Garrulous

“Um, are you going to be alright?” Dr. Pedersen asked. He was standing bent over me, one hand on my shoulder and the other holding a long, thin tube that blew a stream of cool air over my face – something to keep me alert and prevent me from passing out there in his exam room. That was a real possibility after what he had just told me.

And that was a difficult question to answer – was I going to be alright? – any way you took the scalpel to it.

To begin with, my lips didn’t work so well. Pedersen had sprayed an anesthetic up my nose to prepare for the scope he would then snake up my right nostril, though the nasal cavity, and down into my throat. He gave me a few extra squirts of the stuff when I told him I wasn’t sure I felt it taking effect; I didn’t want to take any chances, not after he told me where the business end of the scope would be heading. He had given me a Kleenex to catch any runoff (I still clutched it; he didn’t offer to take it or proffer a wastebasket), but some of the liquid had still managed to dribble down onto my lips and numb them too. Even if I tried, I couldn’t form a coherent answer.

And there was the vast new alien landscape to behold behind that question. Was I going to be alright? You tell me doc, this is brand new territory for me, I’ve never been here. I don’t know these trees, these mountains. I don’t know how to traverse this terrain. This is your land, not mine.

And I wasn’t even really there to provide an answer. Pedersen had finished squinting behind the eyepiece of his instrument, slid the hose out, said what he said, and suddenly I was gone, slipped into a secret compartment, curled up and hiding from the audience. I was alone with a passel of thoughts popping off like firecrackers, first among them, I think: No no no no no, wait wait wait wait wait, the other doctor said – and the one before him – no, this isn’t right. This isn’t how it’s supposed to go down. Wait a moment here. Let’s back up.

Let’s back up.

Two weeks before, I had shone a light into my mouth and seen for the first time the sores that had plagued me, at that point, for over three weeks and made talking an uncomfortable chore, eating painful and something I did less and less, sometimes only with the aid of pain relievers. The light illuminated a little nest of angry and alien-looking blotches at the right base of my tongue, red and purple and grey, ribboned with yellow. And the tongue itself strangely flared on the right side. I went online, added in the other symptoms – sore throat, earaches – and arrived at certain websites.

The next morning, after a terrible, sleepless night, sitting in an exam room at the walk-in clinic, I gestured anxiously to my mouth: “Cancer?”

“No, I don’t think so,” the clinic doctor said. “You’re pretty young. You don’t smoke that much. You don’t really fit the profile.” Like the other doctor I’d seen at the same clinic nearly two weeks before, before I’d thought anything but “well, this is annoying, guess I should get it looked at,” this one also thought it was just cankers, obstinate canker sores. Sometimes those suckers were stubborn. “Yeah, and that tongue does look pretty beat up. You might be chewing on it at night. You might need to get a retainer or bite-guard to sleep with.” That was all. At worst, the possible dorky indignity of a mouthpiece. So, maybe something bigger than a common cold sore but surely not the massive horror that had sprung up in my fretful brain. A huge relief.  I had overreacted.  I explained to the doctor, “Yeah, and my girlfriend just broke up with me. Just yesterday, actually. So, with everything, I probably just overreacted.” Still, the doctor asked, it had been nearly a month since things started? That was a little a strange. He didn’t think it was anything, really, but here was a referral to another physician, an ear, nose and throat guy, a specialist, a good one. Just in case.

Nearly two weeks later, I stood before the admitting counter of the specialist’s office, late and apologetic. I thought I’d given myself plenty of time for the trip, but the early morning traffic had been terrible, dense and crawling. Another visitor, an old lady, agreed, but the woman behind the counter regarded me unsympathetically. “You should have checked in over 20 minutes ago. Your appointment was ten minutes back. We’re busy here, there are other patients. I’m not sure we can fit you in now.” Fine, I thought. While sitting in traffic, I’d considered turning off and heading back. It wasn’t anything, really. Didn’t these things, even the most persistent, eventually heal on their own, anyway? Just give it some time and warm saltwater. I’ll go home and back to bed. Why not?

But I didn’t. I was squeezed in. I was checked in quickly, shown to the exam room, and waited just a moment or two before Pedersen walked in. (Some past and future appointments had me waiting a quarter hour or more for whichever doctor to arrive; 15, 18, 20 minutes alone to consider the paper sheet on the examination table, the mysterious mechanics of an exam chair, the tubes and gauges of various wall-mounted instruments, the number and variety of small jars and boxes on the counters and in the cabinets, the medical hieroglyphics on certain charts and containers, the advice and admonitions and warnings of certain posters, and yes, that is a good idea there, I should do that! I wouldn’t want to catch that! And what does that mean? And how does that work? And what does that do? And, oh God, will he actually find something? Is there something to find? What is he going to find?!) Pedersen left me no time to question and consider the possibilities.

