Syracuse, NY 13210
Volume 9, 2009
From the Heart
A woman sits in the examining room, clutching a flowered poncho about her slender frame. Husband sits on a chair next to her. If you met her at a cocktail party, she would be the elegant one wearing the deceptively simple gown and understated jewelry. Now she looks hollowed out. The color has left her face. I'm suddenly conscious of the small sounds beyond this quiet room. Nurses' voices, something brushing against the closed door. Her gaze never wavers from my eyes. Her name is Sharon.
Sharon's mammograms hang on the X-ray view box. An irregular shadow, opaque white against the cobwebby grey of normal tissue, can be seen from where I sit at the small desk. The radiologist has done a needle biopsy. I, her surgeon, have just had to tell her that it's cancer.
I've eased into it as best I know how. Started with neutral words like "shadow" or "opacity" and then becoming more specific: "growth," "tumor," "cancer." I've tried to emphasize the positives. Now I repeat myself, hoping she hears me.
It's only about the size of the tip of my finger," I say, reaching up and demonstrating. "Your exam is normal. It's excellent that you've been getting routine mammograms. You have a really good chance of a cure."
Tears well. These rooms are stocked with boxes of tissues, and now I hand her one. Her husband draws his chair closer to hers. I busy myself with her chart, give them a moment to absorb what I have just said.
It's six months earlier. I'm lying on a stretcher in the emergency room of this same hospital. My heart pummels the inside of my chest with a new, erratic rhythm. The ER doctor has just told me I have atrial fibrillation. She's admitting me to the cardiac unit.
My physician husband sits on a chair on the other side of the gurney. We all know what this means. I muster enough breath to protest, saying, "But I've always been so active. I've never been sick. I bike to work, eat right..." I'm looking into her eyes. I'm drowning, I can't breathe. She's grasped my hand, she'll pull me out.
"All of that will stand you in good stead," she says calmly.
Ten days later, Sharon lies on the operating table. I stand at her right side, looking down into those eyes, holding her hand. I'm going to do a breast-conserving operation. She won't lose her breast, not today. The anesthesiologist puts a mask on her face. "This is just oxygen," he says.
"You're going to go to sleep now," I say. "You may feel some warmth in your arm, that's just the medicine." I speak softly, slowly, my gestures deliberately calmed to gentle her. Inside, I'm as keyed up as a violinist awaiting the conductor's baton.
A milky white liquid flows into her intravenous line. Propofol, "milk of amnesia," bringing instant unconsciousness and forgetfulness. She moves slightly. The drug always burns a bit as it goes in. Within a couple of seconds, she grows still. I place her hand carefully on the armboard, secure it in place so that I can work. So I can remove the lump, test the lymph nodes. Once she is asleep, things move swiftly.
A cardiac nurse glides in and out of my darkened room that first night, always increasing the drip flowing into my right arm. It's not working. My pulse dances chaotically, tracing an erratic line across the monitor. They will have to shock my heart.
In the morning, the senior cardiologist prepares to do the cardioversion. He checks the equipment, the EKG leads, the paddles. He stands at the head of my bed, his strong fingers hooked under my jaw, holding the clear plastic mask over my nose and mouth. Deep breaths. I'm so tired.
"It's just oxygen," he says. A nurse pushes Propofol into my IV. "Tell me what you did on vacation," the cardiologist says. The drug warms my right arm. Good. "We went kayaking..." I start to say.
Two months later, Sharon is in the middle of chemotherapy. Her hair is falling out, so she shaved her head. Her husband shaved his in sympathy, and so did his buddies at work. Her breast has healed well. The cosmetic result is excellent. When she finishes chemo, she will undergo radiation treatment.
"I used to run three miles every day," she says. "Now I walk. When I can. I get so tired."
"Your body is telling you to conserve your strength. You'll run again. When this is all behind you," her husband says. I nod.
"Just do what you can, for now. Give yourself a couple of months. It will be a bit like training for your first 5K run. You'll have to build back up, but it will come," I say.
"I ran my first 5K in forty-one minutes. I finished dead last," she says. Laughs.
And then stops, as if surprised by the sound of her own laughter.
I go home from the hospital on five medications. Meds to slow my heartbeat, to regulate it, to lower my blood pressure, to thin my blood. My heart won't beat faster than 60, except when it reverts to its hectic, danse macabre. Leaves begin to fall. In our garage, dusty spiderwebs enshroud my bicycle. Every day after work, I trudge around the track at the student center, clutching the handrail for steadiness. I seem to have aged ten years. Early winter snow will fly before I jog again. Scout's pace at first. Jog twenty steps, walk twenty, repeat, repeat, repeat. Slowly, tentatively, starting all over from the bottom. And, in due course, I go into a kind of remission. The meds are reduced, and then all but two of them are dropped.
Sharon continues, "I just don't understand why I got breast cancer. Nobody in my family ever had it. I never smoked. I've eaten right, exercised, kept to my ideal weight..."
This would be a good time to tell her about the research—scientists all over the world, trying to ferret out that very issue. But I've been a surgeon for thirty-five years, and the answers remain elusive.
Or maybe I should share my own story with her. Tell her how I got back into my life again after being sick. But we are in Sharon's story, not mine.
So I just speak from the heart.
It's a rotten disease. It just strikes anyone it pleases. You didn't do anything wrong," I say. "You will get over this and get your life back. And, as for those good habits, all that will stand you in good stead."