August 22, 2012

August 22, 2012
Wednesday
Long, strange day.  A meeting with my producer and his latest intern at Soho House in the morning.  Both are upbeat and encouraging, but no one has magic solutions. I’m anxious and peeved that notes are arriving few and late, and I can’t entirely hide it.  I blame it on the increased load at work as the semester begins, on the assignments that will be due for the class I’m taking, but of course my real unrest is rooted in more than extra paperwork at my day job.
I stay on, alone after the meeting and order lunch, which feels like a last meal, before Paul picks me up for the doctor’s appointment.
Dr. M— gives a solid presentation, first apologizing for drama over email and phone, then cutting to the chase “You were right that the news was less than stellar. You have endometrial cancer.” 
She hands me the report.  I raise an eyebrow when I see it was generated 7/2512. 
You can tell Dr. M– has done this before.  She moves quickly into the “what happens next” part of the scenario.  I will need to see a gynecological-oncologist.  There are five of them at this medical institution. Any would be fine, but she’s talked to one, Dr. Y— who is willing to take the case.  My next steps in any case are to get a CAT scan.  I ask to have a PET as well.  As I understand it, A CAT scan is like an x-ray, and shows the shapes of things. A PET shows the metabolic activity of cells.  Dr. M— says she’ll ask.
“Do you have any other questions?”
I know I’ll be mad at myself later if I let her off the hook. “We should probably talk about why I’m getting this report a month after it was generated.”
Her expression changes to one I believe is genuine distress.  I know part of it must be the fear of being sued, or having me kick up a big fuss, but she also seems sincere when she says, “There was a breakdown in our system, and we’re both upset about that.”  She says, “I can tell you your cancer didn’t spread in that single month delay.”  And I nod, though I know no such thing and I know no one else does either, just as no one knows whether my cancer spread in the month I waited for an appointment to begin with.  I know this is the line that the medical practitioners stick with, right before they say “but now that we do know it’s essential to act as quickly as possible.”  Amazingly, this is not the first time I’ve had cancer diagnosed in the wake of what might be considered a questionable standard of practice. But because it’s not the first time, I know it’s counter-productive to waste time or anger on such things, so I don’t.
We ask other questions.  What does “clear cell” mean.  What does it mean that certain cells are “rare?” Dr. M—can’t say much about the type of cancer etcetera, the gynecological oncologist will be able to help me with this.  I don’t know if it’s true that she doesn’t know, or if she is like a mammogram technician who can see your cancer but tells you that only your doctor can properly interpret the results.

I don’t cry until the doctor leaves the room to get something.  I cross the room to get a tissue and take one from the box.  “You can just bring the box,” offers Paul.  I think, take a second tissue, but leave the box behind when I return to my chair—some bizarre point of pride.  I’m crying, but I’m only using TWO tissues.
After the appointment we drive to the Valley.  Did I say Paul was sending his movie to the Festival Director? Not the case.  Two days later, there is still some issue with “compression.”  After eighteen hours, the power in our house went out for all of thirty seconds—but that thirty seconds was apparently enough to put him back at zero.  Our friend C—works at a place with faster-processing computers, and we are driving north on faith that she can let us use one of them.
We kill time by having dinner with friends. I don’t know them well.  We decide not to mention cancer over Japanese food.  No need to cast a pall.  C—  calls.  She’s not at work tonight, but she has a friend who can let us in.
Paul lets the computers do there work and chats with  C’s friends.  I nod and smile, occasionally laugh, but I am working on my script.  Instead of jumping over to face book, I get distracted googling medical terms. According to Wikipedia, “clear cell” is a rare kind of endometrial cancer, comprising only 6% of endometrial cancers.  According Wikipedia, it is also “aggressive” with poorer outcome predictions than its counterparts.  Great.  I’ve already made an appointment with the Gyn-Onc for the Wednesday after Labor Day, but the word “aggressive” spooks me. I know I’ll call in the morning and change that to the earliest available this week.

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