Dog Lived (and So Will I)

by Rhyne, Teresa J.

  “Okay, well, I was told to report here.”

  “For what?”

  Wow. Okay. “So someone can take me to nuclear medicine before my surgery. I’m not entirely sure.”

  “Well, me either. I’m new here.” She placed her palms flat on the desk and pushed herself upright. “Hang on. Let me go find someone who knows something.”

  This seemed like a wise idea.

  Had I known what was ahead of me, however, I would have thanked her for the delay. A few minutes later she returned with an apologetic and fast-moving nurse, who insisted I sit in a wheelchair while she rushed me down to nuclear medicine through a series of long hallways and service elevators with Chris rushing behind me.

  Nuclear medicine, we discovered, is in the basement of the medical center. And it’s a scary, cold place. Cold in temperature and demeanor. They hand out blankets in the waiting room, but we didn’t know this initially. The nurse checked me in with reception, told me I could take a seat (she needed the wheelchair back), and then was gone.

  In the waiting room with us was a swarthy-looking man in his early forties, unshaved and wearing a leather jacket and boots, and next to him was a woman who looked like “Mom”—just not his mom. Mom like Mrs. Cunningham or June Cleaver or any of those moms who did not have swarthy-looking sons. They took Swarthy back into the treatment rooms, and five minutes later a tech came out and said to Mom, “Mrs. Jones? Your son-in-law would like you to be with him for the procedure.” Mom smiled sweetly (and knowingly) and followed the tech.

  The fact that Swarthy needed support in the arctic nuclear zone scared me further. Also, I was hoping his procedure had nothing to do with his prostate.

  Soon a large and tall man in an official-looking lab coat entered. I didn’t catch his name, or if I did, I blocked it out. We’ll call him Lurch.

  The receptionist said to Lurch something to the effect of, “We have a such-and-such brain serious major procedure today.”

  Lurch responded, “Really? I haven’t done one of those in twenty years.”

  These are not comforting words in a medical center. Please, do not let me find out my brain is in my right breast.

  Lurch went into the exam area but returned in only a few minutes.

  “Ms. Rhyne?”

  I stood up. “Yes?”

  “Come with me.” Lurch turned and headed back from where he’d come, not bothering to wait for me.

  I turned to Chris. “And you come with me.” If he had not been available, I would have made Swarthy’s mother-in-law come with me, too. Lurch was not a man one wants to follow into the bowels of nuclear medicine.

  I caught up to Lurch in the hallway, and he said, still walking, “So you understand why you’re here and what we’re doing?”

  I knew I was in nuclear medicine to get what Dr. Good Karma had described as the “shot of a tiny bit of radioactive material” that would later help him find my sentinel node as he snooped around in my underarm, but still, there was quite a bit of blind trust involved in these procedures. I wasn’t too different from Seamus naively following a cookie right on into surgery. I mumbled, “Um, yeah, kinda…I just know it’s painless.”

  And Lurch laughed at me.

  He let out a big “Ha!” that echoed down the hallway.

  I stopped following him. Just stopped. I stood staring at his back, slack-jawed and immobile.

  He turned back to face me. “Oh, come on. It’s four injections to your breast. It’s going to hurt. There’s going to be pain.”

  I don’t know how I got the rest of the way down the hall into the treatment room. There isn’t supposed to be pain. Dr. Karam said no pain. Had I been carrying my cell phone I’m certain I would have texted Dr. Karam right there: “U said no pain. Lurch says pain. Come quick.”

  In the treatment room I was relieved to find that Lurch the Ass was not the doctor. Lurch is not even a doctor. The doctor was a young woman (of course she was young) and far, far kinder. Lurch is just some masochist who’s spent too much time in the nuclear zone where his empathy froze off.

  Following Dr. Karam’s original text about this procedure, I did a little reading. I did understand a bit about what was going to happen, and a part of me (the part of me that stayed back at the Angeleno and was sipping coffee and resting comfortably) found it rather fascinating. Dr. Karam had given me a book written by his colleague, Dr. Chang. I followed along as I encountered each phase of my treatment.

