Months into Ruth's treatment for breast cancer, after she had completed her chemotherapy, she needed a break. So did I. We cobbled together our airline miles and made plans for a short break in the Caribbean.
One long flight and then a change to a 10-seater and up in the air again. The small plane was hot and Ruth took off her Courtney Love travel wig. Her hair had started faintly coming back — as our friend Steven put it, the blond shoots of her re-emergence. Signs of life.
The little island's runway suddenly came into view as we cleared the saddle between two hills and started to dive bomb. It looked like the pilot would either hit the tarmac or plunge into the ocean. I clutched the armrests and blurted out, "I think we're going to die." Ruth responded as she gazed out her window at the blue sea, "Wouldn't that be ironic?" We hit hard, the plane rattled, and we came to a safe stop.
When we got back from our vacation, our next appointment was with radiation oncology. It was supposed to be routine, no surprises. We'd be in and out of the doctor's office in an hour, her radiation treatment would get scheduled, and then I'd take her out to dinner.
Radiation treatment is the most passive part of cancer treatment. For a few weeks you show up every day for your dose, which takes a few minutes, and then you go home. And at least at Memorial Sloan-Kettering Cancer Center, where Ruth was being treated and I am a doctor, the whole process runs like the Swiss railroad, precisely on time.
After a few minutes, we were put into an exam room and in came the medical resident — a trainee only a few years out of medical school. Polite and personable, he looked like he was going to get us efficiently through this part of the process.
A few questions, a quick exam, a visit from the attending doctor, and we'd be gone. We sat there well rested, ready for the next and final phase. I was even a little tan.
"Now, I just want to review your history with you,'' the young doctor began. "Last fall you felt a lump. And then in October … Dr. Cody felt it … Later the biopsy showed … and the surgery … and the pathology showed … and then chemo … And they first gave you …"
Ruth stopped him. "You don't have to go through this all," she said. "It's all in the record."
He nodded. Then he went right back to reciting her history. The dates, the events, all in a list, one by one.
When he said "October 1st," I saw my friend and colleague, Dr. Chip Cody, touching my wife's breast and heard him deliver the news. When he said "surgery," I remembered Ruth waking up from anesthesia. "Feels like I just got off the overnight to London," she had mumbled. A groggy dehydrated disorientation. Then she threw up.
By the time the young doctor was done, maybe three minutes had elapsed, and he had rattled off every white knuckle spin of the roulette wheel. The lymph node assessment, the bone scan to determine if the cancer had spread beyond the reach of the surgeon, the heart tests as part of her clinical trial, the inspection for whether the tumor was fueled by estrogen and progesterone hormones, and the tests to see if it would respond to the drug Herceptin.
Every single test and finding affected what treatment Ruth would get and what our chances were for the future. The minutes, the hours, the days, the weeks, the months that had passed since that sunny Wednesday morning when the suspicious lump was diagnosed as cancer.
The resident didn't realize how absurd and unfeeling it was to distill the hardest year of our lives into such a condensed narrative, which to me amounted to saying, "Well Odysseus got on the boat, stopped a few places and then reunited with his wife."
He was oblivious to the agony he was causing us as he perfunctorily rattled off the events, even though he had doubtless gone through the same routine many times with many other patients.
Over the years, with my white coat on, so have I, and I have never thought about the effect it might have when I do it. Recounting a patient's history: it's just something that we doctors do. Part of our routine.
But at that moment, in that small office with no windows, about 500 feet away from where I am doctor not husband, I realized how badly I had misjudged what the year would be like, and how poorly prepared I was for it.
When we first fully understood Ruth's diagnosis, I had instinctively pulled out a calendar, just as I had when we found out Ruth was pregnant. I counted the days and weeks, and the breaks in between, factored in a few delays, and concluded" "Seven months. Next summer this will all be over."
My plan was to just hold my breath until then. Just seven months.
It had seemed to work at first. Ruth and I had tackled cancer like a to-do list, ticking off each item and moving to the next step. But we didn't realize how the grind of symptoms and fears and steps of treatments would slow time's passing, or how each step, although we finished it, would never be quite tucked away.
It was only after listening to the doctor's rote description of her diagnosis and treatment that I realized how wrong my approach had been. If I kept holding my breath through this long hard year, I would end up like Shelley Winters after her long underwater swim in "The Poseidon Adventure." Present, but quite dead.
Because the truth is, I couldn't hold my breath and wait for cancer to be over. Each step couldn't be left behind as it was conquered. We couldn't go through treatment and then back to our life because the cancer and the treatment was and always would be our life.
It was a hard landing.
Dr. Peter B. Bach writes about his wife's breast cancer diagnosis and treatment.
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