Reality check

I went for a little ride yesterday. No, I wasn’t at Disneyland or driving some stretch of highway. I was lying on a table in the ultrasound room of the Women’s Imaging Center, waiting for the results of a breast exam. It was a long half hour.

I had a mammogram a few weeks ago, just a routine screening. I got a call on my cell from my gynecologist’s office while I was in Arizona for Riley’s birthday. I needed to come back for a follow up. The radiologist had requested “more views.”

“This happens all the time,” the woman on the phone said. “They just like to be sure they haven’t missed anything.” Well, I was in baby mode, birthday mode, and it was comforting to accept that opinion. I didn’t lose any sleep over it, but I did make an appointment to have the second screening when I got back to Ketchikan.

I went downstairs for the second mammogram yesterday morning. Fortunately for my peace of mind, the radiologist read the images right away. She was still not quite satisfied, and recommended the next step, a breast ultrasound. I agreed; better to be safe than sorry. Since I work in the hospital, I asked the person scheduling to work me in whenever she had an opening. It might be a few days, but she assured me she would do that.

Two hours later I got a call. Could I come down at 2:30? Yes, I was happy to get this done, get it out of the way. A little voice in my head wondered if this was really just a sudden opening, or if there was something the radiologist had seen that pushed me up in the urgent queue? I hadn’t picked up on any concern. But isn’t that the job of professionals? Don’t alarm the patient. Remain calm. And after all, they do this every day. I’m the novice. I can still count on one hand the number of mammograms I’ve had.

The staff in the imaging clinic is extremely nice. I am polite and calm as I check in. The gowns are warmed. The lighting is soft.  No one is excited here, we all know this is just routine. If they don’t seem alarmed, why should I? I could have taken a nap during the ultrasound, except that it’s a bit difficult to relax with gel on your breasts and questions going through your mind every time the tech lingers over a specific spot. What does she see? Why is she slowing down? I know it’s not appropriate to ask the technician to tell me what she thinks. Although I’m sure anyone in that role has enough knowledge to recognize an abnormal tissue mass, it is not the tech’s responsibility to discuss findings with the patient. So I resist the urge to pepper her with questions. I’m a model patient, shifting and adjusting as she completes the test.

Again, the radiologist will read the views right away. And again I wonder: is that normal, or do they seem something that requires urgency? The tech steps out of the room to confer with the doctor, and I’m left to stare at the ceiling and question.

I think the things that I assume most women think: this will be fine. Nothing to see here. I comfort myself. I don’t have a family history of breast cancer. I feel fine. I’m only 50! (Cliché alert: as they say, it looks younger every day!)

Then, for just a moment, I allow myself to imagine. This is how it starts sometimes. Just a routine exam, a little question, another test. And then, something definite. A diagnosis is made. Suddenly the lists are not about errands or chores, they are about appointments, tests, surgery, follow up, treatment. I watched my dad go down this path with colon cancer. I’ve seen others go through this. Why do I think I’m immune from this possibility? Why do any of us think the age old “it won’t happen to me?” I already know the end of the story. I know someday I’ll die of something. But I’m only 50! And that eventual reality is comfortably distant, isn’t it?

I think about the times in life that have focused me: the birth of my children, the loss of a loved one. Or on rare occasions, the poignant moments that stand out, that are frozen in my memory: the good stuff. Why, I ask myself, why can’t I keep the truly important things at the top of the list? Why do they always slip down below the urgent? Why is so much of life about keeping milk in the house?

Maybe we aren’t built to stand the intensity of the deepest emotion, the pinnacle experiences, on a 24/7 basis. They’re intense, these times of insight. They’re beautiful, magical. But intense. Who could live at that level all the time? And maybe, the very fact of routine in life is what keeps the magic in the other moments.

It seemed like a long time the tech was out of the room. Maybe it wasn’t. I was just rounding the corner of all of this in my mind when the door opened. “Ok, just keep up with your scheduled screenings. Looks good.” She smiled and opened the door for me. I went back to the dressing room to change, reassured and feeling vindicated that I had known I was fine all along. Nothing to see here.

Yes, it was all routine. Except for those few minutes on the exam table. They were a sharp reminder of what’s important in life. Funny how the extremes, good or bad, wonderful or frightening, can have the same effect. I left the clinic and walked back to my office, smiling, thankful that this wasn’t the day to switch out my lists. I have to remember to pick up milk on the way home, and the dry cleaning, not schedule a surgery.