Relieved that her appointment with Dr. Substitute was over, the woman walked over to the appointment desk and picked up her schedule. She casually reviewed it as she made her way back to the waiting room and at second glance noticed something slightly disturbing: there were no chemo treatments listed. She turned around and asked the assistant, "Umm...I'm supposed to have some chemo scheduled, but I don't see any of the appointments here?"
"Oh. You will have to go to the chemo desk for that," the assistant replied.
Ooookay. That would have been nice to know!
The woman tried to be patient and headed to the chemo desk. The response she received from the attendant there was equally disheartening: "We don't have any record of you needing chemo."
A bit frustrated, the woman replied, "Well, I know I'm supposed to have chemo today. The doctor told me so and I watched him order it."
Convinced, the attendant made some phone calls.
As the woman sat, thoughts of what should have been filled her mind. She was supposed to be 16 weeks along heading to OB appointments and worrying about buying pregnancy jeans. Instead, she was here in a room full of cancer patients waiting to receive chemo. The two extremes were irreconcilable, and somehow she would need to find a way to reconcile herself to the latter in order to move on with her life.
Thirty minutes later a nurse finally called the woman back to receive her injection. Upon entering the room, the woman noticed that the nurse had two syringes filled with chemo.
"Umm...Is that the correct dosage? I've only ever had one shot," said the woman nervously.
"Yep, it's the same dose as last time. It just depends on how the pharmacist mixes it," replied the nurse and continued preparing the needles without any noticeable concern.
"Are you sure it's the same dosage?"
The nurse looked down at the syringes and then back up at the computer screen. "Yep, it's the same."
"Uhh...okay," the woman said, hesitant.
The residual sting of the shots were like background music to her thoughts as she walked towards the elevator replaying the events of the day. It had been a long one scattered with inconsistencies that made the woman feel uneasy. In the midst of her anxious distrust, the only thing she could do was surrender, trusting that the doctor knew what he was doing, the schedulers knew what they were doing, the pharmacist knew what he was doing, the nurse knew what she was doing, and that ultimately God was in control of it all.
Monday, November 29, 2010
Wednesday, November 24, 2010
Part 20: The Substitute
The woman felt out of place amidst the sea of predominantly white hair. Not quite pregnant, not quite suffering from cancer—it was a queer state. It had been two weeks since her last visit. She had just come from her bi-weekly blood draw and now sat in oncology waiting to be the lucky one called over the intercom. Across from her sat an aged couple. They were both asleep.
Not very promising, she thought, hoping she'd have enough patience to make it through the wait.
A glance through a magazine and many daydreams later, she finally heard her name. The clinical assistant brought her back to a room where she took the woman's vitals and then promptly left, leaving her with the promise, "The doctor will be in shortly."
Either the assistant had made a good faith estimate on the time frame or she had lied through her teeth. The woman decided to take the silent advice from the elderly couple in the waiting room and pass the time by napping. She positioned herself in such a way as to be decently reclined, her feet hanging just off the edge of the bench cushion, but not so much that she wouldn't be able to quickly resume a somewhat normal seated position, were she caught off guard.
At last, the woman heard a knock. In walked a pot-bellied man in his sixties, the substitute doctor while her gynecologic oncologist was out of town. Generally pleasant, he seemed a tolerable replacement. It was obvious he didn't know much about her case. For the first five minutes he barely said a word to her and skimmed her patient notes. Great. I have some guy treating me that has no idea who I am or what's going on, she thought. He then proceeded to review her lab results. Blood counts and liver function looked good, but the HCG value, the one she cared the most about, had yet to post.
"Normally, if the initial run falls above the upper limit of detection, they will need to dilute the sample and re-run it," he said. "I'll just get started ordering up your next chemo dose while we wait."
"But don't you need to know what the actual value is before you go ahead and prescribe another round?" she asked. "What if the value is already at zero?"
"The likelihood of that is pretty slim. And even if it were at zero, we would still prescribe another round."
The answer slightly annoyed the woman. Then why am I even here in the first place? A call asking if I was okay would have sufficed, she grumbled to herself, the dollar signs multiplying in her head.
