Of CT Scans and Kings....

(Year One)

"The time has come," The Archon said, "to talk of many things. Of bloodwork forms, of sealing-wax, of CT scans and kings."

December 17, 2003 AD.... Welcome, welcome. I'm your humble author, and this is a page dedicated to retelling my misadventures during the CT scans and other tests I've gone through in the past year.

The reason why I'm getting these scans slowly emerges as you read. I didn't want to spring it all at once on people who had already become regular readers, but they already know now and it's something of a disservice to make everyone else wade through everything.

On December 17th of 2002 - (checks watch) just two hours short of exactly a year ago - I was operated on to remove my right testicle. It had become home to a tumor that my GP and one of his colleagues, a urologist, thought was cancerous. (Though, for presumably legal reasons, they couldn't come out and say that until the biopsy was back.) Well, long story short, it was cancer and I've spent the past year "under surveillance", getting regular CT scans and X-rays, and having a checkup with an oncologist every month.

I've been moved to a checkup every two months now, and I figure it's as good a time as any to punch up this page a bit.

Now with index magic! Dates are of writing, not actual procedure.

February 24, 2003 AD: A report on my very first CT scan, in Antigonish.
April 2 & 16, 2003 AD: A report on my second scan, and my first encounter with Gastrografin and the Halifax CT scanner.
June 15, 2003 AD: Bloodwork in Antigonish, my first pregnancy test, and the wonders of controlling your own IV line when it's filled with an unknown substance.
July 06, 2003 AD: More bloodwork, pregnant men, and women named 'Allan'.
July 11, 2003 AD: My first chest X-Ray. I begin to glow in dark rooms.
July 11, 2003 AD (Continued): The zen of handwashing and frustrated doctors.
August 8, 2003 AD: Not-so-adorable kids, drinking from urine-sample-style bottles, and a ghost in the machine.
August 8, 2003 AD (Continued): Shaving parts of my body and encountering women's underwear. All in a day's work for a CT scan patient.
August 8, 2003 AD (Continued): Student doctors, subverted LCDs, and guys growing boobs.
August 8, 2003 AD (Special Feature 1): A detailed description of an orchidectomy. If you don't like blood, save yourself the trouble and keel over now.
September 4, 2003 AD: Vanishing forms and more chest X-rays.
September 4, 2003 AD (Continued): Bloodwork, misplaced forms, and the attack of the paperwork drone.
September 4, 2003 AD (Continued): Multiple Leonards, a single resident, and gratuitous nudity. The things you learn at a teaching hospital! Also: The final word on guys growing boobs.
September 4, 2003 AD (Special Feature 2): The sad story of a low-level corporate worker with cancer.
October 21, 2003 AD: A real nightmare. With blood and cussing and everything. Don't read if you can't stomach a cheap horror flick.
November 12, 2003 AD: Your 'umble author meets an interesting pair of people while he waits for his x-ray.
November 12, 2003 AD (Continued): Your author realizes that he's been confusing the names of two buildings since he started this page. Ooops. Your author's oncologist gets confused about paperwork. Ooops. Sometime between these two events someone gets naked. That part was intentional. Warning: Much discussion of naughty bits in the second half of the item.
December 10, 2003 AD: CT scans, floor show included with price of admission.
December 10, 2003 AD (Continued): Another exam, a trainee nurse, and the advantages of spotting dubious logic techniques, like "begging the question" (Which doesn't mean "Makes me think of the question." no matter how you say it.) and "Mistaking correlation for causation."
January 20, 2004 AD - December 12, 2004 AD: Year Two of my exposure to magic ionizing radiation, needles, and latex.
March 9, 2005 AD - December 13, 2005 AD: Year Three of the zappy-zappy CT donut, pokey-pokey bloodwork needle, and juvenile metaphors disguised as humorous writing.

???, 2006 AD: Year Four. Things finally begin to wind down. I hope.

(February 24, 2003 AD: This was originally an e-mail to a mailing list I'm on. One of the fellow list members suggested I put it up here. Enjoy!)

Let me tell you a tale of fun with CAT scans (or, as they're now called, CT scans - they must have got tired of all the feline jokes) and bloodwork. I'm sure this is far from the worst procedure gone through by you guys, but those of you who've never had the, er, pleasure might find it enlightening.

Backstory: My GP and surgeon are in Halifax. I am not. I am on Cape Breton Island, and about 1 hour from the causeway onto the mainland at that. So there's a grand total of 3 3/4 hours (give or take 15 minutes) between me and my preferred medical outlet. I had surgery in Halifax last December, and now there's the followup visits.

After some confusion as to where the CAT scan would be done - the surgeon's secretary told me at the Aberdeen (in New Glasgow, another hour past Antigonish), but St. Martha's (Antigonish) called to confirm the appointment - and some more confusion about what I needed to prepare, we finally got it all sorted out.

So today I walk in to the hospital, armed with copies of the papers the doctor faxed down (last time I got bloodwork, from my GP, St. Martha's lost the papers and it was a rigamarole, he must have let the surgeon know) and the hospital card I got from when I got an ultrasound late November/early December. First thing I do is get the bloodwork done. Well, they don't have the paper again! I said "I have one here" and the guy seemed so damn grateful it wasn't funny. (I know the tests by heart now, anyway. Beta HCG and Alpha Fetoprotein. Guys: If your SO tells you she's getting these tests, you may want to worry. In women they're pregnancy tests.)

I doubt the blood collector remembers my face, but I'm sure he remembers the hunting he did last time I was here. (My timing was good though, they called #30 as I got there, I grabbed #32 from the "Take a number" thingy. By the time I was called in 5-10 minutes later - they're kind of slow - the exposed number next for taking was #40. A procession of people had followed me in.)

After this, I nip over to the radiology lab and present myself. They did NOT lose their paper. Good. They give me a bottle of ReadiCAT/ReadyCAT/however it's spelled, about the color and texture of milk (somewhat more watery than 2% though). Active ingredient barium sulfate, main ingredient orange flavoring to kill the chalk taste. (The real taste didn't really hit you until you swallowed.) Was a bit of a fight to get down (1 US pint of the stuff, if I remember my conversion tables), took half an hour, but we'd budgeted for that. Now I get to sit and wait for 1 hour while the stuff works its way through my body.

As an aside, they put this ReadiCAT in a very sturdy plastic container; the reason for this quickly becomes evident. Because, about the 3rd swallow, the taste really starts to get to you, and you squeeze the container a bit, it being the closest object at hand. With each swallow, you squeeze a bit more. By the end, you think the plastic's gonna buckle.

1 hour and a mildly complaining gastrointestinal tract - breakfast was optional, so I skipped it - later, I'm ready for the CAT scan, chest, abdomen and pelvis. Change into hospital pants (jeans apparently are no-nos, though my cotton t-shirt under my regular shirt was okay) and wait. Now, this place was cool when I was in street clothes, including a jacket. You'd think they were keeping it cold just in case someone became a corpse without being considerate enough to notify a nurse. Deprived of two of my three layers of clothes, it was subjectively even colder. And to top it off, I had been told to change in a convenient room - a breast-feeding room. So here I am sitting in a room, pictures of Squirrel Nutkin and company above me, women's magazines flanking me.... I walked out and across the hall to speak to the nearby opthamologist's (I think that was what he was) secretary for a minute. She must be used to this, because she said I could sit in her waiting area if I wanted. I declined the kind offer: It was colder than the breastfeeding room.

(Update, March 28, 2003: He wasn't an opthamologist. I looked again today while in the hospital for bloodwork and to pick up some Gastrografin for my next CT scan. Then I forgot what it said. He's a cardio-something.)

Ten minutes of walking around trying to maximize my heat generation and now it's time to move into the room with the big DO NOT OPEN THIS DOOR warning. Lie in a funny awkward pose (on back, legs up a bit with a triangular pillow under my knees, arms over my head), get moved into the machine. Have everything explained to me. Technician leaves, a recording telling me when to breathe/hold breath comes on, scanner spins up... I didn't realise they moved at quite that clip! Even though it's all encased, it was more disturbing than the big radiation warning symbols plastered all over. Gave me the feeling of being suspended in a front-loading washing machine that was running. I'm sure the feeling would have been magnified if this were one of those fancy large full-body models you see in news photos (sometimes when they mistake an MRI scanner for a CT scanner) - this one was only about a foot thick.

So here we go. Breathe in, breathe out, breathe in, breathe out, breathe in and hold, (motor kicks in and I start moving), (motor stops), exhale but don't move.

Now the technicians come back (2 women, one who referred to me by name and one who just called me "dear" at the end of every sentence) with a man, the radiologist. Time for step 2. While he's setting up a needle hooked to a spiralling tube hooked to the machine, (other arm, please, I just had bloodwork there), the "dear" technician explained that this time I'd have to hold my breath for longer, 40 seconds, and that she'd stay in-room with me a little bit longer. Also, I'd get:
A) A metal taste in the back of my mouth from the injection. (This didn't happen.)
B) A warm feeling in my body, starting in the arm and moving out quick, from the injection. (This didn't happen, not in this form anyway, and I didn't expect it to. Whenever something injected into me should burn/itch/whatever, it doesn't. Same with the anesthetic before the surgery in December.)
C) Once in the machine, a feeling like I needed to urinate. This would pass quickly and was just an effect of the machine, not an actual need to go.

Now onto the hardest part of the scan, a part I wasn't expecting. They put a spoonful of this weird stuff in my mouth and the technician explained not to swallow until told to. Okay.... Only this stuff is bad. To give you an idea of what it tasted/felt like, take a large marshmallow, with all its vanillay goodness. Make it so it's about the texture of yogurt. Then pump it *full* of vanilla extract. This stuff simply *oozed* vanilla taste. Was pleasant for the first 5 seconds, but that was it. Sort-of-fortunately, it was stuck to the roof of my mouth and I didn't taste as it much as I could've.) A small eternity passes, probably about 30 seconds. Okay, now she tells me to swallow. So I do. And it refuses to go down. So I swallow again. Half of it goes down. She asks how I'm doing. I say I'm half done, need a few more moments. One more try and it still fights to go down. But now she leaves - automated processes had already kicked in, the machine was spinning up and preparing to pump radiation into the area, so I don't blame her - then I realize that I was so damn focused on choking this stuff down that I missed the breathe-in part of the recording and am just hearing it say "...and hold." So I inhale, through my nose, as much as I can get as fast as I can get it and hold it. Machine starts to move, and now the longest 40 seconds of my life commence.

So I'm lying there with arms over my head - have been for 5 minutes straight, except for the brief repose when the radiologist hooked me up with the arm needle - some ungodly vanilla gunk in my mouth that I was supposed to swallow, holding my breath and feeling some of it slip out, wondering if because I didn't swallow all the junk I'll have to do this all again. Then the x-rays from the scanner pass my chest and get down to my stomach and a new peril introduces itself. I did feel like I had to go to the bathroom, but it had NOTHING to do with urination. So I add "Reassuring myself I'm not gonna crap my pants." to the list of things I have to do for the remaining 20 seconds. (And this wasn't just a feeling of crapping one's pants, it was that nasty feeling one gets just before diarrhea makes a quick end-run out of one's bowel.)

(Update, June 14, 2004 AD: It's actually the contrast IV that gives the feeling, but the timing of it makes it feel like it's the machine doing it.)

But those seconds passed and everything subsided back to normal feeling. Technicians get back, and I say "Cooda swaawaaa aaa. Cahhh ih my tro."

The technician asks "You couldn't swallow it all? It got caught in your throat?"

"Yaaaaa." (Well, "I might have been able to swallow it if I had about 20 more seconds to do it in." was more like it, but that's too complex a thought to convey while trying to keep your tongue from contacting the half of a demon marshmallow in your mouth.)

So they gave me large wad of tissue to spit it out in, then they removed the needle and let me go on my way to change then sit in the waiting room for 10 minutes as is standard after getting an injection. I said I hoped that not swallowing all that stuff hadn't ruined all their work (translation: all MY work gagging on the barium and whatever this stuff was) but they didn't seem worried. I guess the radiologist (still in the back room) liked what he'd seen.

A few weeks later, a family member was speaking to my GP over her own medical issues and they touched on my problems. My GP said something that didn't inspire confidence in me: "Well, that CT scan worked out well for Len, didn't it?" like he wasn't expecting it to. They have little faith in that place, it seems.

But the doctors all seemed to like the results. If not quality then medical signs.

And, as a codicil, I'd like to add that they decided I need bloodwork monthly and CT scans every 2 months. So I'm going to be going through this again. Oh well, better this than getting more work done on my decrepit twenty-something body!

As I write this, it's 10:56 PM, April 2, 2003 AD. Approximately half an hour ago I drank the first of 3 doses of a CT scan contrast medium called Gastrografin. Second dose will be tomorrow at 2:30 local time (1 hour before the 3:30 PM scan), third will be when I'm on the scanning table, or thereabouts. 300 ml of water to 10 ml of this stuff. My main thoughts about it are as follows....

A) It's easier to drink than ReadiCAT. While not pleasant, it took 3 minutes to get down instead of half an hour.
B) It tastes like floor cleaner. Actually, no, it tastes like some sick merger of lemon and lime Jello. But I hate both lemon and lime Jello. Now I know why: They taste like floor cleaner.


Well, that was an experience. It's now April 16th, 2 weeks after the above was typed. Here's my second trip around the X-ray machine.

I show up a bit early for the CT scan, so I get to sit in the entryway of the hospital - chairs were nice - and drink my second Gastrografin dose. Still tastes like floor cleaner.

After that was finished, I walked down to the CT scan department and registered. Explained when and how I'd taken the Gastrografin, etc. After some confusion over who my oncologist was (Dr. Reyno - head of medical oncology in Halifax's Cancer Center - was called out by an emergency just before my appointment with him, so coworker Dr. Rayson filled in for him. Rayson was apparently the one who requested the CT scan, but only as a proxy for the absent Reyno), I was sent to change. Not into cotton pants, but into a robe. I got to show off my marvellous legs.:)

A few minutes later, the woman who registered me came back with a cup of something jokingly called a "cocktail". It was a yellow hue not found in nature. Buried within was the third and last Gastrografin dose. The woman had me follow her to the CT scanner room, ushered me in, and left.

I sat down and started drinking - lemon flavored to the point of unpalatability - as a female technician prepped the machine. She explained that it was a new machine (Big "PHILIPS" logo on it. They make medical tech?) and was twice as fast as their old one. Then the power was interrupted temporarily and the machine started making funny noises. I got a good laugh out of that. Over the span of our conversation I'd drank most of the Gastrografin, in fairly large gulps, to get it gone as fast as I could. She leaves the room and tells me to "keep sipping my cocktail". Well, cocktail I understand because it's obviously a mix of contrast medium, water, and lemon flavor. But sip? I was already finished taking my last large gulp. Well, too late now. I noticed that some lemon crystals have made a little crystal city at the bottom of the cup - either this stuff wasn't mixed well, or it had been oversaturated with lemon flavor. My money's on the latter.

Technician comes back, I tell her I already finished. She said that's okay and to get onto the machine. My legs were propped up and my arms put uncomfortably over my head, just like at St. Martha's a few months ago. Apparently the 3:15 appointment hadn't arrived so I got his spot. The machine makes a few more odd noises and refuses to spin up. They realize that the power interruption had bollixed the electronics and they were going to have to reboot the CT scanner's hardware. (The one who told me this kept calling me "Dearie", like the one at a completely different hospital kept calling me "Dear". Is there some requirement that a tech call me "Dear" or "Dearie"...?)

Five minutes later, we're ready to go. Scan 1 is done in about 10 seconds. I didn't even notice the movement of the table I was on through the machine, mostly because this machine has something the St. Martha's machine doesn't - lasers with big DO NOT LOOK INTO LASER PATH warnings. I shut my eyes - my main indicators of movement - as a precaution, since one of the lasers looks to be aimed right at you as you pass through the machine.

They leave me alone for just long enough that I start moving my head around and get told not to move. Hey, not my fault your "breathe in, breathe out" recording doesn't have the "Breathe normally but don't move until a technician comes to assist you." ending message.

Now comes scan 2, for which they hook me up to the machine with the needle in my arm. They explain the whole warm feeling thing, etc. But this one had something the previous one didn't - pain. The woman who gave me the needle was NOT as lucky or good or something, because it hurt like hell. (In fact, it's been almost 2 weeks since the scan and I still see the faint outline of the bruise she left.) This scan was faster, and I didn't have to swallow a demon marshmallow, so that was better.

I also learned that the warm gotta-crap feeling is not from the machine but from the marker they put in me via the needle. They put that in earlier and the feeling came over me before the scan even started. Ended when we were about halfway through, which was something of a nuisance - I started to relax but realized I was still moving, because I dared to open my eyes and see that the laser was tracing a path down my chest and over my navel.

Afterwards, I was left lying there while the people in the back room, behind leaded glass, stared at a PC monitor. They told me I could move my arms (currently positioned over my head) down to my chest. Easy for you to say, I have a needle and an IV line in my left one and I don't know how I can move it without getting the line tangled into something or ripped out of my arm.

So, after I slowly and very deliberately moved my arms to my chest, using the free right to help the needled left to an uncomfortable position that was as close to my chest as I dared, the radiologist who gave me the needle got exceedingly brave and sent a trainee radiologist or nurse out to remove the needle and the two 3-inch long strips of tape they hold it down with. The poor girl took one look at my arm (and the hair that covers my arm like a second skin) and said, with a pained voice, "Oh, I'm really going to have to hurt you! I'm sorry!"

Either my pain receptors were still recovering from the needle I had been given or she was exceedingly good at what she did, as she managed to rip the tape off without taking much hair (and much pain) along for the ride. As for ridding me of the needle, I could've hugged her. With any luck, she'll be the one who's running the place when I return for my next scan, in 2 months, near the start of June. More on that when it happens.

And for those of you who are in the know: Yes, oncologists are tumor specialists. The surgery I had in December was to remove a cancerous tumor. Don't worry, I'm doing very well. I'll jot down the details sometime in the future.

Well, 10:06 PM, June 15th, 2003 AD. (Sorry if I meander between past and present tense, I haven't been sleeping well and my brain doesn't want to play nice.) Another 2 months, another CT scan. This one was similar to the last one, though not quite the same.

But first, a brief sideline. Bloodwork at St. Martha's. I went in to get my two tumor markers done. Beta HCG and AFP. The line's moving nice and fast. Until I come in.

First my number (#24) is called to get my paperwork sorted. They used to have the bloodwork techs do this before they took the blood, but now they're getting minimum wage people to do it. With predictable results.

Okay, they get my name and address right. (#18 is going in to get blood taken.) The woman typing my tests into the PC scrutinizes the paper. That's okay, it's not one of theirs, it's a Halifax-standard one. Might take some time to get used to. (#19 is going in to get blood taken.)

"These two tests, I can't read the writing well. Do you know what they are?" Thank the gods, I'm never content to remain ignorant, so I know them and what they're for.

"Beta HCG and AFP."

"Okay." (Click click click.) "Uhhh...." (Click click click.) "This is going to Maternity."

Now, last time they had this problem. Not only did they put the bloodwork down as a urine test, they were going to send it to Maternity. Evidently the large "BLOOD COLLECTION FORM" title and my obvious maleness aren't enough to make the idea that it's a urine test for determining pregnancy wrong. The last time, the woman was bright enough to correct the Maternity glitch but not the urine one. (The technician had to redo my paperwork anyway - so much for more efficiency.)

This time, I was caught with a woman who was ignorant enough about computers that she didn't want to question hers, assuming it was Right and True. First she retyped her entry, assuming it was wrong, then she simply informed me that the bloodwork was going to Maternity. Evidently when faced with "computer is wrong" and "man is pregnant", the more likely one is "man is pregnant".

STAT: FOR CHEMOTHERAPY. FAX RESULTS TO N.S.C.C. So I take the time to explain that they're both blood tests, and no it's NOT going to Maternity. I say "They're tumor markers, for cancer." I point out the large stamp (See right. Phone number removed and color shifted to blue from red for the hell of it.) and how it stresses this point rather well. (I'm not going for chemotherapy, but they lost their normal "Fax to...." stamp.)

So she types some more. She types like a person who's being forced to touch type. Hands in the right position, but takes forever to find each key on the keyboard before using what she thinks is the right finger to hit it.

(#20 is going in to get blood taken.) And I forgot to mention the soap dispenser. On the partition between the two desks where the form-typer people sit, is a soap dispenser. No reason for it to be there, 3 feet from two PCs and a laser printer. But it is. The nearest sinks are in the canteen across the hall and the blood collection room, each about 20 feet away, both of which have their own soap dispensers.

Meanwhile, the "take a number" thing is on a far wall, 10 feet away, next to a door reading "Outpatients use this door." So are the numbers for outpatients, or for bloodwork? They're for bloodwork, but the logical place for them (between the registration desks) is taken up by a soap dispenser. Evidently too many people have made the error of hitting the soap dispenser to get a number because there's a note on the dispenser reading "This is a soap dispenser." It's very Zen-like, which is a nice way of saying completely incomprehensible and somewhat surreal.

Back to topic: The typist is typing. Slowly. Then she asks how to spell Beta HCG, to make sure. I answer this. Then she frowns and looks on a paper on her desk. Looks on another paper. Asks if I know what HCG is short for. Ha, ha, think you got me now? "Human Chorionic Gonadotropin", I answer. She frowns some more. (#21 is going in to get blood taken.) She looks on the papers again. Finally she gives up and asks the other typer-person.

"What's the computer's code for Beta HCG?"


"Oh. Thanks."

More typing. Finally, the laser printer label feed kicks in and a label comes out. I get this and go to sit down and wait.

Then, one of the bloodwork people goes on break. No matter, I'm #24 and they're finished #21.

The one who went on break was the one who'd done #19, #20, and #21. #18 is still in the chair with someone who's moving so slow the spiders are building webs off him. Fruit fly generations come and go.

Ten minutes later, #22 is going in to get blood taken. But wait! The phone rings. Slowpoke answers phone, speaks for 5 minutes on the possible whereabouts of a co-worker's lunch.

Ten minutes more, and #23 is going in to get blood taken.

Five minutes more, the other technician comes back from break. I get my bloodwork taken. Doesn't hurt much, but later I feel sore on my arm. And find an ugly purple bruise the size of three Canadian (or American, really) quarters laid in a triangular fashion.

Now, on to the CT scan one and a half weeks later:

I register like before, and yet again there's confusion (only this time it's over the fact that Dr. Reyno isn't there anymore - he's working at a US pharmaceutical corporation on a breast cancer drug). I change, I drink the marvellous lemon stuff again, I finish it before they call me.

Instead of being led to the CT scanner, I'm led into the adjacent room, the room behind the leaded glass enclosure in the CT scanner room. (This room, the glass room, and the scanner room are are connected by doors.) Near the door is a niche with a curtain in front of it. I'm seated in a chair behind the curtain. The chair is like the kind you sit in for getting blood for bloodwork taken. The technician (male this time) explains that they're using the scanner more now, so they do the needle-in-my-arm IV hook-up off the machine. (It can be a time-waster, since starting an IV is a serious problem with some people. By which I mean both technicians and patients.)

I was asked, by 3 different people, if I was diabetic. I'm not, but my curiosity got the best of me and I asked the third, the technician, why it was so important. Apparently one kind of medication diabetics use might cause a reaction with the "dye" they inject people with. He got onto something of a script he must use for the diabetics he deals with: He was reassuring me that such reactions were isolated and not yet proven by the scientific method, etc. etc., and even so, they would do things to help minimize my chance of reaction. At this point he realized I wasn't diabetic and stopped the script with a "... but you're not diabetic, so we won't worry anyway."

The technician asked me which arm I'd like the IV in. I show him the bruise on my left arm from the bloodwork, which is now brown and the size of 2 nickels and a quarter. "Not this one."

The technician was shocked: "What did they do, jam the needle in and have it come out the other side!?!"

He was much better at his needle-work. When I mentioned I wasn't going to watch (and might crane my neck away a bit excessively) because I didn't like needles, he said "Don't worry. If someone came in here and said he liked it, I'd send him down to psychiatric instead of giving him the needle." (Then, more jokingly.) "But don't you go acting excited next time just so we'll send you to psychiatric!"

After I was wired for sound, he handed me the fluid-dispenser thing (think syringe but with a fluid-holding area the size of a roll of quarters, with an IV tube instead of a needle) and told me just to relax until they were done the previous scan.

There's something deep and profound about holding a container of liquid that's connected to a tube that's running into your arm. There's also something odd about seeing that, with one move of your thumb, you could push the plunger attached to that container and pump God-knows-what into your bloodstream.

There's something freaky about tiny air bubbles in the container, too, especially if you know what an embolism is.

Most of this feeling wears off if they leave you sitting for twenty minutes because the other person is (judging by the conversation) scanning with the clarity that a vampire shows in his reflection.

Finally, all is ready. I lie down. I am slid into the machine. I close my eyes to avoid the lasers, just in case. I'm grateful because, in passing, one hits me right in the eye.

After I stop and feel no lasers on my eyes, I open my eyes and look. I see the guilty laser and a warning next to it saying not to look into it. I wonder at the placement of this warning, which is positioned so you can only read it after you've passed the laser.

Scan one goes by. Then the liquid container is taken off me and hooked to the machine. Scan two is just like before, though by now it's routine enough that it's boring, even with the flaming bowel feelings. I forget to hold my breath all the way through, and let it out sharply (a no-no - if you have to exhale during a CT scan, do so slowly), only catching myself after a second of exhaling. Fortunately, the bed halted just as I realized this - the scanner had already finished scanning and was moving me out of the machine when I exhaled.

The technician appeared, apologized, and ripped much of my hair out as he removed the tape holding the IV.

While doing this, I asked (between teeth-gritting) about CT scans in general. In specific: What was that demon marshmallow they gave me at St. Martha's during my first scan. "White, consistency roughly like peanut butter, puts you off anything vanilla for a week?"


"It's called Esophotrast. Don't worry, we see a lot of patients and only use it on about one every month, and then the patient has a known throat disorder. Typically throat cancer. Maybe they use it on all their patients."

"Maybe." I shrug with my free arm. "Or maybe all their cancer patients. I had cancer, but not anything that I thought could spread to a person's throat."

Surprisingly, that killed the conversation. The next 15 seconds were incredibly awkward, dragging themselves out to a subjective few minutes. The technician was relieved to get back on script when he put a cotton ball on my arm and put tape over it, telling me to check it for bleeding when I got dressed. I thanked him warmly (feeling kind of bad for maybe striking an unseen nerve with that cancer comment) and left to walk down the hall and retrieve my street clothes from a locker.

Next month I'm getting a chest x-ray. Let's see how the non-rotatey radiation hits me.

(Checks watch.) 1:21 AM, July 06, 2003. Just a short tale before my X-Ray tale, which hasn't yet happened as I type this.

Ah, bloodwork at St. Martha's again. Much faster, but still slow. I notice that they've put a little glass wall up to keep the typist people apart from the rabble. Nice. Now, if only they mounted the "take a number" thing on its frame, the world would be better.

I really think St. Martha's should hire me as an efficiency expert. All I'd do would be to go through the motions of getting registered for various tests, and see where the bottlenecks were. My main advantage is that I work cheap. But I want my own office.

I notice that, as every time before, the typey people are new. Less than one month employee turnover time. Man, that's a bad sign. One of them must be new - she's happy. She also has no idea how to work the buzzer thing attached to the incrementing "NOW SERVING #" sign, as she keeps getting up and asking who's got what number, then registering the lowest.

Eventually my turn comes up, and I register. (I made the mistake of going on a Thursday, when their diabetic clinic is. Lots of bloodwork being done.) She looks the form over closely, finds only the two tests handwritten in at the bottom. She can't read them, which, given the handwriting of whoever filled 'em in, isn't surprising.

"Do you know what these tests are?" she asks.

"Beta HCG and Alpha Fetoprotein."

"Oh, okay." (Looks at screen.) "Uh...." She grabbed the list of tests and their PC-friendly abbreviations and said "You said 'protein' for one of those, right?"

"Yes, I did."

She flips to the "P" section, which shows me she's really new - the tests are all alphabetized by first name. The realization that I have more experience than she does is disheartening, to say the least. She asks what the first word of the test was. I say "Alpha. A-L-P-H-A." Understandably, she still can't find it. She drops those papers and goes for a second set of papers, presumably containing the arcane tests only requested by necromancers, witch doctors, and other exotic local 'medical' practitioners.

I lean forward and read, upside-down, the first page of the first test list. There it was, under the "A"s. I say "Here it is."

She seems surprised. I point it out. The abbreviation for the AFP test? AFP. I felt slightly silly. Though, in my defense, I thought they used all four-letter abbreviations.

She punches it in and, being smarter than some of the drones and not trusting the computer entirely, says "This wants to send it to Maternal Studies. Weird!"

I say, "No, it's a blood test and it's not going to Maternity." She seems happy with this.

Next test: Beta HCG. She starts looking at the first list again. After the last easter egg hunt for the Beta HCG abbreviation, I decide to save everyone's time and say "Just try typing BHCG on your computer."

She did what I asked, which elevates her above 90% of the people who phoned me while I was working for EDS. "BHCG" works. Her reply: "Wow, you should be doing this job!" Memories of my days at EDS doing a nominally more upscale version of the same job caused me to react with a cynical cackle. Only my auto-charisma/non-offense mechanism kicked in (I have such a hard time turning it off.) and the cackle was converted into a quiet, jovial laugh.

Then, there's the great Naming of the Doctors. No typer-person or technician gets them all right. Not one. This time, however....

"So your doctor is a doctor Ackerman?"

"Acker. No 'man' at the end."

"Oh. And also a doctor Allan Wo...."

"Uhh, I don't know my oncologist's first name, but since she's a woman, I'd bet it's not 'Allan'." Some more fishing in the database finds one that sounds more accurate.

The rest of the day was surprisingly mundane. Who'da thunk it?

(July 11th, 2003) Yesterday's X-Ray was amazingly quick. After signing in at the main desk in Diagnostic Imaging (floor 3 of the Dickson Building), I was directed to go down the hall behind me and look for a desk on my left. As I walked down, I felt doubt that I was following directions correctly creeping in (long hall). Signs with "CHEST XRAY ->" and such written on them helped mitigate the feeling. Eventually I found the desk and handed my paperwork over. I was told just to remove my outer shirt and jacket, since my cotton t-shirt was fine for having the X-ray taken. (Judging by the form I had been given by my doctor, she was looking for signs of pulmonary metastasis: i.e. any signs that the cancer had spread to my lungs, as at least one of the four kinds of cancer I had is wont to do. Lung cancer: It ain't just for smokers.)

I went and sat down. Judging by the number of men sitting around in "Johnny Shirts/Granny Shirts/Hospital Gowns/Those Things That Open In The Back Embarrassingly" and jeans, I was about fourth. I sat down and absentmindedly unbuttoned my shirt and spoke with my mom, who'd come along today for moral support and some medical work of her own.

A woman walked out of the X-ray room. "Leonard." Oh, that was a surprise. I hastily removed my jacket and outer shirt and handed them to my mom. As I walked towards the X-ray room, I figured a few jealous looks were aimed at me. Then I realized that I was the only one with an appointment. Doctors and surgeons who work in the building's clinics take priority over other doctors who just send their patients through the walk-in registration, the idea apparently being if it's for someone in the building, it needs to be done on a time schedule. (And indeed, mine did. My oncologist had to see the X-rays at my appointment one hour later.)

The woman directs me towards an interesting and uncomfortable-looking device. I notice that my name, phone number, and some other undecipherable information is showing on a blue-green LED panel on the device. The woman asks "Did I pronounce your name right?"

I say, "Yeah, you did great with it. You wouldn't believe how some people say it." (In my experience, a person who asks if they got my name right is about five times more likely to have gotten it right than a person who doesn't ask.)

I'm told how to stand - rather uncomfortably with my chin resting on a divot on top of the device and my chest pushed up against it. The woman leaves for the other side of a glass partition, and then tells me to breathe in and out, then to hold my breath.

This I do. Then she says something that gets drowned out by the sound of the machine suddenly powering up (at least, that's what I think it is). I thought she said "breathe", but I wasn't sure. Since I'm starting to lose this breath, I just let it out slowly and hope that I'm not ruining anything. By the time my lungs are empty and I need to inhale, she's standing next to me and I figure there's nothing radioactive being done and I can breathe regularly. Seems that the machine's "powering up" sequence is more like a "powering down" sequence - the x-ray's already over by the time I hear it.

Now, I'm set up for the side view. I hold onto a bar above my head and in front of me, attached to the machine. Given the height and position of the bar, I feel like I'm a trapeze artist about to launch myself off some tall platform.

Again with the breathing, and this time I hear her instructions a bit better (which now include "breathe normally - and you can put your arms down"), so I relax sooner. Since my positioning for the side view X-ray leaves me staring right at her through the (leaded?) glass partition, I notice she's looking at something with the exact same look of someone who's on a dialup modem waiting for a 90K JPG to download. Ah, the wonders of electronic imaging. Men spend all day waiting for images of women with their clothes off to download. This radiologist spends all day waiting for images of people with their flesh off to be rendered.

Apparently, both shots were good, so she sends me on my way. The whole thing took less than 5 minutes and the longest part was getting me into position against the machine properly. (Places with non-digital photographic machines take a bit longer, because someone needs to actually "develop" the shots. Even then, you spend most of your time in the waiting room waiting to hear if you need to have one taken again.)

An hour later I'm waiting to see my oncologist. I've been told that a student doctor might come in to talk to me for about 15 minutes or so.

One would think the time for such was allotted but the doctor had taken a coffee break, since I spent half an hour sitting alone in the examination room waiting. At one point a nurse brought another patient in, saw me, apologized for mistaking the room as empty and backpedaled out of the room, patient still in tow. Was exciting.

The magazines were all Peoples about Madonna or Times about September 11th. Both of which depress me.

Here's a thought: On the handwashing thing in this room, it says it's an anti-bacterial soap formulated to help keep medical professionals from spreading diseases from one patient to the next. Below that, there's a note saying that if it causes a rash, stop using it. "If the irritation does not vanish in 48 hours, please see a physician." Question: Isn't that warning, on a product specifically designed for "medical professionals", sort of like telling a person who works in a garage that their car needs to be fixed...? Granted, it might be a nurse or a non-dermatologist using the stuff, but when you make something to be used by people who work with doctors day in and day out....

Eventually, my oncologist shows up. While I'm not levying any sexist complaints, I have to admit that my current oncologist is the first regular doctor I've had who's female. Most of my doctors have been men; men who dressed either like businessmen or in slacks, sweaters and lab coats. So I was somewhat thrown off by the concept of a doctor in a cobalt blue sundress.

But before I continue, a brief bit of backstory. At my last appointment with my oncologist, she told me to get my bloodwork done at the earliest one week before my appointment. (I was getting it about a week and a half before.) The earlier I get it, the more out-of-date the results are. "One week will be plenty of time for it to get to me."

Anyway.... Doctor with the blue dress on looks over the various reports. X-ray looked good, blood tests were fine, however.... "I want you to start getting bloodwork done up here, just before your appointment." (Rather than in Antigonish a week early.)

I ask why. She responds, "They can't do one of the tests at St. Martha's."

"Yeah, I'd heard." (I've known about the AFP thing for a while now. Half the people at St. Martha's don't even know what it is, the people who take the blood think it's related to clotting, the typey people think it goes to Maternity.)

"They send the blood up here. I just found out today that they only send it on Thursdays. You were too late in the day for last Thursday's shipment, and this Thursday's hasn't arrived yet."

Oh, that's peachy. So, basically, I got to Halifax before my blood did. They must send the blood out early in the AM as well, since I got the blood taken in the morning.

My doctor continued, "If you get the blood here, I probably won't have the results in time for your appointment," she took a moment to let out a sigh at this point. "But at least I'll know where they are!"

Okay, fine. No more fun with me filling out the bloodwork info for the typey-people. No more telling them I'm not pregnant and sending it to Maternity is a bad idea....

We discussed the blood results that did arrive. Herein lies a valuable lesson for a person dealing with any dangerous disease: Your doctor is your source of medical care and knowledge, but you're still the main person responsible for taking care of yourself. Listen to your doctors, but educate yourself on things as well. Use the Internet if you must, but make sure to learn the difference between reputable-looking sites and sites offering herbal panaceas and paranoid ramblings on modern medicine. And, if they look reputable, try confirm everything anyway. Hoaxes happen. But, above all, listen closely to your doctor. Ask for clarification on things you don't understand. Write down complex words for later study. Bring along someone you trust who has a good memory; they'll be able to pay attention better than you can, since they aren't under the pressure of hearing their own odds of survival.

My surgeon had told me that, on the blood tests done before my surgery, my Beta HCG had been elevated but my AFP level was pretty much normal. (Every case is unique, so two outwardly similar tumors can do different things to a body's hormones and proteins.) A few weeks after my surgery (So all the pre-surgery excess Beta HCG had been metabolized, apparently - it has a serum half-life of a day or so, so I should have been near normal HCG levels a week or two after my surgery if the cancer had been entirely removed.) it was back to where it should be.

I remembered that, and realized that the most important (to me) of the two tests had been done and I could find out now. I told my oncologist what the surgeon had said. She leafed back a few pages in my medical records. "You're right. Your HCG level was elevated." She leafed back to the front. "And that one, at least, is right where it should be." She went on to talk about how they'd still test for the two of them, of course, but the HCG one will probably be, in my case, the first or only one to change if anything happens. If I get another tumor now, it's likely going to be of the same kind as the one that was removed. (However, I've heard elsewhere that AFP levels increase with metastatic tumors about 30% of the time when they haven't increased in the original cancer.)

Next month is another CT scan. And competent bloodwork people. My next X-ray is in 3 months. Stay tuned....

August 8, 2003 AD: One more trip around the mulberry bush. I went to the blood collection area in the Dickson building in Halifax. I took a number, sat down, and reluctantly slugged down my second dose of Gastrografin. More reluctantly than normal, since the people at the Strait Richmond had given me the stuff in something that looked far too much like a urine sample container. There's no dignified way to take a sample bottle with a pale yellowish-clear liquid in it, pour it into a glass of water, and drink it. Especially not in a crowd. Fortunately(?), some screaming kids took much of the focus off of me with their intent to perform such 'adorable' hijinks like climbing on the outdated magazine table, or their 'charming' intent to call to "Daddy!", currently parking the car in the parking lot.

In case you haven't guessed, the blood collection isn't done in the parking lot. It's done in a building. The parking lot is on the other side of thick dual-paned glass. And a road. Daddy didn't hear his little angels and the presumed-Mommy obviously never corralled the brats their entire misbegotten lives.

But here, the line moves fast and I was called to a desk within three minutes. They were calling people at the rate of roughly one per minute, a far cry from St. Martha's one per fifteen minutes, or the Strait Richmond's one per half-hour.)

I sat down at the desk, handed over my health card and my blood requisition paper. The woman looked at it. I mentioned it was for the cancer center, since faxing things as the form requested seemed a bit silly when the center's 20 feet away. (10 feet if you're a ghost and can move through walls. But ghosts rarely need bloodwork.)

Now the fun starts. She finds my chart number and types it in. "You're not here."

Maybe I am a ghost. "Uh.... This is my first time getting bloodwork here...?" A lie, but it's my first time as a patient of the cancer clinic.

"No, that's not it."

"Oh, okay."

Further confusion ensued over my name, and which bit went first, which was in the middle, and which was last.

Eventually, the woman's body language showed her conceding defeat. Not to me, but to the form. Then she said "Go to bay six, and wait there." (This isn't normal bloodwork procedure. However, my mom has been through this before and said to expect it.)

Well, bay six was occupied by someone else getting blood taken, but the small collection of seats beyond implied that this was bay six's waiting room. I took a seat, sandwiched comfortably between a seat occupied by a coat and umbrella to my left and a storage table with these extra-large urine collection bottles (unused) to my right.

I was kind of glad I drank the Gastrografin on the way in, then.

I was called next, despite all the people there (a sign said to expect such things, as regularly-scheduled bloodwork takes priority over walk-ins, and I guess someone figured my monthly bloodwork counts as being regularly-scheduled) and was relieved of one vial of blood. Fast, and as painless as can be expected.

Next stop, CT scan. No one's around in registration, so I sit down and wait. Someone else, a male apparently in his fifties, shows up a few minutes later, looking for the same person as I am. I explain how long I've been waiting and that I have no idea when the person will be back. An awkward silence ensues, that aura of discomfort between two people who have exchanged pleasantries and information but now have nothing else to say.

Eventually the woman we were waiting for shows up, making quite the entrance in a yellow dress with black and red stars on it. Looked like a still from the 'blast-of-stars' animation when Wile E. Coyote hits/is hit by the ground/train/rock. But hey, if it fits the dress code, why not? She apologized for the wait, justifying it by explaining that they were doing something to the CT machine. Between her accent and the fact that the procedure she described was composed mostly of unfamiliar acronyms, I missed it. I just assumed it was important; they could've been kicking the living daylights out of the thing for all I know.

The other guy waiting cut ahead of me, and I was about to prepare myself for an argument when I realized he was just dropping paperwork off.

After being registered, the woman asks if I've done this before. I say "Twice here." so she gives me the truncated speech about what to do, hands me hospital clothes and then sends me to the waiting room and adjoining changing room. Only she hasn't mentioned when I'm supposed to get my last Gastrografin dose. She waves a cup like the one they give but it's empty. I decide to wait politely, and she fills it with flavoring meant to kill the taste, followed by something vile for the flavoring to kill. Then she puts it down and turns to leave. She stops short and seems surprised I'm still there. So I excuse myself and leave.

I change into fashionable hospital duds, stash my own shirt and jeans in a locker, and wait. 10 minutes later, and I haven't seen the woman come by to give me the Drink of the Gods With No Taste Buds. Maybe she expects me to pick it up. So I walk across the hall and there's a completely different woman is there. I explain things as best I can, and point to the half-filled cup the first woman was mixing before I left. But since neither the woman or I can figure out if the thing's complete as-is, she says she'll go find the woman who mixed it.

Five minutes more and she brings it back, with orders not to drink it. I take the proffered concoction and sniff at it as I sit back down. Seems right, though less lemon this time. I can smell the faint edge of the Gastrografin, hiding behind the lemon like a... uh... like a thing that hides behind lemons.

Yet another five minute wait and a technician walks up to the door and calls my name. I take my Gastrografin and follow the technician to the CT room. She tells me to start drinking, so I do. Unfortunately, by this time she's standing by the machine and ready to put me on it. I drink as fast as fear of indigestion and choking allow. The technician says I've drank enough after I'm half done, but something in me - be it the fact that I can't throw over a half-cup of stuff into a wastebasket meant mostly for paper, or refusal to be beaten by flavored iodine - compels me to finish in one swig. At least it's more tolerable this way than in water, like I normally take it. (They say to use juice instead of water, but they're so exacting on which kinds of juice are wrong that I figure it's just safer to use water.)

I then hustle over to the machine and lie down. I point out that they'll need to use my right arm for the contrast IV, since I just got bloodwork in my left. Besides, I shaved a nice patch for the tape on my right arm.

I point out the stubbled area on my otherwise hairy right arm and mention why I did it. The technician agrees it's going to be less painful to rip off the tape. Then I comment that shaving a CD-sized patch just below one's elbow gives a guy a whole new understanding of the kind of troubles a woman goes through in shaving her legs*. The technician's next comment on the relative surface area of my arm patch vs. a woman's legs was tinged with enough glee to tell me that she enjoyed the concept of some guy getting back even a small bit of the inconvenience womankind has been subjected to. I considered myself properly put in my place.

(* Man, I didn't realize fine stubble itched so much when it came in regular contact with certain fabrics or even one's own arm!)

The IV was set up, and now comes the first scan. Again I close my eyes and again the laser grazes my right eye.

I realize that my underwear (which I'm allowed to keep on) is riding up on me. Couldn't do it two minutes ago, nope....

Now I'm hooked up to the IV with more iodine and the second, longer scan. I had my hands over my head, but the technician - maybe still on that sadistic little high from the leg-shaving thing - positioned my right arm differently. Instead of my right hand resting on my head like my left one was, she had me hold my arm out over my head. Were I standing up and my knees not bent due to the machine's design, I'd look like the Statue of Liberty doing a dandruff commercial. I can see it now: "Itchy scalp? Problem dandruff? Get Selsun Blue Dandruff Shampoo Plus Conditioner! Buy it by the bottle, or by the ton!"

After the second scan, I'm carefully putting my arm down as instructed when the person doing the instructing - presumably another technician - says "You don't need to move your arm so slow. There's no needle in that IV, just a tiny plastic tab."

Well, I did suspect that, but I would have appreciated that tidbit two scans ago.

Even so, I still move at a slow clip. No sense in getting my arm snagged in the IV and ripping something important out of either me or the Expensive Machine.

I was quickly disentangled and, after confirming the stuff they put in me via IV is iodine, just like the Gastrografin, I leave.

Back in the waiting room I retrieve my clothes from the bank of lockers. Despite politely saying "Pardon me", the older woman in hospital clothes sitting next to the lockers stares at me with the oddest look. I ignore the look and, clothes in hand, go back to the changing room. I nonchalantly close the door and drop my clothes on the bench inside. Then realize what the look was for. Sitting next to the disorganized mass of clothes formed by my jeans and shirt is a neatly-folded pile of women's clothing, crowned with a slip and a brassiere!

I ponder this situation for a moment. I could leave and go to the other changing room, but that would require me to leave this room and walk right in front of that old woman again to get to it. Would make it obvious why I left. So I change normally, except for the spot where I regain my composure and make sure I'm not giggling just before opening the door.

As I leave the changing room, I notice that the old woman is gone. She's probably getting scanned, but she might be getting security to come arrest the strange man who's in the changing room with her underwear. Either way, I figure it's safest for me to leave.

The next day's appointment was interesting as well, even without encounters with more underwear. The take-a-number system at the NS Cancer Center had been subverted, as I soon learned. I dutifully took a number (85, how amusing. My bloodwork number yesterday was 86.) and sat down in the waiting room, ready to be registered. I watched as nothing much happened at the desk. Another person, small child in tow, grabbed a number and sat down in a different area of the waiting room, one without a clear view of the main desk. Someone else grabbed a number and marched up to the desk and was registered right away.

After he left, I got up and politely asked the woman at the desk what was going on. Sensing the general thought on my mind, she said it was her fault, he was a new patient and didn't know the rules, she should have corrected him and told him to take a number.... I stopped her at this point since she'd clearly missed that he had grabbed a number, and something bigger was going on. I said "That's all well and good, but I'm just wondering why the number on the digital display hasn't changed in the past five minutes."

She looked at the red LCD-style 83 and frowned. "What number do you have?"

"85." I showed it to her.

"I'll register you now. Oh, wait." She leaned over the desk and called "Is there an 84?"

I'd have gladly stepped aside for someone at this point. But no one showed. I was registered, then things started moving normally. I wondered what would have happened to the guy with the (thankfully well-behaved) kid. How long would he have languished in the far corner had I not got up and asked about what was going on?

Now, comes the fun part, the examination, where I find out if I'm hale and healthy or host to another lump of parasitic mutant cells.

First comes speaking to a nurse (who gets the generic questions out of the way) and being weighed, as always happens. (I'm gaining weight again. I'd been dropping pounds quickly during my last month at EDS due to massive stress killing my appetite for days at a time, so the thought that I'm gonna have to start exercising again is almost comforting.)

Then, the waiting. I fished out a book from my jacket and opened it up. It was a book of short stories (of the kind that I often review). Two pages in and I hit a steamy scene. Despite the fact that I wouldn't expect any arousing text - or any physical reactions of arousal - to last long, I figured that this wasn't the greatest time to tempt the gods. I read the dull as dishwater editor's introduction instead.

A different woman comes in and introduces herself as, rather amusingly, Dr. Petrie. (Guessing on the spelling. All I know is she said it was spelled differently from mine, though she pronounces it the same: Pit-re.) She knows who I am and, more importantly, knows who my oncologist is. I guess this is the doctor-in-training promised last month. She asks a lot of the questions the nurses ask, though asking for more specifics along the way. She also tells me, with obvious happiness - which was nice - that my blood tests are normal.

Now comes the checkup. Oh, before I get to that part, I just realized that I never mentioned my specific form of cancer, except to link to a site about it. The cancer I had was testicular cancer. Nice 1x1x1.2 inch tumor on my right testicle. My operation was a radical orchidectomy (or orchiectomy), which involves....

