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Saturday with Doctors and Writers

Posted Sep 12 2008 11:34am
If you don't like medical detail, just skip this post.

There was a nice little coffee/tea place/restaurant on in Greenwich Village named Anglers and Writers. I was there when it was rainy outside and so when I think of it I think of cold and rain outside and coziness inside, metal fishing implements on the walls and lots of rough-hewn wood everywhere. It may or may not have been like that. I say this in past tense because when we were in the Village in December it was gone. When I wrote the title above I thought about Doctors and Writers: Could there be an intimate restaurant with that name? What would there be on the wall? Black medical bags? Stethoscopes? Can the doctors and writers be friends? That song from Oklahoma!: Oh, the farmer and the cowman should be friends --even though they're at cross purposes. You can't say that about doctors and writers; they aren't diametrically opposed. Necessarily.

Saturday started with a 10:00 appointment with my accidental gynecologist. Meaning he's mine accidentally. I think I went to him for a third opinion, but liked his opinion then chose him to do surgery. He removed my ovary and salpinga, as mentioned earlier in this blog, because I had a cyst that wouldn't leave. The other two opiners said that my uterine fibroids should be cut out, but this guy said they might grow back and surgery might make a mess. He didn't say that exactly but that's how I imagined it: that he wouldn't be able to get all the fibroids and the remains would be bleeding, like little stumps. I liked this guy because he was willing to say that it was pretty clear that the cyst was benign and it was up to me whether to have surgery. I think the other doctors were assuming it was benign but were afraid to say it. What I don't like is that he's hard to get ahold of. His appointment-makers are also hard to get ahold of. Making an appointment requires staying on the phone, punching buttons and listening to bad music. It's a good opportunity to multi-task. He's in an office with a friend of mine from youth. We were in Sunday School carpool together. The gyne is also connected with Fancy Hospital, which means he can look up all my records on the computer. My regular doctor had felt a lump in my (former) left breast in August and told me to get an ultrasound, but since the last time she'd sent me for an ultrasound, the radiologist had found nothing and moreover had pooh-poohed internists as alarmists, I didn't do anything. I had an appointment with this gyne soon after and asked him to check it. He said it didn't feel like anything. So. I was waiting for him to find out through my Youthful friend that the lump had turned out to be Something and to tell me he felt bad, but that never happened. Probably the Friend of my Youth didn't pass the info along because of confidentiality. On the other hand, when my internist found out it was cancer, she called me and told me she was praying for me.

The Fancy gyne looks at least 10 years younger than I am, has even features and is good-looking (which I don't trust in a doctor) in a lithe, boyish way, and wears gym shoes with his doctor uniform. He seems like the kind of guy who would be very funny if you saw him away from the office, like he's holding back when he talks to you. But I might be wrong about this. I think he's very smart.

And lo it was the 27th day of my bleeding and my internist had found a cervical polyp recently so I called the Fancy gyne and got an appointment, amazingly enough, for a few days later, Saturday. And unbelievably I didn't even have to wait. I had mentioned chemo when I made the appointment, and I mentioned it that day to the nurse, so when the gyne came in he knew about it. Or maybe he'd already known about it. I had imagined making a dramatic announcement: Remember that lump you said was nothing? Well (whipping open the hospital gown and letting the silence be eloquent)--. He walked in with the motto on his lips of All Doctors Who Know You Have Cancer: Are you hanging in there? It's quite apt but gets tiresome. Maybe there will be a continuing medical education course that teaches them an alternate opening line.

My taciturn oncologist just asks how I am. Which is fine.

