ADDITIONAL VIEWS | Jeffrey Millstein

 

She sits in the sparsely appointed waiting area, arms crossed, shivering. The room is eerily quiet except for the low hum of a machine somewhere out of sight. Stark white walls glare under fluorescent light. Chairs upholstered in muted green vinyl line the perimeter. No art - only instructional breast exam decals. The radiologist will be out soon, they say.

The place feels like a refrigerator, and her gown is barely thicker than tissue paper. With all the flash of the new lobby, couldn’t they manage cotton? Anything with weight to it.

The chill is worse after the test. She had to place her left breast on the cold metal plate jutting out from the machine. Then the clear plastic shelf descended and flattened it, pressing all the sensuality out of what once felt like a prized part of her body. The technician kept repositioning her, angling her shoulders, lifting, pressing, repeating — again and again. Twenty images, maybe more. She lost count. At one point she imagined her husband’s penis in a steel vice. Let him try to hold still through that.

At sixty, she’s done this many times. Each year feels worse. Not because the process has changed, but because more friends have come back with cancer. There is no cancer history in her family, but that doesn’t seem to count for much anymore. It shows up anyway. 

Two more women come in and sit across from her. Are they here for routine screening, or for the dreaded callback additional views — like hers?

One is older, tall and thin, almost gaunt. Her gown slips off one shoulder and she doesn’t notice. Her hands are tightly clasped in her lap. She stares straight ahead, avoiding eye contact.

The other is younger — maybe late forties. She’s texting, thumbs moving quickly, letting out the occasional soft chuckle. Legs crossed, shoulders loose. Is she certain everything is fine, or just exceptionally good at pretending?

Everyone is alone here. No men are allowed in the all-female waiting room. She could have asked a friend to come, but something in her resists it, as if naming the fear might make it real. 

Maybe she can try positive thinking. There was something on Instagram about that recently – something about different mindsets and incidence of illness or outcomes. Will a positive mindset for another ten minutes in the waiting area really help? She’s grasping.

The technician comes in and tells the older woman the radiologist is ready to speak with her. They walk out together to the consultation area. The technician’s face gives nothing away. 

The younger woman stops texting and looks up. They briefly make eye contact. She looks a little like Jenny, before she got sick. Fair skin, plump cheeks, unstyled short dark hair, bookish rectangular glasses. The way she likes to remember her. Not the emaciated Jenny at the end.

“Excuse me,” the younger woman says politely. “I think they are calling for you.” She startles from her thoughts.

“Oh. Thank you.” She stands, repositions her gown, and follows the technician out of the waiting area.

She follows just behind. The hallway feels longer than it should, ending at a closed gray door. She no longer hears the machine hum.

“Wait here,” the technician says, and then turns the oversized knob and pushes the door inward. A gust of cold, stale air hits her face and makes her squint, and then the door shuts, sealing the chill inside.

The wait seems excessive. Finally, she sees the doorknob begin to turn.

When the door opens, the older woman walks out quickly, her face turned away. The cold air escapes and the inside of the consultation room is unexpectedly comfortable. The radiologist, a sharply dressed woman with a calm, practiced smile, escorts her to a plush chair, and then sits facing her in an identical one.

“Good news,” the radiologist says.

The explanation goes on for another ten minutes or so. 

She doesn’t hear a single word of it.

Jeffrey Millstein is a clinical assistant professor of medicine at the Perelman School of Medicine of the University of Pennsylvania, and regional medical director for Penn Medicine Primary and Specialty Care. He is a devoted primary care clinician, operational leader, educator and writer. His essays have appeared in JAMA, Journal of General Internal Medicine, Family Medicine, STAT News and the Philadelphia Inquirer. Other work by Millstein published in Intima include his short story “Good-Bye” (Intima Spring 2024) and Field Notes essay “Remembrance” (Intima Spring 2020).