Thursday, January 30, 2014

Out of the Woods

I walk up the stairs to the familiar offices on the second floor. I visit this building twice a year on good years, more often in those years when I've felt a lump or a bump or had a scan come back slightly awry. It's not the same building I started this journey in; that was a tiny office down the road whose clientele quickly outgrew the space. Cancer, it seems, is big business these days.

No matter how many years have passed, I still get nervous before each checkup. It doesn't make sense, when seated in a room full of women wearing head scarves or wigs and men so weak they need wheelchairs or walkers, that I would be the lucky one. The survivor. The one who beats it. It comes with a guilt to sit among these faces and hear my name called and know that my emotions when I leave this place are going to be so very different from these others in my tribe. I have a lot in common with the other men and women in this waiting room. But the one difference, the big difference, is a hard pill to swallow.

I've been cancer-free for ten years and will survive. Too many do not.

The faces at the front desk and at the nurses' station where I get my blood drawn and my blood pressure checked and my weight measured have all changed. I don't know if the faces back in the chemo suite have changed; I haven't been back there since my initiation all those years ago. Is Fran, the nurse with the big laugh, the one who cried with me when my veins had hardened and made the IV preparation a Herculean task, still there? I want to know, and yet I don't. This is a hard job, and no one seems to do it for very long. I'd like to think Fran is still charming both those with hope and those without. But I'd also like to think she took a well-deserved permanent vacation to a tropical beach home with plentiful rum. Chemo nurses have earned such luxury.

The one face that hasn't changed is my doctor. He doesn't so much enter a room as charge through it. He is aggressive in every sense of the word; he speaks loudly, he doesn't tolerate bullshit, and he doesn't play nice with his prescribed treatment plan. He wants to kill your cancer. That simple. He's not there to comfort and coddle. It was off-putting at first, because I was young and my cancer diagnosis was tragic and I just didn't get how he couldn't see how very sad this all was. But he grew on me.

Much like, well... a cancer.

I eventually learned that he has a sense of humor. An exceedingly dry one. After all, this was the person I ran into at the frozen margarita booth at a church festival several summers ago.

"I hear those things give you cancer," said a voice behind me.

Not everyone gets to have a cocktail with their oncologist. But I highly recommend it.

As always in our appointments, the "How have you been?" questions are followed by a long silence. He is a thinker and a studier who pores over his notes from last year and my tests from this year for a full five minutes before speaking. I've learned not to interrupt. I won't know what his conclusions are until the end of the physical exam, which has become like a choreographed dance: I raise my shoulders so he can check the nodes above my collarbone, I swallow hard as he checks my thyroid, I raise my elbows slightly and relax my shoulder muscles as he checks under each arm. I inhale and exhale. I lost my modesty many years ago when it comes to medical personnel, so I barely bat an eye as my entire body is scrutinized looking for unusual growths. I remind myself to breathe those times that he spends a little longer in one area of nodes, or checks the same area twice. I tell myself that he's just being thorough and try not to sweat and feel slightly ill.

Sometimes it works better than others.

Today, after the chit-chat and the exam, he goes back to my chart. This is unusual. He hasn't spoken in several minutes, and I prepare myself for news. Good or bad, I'm not certain. But I feel as if something has changed.

"Would it break your heart if I said I think this is the last time I need to see you?"

Oh. Oh. It has been ten years, and I know this means I'm cured. But I'm not ready to let go yet. I will always, always be afraid. There was a monster under my bed once, and even though we've slayed it, it's still there. I've seen enough horror movies to know that sometimes the monsters come back. And they bring friends.

I have no idea what to say. I've become co-dependent. I need to hear every year that I'm okay. I need to watch the instant CBC machine analyze my blood and get the results placed in my hands. I need that appointment card on my fridge, giving me a date I can hang something concrete on. My immune system has seemed a little weak this year, but I see the doctor in January, so I can ask about it then. I've felt a little pain in my upper right side that I'm worried might be my liver; the doctor can check it for me in a few weeks. I sometimes think I feel a lymph node in my neck; good thing I see the doctor this summer. These appointments are my touchstones. It's like tagging home plate. I can't let go.

But it's time. And I know I must.

"It might break my heart. But I think I'll live."

He smiles. I smile. I get a quick reassurance that the door is always open if something comes up, and that I will still be seeing the radiation oncologist once a year to deal with the side effects and risks from that part of my treatment. But the radiation oncologist has only known me from the point my cancer was already in remission and I just needed some rogue cells mopped up. That's not the person who saved my life and made me whole. This guy is. But I know it's time to say goodbye.

"Yes," he says. "I think you'll live, too."

I gather my things and walk out of the room. The doctor turns immediately into another exam room; his work is far from over today. The receptionist smiles when she sees that I do not need to make a follow-up appointment. I walk down the stairs and into the cold winter sunlight.

I'll live.

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