A cancer patient addresses doctors, part one

Part one in a three-part series by Pulitzer Prize-winning poet Rae Armantrout on overcoming cancer.   I will be presenting my own case history, both objectively, to the extent that I can, and subjectively. When we think about other people’s subjective experience, we ask ourselves what it’s like to be them. What is it like then to be told that you have adrenal cortical cancer, a disease so rare you have never heard of it and from which you will probably die? What is it like to discover this when you have been feeling no pain, feeling, especially well even? That is the situation I faced in June of 2006. In the months following my diagnosis, I tried to describe the experience, to say what it was like, in poetry which was later published in a book called Versed (sometimes confused with the anesthetic Versed) and now, in a different way, I will try to describe it here.

In the spring of 2006 I started to notice some slightly disconcerting changes in my body. I was growing a little mustache, just stubble above my lip. I was more annoyed than alarmed. I thought, well, this must be one of those things that happen to post-menopausal women. I’d seen women with hair on their faces before. On the other hand, I have never been particularly hirsute. What was even stranger was that, were my eyes deceiving me or did I have more hair under my arms than before? One day my husband said something about the facial hair and I started having electrolysis, trying to deal with the symptom, not the cause. I knew I must have some sort of hormonal imbalance, but I didn’t imagine, consciously anyway, that it could be anything serious.

The reason I say “consciously” is that during that period, I began to have rather ominous dreams.  I often write dreams down and sometimes use images from them in my poems. During the months before my diagnosis, I recorded a dream about being presented with a dollar bill for every year I would live and counting the money. I don’t remember reaching the end. I must have woken up. I also had a dream about being towed out to sea in a little boat and left there. Do I believe in precognition? Not really. But I think it’s possible that your body may sometimes know more than your conscious mind does.

Finally I went to my general practitioner hoping that she could prescribe something to rid me of the facial hair. I had another irritating symptom too. My eyes were constantly watery. I’ve never heard that symptom officially associated with my disease, but it disappeared immediately after my surgery and has not come back. To her credit, my GP immediately ordered a blood test. It showed that the DHEAS in my blood, which should top out around 130 was, in fact, at 4000. Clearly, this was very wrong so a CT scan was ordered. My doctor told me not to worry. She suspected I had a benign tumor on my adrenal gland.

I had the scan around 6pm. I think it was June 2nd.  Around 7 my doctor called me at home and said the CT showed a large mass which was quite close to an important artery. She thought my life was in immediate danger. She told me to pack a bag immediately and go to University Hospital; a surgical team would be standing by. My husband walked in while I was still on the phone. The first thing he said was, "I thought everything would be alright.” The university operates two hospitals, University and Thornton. University, where my doctor instructed me to go, also serves as the city’s public hospital, treating the indigent. When you know that, you will know that my experience was not quite as my doctor had led me to believe.

We reached the emergency room around 7:45 and I got in line to speak to a receptionist who appeared to be behind bulletproof glass. The man standing in front of me vomited blood on the floor. Neither he nor anyone else seemed especially perturbed. When I reached the front of the line, I told the woman behind glass that my doctor had said I should come immediately; there would be a team waiting for me. She looked at me with bone-tired skepticism as if to say, “Right, Princess, now I’ve heard ‘em all.” She pushed paperwork at me through a hole in the glass and told me to take a seat.

As I scanned the waiting area, looking for a seat, I noticed that most of the would-be patients appeared to be street people, many of whom were either psychotic or high. The room was so crowded that there was no place for my husband and me to sit together. It was around 11 when someone took my vitals and put me on a gurney. They did a chest X-ray and told me to wait. At around half past 12, word came down from somewhere upstairs that my life was not in immediate danger. I was given an appointment to see someone in a couple of days and told to go home, which, by then, I was very glad to do.

When my appointment arrived, I entered an office and was met by two doctors. Perhaps one was an intern. I didn’t see a sign that said oncology. At any rate, they told me that my tumor was operable and set up an appointment with an oncological surgeon at the cancer center. I asked them whether my tumor could be benign. They said, “Oh, the benign ones don’t get this large.” That’s how I found out I had adrenal cancer. I had never heard of it. When I got home, of course, I immediately looked it up on Google, the first source of medical knowledge. I learned that there are two types of adrenal cancer.

The first kind I read about, cancer of the adrenal medulla, is quite curable. The other kind, adrenal cortical cancer, has a five to 15 percent five-year survival rate and is only considered curable in stage one. I knew I had a large tumor. And, unfortunately, my symptoms, the effects of masculine hormones, were characteristic of the more deadly disease. What did that feel like? I guess I couldn’t quite believe it because I continued to function. I realize now how lucky I am to still be alive. I am very fortunate that my GP ordered tests immediately. And I am very lucky that I was not operated on that first night by whatever doctors happened to be on duty, but was able to wait two weeks to have surgery done by a doctor who specialized in surgery on abdominal cancers.     


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