replied to emails and texts from family and
friends. I took medications as prescribed. I listened to birds chirp and
watched the sun light stream through different windows throughout the day. I
took deeper breaths and just closed my eyes from work whenever I wanted to. I
started playing with Twitter. I let myself cry.
The vulnerability was
awkward, but therapeutic. I thought about the disconnect of expectations that
can occur between doctors and patients. I think most doctors realize the
shortcomings of our craft. We have a set of tools that sometimes work and
sometimes don’t, and we try our best to do some good. In the end, we are not
someone’s parent or best friend or spiritual guide. Many patients, though,
demand more. They want to be healed. They seek meaning, connection,
and hope, when they are sick.
I didn’t ask my own doctor
for such existential reassurance. But then, my illness has a defined, effective
treatment. The cancers I deal with at work are usually mysteries, filled with
uncertain disease courses and treatment responses. They cause patients to
question their essential womanhood and values. Who am I if you take out my
uterus? Will my partner still find me attractive? Am I more afraid of never
being a mother or dying of cancer? I listen to the stories patients tell about
themselves, because in there, are the clues to how they see their bodies, how
they make sense of their lives, and ultimately how I can best contribute to
their healing experiences, if they want me to.
I think my doctor picked up
on my pragmatism and knew intuitively that I just wanted to get out of there as
soon as possible. He mumbled during the initial consultation that doctors have
a hard time being patients, that illness is extremely humbling. I have not made
peace with illness, but I have gained a new respect for the process of healing.
There are no magic bullets.
