Expendable Organ

Blog

I'm writing this on June 1, 2006.  By the time I realized I should be blogging, a lot of good stuff had already happened.  So everything before June 1 is recounted with a bit of hindsight; from here on, it will be more ignorant, more truly bloggish.

Examination

Greg is my nurse.  Greg isn't gay, and he doesn't care enough about me to be charmed or not charmed by my winning good humor.  He's a corn-fed redhead, who idly jabs and re-jabs the needle in my hand, looking for a vein.  I'm in an emergency room in suburban Chicago, having flown in from SFO a few hours earlier.  I'm in town because my stomach has been hurting for a couple of months, and I want my mom to take care of me, and my friend the GI doc (Dr. L) can do an endoscopy much sooner than the fancy folks at Stanford Hospital.  But by the time I arrive, I'm a slow puddle, and a family friend and physician (Dr. G) tells me to go to the emergency room, so she can order up some tests and rule out any bad stuff.

The evening's main event is the CT scan.  A CT scan is a slow sled ride through a doughnut, which sounds pretty fantastic, except for the "IV dye," which the hilariously butch CT tech with the short sleeves and deep voice tells me might make me feel "flushed."  She also tells me that it might make my heart do strange things.  Given that I have an occasional arrythmia, this makes me nervous, and I tell her so.  She leans over my hospital-gowned, prostrate, tied-down body and says, with gnomic meaningfulness,  "We're just going to get through this test."  I decide that this is comforting.

She leaves the room to get away from the radiation, and to man the sled controls.  She slides me in, has me hold my breath, and slides me out.  A few of these, and I'm doing pretty well.  Then she says the dye is going in.  I thought it had already gone in, and that I was manfully impervious to its effects.

It doesn't make me feel "flushed."  It makes me feel, as an experienced friend put it, like my body is turning into molten copper.  And my heart starts to flip-flop.  I freak out, in a somewhat less than manly way.  "Ma'am, ma'am, I need to get out."  I try to sit up so I can fidget my insides enough to make my heart calm down.  Sitting up in the tube is dispreferred.  She's mad at me.  She tells me to calm down, and not to move.  It turns out that the rest of "get through this test" wasn't "together, babe" but "no matter what, bitch."

I'm wheeled back to my room.  I have a new nurse, an even bigger, but very friendly non-gay guy.  When I ask for stuff he can't give me, he says things like, "No, there's no love for you, man."  He also says, "I hear you got a little anxious."  "No, I totally freaked out."

A couple of hours later, all the results are in.  Blood tests are normal, CT scan is normal.  It's 3:15am, and I go home.

Lull

My endoscopy went well.  The endoscopy went well.  I showed up at Dr. L's office and played petulant child and wouldn't let anyone stick a needle in me until my friend showed up.  I realize now that I just misunderstood "start your IV," and thought they were going to shoot me full of drugs, but really they just wanted the needles in place.  Whatever!  I want my friend-doctor!

Now that, by most measures, I'm fully an adult, there's a new "Had he and I but met" quality to visits to the doctor.  A few of these people--nurses, secretaries, even some of the residents--are younger than I am, and they seem like real people to me, and I to them.  This is nice in some ways: we can chat, they can be charmed, I have some idea how to communicate with them.  But in other ways, it only makes the fact that I'm far from my best self when my stomach hurts and I have needles sticking out of me all the more acute.

In any case, this was the camera-tube-down-the-throat test and my stomach is nicely pink and ulcer free--they showed me the pictures.  Maybe there's a bit of inflammation--mild gastritis--which would explain my symptoms.  Taking an antacid for a couple of months should fix me right up, and in fact, since they pumped me full of antacid at the hospital, I was feeling pretty damn good.

Shadow

Today I'm a big fan of big pharma.  I've been doubled over in pain for a couple of months, and just a pill or two a day promises to make me all better and let me get back to normal life.  This is why it's important not to give destitute Africans affordable medication.  Woot!

Dr. G calls to follow up the ER visit.  Stomach looks normal.  Hooray!  The pancreas, which is what she was worried about, also looks fine.  Hooray!  But the CT scan shows a "shadow" on my left kidney.  Umm....  We should do an MRI to make sure that it's nothing to worry about.  Ok....  Renal cysts are very common, so I shouldn't worry.  Alright....  And if it is something, they'll just take out the kidney and lots of people lead normal lives with just one kidney.  Uh....

This is the first of what will be several "And by the way, POW!" moments where normal life, or what's come to pass for normal life, gets spun around dizzy.  It's also the beginning of "my poor mother."  She'd been married for about five years when her husband, my father, got cancer and died.  Then seven years ago, she probably saved her own life by finding a lump that turned out to be cancer.  She's a worrywart by nature, and hearing that her son has a suspicious growth in his kidney isn't news she takes particularly well.

Waiting

Dr. G made some calls and pulled some strings to get me a next-day 8pm MRI appointment.   The CT scan was a good ride spoiled, but the MRI machine is an instrument of torture masquerading as medical equipment.  You're unlikely to encounter anything else in normal life as claustrophobia-inducing as being strapped down and slid into a tube that's a few inches away from your face.  And when the machine is taking an image, there's an "Is this really necessary?" loud banging sound.  You, of course, are wearing headphones so that you can be told by the techs when to hold your breath, and that you're "doing great."

Actually, the MRI didn't bother me at all.  I'm not claustrophobic, I'm used to holding my breath from swimming, and I was so damn tired that I was happy to lay down for a while.