The rest gets grisly so feel free to skip.
It seems pretty clear that my bleeding is caused by the fibroids. Or five boys. See below. But he did an endometrial biopsy just to make sure there wasn't another cause, such as endometrial dysplasia, a pre-cancerous condition. He said removing the little bit to biopsy would take 10 seconds and feel like a strong menstrual cramp and he was right. It was strange that he was right. Strange to hear it come from a man. But as L has pointed out, even if he doesn't experience something himself, the male gyne hears over time from women what it felt like and so can pass it back on to me. Thus he is a conduit. For women's wisdom, you could say. He also removed the polyp. I asked to see it. It looked like a tiny red tutu floating in a jar. I asked what he thought about my getting tested for BRCA1 and 2, mutated genes that are a specialty of Ashkenazi Jews. We produce them in disproportionate numbers, along with violinists, comedians, doctors and Nobel Prize winners. (A bit of Jewish jingoism here.) My surgeon hadn't thought I needed testing but when I asked the oncologist last time I saw him, he said I could get tested, since I have an aunt and cousin who had breast cancer. The mutation can indicate that you're more at risk for ovarian cancer than otherwise. The gyne asked if I would have my second ovary taken out the test was positive, and I said yes. Then he said to go ahead. He also gave me a referral for another ultrasound to see if my fibroids were growing. I didn't have the guts to say, Are you sorry you missed the lump? But I did make reference to the lump he had felt, and later he said he was sorry I had cancer. He asked me if I was doing anything fun this weekend. I said I was moderating a panel at the Printers Row Book Fair. I guess that didn't sound fun enough because he asked again and I said we might go on a nude bike ride. If L wanted to. I'd seen it in the paper that morning: World Naked Bike Ride Chicago. Body painting at 6, riding naked or in costume at 9, I liked the idea of going topless. It seemed like a good way to make my former breast public. It's not like I'm exactly proud that I'm missing a breast. But I don't want to be ashamed of it.

My next appointment was with the dentist. I have two sensitive teeth, one of which had started aching. He told me that part of the filling is gone, and that, unsurprisingly, that I might need a root canal. He said to check with the oncologist about taking antibiotics and then to come in Monday and he'd take out the old filling and either refill the cavity or send me down to the endodontist. The story with the other tooth is that the pulp is very close to the filling. He told me that the pulp can grow and move around. Also, fillings can settle. But the thing is, I think that teeth are like hair and nails, but they're not. They're living, feeling parts of us. He gave me a brochure about chemo and teeth. Chemo can dry out your mouth and make it more prone to bacterial growth. He took a look and pronounced my saliva production satisfactory.

Later in the day I thought, Why on earth did I tell my gyne I was going bike-riding nude, even though it was a real possibility? He'll think I'm weird. L said, Everyone who knows you thinks you're weird.

Then came the writer part. At the book fair I went to the authors' (and moderators') check-in room and saw this shortish woman with thick straight gray hair, who looked sort of like a younger Nicole Hollander. It turned out she was Amy Hempel, who is a wonderful, voice-driven short-story writer. She was very easy to talk to. She is the stuff of legend, of the 1980s boom of short-story collections. Many fiction writers with unpublished collections are waiting for the short story to come back in popularity. It's about time now. Every time someone came up to her and learned who she was, they said, I teach your stories. I do too. We agreed that writing novels seems impossible, hard to hold all that information in your head. At her panel she read a short story. It was one sentence long.

At the fair I bought two books from Sarabande Books, a literary press in Louisville. I'd met the Saraband publicist at a dinner in her honor at B & S's house Friday night. Both books are essay collections, both by poets. Today I read the first, A Family of Strangers, by Deborah Tall, finalist for the National Jewish Book Award. It's odd and deceptively simple. Or maybe not deceptively. There's lots of white space. Each segment is about a page long and is made of very short paragraphs. It's about her quest for missing family. Her father was an orphan. The white space makes the book very quiet, gives it a hush. Some of the sentences are poetic and dense and some are not. In a way I think she's "cheating": by surrounding the lines with white space, she's making the reader pay attention to them, and she's declaring them to be poetic. As I said, most of them are. But some are not. I couldn't help wondering if I could "get away" with the same thing: Cut up my essays into snippets and float them in space. My friend P had told me about the book, and that Tall was Jewish. (Tall? What was it before? Talesnick. Maker of tallises.) I'd heard of Tall, who was the editor of the Seneca Review, home of the lyric essay. P also told me that Tall had recently died of breast cancer. She had inflammatory breast cancer, which is rare and aggressive. It's what Molly Ivins died of. In the last piece of the book Tall talks about her diagnosis: "In my grief, I dream most that my children may inherit a legacy of absence and yearning.

"Yet they will have this trail of crumbs I've scattered, this effort to make of us a story."

That was very sad to read. She died at 55.
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