Dog Lived (and So Will I) (19 page)

The time between diagnosis and surgery is a stressful time, and I understand that many folks need sedation in order to stay still in the MRI tube, so it was easy to see why getting volunteers might be difficult. But where others needed sedation, I merely needed a good idea—the blog—and I was set for an hour of confinement well spent inside my own head. I’m more frightened of those three-day cancer walks than I am an opportunity for a noble nap, so I agreed to participate in the study. Since Chris and I had already decided to stay the night at a hotel near the medical center the night before my surgery, the research scientists agreed to do the MRS that night as well.

We headed into Los Angeles on a cool, windy January day with our suitcase packed for two days, a bottle of wine (for Dr. Karam), and reservations at the Angeleno Hotel, a high-rise, iconic round building with views of the city and the Getty Center, about a mile from UCLA. Shortly after we checked into the hotel and made our way to our room, Michelle emailed me a photo of flowers that had been sent to the office by clients. Later she emailed a photo of her and my paralegal wearing pink ribbon bracelets in solidarity and wishing me luck. Chris and I sat on the balcony enjoying the view for a few moments before the wind sent us back inside.

The MRS was scheduled for 8:00 p.m. The building we had been directed to was empty when we arrived. We cautiously made our way down deserted hallways until we were met by another young, white lab-coat-wearing doctor who introduced himself as Scott and thanked me repeatedly for agreeing to participate in the study. After explaining the study again and having me sign paperwork, I was once again dressed in a hospital gown, lying on my stomach in a magnetic resonance tube. The noise the machine made was quieter and I didn’t have a blog to be creating in my head, but otherwise the procedure seemed similar to what I’d undergone before.

Dr. Good Karma even appeared again in person to follow my treatment and, as he said, see what the scientists were studying. I only knew this when he spoke to me through the intercom of the machine and woke me from my nap.

“How are you doing in there?” he said.

Even waking from sleep to a voice with no body present, I recognized his distinct accent and happy cadence.

“Well, I’m good so far. Thanks.”

“We’re out here discussing wine and France.”

I knew these to be two of his and Chris’s favorite subjects. “Well, just don’t forget me in here. And speaking of wine, am I allowed to have any tonight? As long as it’s before midnight?”

“One glass. But make it a good one.”

He was gone before I was removed from the tube, but it was nice to know he’d stopped by to answer the really important medical questions.

Doctor’s orders: Chris and I had a delicious meal of poached egg on frissee salad with lardons and croutons, steak with gorgonzola butter, and truffle fries at West, the restaurant on top of the hotel. I savored a glass of Chateauneuf du Pape. Calories consumed the night before cancer surgery cannot possibly count.

At five in the morning I was wide awake, but it wasn’t because of the food.

We dutifully reported in to the surgery center at seven in the morning. So did about 163 other people. And apparently it was half-off-surgery-for-children day because they were lined up out the door. And crying. Children cry when confronted with surgery. I cry when confronted with 7:00 a.m. and no Starbucks. It was not a pretty or quiet scene. Again, I thought, the surgery center could learn from Seamus’s veterinary surgery center. Since Seamus received green dog bones by the handful each and every time we went to the Veterinary Cancer Group clinic, he associated that drive and that building with nothing more than adoring fans and nearly unlimited cookies. He raced into the building, tail high and wagging. Perhaps the human surgery centers should hand out something equally distracting. Seamus had his green bones; I could do with a little green Starbucks cup. I’d be more willing to submit to medical procedures.

After they took everybody else back to surgery one by one and the family members dispersed, Chris and I were still huddled in the corner. When the clock ticked past 7:30 and then past 7:40, I approached the woman at the desk.

“Hi. I’m supposed to be in nuclear medicine at 7:30.”

“That’s not here.”

“Okay, well, I was told to report here.”

“For what?”

Wow. Okay. “So someone can take me to nuclear medicine before my surgery. I’m not entirely sure.”

“Well, me either. I’m new here.” She placed her palms flat on the desk and pushed herself upright. “Hang on. Let me go find someone who knows something.”

This seemed like a wise idea.

Had I known what was ahead of me, however, I would have thanked her for the delay. A few minutes later she returned with an apologetic and fast-moving nurse, who insisted I sit in a wheelchair while she rushed me down to nuclear medicine through a series of long hallways and service elevators with Chris rushing behind me.

Nuclear medicine, we discovered, is in the basement of the medical center. And it’s a scary, cold place. Cold in temperature and demeanor. They hand out blankets in the waiting room, but we didn’t know this initially. The nurse checked me in with reception, told me I could take a seat (she needed the wheelchair back), and then was gone.

In the waiting room with us was a swarthy-looking man in his early forties, unshaved and wearing a leather jacket and boots, and next to him was a woman who looked like “Mom”—just not his mom. Mom like Mrs. Cunningham or June Cleaver or any of those moms who did not have swarthy-looking sons. They took Swarthy back into the treatment rooms, and five minutes later a tech came out and said to Mom, “Mrs. Jones? Your son-in-law would like you to be with him for the procedure.” Mom smiled sweetly (and knowingly) and followed the tech.