  “Doctors use the radioactive tracer as follows: They inject it in and around the cancerous area (or under the nipple) at the time of the initial cancer surgery. …In the operating room using a portable Geiger counter known as a gamma probe, the surgical team identifies the first draining node and removes it following the removal of the primary cancer. The pathologist then analyzes the node using a technique called frozen sectioning. He freezes the node by using liquid nitrogen and then cuts the tissue into thin slices and views them under the microscope. If he sees no cancer, no further surgery is performed.”

  I had four injections around the cancerous area. Unlike Seamus and his tender rear end, I thought that perhaps where my tumor was located was somewhat fortunate, if one has to have cancer in the first place. Three out of four of the injections weren’t really much. But the one closest to the nipple…yeah, um…ow. Not painful in the way Lurch had seemed to hope, and certainly tolerable, but…ouch. The pain was enough to make me bite my lip but not draw blood.

  Did I mention that Lurch is an ass?

  Chris and I had two hours to kill while the radioactive material found its way through my breast before I was to return to nuclear medicine for “pictures.” We chose not to hang out shivering in nuclear medicine. Instead we sat in a sunny window reading. We laughed when we realized I was reading David Sedaris’s When You Are Engulfed in Flames and Chris was reading Then We Came to the End by Joshua Ferris. Perhaps we should have thought about our selections ahead of time.

  With the hotel, dinner the night before, and the little sunny reading nook where we sat giggling at our respective readings, I could almost pretend we were on a mini-vacation. If we could just ignore the nuclear side excursion and the part where Dr. Karam was about to remove a divot from my breast. And cancer. We’d probably need to ignore cancer for a truly restful vacation.

  When we returned to nuclear medicine, the place was no less frightening. There was an old guy asleep (or so I told myself) on a gurney in the hallway. His contorted bones were thinly covered with wrinkled, dry skin, and his mouth hung open. On the bright side, that eliminated any possible feeling bad for myself I could have mustered.

  The “pictures” turned out to be not as simple as I thought, given that everyone so adoringly referred to them as “pictures.” I was envisioning a quick little x-ray and I’m outta there. Not so fast. I was told to lie down on a rather ordinary-looking medical exam table, but then a panel came down on top of me (they asked again, “Are you at all claustrophobic?”). Two “pictures” that take five minutes each are necessary. The tech kindly pointed out on the screen what they were doing. So I turned my head to see the screen, pretending I knew what I was looking at.

  Of course, this being nuclear medicine, everyone left the room while the pictures were taken. As I waited out the five minutes, I noticed there were actually three screens. The one he pointed to, a much bigger one in the middle, and then one in my periphery vision that I could barely see. But the big one in the middle, while difficult to see, was terrifying. It had a lot of red, some yellow, some pink, and a big ol’ scary-looking jagged-edged black spot in the middle.

  Wow.

  I’d seen lots of scary pictures of my cancer by that time, but that one was the worst. Probably because of the red everywhere, and it was obviously extremely close up since they were looking for a little tiny lymph node, but it freaked me out. I kept trying to figu
re out where this famous lymph node was on the screen amid all that pulsating blood. I also wondered if cancer really was black or that was just how it was depicted on the screen. Finally I decided I just couldn’t look at that picture anymore, and I went back to the perfectly harmless-looking black-and-white screen he had told me to look at. It had a nice little countdown clock on it, too, and that helped calm me. It wouldn’t be too much longer before Dr. Karam removed that frightening, pulsating, jagged, black mass from my body.

  The tech returned. “Good job. We found the node. I’m just going to mark it on you.” He drew on my underarm with a Sharpie to pinpoint the node for the surgeon, which seemed very low-tech for a procedure that started out with a radioactive injection.

  “You’re all done now. You can sit up.”

  I sat up and immediately looked to the large, terrifying screen, ready to ask just how bad it all was. And there in front of me was the threatening computer screen…with a beautiful red, yellow, and pink sunset and the black silhouette of a palm tree sticking up in the middle of it. The words “Polynesian Spa Music” were displayed across the top.

