I walked into the oncology waiting room, my mom following behind me, the eyes of other patients and relatives all lifting to watch us walk in. I knew what they were thinking…
“Which one has the cancer?”
I know this, because I think the same when anyone walks through the front door or into the waiting room from the exam area. Most of the time, you can instantly tell. We are frail, or balding, needing physical support from others, have sores on our bodies, are pushed in wheelchairs, or are simply old. But not me. I walk in with my mom or dad and know they think the patient is the parent…until I walk up to the window and begin talking with the receptionist. I, undoubtedly, stand out. Despite turning 38 last month, in the world of cancer, I’m just a baby.
I sat in one of the waiting room chairs and pulled out a book, avoiding the gaze of anyone who might be sizing me up, looking for tell tale signs of weakness. The door to the exam rooms opens and 4 people walk out, one them being supported by two others. There was no doubt who was the patient among them. He was the poster child (a misleading term) for cancer. He was old, by all definitions, but aged worse from the disease. His wife helped stabilize him as they walked him towards a wheelchair, every step a conscious effort. His skin hung from bones, spotted and marked. His stare, completely vacant. He didn’t talk…everyone spoke for him. I couldn’t help wonder what kept him alive…and why. His existence, pardon my bluntness, is not one I ever want to experience. Surely the doctors, with their unending list of patients, see little hope for treatment. I wonder if they must be simply following the wishes of the family, taking their lead, who want any time to continue sharing love and protection to their husband, their father….understandably. Sometimes, I wonder, if treatment isn’t about the patient at all, but rather the emotional desires of loved ones.
Looking at this frail old man, I couldn’t help but appreciate my predicament, valuing my relative youth, taking comfort in the life I’ve lived to this point, recognizing the reward of health and strength. I am not the poster child.
The room cleared out and we were left alone, waiting to be called to the back for examination and questioning. I didn’t feel sick. I barely felt the waning pain meds. My greatest discomfort was the line of staples still pressed into my skin, wearing out their welcome days ago. The door opened and my name was called.
After basic vitals were taken (128 lbs – race weight! – without the necessary muscle) the practicing resident, who was also one of the accompanying surgeons, gave me a simplistic rundown of my situation, expressing hope and encouragement towards my diagnosis and saying little more that gave me concern or strayed from the original plan. This has not always been the case. He quickly removed the rest of my staples, with minimal pain, and said little else that warranted remembering. This has all become so routine and the in and out of the exams have lost the emotional intensity they once held. The cancer experience, at least mine, has seemingly become little more than a checkup. I still feel confusion, and sometimes even guilt, that it has all become so easy, so routine, so…unconventional. And sometimes I still get scared, because it has become all that. Because I’ve internalized this whole situation and relatively thrived through it in such a way that I’m not as bothered as I used to be. A little more tension might do me good. On the other hand…I’m not the poster child. And I don’t want to be.
The resident left to be replaced by my oncologist, the individual truly in charge of saving my life, and he quickly went through a physical examination, mouthing approval of my healing scar. He followed with another recap of my surgery.
“I got about 3/4’s of it out…”
“I thought I could get it all…”
“Didn’t want to risk a temporary colostomy…”
“Trouble near the colon….”
“Decided to hold off and not do further harm…”
Nothing new surfaced from what he told me in the hospital. Thankfully. It all went as good as it possibly could have considering the circumstance, meaning I still have cancer, but considerably less than before, and now we have more decisions to make.
We continued discussing recovery.
“I feel shockingly better than I did last time.”
I am not a poster child.
I pressed him about the logistics.
“So you said that maybe the chemo treatments might have got to the tumors and made them easier to get out this time, right? So, were they easier to get out? Is that what happened?”
“Well..yes. They were easier to get out this time, and I wish I could have gotten them all out…now, whether it was the chemo that made them easier to get out….I can’t say. We really don’t know.” he admitted.
I knew this. We know very little about cancer, about chemo…so this I accept. We try everything and hope something works..even the processes of the human body. He confessed that it may just be the immune response from my own body. It could be of my own biological doing. It could just be a trigger..of which we don’t know. He recounted stories of other patients who came up with No Evidence of Cancer all on their own…without surgery…without chemo. It happens.
He talked further about the future.
“So, our plan now is to let you recover, for you to get stronger, and then take a CT scan in a few months to see how things are going. Then another in 6 months. We will keep you off chemo, but keep checking in before starting again.”
I stumbled over his last sentence. Chemo? Again? Please no.
Our plan prior to surgery was to “wait and see”, to see if chemo really was the dominant factor in reducing cancer or some other non-chemical mechanism, the human body, dumb luck. Anything. Anything but chemo. I thought we were going to wait and see…and that is what we are doing, but I guess I hoped we were leaning on that possibility more than the expectation of undergoing chemo again. That was stupid of me, however, because I know chemo is ALWAYS an option. I know the CT scans can come back to tell a more ominous story, but I just didn’t..and don’t..want to believe it. I want to believe I’m not the poster child, that I’m different, that I don’t need chemo. And that is a dangerous position to take…I know better…I need to stay neutral.
Still, we were just talking options. It just felt like he was more definitive in his statement. As if to say, we’ll see how things are going and then start chemo in 6 months, instead of saying, we’ll see how things are going and IF NEEDED start chemo…or forego it all together. I wished he was a little more fluid with his statements. Still, this are just options, and this is one.
We talked about surgery too…again…a third time. This I was more prepared for.
“We’ll look out about a year from now, or maybe a year and a half and see about going in and getting the rest,” he explained.
This time there was less “if’s” in his declaration. The third time is a charm. With how much he removed the first and second time, it seems a definitive that the third time would be the last time, and despite still reeling from the necessary abuse, I didn’t flinch. Let’s do it. Get it out of the way. Get it out of me and let’s move on…finally. But, despite the confidence and positivity of this approach, this is still just an option.
In the process of cancer, everything changes. Sometimes rapidly, sometimes unexpectedly. We never know how it will all proceed and a year away in the cancer world is akin to a lifetime…so much can happen. Cancer could come roaring back….or it can disappear without a trace. It can be killed and it can just die. Nothing is guaranteed within a year.
Without much more of consequence said, that was the end of the appointment. He gave me free reign to eat with abandon, do everything I enjoy, and just live my life until we meet for a CT scan and reassess the situation. There was no need to take immediate action, to respond to desperate circumstances, to give timelines, projected lifespans or survival percentages. I am not a poster child. I don’t need that information right now. I simply need my options.
We walked into the empty waiting room and out of the building towards the car, still a little defeated from the potential for chemotherapy in six months, but trying to remind myself that I’m not a poster child, that my situation is different, that maybe, just maybe, I can avoid chemotherapy completely. I won’t say I can avoid surgery too…but if I must reach past my boundaries for something, it can at least be a treatment without chemo.
Who knows…I’m not the poster child for cancer, so all possibilities are still on the table.