Part 2 - “Hear No Evil” Or A Tale Of Pomegranates

Part 2 - “Hear No Evil” Or A Tale Of Pomegranates

It took a total of roughly one and a half months to finally get me scheduled and tested after I sounded the alarm and called the cancer center, describing what was happening. Let me tell you, cancer keeps these places busy! Having to wait over a month to get a time slot with the oncologist or a spot to squeeze in a scan?! I’ve had experiences with cancer centers where my oncologist and his RN, as well as the injections, were only available on Mondays because they were traveling to different locations on the other days of the week to serve more patients. The logistics behind this were baffling and if for any reasons you missed an appointment, you were in for a ride. Not a fun one because hormonal injections like the ones I was receiving are incredibly time dependent. Anyway…In those one and a half months my cancer exploded into lesions around the main mass and traveled to my armpit and up my neck into the lymph nodes. It was like a movie, like I had been infected by some alien fungus that was bound and determined to gobble me up as quickly as possible. There was no longer any question of whether or not it was cancer. The only thing on my mind was: “How long before it reaches my brain or another vital organ?”

Death becomes very real. It’s a profoundly strange moment when your perception changes from the typically unknown point of death, something that is “out there somewhere in the relatively distant future” to “please grant me a couple of years to fix some things and wrap up my life.” You literally start bargaining with whoever or whatever your God is. We all know that eventually we’re going to die, possibly even sooner than later due to a condition or the potential accident and what not, but we live in the comfort of obscurity. The fact that we don’t know “The When” creates this sense that “right now I’m not affected by death.” Life is not the priority, and we put fillers and illusions ahead of it. We put in extra hours for work, or binge watch another TV show rather than fix a relationship or experience something we always wanted to experience, because there’s no urgency (or so it seems) and we’ll just tackle that another day. We stall on life itself as if we are afraid of living - the irony.

Cancer, and other conditions of a terminal nature, rip that illusion away from you. Suddenly, you find yourself in this place where you have to figure out how you want to leave the planet and those you love, while the clock is ticking. And life doesn’t exactly make any of this easier in that we’ve created a type of structure in society in which you’re not really allowed to change your priorities because it could affect a steady income and support. I’m blessed to have a husband with a job that allows me to stay home, but it’s still financially a struggle. It’s a lot harder for those who don’t have that. Here is where I have to actually admit that cancer to me personally came as a rather unexpected savior, another little irony. I’m grateful for it because since my diagnosis in December 2020 more has been set in motion for my family to get to the bottom of things than in the past 20 years combined, because time is running out for me and that is affecting our whole family. I’m happier now than I’ve ever been - that’s the strange flipside to cancer, for me anyway. That’s really saying something because cancer is no walk in the park and I know when I’m gone it’s going to be tough for my family for a while. And still, I’m grateful.

While “the welt” itself was painful, that was of course only the beginning. After the initial visit with my oncologist, a variety of tests were scheduled among which were a mammogram and biopsy. I don’t think mammograms are fun for anyone but when you’re like me and lucky to fill a training bra and one boob is filled with a 2 inch dumpling that then gets pancaked between two cold plates to get some pictures, you really wonder what brilliant “chef” came up with this technique. But that wasn’t the worst of it.

You’ve been to the doctor, you know the story. You come in, sit down, fill out your history, symptoms, etc. Then the nurse will go over it all and type in some of your responses, making you wonder what the point of the “paperwork” was to begin with. And then the doctor comes in and repeats what the nurse just did. And then, the next visit, you may very well repeat this entire process, for certain if you switch doctors. Don’t get me wrong, I think getting a patient’s medical history is incredibly important, which is also why I explained to my oncologist that I experience pain medication and numbing agents differently than most other people and that my brother is the same way. I’m finally getting to one of the little monkeys - the one that “hears no evil.” I’m not necessarily talking about the individual here but rather the medical establishment as a whole, so bear with me.

