Month: June 2022

 

At the front of the medical clinic—I call The Mountain–is a revolving door. Most medical centers have revolving doors. It’s an efficient door, if you think about it, allowing high-speed entry and exit in and out of high traffic buildings. There you are on your way to meet a doctor. You step into the circular wedge large enough for one. The thick rubber edges whoosh as the glass dividers suck you in from the street and spit you out into the building’s interior. And voila, you’ve transformed from pedestrian into patient. Inside, you shake your umbrella or stomp the snow off your boots, and approach the attendant sitting at an information booth. You need directions. Information on where to go next.

My spinning through the revolving doors of The Mountain had many beginnings. There was the first spin in January of 2009 when a cyst ruptured in my abdomen and blood appeared in my urine.  I heard the word cancer for the first time–a word my doctors soon dismissed in February after scans and labs. I dismissed the word too. Then the second spin began in March with routine meetings for counseling. This was a real beginning, the public release of six years of marital spinning so disorienting that normal had become abnormal, and abnormal had become the norm. Throughout this time, I co-spun with my mother through the revolving doors at her own cancer clinics.

I spun through revolving doors in boots, then clogs, then sandals; my back covered in wool, then denim, then cotton until my shoulders were bare.

*

At which point, the actual physical spinning began.  I opened my eyes one morning and the world rotated on its axis—the floor, the walls, and the light fixture on the ceiling of my bedroom in my Berkeley Avenue home. I couldn’t sit up for fear I would fall onto that ceiling or through a window.

“I need help!” I screamed to whoever might be home.

My son Ryan appeared beside my bed, looking confused at the sight—his mother gripping the sheets with eyes squeezed, looking as though she might vomit.

“Ask dad to call 911,” I gasped.

It was Father’s Day—June 21, 2009–a day I had no idea how to celebrate given the spinning of my relationship with my husband Mark.

Then there was the ambulance, the stretcher, the bumpy ride through the pot holes, the lights shining in my eyes, the sounds of muffled feet moving across linoleum as my body was delivered to the emergency room; and the thud as attendants rolled my body onto a hospital gurney.  For hours, I lay on that gurney exhausted, nauseous, disoriented, and unable to focus.

And finally, when the doctors said there was nothing else to do, they released me with prescriptions for Valium and motion-sickness medicine, and instructions to see a neurologist.

*

 I soon returned on my own two feet to the revolving doors of The Mountain.  One appointment lead to another and then another and then others. I called the clinic for referrals to specialists, listening to the familiar recording:  “Your care is important to us.  Please stay on the line.”

At long last, a doctor explained that I had lost one third of my balance function.  “Why?”  I asked.  “We don’t know,” he replied.  Of course, the doctors had their theories—perhaps an inner ear virus or a blood clot.   They referred me a Balance Clinic for physical therapy for my brain.  They told me my brain would adjust over the coming months.

I spun again through the revolving door of The Mountain in sandals, then clogs, then boots; my back bare, then covered in cotton, then denim, then wool.   Co-spinning with my mother, marital spinning with my husband, spinning with doctors over unknown diagnoses.  Sucked into the medical machine by glass panes with thick rubber wipers from the street to the interior of The Mountain.   Disoriented, yet asking for directions on where to go next.

 

***

 

Writing Prompt:  Create a list of moments when what was happening in your outer (physical) life matched what was happening in your inner (emotional) life.  For example, perhaps your outer-and inner-lives were both spinning, or being neglected.  Then create a list of words or sentences that describe these outer and inner experiences.  Free write (without censoring yourself) a description of one of those moments when your outer life was reflecting your inner life.

 

Author:  Pamm Smith
Image Source:  Yury and Tanya on AdobeStock

 

Audio Cast:

 

I scheduled an appointment with a genetic counselor in the cancer-treatment clinic attached by tunnels to the “Mountain”—a building that shot up into the sky like the Tetons.  Surely a geneticist would have answers to whether my genes were predisposed to health or illness.  Surely a geneticist could predict my cancer risks from my family’s history.

When the day came, I parked in the familiar ramp on the top floor of the cement garage and walked the six gritty flights down and across the windy street; then pushed through the revolving doors of the Mountain; and descended the escalator to the underground tunnels winding to the cancer treatment clinic.  Inside, the waiting room bustled with patients sporting bald heads and scarves, canes and walkers, IV poles and oxygen tanks. The mean age looked to be well beyond my forty-nine years. More like my mother’s age of seventy-five. I felt out of place—too young, too fit. Surely my genes were too normal to belong here.

Still, I recognized this place as though I were a regular. The same upright chairs upholstered in utility strength fabric lined against the wall. The same coffee machine gurgling and steaming and puffing the aroma of dark roasted beans. The same strategically hung artwork–paintings of poppies hopefully reaching for the sun.