She glanced over toward the computer screen and noticed an error message pop-up. He had been sitting at the computer for at least ten minutes and was making comments to himself. Apparently the ordering system was not the most user-friendly. The longer it took him to place the chemo order, the more confidence she lost in his competence. Considering the personal impact this drug would have on her body, she was markedly concerned. Her mind raced to the close call at the hospital a few weeks back. She tried not to worry.
The doctor finally figured it out and had the woman get up on the exam table where he listened to her heart and pushed on her belly. She began to ask him all the questions that had been collecting in her mind over the last two weeks and she was disappointed by his answer. "You're getting out of my level of expertise," he said. "I'm not in gynecology, I'm in oncology."
Dejected, she decided to keep her mouth shut from there on out. Why do they have some guy who can't even answer my questions treating me? she wondered in frustration. He freed the woman to head to her next appointment—her first injection of chemo round two. "The girls will get you your schedule," he said and oddly ended with a question, "Do you have any kids?"
You've got to be kidding me. "Nope. This was my first," she said and walked away.
Not very promising, she thought, hoping she'd have enough patience to make it through the wait.
A glance through a magazine and many daydreams later, she finally heard her name. The clinical assistant brought her back to a room where she took the woman's vitals and then promptly left, leaving her with the promise, "The doctor will be in shortly."
Either the assistant had made a good faith estimate on the time frame or she had lied through her teeth. The woman decided to take the silent advice from the elderly couple in the waiting room and pass the time by napping. She positioned herself in such a way as to be decently reclined, her feet hanging just off the edge of the bench cushion, but not so much that she wouldn't be able to quickly resume a somewhat normal seated position, were she caught off guard.
At last, the woman heard a knock. In walked a pot-bellied man in his sixties, the substitute doctor while her gynecologic oncologist was out of town. Generally pleasant, he seemed a tolerable replacement. It was obvious he didn't know much about her case. For the first five minutes he barely said a word to her and skimmed her patient notes. Great. I have some guy treating me that has no idea who I am or what's going on, she thought. He then proceeded to review her lab results. Blood counts and liver function looked good, but the HCG value, the one she cared the most about, had yet to post.
"Normally, if the initial run falls above the upper limit of detection, they will need to dilute the sample and re-run it," he said. "I'll just get started ordering up your next chemo dose while we wait."
"But don't you need to know what the actual value is before you go ahead and prescribe another round?" she asked. "What if the value is already at zero?"
"The likelihood of that is pretty slim. And even if it were at zero, we would still prescribe another round."
The answer slightly annoyed the woman. Then why am I even here in the first place? A call asking if I was okay would have sufficed, she grumbled to herself, the dollar signs multiplying in her head.
She glanced over toward the computer screen and noticed an error message pop-up. He had been sitting at the computer for at least ten minutes and was making comments to himself. Apparently the ordering system was not the most user-friendly. The longer it took him to place the chemo order, the more confidence she lost in his competence. Considering the personal impact this drug would have on her body, she was markedly concerned. Her mind raced to the close call at the hospital a few weeks back. She tried not to worry.
The doctor finally figured it out and had the woman get up on the exam table where he listened to her heart and pushed on her belly. She began to ask him all the questions that had been collecting in her mind over the last two weeks and she was disappointed by his answer. "You're getting out of my level of expertise," he said. "I'm not in gynecology, I'm in oncology."
Dejected, she decided to keep her mouth shut from there on out. Why do they have some guy who can't even answer my questions treating me? she wondered in frustration. He freed the woman to head to her next appointment—her first injection of chemo round two. "The girls will get you your schedule," he said and oddly ended with a question, "Do you have any kids?"
You've got to be kidding me. "Nope. This was my first," she said and walked away.
Sunday, November 21, 2010
Part 19: Goodbyes
"What should we do for the service?" the woman asked her husband. She wondered if he thought it strange that she wanted a service in the first place. Her husband seemed okay with it, so she didn't worry too much about it. As they discussed the details, the woman made some notes.
"This looks good!" she said smiling. "It will be a wonderful service."