When I was 16 years old, I had developed a pea-sized calcium deposit on my knee cap about a year after an injury - a horrifically failed attempt at one of the latest hip hop moves of the times. The surgeon gave me a local anesthetic and then began his handy work. Insert an emphasis on handy because I remember his arthritis stricken hands, and yet he moved so quickly. Clearly, decades worth of practice. Not far into the procedure, he grew agitated with me because I was wincing and squirming. “You shouldn’t be feeling that, so, please lay still.” I replied: “I feel what you’re doing. It hurts. A lot.” With a sigh, he decided to humor me and told me to look up at the ceiling. “Do you feel that?” he mumbled through his surgical mask. I nodded, squeezing my eyes shut, sweat forming on my upper lip - I felt like vomiting. “What do you think I’m doing right now?” he asked. “It feels like you’re scraping my knee cap from the inside with a fork or something.” It was like metallic tinks echoed through my bones and into my skull, like he was playing guitar with my knee. Not a tune you want to dance to though. There was no actual physical sound, but whatever it was, it made my gut turn. The sensation stopped and, relieved, I opened my eyes to find the surgeon staring at me through scraggly thick white eyebrows. He was holding up a metal tool that had a hook for a tip. Without another word, he grabbed another syringe and injected it into my knee. I didn’t feel another thing until it was over.

I told my oncologist this very story, as well as my brother’s similar (although a lot more extreme) debacle with his broken leg, and she nodded patiently and promised to make a note of it for my upcoming breast biopsy.

Frozen

While getting in took a while, the moment I saw the oncologist and she had had a look, the urgency stepped up a few notches and from there most tests and appointments followed relatively quickly. It’s hard to describe what this process feels like because there are so many things happening with you at the same time. For me, COVID added an additional interesting flavor for a variety of reasons. The day of the biopsy, I had already gone through multiple other tests. I don’t even know how many doctors, nurses, and students had already stared at my breasts at this point. That in itself is a demeaning experience, now add to that the fact that not a minute goes by where you’re not thinking about cancer and the uncertainty regarding the length and quality of life you may have left. COVID added a cold distance to something that already felt detached. At the worst time in my life where compassion was needed the most, I found myself treated like a leper.

I remember the walk across the parking lot from the Louisville Cancer Center over to the Women’s Breast Health center. 200 meters at the most. Ron was sitting in the van and I waved at him with an “it’s ok” kind of smile as I walked past. He looked sad, guilty, helpless. It was pointless for him to get out because they wouldn’t allow company during the thick of social distancing. I remember soaking up the chilly winter air. It was pressing down on me, helping me stay grounded. I’m usually someone who can’t really function when doctor’s appointments loom because I hate it so much. I have to get the appointment behind me in order to get back to life and do my thing. Somehow, all that changed during this ordeal. Maybe because I already knew what was wrong with me, it was more a matter of finding out how bad it was. Typically, going to the doctor is utterly disappointing and embarrassing for me because no one has ever been able to get to the bottom of my symptoms (pre-cancer). Some doctors send you through endless tests that feel like random stabs in the dark, miles away from what you’ve described, others get downright rude with you, and some will even laugh and mock you. So, eventually you reach a point where you just don’t even want to try anymore and suffer quietly, while wondering “is it all in my head?” I’m very deliberately using the second person here because I know this is not just my experience.