  When they insisted on wheeling me back to the surgery floor in a wheelchair, I couldn’t argue. After all, I’d been seeing cancer in the sunsets.

  • • •

  I remember only this much from surgery: the anesthesia nurse was Steve, and he was very kind and good at what he does. The other anesthesia nurse (apparently there to supervise Steve) was an attractive woman with a really cute, colorful surgical hat—until I noticed it was images of coffee and had latte, cappuccino, and other such words all over it, which was just cruel to me in my then state. She was justifiably concerned I might rip it off her head when the anesthesia kicked in and I lost the last two inhibitions I had left.

  Chris held my hand as the anesthesiologist injected me and as I counted down, “Ten, nine, eight…” That was all it took.

  And the infamous blue dye shot straight to the nipple? True to Dr. Good Karma’s word, his skillful hands kept the pain away. Although he assured me that I felt it because I “tried to help”—which is to say I tried to knock it away. Also true to Dr. Karam’s words, I urinated turquoise blue for several days.

  There was, however, one promise Dr. Good Karma did not keep. He was not at my bedside with a Starbucks short, double, nonfat latte when I awoke from the surgery in my anesthesia fog. This is how I learned he had other patients. (The nerve!)

  When Chris and I returned to the hotel that evening, I thought I was doing pretty well, but I was tired. I needed to lie down. I took off my light pink hoodie jacket and headed for the bed. Chris gasped.

  “Baby, don’t lie down yet.”

  “Why? I need to. I need to sleep,” I said, leaning wistfully toward the mattress.

  “Well, you’re bleeding. A lot.”

  I looked down at my breast, fully expecting it to be squirting blood from the nipple. Thus, I was relieved to see that it was only a five-inch circle of dark red blood that had seeped through the gauze, the bandage, my shirt, and the formerly cute hoodie jacket at right breast ten o’clock, across to my underarm.

  Chris reached Dr. Karam on his cell phone while I grabbed a towel and lay down on the bed to sleep. That or I passed out. I really can’t deal with blood.

  When I awoke, it was after 8:00 p.m. and Dr. Karam was standing at my bedside.

  I looked around the room. The lavender and gray furnishings and mid-century look told me I was still in the hotel room. “This brings a whole new meaning to house calls, doctor.”

  “It does! And this is a nice house you’ve got.” He knelt down beside me. “I didn’t want Chris to wake you, and I was finishing up my rounds anyway. I’m sorry I didn’t get to see you after the surgery. I had another surgery, and it got more complicated. But for you, everything went very well. I’m very happy.”

  He changed my bandages while telling me that preliminary reports indicated no lymph node involvement and he believed he got the tumor. He was hopeful we’d have clean margins, “just like Seamus.” He handed Chris a bag of supplies for future bandage changes and informed me that I bleed a lot. I would discover this again and again as I went through treatments, but at that point, snuggled warm in bed, bandages freshly changed, assurances that surgery went well, and the world’s greatest boyfriend and Dr. Good Karma nearby discussing wine again (we’d now had the chance to give Dr. Karam the thank-you bottle of Pinot Noir), further treatment was far from my mind.

  Chapter 17

  THE GAMBLER

  I’d like to tell you Seamus is the kind of dog who senses when his master is sick or tired or just not having a good day and cuddles, stays by my side, brings me my slippers, and licks my tears (if there were any) away. But you’ve read this far, so you know better. He isn’t that dog.

  He’s Seamus. He is the master.

  As I recovered from surgery, he spent time on the couch with me but usually stole the cashmere-blend throw blanket for himself and left me with the cotton one. He wanted cuddles only when he wanted them, whether I needed them or not or was awake or not. He continued to force the breakfast issue by bounding up into our bed at seven in the morning and shoving himself between Chris and me. Luckily, my surgery was on the right side and I sleep on the right side of the bed, which meant my left side generally bore the brunt of Seamus’s morning demands. He kept me in good spirits and laughing, though, and he kept my mind off me. I liked being home with just Chris and Seamus and the occasional visitor. I liked the peace and quiet, and Chris seemed more than able to handle taking care of me. I couldn’t lift my right arm, I needed regular medication, and I was tired, but other than that, I was functioning.

