From Both Sides
by Ellen Weisberg
Table of Contents|
parts: 1, 2, 3, 4
I was asked on several occasions if I or “they” — the medical doctors — knew how I got cancer, as though it was likely to be anything obvious that I could have avoided if I’d been more careful. I understood where the questions were coming from: people get scared when they see others falling victim to a fate that they themselves could fall victim to at any time.
I completely got the fact that it was more comforting for people to hear something along the lines of: “I worked every day in a laboratory chock full of carcinogens and teratogens and otherwise nasty, toxic stuff.” Or: “I had a deplorable diet.” Or: “I frequently camped out near toxic waste dump sites.” Or: “It was something that I saw on Amazon that I really wanted and I had ordered it special using a promo code.”
People seemed to want or need to believe that there was a driving force behind the affliction, something that I opted into, whether knowingly or unwittingly. So, having an understanding of the source of the morbid curiosity, I resisted the temptation to be snarky or defensive and just said simply that I think cancer develops in different people for different reasons.
I believe that for some it’s mostly genetic predisposition. I liked using Jughead from Archie Comics or Shaggy from Scooby Doo analogies, examples of characters that probably ate as much as Fat Albert but differences in their virtual metabolism kept the first two from getting fat. We all have our inheritance of good and bad stuff inside us dictating how our cells are going to behave over time, and maybe in some cases this is all there is to the story, and you could live like someone with bubble-boy disease and still get cancer because you tested positive for the same villain gene that caused your Aunt Fanny’s lymphoma.
Maybe for certain people, over time, the aging cells, which are constantly dividing and making mistakes that typically get corrected, fail to correct themselves because of a faulty DNA repair system. Or, over time, a person’s immune response doesn’t fend off the evil-doers as well as it used to.
Maybe it’s mostly the result of an accumulation of “hits” from the environment, each one alone slightly increasing the odds of developing a malignancy and, together, creating an ominous maelstrom from which there is no escaping. The famous researcher Burt Vogelstein published a paper describing cancer as a result of random mutations: just bad luck.
All I knew in my case was that my mother had battled a more extensive version of the same kind of hormone-responsive cancer that I had, except in her case she was around 15 years older than I at the time of her diagnosis. I had also learned from cousins I’d confided in that my father’s side of the family was riddled with cancer. And so I couldn’t rule out the possibility that there was something of a hereditary nature making me more susceptible to it.
I’d also heard many times that stress can do quite a number on the body and, as I was not exactly a Type B personality, I similarly couldn’t eliminate as a candidate my inability just to let things flow and be chill. All taken together, it could have been just about anything that got me to where I was and, apart from being more cognizant of what I was taking into my body and what I was doing with my body, I was at a loss as to how I could have prevented myself from getting sick.
The past year for me cut deeply. It taunted me with the realization that time was getting shorter as I was moving through it. More so than ever before, I found myself dissecting and analyzing how I was spending my time and with whom I was spending it. Because in the past year, I was pulled away from the leukemia research and studies I had been dutifully doing at the bench and had become someone else’s experiment in the same cancer hospital. And in the past year, my life had changed in ways that I never expected, and knew would never reverse.
* * *
That first instance of irreversible change was one I’d find myself relaying to people over and over again, like a Vietnam War veteran recounting his or her most gut-wrenching memory. I was just lying in bed with my husband, watching television, completely taking for granted the hundreds of times I’d lounged like that before without incident.
The ribbed, long-sleeve shirt I was wearing over my pajama bottoms was hiking up a little on me and, as I adjusted it, my hand brushed against the side of my body. It was a moment I realized that something wasn’t right, something didn’t feel right. The only thing “right” was where the swelling was, on the far right-hand side of my breast.
Wait, I thought. It must be my bra.
Wait, I thought again. I’m not wearing a bra. In fact, I don’t own a bra.
More desperate grasping followed. OK. Then it must be my shirt. My thick shirt. Some kind of bump in my thick shirt. No. The shirt I’m wearing is a very thin material. I was running out of sanity-preserving ideas.
My body shot straight up like a launched rocket. What I was feeling... was me. My skin. My swelling. A swelling that — to the best of my knowledge — had no business being where it was.
I had my husband, a pediatrician, feel it.
“Oh,” he said, reassuringly. “That feels like a fibroid cyst. I just saw a girl in my office last week with the same thing.”
“Just like this?” I asked. I was panting like a dog at a treat.