So there’s that, along with having had several traumatizing experiences. The knee was one thing. When a dentist drills out all of your molars that don’t even need it, no anesthesia either, that’s another. That happened when I was eleven. The man drilled all the way into my gums, and at one point, I bit his thumb. I found out over a decade later that he was a crook and lost his license. Yes, I have a dentist phobia to this very day, and we’ll come back to this specific monkey eventually (the dental-impact-monkey, not the “dentist” himself - I reserve other names for him). The point being, I used to try my damndest to get around certain doctor’s appointments or postpone them. But here I was, for some reason not fretting about what was coming. Just marching from one appointment to the next. I was babystepping like Bob. I kept telling myself “just get to the door, just get to the desk, just get on the elevator, just get to the dressing room…” And so it went, all the way until I layed there awkwardly on the examination table, top exposed, waiting for the guy to do the biopsy of my breast and armpit lumps. I had to oddly balance sort of on my side, with my arm over my head. It was growing numb before he even started. In my attempt to avoid looking at the ultrasound screen that would guide the doctor, I focused on a large poster on the wall that bewildered me - a close-up of a cut open pomegranate, juicy red bits splattered across a tablecloth. Not my choice for a doctor's office of this kind, but each to their own I guess. I had given the doctor the short version of my concerns regarding anesthesia to which he responded with a nod while he continued with the prep. He administered the numbing and I closed my eyes and started singing in my head. There’s a hindu song I learned years ago called Gayatri Mantra. It’s beautifully upbeat, almost whimsical. I use it a lot when I need to distract myself. Its meaning revolves around illuminating a heavy heart and bringing joy. Looking back, maybe I should have sung harder. After a few surface test pokes, the doc declared that I was ready and he would now insert the (rather large) hollow needle with the chomping bit at the tip through the side of my breast and then take the tissue sample from the growth in question which was tethered to my nipple. As he inserted the device, I remember being able to tell its location, which was not a good sign to me but I told myself to trust the doc and so went back to my song. I think I was shouting in my head by this point to drown out the doubt and fear. I could swear I was feeling–

…and then SNAP!

I have never in my life felt anything like this. My leg shot out beyond my control and then I froze on the table like grotesquely mangled road kill stiff from head to toe and my arm still above my head, unable to inhale or exhale. It felt like someone had stabbed me through the nipple and then rammed the knife all the way into my spine, igniting fiery waves of electrical signals that swept outward all the way to my fingertips. Over and over. A couple of tears escaped my eyes while I stared at that dumb disemboweled pomegranate on the wall and a clock right next to it. I was desperately trying to speak, but I couldn’t. I couldn’t move a single muscle. The clock’s seconds hand however moved 40 times before I was finally able to respond to the doc who had been nervously calling my name repeatedly. “Yeah, I felt that,” I eventually grunted, body still frozen, trying to remember how to breathe. Now, the doc apologized profusely and applied more anesthetics because we weren’t done yet.

SNAP

I felt that one, too, but the pain was considerably less and faded within a couple of seconds. I gasped for air and composed myself to get it over with. More anesthesia. While I didn’t feel much of the last samples that were taken, the snapping sounds were nerve wrecking, pounding, headache inducing. I was scared shitless at that point but kept on singing in my head. The report later read that I “tolerated the procedure really well.” That’s all. MY report would have read that those were probably the longest 40 seconds of my life.

After that I felt a new degree of sympathy for my brother and his broken leg when he was only 14 years old - a very complicated fracture that required a metal plate and screws along with a skin graft. That experience shaped the rest of his life and I understand now more than ever why. Pain doesn’t really ever fade. It just migrates quietly into the deepest recesses of your brain and settles there, festering. And the people that need to won’t listen.

The point here isn’t to scare anyone away from getting a biopsy done when it’s needed, but rather that pesky monkey that holds its ears shut. That medical industry mentality that persists, insisting the patient doesn’t know their own body and that one’s medical history is not all that relevant, because we’re all the same, right? (Oh, I will get to the one-size-fits-all-monkey!!) Maybe everyone feels this level of pain during a breast biopsy and I’m just a wuss, I don’t know, but either way these things need to be recorded because that’s the only way we can make improvements. When my family moved to South Carolina a year after, my new oncologist suggested a biopsy of the neoplasm that had formed and I shook my head. With a compassionate frown he asked “Why not?” There was a playful undertone that felt like an unspoken line of “What’s the big deal?” I broke into instant tears (which really isn’t typical for me) and explained. And while he listened, none of that made it into the records either. Not that I felt serious pain during a previous biopsy, nor that I was now deathly afraid of another, despite the fact that it could dictate the line of treatment for a deadly disease. General anesthesia didn’t even come up as an option because at that point I was marked as the stubborn whiny problem patient, like so many times before.

(to be continued…)