There was a room open and she was available. It was like scheduling a hair appointment instead of a hysterectomy. We all knew what I had, and that probably wasn’t going to change, so the sooner we could get this tumor out of me the better. I told her to book the O.R. I was glad I’d called. If I hadn’t, if I’d waited until my first appointment with her that Friday, my surgery might have been pushed even farther back. No sir, let them reserve the room for me, here and now. I figured I could always cancel if anything changed, but I can’t get a room if it’s already taken!
I told her my sister, the nurse, had said, “Get your surgeon to do her own biopsy.”
“Fran, I’m happy to do whatever it takes to make you feel confident about the situation, but I just want you to know that the 9377 Cancer Schmancer 2/28/02 4:18 PM Page 89
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first thing I asked your gynecologist was, ‘Are you sure this biopsy belongs to her, do the dates match, does the name match?’ The tissue that was biopsied was you, Fran, definitely you. Plus, I also showed the tissue to my own pathologists to make doubly certain the report was correct. Again, I’m happy to satisfy your sister—as I said, whatever it takes, I understand you’ve been put through the wringer. But there’s no doubt this is you, and you do have uterine cancer.”
“Well, my sister said to do it, and I really think we should.”
So even though I hadn’t yet met my surgeon, the surgery was scheduled for Wednesday, June 21. I ultimately asked my parents to make the trip and they booked their flight for Tuesday. I alerted Ramon and Angelica to get the guest house ready. I wanted to be strong for what lay ahead, so I hiked; I wanted to feel confident, so I colored my hair; I needed to remain positive, so I saw my shrink. Oh, and I prayed. Man, did I pray. . . .
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The Triple C Ranch
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on Friday, Elaine picked up Rachel and met John and me at the special parking lot for cancer patients at Cedars. John brought a pad and pen for notes. I wore some cool pants and a tie-dyed top I’d bought in London. As we walked down the hospital hallways, I looked so healthy I felt like I didn’t belong there.
Paintings and sculptures lined the walls, a much-appreciated distraction.
A strained cheerfulness sifted through our chitchat as we rode the elevator to the lower level where I’d meet the surgeon, Doctor
#9, for the first time. We were instructed to go straight to the nurses’ station, past a magnificent saltwater aquarium that sat in a prominent position in the waiting area, another well-chosen touch of beauty and grace in an otherwise abysmal destination. The room was filled with somber people and their somber families, each experiencing their own kind of misery. The most heartbreaking were the children.
All the nurses recognized me right away as I was ushered into an examining room that included a wall of chairs and a curtain that, when drawn, would divide the room in two. Rachel talked 9377 Cancer Schmancer 2/28/02 4:18 PM Page 92
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about the twins, her toddlers, as Elaine held up her compact and applied her lipstick.
Three different women, each with a task, entered the room.
One took my blood pressure, one took my temperature, and one took my pulse. I knew they all wanted to gawk at me because I was the Nanny. Surely other people don’t have a separate nurse just to take their temperature. It was inappropriate and made me feel self-conscious. Didn’t they realize I had cancer? But I guess they were all just too excited to meet the Nanny and couldn’t help themselves.
One by one the nurses voiced their love for the show and expressed how much they missed it. Each shared an anecdote about a child or a parent who was particularly devoted. They all commented on how much younger I looked in person than on TV, which I could have taken as ass-kissing, but opted not to. It’s a strange paradox being treated like a star when on another level you’re actually a cancer patient. I didn’t know how to respond.
And even though I didn’t like it, I didn’t blame them, either.
A short time later, after removing my shoes, jewelry, and belt, I still weighed in at close to 140. “Why do hospitals always have
‘fat’ scales?” I joked halfheartedly as the nurse pushed the metal balance farther and farther to the right. I wondered how much a woman’s reproductive organs weigh and how much thinner I’d be after the surgery.
