Dog Lived (and So Will I) (16 page)

We pulled into the UCLA Medical Center on the same campus where Chris and I had met many years earlier in a writing class. The Medical Center is a sprawling, gleaming white compound with three high-rise towers, one low-rise administrative building, and underground parking that could house a city, which must be why they charge eleven dollars per car, even if you’re only there for an hour.

“You know another thing that’s like finding treatment for Seamus?” I said.

“Driving to LA?” Chris said.

“Well, yes, but also the ‘shit, this is going to cost a fortune’ feeling.” I pointed to the cars parked in the “reserved for doctors” spaces—Mercedes, Mercedes, BMW, Jaguar, Mercedes, BMW, Porsche.

“It’s West LA. Those cars are required. And leased.”

We went to Tower 200 and walked down a gleaming, sunlit hallway with large, bright artwork. The sign outside Suite 240 said “Gynecology & Obstetrics,” which stopped me for a moment until I recalled Dr. Karam’s dual specialty.

Obviously, it stopped Chris, too. “I’m not going to lie. That sign is freaking me out,” he said.

“Really? More than cancer?”

“Good point…I think.”

I signed in, and we took our seats. There were seven women and one man waiting with us. I found myself wondering, were all these people cancer patients? Did everyone have a sad story, like the dogs I couldn’t look at in that other waiting room? But no, that wouldn’t necessarily be the case here. I wasn’t yet a diagnosed cancer patient, and I suspected the whining, loudly complaining young woman with the sheepish man at her side was probably there because she was newly pregnant. I don’t think cancer patients are really all that pissed off at having to wait twenty minutes. We’ve got bigger things to be pissed off about.

I was called back to the exam room almost immediately. Chris followed.

“You know Dr. Karam is a man, right? This isn’t going to be as much fun for you,” I said.

“I have different reasons for being here this time.”

The staff was friendly and efficient, and in no time at all I was dressed in the customary paper towel with sleeves, and Chris and I were alone in the exam room waiting for the doctor. I held the films I’d picked up from Riverside and all of the various medical records I’d gathered from the imaging center, the other surgeon, and the radiologist. We didn’t have to wait long.

Dr. Karam bounced into the room, smiling and energetic. He was average height but thin, with a head of wild dark curls, the requisite white lab coat, trendy glasses, and clogs. And he was young. Really, really young. Still, he exuded confidence and intelligence. I liked him instantly.

“You look too well to be a patient,” he said while shaking my hand.

I refrained from saying, “You look too young to be a doctor.” I was twenty-three when I graduated from law school, and I had hated it when people told me I was too young to be a lawyer.

“I hope so. I don’t really want to be a patient.”

“That’s true. No one really does.” He smiled warmly.

I introduced Chris, and the three of us chatted and discussed why we were there and the difficulty we’d had getting an appointment in our hometown.

“I’m sorry you had trouble. That’s a long time to wait when you get news like this,” Dr. Karam said. “Let’s see what we have.”

I handed him my files and films, and he studied them carefully, finally looking up and saying, “May I examine?” Which is a nice way of saying “show me your breasts” without also throwing Mardi Gras beads.

This would mark the fifth exam of my right breast (not counting Chris’s exam) in the last month. I could find the lump in under a second by now, but if you were new at it, there was a little searching involved. Dr. Karam found the lump easily though and said simply, “I see.”

“I was kind of hoping you wouldn’t.”

“You can get dressed. I’ll be back in a moment, and we’ll talk.” He left carrying the records.

Chris and I looked at each other. “That was fast,” he said.

“He seems so young,” I said.

“He does. But he seems to know what he’s doing.”

I was glad Chris liked him, too. “He does. I like him. Where is his accent from?” I had unending faith that Chris could, because he usually did, identify (and subsequently impersonate) just about any accent.

“Well, by the name, I’d say he’s from the Middle East, but there’s a western European accent as well. Interesting.”

Dr. Karam was back in about five minutes, looking and sounding more serious. “If you can wait here, I’d like to go downstairs and see if I can get you in for a biopsy this afternoon.”

“This afternoon? Today?”

“Yes. Is that possible?”

“Well, yes. We’re here. It’s just an afternoon procedure and I can drive back home and go to work tomorrow?”

