Throughout this whole process of course, I’d been scanned and tested a number of times. The news, according to Dr. Falkson, was good. The chemo seemed to have done its job. The areas of concern that Dr. Petsikas had tagged seemed to be gone.
However, the recommendation was that we proceed with the radiation. Those little spots had been on the pleural membrane, the sac around my lungs, and the thymoma itself had been pressing against my heart. Even just a couple of cells still hanging around could be bad news down the road. By the time they were big enough to show up on a CT scan, they’d have a pretty good root in spots I’d rather they stayed away from.
As Dr. Falkson was aware of our trip plans, he agreed that any additional treatment could be scheduled to begin after we returned.
So I was once again scanned, this time in order to determine the exact placement of four tiny tattoos that would be used for laser sightings to line up the equipment for each of the thirty treatment sessions that Dr. Falkson planned.
And then Meaghan and I hit the road. After the uncertainty of the last few months, it was wonderful to just put miles and miles behind us, and to have the opportunity to spend time not only with Meaghan but with my sons, Brian and Jeremy, my daughter-in-law Nicole, and my grandchildren. We had hoped to be there for the birth of my fourth grandchild, but he decided to hold out until after we had to leave.
Once we were back home – which was now in Kingston, a move we had planned before the illness – I checked in with Dr. Falkson’s office and was told when to show up for the first session.
Since I work primarily from home, and since radiation did not involve the side effects I’d experienced during chemotherapy, I was able to return to work. I still tired easily, but as long as I took that into account, things went along pretty well.
So each day, Monday to Friday, for six weeks, I would walk up to the hospital (which was now only about a twenty minute stroll), take off my shirt, climb onto the table, and hold still while the technicians zeroed in on my tattoos, left the room, and fired the phasers. Climb down, don shirt, have a nice day folks, walk back.
Piece of cake. (although I did get to know where every park bench was on the route.)
And then that too was over.
There will be follow ups for the rest of my life of course. I also have some peculiar aches and pains. They may be no more than the normal creaking and clanking of a body that’s a little more beat up than it was a year ago. The thing is, like someone who jumps at every shadow after being mugged, I no longer shrug off such things as easily as I used to.
Thymomas sometimes come back. Stage IV thymomas sometimes metastasize to other places. Sometimes, people who have gone through this live for decades, with nothing more lasting than a tendency to look over their shoulder frequently.
Only time will tell.
In the meantime life, as they say in the epilogue to every good story, has slowly returned to normal. And to be honest, that’s the most curious aspect of the whole experience. Shouldn’t I have emerged a “changed man”? Shouldn’t I have some profound insight into “cheating death”? Shouldn’t I at least have x-ray vision or titanium claws in my hands??
Apparently not.
Like the veteran who returns from war while so many of his mates did not, I want to honour the memory of others who have not been as fortunate as I have. I’m not quite sure how to do that. Yet. Perhaps telling my story in this way in this space is a place to start. I’m open to suggestions.
Thank you, dear reader, if you have stayed with me through this story. If you think that it may, in any small way, help someone else, I hope that you will share it.
And if you know of anyone who is going through a difficult time, be it a life-threatening illness or anything else, I hope that you will do for them what so many did for me – call, write, spend a few minutes, laugh, cry. Be there.
If there is meaning in life, and I believe that there is, it is found in how we act toward the world. And most especially, toward each other.
Thank you
David
And I “creaked” when I moved in certain ways. The wires holding the two halves of my breastbone together could not, of course, prevent some movement. It was an effect that, thankfully, gradually went away as my bones knit back together, but while it lasted it was definitely unnerving.
It wasn’t long before Meaghan and I were sitting with Dr. Gregg. He laid out the details of how the chemotherapy regimen would be work. The treatment employed a series of four drugs – adriamycin, cisplatin, vincristine, and cyclophosphamide (called the ADOC protocol). It was a combination that had been found to be most effective in thymoma treatment. I would receive six rounds. Mondays I would get the first two, Tuesdays I had “off”, Wednesday for the third, and Thursday the last. Two weeks between rounds. Which meant that the whole plan would last eighteen weeks.
Dr. Gregg went over expected side effects again. There were three significant issues - nausea, the hallmark of every cancer-related doctor show I’d ever watched; hair loss, the “badge” of people in my new members-only club; and a compromised immune system (please don’t let sick people cough on you, Mr. Keating, it could kill you). Other minor issues included potential hearing loss and temporary (hopefully) peripheral nerve damage.
Because I lived a two hour drive from the hospital, I decided to stay at the Quinte Thousand Islands Lodge, a hostel for people like myself who were undergoing cancer treatment. It was just a few minutes walk from the hospital.
I have to confess that chemotherapy was the part of this whole experience that I dreaded the most. (Well, with the possible exception of the whole maybe dying thing). I don’t like feeling sick. I don’t like throwing up. That teen drinking commercial that shows a girl passed out beside a toilet with something icky in it makes my stomach churn.
Nevertheless, I showed up as ordered on the following Monday morning, had some blood work done to ensure I was fit enough to have poison coursing through my veins, and had an IV connection slid into my arm. Oh. Did I happen to mention that I have small veins and hate needles? It took a couple of practice runs before the nurse was satisfied she’d hit a good spot.
For the next six hours I sat in a recliner with a blanket over me while several bags of innocuous-looking fluid slowly emptied into my arm. I did not, to my great relief and surprise, get sick. Due largely, I’m sure, to the handful of anti-nausea pills I’d been given before treatment started.
Meaghan and I had decided that for the first round I’d go home for my “day off.” I think we both just wanted to have each other around. I know I did. So off we went back to Marmora. We had to stop a couple of times. I took more pills.
Over the course of the eighteen weeks I met a lot of very brave people, both those in my “club”, and their families who were there to support them. Chemo involves a lot of sitting around; waiting for blood work, waiting for the drugs to be prepared, waiting for them to infuse. It all takes time. There’s time to talk. We didn’t talk a lot. Feeling ill will do that to you. We did, however, exchange anecdotes, quips, or just a smile.
The camaraderie between the patients, the nurses, and the volunteers was amazingly relaxed. It belied the deadly earnestness of the battle that was being waged invisibly in our veins.
Three weeks in, when hair started to appear in my comb in greater than usual amounts, Meaghan wielded the clippers and razor. For the next three months, shaving involved all of my head. Everyone who saw me told me how I was one of the few people who could “pull off” the bald look. They were lying. I appreciated it.
I want to emphasize that I was extremely fortunate. My reaction to the ADOC drugs was mild. Once I learned to gauge my food intake (I learned to absolutely love the blandness of Shredded Wheat. And I’ve lost count of the number of watermelons Alan cut up for me), I did pretty well. Walking was an adventure sometimes, focusing on a computer screen for more than a few minutes an impossibility without dizziness.
Considering what some of my peers were experiencing, I was blessed and I knew it.
And then it was over.
I had a few weeks to regain my strength before Meaghan and I were to head out to Alberta and BC to see her brothers, then back to Ontario and radiation.
Time to see Dr. Falkson again.
]]>He just said one word. “Yes.”
I turned my head back to Meaghan. She was still smiling. I smiled back. And then, I guess, I went back to sleep for awhile and Dr. Petsikas fixed the leak.
I’m not sure when I woke up again or where. My next clear memory is of sometime the next day. I was in Intensive Care, feeling a lot like John Hurt’s character Kane in Alien after the creepy crawly makes it’s exit from his guts. I looked down at myself but didn’t notice any bits and pieces of ribs or internal organs laying about anywhere. Apparently, Dr. Petsikas was considerably more tidy than Ridley Scott would have been.
There were, however, three tubes sticking out of me. Which seemed to me to be about the size of the milker pipes we used to use on the farm (they were considerably smaller). For drainage, a nurse informed me, pointing to the handy dandy container that they were attached to at the foot of the bed. Ewwwww.
A little later, a couple of physiotherapy ladies dropped by. They wanted me to stand up.
Say what???
I think you have the wrong bed, ladies. Someone cut my chest apart yesterday. I’m not sure “standing” is one of my options yet. They simply smiled, mentioned something about having a distant cousin named Torquemada, and insisted.
They provided lots of support, and demonstrated how one holds a folded blanket against one’s chest while attempting the formidable gymnastic feat called “standing”. The folded blanket, for anyone who hasn’t had open chest surgery, is to help keep one’s ribs and breastbone together, as otherwise they have a disconcerting tendency to grind against each other, not being all of one piece the way they were prior to yesterday.
I stood up.
I threw up.
I laid down.
The ladies smiled and went away, muttering something about bringing a “big meat hook” next time. (I might have imagined that last part.)
Meaghan and Alan came to visit a little later. She looked relieved but tired. Yesterday had been a lot longer for her than it had for me. They had planned to visit her mother in Ottawa, a couple of hours drive from Kingston, but Meaghan thought they should stay and sit with me instead. Nonsense. I was going to sleep most of the day. I’d survived the surgery. Time for her to take a breath. I figured she could use a bit of mother’s love just at the moment. Off they went.
Later in the day, Dr. Petsikas dropped by and confirmed that yes, they had indeed gotten all of the beast. However, it was not, as they’d thought, the size of baseball. It was more like a cauliflower. Huhn. When I was a kid, my mother used to tell me that if I ate food without washing off the dirt, vegetables would start to grow in my stomach. Smart woman.
It was, I believe, the next day that everyone was satisfied that I no longer needed to be in ICU and I went back to my room. I say “I believe” because I have to admit that, although I was euphoric over how well things had gone, part of that euphoria was probably due to drugs. Either way, I got back to my room feeling pretty fortunate.
A fellow by the name of Rick was still my roommate. Rick had been wheeled in the day before my operation after having had surgery to remove part of his cancerous lung. He was not as fortunate as I had been. During surgery, the doctors discovered that his cancer had spread. They would begin chemotherapy and radiation. It was hoped that he would survive until his son and daughter finished school.
The next day Rick went home. I think of him often.
As for me, I was in hospital for several more days regaining some strength and mastering the folded blanket trick. A steady flow of residents and students came by to ask about my progress, to poke and prod, and to practice their bedside manner. If my experience is any indication, this country is training a cadre of top-notch, dedicated, upbeat and enthusiastic health professionals. I was in good hands.
I gradually gained mobility and eventually the drainage tubes were removed. I was free to roam the corridors and I did. A friend visited and we even ventured all the way to the cafeteria for a salad. I didn’t win any footraces, although there was one older gent there who could only manage a few steps before stopping to catch his wind; I thought I might have had a chance against him.
Dr. Petsikas had been by several times during this period of course. The mass had been all in one piece as he’d previously noted. That’s pretty typical for thymoma. However, it had been pressing hard on my lungs and heart (which, as we knew, was the cause of the fluid retention). There were two small spots on one lung that he had flagged as concerning. He had not cut them out because, well, they were part of my lung after all. The consensus was that it would be better to do a round of chemotherapy and perhaps radiation and see how they responded. Dr. Gregg would be in touch.
I went home again.
]]>Not long after I went home, I got a call setting up a consultation appointment to determine exactly which combination of the three my treatment plan would be.
Within a couple of weeks Meaghan and I were sitting in an examination room in the Cancer Centre of Southeastern Ontario at Kingston General Hospital. We were there to meet Dr. Falkson, the radiation oncologist. He, along with Dr. Gregg, the medical oncologist (chemotherapy), and Dr. Petsikas, thoracic surgeon, were jointly consulting to determine who got to do what to me when.