The fact that Swarthy needed support in the arctic nuclear zone scared me further. Also, I was hoping his procedure had nothing to do with his prostate.

Soon a large and tall man in an official-looking lab coat entered. I didn’t catch his name, or if I did, I blocked it out. We’ll call him Lurch.

The receptionist said to Lurch something to the effect of, “We have a such-and-such brain serious major procedure today.”

Lurch responded, “Really? I haven’t done one of those in twenty years.”

These are not comforting words in a medical center. Please, do not let me find out my brain is in my right breast.

Lurch went into the exam area but returned in only a few minutes.

“Ms. Rhyne?”

I stood up. “Yes?”

“Come with me.” Lurch turned and headed back from where he’d come, not bothering to wait for me.

I turned to Chris. “And you come with me.” If he had not been available, I would have made Swarthy’s mother-in-law come with me, too. Lurch was not a man one wants to follow into the bowels of nuclear medicine.

I caught up to Lurch in the hallway, and he said, still walking, “So you understand why you’re here and what we’re doing?”

I knew I was in nuclear medicine to get what Dr. Good Karma had described as the “shot of a tiny bit of radioactive material” that would later help him find my sentinel node as he snooped around in my underarm, but still, there was quite a bit of blind trust involved in these procedures. I wasn’t too different from Seamus naively following a cookie right on into surgery. I mumbled, “Um, yeah, kinda…I just know it’s painless.”

And Lurch laughed at me.

He let out a big “Ha!” that echoed down the hallway.

I stopped following him. Just stopped. I stood staring at his back, slack-jawed and immobile.

He turned back to face me. “Oh, come on. It’s four injections to your breast. It’s going to hurt. There’s going to be pain.”

I don’t know how I got the rest of the way down the hall into the treatment room. There isn’t supposed to be pain. Dr. Karam said no pain. Had I been carrying my cell phone I’m certain I would have texted Dr. Karam right there: “U said no pain. Lurch says pain. Come quick.”

In the treatment room I was relieved to find that Lurch the Ass was not the doctor. Lurch is not even a doctor. The doctor was a young woman (of course she was young) and far, far kinder. Lurch is just some masochist who’s spent too much time in the nuclear zone where his empathy froze off.

Following Dr. Karam’s original text about this procedure, I did a little reading. I did understand a bit about what was going to happen, and a part of me (the part of me that stayed back at the Angeleno and was sipping coffee and resting comfortably) found it rather fascinating. Dr. Karam had given me a book written by his colleague, Dr. Chang. I followed along as I encountered each phase of my treatment.

“Doctors use the radioactive tracer as follows: They inject it in and around the cancerous area (or under the nipple) at the time of the initial cancer surgery. …In the operating room using a portable Geiger counter known as a gamma probe, the surgical team identifies the first draining node and removes it following the removal of the primary cancer. The pathologist then analyzes the node using a technique called frozen sectioning. He freezes the node by using liquid nitrogen and then cuts the tissue into thin slices and views them under the microscope. If he sees no cancer, no further surgery is performed.”

I had four injections around the cancerous area. Unlike Seamus and his tender rear end, I thought that perhaps where my tumor was located was somewhat fortunate, if one has to have cancer in the first place. Three out of four of the injections weren’t really much. But the one closest to the nipple…yeah, um…ow. Not painful in the way Lurch had seemed to hope, and certainly tolerable, but…ouch. The pain was enough to make me bite my lip but not draw blood.

Did I mention that Lurch is an ass?

Chris and I had two hours to kill while the radioactive material found its way through my breast before I was to return to nuclear medicine for “pictures.” We chose not to hang out shivering in nuclear medicine. Instead we sat in a sunny window reading. We laughed when we realized I was reading David Sedaris’s
When
You
Are
Engulfed
in
Flames
and Chris was reading
Then
We
Came
to
the
End
by Joshua Ferris. Perhaps we should have thought about our selections ahead of time.

With the hotel, dinner the night before, and the little sunny reading nook where we sat giggling at our respective readings, I could almost pretend we were on a mini-vacation. If we could just ignore the nuclear side excursion and the part where Dr. Karam was about to remove a divot from my breast. And cancer. We’d probably need to ignore cancer for a truly restful vacation.

When we returned to nuclear medicine, the place was no less frightening. There was an old guy asleep (or so I told myself) on a gurney in the hallway. His contorted bones were thinly covered with wrinkled, dry skin, and his mouth hung open. On the bright side, that eliminated any possible feeling bad for myself I could have mustered.

