Where have you been? Where are you going? And why?
We detest the moments when the world we’ve settled into changes. These events transpire unexpectedly; we hear the “click” of the door that has locked behind us, a door devoid of even a window to peer through. The cold wind of absence welcomes us to exile. The moments occur when the things and people and places in the world we’ve painted break or move or crumble. As the color drains from life, we spend our energy working to beat down the door, just to remember what it was like right before the world changed forever. We gently rattle the locked handle a moment, and then do so violently. We use our shoulder as a medieval battering ram, as if our aggression might force us back through reality’s barred door. As our conscience accepts that we’re locked out, we give a couple kicks before we slide down the door to sit as if to give truth the cold shoulder. Like a child that’s just been shoved out of his playroom, we park ourselves at the base of the door, unwilling to step off the porch into the barren wasteland.
We experienced such a wrecking ball at my most recent check up. Our hospital routine went smoothly as I checked in at the cancer center and then hiked down the mile-long hallway to Radiology. When I found out I would wait an hour for my CT scan, I worked my way around protocol by arranging for my visit with our doctor to precede the scan. Dr. Roth entered with his usual chirpy greeting, which has increased exponentially since we started bringing the babies. Having missed their nap, the twins’ response didn’t reflect his joy. He flipped through some of his folders as we made small talk. In a movie, the music would have stopped right as he changed the subject: he plans to leave Vanderbilt for Washington University. Not the worst news I could receive in the cancer wing of a hospital, but a tear in the Thomas Kinkaid of my life, for sure.
On the drive home, I found myself running in vain up a slide too slick while Status Quo looked down upon me. Often in life, it’s only when the piece is removed from a puzzle that we realize something is missing. I continue to grieve over the loss of a puzzle piece. God weaved Dr. Roth into the fabric of our lives so naturally that he’d become like family. We trusted him to monitor my health and honestly looked forward to my check-ups. My next visit in August will be Rothless. I’m so thankful that I’m almost to three years; the chances for relapse are statistically in the rearview mirror.
A funny story involving Dr. Roth that dates back to my last blog update: I wrote previously about a USA Today article that warned of the dangers of flippantly prescribed CT scans. I brought the article to get Dr. Roth’s thoughts. He barely gave it a glance before remarking, “Oh yeah, Liz from USA Today calls me periodically to check her facts about these things before publishing, and…” The press consults my doctor before printing the USA Today. If I didn’t realize the good hands I’ve been in, I do now. It’s safe to say if my cancer markers ever progress from innocence, I will check to see if Southwest flies to St. Louis.
It is indeed a strange circumstance when the things and people we trust become sources of error. I walked into the kitchen this week anticipating bacon, eggs, and the Tiger Woods decorated sports section. Instead, my wife handed me the USA Today’s Life section with a three-quarter page article on the dangers of CT scans. The picture shows the long, cold bed covered in tear-away sanitized paper, a technician adjusting the settings, and the waiting white hole that more resembles a Play-Doh creation.
“Recent studies found that patients may receive far more radiation from the common diagnostic tests called CT scans than previously estimated. These scans may cause 29,000 new cancers a year- as well as 14,500 deaths.”
The USA Today suggests many doctors know less than they need to about the radiation dosage sizes and often prescribe CT scans to cover themselves. Some children actually receive adult-sized radiation doses due to negligence. Others times, the risks do not outweigh the benefits, though the doctor schedules the scan out of routine habit. One frightening 2004 survey statistic stated that only 50% of radiologists recognized CT scans increase risks of cancer.
Great. Perhaps this makes me like a 101st Airborne soldier in a Nazi POW camp that must risk death to escape. If he stays put, he’ll surely die. Yeah, that sounds much more valiant.
I will undergo my next scan in February. How could something so painless and effortless harm me? I lay there, close my eyes, and listen to the computerized feminine voice, “Breathe in. Hold your breath. Breathe. Breathe in. Hold your breath. Breathe.” Then the IV shoots liquid into me that tastes like I am sucking on metal. I do my best not to stare directly at the red light above my head, despite the written warning: “Do Not Stare at Laser”. Then I walk down the hall to hear my doctor inform me of the good results.