“Yes, most people can. It shouldn’t be a problem.”

“This sounds serious.” Of course, I knew it was, but I also knew these were my last few moments of pushing this away. Sitting in bed, safely at home with a beagle between us, and saying “It’s cancer” to Chris was suddenly very different from sitting in a doctor’s office waiting for him to say “It’s cancer.” The diagnosis is more serious when the person saying it is in a lab coat than it is when he’s wearing pajamas.

“Let me show you,” Dr. Karam said.

We followed him to another small room where my films were placed on a light board—the July mammogram that didn’t show a thing, next to the December mammogram with a white mass. He pointed to the mass.

“This is what we are concerned with. As you can see, it wasn’t there before. This is something we don’t like. I would like to have it biopsied right away, and we can also schedule an MRI. If you don’t need the MRI, we can cancel it, but if you do, we’ll be ready to go.”

“If I do? Meaning, if I have cancer?”

“Yes.”

“And I take it you think it is cancer?”

He leaned his head to the right and focused on me. His voice was kind. “It walks like a duck and talks like a duck…We’re going to treat it like a duck right now.”

At the time, I wasn’t able to laugh at the thought of a duck in my breast. I didn’t make the “duck breast” jokes until later. “Biopsy it is,” I said.

We waited in his office while he went downstairs. In twenty minutes, he arranged a biopsy while Chris and I discussed rearranging our dinner plans.

Dr. Karam returned, looking dejected. “I’m sorry, but they can’t do it this afternoon. It’s too late already. I’ve scheduled it for tomorrow morning. Nine a.m. Is that all right?”

I couldn’t imagine saying no. “Yes. That’s fine. We’ll just have to leave at 5:00 a.m. to be here on time, but it’s not like I’m going to sleep tonight.”

After a few minutes of discussion, Chris and I decided we’d meet his friends and go out to dinner after all. Why not socialize while we still can? And always, there was the traffic concern.

Thus a few short hours after I’d been told the lump in my breast walked and talked like a cancer duck, I was in an Italian café in Brentwood meeting Chris’s friend Ashley for the first time, along with his longtime friend Emily and her date that evening, whom neither Chris or I had ever met (and would never see again). I briefly wondered if I was allowed to drink wine before a biopsy and then ordered some anyway.

Dinner went on surprisingly normally with introductions and discussions of how the holidays had been until someone asked what we were doing in LA.

Oh, that. Right.

They were all in their early thirties and, I assumed, would be pretty unfamiliar with breast cancer. I suddenly felt very middle-aged as I explained how we’d spent our afternoon.

“Oh my god! And you’re just calmly here having dinner with us,” Emily said.

“Well, yes. You’ve all been a nice distraction, and it beats sitting on the freeway, right? Sorry to be a downer though. I’m sure that’s not what you guys want to be hearing from a virtual stranger.”

“My mom had breast cancer. I know all about it. I went to her appointments with her, so I know a surprising amount about breast cancer. Just let me know how I can help. Call me anytime,” Ashley said, becoming the first of a long list of people offering help.

“Oh, I’m sorry to hear that. How is your mom doing now?” I said. Chris pushed his thigh against mine under the table.

“She died a year ago. I know you don’t need to hear that right now. Sounds like you caught this early. You’ll be fine. If you need any referrals, though, let me know. My mom had great doctors.”

Shit. She died. From the very thing I likely had. I struggled for a response. What does one say? How does one make all this go away, just for one more evening? I was new at this. There was so much to learn.

“I’m sorry for your loss. And thank you for offering to help. I will keep that in mind if I need it. But for now, let’s just forget I said anything and enjoy a nice evening ignoring cancer, shall we?”

The clinking of wineglasses was a nice transition and muffled the exhales of relief.

We were home by eleven, and although we went straight to bed, I couldn’t sleep. I tossed and turned, wondering if I should be telling my family, worrying about the possibility of chemotherapy, a mastectomy, hair loss, nausea…a variety of possibilities, all horrible. I tried to stay focused on the biopsy—the thing immediately in front of me. That much didn’t sound bad. Dr. Karam had described the procedure. I’d lie still for about thirty to forty minutes while they insert a needle into my breast tumor area. They use a tool that he described as a little “Pac Man” that extracts three to five chunks out of the tumor. And it’s over. I’d have bruising and maybe some pain, but not much. And when it was over, I’d finally have some answers. I took a deep breath and curled myself up against Chris, spooning around him. I finally fell asleep just a couple of hours before my alarm clock rang.