The “pictures” turned out to be not as simple as I thought, given that everyone so adoringly referred to them as “pictures.” I was envisioning a quick little x-ray and I’m outta there. Not so fast. I was told to lie down on a rather ordinary-looking medical exam table, but then a panel came down on top of me (they asked again, “Are you at all claustrophobic?”). Two “pictures” that take five minutes each are necessary. The tech kindly pointed out on the screen what they were doing. So I turned my head to see the screen, pretending I knew what I was looking at.

Of course, this being nuclear medicine, everyone left the room while the pictures were taken. As I waited out the five minutes, I noticed there were actually three screens. The one he pointed to, a much bigger one in the middle, and then one in my periphery vision that I could barely see. But the big one in the middle, while difficult to see, was terrifying. It had a lot of red, some yellow, some pink, and a big ol’ scary-looking jagged-edged black spot in the middle.

Wow.

I’d seen lots of scary pictures of my cancer by that time, but that one was the worst. Probably because of the red everywhere, and it was obviously extremely close up since they were looking for a little tiny lymph node, but it freaked me out. I kept trying to figure out where this famous lymph node was on the screen amid all that pulsating blood. I also wondered if cancer really was black or that was just how it was depicted on the screen. Finally I decided I just couldn’t look at that picture anymore, and I went back to the perfectly harmless-looking black-and-white screen he had told me to look at. It had a nice little countdown clock on it, too, and that helped calm me. It wouldn’t be too much longer before Dr. Karam removed that frightening, pulsating, jagged, black mass from my body.

The tech returned. “Good job. We found the node. I’m just going to mark it on you.” He drew on my underarm with a Sharpie to pinpoint the node for the surgeon, which seemed very low-tech for a procedure that started out with a radioactive injection.

“You’re all done now. You can sit up.”

I sat up and immediately looked to the large, terrifying screen, ready to ask just how bad it all was. And there in front of me was the threatening computer screen…with a beautiful red, yellow, and pink sunset and the black silhouette of a palm tree sticking up in the middle of it. The words “Polynesian Spa Music” were displayed across the top.

When they insisted on wheeling me back to the surgery floor in a wheelchair, I couldn’t argue. After all, I’d been seeing cancer in the sunsets.

• • •

I remember only this much from surgery: the anesthesia nurse was Steve, and he was very kind and good at what he does. The other anesthesia nurse (apparently there to supervise Steve) was an attractive woman with a really cute, colorful surgical hat—until I noticed it was images of coffee and had
latte
,
cappuccino
, and other such words all over it, which was just cruel to me in my then state. She was justifiably concerned I might rip it off her head when the anesthesia kicked in and I lost the last two inhibitions I had left.

Chris held my hand as the anesthesiologist injected me and as I counted down, “Ten, nine, eight…” That was all it took.

And the infamous blue dye shot straight to the nipple? True to Dr. Good Karma’s word, his skillful hands kept the pain away. Although he assured me that I felt it because I “tried to help”—which is to say I tried to knock it away. Also true to Dr. Karam’s words, I urinated turquoise blue for several days.

There was, however, one promise Dr. Good Karma did not keep. He was not at my bedside with a Starbucks short, double, nonfat latte when I awoke from the surgery in my anesthesia fog. This is how I learned he had other patients. (The nerve!)

When Chris and I returned to the hotel that evening, I thought I was doing pretty well, but I was tired. I needed to lie down. I took off my light pink hoodie jacket and headed for the bed. Chris gasped.

“Baby, don’t lie down yet.”

“Why? I need to. I need to sleep,” I said, leaning wistfully toward the mattress.

“Well, you’re bleeding. A lot.”

I looked down at my breast, fully expecting it to be squirting blood from the nipple. Thus, I was relieved to see that it was only a five-inch circle of dark red blood that had seeped through the gauze, the bandage, my shirt, and the formerly cute hoodie jacket at right breast ten o’clock, across to my underarm.

Chris reached Dr. Karam on his cell phone while I grabbed a towel and lay down on the bed to sleep. That or I passed out. I really can’t deal with blood.

When I awoke, it was after 8:00 p.m. and Dr. Karam was standing at my bedside.

I looked around the room. The lavender and gray furnishings and mid-century look told me I was still in the hotel room. “This brings a whole new meaning to house calls, doctor.”

“It does! And this is a nice house you’ve got.” He knelt down beside me. “I didn’t want Chris to wake you, and I was finishing up my rounds anyway. I’m sorry I didn’t get to see you after the surgery. I had another surgery, and it got more complicated. But for you, everything went very well. I’m very happy.”

He changed my bandages while telling me that preliminary reports indicated no lymph node involvement and he believed he got the tumor. He was hopeful we’d have clean margins, “just like Seamus.” He handed Chris a bag of supplies for future bandage changes and informed me that I bleed a lot. I would discover this again and again as I went through treatments, but at that point, snuggled warm in bed, bandages freshly changed, assurances that surgery went well, and the world’s greatest boyfriend and Dr. Good Karma nearby discussing wine again (we’d now had the chance to give Dr. Karam the thank-you bottle of Pinot Noir), further treatment was far from my mind.