2014년 1월 29일 수요일

Call It Intuition or Denial

The semi-annual followup scans that I have to go through since my surgery is a veritable ordeal in my otherwise painless life.  I am duly aware of the fact that my usually eventless and relatively comfortable life leaves me not much to complain about.  I humbly accept the fact, and I am mostly content too.  I also know that the successful treatment and surgery outcome is something to be grateful for.  I am profoundly grateful, indeed. Yet there is no denying that the regularly scheduled scans are no small bumps.

A whole-day affair it is.  After drawing blood for all kinds of tests, it is a succession of mammogram, breast ultrasound, CT-scan, and bone scan.  The bone scan requires three to four hours of waiting, as the injection needs to diffuse throughout all the bones in the body, so on top of all the small waits here and there between this and that at the hospital, there is also this interminable wait before the whole thing is over.  One could go home or out somewhere but I object to leaving the hospital because I know how much I would dislike coming back.  It's fortunate that whiling away hours in one spot with a book in hand is no problem for me.  So this interval is spent for lunch, reading, and some scrabble on my iPad.  It is a long day at the hospital: today I left home at 8:20 am and came home after 3:30 pm.

The fear of recurrence has become a constant companion in my life by now.  Good days are ordinarily the days when this companion makes itself scarce.  This, however, is the day when this fear takes the center stage; and it will claim my attention full on for a week.  The week between this day and the day when I go see the oncologist for the results is a strange borderland where this fear magnifies the fact that my life straddles the fantastic yet so very threatening dividing line between possibility and reality.

Le supplice du jour: the ultrasound is the biggest of all the ordeals.  As the radiologist slowly and steadily moves the cold, lubricated handle over the skin, you can feel every inch of your breast being seen through.  Any little pause and click that the radiologist makes with her machine seems to indicate something wrong.  Any typing that is being done into the machine might mean some noteworthy abnormality.  During the ten to fifteen minutes of this ultrasound scanning, you simply tighten up into a ridiculous mass of sheer vulnerability.  It is a maddening quarter of an hour where you experience your body not as a house of your life but as a dangerous host of antagonistic possibilities. This is the overwhelming moment you comprehend the simple yet elusive fact that the body is a heap of stuff over which you have no control.

The radiologist who ran the ultrasound on me today was a young male doctor who didn't say much.  There were some pauses and clicks, and of course all kinds of foreboding crowded my mind.  After he muttered "all done" and disappeared, I made a terrible mistake of looking at the monitor he left on.  In the complicated layout of data and pictures and what not on the screen, I saw my name, the date, and a few words that I well recognized.  Oh shit, is that another finding in my right breast?  It's like a lightening inside my head.  But it's hard to say what those words were for, as I could not clearly make out the rest of the screen.  Did he find something new today, or does it refer to the originary pathology for my regular scanning?

As I get out of the ultrasound room and get dressed, I am unable to focus.  It takes a few minutes to regroup.  Mechanically moving on to the CT-scan room, it occurs to me that the radiologist would hardly be able to specify whatever findings that he might have seen today as "malignant."  It is likely that those words I saw refer to my original diagnosis, since I was there for those scans as the patient with that diagnosis.  I reluctantly but cautiously feel my right breast and there is no distinct mass that I can discern.  Once again I tell myself that the radiologist could not have typed those words in.  There is no lump that I can feel.  Even if there was, he could not have determined the nature of whatever lump so precisely right then and there without a biopsy.  I carefully retrace the entire course of the examination.  He did not type much while examining the right breast.  I keep telling myself these things over and over like a mantra.  The more I think of it, the more I am convinced that it was my original diagnosis that probably has become my label.  Call it intuition or denial, it is good for now.  I should go with it, at least until I see my oncologist next week, although I am also carefully harboring that other possibility in one corner of my mind.  Yes, it is possible that he found something new today and wrote it down; I cannot rule that out.  I also know that something entirely different and unexpected may catch me by surprise, while I pore over what I saw on his computer screen.  As I sat in the waiting area in the CT-scan room, however, the fear gradually subsided even in my entangled mind.  Whatever it might be, if anything, there is nothing I can do but accept and deal with it.  For the rest of the day, I was able to put the fear aside.  For the rest of the day, I reminded myself of the resolution I had made to myself some time ago: I'll keep doing what I do for all the days I live, be they short or long.  In the hospital coffee shop, Martha Nussbaum's Poetic Justice keeps me good company.

As I live in constant fear, I realize over and over that fear is not sustainable, long term.  Our mind is clever enough to manipulate itself out of this dreadful state of fear.  It will desperately come up with some way to wriggle out out of it.  It will think of something, some reason that would nullify it or counterbalance it, even though the fear never disappears completely.  Coloring my life as a constant flirtation with the sublime is one way of doing it.  Braving the naked fact that my death would ultimately cause only very little disturbance to the world is another.  Honestly, though, it is not necessarily death itself that I fear most.  It is beyond fearful for sure, the absolute finality of it; but I mainly understand it to be the return to the state before my birth, and seen that way extinction doesn't seem so horrible.  It is the slow yet certain, incapacitating and painful, course of dying occasioned by difficult illnesses that I fear most.  Any one and every one will share this fear.  The difference is that my first-hand experience of cancer treatment lets this fear have a stronger and more real grip on me.  Picking things apart like this and becoming more aware of the nature of my own fear, however, doesn't help much.  Who could control her fate and choose the mode of her death?  Living with this shadow of death, this helplessness, this ultimate lack of choice, must be the essence of life; facing mortality is the burden of living itself that any conscious person should bear.  It is just that this burden is so very vividly felt in my daily life.  Perhaps I should be proud that I am living the essence of life, right in the very thick of it.  So there.  I repeat to myself: I'll keep doing what I do for all the days I live, be they short or long.  It is simple self-hypnosis, yet a surprisingly soothing therapy.  To keep doing what I do for all the days I live may not amount to much, but it certainly would be the best I could do and not the easiest, either.  Being able to go through with it would be something, at least to me, and finding out that I could would be a priceless solace.

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