I had no funny little beagle howling in my face and ushering me downstairs to give him breakfast. Seamus was at Ruff House, where it looked like he’d have to stay another night unless we were able to get back from the biopsy by six that evening. I hoped we would. I knew I’d feel better if Seamus were home with us.

Despite leaving the house at six, Chris and I got stuck in morning traffic. We arrived by 9:15 but as it takes a good fifteen minutes to get parked and get to the building, we were a full half hour late by the time we checked in at the imaging center.

“Teresa Rhyne,” I said as I signed the check-in sheet.

“Your birthdate?”

“February 17, 1963.”

“What month?”

“February.”

“This says March.”

I wasn’t really sure what to do about that. I was nervous—you know, breast cancer biopsy and all—but I was still pretty sure I knew my own birthday. I’d had a few of them by then.

“Okay, well, it must be wrong.” I showed her my driver’s license.

“We’ll get it fixed. Have a seat.”

When I was called back to the procedure room, I had to go alone. No visitors were allowed in the surgery room. I kissed Chris good-bye, and he squeezed my hand. We probably looked like a Renaissance painting of a couple parting, their fingertips slipping apart as they look longingly back at each other. Or we did in my head anyway. I’d come to rely on Chris’s cajoling me out of my pessimism and distracting me from the seriousness of what I was undergoing. I didn’t want to be alone, but I was.

I was of course given a hospital gown to change into, but I only had to strip from the waist up. This was mildly comforting to me. No real medical procedure is performed on a patient still wearing jeans.

Once again someone in scrubs read from the computer screen and got my birthdate wrong.

“I’ll get that fixed right away,” she promised.

I smiled and made a mental note to continue to say my birthdate as “February 17 but your computer thinks it’s March.” I also noted that UCLA’s computer system was not nearly as effective as the felt-tip marking of “SHAY-MUS” on his chart. I had visions of not being allowed surgery since my driver’s license did not say March 17.

As I moved from place to place—gown change, blood pressure check, weight, temperature, another waiting room—the feeling that I was, in fact, a cancer patient increased. There was a woman who seemed to be one step ahead of me in each of the procedures. She was visibly shaken, distraught even. I wondered if she already knew her diagnosis, but I didn’t talk to her. There seemed to be an unwritten “do not speak” rule followed even by the medical personnel. The only words spoken were instructions on what to do when. Move here. Wear this. Wait here. Sign this.

Finally it was time for the ultrasound, and I was led to a small room with a lot of complicated, computerized machinery. The radiologist was a resident who introduced herself as Dr. Koo. She too looked fifteen years old. Did UCLA only hire new graduates? Is there a special recruitment for child prodigies? After two years do they make them move on, citing their loss of youthful appearance? This was west Los Angeles, after all.

In the middle of the ultrasound of my “right breast ten o’clock,” Dr. Karam poked his head into the room to confirm the MRI he’d scheduled. If it turned out not to be cancer, we could cancel the MRI, he reminded me.

“You seem to only be talking about this being cancer, so I’m guessing we won’t be canceling that MRI. I assume you know already that it’s cancer.” I continued to push for a diagnosis—I needed something definitive. And I suppose I was still hoping the duck was actually a chicken or a goose or something not-duck.

“I’m 95 percent certain it’s cancer,” Dr. Karam said.

Dr. Koo exhaled. Clearly she also could tell it was cancer but couldn’t say anything. When Dr. Karam left, Dr. Koo launched into a “survival rates are really high when you catch it this early” spiel. I was alarmed to hear this. Survival?? What does that have to do with anything? I’ve just got this little cancer thing; we’ll deal with it and move on. No dramatics, please. Dr. Koo did not know that Seamus had already taught me what she was trying to tell me. She did not know that I did not hear “death” when the word
cancer
was spoken.

Then Dr. Koo said something even more absurd. She smiled shyly. “Your doctor seems really young.” This, coming from Little Dr. Cindy Koo—who looked no more than twenty-two—still makes me laugh.