I sat on the elevated “bed” covered with disposable white paper, the kind that’s always ready to be ripped off for the next patient. Leroy took my vitals while Shannon watched our babies entertain Nurse Liz. I saw his white jacket and heard his footsteps as he walked through the door. The smile across his face reflected more joy than I could take credit for. I’m not even sure I was his next appointment, but he swung into the room like Santa Claus on Christmas morning. “The first thing he told me this morning was ‘the babies are coming today!’” Nurse Liz exclaimed.
Over the last two years, our doctor has walked with us through the valley of cancer. He listened intently when we reported that tests indicated the tumor wiped away most hope of having children. He celebrated us on a far more personal level than I’d expect from a doctor who sees hundreds of patients. He would scowl at me during my check-ups over the past months when I showed up without Summer and Maren. Now, he could rejoice over them in person.
I’m not sure whether the twins were the icing or the cake for the celebration. That day also marked the two year milestone for my body being cancer free. In August 2007, my doctor laid out the facts, telling us not to exhale for two years. Last Tuesday we raced past that checkpoint. I will return to the hospital in four months rather than every two months.
On a somewhat related note, go read Same Kind of Different as Me.
If I didn’t have this to post today, I wonder if I would have remembered Easter for another 363 days.
I experienced Easter service at my Friday cancer check up (and I’m cancer free, thank God). In past blogs, I’ve pondered the physical decay that cuts so deeply to those willing to look on the frail faces in the clinic. Today I realized that decay has other forms. An elderly couple sat next to me as I waited to see my doctor. She held the clip board with health survey questions while he sat silently beside her. She wore a pair of glasses that apparently blocked her vision in one eye. While a nurse walked us to see our respective doctors, she recounted all of the recent pains, in three new places, that left her in agony. How long had they been married? Was her battle with cancer terminal? What battle rages in the man’s heart, knowing he may soon lose his soul mate to a disease he did not expect nor understand?
God punctuated the fall from Eden with a response that affects every bit of our physical world. Childbirth pains. Sweat and blood spent toiling to work a job. Tornados and earthquakes. Cars that break down. Toaster ovens that catch fire. Disease and sickness. But at the very heart of the exile?
God walked with Adam and Eve. Adam knew his wife intimately in fullness. The experience of connection flowed as freely as a river, but one capable of flowing in both directions. Then all relationship severed with sin. A friend told me the eye contact I share with my daughters as newborns would be the closest to heaven our relationship will ever experience. Participating in the redemption of relationship remains my only option.
Easter is a celebration of reconnection. Restored relating. Mended relationship. And as I sat before this couple wondering about their foreseeable disconnection, I also sat within eyesight of an Easter bonnet contest. Fourteen pastel colored bonnets rested on a table with a decorated shoe box for ballots. I rolled my eyes when the receptionist asked me to vote for my favorite. As I sat waiting for my doctor, a new appreciation swept over me: Easter is present at Vanderbilt Hospital. I looked for a bare cross amidst the pallid green and yellow eggs without success. There were no hints of an empty tomb. I saw no sign of Peter’s dusty sandals that ran all the way back to town. No snapshots existed of hysteric men and woman in the upper room celebrating in a manner that puts championship locker room parties to shame.
However, amidst fluffy bonnets, painted eggs, and artificial grass, I smiled that Easter, the celebration of Reconnection, was still recognized in a place where death and sickness reign as king and queen. If signs of their rule are death do us part and final goodbyes, Easter sat in the clinic corner like a knight-turned-pauper, stripped of its real Easter message, but present nonetheless, the hope of eternal hellos.
The doctors said our chances were slim after the cancer annihilated much hope. Now I sit here cancer free celebrating a birthday not my own.
I’m shaking my head as I look over the last twenty-six updates. Such a blessing to sit here again cancer free. I marvel at the topics covered throughout the journey. During my last hospital visit, I did not ponder shipwrecks or Michael Scott or NASCAR. This time a picture grabbed me as I waited my turn in the lonely office, accompanied by the patient table, cotton swabs, and a sink.
