Tuesday, January 6, 2009

Laughter where you least expect it

I began the new year with a regularly-scheduled pelvic CT scan and chest x-ray yesterday as part of my ongoing long-term cancer surveillance protocol. These scans are by now tediously familiar. So familiar, in fact, that not only do I recognize all the office employees, technicians, and nurses in radiology, but I even recognized another patient in the waiting room yesterday. I assumed she's on the same surveillance schedule I'm on. Perhaps it was mere coincidence.

Facebook on my iPhone kept me distracted as I sipped my oral contrast and waited for my turn at the CT machine. The nurse who called me in, however, was a new face (well, at least to me) and she was like a burst of energy in an otherwise quiet office. She immediately engaged me in conversation about surveillance, about the emotional ups and downs, about how we're about the same age, how she loves what she does despite the fact that so many people (justifiably, I suppose) think of oncology as such a depressing field of medicine. She told me how she focuses on the good aspects of this field: how she gets to see patients with yet another all-clear, she sees the same patients coming back looking healthy and well. Patients looking like me, she made a point of mentioning. She admitted she and the rest of the staff often cried. They cried when they saw a patient being taken off a schedule of scans because the patient had died. But they also cried with joy when seeing a patient win yet another battle in his or her personal war with cancer.

She said all this as she pierced my right arm to run the iodine IV and we talked about how pointless it was to be cranky or annoyed at this whole routine, no matter how unpleasant. After all, it was for my own good and any discomfort was temporary. I remarked how silly the whole game of constantly being asked for my name and birth date was but was told just why it was done. Discussing the effect of the intravenous iodine (a creeping warm sensation), the nurse left me with a funny anecdote: An elderly man came in for his first-ever CT and, on being advised that the IV iodine would result in a warm feeling up his body, including his groin, he replied "Honey, I haven't felt anything warm down there in a long time."

Maybe I can laugh because, despite the anxiety I feel at the very need for frequent scanning (every six weeks right now) and the possibility of needing chemotherapy, I still have an excellent prognosis. Reflecting on yesterday afternoon at the cancer center, I feel a little guilty at having managed to laugh and keep a smile while in the very next room someone might have been staring at their own mortality. But such is cancer survival. The highs and lows of life, the laughter and the anxiety, rush by at a much faster rate than might have once been the case before cancer. The ebbs and flows come so quickly as to become almost simultaneous. Even now, I ponder how I would deal with the possibility of going through four cycles of EP while smiling to myself as I recall how ebullient the nurse was yesterday.

Maybe it's the ability to balance those two aspects of cancer survival, the laughter and the anxiety, that helps every cancer survivor go on living a full and good life. The anxiety alone can be crushing, but tempered with the laughter, it becomes manageable and even familiar. As familiar as waiting in a radiological waiting room sipping contrast fluid.

My next chest x-ray is in six weeks and, assuming my scans yesterday come back negative for relapse, my next CT scan is in three months. I look forward to seeing the folks in radiology, including the nurse from yesterday. Her name, by the way, is Jill. Thanks, Jill.