‘Please allow me to introduce myself...’

Day 30:  

General status update

Hair: no change.

Nausea demon: exhausted after giving his all in the titanic struggle of the last few days, he is mostly staying in his room at the moment, allegedly working on an overdue essay for his OU Counselling Diploma, although it’s the first essay crisis I’ve ever witnessed accompanied by an Angry Birds soundtrack. 

Chemo Muse: demanding that we sit down and have a strategy meeting to plan the remaining 13 days of this chemo cycle, so we can maximise my productivity before it all goes haywire again at the beginning of FEC3. 

Chemo Brian: We’ve had a few interesting conversations over the last few days about his rock’n’roll past, and it turns out he was actually at Woodstock – amazing! He can’t remember anything about it, obvs. 

Sense of smell: spectacularly ramped up again - every whiff of cooking food is the olfactory equivalent of Very Loud Rock Music of the Most Unpleasant and Cacophonous Kind; in essence, I have Megadeth performing a stadium concert in my nose.

Superpowers: It has been suggested to me by a friend with a close acquaintance with the Marvel Comic films that my chemo ordeal should qualify me for at least one superpower- if I have any choice in the matter, it’s certainly NOT going to be sense of smell. 

Fatigue/weakness: was unpleasantly surprised today, when I went out, by feelings of physical exhaustion and extreme weakness. Found it v. challenging to climb 2 small flights of stairs, and had to get a taxi home, because I felt as if my legs were on the point of giving way, and I was likely  to end up in an undignified crumpled heap on the pavement at any moment. This is entirely normal for chemo patients, as far as I can gather; after all, I am walking around in a cloud of mustard gas, albeit on the inside. 

Sleep, lack of: sleep deficit starting to build up again after 3am bedtime yesterday, but not yet critical.

Anxiety level (1-10): just humming away there steadily, in the background. Tunelessly.

State of mind: Dogged

 

When Dr. Frank Burns, in the Korean war medical comedy M.A.S.H, complained that he couldn’t understand why people took an instant dislike to him, Captain John McIntyre simply replied: ‘It saves time, Frank.’

Imagine the soul of Dr. Frank Burns incarnated inside the etiolated body of Lord Peter Wimsey, with Savile row suit, de haut en bas manner and languid patrician tones to match, and you will have some idea of what faced me when I went to the Breast Clinic at the Charing Cross Hospital at the end of August for further investigation of the lump I had found 2 weeks previously in my right breast.

The only thing lacking was the monocle.

Oh, and the exquisite manners.

The man who stood and called my name from the door of an office was already seated at his desk by the time I walked in and sat down -  alone, vulnerable and terrified (R was there with me for moral support, but had to stay in the waiting room).

Without deigning to introduce himself, he simply said ‘Well, your doctor has referred you with a suspicious lump, so I’d better take a look at it before you have the mammogram and ultra-sound and, if necessary, a biopsy.’

I removed my upper clothing, and allowed him to examine my right breast, but remember very little of our conversation over the next few minutes because my brain had dissolved into a red mist of rage that this man had not even bothered to tell me who he was.

The doctor, whoever he might be, duly confirmed the existence of the lump, deemed it worthy of further investigation, dismissed my concern about what might be a swollen lymph node under my arm as something they would look at with the ultrasound, and told me to return to the waiting room until I was called for my mammogram. I refastened my bra, rebuttoned my blouse, and stood up; my hands were literally shaking with rage.

The doctor looked away from me, and down at his notes; I was dismissed. I remained standing in front of him and said ‘Umm… what is your name?’

He looked up from his notes with the startled expression of a man whose pet Labrador has suddenly asked him a question, and drawled

‘G------’

The name he gave was one which can be both a given name and a surname, which confused me for a moment, and I said

‘Doctor G.?’

‘Mister’.

Consultant surgeons, of course, are referred to as ‘Mr’ rather than ‘Doctor’ in some kind of arsey-versey form of status attribution; I knew that.

Bugger.

‘Thank you, Mr G.’ I said, quietly, and left.

 

I don’t remember much about the mammogram, except that it’s much like having your breasts squashed, one at a time, between the two halves of a giant sandwich toaster; the next thing I clearly recall is lying on the bed in the room where the ultra-sound is administered, and articulating my extreme displeasure with Mr G.to the startled radiologist and attending nurse, both female.

Both of these women had introduced themselves as soon as I walked into the room.