Apparently they’d tossed a coin and Dr. Petsikas had won – cutting would come first. The other two would have to fight over what, if anything, was left. Now, Dr. Falkson didn’t put it exactly that way, of course. He said a lot of stuff about how they’d looked very closely at my scans and that it seemed that perhaps the beast hadn’t yet, quite, sunk its hooks into any other important stuff in my guts. Like my heart or my lungs. That being the case, they thought it prudent to go to surgery first. Normally, as I’d discovered in my research, this was an option primarily used for earlier stage tumors.
However, I thought that it sounded like a fine idea. I was of the opinion that I’d rather have someone on the outside deciding when to cut the beast out than to wake up one morning with Sigourney Weaver tut-tutting over the exploded mess that the thing had made of my chest by deciding to vacate on its own (okay, that wouldn’t literally happen. But the alternative, not waking up one morning, was no more appealing.)
After a brief discussion with Meaghan, we gave this plan the thumbs up and a few days later found ourselves meeting with Dr. Petsikas. He outlined what would happen next, set up some tests, including an MRI, and told me he’d see me in hospital when I settled in, a couple of weeks hence.
That couple of weeks passed quickly. The only test I hadn’t undergone before, the MRI, wasn’t as bad as I’d expected. That is, as long as you don’t mind being stuffed into a machine with an opening the size of a ventilator shaft for 40 to 60 minutes while a motorcycle gang revs its engine just outside your head.
On the up side, a technician, selected, I’m convinced, for the skill of being able to sound like an angel, whispered encouragingly into the headset I was wearing so I never felt alone.
In other words, piece of cake.
As upbeat as I tried to be, I had no illusions as to the seriousness of my situation. Nor do I want to minimize the harrowing and traumatic experiences of others. I met many fine and wonderful people in the course of this. Some have not been as fortunate as I. They are often in my thoughts.
In the world of cancer, things are measured in “stages.” The actual scale differs from one type of cancer to another. In my case, I was a Stage 4A on a scale that had no Stage 5 and only used one more letter of the alphabet.
I spent the time before returning to hospital making sure that, as the cliche goes, my affairs were in order. It’s a very odd feeling, disconnecting oneself from life. One of the oncology residents who visited me during my first hospital stay had suggested that I “prepare for the fight of my life.” I took him at his word.
I went back to hospital five weeks after having left. I met the anesthesiologist, some of the surgical team, and a constantly changing roster of floor nurses and assistants whose one common quality seemed to be the desire to make as many people as comfortable as possible in the midst of difficult and terrifying times.
And then, early one morning I said hello to Dr. Petsikas, cracked a lame joke with some nurses whose faces were hidden behind masks, and slid from my hospital bed onto a shiny steel table in a room that looked like it should be on a television show. The anesthesiologist apologized for having to stab me twice with one of his needles (I do not have very cooperative veins). I told him it was not a problem, I was expecting to have a somewhat bigger hole in me shortly.
…. and then I went to sleep for a while.
]]>Opinion was divided on which of the two was “better” (read “less likely to kill me in the near future”). Lymphoma is much more common and had the benefit, if that’s the right word, of being more extensively researched and understood, with a wider range of treatment options.
Thymoma, on the other hand, is relatively rare. Which means less is known about it. Since the indications seemed to be leaning in this direction, Dr. Thakrar printed off a thick sheaf of information on thymoma for me. Turned out there were a couple of types. A “plain, old” thymoma was essentially a matter of the thymus gland, which normally goes dormant when we hit our teen years, forgetting to “turn itself off.” It just keeps growing. And growing. Until four or five decades later it almost kills you. Since it tends not to metastasize (spread), however, treatment is very focused and success rates are high. Hence the potentially “better” diagnosis.
If this was a “thymic carcinoma“, however … well, best not to plan any Christmas parties. Or St. Patrick’s Day for that matter. Valentine’s Day, a couple of weeks away, was in question as well.
Hunh.
While I waited for the official diagnosis, things became pretty routine. My cardiology team concluded I was stable enough to have the drain taken out and to be disconnected from the monitoring equipment. Which meant that I could be transferred to a regular bed and had the run of the hospital. Exciting stuff let me tell ya.
Even more exciting was the news that I could go home. I’d been in hospital almost two weeks at this point and while the care had been exceptional, as Dorothy said there’s no place like home.
It wasn’t until the very hour that I was to leave – while, in fact, I waited for Meaghan and Alan to pick me up, that I received the final conclusion and could name the beastie in my chest – Thymoma. The plain, old kind.
I’m not sure that my reaction was quite what the oncologist who delivered the news, Dr. Gregg, was expecting.
I smiled.
And then I went home.
But not for long.
]]>In any case, now we knew what was causing all the fuss, at least in general terms. But the doctors needed to know what, specifically, this “mass” was in order to decide how to go about treating it. One thing I knew for sure – it needed to go.
Before I did.
The way doctors find out exactly what shadows on CT scans really are is to do a biopsy. Which, as you may already know, is a fancy way of saying that they take a piece of it out and pathologize it (I know, that’s still not a word). In my case, there were two choices as to how to do this. The first was to slice an opening in my chest, reach in, cut off a little helping, and sew me up again.
Which was how I met Dr. Petsikas. Actually, I met his resident team first, which was led by a very intense young lady. Standing by my bed, she seemed ready to pick up a knife and do the job then and there. She also seemed a little disappointed by the possibility that she might not have the opportunity.
Dr. Petsikas came in the next day, swept past my bed on the way to the computer terminal at the nurse’s station, and asked if I wanted to see the beastie in my belly (well, okay, not literally my “belly” – I just think it has a nicer ring to it, don’t you?). Once I recovered my bearings, I said “sure.” I have since come to believe that all surgeons have this no nonsense, full-speed-ahead approach. Which I think is a good thing. One does not want the person who has you laid open like a filleted mackerel to be hesitant about what to do next or how you’re supposed to go back together.
I confess that the images Dr. Petsikas showed me didn’t really make a lot of sense to me. I could see the image of the “beastie” well enough, I just didn’t have any context for it. Doc’s comment that it was, probably, about the size of a baseball, had a lot more impact. Kinda like being hit in the chest with one, if you want to know the truth.
How the devil did something that big get there without my noticing?
In the end, the decision was made to go with a “needle biopsy.” The up-side was that it was a less invasive procedure. The down-side was that, once again, I’d be awake during the process. Not to mention being in a CT machine the entire time. And expected to hold still.
The doctor who performed the biopsy was a very pleasant fellow whose name, I’m sorry to say, I cannot remember. He made very sure that he briefed me on exactly what would happen, what my options were, and what he needed to get out of the the whole thing for the pathologist. Essentially, a rather large hollow needle would be inserted just above my breast bone, slid in until it rested on the beastie. Then a little nibbler would be inserted through the needle and pushed up against the beastie; after which the doctor would chew little pieces of it off and put them in a jar.
Hopefully, the beastie would not decide to escape on its own, ala Sigourney Weaver and Alien, when we bit it.
The whole process, I’m happy to say, went off without a hitch. Doc had said the most nibbles he’d ever gotten during the procedure was twenty four, and at worst, he’d be happy if we got two. We went for the record and took thirty. First record I ever broke. I did try to get him to just keep nibbling until it was all gone but he didn’t think that was really an option.
Back to waiting.
]]>Still, there was no need to panic anyone. I was in a good hospital, with a great team of doctors, residents, nurses, and students. In truth, I didn’t feel bad, and with fluid drained from around my heart, it seemed a little premature to call the pine box people. So, while I made sure to talk to everyone, and to tell my closest friend that I’d left messages on my computer “just in case”, I didn’t start saying kind things about the Grim Reaper just yet. (although I loved him in Bill and Ted’s Bogus Journey).
The doctors had a plan to find the cause of my curious condition. As they weren’t prepared to discharge me until they did, I spent a total of two weeks in the Cardiology unit at Kingston General. Once they were reasonably confident that I wasn’t going to suddenly check out in the metaphorical sense either, they moved me to a “step down” unit – which is basically a ward with four beds, its own nurse and restricted access. I remained hooked up to a heart monitor during this time, so going anywhere, including the bathroom, meant trailing a mess of wires across the room. Still, if something did happen to my ticker, it was good to know that someone would be alerted right away. At least they could roll me out of the hall so no one tripped over me.
