“Cancer!” I stared in disbelief at the angry radiologist who had just pronounced the death sentence on me. “You have Cancer and I don’t think they’ll be able to get it all out!”
The diagnosis no one wants
The need to tell a patient that he or she has a life threatening disease is never a pleasant task. But what happened to care and empathy?
“You’re a registered nurse. You’re fifty-three. You should know of the need to have an annual mammogram, yet you haven’t had one! What’s the matter with you?”
I blinked at him, then explained that for the past three years I had requested my gynecologist to order a mammogram at each annual check-up. Each time I got the same reply: “You don’t need a mammogram. I will tell you if you have anything to worry about. Trust me.”Well I had trusted him. Look where it had got me. Click To Tweet
“Who’s your gynecologist?” the radiologist demanded. As I gave the name he flushed angrily and made no further comment. I seemed devoid of feeling. This couldn’t be happening. At the man’s request, I climbed onto the bed to allow him to do an ultrasound of my left breast. As if from a distance I heard my voice.
“I don’t know anything about ultrasounds. Please explain it to me.” He swallowed hard as if to contain his fury, then proceeded to show me a picture I will never forget. An ugly black spider with many legs lay deep within the breast tissue.
A picture of cancer
At that point I knew I had cancer. It looked like a fat black revolting beast, with dozens of tiny thread-like tentacles reached into my breast. My feelings returned. I felt sick.
My mind traveled back to the appointment with my gynecologist just a few weeks ago.
“I know you’re not in favor of regular mammograms,” I had said. “However this little lump really does seem to be getting larger, and for my own peace of mind I would like to have it checked out.” If he still refused to allow a mammogram I intended to go to our family doctor and request one. “I know there’s no family history of cancer, but everything I read stresses the need for a regular mammogram after fifty. It’s three years since I turned fifty and it would put my mind at rest.”
He made no comment, and proceeded with my annual check-up. Despite being a well-educated specialist, he held the rare stance that ‘unnecessary mammograms’ were dangerous. Every year I brought up the subject. Every year he said it wasn’t necessary. Every year I listened to him.
After the gynecologist completed the necessary evils of this particular type of check-up, he smiled, sat down and pulled out his pen to write.
Choice of surgeon
“What surgeon would you like to go to?” he asked.
I jerked upright. “Surgeon? I don’t want to see a surgeon! I want a mammogram!”
He glared at me over his glasses. “I have told you over and over again. You don’t need a mammogram. There is no problem with your breasts. But this lump is worrying you—so it needs to come out. Now, what surgeon would you like to see?”
A few weeks later I visited Dr. Jannie Prinsloo. As a registered nurse I had often cared for this man’s patients. An excellent, if radical, surgeon, he didn’t believe in small incisions. He was also extremely volatile with a caustic tongue and no time for mistakes. As nursing staff we avoided going with him to a patient’s bed wherever possible. He only spoke Afrikaans, a language unique to South Africa, and he talked so rapidly that my normally adequate understanding of the language often failed to keep up. I did not like the man. Yet when I had to name a surgeon, I immediately chose him. I knew he was an excellent surgeon. In any case, the lump was tiny. How big a cut could this be?
As I sat down in front of the big man, I immediately noticed a different attitude. I was now his patient. He was polite, courteous, and spoke English! He recognized me immediately and from that first visit, always called me “Sissy,” an abbreviation of the Afrikaans name for ‘Sister,’ as the registered nurses are called in South Africa. He gave the reference letter from my gynecologist a cursory glance.
Where is the mammogram?
“Where’s your mammogram?” he demanded.
“I haven’t had one. He doesn’t feel I need one!”
“You what?” he asked incredulously. “You sit here, a registered nurse over the age of fifty with a lump in your breast, and you haven’t had a mammogram?”
I tried to remain calm. After all, my gynecologist had been the stubborn one, not me.
“Sissy!” Pale blue eyes pierced into mine from beneath bushy eyebrows, as he leaned across the huge desk. “Before I even look at your breast, I will tell you now—you will have a mammogram. And because you have not had one which we can use as a baseline, you will also have a breast ultrasound, to be sure nothing is missed.” His heavy Afrikaans accent challenged me to argue.
“I will be glad,” I replied meekly. “I’ve been asking for a mammogram for the last three years.”
Fine needle aspiration
After the examination he sank a needle into the small pea-shaped lump and aspirated fluid which he injected into an empty glass vial. He picked up a fresh syringe and did the same for another tiny cyst he had found. He labelled both tubes carefully and indicated I could get dressed. He retired behind his desk in the next room where I could see him making notes on a large pad.
After I joined him, he leaned back and looked at me. “There is no problem. I agree with your doctor—these are cysts. However I still want an immediate mammogram and ultrasound of both breasts.” He stood to show the interview was over. “I will phone you if there’s a problem. If you don’t hear from me you know everything is fine. And . . .” (was that a glimmer of a smile?) “Don’t lose sleep over this. I’m sure you’re all right. These are just routine tests.”
Well, I didn’t lose sleep. In fact it took me a couple of weeks to get around to scheduling the x-ray and ultrasound.
Over to you:
What is your experience of this diagnosis? Have you heard it said to you? Or to a loved one or a friend? Please leave your response in a comment below.
NEXT CHAPTER: Chapter 2: The Diagnosis No-one Wants to Hear