Strength, and Instruction
I had an appointment at 8:30 this morning to get the results of my biopsy at the doctor's office. I've also have another test that I've been putting off, a cholesterol test, so I decided to go by the hospital lab early, have the blood taken and then eat breakfast in the hospital cafeteria before seeing the doctor. Actually (you've not supposed to admit this) I like having breakfast there - fruit, eggs, orange juice, coffee - ten minutes eating it in a booth by a window: styrofoam plates, plastic forks and little packets of catsup for scrambled eggs and two strips of bacon. Not much doubt what the doctor is expecting. Not much doubt what I am expecting. I know it's one of the manageable cancers, but cancer is cancer, and manageable is no great comfort in a cafeteria. (Am I writing this or am I living this? Is this staged or is this real?)
I arrived fifteen minutes early. There was a Vietnamese family in the waiting room, a man in his thirties standing, pacing, distracted; waiting for the doctor. A patient and his family: Wife? Sister? His two children? Eight thirty, my appointment time, reading a New Yorker. They called the Vietnamese man through the door into the examination room area. I am no longer able to read the New Yorker. I sit and watch and listen. This is weird. Another couple comes in, older, worried, fidgety. Or am I projecting? Eight forty five. The older man is called and disappears inside.
The receptionist leaves to move her car from a metered to a non metered parking space. By now it's nine. I go out and feed my own meter. This is weird. My doctor comes into the receptionist's area behind the counter. He is talking with the nurse. Some test or other he needs to conduct on a patient. She says he has no openings for another month. Yes, he says, but he needs to do this (test, procedure?) today or tomorrow so they might as well do it now. No eye contact. Busy.
I am thinking this is no way to hear bad news: patients here, patients there, the doctor way behind schedule. They don't say anything. It is nine ten.
The nurse calls me in. She needs a urine sample. She always needs a urine sample. I've discovered in urology time that I can always come up with a urine sample. I think I knew this once before, in another life, on another planet. "You can always come up with a urine sample." This, for some strange reason, gives me comfort. She leads me into the room where I had the biopsy, an examining table, a machine with a CRT and rows of dials, the sonogram machine from last week, a short swivel stool and a chair. For some reason I want to sit on the stool. Door closed. Just me and the machine, the CRT displaying a blank input form. I remember it from the biopsy. My name, my address had been entered. I am thinking this is no way to hear you've got cancer. I am thinking this is weird, but I am also realizing I could use this, if I wanted, in a story. Writing this journal has changed some things, let me tell you. I am sitting here in the doctor's examination room waiting and I am watching myself sitting here in the doctor's examination room waiting, taking notes.
The doctor enters with my file in his hand. All business. "So, do you want the good news or the good news?" he asks.
Shit. I've dodged the bullet.
"No sign whatsoever of cancer."
So what does that mean? The PSA numbers were high.
I knew from reading things I'd found on the web that he'd taken what is considered a large number of samples. He said, in one area that had looked suspicious, he'd sampled twice. Nada. Nothing. Limbo.
How often does this happen? How often do you get a negative result and then find the real deal later?
Often. (I remember my cousin had a clean biopsy. It was the second that was positive. I look at the sonogram machine. Not, I suspect, for the last time.) Nothing the first time, the second time, and then you find it later. But not always. He has one patient who's numbers have remained high for five years and he's had five biopsies. With others, the PSA numbers fall: An unexplained blip on the chart. There are no guarantees, one way or another.
I'm in a small room near Summit hospital in Oakland sitting on a plastic stool with a urologist who's just told me that he hasn't detected any cancer inside and I am thinking "this is weird", but I am not complaining.
Back in another three months for more blood, another examination. And what then if the numbers remain high? Another biopsy? I suppose.
Back to work. I'm late, but I need to sit and read the paper and have another cup of coffee and think. Or not think. My world is different, but I'm not sure how. This was a gift, no matter which way it might have gone, a revelation of what is important and what is not. Unless I remain the fool, it will give me strength, and instruction.