A CT scan performed a couple days after my admission showed fluid coming back around my heart. So it was decided to redo the drain, this time leaving it in place for an extended period. As I was not, of course, the only patient in the step down ward when this was done, the other patients and their visitors could hear what was taking place. Their view was obscured by the curtain which was drawn around the bed. Only thing was, as the nurse had to go in and out frequently, that curtain was often parted. I vividly recall the look on the face of a young girl visiting her grandfather in the bed across from mine. Her eyes were wide open and seemingly fixed on the split in the curtain, as she was staring in astonishment each time it opened. I smiled encouragingly back at her and winked.
I mentioned (in Stick a Pin in it) how the drain is inserted. One of the doctors working with Dr. Thakrar would be doing the insertion this time, with Dr. Thakrar assisting on the ultrasound. It would be his first tme. It took considerably longer, something for which he felt obliged to apologize on several occasions. From my perspective, the procedure, performed under local anesthetic, was not painful nor even uncomfortable. If poking around in my chest helped this intense young man perfect his technique and maybe save someone else’s life someday, it was a win all around.
Once this second drain was in place, my heart remained clear. While the doctors had hoped that my body would begin to naturally clear the fluid in my lungs (which was, after all, what had taken me to hospital in the first place), that didn’t seem to be happening. So it was decided to drain them as well. Or, more accurately, to drain the space around them since the fluid was actually building up outside the lungs in the membrane that they hang in. It’s called a pleural effusion.
I didn’t get to see the handiwork for this procedure as its done from the back. “Please sit on the side of the bed Mr. Keating, and kindly don’t move around too much. That’s right, just lay your head on the tray, here’s a pillow. This won’t hurt a bit.” Uh huh. Actually, there really wasn’t any pain, and, while it was a longer process, it went smoothly, with a litre of fluid being whisked away for analysis. Afterward, the woman in bed beside me asked if she could pray for me. Apparently it sounded much worse for those who couldn’t see what was going on. I suggested, since she was also in a high-care unit, that we pray for each other. She thought that was a good idea.
While these procedures were going on to alleviate my symptoms (I still looked like a Michelin Man) there were also tests to determine what was causing the problem in the first place. My heart seemed in good shape. In fact, if it hadn’t been in such good condition, I would probably not have lasted long enough for anyone to do anything. Too bad, please make a donation in lieu of flowers.
So I was echoed, and ultrasounded, and CT’d from head to toe and everywhere in between. And I mean everywhere. My blood was drawn and tested. My personal history was explored -
- “Have you been out of the country lately?” No.
– “Do you take any recreational pharmaceuticals?” No.
– “Have you enjoyed the company of…” No, and sheesh!
– And of course the samples from around my heart and lungs were cultured and pathologized (is that a word?) All came back negative. Halleluiah! I was healthy as a horse. A bloated horse, but you get the idea.
Except …
“Hmmm. Mr. Keating, there seems to be a mass of some kind in your chest. Shouldn’t be there. Fairly big sucker too actually. Pressing on the heart you see. Which is irritating your heart. Which is responding by creating all this fluid.
“The good news is that we’re pretty confident that this is the source of your problem. The bad news is that, well… there’s this really big mass in your chest.”
Oh.
]]>I’d gone from being pretty certain that I was going to need something as simple as high blood pressure pills for the rest of my life, to wondering if I’d have an opportunity to say goodbye to my family, to cautious optimism that whatever was wrong with me might possibly be treatable. It’d been quite a ride.
Little did I realize it hadn’t even begun.
This procedure wouldn’t exactly “deflate” the Michelin Man. It was more a matter of giving my heart room to do its thing. With my ticker back to full capacity, it was hoped, my body would naturally start to deal with everything else.