  My mother had come out to California when she and my stepfather were on their vacation, before my surgery, and even then (when I looked and felt healthy) it was clear my diagnosis had caused her a great deal of stress. She was calling regularly and initially wanted to come out to help as I recovered. I told her to wait. It seemed more likely that if I needed more help than Chris could provide, it would be during chemotherapy. This turned out to be a wise decision. My mother broke out in stress-related shingles before I even recovered from the surgery.

  Dr. Karam called, emailed, and texted to check on me the day after my surgery and again the next day. By the time he called on the third day with the pathology report, I had forgotten I was waiting for it. I’d finally been able to shower and vaguely blow-dry and style my hair with limited success since I couldn’t raise my right arm above my shoulder, which happens to be where my head and hair are located. I felt good enough that my neighbors and friends Jane and Francis had come by to visit, bearing food. Between our conversation and Seamus’s howling for the food, I almost didn’t hear the phone ring.

  “Hola, T. This is Amer. Your margins are all clear. I’m so happy. This is all good news.”

  “Oh. Hi, Dr. Karam. Right. Clear margins. Wait, I thought we knew that already?”

  “This is from the pathology report, so it’s all good. Now we know for certain. And your tumor was 1.7 centimeters so the mammogram was actually more accurate than the MRI.”

  “And that means?”

  “Stage 1c, but smaller than we thought. Not as close to two centimeters. And you’re all done with surgery.”

  “So you’re breaking up with me?”

  “Ha! No. I’m still your doctor and primary contact. You still need to see me.”

  “Am I still having chemo?”

  “Likely, yes. We’ll get you to Dr. Glaspy for that. Chemo is really going to be good for you—necessary for this. It’s an aggressive cancer, and chemo is best. But today this is good news. Clean margins are very good news.”

  “Yes, I remember that. Clean margins. That was a big deal for Seamus, too.”

  “How is Seamus?”

  “He’s good. He’s right here with
me.”

  “Yes! I hear him.”

  One should always have an enthusiastic doctor. And one who listens. My surgeon not only could remember my name, my condition, and my medical history, but also could remember my dog’s name. And he cared about all of the above.

  I shared the news with Chris and Jane and Francis, who happen to be three of the smartest, most articulate people I know. But what vocabulary suffices as a response to “I’m now cancer free”? We were all reduced to simple exclamations of relief that weren’t much more than a teenager’s “ohmygawd!” Luckily, in addition to being charming, intellectual, and Irish in all the best ways, Francis Carney made a mean martini. I celebrated my clean margins with a dirty martini. The green olive played the role of the green dog biscuit perfectly.

  • • •

  After my follow-up appointment with Dr. Karam, he walked with Chris and me over to the oncology department in another building to meet Dr. Glaspy, the oncologist.

  “You’re going to like him. He’s the best there is. He will tell you exactly what you need to do,” Dr. Karam said.

  “He’s going to tell me I need chemotherapy. Chances are, based on that alone, I’m not going to like him.” I was still hoping that somehow, some way, I’d be spared chemotherapy. Although Dr. Karam had been very good at leading me gently to the near certainty of it, I was too frightened of chemotherapy to have yet accepted the message.

  “That may be, but what is that expression? Don’t shoot the messenger.”

  After introductions, Dr. Karam left us with a parting, “You’re in good hands.” He gave me a hug and shook Chris’s hand.

  Dr. Glaspy was nothing like Dr. Karam. He was a large man and his demeanor was serious and somewhat reserved. I thought perhaps I’d been spoiled by having a funny, gregarious surgeon who was so kind and empathetic, so perhaps my judgment was skewed.

  Dr. Glaspy began to explain his role in my care.

  “My job is a little like a guy on a riverboat with the gamblers. You know those riverboats with tables of guys playing poker?”