Just then a faint emotion stirred within her and began to crescendo. Before she knew it tears were filling her eyes and she started to sniffle. At last an audible cry emerged.
The woman's husband took her in his arms and comforted her. "Just let it out," he said in a warm voice.
While she had cried different times over the past couple weeks, it had been about other things—the stress, her condition, the long road ahead. This was the first cry in awhile that actually grieved the loss of her pregnancy, yet it felt just as fresh as the first time and emotionally it was just as hard.
The cool Sunday morning air filled her lungs as she made her way to the backyard where she found her husband standing by the small spruce tree. Sunshine settled upon the tiny hole beneath the lower branches he had dug just moments before in preparation to receive the package she held in her hand wrapped in a white napkin.
Together they stood looking down at the site, the wind blowing and the sound of passing cars traveling along the nearby country road resonating in the distance. They began to sing:
How great is our God.
Sing with me, how great is our God.
And all will see how great, how great is our God.
Sing with me, how great is our God.
And all will see how great, how great is our God.
She placed the tiny package into the small hole. After each shared a few words, the husband closed in a prayer.
“Dear Lord, we thank you for the gift of each other and for this pregnancy. Even though it wasn't a baby, it was still special. We pray for healing in the months ahead—spiritually, emotionally, and physically—so that someday we can try again and be blessed with a baby.”
With a small spade they took turns covering the newly filled space with a mixture of soil and wood chips. Every spade-full finalized reality. Dreams of starting a family, caring for a baby of their own, passing on the many things they wish to teach, and enjoying God's gift of a new person had been postponed. They offered up one more moment of silence, then turned and together walked away.
Friday, November 19, 2010
Part 18: The Delivery
It was just like any other Saturday morning. She awoke at her normal time while her husband lay sleeping under the mound of covers. He would be there till at least 9:30 a.m., to the detriment of the woman, of course. An early morning chat with her husband over coffee was her Saturday morning dream, a dream, unfortunately, crushed every week. Alternatively, she knew his dream was to sleep in, and somehow she worked up the weekly discipline to restrain herself from harassing him awake before the allotted time...most Saturdays, anyway.
Her first stop was the bathroom.
Ummm...that was weird.
The woman had passed clots before, and large ones at that, but this did not feel like a clot. Peering into the toilet she saw a dark shadow resting at the bottom. Curiosity got the best of her and she fished it out.
Upon further examination, the woman determined that what she had in her possession was indeed the mass from inside her uterus. It measured a little over 3.5 cm in length, just like what the doctor explained from her ultrasound a week and a half earlier.
She hurried to the bedroom.
"Honey," she whispered nudging her husband hoping he wouldn’t mind too much. "I think I just passed the tissue."
Looking at her with tired eyes he acknowledged the situation and lovingly rolled out of bed to take a look.
"Yeah, that definitely looks different than a clot," he confirmed, still a bit groggy.
They deliberated the meaning of it all, wondering, perhaps, if it was a good sign for things to come. Little did they know it would mark the end to two and a half months of the woman's bleeding. They questioned what to do with the the tiny mass. After a few moments of silence, the woman replied saying, "I think I'd like to have a funeral."
Her first stop was the bathroom.
Ummm...that was weird.
The woman had passed clots before, and large ones at that, but this did not feel like a clot. Peering into the toilet she saw a dark shadow resting at the bottom. Curiosity got the best of her and she fished it out.
Upon further examination, the woman determined that what she had in her possession was indeed the mass from inside her uterus. It measured a little over 3.5 cm in length, just like what the doctor explained from her ultrasound a week and a half earlier.
She hurried to the bedroom.
"Honey," she whispered nudging her husband hoping he wouldn’t mind too much. "I think I just passed the tissue."
Looking at her with tired eyes he acknowledged the situation and lovingly rolled out of bed to take a look.
"Yeah, that definitely looks different than a clot," he confirmed, still a bit groggy.
They deliberated the meaning of it all, wondering, perhaps, if it was a good sign for things to come. Little did they know it would mark the end to two and a half months of the woman's bleeding. They questioned what to do with the the tiny mass. After a few moments of silence, the woman replied saying, "I think I'd like to have a funeral."
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