I recognized the people too—adults clutching Styrofoam cups in one hand and cell phones in the other.  Smiling nurse in blue scrubs who periodically emerged through swinging doors.  Nurses calling out names for patients who stood in pressed business attire, and others who rose slowly with sweaty brows and untucked shirts and hair jutting at angles from the back of their heads.

I had accompanied my mother through similar twisting halls to exam rooms where she’d undress and wrap herself in an oversized robe tied with ribbons.  I had seen her sit on crinkly white paper, transformed by the ties and paper and cold air up her slumping back into a patient.  I’d seen the brisk strides of doctors breezing in and out in long white coats with stethoscopes draped around their necks. I’d heard their declarative voices and the uncertain murmurings of my mother.  Everywhere, keyboards clicked and shoes shuffled across linoleum.

I recognized this place, so familiar since my mother’s cancer diagnosis.

But now, I was the patient inside the Mountain. Not my mother, but me.  Waiting for answers.  Looking for certainty.

*

I don’t remember much about my meeting with the genetic counselor. I don’t remember leaving through the revolving doors of the Mountain. I don’t remember the gritty parking garage or bouncing in my insubstantial car through the pot holes along the Mississippi River road.  But when I finally pulled into a parking lot at the bank of the river, the fog cleared.  The maples that lined the shore came into focus.  All I could think about was a sliver of conversation.  I couldn’t shake her voice.  I couldn’t shake my own.

Has your mother had cancer? the doctor asks.

Yes, breast and ovarian, I say.

And your father?

Umm, yes. Kidney.

And your grandparents?

Yes, my mother’s mother had breast and ovarian cancer.

So both your mother, and maternal grandmother, had breast and ovarian cancers?

That’s right.

Has anyone in your family been tested for the BRCA gene?

My mother tested negative.

In my memory, I see the doctor’s head pop up and eyebrows rise; I hear her voice quicken as if breathless.  I feel her energy animate with the excitement of a researcher finding an unusual subject–an outlier in the tails of the normal distribution. A person with a repeating family cancer history but without the BRCA gene. An anomaly.

So what’s my risk? I hear myself ask.

You must have a gene we haven’t yet discovered.  Your risk is higher.  But we don’t know how much.

You don’t know?

We don’t know.

The fluttering of the maple leaves came back into focus with the words “we don’t know” ringing in my ears.  The Mississippi River raged behind the line of trees with the faster-than-usual current from heavy rains.  I closed my eyes and bowed my head onto the car steering wheel and thought the strangest thought:

I wish I had that gene. At least then I’d know my risk.

*

In the coming weeks, I routinely sat in my car under the maples by the Mississippi River—ignition off and my son Ryan sleeping in his booster seat.  My mind had become a squirrel running up and down trees; jumping sideways to an adjacent fence; eating the small bites of food left by strangers.  I re-played the voices of doctors as they had talked to my mother, then me, then the two of us together.  In my mind’s eye, I studied their voices and body language for clues.  Patterns.  Inconsistencies.  Certainty.  Uncertainty.  My thoughts jumped from tree to tree with visions of conflicting words and body language.

Jump.  You’re healing well from surgery, a nurse tells my mother.  But she looks sicker than I’ve ever seen her before.  Jump.  The blood in your urine may be caused by cancer, a doctor says to me.  But he sits tall and relaxed as he scrolls through the test results on his computer screen.  Jump.  This is a routine CT scan, a technician says to me.  But he insists on pumping dye into my body that will light up tumors as I lie on a tray in a whirling CT machine.  Jump.  We have other medications we can try, a doctors says to my mother.  But she looks to be having trouble sitting upright in her chair.  Jump. I see no reason for concern, a doctor says to me.  But I want to see you again in one month.

From though to thought, concerned eyes look at my mother. Concerned eyes look at me.  Words and body language bump against each other in conflict.

A flash of lightening streaked across the sky, bringing the maples outside my car back into focus. I held my breath and counted—one, two, three—before the clap of thunder roared.   A deep vibration rose up from the earth through the car’s floor. Then the clap of a terrifying thought:  What would happen to Ryan if I had cancer? 

Ryan startled—crying and panicked.

“Everything is okay,” I said.  I had gotten good at lying.

I switched on the ignition and pulled out onto the winding river road towards my Berkeley Avenue home.

I would come back to this park by the Mississippi the next day, and then the next day, and then the next.

I knew that for certain.

***

Writing prompt:  Create a list of moments when you felt uncertain.  Then create a list of actions you took to gain certainty.  For example, was there a place that you went to think?  Were there conversations that you sought out to learn more about a situation?  Free write (without censoring yourself) a description of one of those actions or places.

 

Author:  Pamm Smith
Image Source:  National Cancer Institute on UpSplash

 

Audio Cast: