Dog Lived (and So Will I)

by Rhyne, Teresa J.

  So from August to December we’d been working on the relationship. We’d seen them a few times, and I could see they were trying hard, but I found it difficult to trust their actions or motivations. I continually expected that there’d be trouble once again, as though they were merely gathering evidence against me. I could not get out of my mind how kind and considerate they’d been to me a mere forty-eight hours before instructing Chris to leave me. My relationship with them was thus cordial but distant. I had told Chris that I would appear at the obligatory events—birthdays, holidays, weddings—but that he’d have to attend the voluntary, informal family gatherings alone.

  Christmas Eve dinner, with many of the same aunts and uncles I hadn’t seen since that fateful Thanksgiving, was on the “obligatory” list. I considered bowing out but couldn’t figure out how to say “I can’t be there because I’m pretty sure I have cancer even though the doctor hasn’t said that yet” in a way that sounded less than pathetic or just an outright bad lie. Staying home alone with Seamus sounded appealing at first as well, but staying home alone with my thoughts echoing around an empty house did not.

  And Seamus was another unresolved issue. Chris had kept up a regular walking routine with Seamus, walking him farther and faster than I ever had, but it never helped. The more we gave, the more Seamus became entitled to. We now never left him alone, both out of courtesy to our neighbors and fear they would take their complaints to animal control or the homeowners’ association. If Chris and I both needed to be gone, we hired a dog-sitter or took him to stay overnight at Ruff House, which by then had a new owner, but luckily Marti was as adoring of Seamus as Denise had been. But I didn’t want to leave Seamus overnight on Christmas Eve because we wouldn’t be able to pick him up until the twenty-sixth. The one part of Christmas I’d come to enjoy was the morning alone with Chris and Seamus, a fire, a strong cup of coffee, and a stack of books that were our usual gifts to each other. I didn’t want to give that up, especially under these circumstances. I needed my support group of two.

  We decided to take Seamus with us.

  Chris’s parents’ neighborhood was not, however, one that would tolerate a howling beagle. For that matter, their home décor was not one that would tolerate a hyperactive beagle with a penchant for luxurious beds that bordered on obsession. Although they were “dog people,” Chris’s family’s dogs tended to be like them—beautiful, tidy, well-behaved, and from small, tight-knit packs. My family’s dogs were like us—big (in size or personality), unruly, prone to bad behavior, and running about in large packs known to assimilate strays. They were willing to have us bring Seamus along, but there would need to be some rules. We put him in his crate in their garage while we went to a restaurant for dinner.

  Without even being present at the dinner, Seamus was once again my buffer. I elicited laughter from the entire table by reporting on how Seamus had earlier that week eaten nearly three pounds of gourmet cheese, courtesy, once again, of the deliveryman’s failure to read the note “do not throw packages over fence” posted right above the “dog in yard” sign on our gate. That led to many more stories of Seamus’s food escapades, including the now legendary sourdough escapade. I found it easier to not think about the lump or the “highly suspicious of malignancy” message if I engaged in conversation, rather than sitting alone with my concerns, which is what I generally did around his family.

  Once we returned to Chris’s parents’ home, Seamus was released from his crate and allowed to join the festivities. Chris made sure my wineglass was filled and Seamus was occupied with toys. I sat on the floor of the formal living room with Chris’s sister, Courtney. Courtney is the youngest child in the family by several years, and she plays that role well. She is perpetually the center of attention. In other words, she was the perfect person for me to spend the evening with. She kept up a steady stream of conversation about I don’t know what with no need for me to reply much more than to occasionally nod. Seamus ran in and out of the room, sniffing around the table and approaching me to see if I might have any handouts. Finding no food available, he’d run from the room chasing after Chloe, the small, adorable cockapoo that had been Chris’s parents’ family pet for fourteen years and reminded me of my childhood dog Tippy.

  We left at ten that night, with Chris driving and Seamus exhausted and resting in his crate for the hour-long ride home.

  “Well, that went better than I thought with Seamus,” I said.

  “It did?” Chris said.

  “Well, yeah. He didn’t seem to be too much trouble. And your parents seemed fine with him.”

  Chris turned to look at me, astonished. “He took a dump in the middle of the living room.”

  “He did?”

  It’s fair to say I was distracted. I don’t know that I could have managed knowledge of cancer on the horizon and dog shit on the ivory carpet simultaneously. I also don’t know how Chris, or his parents for that matter, managed to keep that odiferous fact from me, but I’m glad they did.

  The three of us got our quiet Christmas day home alone. Chris and I both splurged on books for each other, food for the three of us, and new toys for Seamus, with each of us trying to outdo the other on the latter. Yes, by then we knew it was wrong—very wrong—to spoil this dog in this way, but it was endlessly amusing to see Seamus toss the newest toy in the air, chomp it in his jaws, and hear the frantic squeaking noise repeatedly until we chased him around the house. He had no use for the toys that did not squeak. No rubber toys or cuddly toys for Seamus. Just toys with squeakers for hearts—all the better to rip them out, leaving a trail of stuffing.

  The following day we drove to my father’s home that he shared with his wife, Nancy, in the desert near Palm Springs. There were fourteen of us together that day. And two dogs. Seamus, of course, and Max, my dad’s Australian shepherd.

  My Christmas gift to everyone was a family photo, shot by a professional photographer friend of mine. At the time I planned this it served two purposes—I didn’t have to shop for everyone and it would be a once-in-a-lifetime gift everyone would enjoy. Now, the photography session would nicely serve a third purpose—it would record for all posterity the final moments before cancer invaded our family and it would distract me nicely from that fact.

  We had four more days to muddle through before I could finally see a surgeon.

  Chapter 14

  DR. GOOD KARMA

  “This cannot be the place,” I said.

  “Check the address again,” Chris said.

  I looked at the paperwork in my lap, then I handed the referral sheet to Chris.

  “It doesn’t even look like a medical clinic,” I said.

  “I was thinking that. It looks like an old real estate office or something.”

  “And it was a gas station before that.”

  We stared at the gray, cracked-stucco, two-story building at the end of a mostly vacant strip mall.

  “Well, let’s go in. Maybe it’s better inside?”

  Chris held open the door of the clinic for me. I stepped inside.

  The waiting room was filled to capacity. Each patient seemed to have three or more children in tow. A man brushed by us, not waiting to be all the way outside before lighting up his cigarette. Three feet from the door was good enough for him.

  I turned back to Chris. “I have insurance.”

  “Apparently this is what’s available during the holidays,” he said. “Look, we’re here. It’s just a consultation. At least talk to the surgeon.”

  “It looks dirty. I don’t want to be in a dirty surgery center.”

  “Well, let’s hope this isn’t where surgery is done. Go check in. Maybe they send you off to a different place after you check in.”

  “Your optimism is astounding.”

  At the reception desk I was handed a clipboard full of paperwork and told to take a seat.
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  There was no seat available.

  We leaned against a wall while I tried to fill out paperwork until finally one patient was called back and two children trailed after her, opening up a row of seats in the far back corner of the room.

  Seated, I concentrated on the paperwork and kept my head down.

  “Is that actually Astroturf?” Chris pointed at the bright green grass-like flooring.

  “Maybe just industrial carpet?”

  “There’s no padding.”

  “How do you know?”

  He pointed to the corner of the room. The Astroturf carpet had peeled back and disintegrated, exposing the concrete floor and a few candy wrappers. “Did you tell them you had insurance?”

  “I’m going to see the surgeon. But I don’t think I can be treated here. This is awful.”

  The man who left to smoke returned and took the seat next to Chris, bringing his tobacco smell and cough with him.

  We waited forty-five minutes—through the smoker’s throat clearing, the children’s tantrums, and several loud, mundane cell phone conversations—before I was finally called back to an exam room. Chris followed me and sat with me for another fifteen minutes while we waited for the doctor.

  By the time Dr. Tamil entered the room, I was anxious and angry. Why was it so hard to get medical care even with a “highly suspicious” condition? I recalled Dr. Sorority Chick and her cold, uncaring attitude and tried to steel my resolve. I would get some answers, whatever it took.

  But Dr. Tamil was reserved and quiet. Despite her surroundings, she had a dignified air, and her opening remarks disarmed me immediately.

  “I am sorry for your wait. I understand this is difficult, and we are, unfortunately, severely understaffed this time of year,” she said.

  “That’s because you are the only clinic open during the holidays, apparently.”

  She nodded, resignedly. “I’m afraid that’s close to the truth.”

  She had, however, already read my charts and reviewed my mammogram and ultrasound. And she did not rush through our appointment.

  I lay back on the exam table while she palpated my right breast.

  “It’s very good you found this.”

  “So I’ve been told. But somehow, I don’t feel good.”

  “I understand. It is a problem. But I do not recommend surgery first. I disagree with your primary care physician. You are young. There is no reason to have more scars than necessary. I would recommend a biopsy first, to be certain we know what you are dealing with. Then we can proceed to surgery, if necessary.”

  “Meaning if this is cancer?”

  “Yes.”

  “We don’t already know this is cancer?”

  “Not for certain, no. I don’t want to mislead you. It does not look good, but a biopsy would be recommended before surgery.”

  I sat up and closed my gown. “Okay. When can we do that?”

  Dr. Tamil sighed and slouched up against a counter. “If you were in a specialized cancer center, the biopsy would take place in the next couple of days, most likely. If the biopsy showed cancer, we’d schedule an MRI and then surgery, and this would all occur in a week to two weeks.”

  “Two weeks?” That seemed both quick (to be in surgery) and interminably long (to have cancer hanging out in my body).

  “Two weeks if you were at a specialty cancer hospital. That is not here. Not in Riverside County. You have good insurance and you could go to City of Hope or UCLA or some such facility, and that is how things would proceed. I and some other doctors are working hard to get that out here, but it does not exist here. Not yet.”

  “So what happens here?”

  Dr. Tamil now sat, her weariness as palpable as my tumor. She explained the long, through-the-looking-glass process ahead of me.

  • • •

  I met my friend Stacey for lunch a few days later.

  “Um, wow. You look great. Nice suit. Are you losing weight?” she said.

  “Probably.”

  “Shit. What’s going on?” Stacey is the same friend who pointed out to me that when something is really wrong in my life she can tell because I always look really, really well put together. Her methods were tried and true.

  Every year after Christmas, she and I got together to compare who had suffered the most through the holidays. I knew this year I would win the “whose holidays sucked more” contest. I told her about my highly suspicious lump and the visit to the Medical Clinic for the Holiday- and Hopeless.

  She leaned forward. “You have to get out of town. Go to UCLA.”

  “No, it was okay. The surgeon herself turned out to be very nice. She seemed quite capable. I liked her. And the surgery won’t be in that facility. Turns out that was a temporary space.”

  “So when’s the surgery?”

  “Well, that’s complicated.” I stirred the lettuce on my salad plate. “And a bit unbelievable. I’m still waiting for them to schedule the biopsy. I personally carried my ultrasound and mammogram films to the radiologist’s office hoping to speed up the process. But no. I was told he’ll review them, someday, apparently, and the scheduler will call me with the date for the biopsy. Right now, it looks like January 16. I’m waiting to hear if they can get me in sooner. And Dr. Tamil is trying to help with that.”

  She would not have been surprised to know I was in my immaculate Tahari black suit and black patent leather Cole Haan Nike Air heels as I drove around picking up and delivering my medical records to various offices overcrowded with patients, without once smearing my red lipstick or disturbing my carefully coiffed and recently highlighted hair.

