Oncologist Says, "Don't Have a Cow, Man!"

I should be used to this by now, but I'm just not. I freaked. K freaked. My parents freaked. B was quiet (13 year old boys can be unreadable). Ginny the dog knew we were freaked but not why, so she just looked sad and licked us. Katie the cat was unimpressed.

But, the morning after we got the new Droopy and Pokey's pathology report, the ever valiant K got right to work. Lickety-split, she got me an appointment with the recommended oncologist at F'in' Famous Cancer Hospital (Dr. B*) for two days later (today).

In the morning, we had to rush to make the train for the Big Fruit. For once, it was K's fault. (Alright, I was only 30 seconds ahead of her, but I have to celebrate when something like this happens.)

When we got the station, we couldn't find a parking space. With time running out, I ran into the station alone. I promptly got on the wrong platform. If I had gotten on that train, I would have been headed north, which wouldn't have helped anything. Luckily, K found a space fast enough that she was able to save me from my own cluelessness, and she yanked me onto the other platform, leaping over the rails in a single bound (not really, but I know she would have if she had to).

Once on the train, I tried to catch up on sleep, but there was a big-mouthed troll yelling and slobbering into his cell phone for the whole trip. Quiet car next time!

At one point, as we pulled out of the station in a desolate Connecticut town, the train stopped. The conductor announced that a freight train had derailed in the Bronx, and we would have to wait while they cleared the tracks. Internet search revealed that the accident had released thousands of wild Pokemons that had been bound for New Haven. K produced a bloodcurdling roar of frustration. (OK, not really on the Pokemon part.) We contemplated taking the train back north and driving, but we wouldn't get to the appointment on time. Somehow, though, Amtrak figured out a work-around, and we were moving again after not too long.

We arrived in the Big Fruit an hour and a half later than planned. However, K had, wisely, made sure that we had plenty of time to get across town for my 4:15 appointment even if we were late. However, she had left so much time that she let me persuade her to walk to there from the station. That's 7 avenue blocks and 31 street blocks. I really wanted to look at the brand new 432 Park Street Tower.** It's taller than the Empire State Building.

I don't think I'll do that again. The building is a priapistic monstrosity.** On top of that, as we progressed, it grew late. We tried to hail a cab. Not realistic. As I should have remembered from my time living there, the taxis all change shifts between 4 and 5, and a lot of them don't want to pick anyone up after 3:30. So we ran the rest of the way, making it to the registration desk at 4:16. By that time, the oncologist had already left the station with her other passengers. . .  No. Actually. No. I'm thinking about trains. We got there and waited.

We didn't see the doctor until 5:32. (Actually quite a bit longer than my patients had to wait yesterday, but no big deal. And, to be fair, they did vitals, and her nurse came in and asked a lot of questions first.)

Anyhoo, in walks Dr. B. She cut to the chase. "Look, man," she said, "don't have a cow. Yeah, the pathology looks ugly, but let's face it. You're ugly. Especially on the inside. Don't take that the wrong way. I just mean that you've had more radiation to your head than anyone I've ever seen. You're a human Fukushima. Dude, no one knows what to make of that funky junk sitting behind your nose. Yeah, yeah, I know. It could be a squamous cell apocalypse, but those move really fast. If this were a big squamous cell carcinoma, I would expect that it would have gotten through to your cranial nerves by now, which would be truly gnarly. They said it looks like squamous cell carcinoma, but there are a lot of other things that can look like that. Basal cell carcinomas, adenomas, bubbanomas, and, of course, regular bits of your skull charcoal. Radiation induced cancers move fast, so my bet is on charcoal." (OK, so she actually sort of said most of that, but much much much more appropriately and professionally. But you get the jist.)

K and I breathed a sigh of relief. We rewound our emotional tapes to before the scary path report came out.

Dr. B continued. Basically, on the chance that there is something awful in there, she wants the testing to start ASAP, which means another operation. I had thought that, since there is no cure, it is not worth doing anything unless the tumor 'declares itself'--advances to the point where it causes symptoms. But, as she explained, those would be pretty awful symptoms, because it would likely first hit the cranial nerves. The cranial nerves are what allow you to see, hear, smell, swallow, chew, and various other things such as waggle your eyebrows suggestively at your wife. Also, at F'in' Famous, they want to do much more complicated testing than they did at Wicked Famous. The results take 6-8 weeks, and she wouldn't be able to start the best treatments until she knew the answers. I really wouldn't want to go that long without waggling my eyebrows at K.

And, worst case scenario, if this is squamous cell carcinoma, it is true that the only standard treatments are life-extending, and not curative. But some patients' lives seem to be extended indefinitely as long as they stay on treatment. And there are some very promising treatments just over the horizon.

Obligingly, Dr. B spoke to my parents on speakerphone, answering all their questions.

Much relieved, although not completely worry free, we left the appointment. I have seen a lot of excellent doctors in some of the best hospitals in the world (and in some ordinary hospitals). This was a superb doctor. She gave us as many details we wanted. She gave us the good and bad scenarios, the approximate probabilities of each, and possible plans for them. We left the office with clear next steps. Dr. B dealt with the whole family with confidence and kindness. That's how it's done.

We had a little more excitement. Dr. B took her time with us, for which we were grateful. However, it left us with very little time to make it to a 7 o'clock train. We took a cab this time, but, closer to the station, the traffic was so jammed, we got out and ran. We made it. I'm writing from the train. (The wi-fi is fast enough to do this, but, luckily, not fast enough to do work.)

So, we have a plan. Another surgery, this time in the Big Fruit, ASAP. A 6-8 week wait, and then, hopefully, free and clear before Christmas. (Or the squamous obscenity shifts into high gear, one side of my face goes completely slack, and I go blind.)

Sorry for the roller coaster ride. It's enough to shake lose a kidney stone, but I think that maybe the roller coaster might just smooth out into a regular train trip home.

Be well,

Tom


* I haven't figured out a pseudonym for Dr. B. Her name actually means 'saint' in a foreign language, but 'Dr. Saint' is a little melodramatic.

** I have an original idea! Let's take the most boring shape and color for a building and make it really big. In fact, make it YUGE! It'll look like a giant, low budget 1980s office building! Yuck!

Ginny and her friend Iris