While the ultrasound guy prepped his equipment, the nurse helped Dr. Thakrar gown up and then laid out the shiny metal instruments according to his directions. Perhaps oddly, its the creation of a sterile “theatre” around my bed that I remember most clearly. I’ve had a couple of operations in my life – a hernia, my appendix, that sort of thing. But one tends to be sedated when those processes take place. This was different. The care that went into ensuring that none of the instruments touched any part of the room or the bed I was in; the procedure for sterilizing the ultrasound wand; even the way the nurse assisted with the doc’s gown, both impressed me and brought home just what was happening.
On the other hand, everyone seemed pretty relaxed. Including me I think. After all, no point in getting all in a tizzy was there? I was in a very good hospital, with obviously competent people, who were doing exactly what they’d spent most of their lives training for. We might just as well enjoy a little comeraderie on this journey that fate had thrown us together on. So we joked a bit about sharp objects, and how steady Dr. Thakrar’s hand was, and how still I was going to be able to stay while he was sliding that needle in, using the shadow box images of the ultrasound as his only guide.
When the procedure began, however, all levity stopped. Nothing could have been more professional. I have never stopped being amazed, then or in any of the procedures that were to follow, at how such a disparate group of people can meld themselves into a coherent unit to accomplish the task at hand. The nurse had whatever the doctor needed seemingly instantly; a few words exchanged between doctor and ultrasound tech were enough to adjust the view of my intermal machinery so that the needle ended up where it was supposed to be, and in, it seemed to me, less time than expected.
Drain in place, a hose and container were attached and the tap turned on. It took no more than an hour to complete the entire procedure. “Now, Mr. Keating, lets see how you respond, and lets see if we can find out what caused all this nastiness in the first place, shall we?”
Sounded like a plan.
]]>Shortly after my daughter Meaghan, and her boyfriend Alan showed up, and while we were waiting for the whole “drain” thing to happen, a different doctor dropped in. This fellow was an instructor at the university and he wondered if I’d mind if he brought by his first year medical class to have a boo at me? Hey, I’m a big supporter of the health care system in Canada. Anything I could do to help imbue future doctors with wisdom and compassion I was up for. Bring ‘em on.
So a few minutes later I found myself surrounded by a dozen or so fresh-faced young men and women who bore expressions ranging from boredom (heck, this guy just needs to go on a diet) to intense fascination (oh, I hope he’s got something exotic). My daughter didn’t look any too comfortable with all the attention I was getting so I asked her if she could maybe go see if she could find me a newspaper. “Take your time honey, I’m in good hands.”
The doctor/instructor began by asking his eager charges a number of questions about what they could tell from a visual observation of my fine, fit form. Well first of all, observed one, I didn’t look all that fine or fit. No one offered the “Michelin Man” comparison but I think the fact that I was in one of the fishbowl rooms was a pretty good clue that obesity wasn’t the prime motivator here. To confirm, though, the student in the hot seat did ask about my weight prior to my admission to hospital. “Trying to lose a few” was my reply. Which was true. I had been about twenty five pounds overweight before I gained the additional twenty in the previous two weeks.
“So,” says the instructor, “obesity was not a major factor. Lets look more closely at the patient’s condition.” This was when I got to play medical dummy, a role I’m apparently quite good at. One by one, each student got to thump my back, my chest, and take a gander at my, currently oversized, gams. By the time they were done, they all knew how to determine just how high the fluid in a patient’s lungs had risen (the thumping the back process – kinda like tapping a drum until you hit the hollow sound), and therefore how much breathing capacity said patient retained. All agreed that I was running on significantly less than half capacity.
Say what now? Hearing such things discussed dispassionately by a group of twenty-somethings who were, I was quite certain, still spending weekends checking out the local nightclub scene, somehow gave it a whole new flavour.
Being in the cardiac ward was a bit of a clue as to the direction of investigation of course. Still, the instructor asked for suggestions from the floor – “What is up with Mr. Keating?” The girl who offered cardiac tamponade got the gold star; that being the proper term for “so much fluid around his heart that it’s workin’ like it was free divin’ in the Marianas Trench.”