Then two other nurses, Lucy and Wanda, who seemed to work directly with my surgeon, arrived. They were extremely pleasant both in appearance and personality. If I were a surgeon, the first thing I’d look for in a nurse after her qualifications would be a good bedside manner. It makes such a difference in your experience.
On the other hand, personality shouldn’t be the deciding factor in which doctor becomes your surgeon. The way I see it, most surgeons are in a personality class all their own. Doing precision 9377 Cancer Schmancer 2/28/02 4:18 PM Page 93
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work with a knife doesn’t call for the same tact or charm a non-surgeon must display in meeting, greeting, and comforting patients on a daily basis. When it comes to surgery, get the best in the field and forget about the rest. You’re not looking for a date or a potential spouse. You’re never going to go to the movies together or out to dinner. What you need—the only thing you need—is someone who’s good with a knife. Period.
When Doctor #9 entered, we were all surprised at how young and attractive she was, considering the level she’d reached in her field. She pulled herself together really well: Armani suit, Chanel shoes, makeup, hair, and nails all done to a T. This is my surgeon?
I thought. She looked more like a studio executive. Elaine, who was the oldest and I guess the one Doctor #9 appeared youngest to, exclaimed out loud that she “couldn’t believe how young and gorgeous” she was.
It was true: Out of the many doctors I’d seen, she made by far the best presentation. A feather in her cap, I’d say. John took out his pad and pen to take notes, titling the page “Sweetie’s Visit to the Triple C Ranch” (short for “Cedars Cancer Center”). The first and most shocking statement Doctor #9 made was how terrible it was that it had taken this long to diagnose me. She couldn’t understand why none of the previous doctors thought to do a D&C.
“What I teach all my students, and what everybody learns in med school, is: bleeding between periods, biopsy. Period. What happens between medical school and practice I’ll never know!”
That’s exactly what she said; I’ll never forget her directness. She added that, based on my menstrual history, I was probably suffer-ing from something called luteal phase defect. Luteal WHAT? I had a defect that no one knew about?
Probably from as early as my very first period, she theorized, I’d always run low on progesterone, and if there’s one thing the uterus hates more than anything, it’s what’s called unopposed estrogen.
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That’s when you have too much, or even normal amounts of, estrogen, but it’s not balanced or countered by the appropriate amounts of progesterone. I’d always had extremely short cycles (nineteen to twenty-four days, tops), and the one and only time I accidentally got pregnant, I began to miscarry immediately. I was in my late teens, already with Peter. I’d just had my period and thought it would be okay not to use a condom. Whoops. At the time I didn’t dwell on the implications of my inability to carry the pregnancy forward. I was simply relieved not to be confronted with a difficult decision. Had I seriously tried to have a baby in my twenties or even my thirties, I might have been diagnosed with the hormone imbalance years before, because I probably wouldn’t have been able to go full term. Instead, the condition caused the glands in my uterine wall to rebel and grow a malignant ball the size of a walnut.
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I felt anger toward the medical community and the doctors I’d seen prior to Doctor #9, including Doctor #8. Even though she ultimately was the one who diagnosed me, she should have given me the D&C right away. Why didn’t she test me for uterine cancer before treating me for a perimenopausal condition I didn’t have?
Why assume it’s one thing when you haven’t ruled out another?
The surgeon, while snapping on her rubber gloves, bluntly added, “Politicians and celebrities get the worst medical treatment. Who wants to stick their thumb up the ass of the president and tell him he’s got cancer?”
Well, no one really knew how to respond to that one, so there was a general wave of nodding until I blurted out the incongruous remark, “That’s how Elvis died!” Which got no reaction at all.
This was the first time a connection had been made between my fame and the lack of a diagnosis. I hadn’t thought of it before, but there it was right under my nose. Right in her office with those nurses. Can anyone be thorough in their job when they’re completely distracted by celebrity? I wondered.
