Relieved

Dr. Lee calls me in the morning with the biopsy result from a week ago.  The second my phone rings, I instinctively know it's her.  My heart sinks. She's supposed to call me at 5 pm--why is she calling so early unless it's urgent?  I begin to analyze her tone, but her hello is so finely balanced that I cannot immediately tell what that voice is about to deliver.  I think I can read from her voice what sort of verdict I am in for.  This of course is total bullshit.  Seasoned doctors like her wouldn't necessarily show it in the ways that patients imagine they can read.  But doctors are people too, and they will find it easier to give good news, surely.  And am I not an expert analyst of any text and context?  I can go on rationalizing and de-rationalizing, as if this endless rumination mattered more than the actual results and what they entail.  It's pitiful but I can't help it.  I get so wired up about these medical conversations; I'll pick apart littlest clues over and over--for any detail that might mean something, any hint that might shorten the suspense.  But it's Dr. Lee that makes everything good by getting to the point without ceremony.  The new lumps proved to be nothing to worry about: they're just hardened fatty tissues, as she had assumed, and they're going to melt away in time.  She called as soon as she got the result because she knew I was anxiously waiting.  So much for my interpretive skills.  Everything depends on the doctor, and thank goodness I have this awsome woman who is kind and considerate in addition to being extremely professional.

It's been almost three weeks since I found these new lumps.  It's a long enough time to spend in fear and uncertainty.  Fear, however, is so exhausting that it is unsustainable, I learned.  Somewhere in the middle of those three weeks, I stopped being actively scared, even though I was still worried and afraid.  Instead, inertia set in.  And it wasn't easy to fight it out.  Even though my anxiety had lessened since seeing Dr. Lee last week, waiting for the biopsy result was still a drag.  You can never be sure, for, as Dr. Lee says, "there are quiet a lot of exceptions."  That off chance weighed me down; despite what I was consciously thinking, my body and my unconscious still lagged behind, and it was getting increasingly difficult to get out of bed.  I'm relieved to be out of the tunnel now.  It's disheartening to imagine how many more of these suspenses I'll have to live through in the future.  But for now, I am happy to be healthy and happy to be enjoying this sense of relief.

As I was waiting for the biopsy result, I kept making a list of things that I would do once I'm off the hook.  There was no reason why I shouldn't have done those things before the result was in, and I know it isn't always healthy to be thinking in those terms.  But when you just can't help asking "what if" and putting your life on hold in face of the very concrete fear of recurrence, perhaps it is better to turn it around and use that logic to reward yourself afterwards.  Now that I'm all good, I will do those things.  Buy a pair of kickass suede boots.  Get new eye glasses.  Update Terry.  Get back in touch with Nawon, who left a message at the office.  Write a thank you note to that nice orthopedic surgeon who helped me with the hip joint stretching for weeks.  Drive to Damyang and see the famous bamboo colonies and metasequois forest.  Go to Tokyo.  Plan that trip to the US.  And go see that hair lady.  I think I will now.

What if

Yesterday I went to see Dr. Lee at the National Cancer Center.  She is the surgeon who operated on me on February 28, 2012.  I saw her only two months ago for the first followup meeting since my surgery, and everything was fine then.  About 2 weeks ago, however, I found two new lumps right next to the surgery scar.  This is the last thing you want, especially if you recently came out of the long hard process of getting rid your body of cancer.  Seriously. The first thing I did was call the NCC to make an appointment, but the earliest I could get was November 5, which meant thirteen days of suspense--thirteen long days that I would spend in the circular torture of uncertainty, fear, hope, and despair.  I had had a few scares about other symptoms since the end of the radiation treatment, which sort of familiarized me with the routine of this torturous waiting.  All those scares ended up being nothing serious.  Yet this was different, surely--two hard round lumps were found again in the remaining breast where malignant tumors had been removed.  Imagine what I could not but imagine.  I saw Dr. Lee the next day at the NCC breast cancer awareness event, and when I told her about the newly found masses, she felt them over the shirt and said that they were probably fat tissues hardening near the surgical scar.  But she still wanted to look at them closely to be safe.  The chance of recurrence at this point was low, but she also said that there were "quite a few exceptions," which was why she didn't want to brush them away.  She told me to come see her on November 5.  She could put me in an earlier spot that day, but could not get me anything before that date.  A few reassuring words from her were better than nothing, but she still wanted an ultrasound and possibly a biopsy as well.  A biopsy again?  From that day my sleep was disrupted: I woke up at all hours and kept having...not exactly horrifying nightmares but ambiguous dreams that left unpleasant aftertaste.

