Wednesday, September 5, 2012

Cancer Candid Camera

Sometimes I get a big kick out of the difference between my vision of what I expect, and the reality of how it turns out. I could give you countless examples, and I’m sure you could contribute just as many. I remember how exciting I thought it would be to buy my first car when I graduated from college. With a professional looking outfit and a (forced) confident strut, I walked into the Honda dealership to make my first big purchase as a real-life adult. I envisioned smiling with pride as I signed papers with a big heavy pen. I envisioned playing “Free Falling” as I drove off of the lot with that new car smell fresh in my nose. My new car, my new career, my whole life ahead of me. That was the vision. The reality? About four hours after sitting around the dealership being tossed from one untrustworthy guy to the next, I left in my Dad's car, looking like I had just weathered a boxing match – disheveled, tired, confused, and hungry. I wasn’t even sure when I was going to get my new 2002 Honda Civic. When did the plates come in again? Where they going to call me? How much will I owe them every month? Can I even afford that? I was free falling alright – straight into the reality that buying a car isn’t any fun.

Add kids, and the examples are endless. One of my favorites involved me trying to recreate a tradition we had in my family as I was growing up. Around the last day of school every year, my Mom would take Rachel, Sean, and me to the bookstore to buy a whole bunch of books that we would read that summer. I loved that trip not only because I love bookstores, but also because it meant the start of camp, trips to Grandma and Grandpa's house, time with cousins, ice cream, all those awesome summer joys.

This year I decided to recreate the tradition in our house on one of the few nights in the June that Brian had a late event for school or hockey, I can’t remember. So Teddy and Annabel and I marched off to Barnes and Noble. When we got there, I realized I forgot the diaper bag. No big deal, we’ll be quick, I thought.

“Come on guys, let’s find some great books for the summer,” I said as we held hands in the parking lot, me as naive as my former self ten years ago walking into the car dealership. “I want to play with the trains,” Teddy responded. Oh yes, those friggin’ trains. They were a welcome distraction when Teddy was too young enough to care about books, but now the bookstore had become “the store with the trains.” Me being the militant mother that I am, we stopped to play with the trains. Then Teddy told me he had to poop. “Great job, buddy, thanks for telling me! Let’s find the bathroom.” We found it, and he went, as I tried to corral Annabel from crawling into the next stall. Now, back to the family tradition, I thought. Teddy faked a minute or two of caring about which books we chose until he headed back to the trains. What the hell, that's fine, I thought, and I took a seat to watch Teddy, Annabel, and a few other little ones perfect their boxing out techniques in order to protect “their trains.”

Then I smelled something. Please don’t be coming from my child, I thought. But it was. A large gift from Annabel, who always seems to know when I forget the diaper bag. Back to the bathroom (Teddy, trains in hand). I don’t consider myself a dumb person, but sometimes, I really wonder what was going through my head. Partly, I know what I was thinking at that moment that I lifted Annabel onto the changing table that I always blindly hope is nailed in tight to the wall – if I put her in her car seat with that enormous gift, it would end up out of all ends and that won't be easy to clean up. So instead I decided I would take off her diaper, dump the package out into the toilet, use toilet paper since I didn’t have wipes, and put the somewhat clean diaper back on her. That was the vision. 

The reality, however, involved Annabel screaming on the changing table as I tried to fling clinging poop from her diaper into the toilet. When I missed, we had a mess on our hands. Literally. It wasn’t really poop you could fling. Poor Teddy tried to help. But there was no salvaging this diaper. Not a problem, I thought, she’s empty now, she’ll just go without a diaper. We cleaned up the bathroom so that aside from the smell, there was no evidence of the desperate parenting that had taken place there. We washed our hands, and we proceeded to the register to buy our stupid books. Annabel peed on the way home, but whatever, those car seat covers are actually pretty easy to wash, and in retrospect, I should have just gone that route from the start. That night, we read one of our new books. And the summer began, family tradition restored. Kind of.

You know that appointment I had with the psychiatrist at Dana Farber yesterday? Let’s just say the disparity between the vision and reality of that appointment was about as big as the disparity I experienced at Barnes and Noble last June.

Call me crazy (I am), but I thought I would sit down with this man and he would comfort me, at least a little bit. I figured I’d cry a little, he’d repeat lines that he’s delivered a million times to people like me who have been shocked by a cancer diagnosis. I’d feel relief when the hour was up, I’d have thoughts I could come back to in the coming weeks that would help me cope, and he’d give me a hug and tell me everything would be OK. It was a lovely vision. So many visions are.    

I have vowed to never use this space as a place to blast anyone, especially people in clinical positions, not only because I don’t want to burn any bridges in a relatively small world of health care, but mostly because I honestly believe that some part of every clinician means well. However, since my review of this doctor is less than stellar, we’ll use a pseudonym. "Dr. Shrinky Dink" was my first choice, but that feels disrespectful, so let’s just stick with Dr. Funt.