Then I went home and went into suspended animation.  Even when everyone tells you that it's quite unlikely that you have anything in your body worth worrying about--like...CANCER!...a word that no one would use, even though we were all thinking it--waiting for results is like carrying around a big planet.  Jupiter, maybe.  You feel real, physical pressure pushing you into the ground, and your thoughts can get away for brief little flights of fancy before--slurp slurp gravity--they're sucked back down into portentous waiting.  I must have played a few hundred games of Tetris that weekend.  Reading was too hard, television wasn't sufficiently distracting.  I just wanted to leave my mind alone, and let it get on with the tricky of business of hoping and preparing.

Diagnosis

Cancer?!

I so should have known.  Dr. G was playing me, and I didn't even realize until later.  I had the MRI on Friday, and on Monday they still didn't have the results.  I called, I called again.  They hadn't even looked at the results.  Same on Tuesday.  We were decrying the callousness of the medical establishment.  Don't they know I'm waiting to find out if I need to have my kidney removed?  Can't they bother to look?

Dr. G called me on Tuesday and said that the best thing to do was to go to the hospital together and raise a little hell.  I wondered why she didn't just go over there herself, raise hell, and report back.  But I met her bright and early on Wednesday morning, and we marched into the radiologist's office, where the radiologist seemed to be, well, expecting us.  A wisp of a flicker of suspicion blew through my mind, but the radiologist had such a fancy monitor, and those were my insides on the screen, so I looked. 

And by the way, POW!

Of course, Dr. G had known, and hadn't wanted to tell me over the phone; wanted me to see and understand for myself.  She also knows my mother, and knew that we'd need a plan for telling her.  Most people don't understand, until they see it for themselves, what Old World freaking out is like.  I'll spare my mom, and withhold the details, but it involves making a not-very-Midwestern spectacle of oneself.  I told her, and relatives were called in for reinforcements, and by early evening, we'd all come around to the view of the linked post: manageable, could have been worse, pretty damn lucky, in its way.

Destiny

A few weeks before I came to Chicago, I was at my doctor's office in California, getting my annual physical and a referral for my stomach trouble.  By way of asking him to examine me double-good, I said, "I'm about the same age my dad was when he died of cancer, so I'm kind of paranoid about getting cancer this year."  Father's kind of cancer?  Lung.  Smoker?  Yes.  It didn't exactly light the examining fire under my doctor, but then again, how is he supposed to respond?

But I have always expected to get cancer this year.  A friend said that I seemed relieved when they told me about the kidney cancer, because I'd finally gotten it, and it was so manageable.  At least when our deepest fears are realized, we can get on with dealing with them.  So, just a few hours after the initial "do you mind if I sit down?" of the diagnosis, I felt good.  Not only had I been proved fucking right, but I'd gotten off easy.

Foul

Aren't there any cancer rules?  Here's one I would have thought would be near the top: you can't tell a guy he has cancer twice in one day.

We'd calmed down my mother, noted my luck in the tumor being found, and were on to making a plan to find the best kidney surgeon in Chicago.  The phone rang, and it was my friend, Dr. L, who said he was outside my mom's place, but didn't want to come in.  I figured he was in a hurry, and met him outside.

"You have got to have another endoscopy."
"I'm tired, Dr. L.  Is it really so urgent?"
"The pathologist thinks he sees some suspicious cells in the tissue samples we took."
"Suspicious?  Cancer suspicious?"

And by the way, POW!

I think I actually fell back against the wall.  I knew enough about stomach cancer to be scared.  It wasn't any fun for Dr. L either, since we've known each other for almost twenty years.  He told me we'd found it about as early as medically possible, and that the prognosis was much better than a typical case of gastric cancer.  That helped.  Then it was back inside, where I wasn't going to speak a word of it to anyone; not until we had confirmation.

Death

I had another endoscopy the next day, and began what would be a week of waiting--for the results, and then for a double-check from the University of Chicago.

Being diagnosed with two cancers, one of which takes you to some unhappy places on the internet, can't help but bring you around to thinking about death.  You imagine your funeral, wonder who'll care, who might be devastated, where you want to be buried, how they'll get into your apartment, whether you left it a mess, whether there's anything embarrassing on your computer, who you might want to get in touch with, how much you'll waste away before you die, whether it's time to move to Oregon and off yourself early, how quickly you can train a replacement at work, and about your poor, poor mother.

And I found, not to my complete surprise, that though I'm afraid of plenty of things--going blind, losing mental clarity--I'm not particularly afraid to die.  The thing about expecting to get cancer is that you have to more or less make your peace with death.  No one lives forever, the light goes out, and then you're dead, and don't care anymore.  That's what I thought, anyway.

Deception

Cancer turned me into a massive liar.  There was the developing public narrative of great good luck and the commonness of kidney removal, and there was my secret knowledge that the kidney was the least of my problems.

Americans are reluctant to call or write, because they don't want to be a bother.  Iranians call constantly, because they don't want you to feel alone.  As one friend said, they're both right.  But in this case, when people called it was all, "Yes yes, of course you're right, this kidney business will be just fine.  Yes, I'm feeling great.  Quite lucky.  Oh, your aunt has just one kidney?  Terrific!"

And I could see my mother slowly reconciling herself to the kidney problem, sleeping a bit more, eating a bit more, and I kept thinking about having to break news to her all over again.