On the back of the door a poster-board sized picture advertised the hospital. You see the back of the doctor’s head as she in her white MD coat addresses the patient. I cannot see her expression, but from her body posture, I imagine it confident and cheery. The picture plainly focuses on the patient. She sits eagerly, though not panicking by any means. Her eyes engage the doctor’s with assured anticipation. Her black silky hair rests beautifully on her shoulders. Her slim figure relaxes with a slight lean on her right arm that props her up. Without a doubt, she maintains her health with a substantial diet and frequent exercise. Her breasts fill her shirt quite fully. I’d guess her age to be no more than thirty-five, and I see no undesirable rashes or acne on her smooth skin. Most men I know would have a hard time keeping their eyes off this woman. The line just below the picture reads, “We know you have questions about your treatment options. We have answers. Ask about a cancer clinical trial”.
My God how we long for Eden. This poster uses sex appeal to advertise cancer treatments.
If the normal people sitting in the waiting room resembled her, I’d need a lot more accountability. No, the people I see in the hospital enter in wheel chairs or hobble in hanging on the arm of their spouse. The worst have tubes attached throughout their body while someone pushes them around on a stretcher. Some have masses protruding from mysterious places, and others wear hats to cover their chemo ravaged head. And though some resemble the “normal” folks you might see on the street, most have aged long past thirty-five. Imagine the response the hospital would get if they used these images to advertise.
In a children’s book, Sally Llyod-Jones writes, “And though they would forget him, and run from him, deep in their hearts, God’s children would miss him always, and long for him- lost children yearning for their home.”
The words we read to children speak a story most adults know but will never understand. And so we use the hunger for Eden to treat our exile.
Last Tuesday marked my second cancer check-up for year two. Shannon and I arrived an hour early. The appointment duration can vary between thirty minutes and over two hours. The wild card this time, though, included a brand new cancer clinic built over the last couple months. The room spread out neatly with the receptionist desks directly across from the automatic glass doors, the laboratory far to the right, and patient seating surrounding it all in a half-circle. Clean and neat wood floors covered the sterile clinic. The food stand offered some excellent blueberry doughnut holes.
A regular appointment includes three stops: blood draw, x-rays, and meeting with the doctor. I quickly learned that the x-rays and doctor visit would occur in different parts of the hospital. This became something like a NASCAR race, speeding around with frequent pit stops. I raced from check-in to give blood. Then we walked around the hospital to radiology, only to be directed down another hallway to meet my doctor. I asked him how much input the MD’s had in the design of the new facility. His disdainful look explained it all. Finally the checkered flag waved.
I am clear for another two months. In the midst of the race I failed to recognize something, probably because of the race, or maybe something scary in my heart: I treated this particular visit as lightly as a flu shot, merely an inconvenience. Walking under the cancer clinic doorway failed to sober me. Instead, I revved my engine to see how quickly we could leave. It was not due to fear or denial, but rather forgetfulness. I focused on other things: eating lunch with Shannon, getting back to work, task lists. Like Old Testament Israel, I failed to remember dependence. I am taking this journey for granted, and that alarms me. I wish it terrified me more than cancer.
Today’s clinic visit marks one year without remission. Hallelujah! And the icing on the cake? My visits to the hospital will now occur every two months. It was a year ago tomorrow that I underwent surgery and the cancer was diagnosed. In memory of that day, I post this picture. My dear brother-in-law saw this shirt and thought of me. Isn’t it touching?
“The doctor will be right with you,” said the nurse as she directed us towards the door. A maximum of about four can fit into the check-up room. White paint covers the walls –no art, no inspiring pictures. We take the only two seats in the room, which face a little rolling stool reserved for the MD. And then we wait, sometimes for only a few minutes, but other times longer. The isolation of the room can be oppressing, if not intimidating. There’s the paper covered bench to my left, letting me know I’m in a hospital. If that isn’t enough warning, the sterile and disposable gloves rest in a box on the counter, waiting. Staring at the box, I can just hear the SNAP! of the glove fitting the doctor’s hand. Then there’s the pile of magazines. And I wonder, Who really wants to read about how to better decorate their bathroom just moments before the doc comes in to give results on cancer readings?
