C18.9: MALIGNANT NEOPLASM OF COLON, UNSPECIFIED | Rohini Harvey
That day in January when I was diagnosed with colon cancer while working an evening shift at the hospital, there was a frantic string of texts and missed calls, a message on my pager. Angelica, my residency classmate and current physician was trying to get in touch with me about my biopsy results. What she had thought was ulcerative colitis must be Crohn’s, I figured. I left the floor at work, walked down to Angelica’s office and sat down. It was after hours and no one else was there. As she talked to me, her voice wavered. My friend, I don’t know how to tell you this. The printed pathology report was in front of me as if a voice wasn’t to be believed, as if Angelica couldn’t trust her own words without written confirmation. Angelica’s desk was solid, large, substantial. I was sitting on a wooden chair. In my memory the bare walls were light green like a Norman Rockwell print, but now that seems implausible.
Then there was nowhere to look but the paper. Adenocarcinoma. Cancer. She rushed the pathology when she saw the tumor. Tumor. I had thought it was just a polyp. But in the recovery room I was too falsely jubilant from the sedation medications to see that even in photos the mass was an ugly, skull-shaped pink thing, large, fleshy, bloody, bobbing mockingly on its stalk. Angelica found not only ulcerative colitis, but a malignant neoplasm of the colon. All I could think was that the sparkly skull-and-crossbones socks that I had carefully selected to wear for the procedure had done nothing to protect me.
I left the room and stepped into the hallway with the pastel geometric floor tile patterns, turned left at the orange and white striped connector, then sprinted upstairs to my office. Hyperventilating, I strung together some words for my residents- sick... leaving...call me- and somehow ended up back downstairs by my car. The sun must have been setting as I drove, flanked by old lumps of mountains. I ran my case in my head as I had run so many others on this long drive home, wondering where I went wrong. Thirty-five year old previously healthy female physician with a family history of colon cancer presents with lower GI bleeding. But I had been right about the ulcerative colitis and I felt better after two days on prednisone. That didn’t sound at all like malignancy. I was the first thirty-five year old female with colon cancer that I knew. Thirty-five year old females who have infant twin babies don’t get colon cancer. I punched the steering wheel. One word. Cancer. One word and I can never give it back. Cancer. Thirty-five year old female with colon cancer. Me.
The mountains outside were not reassuring. Not tall or snowcapped, they were instead soft and short and round, yet prickly with bare trees rather than smooth from planes of sharp rock. They were like stern, distant grandmothers. Those old lumps, the mountains. Surely they had witnessed this spiraling out of control before from one word, or from one faulty move, an accidental flick of the steering wheel in the wrong direction, a patch of ice or a frightened deer. Surely those old mountains had contained others’ thoughts and fears in the thousands of years of their existence. The road turned away and suddenly they were behind me. I was alone again, thankful that the road was curvy so I didn’t have to see the whole of what was ahead of me.
Somehow I made it home. It was unnaturally still and dim in the house as if no one was there, not even my seven-month-old twins. All of the curtains were drawn. I resisted the urge to speak in hushed tones as Andy, the babies and I sat on their cheerfully colored play mat on the floor of the living room. It was early in the evening and I had just walked out the door in the middle of my admitting shift. Andy and I held hands, and we each had a baby in our arms. Now I was trying to tell Andy, having just learned the power of one word, a diagnosis, a billing code, something I used to throw around at work with hollow gravity. Before this I didn’t know how one word could cause a cascade of catastrophic emotions choking every breath, every sight, every sound, every bit of life. Before this I thought that cancer was a generic, non-threatening umbrella term representing hundreds of different illnesses that could only be defined by the specifics of the involved cells, their locations, and how much they had spread. Until then I wondered why just the word cancer was taboo.
It’s cancer, I said, instantly drowning Andy with the weight of the word. The babies, who didn’t understand, stared at me. Time stopped.
I had a feeling that was it, he said minutes or maybe hours later.
Did you know? I asked.
Yes. He just knew.
All of us, Andy, the babies and me, we held hands and held on as I drew them into my cancer.
Rohini Harvey studied anthropology at Amherst College and attended the University of
Rochester School of Medicine and Dentistry. Now a hospital-based doctor practicing
internal medicine and pediatrics in Western Massachusetts, she was unexpectedly diagnosed
with a serious illness, which forced her to straddle the line between physician and patient.