Essay from NY Times

kira66715 · April 2011

This was at the back of the magazine: and as I read it, some familar themes, about dealing with health care providers, and our emotional responses resonated with me. And the whole issue of dealing with a chronic problem that may not be fully under your control.

Kira

April 15, 2011
The Waiting
By DAVID RAKOFF

I am nothing if not compliant. I held still as I was shuttled back and forth through the wondrous high-tech doughnut, inhaling and holding my breath when instructed. Less than three minutes later, I hopped off the narrow table and put my sweater back on.

"Have a fantastic day," the technician said as I left.

"Fantastic"? Fantastic days are what you wish upon those who have so few sunrises left, those whose lungs are so lesion-spangled with new cancer that they should be embracing as much life as they can. Time's a-wasting, go out and have yourself a fantastic day!

Fantastic days are for goners. Was I fated to take some final vacation to see Venice for the first and last time? Or should I corral some long-cherished idol (I'm talkin' to you, Meryl Streep) into posing for a photograph with me, both of us giving a thumbs up to the camera before she beats a hasty retreat back to the Land of the Living? That kind of fantastic day?

In truth, after close to three years into my current illness - a rather tenacious sarcoma around the area of my left collarbone - I try not to invest too much importance in the casual words of others, mostly to let them off the hook. With the exception of the wildly unprofessional X-ray technician in 1988 who, spying my radiation-strafed lungs (a result of the primitive treatment for my first bout of cancer, and the likely cause of my present sarcoma), asked how long I'd had AIDS, caregivers seem trained to keep their language and voices neutral, for just this reason: it's an unfair burden on them when so many of us who are sick are looking for signs or unstated reasons to hope during the waiting.

And there will always be waiting. It begins immediately. Unless your presenting problem is a headache and you show up at the hospital with a knife sticking out of your skull, tests will always have to be done and then results will have to be delivered. Biopsies must be frozen, sliced, dyed and analyzed. If a culture has to be grown, then you have to bide your time while cell division takes its course. Disparate hospital departments, if not entirely disparate hospitals, cities or states will have to find and speak to one another, leaving you with nothing but a lump, inexplicable bruising, months of unexplained fatigue, your own imagination or, heaven forbid, the Internet to occupy your mind. Those weeks before diagnosis can be among the most torturous times. There is a reason you're called a patient once the plastic bracelet goes on.

It has taken years for me to learn not to analyze the voices and vocabularies of those taking care of me. For the most part, I've been very lucky even as I've been less than fortunate. The doctors and nurses in my life don't prolong the anticipation with pleasantries. We joke around a lot, but that's the second order of business. With a long illness, there are stretches of triumph that feel like cosmic rewards for good behavior followed by inexplicable setbacks that seem like indictments of your character. With so much muddy logic crowding out reason, it's best when news, good or bad, is delivered quickly and clearly. I will forever be grateful to my oncologist for opening the door and saying, "Damn it, the tumor's 10 percent bigger," before he even said hello.

I would never be able to do their jobs. In the same boat, I would probably mimic my first surgeon, who was so flustered and out of his depth - he'd seen the mass, taken out only part of it, thereby spreading cancer cells through the area, and closed me back up - that he engaged me in banter about the modern-dance scene and a ubiquitous no-knead-bread recipe before telling me that I had a malignancy. I felt hoodwinked and unsafe: the blood-soaked prom queen minus her vengeful power of telekinesis.

We like to think that the empathy broadcast with the swooping, downward intonation of the "aaawwww" is an evolutionary comfort; something we are programmed to welcome and offer freely ourselves. As a comment on something that has already happened, it probably works. But as an anticipatory tool, it does not soften the blow, indeed it does the opposite. It leaves you exposed, like grabbing onto the trunk of a tree for support in a storm only to find the wood soaked through and punky and coming apart in your hands. The sweetest bedtime-story delivery is no help when the words it delivers are a version of " . . . and behind this door is a tiger. Brace yourself."

Have a fantastic day.

David Rakoff is the author, most recently, of the essay collection "Half Empty."

http://www.nytimes.com/2011/04/17/magazine/mag-17lives-t.html?ref=todayspaper