Cancer becomes a reality in these moments. We sit, speaking very little. Waiting. Footsteps right outside the door…it opens. From my vantage point, the door is opening toward our chairs, giving me the first look. I see the familiar bifocals, the white jacket, the…wait a second, that’s not my doctor! The man entering looks more boyish, with a smooth face and black silky hair. He smiles, moving with the energy of someone who’s not seen patients die. He extends his hand to introduce himself, and we do the same. This far into the process I’m not supposed to be meeting new people, I’m thinking. I don’t want some trainee. He senses the tension, and immediately speaks to it, letting us know that our doctor will be in shortly. As a residency student, he would like to ask me some questions. My shoulders loosen and sink. I cross my legs and recline a bit, answering away. Soon enough, our doctor enters, smiling warmly, wearing his white coat like an army general with stars and badges covering each breast and shoulder. A calm accompanies his presence into the room. The four of us small talk awhile before he tells me my results are good for another month. Upon leaving, I honestly shake the new guy’s hand. He isn’t so bad, not like Doogie Howser was last fall…
Surprise! It’s Doogie
…During one of the first visits, probably last October or so, Shannon and I were sitting much the same in the office waiting. We’d just grown comfortable with our doctor’s care and actually looked forward to seeing him. Without warning, a young man barged into the room, his white coat starched as if worn for the first time. He failed to introduce himself clearly, also leaving out the fact that our doctor wasn’t sick or retired or on vacation. We were left to guess. Instead, he grabbed the stool, spun around and began informing me about my situation. I’m not even sure he acknowledged Shannon. Great, we thought, we’re stuck with Doogie Howser. I also diagnosed that he struggled with little man’s syndrome. Those cures are rare.
“Let’s see here, so Luke, you do know that you have stage 1 testicular cancer. (Why the hell would I be here?) We’re going to be monitoring you every month with blood work. (Yeah, I’ve got a gauze over my arm from that needle five minutes ago.) Once every three months you’ll have a CT scan. (Uh-huh)” The information he shared had been obvious procedure known since day one. But we served as a punching bag for this up and coming heavyweight to practice. Doogie Howser finally finished his thesis and told us the general was on his way. I almost started humming Doogie’s theme song.
I contemplate taking the humor route versus the serious tone in this update. I guess I’m thankful I’m even debating. My markers are reported normal for May, so we’ve made it another month without remission. Had we received bad news, I would most definitely take the serious route. Or would I? What I experienced at the hospital got me thinking.
After walking the two miles down the hospital corridor to the radiology department (I have yet to learn the best place to park for CT scans), I checked in and waited my turn. My name was finally called and as I was rounding the corner, he stole my attention. A man, clearly desolated by the powers of chemotherapy, sat motionless in a wheelchair. His head tilted to the side as if sleeping. The hospital gown he wore made me shudder. Just the remembrance of wearing one of those makes me feel less human. A clear IV tube, obviously feeding him something nutritious, traveled up his whole upper body and rested under his nose. Who knows what his diagnosis was, what “stage” he’d been tagged with. He was at the mercy of anyone that would care for him.
A nurse brushed by me just as another nurse stepped out of door right behind the man. “Oh Janie,” nurse 1 called out, “did you hear the girls are all going out to Chili’s tonight?”
Jubilantly the number 2 responded, “Oh yesss, can’t wait. Remember what happened last time with Terry there! Hilarious!”
All of this dialog flying right over the man’s head, cutting its way through his presence.
The clash of comedy and tragedy plagued me. Is it even possible for a doctor or nurse to deal day in and out with such fallenness without numbing themselves? I walked the rest of the hallway unsure of what to do with such a paradox. Then a cute, innocent looking redhead called my name, claiming to be my caring IV prep nurse. I trusted my judgment. Turned out she was stabbist, leaving a bruise in my left arm to prove it. And alas, more humor mixed with pain.