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The next thing ya know, we’re on to colonoscopies. I wasn’t thrilled with the idea of having a camera shoved up my butt, but I knew I wanted one and had mentioned it to her when we first spoke on the phone. My stool had changed in recent months, but the closest thing I could get to a diagnosis was my internist’s telling me I was eating too much spinach.
My dad’s older sister, Rosalind, a dear aunt of mine, had died from ovarian cancer that eventually spread to her colon. As years go by it’s difficult to differentiate between diagnostic fact and family folklore, but that’s what I believed to be true. My fear was that my cancer had been diagnosed too late and might have spread like hers.
The surgeon had no problem with scheduling a colonoscopy, and repeated again and again that she was willing to do anything I wanted for me to finally feel like I was in the right hands. A gas-trointestinal specialist, Doctor #10, would perform the procedure the day before my surgery. That way I wouldn’t have to take the barium, which clears out your intestines, more than once.
With great fanfare Wanda drew the curtain to separate me from John, Elaine, and Rachel as the exam was about to begin.
She held my hand as Lucy and the surgeon did another D&C on me, this time sans Novocain. Though Doctor #9 still felt the second biopsy wasn’t necessary, she wanted to gain my trust by accommodating my sister’s request. She even took my sister’s work number at the hospital to fill her in on everything. Doctor
#9 really went to great lengths to rectify the damage that had been done by her colleagues. Meanwhile, she seemed to be going to town down there, snipping away tiny chunks of tissue that Lucy gingerly dropped into a vial for biopsy. Man, did that hurt.
Thank God it only lasted a minute.
While Lucy helped me clean up and get dressed, Doctor #9
moved to the other side of the curtain to talk to Rachel, John, and Elaine. “This will be a piece of cake,” she said. “The gynecologist’s 9377 Cancer Schmancer 2/28/02 4:18 PM Page 96
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biopsy indicated the tumor was a baby cancer, just beginning to turn malignant. It’s one hundred percent curable.”
We all left feeling encouraged and good about my surgeon. It was a relief that it was over. John left for work while Elaine, Rachel, and I went out to lunch. As we ate and drank and tried to remain optimistic, I couldn’t stop thinking about those patients in the waiting room. The sadness in their faces, the thinness of their bodies, the baldness of their heads. Would that be me? Is that where I was headed? I didn’t want to go there at all, so I rejoined the conversation in progress: babies, vacations, the menu. When the waiter walked by, I ordered another glass of wine.
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“Now I’m Concerned”
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over the weekend I worked with John writing our MTV pilot. I remember awakening during the night in one of my scared moments of tears and whispers, begging him to finish the script with me. “Who knows what’s going to happen? This may be our last chance to complete it.” I wanted to see his idea become a teleplay. I hated the idea that I might be leaving this earth with an unfinished piece of work. So with the weight of an uncertain future resting squarely on my shoulders, we pulled out the laptop and attempted to write a comedy. And I’m grateful we did, because it was fun to return to our make-believe world. I thought it romantic, the notion we were creating a place no one else knew about but us. It was an escape from reality I welcomed.
I also prepared the guest house for my parents’ arrival, and continued to hike as well. When Monday rolled around, John left for work and I geared my day around the barium I was to drink that afternoon in preparation for the colonoscopy on Tuesday. My dad had had one recently and said it was nothing. I thought it strange that everything I was getting, my mom or dad had also recently gotten. They were able to share their experiences with me, 9377 Cancer Schmancer 2/28/02 4:18 PM Page 98
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guiding me with firsthand knowledge. It was like I was a child again, a big 140-pound baby—something I hadn’t allowed myself to be in a long time.
Rachel and her husband, Greg, made plans to come out to the beach and have lunch with me before I had to take the barium drink. After that, I’d only be able to have liquids or Jell-O until I came through the surgery on Wednesday. It was a beautiful day, the sun was glistening on the ocean, and I made a reservation at Geof-frey’s, a restaurant on a cliff overlooking the Pacific. I always feel like I’m in Hawaii when I go there, and I thought Rachel and Greg would enjoy dining alfresco by the sea.
