My dermatologist’s office is on the fifth floor, take a right off the elevator, and it’s the last door at the end of the hall. A very long hall. This was the second time I had walked that long, quiet hall. The first time had been two weeks earlier, at my initial appointment with this derm.
Now, here I was, pulling open the door and stepping into a waiting room that was not quite empty of people, but full of holiday cheer. The receptionist looked up, smiled, and greeted me by name. That was encouraging.
As I grabbed a magazine and sat down in the chair closest to the door leading to the exam rooms, I avoided eye contact with anyone else and willed my heart to just shut up as I closed my eyes and remembered the last conversation I’d had with my derm.
He used words you can never take back, and they had to do with cancer.
I was so new to the world of being a patient that it didn’t strike me as strange that the doctor called me with biopsy results. Of course, now I know they call only when the news is bad, and the nurses call when it’s good.
Towards the end of that appointment for suspected rosacea, I pointed out something on the back of my arm that I had never noticed, but had been itchy that morning. It looked weird – not quite a bite, but not quite a mole. He hmm’d over the spot, said he was pretty sure it was nothing, but it looked just off enough that he thought a biopsy was warranted.
“So it looks like that spot on the back of your arm is a malignant melanoma,” he said in that phone call.
Malignant?? Even though I have a fairly good grasp on medical jargon, in that second, I thought he meant “metastatic.” At that point I sat down on the bumper of my car and stared at all the stuff piled in my mom’s driveway that needed to be neatly rearranged in her garage.
“We probably got most of it with the initial shave biopsy, but I’d like you to come in so we can do a punch biopsy. How about Friday at 2:30?”
You mean there’s more than one kind of skin biopsy? Probably got most of it? Most of what? Friday? Friday? That’s the day after tomorrow. Why so urgent?
Wait. You mean you schedule your own appointments? Now I know that that only happens when he’s dealing with malignant melanoma. He pulls up the schedule on his computer and makes it happen. At the time I thought it was really cool that he didn’t have to transfer me to the front desk, and joked about it. Squirrel. Distraction. Let’s talk about something other than malignant melanoma, okay?
My Darling Derm then went on to briefly explain the depth of the lesion and what our next steps were. He was reassuring, upbeat even. I’m thinking “depth?” “lesion?”
It was still awkward. Hello person I’ve only met once – you have a life-threatening disease.
Meanwhile, Back at the Office
Now I tried to breathe as deeply as I could without drawing the attention of the two other patients in the waiting room. I opened my eyes and took in all the holiday decorations. Obviously this office was a happy one – I could hear laughter among the busyness in the back. It’s a two-doc place, my derm and his wife, and the small waiting room was somehow a reassurance that I would not just be “the melanoma in exam room A.”
The Christmas carols that played softly were not annoying, but soothing in their familiarity, and after a few minutes I was actually reading the magazine I had picked up. I heard my name called and the young woman with my file smiled, held the door open for me and showed which exam room to go into. I remembered her name – Diane – and she patted my arm as I walked past her into the exam room with the large, movable lamp attached to the ceiling.
Diane confirmed my history. I complimented her on her hair cut. She was eager to make me comfortable, and I was just as eager to demonstrate that I was not nervous.
Darling Derm came in, sat down and went over what he had told me on Wednesday. He explained why a second biopsy was required – the first one did not get “clear margins,” and this one would go a bit deeper into the dermis, hopefully removing the remaining cancer cells. He told me about the depth of the lesion, and that we weren’t clear on how deep the cancer really went since, well, no clear margins.
Punch biopsies are aptly named as they do feel like someone has given you a robust punch. Darling Derm gave me some more details about what we were looking at while he cleaned the wound. Most of his words rushed past me like the rain blowing around outside. I tried to soak up the words, but they streamed past me.
How I wish he had given me some direction. A hand-written note that included the terms he was using. The best websites to visit for information. Some kind of hand-out. A follow-up phone call.
