The Big, Bad, Terrifying Medical Machine 21 comments

20 Mar 2004 @ 03:41, by Richard Carlson Endless is my vow under the azure sky boundless spring. ---Soen Nakagawa I wish we were not so single-minded about keeping our lives moving, and for once could do nothing, perhaps a huge silence might interrupt this sadness of never understanding ourselves and of threatening ourselves with death. ---Pablo Neruda Cease from practice based on intellectual understanding, pursuing words, and following after speech, and learn the backward step that turns your light inward to illuminate your self. Body and mind of themselves will drop away, and your original face will be manifest. ---Dogen A couple of times during my life, circumstances have forced me to accept quite atypical work off the beaten path of success for my career plan. The first time was in the late '60s, following a devastating (for me) divorce, when I became a glorified attendant of some sort in a private psychiatric hospital outside New York. The second time was more recent, after we'd moved to Ohio and I took a bureaucratic job with the Social Security Administration. Both jobs involved receiving considerable hostility from the people I was supposed to serve. But I think of those times fondly because I learned so much. For one thing, I discovered people who have such jobs are real human beings, like you and me. Most often they turn out to be terrific folks who confront the pressures of every day, looking into the eyes of a public that hasn't the slightest personal interest in them. Bureaucrats particularly are despised as stupid, careless, faceless clods for whom sadistic regulations carry biblical weight. I remember Speaker of the House Newt Gingrich a few years ago lecturing the Congress and the American people savagely about getting rid of government bureaucrats. His Republican Party continues bent, it seems, on destroying the livelihoods of all social service workers. Well it's true, sometimes you've stood in line or sat in a waiting room for a couple hours, and when you finally get to that lifeless form behind the counter or the desk, you forget the person has been deluged with all these people during the same amount of time. And the machines aren't working, and the regulations have been made up by people who just want to prove to their superiors that they're doing something with their time, and what you have are 2 people facing each other ready to fly out of their skins. I can't tell you how many times my work experiences have helped me through a process like that. And that was the case yesterday. Late Wednesday afternoon I was given a diagnosis of prostate cancer. Early Thursday my doctor's office phoned with an appointment for a total body bone scan at a small, local hospital that I like, which shall be nameless for the purpose of this Internet article. The most insidious activity this kind of cancer does is spread to the spine, just outside the pelvis, and from there throughout the bones. It also heads for the lymph nodes, but this test isn't for that. A bone scan is routine and necessary to decide the next step. So the appointment was for yesterday, and would take 4 or 5 hours and I was supposed to drink gallons of water during the day and night in between. I would be injected with an amount of radioactive substance into my bloodstream. The substance would circulate through my body and be absorbed by my bones. A nuclear medicine body-imaging camera then would scan me for abnormalities. I needn't tell you I was a little on edge when I got there. One of the reasons I like this small hospital is because of its friendly atmosphere, but the cheerfulness of the woman who checked me in couldn't lighten me tremendously...though it helped. The lady at X-ray was an ancient who must have worked there since they laid the cornerstone. Her little office was lined with folders containing every X-ray taken in the last 5 years. She was shredding documents...and I cracked my first joke of the day. It didn't get a big laugh. Then I was introduced to Sue, which is not her real name. She would be my technician, and she led me to a cluttered room, for which she apologized, and laid out little lead-lined containers. Sue was light and quick and very cheerful, maybe in her early 30s. The needle went in perfectly, so that I barely felt it, and I said so. Some blood was extracted, which went into the containers, and then the mixture was injected. She asked me what this was for, and I told her, which slowed and darkened her a bit. She told me to do whatever I want for 3 hours, but to keep drinking. I asked if whiskey would be all right, and she answered, "As long as you can get up on a table and not fall off." We had established a pretty good working relationship I thought. Three hours later we met again, this time in the nuclear medicine room. The scan costs $2000 and there must be a half millon dollars worth of equipment in that room. Sue was quiet and serious now, but still moving quickly...and I was nervous as hell. There were no noticeable side effects from whatever was inside me, though I wondered if my pee would glow in the dark. I was going to have to lay motionless on this table platform for 35 minutes, while the machine slowly moved around me from top to bottom and then back up. She made adjustments, checked 3 different computers, moved me a little, and then we started. For 20 minutes not a word was spoken, and I kind of meditated/dozed while the huge machine did its thing. I thought Sue had left, but suddenly she was beside me---and I jumped. She apologized but said she was afraid the camera was going to hit my feet. She pushed