Wednesday, July 30, 2014

Biopsy Biography II - The Results

The Results

First let me say, this turns out okay.

I shouldn’t have posted my biopsilogical odyssey before I posted a result.  It wasn’t my intention to leave people hanging, though you have to admit, a good suspense story…

When I called for the results – and I admit, I put it off – the office manager told me I needed to come in…they found “a little bit of cancer.” 

I’m the best guy I know to come onto a grisly auto accident or deal with a victim or perpetrator of domestic violence or have to put an animal down, because I have a delayed reaction to trauma.  I separate almost instantly so I can see what can be done, then fold later.  But I do fold.

There was about a twenty-four hour period between the time I got the information over the phone and the time I sat down with the doctor.  I had played around with the possibilities for almost a week following my biopsy, but for that last twenty four hours I had to sit with the WORD. 

I went to the pool and worked out, feeling maybe as strong as I had in a long time, but carrying the irony that this might be stronger than I would feel, like, ever again.  I did what we all do, I think: promised to use my time better, be more embracing of people who irritate me, remember we’re all in this together and slap the Christian Right harder for being so insensitive as to keep wounded kids from reading their truths in our works because they don’t like the word “fuck”, even though that’s not a biblically barred word.

My urologist, whom I earlier characterized unfairly in my quest for comedy (he didn’t REALLY say I wasn’t a Stotan; it was just too good a line to pass up) showed me two areas of my prostate that contained a small number of cells.  He affirmed some things of which I was already aware: that almost any man who lives long enough will encounter this situation, that about fifty percent need no treatment, and that we often over-treat it because of irrational fear of that WORD.  That said, I’m not off the hook.  I’ll be on an “active surveillance” program that gets me into the doc every three months for a blood draw, and will get me another biopsy within the next year to be sure we’ve got an eye on those malevolent little buggers, and can get a leg up on them should they try anything funny. 

Truth is, I’ve been giving people bad news long enough that I know how to take some, and because of my life as a close observer of human mal- and mis-treatment, feel incredibly fortunate not to have received more of that bad news than I administered.

Some good things - even more than a renewed appreciation of my existence - have come of this.  Your responses on Facebook have told me, 1) either the doc messed up with my anesthetics or my body is extraordinarily resistant to whatever they used, and when I sign up for that second biopsy I’ll make mention of that, and 2) I have a delightful connection with a vastly diverse collection of generous people.  For that I thank you.

In the name of full disclosure I need to say one more thing.  Though I appreciate the number of people praying for me because that is how you show your love and regard – and I DO appreciate it - I don’t receive those prayers because if I believed in, and loved, a God who would hear those prayers and save me, I’d have to hate a God who would turn his back on those who prayed for my sister, who died miserably nearly two years ago of pancreatic cancer, and for my old high school quarterback who died almost exactly a year later of the same.  I would argue that each was a far more graceful and deserving human than I.  Instead, I am enormously grateful to a universe that embraces us enough to let randomness rule.  It makes life exciting and terrifying and unpredictable, and sets a course on which each of us has influence over whether we soar or crash.  It is a universe that embraces the ghastly along with the glorious. 

Nothing exists without its opposite.

Again, I apologize for writing that original piece as a cliff-hanger.

Too late to make a long story short, but bottom line, there’s a pretty good chance that my prostate won’t leave me prostrate. 

Biopsy Biography

Biopsy Biography

I’m often asked by teenage students during Q and A after a presentation if I have any general advice for them.  My normal response is, “Don’t listen to me.  I’m an old guy and I will try to get you to avoid the mistakes I’ve made in my life even though I know you have your own mistakes to make and you won’t learn from lectures, you’ll learn from experience.