Most patients who receive a cancer diagnosis report sinking into a fog that prevents them from hearing what their doctor says. That’s why we head to Dr. Google.
My brain cleared as he told me his office would contact a melanoma surgical oncologist at a local university hospital. “He’s the best,” I was reassured. The word “oncologist” did not reassure me.
So I fell back on my default anxiety technique and cracked a few (truly lame) jokes. All us new best friends laughed.
Diane gave me the business card for the oncologist, and told me to call in about an hour, to give her time to contact the correct people at the university. All my paper work and lab results would be faxed over and received when I called to schedule an appointment. Of course paperwork would be involved.
A Reality Bite at Trader Joe’s
I left the office, walked back down that hall, rode down alone in the elevator, found my car, drove out of the parking structure and headed to Trader Joe’s in the rain. A week’s worth of groceries were waiting for me there, as were a bottle or two of wine that had my name on them.
As I pushed my cart through the Friday afternoon shoppers, pretending that my life was as normal as theirs, and this rainy day was just like any other, my brain snapped and I stopped pushing my cart in the produce section and pulled it close so as not to bother anyone looking for broccoli slaw.
The noises were the same as always. The elderly people from the nearby retirement community expressed their apologies when they bumped their cart into someone. Two bells rang – a sign that help was needed at the check-out. A child was whining, done with shopping, and wanting to go home. A cheerful employee walked past me, chatting to a customer looking for the petite green beans. So many people blathering away on their cell phones.
I could see nothing out of the ordinary. The old people who reminded me of my mother. The baskets of holiday holly and pine sprigs. Piles of pears and apples and sweet potatoes. A display of holiday temptations, perfect for gift-giving.
But it was not the same as always. It was not ordinary. I had cancer. Couldn’t these people tell?
And, that’s when I snapped out of it. That’s when I woke up. Or, maybe God was snapping his fingers in front of my face.
Who was I to decide that all these people weren’t pretending their lives were as normal as mine?
All these people – the employees, the old people hanging on to their carts, the whiny kid’s mom, the harried folks on their cell phones – had Issues. Indeed, some of these people probably had major health issues. Others might be having problems with a boss. Some might be dealing with teenagers run amok. Inlaws arriving for a stay. A dying parent. A sibling lost to addiction. A son in Iraq.
Everyone has a story.
We are all bound together by the fact that we all have Issues that we deal with even as we grocery shop. While we live the lives that have been delivered to us.
We’re not pretending our way through the mundane parts of our lives. We’re taking solace in the fact that we are still participating.
What choice do we have?
And so, my groceries fly through check-out while a perky clerk talks with me about weekend plans. Her boyfriend has just started a new job, and she’s nervous about how he’s doing. I show her the bottle of Proseco I’ve picked up for Christmas dinner. “Bring home one of these,” I tell her. “Make it a celebration even if he had a bad first day. Celebrate the change.” She looked at me blankly for a moment and then her whole face smiled. “Celebrate the change! I like that!” Fist bump.
No Crises Here
I roll my cart out to the car, thankful the rain has turned into just a drizzle, and load the groceries in the trunk. I get in, but don’t put the key in the ignition. Closing the front door instantly muffles the sounds from outside.
Has it been an hour since I talked to Diane? Close enough.
And, before I pull out the cell phone to make an appointment with a freakin’ oncologist because I have cancer, I notice the street lights come on. A deep breath brings with it the insight that there’s still traffic on the freeway, there are still bills to be paid, and small children still wonder about Santa Claus.
The planet is still spinning. Perhaps it spins because of all the energy given off by all the Issues all people have dealt with every day, every year, every century, every eon.
It’s the Issues that let us know we’re still here.
I may be the only person in that parking lot with malignant melanoma. But I’m not the only one dealing with a story. We all just deal with as much grace as we’re capable of.
The life motto I came up with a few years earlier bounces into my consciousness. “No crises. Only adventures.” I look at the number on the business card and dial.