It didn’t start off well when Dr. Funt couldn’t find me despite that I had checked in at the front desk and was waiting in the waiting room. When he finally called me in, he lead by asking me if a "palliative care fellow" could sit in on our session. “Sure,” I said calmly, as the Ph.D., M.D., who was probably about my age, took a seat in the room. But inside, my blood pressure rose (and it had already been high according to the vitals I had just had taken) as I thought to myself, Isn’t palliative care for people who are about to die? I sat down.

I honestly can’t remember the exact words we used in this conversation, but the pieces I have summarized below are close enough. Dr. Funt began by asking me something along the lines of, “What brings you here today?” I almost laughed and cried at the same time. Seriously? “Um, cancer. I was just diagnosed with cancer and I’m scared out of my mind.”

Pause.  Blank stare in my direction.

“What are you scared of?”

Another moment where I couldn’t decide to laugh or cry. “Hum, maybe what everyone’s scared of when they hear they have cancer – that I’m going to die,” I replied, somehow crying and smiling at the same time. Crying because it’s still hard to admit that I am afraid I’m going to die and laughing because my own internal voice was joking with me, asking, This is therapy?

“I see.” Pause. (Internal voice – Was I supposed to talk more? In the movies, he’d ask me the questions.)

“Do you have family in the area?”


“How’s your husband dealing with this?”

“He’s upset.”

“Do you have brothers or sisters?”

“Yes. A sister and a brother.”

“Where did you go to school?”

“Bowdoin College.”

I was stumped. Was I in the wrong appointment? We continued this superficial back and forth for a while longer. Finally he asked me what was helping me cope. I told him that what helped me most was hearing the stories of people who have had serious battles with cancer and won. He nodded. Silence.

At one point, I asked Dr. Funt what his job was. Maybe I really was in the wrong appointment. He told me that he meets with people and helps them find what will work for them (or something like that). OK, so maybe this was a big miscommunication. I thought he was actually going to provide me some counseling. So I take some responsibility for how badly this all went, and that’s the only reason I didn’t get up and leave.

But it was bad. Really bad. This man was so disconnected that in that entire hour, I didn’t feel a single ounce of empathy or understanding from him. I swear to you, I think most of Brian’s psychology students could have done a better job.

At the end of the appointment, the palliative care fellow who was shadowing this doctor spoke up. He asked me if anyone has told me what an amazing job I’m doing. I started to cry. “There are many people who are told what you’ve been told and can’t get out of bed, can’t take care of their kids. But you’re doing all that and you’re doing a great job. And you’re the type of person who will continue to do a great job through your treatment.” I can’t remember if he said that I’ll be cured, but it didn’t matter. What the seasoned expert couldn’t achieve in an hour, this novice achieved in a minute – turning a bit of my fear into a feeling of pride and accomplishment; turning a bit of my doubt into confidence. Acknowledging my pain, and looking at me as if he wanted to make it better.

I was glad my Mom was in the room for the appointment because no matter how much I write about it, I couldn’t do justice to the reality of that hour. When we walked out of the appointment, I told her that I thought we had just been taped for an episode of “Cancer Candid Camera.” Dr. Funt was a perfect character for such a skit. But the big reveal never came, so I think it was the reality, where my vision had been something totally different.  Nevertheless, we've enjoyed some good laughs about this appointment, and laughter is always a great medicine.

In the end, I give Dr. Funt credit. He called me last night and helped me set up an appointment with a psychiatrist out of the breast center at Dana Farber. I meet with her Monday morning. Ever the optimist, I have a vision that this appointment will be the one I was hoping for yesterday – one where I feel a human connection to someone with whom I can talk about things that I don’t want to dump on my family or my friends.

(Oh, and in an upcoming post, I will tell you about my appointment with the nutritionist, Stephanie Meyers. She was beyond fabulous and she deserves everyone to know it. I learned so much from her, and despite my life rule of never talking about diets, I’ll share some of what she told me because it was really interesting.)

Ultimately, if there’s one thing I can take from yesterday's debacle, it’s the realization that vulnerable people, including myself, often need to turn to strangers for help. Every day men, women, and children walk through the doors of a hospital, a school, a nursing home, a gym, a lawyer or a therapist’s office, or countless other places, desperate for compassion and guidance from people they've never met or even heard of. The professionals that receive us have a huge, very challenging, and indescribably important responsibility. They have to choose their words wisely, because each and every one matters. They need to be careful of their facial expressions and their tone, because we read into every one, consciously or subconsciously. Somehow, amidst the volume of their clientele, the busyness of their days, and their own personal priorities, those professionals need to treat each of us as unique, yet connected by a similar hope – that even though we’re afraid or weak or downright ornery, we’ve come to them to try to make us better. And when they do that, they have a special place in our hearts forever.  

1 comment:

  1. Hi Tara,

    I saw your article in the Citizen and just wanted to let you know that I'm thinking about you and rooting for you to kick this cancer's a$$.
    Take care.

    Laurie (Conroy) Marr