So that was it. I believed him. But I’d still need to get it checked. Just to make sure. Right?
I slowly lay back down again. Someone said something on the television, but I really couldn’t hear what it was. I could only hear the thoughts in my head.
I’d just make sure.
I called the local Harvard Vanguard the following morning. An appointment was scheduled for me for later that afternoon, which I was thankful for but, at the same time, was frankly wishing it hadn’t been treated with such urgency. If I’d told them I had an ingrown toenail, would they have similarly taken me in on the same day? Or a pustulating boil? Or an anal fistula that would put King Louis XIV to shame? What did it take to be hustled in like that? Was it just slow there, and they happened to have a vacancy that on a busier day they wouldn’t have? Was I thinking too much?
My blood pressure was taken first. It was high. My weight was measured next with all of my clothes — and heavy boots — on. It was needling me that this information, skewed and weird, especially the high blood-pressure reading, as it had always been low in previous checkups, was going to be funneled to the physician that was going to see me and give me my first assessment of what was going on.
When I saw the doctor, she seemed kind-hearted and jovial, with enough smiles and chuckling during our little stretch of small talk to put me initially at ease. Then we got down to business.
“Do you have a family history of breast cancer?” she asked.
“Yes. My mother was diagnosed with breast cancer. It was stage IV,” I said. “It had spread to her lungs.”
“How old was she?”
I tried to remember her exact age at diagnosis. “It was in her late 60’s.”
The doctor nodded and wrote something down. She soon started examining the mass by just pressing down on it and crudely measuring its circumference with her fingertips, and I naively confided in her what my husband had said about it feeling like a benign fibroid cyst.
It was then that her sense of humor really kicked in, and after a snort and chortle that was dripping with condescension, she told me that you can’t tell by just feeling it what it is. And then she said, “It’s too firm to be a cyst.”
But didn’t she just tell me that you can’t tell...? Ah, never mind.
The doctor then told me that she would order a mammography and ultrasound, and she would try to get this for me in a week.
My first thought was, A week? I was hustled in here within 24 hours based on a flimsy over-the-phone description of who knows what, but now that it’s been sized up as “too firm to be a cyst” by a credentialed professional, I may or may not be scheduled to come in again for up to seven whole days?
I knew enough from my own experience and training in cancer research that biologically, at this unknown stage, a few days might not really make all that much difference. But psychologically, every passing day that was not focused on the problem at hand felt like eternity.
A nurse who had been standing at the reception desk and listening in on our conversation waited quietly for the doctor to leave. She then said to me in a low, reassuring tone, “They will probably be able to get you an appointment in a couple of days. The radiology staff shouldn’t be too busy.”
I waited to be called. But there was no call.
* * *
It was a day later, and at the very least I wanted to know when the mammography and ultrasound would be scheduled. If I had to wait a whole week, I’d make sure to stock up on hard liquor. If I was going to be taken care of immediately, I would give my liver a break.
So instead of staring at the phone and trying to use my psychic energies to get it to ring, I called them, only to find out the inexplicable, damning truth that the doctor hadn’t ordered me anything. Seriously? This was a true “what the f???” moment that forced me to use as much restraint as I could to not try to physically reach through the wires and punch the person on the other end.
What kept the scene from turning ugly was that I knew the receptionist I was talking to wasn’t the problem. I knew that it was my laugh-riot stand-up comedian of a physician that had dropped the ball and hung me out to dry for reasons that went beyond my comprehension. This was, after all, kind of an urgent matter, wasn’t it?
“Uh... Why...” I stammered. “Why wasn’t an appointment set up?”
There was an echo of dumbfounded stammering on the other end. “I’m not sure,” the receptionist said. “Let me see what we have available.” There were a few seconds of silence before she said, “So it looks like the earliest appointment I can get for you is in... two weeks.”
You have to be kidding. “But a nurse told me I’d probably be able to get something in just a couple of days.”
“Oh, no,” the receptionist said. “I don’t know who told you that. We’re booked.”
“Okay.” I hung up the phone, defeated. I tried to think of where the nearest liquor store was.
The nurse/receptionist, whose name I learned was Lisa, called me back. “We can do better,” she said. “I have an opening one week from now.”
“Thanks,” I said, my tone softer, but the dejection in my voice still irrepressible. “I appreciate you calling me back and trying to get me in sooner.”
She called me back a third time and said, “Guess what. We’re in luck. I just got a cancellation for tomorrow.”
