a bit of history 2: the first in a long line of doctors

a lump is determined to be malignant and so we are sent to an oncologist, a cancer doctor.

if you are j, at this point you will mostly likely want to stop reading, because you are not going to like what you read. it will cause a family squabble about the need to leave the past behind.

for those of you who are not j, the reason that a family squabble would have been in the offing over what you are about to read is because i did not like, do not like nor will ever like the first oncologist we met with, the ear, nose and throat surgical oncologist. while he may be a fine doctor devoting his life to a noble cause, he is also a pompous ass and if i never have to see him again in my life, i will consider myself lucky.

ok, i now that i have gotten all of the ill will off my chest and you are aware of the strong prejudices i have against this doctor, i will proceed continue the history of j's cancer. on the matter of this doctor, whom i will call dr. f, consider yourself warned.

after the call from the ent doctor who discovered that the lump was malignant, j was advised to call over to beth israel hospital and make an appointment with a dr. f. the first appointment available was in three weeks, which he took, though it seemed like a long time to sit about and wonder what sort of havoc a cancercerous lump is causing. but at this point, we had no idea what we were about to get ourselves into; we had no idea how to operate; how to act, how to deal. it turns out that three weeks was way too long to wait, because when the ent doctor called to check that j had made an appointment, he then got on the phone and we were suddenly able to get in to see dr. f within a few days.

there are a couple of questions i have always wanted to ask one of our doctors, but always forget to and one of the big ones is: do you supply your own white lab coat or does the institution for whom you work; and further, who is responsible for washing them? i can't tell you how many "white" lab coats i have seen on doctors or nurses in supposedly reputable hospitals that are straight up filthy. i understand that the pockets get dirty from putting your hand in and out and pens leak and make marks when not capped, but please, we all do laundry: when things get dirty you wash them. i mean, if you went into a restaurant and the waiter was wearing an apron that was covered in specks of dried food, you would be a little repulsed, would you not? it seems to me that it is a lot more important for the person sticking their hands into body cavities and making important treatment decisions to be the model of cleanliness than the person who carries the eggs benedict from the kitchen to your table. but i would leave a restaurant where the staff looked dirty, wouldn't you?

at this point, i bet you can make some pretty accurate guesses about what i noticed about the good dr. f first. a couple of other fairly disturbing details became evident soon after he swooped into the exam room in which we had been deposited. they included a head lamp of the sort used by cave explorers attached to his unkempt head and a pair of dark brown tassel loafers, narrow width. he had the distracted air of someone trying to make no impression whatsoever and an inability to look one in the eye. now, i am a fan of the eccentric genius, but i think it is a completely inappropriate persona to assume when you are in a field when you are dealing with people whose emotions may be heightened by the threat of serious illness; because eccentric geniuses are not generally known for their warmth. and when delivering the diagnosis of cancer, a little warmth is called for.

i have been told by another medical professional who i speak to that many times, a doctor will not be completely forthcoming about the extent or seriousness of a person's condition because they don't want to scare them or they assume that the person doesn't really want to know. i don't know if these doctors assume that because a person hasn't been to medical school that a person isn't able to understand medical concepts or terminology, but i am here to say that that assumption is wrong. and what makes me so mad about that idiotic assumption is that a doctor is a stewart, not a god. as a patient, you have allowed the doctor access to you; because you are patient, a doctor should not be allowed to take your body away from you and by not being completely straightforward about what is going on in your body, a doctor is playing god, making decisions about you as if you are a mere appendage to the cancer.

is it because people are easier to deal with when they are just a body? is it because if, as a doctor, you open yourself up to questions, to scrutiny, it may soon become apparent that all you are really doing is guessing. we want doctors to have all the answers, to cure us and to make it all go away, but from what i have seen throughout j's bout with cancer is that the doctors are making at best, educated guesses about how to treat each person's cancer. but rather than be honest about that and allow a patient to come to terms with the great uncertainty of cancer from the start, the doctors try to give this sense of false security by turning patients into children: they have the knowledge and us it to lead patients around by the nose.

but i digress... so we meet dr. f and his terrible footwear and he sticks a tube down j's nose and pokes him and has a pathologist come in and painfully aspirate him a few times and announces that j has a parotid gland tumor which had also infected some of the local lymph nodes, type of cancer unknown until he had gone in and surgically removed the tumor, which was tricky because he couldn't be sure it hadn't wrapped itself around the facial nerve which may have to sacrificed which would cause facial paralysis which may or may not evetually go away but the surgery will only take about three hours and would you like to schedule it for three weeks from this coming thursday?

huh?

when we said that we thought we would like a second opinion he suggested another doctor, i think his boss, at the cancer center and added that we should also see this other guy, who didn't take insurance (note: a doctor knowing anything about insurance coverage is a BAD thing. it means it has been an issue before.), but since they might have to HARVEST a nerve from j's ear and this would be the guy consulting, if we wanted we could see him.

sounds pretty straightforward right? WRONG! first of all, i would never again go and get a second opinion from a doctor in the same group. they all meet together about cases which means that they all look at them the same way. a second opinion should be a fresh set of eyes and ears, not an echo. and you either need a patient to see a consulting doctor or you don't. and you certainly don't involve money. if we really needed to see this doctor, the money is a non-issue. (the money issue came up with one other doctor and i didn't like him either!)

anyhow, we went and saw this consulting doctor and it was a true waste of time and $300. he didn't tell us anything that we didn't already know and he was was pretty surly to boot. in the end, though dr. f did HARVEST a nerve, it wasn't necessary and caused problems rather than fixing them.

so the surgery was scheduled for a couple of weeks (or maybe a week, i can't remember) from around then and we proceeded to jump through the various hoops that needed jumping to get j surgery-ready: pre-testing etc...

at this point, we were still in the dark about just how big a deal this was or might possiibly be. our past experience with doctors and illness had been something is wrong or broken and a doctor fixes it and off you go! j had been pretty healthy most of his life, with the exception of a mysterious allergic reaction to something when he was about 12 which his doctors had never been able to explain, something which involved hives, and ACL (whatever that is) replacements on both knees. i had had a c-section three months before, but i didn't really think it was all that big a deal, even though "they" say that stomach surgery is the most painfully surgery to have and a c-section is major stomach surgery. i like to think that i have a high pain tolerance: i didn't even use up all of my morphine-on-demand and i still have all of the pain pills they sent me home with, because well, you never know when you'll want to relax after a hard day with a margarita and a percoset, which seems to me a much more fun use of prescription drugs than the alleviation of pain.

up next: neck dissection and lympodectimies. whee!