  “That’s twelve more days. It’s absurd. And that’s just for the biopsy. Then what?” She stabbed her Caesar salad.

  Yes. It was absurd. As Dr. Tamil explained, locally it was three weeks before the biopsy could occur, a few days to a week for the results. If the biopsy showed cancer, we’d then schedule an MRI, which would take another couple of weeks. Once we obtained the MRI results, we could schedule surgery, and that would be anywhere from three to six weeks later. All totaled, if this was cancer, it’d be hanging out in my body for another nine to twelve weeks. Unfathomable.

  But what choice did I have?

  I was already so tired. Ever since the “highly suspicious of malignancy” call, I’d been unable to sleep or find medical care. No sooner did I make it through Christmas and to a surgeon than all medical offices closed up shop and stopped answering the phones for the New Year’s holiday. By the time I was having lunch with Stacey, the dark cloud of cancer had been hanging over me for nearly two weeks, and I still didn’t know if I had breast cancer. I didn’t even have an appointment for my biopsy, let alone any surgery.

  Once I shared that with Stacey, she became even more adamant. “Look, you can’t stay in town for this. You can’t. We don’t have the specialists you need. We don’t even have enough doctors. Obviously we don’t have the facilities. I’m telling you, you need to get to UCLA.”

  “I don’t know how to do that. Do I just call UCLA? And who? What do I do, just call the UCLA Medical Center and say ‘Hi, I may have cancer. Can somebody there check it out for me?’ to whoever it is that answers the phone?”

  “Pretty much, yes. That’s what you do. I’ll get you the number. What kind of insurance do you have?”

  “I have a PPO.”

  “So you can go wherever you want? You don’t have to stay in their groups, right?”

  “Yeah, I guess so. The surgeon was telling me that with my insurance I could go to a cancer center and the timeline would be greatly compressed.”

  Until I said that, I didn’t realize that Dr. Tamil may have been suggesting that I do exactly that. I didn’t realize that maybe she knew that the timeline locally wasn’t acceptable and was encouraging me in
the only way she could to seek more timely care.

  What an idiot I’d been! I needed to get out of town! Even the surgeon thought so!

  “Exactly.” Stacey stabbed at her Caesar salad again.

  On my way back to my office I drove through Starbucks for a double latté. Caffeine for lunch was becoming a staple. Within an hour of my return to my office Stacey had emailed, forwarding the email from her own UCLA doctor.

  Hi Stacey—

  Is it a breast lump? If so, I can probably get her in to see someone sooner…but let me know the location of the lump, so I know who exactly she should see.

  Hope you’re well,

  Jeannine

  I couldn’t reach my doctors by phone for days, and here Stacey had received a personal email from her physician within an hour. An email? From a doctor?

  I responded:

  Stacey (and Dr. Rahimian):

  Thank you both for your prompt response.

  It is a breast lump and it is continually described as “right breast 10 o’clock”—which is pretty accurate. It’s most easily felt when my arm is lifted up because it’s approaching the underarm area. I’ve been told it’s not a cyst (this was after the ultrasound).

  I’d appreciate a referral. Right now I’m scheduled for a biopsy on January 16. Thank you,

  Teresa

  The response came five minutes later directly from Dr. Rahimian, a gift from the universe, bearing yet another gift:

  Hi Teresa,

  I would recommend Dr. Amer Karam. He’s a gynecologist at UCLA who has a specialty in breast biopsies and surgery as well. I trust his surgical skills and his judgment very much. I just called the office and his next available appointment is January 8. The number to call to make an appointment is 310-xxx-xxxx.

  Let me know if you need help with anything. When you see him, let him know that I referred you.

  Jeannine

  I called immediately and was given an appointment with Dr. Karam for January 8 at 2:00 p.m. Two days later.

  When I told Chris, he was more relieved than I had been.