I was grateful for her caring and persistence, and I thanked her, this woman named Lisa that I’d forever remember as my angel from the heavens above. The image of buying a week’s worth of booze to drown my sorrows was quickly replaced by an image of buying an evening’s worth of celebratory champagne. I was going to get some answers. And I wasn’t going to have to wait a week or longer to get them.
Or so I thought.
* * *
Lisa knew who I was as soon as I approached the front desk of the radiology department. I resisted the urge to hug her and made a beeline for my mammography, where I could look forward to having my right breast squashed flat like a marshmallow in a s’more.
The technician was blond and perky, and seemingly hell-bent on removing the panic that was obviously plastered on my face.
“You look nervous,” she said. Her words reminded me of my very first mammography, when my mother’s battle with metastatic, hormone-responsive breast cancer was in its infancy and I was hyper-emotional and had broken down in tears. I kept it together during all of the mammograms that followed, but my mother was very much on mind during each and every one.
She motioned for me to take a look at an image she had taken. “To me, this looks just like a cyst. See how perfectly round it is?” I had to squint to see what she was referring to, this faint outline of a circle in the midst of a gray and black pixelated mess. It reminded me of the worst of the protein gels I’d run during the years in the lab, probed with a really, really crappy antibody with an unacceptably high noise to signal ratio. Such a result would be considered unable to be easily interpreted and not of publication quality.
I was looking at what would be described to me later as “dense breast tissue,” which is difficult to see beyond. Even the questionable ball of flesh that was big enough to be palpable and detected by my just sweeping my pointer finger past it was barely visible on the screen to the naked eye in the midst of all that opaqueness.
I had an ultrasound, or sonography, next. It was a fair alternative to the mammogram, with sound waves being used to “read” the strange swelling inside of me. The ultrasound technician was just as bubbly and friendly as the mammography technician, and had put me completely at ease with lots of smiles and small talk. She left the room to consult with the radiologist, and I readied myself for both of them to walk back in and tell me the swelling was just as the mammography technician had said: no biggie, just a cyst.
While I waited for them, I started making a mental list of all of the dietary changes I would be making to be healthier, now that I’d been given my body’s stern warning and a second chance. I was in the middle of planning to switch some of my coffee consumption to green and black tea, to eat more fish and resist the temptation to get the convenient Drive-thru Happy Meals on my commute home from work in the evenings, when the Grim Reaper walked through the door disguised as a radiologist with wispy, longish gray hair cradling the top of a high forehead and a deceptive twinkle in his eye.
He smiled and shook my hand. Some pleasantries were exchanged.
“What do you do?” he asked.
Lately? Worry, I thought. “I do leukemia research,” I said.
“So you’re a doctor?” he asked.
“A researcher,” I said. “I have my Ph.D. in pharmacology.”
The pleasantries abruptly ended.
“According to the ultrasound, what you have is definitely not a cyst,” he said. “As it’s abnormal tissue, you will need a biopsy.”
Not the result I was expecting. I attempted the same joke I’d been saying to anyone who would listen for the past couple of days. “I’m too busy for this,” and “I’m sorry, but my schedule just doesn’t easily accommodate being sick.”
The joke did not go over well with the Grim Reaper, who quipped, “I’m sure a lot of people could say the same thing.”
No, I thought. I was just joking. Swear. Promise. I didn’t genuinely think that I was so special that I should be separated from the masses and exonerated from illness just because I was a cancer researcher and mother with time-consuming hobbies and parents with major health issues I needed to help support, and I barely had enough time as a reasonably healthy person to keep all of that in motion. I was just sayin’...
The Grim Reaper told me that 75 to 80% of biopsies turn out to be nothing, and that the odds were in my favor. Then he added, “I realize for you it’s going to be either 0 or 100%.”
Such a funny guy.
I made the mistake of trying to pry information out of him that I hoped would make me feel better. I thought back to the mammography and the perfect circle the bubbly technician had pointed out amidst the blurry gray background. “But it’s fairly isolated, right?” I asked.
The Grim Reaper shook his head and said in a non-committal tone, “Now we can’t say anything based on the ultrasound. We have to wait for the results of the biopsy.”
My husband and daughter and I went to a chain restaurant that evening for dinner. I picked at my meal. This did not seem to be a time for enjoyment of life or its celebration. Instead it was a somber reminder of the sudden twists and turns life could take at any moment, especially when we are least expecting it.
* * *
Copyright © 2019 by Ellen Weisberg