After allowing the gang to practice their bedside manner – some were quite good; A+ for compassion folks – by spending a few minutes asking me whatever they wanted to, the instructor gathered his charges and moved on, presumably to some other, equally “interesting”, patient. And while my naturally ironic view of the world found the whole thing humourous, I was also surprisingly reassured by the knowledge that I was in a place where whole classes of doctors and future doctors wandered around just looking for symptoms and side effects of interesting and challenging conditions. If any place had a shot at resolving whatever was causing my issue, this was surely it.
It wasn’t long after that Dr. Thakrar reappeared, trailing different people and carts full of equipment. Some of which looked rather sharp. I suddenly remembered why I didn’t watch horror movies. Too many sharp things that ended up in too many people.
Doc was, however, reassuring in both word and deed, explaining to me what each person in the room was responsible for, as well as how long they’d been doing what they were going to do. The nurse assisting, as it turned out, would be assisting in this particular procedure for the first time. Was I okay with that? Sure. Heck, everyone has to have a first time, don’t they? Might as well be with me.
Sounded like a Billy Joel tune.
]]>It wasn’t long before a cardiology resident, along with a couple of additional people who were briefly introduced, appeared at my bedside.
I should take a moment here and explain a little about how the resident system works at the hospital. At least to the extent I understand it.
New doctors spend five years in “residency”, essentially working under the direction of a senior physician, while they hone their skills. As they advance through the program they gain greater autonomy. As part of the process, those who are more advanced in their residency have less experienced doctors and other specialists as part of their team. In this way, everyone gains from the experience of the others and a certain synergy comes into play that makes the environment rather dynamic.
At least, that was my experience. I should also note that I found throughout this entire experience that the health care system performed beyond my expectations. But more about that as we go along.
Dr. Thakrar, the lead resident who would be my primary contact throughout this phase of my illness, wanted to know how I was feeling. He asked a number of questions about symptoms. Had I had any shortness of breath? Fatigue? Numbness?
Didn’t think so; not really; and nope. Just this funny taste in my mouth. And of course, a minor issue with gaining twenty some pounds in two weeks.
Doc didn’t question my comments on lack of symptoms, although he later confided that his own observations were somewhat different. Guess I wasn’t all that clued in when it came to my own functionality. Funny how things can sneak up on you. Even life-threatening things.
Instead, he explained what was going to happen next. With my permission of course. But heck, what was I gonna say, “no”? Not likely.
They felt that the most immediate need was to relieve the pressure on my heart. After all, I’d already just survived a rather alarming cardiac episode, and they would prefer that I not have a repeat incident. I was all for that as well.
So Dr. Thakrar would set up a procedure, the name of which escapes me at the moment, that would see him bring in a nurse to assist and an ultrasound tech to guide him while he slipped a drain in through my chest and up alongside my ticker. No sweat, done right here in the bed Mr. Keating. A little local anesthetic, you won’t feel a thing. See you in a couple hours, as soon as we’re all set to go.
Then they left me alone for a bit. During which time my daughter Meaghan, and her boyfriend Alan, arrived.
After lots of hugs and a few tears, we looked at each other and said, as I recall, the equivalent of “huh.”
We’ve never been a family to panic in the face of crisis, and we’ve had a few over the years. My sons’ mother, as I mentioned, died when they were very young, in a car accident. My dad died at home while we held his hand. My daughter’s mother up and left one afternoon (the reasons for which were many, varied, not entirely unexpected, and at least equally my fault). Then two years previously, my daughter had shown up on my doorstep at 10:30 at night when her stepfather had thrown her out (the reasons for which I shall not stoop to include here – save to say that some stepfather stereotypes exist for a reason). And a year ago, we’d spent the day after Christmas in hospital while my daughter had an emergency appendectomy.
In each situation, there seemed little point in bemoaning fate, circumstance, or the vagaries of the world. Better to simply say “huh”, and deal with it.
Huh.
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