The radiation waiting room could be a dentist's office. No one looks up as I walk in. A man is rattling a newspaper as he turns the pages. He folds it down and gives it a smack. I like hearing such common, ordinary sounds in this extraordinary place. I eavesdrop on two men talking about golf although I don't know anything about the game. An old man sits with a severe dignity. A fat woman in tight pants is working the perennial jigsaw puzzle on the coffee table. (When gradually, with each visit, absent hands have slowly turned it into a finished pastoral scene, another boxed puzzle silently emerges in a thousand pieces.) A young blond woman is drinking the rank coffee from a Styrofoam cup. I am sitting next to her. She says hi. I say hi. How are you doing? I expect her to say fine (we all do) but she tells me about her nausea and fatigue with wet eyes. I nod. I don't know what to say. Anyway, what is there to say? Still, the room is just a room. There is the bitter coffee, the water cooler and paper cups, a seascape on the wall, the jigsaw puzzle. A TV drones on, as annoying and ignored as those posted in airports. Some days there is candy. No life and death drama here. Except for the young blond woman everyone is waiting calmly, cheerfully, even. Is it because of (so far) outwitting the inevitable? F***ing the fickle finger of fate? It's enough to make you cheerful. Who knows what other powers you possess? Healthy people don't know anything. You belong to an exclusive club that no one wants to get into.
We are marked with distinction. We are secretly arrogant and narcissistic. We think we are interesting.
I Google cancer hospitals and doctors and learn that the best place to be operated on for breast cancer is the MD Anderson Cancer Center in Houston, Texas.
I call for an appointment. The woman who answers the phone sounds like a normal scheduler, but she is really a powerful, career-dedicated, unmovable gatekeeper who won't let you in and doesn't care if you live or die. I call again and again, but she is determined to keep everyone who has cancer out of the coveted MD Anderson Cancer Center. I beg, I plead, but she barricades the gate and tells me it will be at least six weeks. If then. Her voice is firm, pleasant, ruthless.
As I hold the telephone to my ear, I imagine cancer cells rampaging from my left breast throughout my body. Breast cancer is a disease of direction; it has a mind to travel: the bones, colon, brain, liver, kidneys, larynx, throat, lungs, are all coveted destinations. Although it is at home and comfortable living in your breast it knows the way to the lymph nodes where it can wander to and kill you, giving a whole new meaning to time and space. As I frantically work the telephone trying to get admitted to MD Anderson, the space is the space in my body, the time is how much is left.
Silently waiting for its moment, cancer crosses borders, ethnicities, languages and cultures, gripping every heart with the same terror: a Sunni in Iraq, a Communist in Cuba, a Republican in Texas, a bag lady in San Francisco, a movie star in Hollywood. A high school cheerleader. Cancer is democratic, egalitarian; everyone is eligible, no one immune. Some 216,000 women in the United States will be diagnosed with breast cancer every year because cancer is there and so is your breast and like it or not you're in the game of cancer roulette.
I live in the hometown of Lance Armstrong, the bicycle-racing athlete. As the entire world knows, he has not only beaten his bike-riding competitors again and again, but also "beaten" the odds against his deadliest opponent, cancer. And among the cheering crowds, I wonder if people with cancer, like myself, were also made to feel as diminished as the losers of the bicycle race. Cancer is not a sport, with winners and losers. It is a disease.
Before Oprah and Dr. Phil and Jerry Springer and the rest, before support groups and tell-all memoirs, if you had cancer it was kept as secret by your family as a madwoman in the attic. The words "cancer" and "mastectomy" were never uttered, as if the sounds themselves were as dangerous as the disease.
My father was murdered in a bootlegging turf war with the mafia. Although it wasn't cancer that killed him, my family felt the same secrecy, disgrace, and guilt. Like cancer, it was the death that had no name. Like cancer, my mother never acknowledged my father's death. Not once. Not in her entire life. He was our cancer.
Gathering your health information and getting organized before your appointment are the key steps to ensuring a productive meeting with your doctor. This is especially important if you're seeing multiple doctors or are meeting with a new physician for the first time.
Make sure the doctor you're seeing has copies of your latest X-ray, MRI or any other test or lab results, including reports from other doctors that you've seen. In most cases, you'll need to do the legwork yourself, which may only require a phone call to your previous doctor's administrative staff, asking for it to be sent, or you may need to go pick it up and bring it to the new office yourself.
Make a list of all the medications you're taking (prescription drugs, over-the-counter medications, vitamins, minerals and herbal supplements) along with the dosages, and take it with you to your appointment. Or, just gather up all your pill bottles in a bag and bring them with you.
Your doctor also needs to know about any previous hospitalizations, as well as any current or past medical problems, even if they are not the reason you are going to the doctor this time. Genetics matter too, so having your family's health history can be helpful. The U.S. Surgeon General offers a free web-based tool called "My Family Health Portrait" that can help you put one together.
Make a written list of the top three or four issues you want to discuss with your doctor. Since most appointments last between 10 and 15 minutes, this can help you stay on track and ensure you address your most pressing concerns first. If you're in for a diagnostic visit, you should prepare a detailed description of your symptoms.
The best advice when you meet with your doctor is to speak up. Don't wait to be asked. Be direct, honest and as specific as possible when recounting your symptoms or expressing your concerns. Many patients are reluctant or embarrassed to talk about their symptoms, which makes the doctor's job a lot harder to do. It's also a good idea to bring along a family member or friend to your appointment. They can help you ask questions, listen to what the doctor is telling you and give you support.
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