Still, there’s likely an upcoming situation I think you should be aware of.  I don’t want you to focus on it now, because it could be a source of great anxiety, should you dwell on it too heavily.  Sometime a long way down the road you will start hearing your doctors using words that end in –oscopy or –opsy.  Likely they will tell you that you need one or the other.  What your doctor will really be saying is, “I want to hurt you.”  He will tell you he’s going where no man, or woman, has gone before to examine organs that don’t get a lot of visitors.  He will be going through a door built to open one way.  And he will be going in the other way.  You will be resistant at first because well, that just doesn’t sound fun, but he will use the C word or one every bit as frightening, and you will acquiesce.

I can’t tell you what your experience will be like because we’re all different, but I can say I’ve had conversations with a significant number of people who have gone through one or the other of these processes and the percentage who have described it as pleasant is, well, none.

My own journey began when I got a call from my general practitioner following my last physical, saying my PSA numbers were a little elevated and she wanted me to see a urologist.  I’m not particularly well versed on what any given medical specialist is good at, but I do know this guy works south of the belt line, and that makes me a little nervous.

I sit down in the examination room as he introduces himself and looks at my paperwork. He has a bit of an accent, which he identifies as Romanian.  His articulation is quite precise.  He says, “We need to do a biopsy.”

Now I haven’t spent a night in the hospital since I had my tonsils out in 1952 so I don’t know a lot of medical terms, but I know that one.  I say, “You need a sample.”

He nods.

I say, “Uh is there, like, a sample floating around down in there, or you gonna have to whack off a piece.”

He smiles.  “Pretty much I have to whack off a piece.”  He says it such that we both understand that’s my terminology.  “Ten pieces, actually.”

I remember another bit of medical terminology I learned about ten years ago when another urologist who didn’t seem to know the terms of the Geneva convention decided he needed an up close look-see at something next to my Adam’s Apple and went up the down staircase in through my penis.  I use that terminology now.  “That sounds like it might cause me a ‘little discomfort.’”

“A little bit,” he says.

He is very matter-of-fact.  I don’t know the relativity of “a little bit.”  I mean, who knows, he might be one of those guys who walks across hot coals on weekends, or sleeps on a bed of nails.

Note to the medical community:  A little discomfort occurs when someone farts in a stalled elevator filled with two more people than “capacity.”  A little discomfort occurs when you’re buried up to your neck in a fire-ant hill.  Or when someone runs a screwdriver through your ear.

To his credit, my urologist only lies to me once, and he can’t know it’s a lie.  “This won’t be as bad as you’ve imagined,” he says.

I don’t get a good look at his tool kit before I lay on my side, pull one knee up so he can get a good look at his point of entry – onto which I should have tattooed “Exit Only” -  but looking back, I assume it consists of  a single-hole paper punch purchased for under five bucks at Office Depot. 

The first and second punches leave me speechless.  It is as if he inserted a pair of rectal hornets.  The third has me desperately probing my meager historical knowledge for information regarding U.S./Romanian relations.  By punch number five I’m asking myself, How bad could dying of cancer be?  After six and seven I ask him that.

            “Very bad,” he says.  “We’re almost there.”

            I’m counting backward now, threatening him with Homeland Security between piercing white-hot snips. In perfect cadence with his final soft tissue ambush, I scream “Stotan!” 
            “There will be a little blood,” he says as his nurse covers me with the oversized Kleenex she gave me to preserve my dignity.  “Call me if it is excessive.”
            Then my doctor says, “We should have the results in 24 –to – 72 hours.  If you haven’t heard by next Monday, you call, okay?”

            “Do you have any questions before I go?”
            “I do.”
            He nods go ahead.
            “When you were a little boy in Romania, like maybe 10, what did you want to be when you grew up?”
            He smiles. “I assume that question is rhetorical.”

            I smile back.

“And now I have a question for you,” he says.  “A real one.”


            “What is Stotan?”

I start to brag a little and tell him it’s the name of a novel I wrote, but I’m not feeling all that conversational.  “It’s an Australian term,” I tell him.  “a cross between a Stoic and a Spartan.”

“I see,” he says. “A combining of terms.”  He shrugs, “Well you are certainly not that.”