One of the worst parts of having cancer is this fear of recurrence and metastatsis.  The mere idea of going through another round of chemotherapy sickens you, not to mention the overwhelming reality of mortality closing in on you.  You literally startle with every pain, every new symptom and every unfamiliar feeling in the body.  And no one will tell you that you're just being neurotic.  Instead, doctors will say that you can never be too vigilant about anything unusual now and, if anything, they will want to have a closer look.  I sincerely miss the days when I was just another crazy hypochondriac.  The physical comings and goings that these appointments and tests entail are the least difficult part.  Even a regularly scheduled followup test seems like an exceedingly tough hurdle.  You feel small as you realize that you've become ridiculously dependent on the semantics of doctors' facial expressions, tonal changes, and gestures.  Then, whenever you're about to do something, the inevitable question arises: "What if I did this and then got the bad news?"  This question is a definite party-pooper, for nothing much retains its initial significance when measured against it.  It can and will stop you from doing whatever you were going to do.  You find yourself putting everything on hold, suddenly abject in front of the frosty reality of all-encompassing meaninglessness.  Thus your life grinds to a halt, until the results put you in the clear for now.  Even then it feels more like a reprieve than anything else.  So easy to just let yourself go in the way of fear and negativity.

The first few days after discovering the new lumps were slow and difficult.  Just like the days before I learned the result of my first breast biopsy.  I could not think of other things, and I kept feeling those lumps as if to make sure they were still there, just like I did last fall.  But every time I put my fingers there, I also hoped to find them miraculously gone, just like I did last fall.  As stupid and desperate that hope was, the disappointment and despair were fresh each time I learned that they were still there.  Pressed too much and too often, the lumpy area began to hurt and consequently the entire breast and arm ached, as if the mind-blowing agony wasn't enough already.  By this time I forgot how glad I was that she had left my breast almost intact and unscarred.  Why did Dr. Lee not remove the entire breast?  I was tired from all this fear and pain and did not feel like doing anything.  What was the use, when I didn't even know how long I'd live?  Inaction seemed the only logical choice.  Yet I couldn't just sit around fueling dark thoughts.  It wasn't easy to peel myself off the bed in the morning to go swimming, walking, grocery shopping, and so on, but I did.  I went out to talk about their theses with my graduate students, and I went out to dinner with friends.  All these things that I did, however, kept reminding me that I was living in this body which was mortal, already damaged, possibly beyond repair, and definitely beyond my control.  After a few days, though, I stopped fingering the lumps.  Numerous times I had ascertained that they were there, and there was nothing to be done about them until I saw Dr. Lee.  As the days of uncertainty were prolonged, resignation took over, and I thought about the lumps a little less.  Perhaps my mind needed to restore quietude or something similar in some way.  It wasn't optimism.  It was as if my mind was trying to dissociate itself from fear by remembering that fear too was useless after all.  The resilience of human mind probably enables us to cope with the worst in this way.  I couldn't altogether stop asking myself "what if I did this and then got the bad news?" but I didn't let it stop me from doing things.  I even started this blog as if to defy that question.  So, the second week in waiting crawled by and I went to see Dr. Lee yesterday.

After the ultrasound Dr. Lee gave me the same explanation she had already given to me at the NCC event.  She did order a biopsy and arranged it so that I didn't have to make another appointment for it.  Although I had to wait three hours in the hospital because she squeezed me into that day's packed biopsy schedule, I was glad to have it done before the day was over.  The young radiologist who did the ultrasound and took the tissues was matter-of-fact about the frequent hardening of fat tissues adjacent to the surgical scar.  All things considered, it is likely that that's what the new lumps are.  She didn't even seem to think that a biopsy was absolutely necessary.  That's not a bad sign.  Now I wait another few days before Dr. Lee calls me about the biopsy result.  I am not as worried as two weeks ago, but my sleep is still disrupted.  I don't like the fact that the fear of recurrence has this negative effect on my store of joie-de-vivre, which wasn't overbrimming in the first place.  I can no more pretend that it isn't true than I like it, though.  Maybe we in middle age should all be content with semi-joie whenever possible, as Kim says.  Still I don't understand those people who persist with perennial optimism under similar circumstances.  Are they stronger than me?  Is it sheer will, or is it self-deception?  The insidious question "what if" always hovers over my head.  What if, indeed?  I don't know that one could live as if that question didn't matter, or that one should.  On good days I forget to remember it.  Usually it takes an awful lot to plug on, countering that question with "even so!"  Yet I am told to maintain a positive outlook on life, for it helps reduce the chances of recurrence.  I can only smile at the lethal irony.