With the freshly minted diagnosis of a malignant tumor in my right breast, upper right quadrant, I polled the friends who had had surgery for these kind of things. A, B and C were close friends, and E and N were neighborhood aquaintances. All were between ages 40 and 50 at diagnosis, roughly between the years of 1993 and 2003. I decided to go with a female breast surgeon who was affiliated with a progressive women’s health clinic in southern Maine. I would need to drive two hours for my appointments, but thought that I could manage that for a few trips in exchange for what I imagined might be a more sensitive and personalized approach to my care.
My husband and one of my sisters accompanied me to my initial interview. Dr M’s office was at a sprawling building situated near a secondary highway in Scarborough, ME. As we drove into the virtual rabbit warren of parking loops, I read with dread the sign over the main door: Cancer Care Center. Every cell in my body wanted to head the other way. I could not believe that people were walking in and out of there as if it were no big deal. I wrestled with Resistance and an attitude that was deteriorating by the minute. I was drowning in self centeredness. The waiting room was expansive. A member of the nursing staff brought me in to meet Dr M, a relaxed and intelligent looking woman in her 50’s. I remember little about that meeting, beyond the utter ordinariness of it. The mismatch between my extreme anger and fear, and the quiet efficiency of the medical office was profound. I was given a brief physical exam, a date for a lumpectomy with sentinal node biopsy, and a lab slip for extensive blood work. I felt embarrassed by the matter-of-factness of it all, and my continuing disbelief that I was now on a breast surgeon’s schedule for a procedure on the upcoming Tuesday in February.
Tom drove me to the hospital in Portland for an early start at day surgery. What I recall most is the utilitarian nature of the nuclear medicine department, where I was sent for a wire localization procedure upon arrival. This had not been realistically explained to me beforehand.
The hospital basement was old and dark. I waited on a wooden chair set in a hallway, where employees walked rapidly in all directions. A young intern came for me and had me enter a tall ceilinged, narrow room. I was asked to get up on a very narrow table with my chest exposed. Her job was to inject the right breast area with a deep blue dye, to help the surgeon locate the sentinal lymph node. She then had to insert a wire into the tumor itself, to guide the surgical process. OK. She was very quiet, somber and focused. “We are running late here, you don’t need anesthetic, do you?” Since I had no concept of what she was supposed to do, I had no answer for her. She quickly moved on, and I felt searing heat from the dye injection. It seemed to go on and on, as she struggled to get the dye into the correct place. I must have winced, as she quickly said to just hold still, I need to get this exactly right. She stopped to change her instruments, as a cold sweat formed on my face and arms, and quite possibly on hers. I felt nausea and hoped like hell she was almost done. As she worked the locator wire beneath the skin and into the lump, I could tell I was in trouble. “I’m done, you should sit up.” I began to do just that and almost threw up. She glared at me with a frustrated look. I tried to get down from the table and walk, but my knees gave out and I asked to lie back down. She clearly was not on board with this patient’s response, but she said, “Oh, alright, you can rest in here a minute.” I was lead to another alcove with an equally desolate appearance. The gurney felt like a safety zone, as I shivered and sweated and fought off the waves of nausea.
Some minutes after lying down, a slight commotion sounded in the hall, Dr M swept in and glared at me, saying, “Where did you go? We are late! We need to get back to surgery NOW!” She turned and left, as I haltingly sat up and tested my ability to breathe and move. I stood up and crept towards the hallway. No one was around. I had no idea where to go. I knew the surgeon was angry with me but I hadn’t a clue how to comply with her command.
Eventually I was directed back to the surgery suite. Many people were involved at that point, starting an IV in one of my freezing cold hands. It took three people to try to find a good spot for the IV to go, before a doctor was summoned to get the thing placed correctly. Two nurses settled me into the anesthetized state with warm blankets and slow, kind voices. I was unaware of the rest of the procedure, and came to with the same nursing team tucking more blankets around me and checking vitals. Tom and my dear friend, A, welcomed me back and were extremely helpful in transitioning me from city hospital to our rural home, two hours north. I was able to rest and go at my own pace for the next few days, as I adjusted to the soreness and swelling that lingered for the next few weeks. (to be continued)
(next up: post-op, oncology and radiation.)