‘I cannot believe how rude that man was’ I said, lying on my left side, with my arm held awkwardly above my shoulder, as the radiologist smeared the jelly for the ultrasound over my right breast.

‘He didn’t even have the basic courtesy to tell me who he is’.

Medics cannot, of course, join in patient criticism of other medics; but something about the exchange of glances between the doctor and the nurse made me think that perhaps Mr G., the consultant breast surgeon, was not greatly loved by them, either.

It struck me that Mr G. was, although extremely well-preserved, clearly in his sixties. 

‘He appears to have gone to medical school’ I added ‘in the era before they regarded empathy and interpersonal skills as necessary attributes for doctors.’

I calmed down gradually, as the ultrasound examination went on, and on, and on.

Before coming to this appointment, I had been reassured to read that 90% of breast lumps are benign, and most of those are simply water-filled cysts.

‘ I know you’re not allowed to make diagnoses on the hop, ‘ I said ‘ But is it possible to tell from the ultrasound whether it’s just a cyst?’

‘Oh, it’s not a cyst’ said the doctor, softly, as she continued her manipulation both of my breast and the computer screen onto which the ultrasound images were projected.

‘Oh, right.’

I did not enquire further, having the idea in my head that no truly accurate diagnosis could be made until a tissue sample had been analysed by the pathology lab. It had said on the Charing Cross website that they aimed to give you a diagnosis by the end of the day, if possible, but I presumed this would only be the case if your lump was obviously a cyst. Fibrous lumps would need to be investigated in the lab, wouldn’t they?

The doctor reassured me that the tiny lump near to my right armpit was not a lymph node, or anything else significant - good. The ultrasound examination moved on to my right breast, and was again lengthy and thorough. Then the doctor explained that she needed to take biopsies of the original lump, and another tiny ‘suspicious area’ which might be something, or nothing, in the same breast. She explained the biopsy procedure clearly, gave me a local anaesthetic, and took the tissue samples with painless efficiency, warning me ahead of time that the biopsy needle makes a clicking noise when it punches out the tissue sample, much like a hole punch for paper.

By the time it was all over, I had been lying on the bed with my arms in strange positions for about 2 hours, and was a little shaky. The doctor told me that the clinic would give me an appointment for the following week, at which I would be told the biopsy results.

‘Is there any chance I could have the appointment with a different surgeon?’ I asked. ‘Because if I’m going to be told I have cancer, I do not want to be told it by THAT MAN.’

The nurse, who had held my hand whilst the biopsies were being taken, and generally soothed me all the way through, said that she would go and have a word with the woman on reception to see if that could be arranged. She left the room just as Mr G. came in, to see why everything had taken so long. He stayed to speak to the radiologist, and I was sent back to the waiting-room again; it seemed there must be a final meeting before I could go home.

R was nearly frantic with anxiety, because I had been gone for such a long time; I told him not to worry, they were just very thorough, and we waited for the next summons, hand in hand.

Back in Mr G.’s office a few minutes later, this time with R sitting next to me, I was too tired and cross and confused to pick up on the finer points of what the man was saying, and how he was saying it.

Or, perhaps more importantly, what he wasn’t saying.

Mr G. smiled, inasmuch as a glacier can smile; it could equally well be described as a slight furrowing of the ice.

‘Well, you did have a bit of a time of it in there, didn’t you? It seems there’s a lump with a clearly defined ridge - we are sending the tissue samples for analysis, and will see you again in a week’s time.’

‘Not if I can help it ‘ I thought, entirely missing the significance of his slight stress on the phrase ‘with a clearly defined ridge’. As far as I knew, he couldn’t make a diagnosis of any kind yet, and it was well past time to get the hell out of there. I asked no further questions, and he volunteered no further information.

‘Thank you, Mr G.,’ I said, and we left.

Outside, I conducted a whispered conversation with the receptionist about the possibility of making my appointment for the biopsy results with any breast surgeon at all on Charing Cross Hospital’s extensive list who was NOT Mr G. She did her best, but it was holiday season, and cover was sparse; if I wanted to see someone else, it would have to be in 2 weeks’ time, not one.

And so I left, despondent in the knowledge that whatever fate the Gods were choosing to deliver to me the next week, their instrument of delivery would be none other than Mr G. 

 

As we walked back up the Fulham Palace Road towards home, hand in hand, the sound of Mick Jagger’s voice started to echo through my head: