5. ALICE IN MEDICAL LAND
I am a medical wimp. Ever since Grade 1, when the school doctor and school dentist came on the same day to my little primary school near the Gulf of Carpentaria, I’ve dreaded needles and injections. The glimpse of a syringe or the smell of anything connected with pain to the body immediately makes me feel faint.
I don’t remember if there really was pain that day – but the shock of the polio jab, the wheezy sound of the dentist’s chair being pumped up and down … these are apparently unforgettable. So is the sense of fear all around that day.
As for hospitals – I’m not sure if there is a word to easily categorize the state they once put me in. For years, I couldn’t walk more than a few metres within a hospital without blacking out.
So now, as I progress through these weeks of medical drama, just doing whatever is required, I watch myself with bewilderment. How does the brain do this? Suddenly I switch off and am almost hypnotized, without any will of my own.
Perhaps it helps that I have a secret protection that makes me feel more distant: my name.
Because I’m usually known by my second name, the name which is more often called in doctor’s waiting rooms is not the one I feel is really me. The call goes out for ‘Alice’, and a puppet responds. Alice lies down on the slab in the operating theatre. Alice says “yes, I’m fine – and my date of birth is …”
Sometimes, thoughtful receptions and doctors’ assistants try to get things ‘right’ by marking my file ‘known as Jean’, but invariably when we get to the major players in these dramas of potential pain, the script they’ll follow can be relied on to call for Alice.
In case they later realize they’ve missed a courtesy instruction, I oblige by saying I’m “Alice Jean …” whenever we reach the obligatory check question where it’s important to be sure they have the right patient before them. “Thank you, Alice,” they respond. And so I let Jean escape to somewhere far from all this danger, and Alice takes over.
Afterwards, when I snip off the identity bracelet, I let Alice fall away and stay in Medical Land. It’s a very minor rehearsal of what it could be like to have a split personality and I’m perfectly aware I’m doing it. It’s just a small protective game – it began as an alternative to being irritated at being called the wrong name, but when I realized how well it worked in a hospital environment, I decided to keep it in mind for similar situations.
So now the surgeon says, “We will do this, Alice” and “Here are your X-rays, Alice” and “These are the areas of microcalcification and abnormal growth” – and I can look at the ghostly image on his wall, and what he says are ominous, worrying little specks in the moonscape labeled Kent, Alice etcetera, and I know yes, that must be my body he’s talking about, but at the same time this Alice person is the one who’s going to have to deal with it.
This is what writers do all the time, isn’t it? We create characters and let them work through our conflicts and fears. By the end of the story (or poem), sometimes the character is so real she’s walked off into another world, carrying all the angst so that we’re no longer burdened by it.
On my hospital admission form, my surgeon has described the procedure Kent, Alice is about to have as ‘Wide Excision, Localised Wire, Left Breast’.
The nurse counsellor’s form calls it an ‘Open Biopsy, with hooked-in localisation wire’.
I’ve also been told it’s “only a lumpectomy, not a mastectomy”.
I’m not sure which sounds better. Or worse …
The first two titles are at least descriptive. They explain why, on the day before surgery, I have another appointment at the breast clinic. To help the surgeon locate the exact area he has to cut out, a wire will be placed in my breast.
A month ago, the very thought of this would have made me feel ill. It still does.
The radiographer is sympathetic and upbeat, however, as she greets me. “You’ll be glad to hear this won’t take so long today. Only twenty-five minutes!”
Then we’re back in the room with the torture table where, once again, I have to lie on my stomach with my left breast prodded and persuaded to drop down a conveniently placed hole. This is my third time, so I should have the hang of this (literally) by now, but no matter how I wriggle my chest and counterbalance my legs, I still can’t get comfortable. It will only be for twenty-five minutes, though, so surely that will be bearable …
Compared with the core biopsy, this procedure is less disturbing. The local anaesthetic stings in, there is a prick and push as the wire follows …
When it’s all in place, we go to another room for more mammograms to check that the location is right. A new woman appears and studies the screen. Time ticks on – and she is still pondering, murmuring to the radiographer …
Eventually, they come across to me to explain that the wire is at one edge of the area that’s questionable. Probably, it would be better to put in another wire at the other edge – there would be less risk then of any suspicious tissue being missed …
So, back to the table and another half hour lying with half a view of a tropical sea and the Taj Mahal. The local anaesthetic is working better now, so I don’t feel much – but I do hold my breath after the next set of mammograms to review this new wire’s placement. What if it isn’t right – or enough?
After careful study, judgment is reached. All OK – we can tape you up now so that you’re not wandering around like a big octopus caught on two fishing lines. The protrusions disappear. I’m glad-wrapped in dressings and tapes and sent off to dress and go home, as if there’s nothing very odd at all under my blouse.
Tomorrow, I go to hospital. There’s no putting it off now that I’m all wired up like this! I have my X-rays from today’s session and notes for the surgeon (with strict instructions to hand these to no one but the theatre team) – and when I look at the films the next morning, the little patches of speckled calcium are clearly obvious, marked off by the wires. That is what is to be targeted by the surgeon: an area about the size of a fiftycent coin.
My room at the hospital has a view across the adjacent bush to suburbs of Newcastle, then north to the horizon and all the way over to the pure white streak of Stockton Beach.
“I could settle in here for a holiday,” I think. It’s so quiet and calm – until the nurse arrives and there’s no pretending we’re here for anything pleasant.
Already it’s time for a shower with a special cleansing sponge, and the donning of the blue and white seersucker theatre gown and white surgical knee-high stockings. My operation is scheduled for 4 pm – one and a half hour’s time – but in fact it will be nearly 6 pm before I’m wheeled out with a great clatter and committed to a world without windows somewhere far from here.
Till then, all cleansed and gowned and hygienically mob-capped, I lie with my legs being massaged by a mysterious, gurgling machine, and only a fraction of the panorama visible, and I settle down for the best rest I’ve had in weeks.
I’ve brought a book to read: The Small Pleasures of Life, by Philippe Delerm. It’s a small book, slim and light enough for me to hold up above me for short periods while I’m lying prone – and its content is equally light, but satisfying. Each short essay is a poetic exploration of an ordinary moment – buying Sunday cakes at a patisserie, or realizing it is almost summery enough to eat outside … What makes life precious is what these fragments are all about, and just a few of them, with rests between each five minute read, are all I need for good distraction while I wait.
Eventually, down in the anaesthesia bay, the stretched-out hours are almost over. I’m alone in the small room, staring at shiny metal doors that lead into the operating theatre. The walls of the room are stacked with medical equipment and signs about emergency procedures. There are clatters and little bursts of jolliness from the other side of the swing doors – they’re almost ready for me, just cleaning up after the patient before.
If I die in there, I think, this will be the last thing I saw in my life: a sterile room with two blank steel doors.
So I think instead of what I’d rather remember on the verge of death. People. All the people who’ve mattered during my life … the dead and the living, the close (family, friends) and the fleetingly touched as well … Imagining all their faces is comforting, calming …
Then the doors swing open – and my trolley gets its final push.
While I’ve been waiting, various members of the theatre team have popped out to see me, to check I’m all right. Everyone has been cheery, as if they’re having a great time cutting people up …
My surgeon himself appeared and reassured me that it wouldn’t be much longer before he took “a big chunk” out of me.
“Not too big a chunk,” I said, like a party-pooper.
“Just getting the chainsaw ready!” was his reply.
By now I suspect I am in a dulled state of benign acceptance of whatever is about to happen. The black humour doesn’t lighten my mood, but it doesn’t offend me, either. I think of Green Wing and the horrible antics of its operating team … Even at home, safely watching TV from the sofa, this makes me squirm – but trapped on my trolley, all I can do is mentally shrug and trust nothing so mad is going on here.
Thankfully, my view of this theatre is brief. The anaesthetist promises me he will soon give me party drugs. “You’ll have the best ten seconds of your life,” he says. “And then, when you wake up, all of this will be over.”
I don’t actually notice the wondrous ten seconds – but he is right about the operation being over when I come to again.
Back in my room, the view now is of city lights – the street lights in yellow lines stay on all through the night and I gaze out at them every hour, when I’m woken as a nurse comes in to check me.
By dawn, a few cockatoos, like white blown scraps of paper, are drifting and falling over the trees. Yesterday’s sky, which was so clear and sparkling, is now completely grey. Smoke from the last week’s fires has thrown a thick veil over everything.
I’m still hooked up to the massaging machine for my legs, plus a drip and oxygen, and a tube is draining out a blood-coloured fluid from under my left breast. I’m swaddled from armpits to waist in a roll of foam which fastens down the front with a Velcro strip … Until I’m finally allowed to try, cautiously, helped by a nurse, to walk to the bathroom with my entourage of drips and tubes and drains, I’m helpless as a mummy. But all things considered, it’s not too bad! I am alive, I’ve managed to eat a very dainty breakfast of surprisingly delicious Weetbix and vanilla yoghurt, and life seems to be about to carry on.
When the surgeon arrives to check me, he looks worse than I feel. Yesterday must have been a long hard day for him, as he has puffy yellow pouches under his eyes, even though he’s still bright and darkly witty.
He takes a quick peek, asks how I feel.
“Do you want to go home? Of course you want to go home …”
In an instant, all the nurses’ plans are overturned, and instead of showering and putting on pyjamas, I’m showering and then being re-swaddled in the tight foam, only just managing to button up my blouse over that bulk, and suddenly waiting, dressed and packed up, for the smoky drive home.
Everyone at the hospital has been so solicitous, so cautiously caring. But also, a little distant. They must live with so many sad prognoses that they try not to be too connected to patients.
The surgeon’s nonchalance is a strange contrast. Perhaps he’s already confident my results will be good, even though he can’t say so yet?
A day later, though, any hopes I have about this are quite destroyed when I look at my breast and see, under all the clear dressing, what I think are the hook wires put in to guide him. Oh no! I think in an attack of panic. He’s left them there because he has more to do!
Very anxiously, I peer down at the marks and threads and the jagged red line of the cut – and slowly, warily, I decide what I’m looking at are actually the neatly arced and tied ends of his stitching threads.
In a week’s time, I have an appointment at the BreastScreen clinic for a check on the surgery and the pathology results of what has been cut out from the breast.
Another long week of waiting …
7. LAST DAY AT BREASTSCREEN
For all our previous appointments at BreastScreen, we’ve been early. But on this morning, one week after my surgery, Martin seems in no hurry to rush to arrive and hear the results of the pathology tests. It’s probably coincidental – or perhaps not.
We’re not late. But the nurse counsellor appears in the waiting room almost as soon as I check in at the desk. She’s beaming. Says “You’ll be glad this is over.”
“Well, at least this part of it is,” I say cautiously.
“No,” she smiles. Then adds quietly, “It’s all over. Your results are good.”
The surgeon’s happy, too. The 45 grams of tissue he’s removed show no traces of cancer. There’s no more treatment needed. We’ll need to watch for any further abnormal growths – but he’s confident that everything suspicious has been caught in time, and all that’s needed now are vigilant mammograms every twelve months.
I suppose I should be exuberantly pleased and grateful. Naturally, I just go into shock – and am quietly relieved.
My wound is checked, the plastic covering gently unstuck, the stitches removed – and it’s time to leave, armed with a piece of paper which is a muddle of figures and medical words, but also a reprieve.
After six weeks when time, and the world, threatened to topple into some state I’d never known before, now it is time to edge back towards the ordinariness of being alive.
It’s time to celebrate – which we do by going again to Estabar on Newcastle Beach, just as we did in a more solemn mood after learning that I needed surgery. The wind is blustery again, and cold – and the café is quite busy for 10 am on a Friday morning. Ageing cyclists and walkers, virtuous after their exercise, indulge in caffeine, if not cake. People are talking of travel – possibly some of them are travellers? Everyone seems to have time to just sit, being companionable, uplifted by the closeness to the ocean and the big, bright sky above it.
“Now you can go and do whatever you want with today,” my surgeon said as he farewelled us. Such a simple statement, but how different his words could have been, if my results had been different. In the car park, as we were preparing to drive to the beach, he came out to his big white SUV and his face was closed, the look of a man with serious work to go to.
As well as hot chocolate with a whiff of ocean, to celebrate I bought myself a bunch of peonies. I love these big frilly flowers – I used to buy them at the markets in Paris for next to nothing, and their blooms would fill out above the simple glass jug like giant pompoms of pink tissue paper. Here, they’re expensive, exotic – and I don’t expect they’ll last as long, in our heat, especially after being grown like precious, pampered things.
After the last six weeks, though, I felt that simply being alive is precious. And I felt I deserved to be a little pampered myself, as well. And though they are so rarely available, there at the florist’s at Westfield, they were: peonies.
Only five big buds to a bunch; mostly very delicate pale pink, but with two of each five showing a slight blush, just the briefest flaring of a deepening red.
One week later, I’m mending well. Physically. And the peonies, fragile and ephemeral as I know they must be, are hanging on.
Here is one of them: a peony, making the most of its short life.