a button, and then asked me to raise my knees a little. I said, "I only wear size 9 1/2. My feet can't be that big." She acknowledged that, and then started to rush around the room...clicking keyboards and pushing this button and that. She said those words you hate to hear: "The machine never has done this before." I sighed. Must be this girl's first time on her own, and that's what I get for coming to a small hospital. Here I am full of radioactivity...and probably I can't take this test again for a while. I suggested that I drive to another hospital right away while I'm still hot and glowing. She said no, that she'd get it...but we have to start over. I took off my shoes. Sue said she had clicked Pause, to move my feet, but that the computer now was requiring her to begin a new scan rather than continue. It was a glitch. She said she would do this one manually. She seemed to know what she was doing. I asked if she was a nurse or an X-ray technician or what. She answered gently that she ran the department. Then she told me how that came about. The machine started again, and I lay there. She'd been doing this at the hospital for 12 years, fresh out of wherever you learn to do this stuff. The first 2 years she had 2 different bosses. Then they asked her to take over. She gave it a try (she has 7 kids at home) and became frustrated when the other techs (a union shop) insisted on being asked to take an extra shift, rather than follow orders. She ended up taking the shifts herself because they usually said no. She thanked the administration for the opportunity to direct the department, but asserted she preferred her old job back. Her superiors replied that they hated to see her go. In other words, she would continue in administration or lose her job. So there she's been, working day and night, commuting 45 minutes each way, and taking care of 7 children (4 of them adopted) and her husband. The camera was down around my chest by now, and I asked if I could talk. I told her about my first job...which was in The Bronx, chairing a department in a field for which I hadn't been hired. We started commiserating, and our initial relationship chemistry returned. She was pregnant at 15, but they got married and she's proud of the strength of her relationship. That child is now 21, wants to be a teacher, but joined the National Guard for monetary help---"before all this CRAP got started," she said. His university work has been interrupted twice, because he was called up for duty, and both times OU simply cancelled out his courses rather than let him pick up where he left off when he got back. He gave up, took a factory job, got laid off, and now is on unemployment. (I'm wondering how many other guys out there have this story.) Her youngest biological child is 9, but at some point they licensed as a foster home. Sue is the eldest in a family of 11 children, so she wanted a large family too. They were looking to adopt another little girl. The first kid they got was a boy, aged 12. They were doing weekend respite care, but on the 3rd visit the boy pleaded to stay. Children Services reminded them the boy was up for adoption, and Sue and her husband agreed to it. Soon it turned out Bob (not his real name) had a younger brother and sister also in foster care...and they started coming on weekends. So what could they do? Most recently, Children Services (really good foster homes DO seem to be a rare thing) sent them a little girl who had been slapped around in foster care. And they adoped her. Sue said her main worry is that her biological children aren't getting all the attention they should have...and so sometimes she feels guilty. By now the camera was coming back up towards my head, and I knew my time for talking was growing short. We just couldn't do this whole thing again. I was impressed with the dutiful beauty of this person with whom I'd spent more than an hour. I told her so, and said I worried only if there was too much stress in her life. She laughed, and said it keeps her going and that's a good thing. The picture was done, and she sat down to view the screen. I sat on the floor and put on my shoes. She was looking at my pictures. I didn't want to take advantage of the situation, and I knew she wasn't qualified as a radiologist, who will look at the pictures on Monday, or to tell me about it, which my doctor will do next Wednesday. She said, "Would you like a copy of this?" Despite my immense anxiety, I answered yes at once. I said, "I broke my ankle once." (Breaks and arthritis show up besides cancer growth.) She said, "Which one?" I moved both my feet, going blank for a minute. "My right I think." "There it is," she said. And we looked together at the screen. "It looks great to me," Sue said...and clicked Print twice. I don't know if Sue broke any rules commenting like that and giving me a copy, and I didn't ask. We were busy now looking at photos of her whole family which she had up on the wall. They look happy. And even though I know a more trained eye may find something I'm going to have to attend to in those pictures you see up at the top of this article, I felt relieved. Besides my own personal health issues, I had experienced again the basic goodness of another human being. Sue is a technician, a bureaucrat, a technocrat---and that whole procedure could have come and gone without the slightest interaction. As we parted and hoped we meet again someday---"under other circumstances"---Sue said, "Looky-here, I've told you the whole story of my life." And I said, "It's been an honor to meet you." And so I had to tell you too.

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