We talked about poor Nancy Marchand dying of lung cancer.
Not too morbid while having a little lunch. How wonderful for her she got to play such a great part on such a landmark television series as The Sopranos all the way up to the end. I saw her perform off-Broadway in The Cocktail Hour, and always loved her after that.
I was glad I’d done The Nanny. It made me feel successful in my career goals. What would be my next part? Would there be a next part? I ordered the fish, grilled crispy over spinach and whipped potatoes. Usually I like pasta, but this sounded good.
Greg and I had wine; Rachel never drinks. We raised our glasses and toasted to it all going well, and all being over on Wednesday.
As we all got back in my car and headed home, I called for my messages on the cell phone. The nurse had left a message saying that the surgeon had more information from the most recent biopsy (the one my sister had insisted on) and would like me to stop by her office before going in for my colonoscopy tomorrow.
That’s as much as I heard before the phone went dead and I was stuck in a cellular void of no reception for the rest of the way home. Now, it couldn’t have been more than ten minutes, tops, but I felt my entire piece of salmon get stuck in my chest as I frantically kept trying to get a signal so I could connect with the nurse.
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When Greg, Rachel, and I arrived at the house, Angelica and Ramon were still there. “Fran, how many minutes can you record on your video camera?” Ramon asked as I entered the kitchen.
“I don’t know, forty?” I guessed as I dialed the nurse on my hard line. Ramon and his timing, always with the obtuse questions. It’s part of his charm, I guess.
Rachel tried to ground the situation with simple logic: “Whatever it is, we’ll just deal with it, that’s all.”
I remembered I had to take the barium drink. Greg, otherwise known as “the bartender from hell,” prepared it. When I got through to the nurse, she simply repeated the message she’d already left, but I dug in my heels and said, “I’m sorry, but there’s no way I will be able to wait until t
omorrow to find out what this new information is!” She explained that Doctor #9 was in surgery all day.
“I don’t care!” I answered, with panic in my voice. “Can’t she call me on her way from one operation to the other?” It seemed unfathomable to wait. I mean, how torturous. She said the doctor would be coming out in a few minutes and she’d try to get her to call then.
Rachel said, “We’ll wait with you.”
“Are you sure? I mean, I know you probably should be getting back to the kids,” I said, feeling like a burdensome pain.
“Don’t be ridiculous, the kids are fine. We’re not leaving,” she insisted. Once again, I was learning something valuable: When those around you offer to help carry the load, take it for the lifesaver it is and simply say thank you. So we all went into my bedroom and played with Chester. That dog was so intelligent and plugged in to me, he sensed right away something was wrong and anxiously awaited the surgeon’s call along with the rest of us.
Well, just as I was massaging Chester’s little old bones (he was now eighteen years old) and listening to Rachel tell a story, the 9377 Cancer Schmancer 2/28/02 4:18 PM Page 100
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phone rang. We all froze. Rachel stopped talking, Angelica stopped folding laundry, and I grabbed the receiver. It was Doctor #9.
I picked up my notepaper and pen from the side of the bed as Rachel and Greg held their breath. There was no small talk, no pussyfooting around, no soft-pedaling. She came right out and said, “I’m glad we listened to your sister because the second biopsy shows a more advanced cancer than the first.”
“What do you mean, ‘more advanced’?” I said. I looked up at Rachel, who was hanging on every word.
She explained that a more extensive scraping of the uterine tissue indicated not only cells that were grades of one and two, but also threes and fours.
My head was whirling. Thank God for Nadine. The request she made for a second biopsy might have seemed like overkill at the time, but proved to be one of the single greatest pieces of advice I’d received from a medical professional throughout this whole unfortunate mess. How could this be happening? “What does that mean exactly?” I asked, always trying to understand and write down everything she said.
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