I wake early in damp, crumpled sheets. Turning to dislodge my leg, a searing pain shoots up my back. I gasp, breathe, then ease my feet onto the carpeted floor. My husband, Dan, has already left for work in San Francisco. Wincing as I stand, I make my cautious way down the stairs, a step at a time, holding tight to the bannister. I head toward my home office.
Up until the wracking spasm of today, I had successfully ignored my other odd symptoms: leg and foot cramps, night sweats, and facial swelling. I type them into Google. In a nanosecond, the results flash onto my computer screen: a kidney infection. A quick trip to the doctor, a bottle of antibiotics, and I’ll be fine. Downing three aspirin, I resent this disruption to my day. I promised one of my clients, a large medical center, that a draft of their annual research report would be completed today. It cannot wait.
I brew myself a double cappuccino, and even for this routine appointment, I dress well: an ivory, cashmere sweater, new gray jeans, and expensive black suede boots. I apply daytime makeup, as I learned from a professional when I started my career thirty years earlier, and style my shoulder-length light brown hair. I will get better treatment if I look like a person of substance.
At 10 a.m., the paper on the exam table crinkles beneath me as I cross and uncross my ankles. Being on the receiving end of someone else’s schedule makes me irritable. I shift and a jolt of pain—hot, yet freezing, like electricity—shoots up my back; through clenched teeth, I moan. After a soft knock, Dr. Gould, my internist, enters. Mid-fifties, balding, too heavy, and all business, he nods; I try to smile. I’m not a doctor-goer and can’t remember the last time I saw him. Perhaps I should apologize—for being an alarmist, a malingerer, a time thief—for keeping him from the real patients, the ones who are actually sick. While I have few warm feelings toward Dr. Gould, I want him to like me.
After a brief hello and describing my back pain as severe, I say, “It’s probably a kidney infection.”
He turns toward his computer. I suspect he’s rolling his eyes and thinking, “Oh no, not another self-diagnosing patient with a medical degree from the Internet.” He glances back at me, eyebrows raised. “Possible.”
“I have other symptoms too,” I say.
“Night sweats, leg cramps, puffiness around the eyes. Kidney infection is what Google came up with.”
I feel stupid. The coffee is still bitter at the back of my tongue.
“I’ll order a urinalysis.” He walks toward the door. “Take acetaminophen for pain.”
He’s been so uninterested in my wacky symptoms that I nearly convince myself to stop right there. Still, I mutter, “I have a lump.” With his hand on the doorknob, he turns and seems to look at me for the first time.
Instructing me to lie back, he pushes around my neck, under my arms, and palpates my stomach. The room is chilly and too bright, but I feel no pain at his prodding. His eyes are closed. Why he is frowning?
“How long have you had this lump?” he asks.
“I don’t know. A year? Maybe less.”
My eyes narrow; my forehead creases. I don’t like his tone and feel defensive.
“I asked another doctor about it. He said I was just fighting a virus,”
He gives his head the tiniest shake as if he either doesn’t believe me or cannot fathom the stupidity of his fellow practitioners. Perhaps both. But I had asked another doctor.
Months before, at a routine appointment with my Ob/Gyn, I’d peered over the top of his shining bald head and said, “I have this little thing, like a knot, on the side of my neck.”
“What?” the Ob/Gyn mumbled.
“I have a lump. It might be getting bigger.”
Without a glance, he waved his hand, snapped off his latex gloves, and said, “You’re just fighting a virus, or something. Don’t worry about it.”
Granted, necks were not his area of expertise, so I accepted—was even relieved at—his brush off and continued to ignore the little nuisance.
Dr. Gould turns to the exam-room computer and while typing says, “We’re going to do a work-up. Labs first, then an x-ray.”
I sit up. My shoulders slump. “Really? Can’t I just get some antibiotics?”
I glance at my watch and try to calculate how long it might take to finish the project that is due today.
“Not yet. We need to see what’s going on.”
Sulking, I walk down two flights of stairs to the first-floor lab and hand my medical card to the receptionist who calls out, “Stat’s here.”
Is she referring to me? Why am I the emergency? This is so weird.
Whisked to the front of the line, vials of blood, then x-rays, are taken. Glad that I’ve been treated so quickly—while at the same time troubled by the rush—I am too short of breath to climb the stairs and ride the elevator back up to the third floor. Dr. Gould waves me into his office, indicates a chair, and closes the door.
Sitting at his desk, he powers up his computer. The familiar sound reminds me of my work deadline. He types at the keyboard, then glances at me with knit brows and appears somewhat ill himself. Letting out a long breath, I wonder what a kidney infection looks like and why he corralled me into his office to pow-wow about such a no-problem problem. Tempted to say, Was I right? I decide to let him go first. My back aches. The computer screen lights up and an image comes into view.
Turning the monitor my way, he says, “You don’t have a kidney infection.”
“Oh,” I say, feeling foolish again for having suggested it.
“I must have tweaked my back.”
My right foot circles above the beige carpet. I love the boots I’m wearing.
“A tumor may be the source of your pain.”
His words are ambient sound, garbled information that doesn’t apply to me.
“Sorry?” I ask.
“The pain could be from a tumor. Pressing on your spine.”
Outside the third-floor window, traffic moves. The arid northern California hills remain singed after a summer of no rain. The San Rafael Mission bells chime the eleventh hour. Everything is the same—reliable, even mundane—yet not at all the same. Objects seem to be moving away from me.
I shiver. Leaning forward, I squint at him and then at the computer. “A tumor,” he says again, clutching his hands.
Cold, I push my hands deep into the pockets of my cardigan.
Pointing to the screen he says, “I don’t like the look of all those spots.”
Besides the quiet buzz of the computer, I hear a thudding in my ears, soft yet distinct.
I’d walked into my doctor’s appointment a middle-aged woman fretting about an expanding waistline, vaginal dryness, a slumping stock market, and a handful of other issues even less important.
“Likely lymphoma,” he says. “I’m sorry.”
There’s a heart, lungs, and stomach, but also filling the screen are bright spots that resemble glistening hailstones scattered on a sidewalk after a storm.
Lymphoma? Cancer happens to other people.
“Non-Hodgkin’s lymphoma. A type of blood cancer.”
“Blood cancer,” my voice is disconnected, as if it comes from the walls or the ceiling but not from me. I struggle to take a breath.
“Don’t worry. It could be easily treatable.”
Don’t worry? He said doesn’t like the look of all those spots.
“I’ll call as soon as I have your labs. We’ll know more then.”
He stands and puts his hand on my shoulder.
“You okay to drive?”
I nod. But when I get to my feet, another spasm shoots up my back and I gasp.
“You sure?” Dr. Gould asks.
“Just some pain. I’ll be fine.”
As I walk to my car, I remember that Dr. Gould didn’t order a urinalysis. How will he be able to diagnose my kidney infection without a urinalysis?