Thursday, June 20, 2013

A Visit to the Oncologist, in Two Parts

Part 1: Before the Visit

I'm a little amazed at how weird it feels to be a patient again -- even if it's only for blood work and an office visit. It's been just over four months since my last chemo and 3+ months since my last scan, but it seems of another time.

Part of the time distortion is that April and May are crazy busy times around here. Sports, schoolwork and a whole lot of work work has meant a lot of activity, and when you compress all of that in a short time frame, it tends to distort time in a way, stretching it and winding it up at the same time.

But as I sit in here in the clinic, I'm struck, odd as this sounds, by the number of sick patients. I realize it's a cancer center, but  after spending the first two years of diagnosis working to redefine (in my mind) cancer patients as someone who felt and looked like me -- that is asymptomatic and surprisingly healthy --  I've forgotten that many cancer patients here on Y8 look much sicker - tired, masked, bald or weak. It's a stark reminder,

Fortunately, I feel fine. My vitals were all fine. My weight is healthily down; my pulse is back to its low running rate. I'm just waiting to see Dr. L to hear about my blood work and such. I expect to hear nothing surprising, but there is -- and will always be -- that nagging anxiety that there was something in the lab work, some growing lump. As I've said before, there's very little I can do to control that.

Part 2: After the Visit
Everything's fine. Let's start there. But I left feeling a bit disappointed nonetheless. Dr. L was running late so I ended up seeing my NP, who is fine and nice enough, but isn't Dr. L. So that was the beginning of the let down, but what exactly does one say in those situations: "Oh, hi. I thought I was going to see Dr. L..." with the implication being, "and that's who I would have preferred to see."

No, that seems awkward and mildly insulting. So we just see the NP. But the disappointing point is that, although my blood work looked fine, there's nothing particularly informative about it. As she explains it, there not really going to see any signs of my lymphoma in my blood work, unless it's relatively advanced. And if it is relatively advanced, well then, I'd probably know about it because I'd have, repeat after me, fellow veterans of oncology visits: night sweats, fatigue, etc.

So if the blood work isn't informative, and the office visit consists of asking me how I'm doing, feeling my lymph nodes and spleen,  listening to my lungs (I'm guessing that's what we're doing with the stethoscope), and asking me how I'm doing... well, it just seems like we could all but do that by email, couldn't we?

At the root of my disappointment, I think is this: when we're post-chemo, or in remission, or whatever we're going to call this waiting-for-lymphoma-to-return phase, what we want is hard confirmation that we're okay. Isn't that why, at it's most basic level, we go to a doctor, any doctor? If we're feeling sick we want the doctor to make us better. But if we're feeling okay yet are concerned even ever-so-slightly that something might be lurking (as, I should add, all cancer survivors tend to be), then we want the doctor to say, "you're fine."

And even though I feel fine and have no reason to think otherwise, that's what I didn't get on Tuesday.

--Michael