In my moment alone, I did register that the examination room, in a suite on the fifth floor, was the first I’d been in with windows, large west-facing windows that filled the space with morning light. And that here the posters were more specific than those in the walk-in clinic, which spoke of the flu and the cold, general malaises moving through the population. Here were cut-away profiles of the human head, its intricate pockets and passageways demarcated in different reds, pinks, and peaches. And here was Pedersen in white coat, tie, and dark dress slacks, different from the clinic doctors, who bounced hurriedly from room to room in cottony, pajama-like scrubs, attending to this and that, runny noses and upset stomachs, a little bit of everything. He was a specialist, an initiate in the particular mysteries of the ear, nose, and throat. Someone who would put his finger on my little problem and let me move on, all I wanted to do after everything that had happened with Gen, just move on. Enter the next part of my life. I had even found an apartment already, would sign and move in the following week.

Pedersen carried a clipboard that certainly held the reason for my visit, but still he asked: “So what are we here for today?”

He didn’t seem particularly interested in the question, perhaps a little rushed – at 8:15, perhaps already behind schedule thanks to me, this annoyance to ripple through the rest of his day – and I was no longer particularly worried when I explained, gesturing dismissively to my mouth, “Well, it’s just these stubborn sores.”

“Well, let’s take a look.” He pulled on a pair of latex gloves and had me open wide. He directed the beam from a small, slender light into my mouth and looked in. He reached in and felt my tongue and its base with one hand, and then with both pressed fingers behind my ears, along my jaw, and down my neck, landing and tapping out a final exploratory rhythm in the hollows above my clavicle.

“Um, I’d like to take a look down your throat,” he said and explained the scope. Oh, well… anything, I guessed, to find the problem and a remedy. To move on.

A moment or two after he set aside the instrument and as I was trying to shake off the novel and unpleasant sensation produced by the tiny black hose twisting and slithering its way through my airway, he said, “Well, I think it’s cancer. It looks like cancer, it feels like cancer, it smells like cancer. I could be wrong, but I don’t think I am.”

Smells like – what? Wait a minute, what?

A curtain of fluttering, blinding white fell across my vision, and Pedersen would soon produce, like a magician, seemingly out of nowhere, that second hose, a wand of hissing air to wave across my face and conjure me back into the moment for, like a prop rabbit or dove, I had disappeared. Or it must have appeared that way to him. I was still there, beholding a string of thoughts igniting and exploding:

Cancer… cancer… CANCER?! But the other doctor said – and the one before him? Wait a minute here. This isn’t right.

And:

HA! I knew it! I was right. HA!

And:

Smells like cancer. Huh. I guess that explains why the floss didn’t help.

And:

I’m not ready to die. Please, I’m not ready.

And:

Good job, Gen! I guess you got out just in time, huh?

And:

HA! So right!

And:

Pedersen, poor guy, having to start out his day like this. I wonder how many times each week he has to break news like this to somebody?

And:

This can’t be right. The other doctor said – and the one before him? Whoa, let’s back up here.

But we didn’t. We were still in the present, part of my face numb, Pedersen blowing air into it, keeping me from pitching onto the floor. He wasn’t done with me. “Are you with me? Okay, I’ll need to biopsy the tumor, to make sure. Are you with me?” I guess I nodded, but I was only partly there. Though I’d felt all kinds of squeamish over the scope, I barely registered the next procedure and its escalating violence. He sprayed my tongue with one anesthetic; pricked it in several places with a lancet to administer another; and finally, produced a much larger needle that he proceeded to stab into my tongue, four times I think. I felt nothing.

Pedersen performed a final trick, a prediction of my future. “Okay, are you still with me? We can fix this. I didn’t see anything in the throat or feel anything in the nodes, so I think it’s just the tongue. That’s good. We’ll do some scans to make sure. If the tumor was smaller, I could remove it here, but I’ll have to send you someplace else. Maybe OHSU. A surgeon will cut out part of your tongue, about half I’d say, and replace it with tissue taken from elsewhere on your body, probably your arm. And then you’ll have some radiation. This is fixable, Okay?”

That brought me back fully into the present. Okay, okay. This is possible. This is real. This is what will be done to me. Okay. I’ll let you do whatever you need to do. Scan. Radiate. Cut away. The question then arose that inspired a sudden need to speak, quite difficult with tongue and lips nearly frozen: what should I do? I strained to move the stopped parts of my mouth and form and emit words.

I think he sensed the inquiry behind my facial contortions. “Oh, you’ll need to quit smoking, of course. And keep up your weight.”

What else? Give me the rules for this place, damnit! I wanted to demand. You looked in your eyepiece and waved your wand and moved me to this strange land, specialist, now help me out! Do what you do, but I’m in this, right in the middle, I need to do something, give me something to do, what do I do? How do I proceed from here? What do I do to keep from sinking, to pull myself out, to live?

I strained. “Waa elf thwoob I do?”

“Excuse me? Oh, just keep up your weight. Eat milkshakes if you have to. And don’t go poking around the internet, you’ll just scare yourself.”

Milkshakes? Surely there was more to it, but Pedersen had me up and out of the chair, patting my shoulder, on the way to the door, tissue still in my hand. I had been late to the appointment, after all, and they were busy. There were other patients.

This entry was posted on Sunday, July 26th, 2009 at 2:03 pm and is filed under The Big C. You can follow any responses to this entry through the RSS 2.0 feed. You can leave a response, or trackback from your own site.