Just a Flesh Wound

Ann Taylor is wearing a Muji dress, H&M boyfriend sweater, Target scarf, and Gentle Souls flats.

I distrust doctors, avoid hospitals. I get my teeth cleaned and my hair cut, and leave it that. Cancer, of course, required us to entrust Carole’s life to the medical-industrial complex. Our trust alone was not enough for the medicos; they wanted us to think that they were our friends. They wanted to talk and laugh with us on a prescribed schedule, to seem to be interested in us, to make us feel comfortable in what is one of life’s most uncomfortable situations. They acted as though they wanted to connect with us, like actors breaking through the fourth wall to sit in the audience. We had no choice except to rely on these seemingly kind strangers.

We met our first cancer friend in the breast surgeon’s office. She was a delightful woman who told us she would be our cancer nurse. We spent much of an afternoon with her, laughing and smiling while she explained what the surgeon would cut, why and how. She told us we could call her any time night or day. As we got up to leave, she and Carole exchanged online shopping tips, found their shared taste in bags (not too big) and shoes (not too flat)—girlfriends, for sure. We never saw her again.

When wan, skeletal woman, with a too wide grin that revealed too much denture, asked if she could sit with us in the cancer-center waiting room, I fought hard not to bury my head in the magazine I had been flipping through. I wanted her to go away. I knew she was a cancer volunteer, a survivor. I wanted her not to invite us to join her club, which by sitting in those chairs and that waiting room we had already joined. Of course, we smiled. Of course, she sat down. Of course, she explained that she had survived many different cancers and told us we could call her any time night or day. Before we could get away to an examining room, she gave Carole some coupons for things cancer patients need, including a chit for a $49 synthetic wig. To my surprise with all that was going on, the gift of a cheap fake wig hit me with such a strong cocktail of emotions that I felt buzzed on suppressed laughter and repressed tears. We never saw her again.

I grew up in and around a medical school and its teaching hospital, where I got the impression (encouraged by my father) that surgeons were humorless, arrogant men who liked to hunt deer and might describe themselves as godlike if given the opportunity. I diverted myself by remembering after-dinner surgeon bashing, the first time we squeezed ourselves into the cancer surgeon’s exam room. A nurse followed us into the room with her rolling digital display and measuring instruments to take Carole’s temp and blood pressure. Thinking my own thoughts and trying to be considerate of the nurse, I took the chair next to the little wall desk to give her room to reach Carole in the chair to my left. When the surgeon swept into the room, she asked if Carole had placed me in the seat closest to hers so that I could act as a buffer. Was this surgeon levity, a lighthearted reference to every patient’s wish to distance herself from cancer bad news, a lesbian-recognition joke, or just an it’s-all-about-the-surgeon moment? Carole and I looked puzzled, which we were, and did not respond. The surgeon glanced at her computer monitor and said abruptly that she would see us in two days in pre-op. On her way out of the room, the surgeon told us she was on call for us day or night. After a brief post-surgery appointment during which she praised her own skill, I never saw her again, but Carole has a six-month follow-up scheduled.

When we went to our first appointment with the medical oncologist, Carole brought an annotated copy of her pathology report. She had looked up every term she did not know, parsed all the numbers, and correctly named the stage of her cancer. She expected to have a serious discussion of her condition, treatment plan, and prognosis based on the report. Unintentionally Carole had denied the doctor her role of comforting explainer. In response, the oncologist seemed to say, “No point in talking about your case, Miss Smarty, you know more than you should know already.” We spent our allotted hour in small talk. In a steady stream of trivial questions, the doctor asked about my job; learned the kids’ names, their colleges and careers, marital and parental status; asked where we grew up; and recommended a novel set in Seattle, Carole’s hometown. She told us we could call her any time night or day, and eventually, we will see her again at a scheduled post-radiation appointment.

Because Carole is Jewish and has cancer on her family tree; because Angelina Jolie had recently revealed her radical reaction to her own genetics; because you can walk into a lab, fill a few viles with your blood, and wait for results from a test that was until recently science fiction, Carole decided to have her breast-cancer genes sequenced. She filled out a seven-page questionnaire, calling relatives, pulling up her Ancestry.com family tree, digging deep, being as thorough as she always is.

At the lab, we met a smiling, young woman who said she would help us decide if we should go forward with the test, if Medicare would pay for the test. After some general cheerfulness, she began to ask Carole the same questions she had already answered on the questionnaire. Had the lab assistant even read the document? “Not really,” she felt no shame in telling us, saying something like, “Much better to have a friendly little chat about all your relatives who died from cancer.” On a blank, 8 ½-by-11-inch piece of paper laid horizontally facing her, the young woman attempted to branch out Carole’s family tree as Carole talked to her. Ancestors who had cancer got big black dots, which the tech explained would show a pattern, if there were one. Watching the tree grow upside down, we saw quite a few Jewish genes assigned to her father’s side, when her mother’s family is the Jewish, not his. Black dots occasionally landed on the wrong people. The young woman was working in marker, so when we pointed out her errors, she crossed them out and drew corrections over her mistakes. After we had spent more than an hour on the tree, now badly damaged by the scribble storm, I wanted to scream something I never thought I would want to scream, “You know there’s an app for this!” But I didn’t. I was coming to understand the relationship between an unnecessary messy drawing, a morning wasted on redundancy, and a highly sophisticated genetic test. It’s cancer, of course, that great bugaboo to be approached as though it wasn’t, with friendly, time-wasting, almost silly diversions not-so-cleverly designed to keep our fear in check then hit as hard, as medical ethics allows, with whatever weapons are currently in the arsenal. When the doctor eventually came into the room, he barely glanced at the paper and approved Carole for a blood draw. She had needed one Jewish ancestor with cancer to qualify for the test.

Hospital protocol requires that you state your name and birth date each time you present yourself—a simple routine, not a greeting or a conversation starter, no more a joking opportunity than an airport security line. Thirty-three times, we went to the hospital for radiology treatments, each day at the same time. We checked in at reception, sat in the waiting room, thumbed through months-old magazines, remembering summer fashions and strawberry deserts. When a radiation technologist entered the room and called her name, Carole popped up from her chair, eager to get on with it. Together she and the tech walked through double doors into Radiology, where the tech would stop and ask Carole to identify herself. One jolly tech, who showed up many days, often turned to Carole with a big grin and asked with exaggerated drama, “And who would you be?” Irritated, Carole wanted to answer, “Meryl Streep,” “Lena Horn,” “Not here,” but she said what she was supposed to say, until one day she could no longer keep up the friendly pretense and let the tech know why. We did not see her very often after that.

In Cancerland, negative is positively great, and positive is very bad. A breast tumor is a lump, which sounds as unthreatening as something you would prefer not to find in mashed potatoes or pudding, not something to be slashed, burned, and poisoned (Susan Love’s phrase). The medicos act friendly, but their time is not your time. They are not really your friends, and they expect, once you are done, never to see you again day or night. Patients wait and worry and hurt in dark fear. Hospitals move ahead efficient, cheerful, and brightly lit. The experience of cancer is topsy-turvy, ass-backwards, f**ked-up, a Monty Python movie, with few laughs. No surprise that one afternoon, as Carole left a treatment room to walk out of Radiation toward the doors to the waiting room, a tech turned from her computer and said, “Breast cancer is not so bad, you know, because your beast is outside your body.” As the Black Knight said to King Arthur, after the king severed first his left arm than his right, “It’s just a flesh wound.”