Meeting The Surgeon

Remind me to not allow myself to be ‘worked in’ for my next MD consultative appointment.  Arriving with ease at the Simon Cancer Center at 8:43A for registration and apologizing for being a few minutes late I was called into the exam room a few minutes later.  At 10:45A I stood in the door to Exam 1, gasping for air having clawed the walls waiting.  Ironically at that very moment the Doctor arrived.  ‘What’s wrong?’ he asked.  ‘Been in here too long’ came my reply.  ‘Yeah, we worked you in.’ came his criptic reply.  At that point I was not sure if I should bow down to this arrogant …….or simply throw my arms around him and dry hump his leg in gratitude.  Frankly his demeanor as he came into the room set me back, a certain cockiness.  My mind raced to categorize him, flatten the details but I resisted the temptation to get off on the wrong foot.  As he started I remembered that this guy is also a college professor.  Suddenly much of his earlier impression was shown in a new perspective.  I now found myself in greater appreciation of this guy as he laid it out, probably for the tenth time already this morning.  I am sure if you interrogated each of us individually you would get 4 different versions of what was said in that room, that stuffy little room with the heavy door.  ‘At this point’, he paused, ‘we would take it out’.  I then heard in summary my odds, risk vs benefit with regard to diversion options and fell into mental numbness.  I had heard it all before.  ‘there is no study on how long you live if you do not have the surgery’ he said, ‘but this cancer will eventually kill you if you have it.’  And that is the hard reality.  However remote the chance of a cure may be the only way at present is a radical cystectomy. 

May I digress for a moment and point out that just as it is with ologists (any need to see one is not really a good deal no matter what kind, gynoc, cardio, uro, proct and so on) so it is with ectomy’s (tonsil etc.).  Also any surgical reference that includes the word ‘radical’ simply cannot be a good thing.   

Your bowel routine will be forever altered, you will wet the bed, you will be cathed for 3 weeks as he outlined his ‘favorite'option for diversion, the neobladder.  No matter the diversion choice the lymphedema will get worse because he will take out every node he can.  This is done because detection science is way behind and given the nature of the disease and reoccurrence rate the surgeon prefers to fall on the safe side.  And on it went.  As questions arose in my head Jocelyn asked them as if on cue.  Vanessa dutifully took the notes as a good parliamentarian.  Minutes from any meeting such as this are critical over the long haul.  Even though I knew what to expect the reality of sitting face to face with someone who will change your life in very fundamental ways permanently is still something of a shock.