Uhhh, this is a bit gruesome; feel free to skip down a bit.

It involves cutting into the lower abdomen. Well, it's actually low enough that it's considered the groin, but it's like a lower version of an appendectomy cut - a bit above and to the right (from my point of view) of all the male-specific bits. Then they take hold of the various cords and such connecting the testicle to the main body, and simply pull it out by the 'cables'. If everything's okay and someone somehow made a big mistake, they can still put the testicle back in. How they push the little bugger down about 3 inches, I don't wanna know.

But more often, it needs to be removed. (They don't go in unless they figure something's gotta come out!) They just tie it off and cut it off, along with the various 'cables' and such (hence radical orchidectomy - done to make sure the cancer hasn't made it to the lymph nodes or other stuff). It's different from castration, which is a bilateral orchidectomy; both (hence bilateral) testicles are removed through the scrotum and none of the 'cables' are removed. The nurses in the outpatient department had confused my radical for a bilateral and thus were ignoring the big pile of gauze stuck to my front to check for any bleeding from a scrotal incision. After the loop the knockout drugs threw me for - 3+ hours of sleepytime for what should have kept me out ONE hour - I was still kind of zonked and wasn't really in the mood to ask them if they thought the surgeon was just testing the knife on me where the bigass gauze pile was.

Much of my right pubic area (and even somewhat further afield - talk about thorough) was shaved for this operation, I hope the nurse got a good laugh out of that one. I looked like the before and after for some really good bikini wax. (Incidentally, I was out like a light when they did that. Probably to save me the embarrassment. Which is thoughtful.)

Oh, and incidentally, next jackass who says "I'd give my left nut to screw (female, often famous)!" gets shot. First of all, it's crass unless you've got a pair of cashews and a screwdriver in your hand. Second, you probably wouldn't, being insecure in your sexuality to the point where you have to discuss the condition of your individual little sperm generators. Third, if you ever have the choice, lose the right one. 9 out of 10 testicular cancers appear in the right one. I should know, I "gave my right nut" so I wouldn't die. And fourth, you can't be that desperate for a piece of tail unless you are a very sad little man. Oh, wait, you probably are. Never mind.

Many parts of me were checked up. More than usual, in fact. The remaining testicle (chance of recurrence in, er, "lefty" is something like 1 out of 8) wasn't one of them. Go figure.

Dr. Petrie explained that if I was uncomfortable with my testicle being examined by a woman, it could be skipped, however.... (I get the feeling this is a legal disclaimer type thing they have to give in case the guy is antsy about it, since my female oncologist gave a similar speech my first month visiting her, while the male doctors I've seen after the surgery never thought much of examining that area. Makes me wonder if a male OB/GYN gives a disclaimer too, despite the fact that you expect he's going to be looking in such places.)

I cut her off before we got too mired in who was responsible for what if I didn't want whatever. I said "No, I don't mind." and I recounted the post-surgery story I mentioned above. (In case you skipped it, it involved not one but two nurses thinking I'd had a different operation than the one I had, ignoring the obvious gauze-covered operation site on my lower abdomen to go looking for a nonexistent one in a far more intimate area. After being that kind of floor show, one adopts the mindset of "You've got a diploma, you're not drooling or otherwise acting strange, you seem to know where to look for what, sure, take a look".)

Then I mentioned that I'd had an examination last month.

Dr. Petrie said "Just last month?" She seemed surprised.

"Yeah. Last month." I didn't mention that I remembered it because the image of a woman in a blue dress and latex gloves stays with you. "I usuall-"

She stopped me there and said "No, that's okay. Never mind." She clearly knew about the two months between exams policy.

The sudden rejection got me, of all things, mildly affronted. Even though this is entirely doctor-patient, the quick shift from 'I'm asking permission to see' to 'I don't want to see' stung a bit. Bah, men. They're all filthy-minded pigs.

Ah, but now onto the examination. Various checkings of my lymph nodes in my neck and under my arms. I like this part. It's like a mild massage, with my neck getting kneaded. Gets a bit of tension out. Not as much as a proper massage, of course, but what do you want for free?

Blood pressure normal. Man, the way that dial twitches with my heartbeat freaks me out.

Eye and mouth examinations as well. She said to look straight forward, but it's damn hard to do when she's flashing a light right in your eye. The next five minutes were composed mostly of blinking confusedly and trying to discern that there was a person on the other side of the glowing red afterimage.

Heartbeat fine. Stethoscopes are amazingly versatile, but so damn cold.

Lungs fine, stethoscope's been warmed a bit by my chest so it's better. When a doctor says "breathe deep" I automatically go to mouth-breathing. Sound like an obscene phone call. No idea why, one can breathe just as easily through one's nose.

My chest and stomach got used as a percussion instrument. I didn't know the song the beat was for, though. Tap-tap, pause. Tap-tap, pause. Move to another spot. Tap-tap, pause. Tap-tap, pause.

Then came the oddest test yet. Dr. Petrie pushed gently on my stomach (right side, near navel) and told me to breathe deep. I did. Then she did the same, only this time she pushed harder. Was a bit of effort to get my lungs filled.

Then came something even odder. She explained that while the hormone changes of the cancer can be caught on blood tests, she wants to check for physical symptoms of same. Namely, female-like breast development. I just shrugged and said "No, they've always been this big." Well, big relative a male. I tried to give them a Girls Gone Wild-esque bounce, but they don't have quite enough mass behind 'em to do it convincingly.

Then came the surprise. Dr. Petrie said that was normal fat storage for a male. She was talking development of for-real female-looking breasts (as in, same size and structure) due to the hormone imbalance. (I've done a bit of reading. It's called gynecomastia. Apparently - though my doctors didn't mention it and I can't find any documented cases in a cursory search - it sometimes goes far enough to become galactorrhea, lactation when it isn't supposed to happen. Which freaks the hell out of me, because I've spent most of my life thinking that lactation is something guys just don't do.)

So I got my boobs tenderized. At least, with all the poking, prodding, and such, you'd think that's what she was trying for. It didn't hurt, but I felt a little like a UPS package when it was all over. Then she tells me that it seems okay, but she wants my oncologist to check. (That scares the hell out of me.) She leaves, and comes back with my oncologist in tow. The only check my oncologist does on me is to poke briefly at my chest and say "Seems perfectly normal."

I've got normal boobs. Wooo. (I've also got assurances from a urologist about something else being normal, but that's another story.) Though I never knew that you could tell the difference between male and female breast development by feel. But then, I suppose that's because feeling up a woman that rough, even if you're in a situation where standard fondling would be acceptable, will get you slapped. That, and I've never fondled myself for comparative purposes.

Most of the rest of the visit was my oncologist talking to me about the bloodwork and how she wanted me to keep getting it in Halifax. She also bumped up my chest x-rays to once every two months. When I think of choriocarcinoma (one of the cancers I had, a rare and aggressive little bastard that likes making a home for itself in a poor sod's lungs), I get a little unsettled.

The checkup ended with me recalling the bloodwork portion of my last visit. I must be a good storyteller.

Thursday, September 4, 2003. Well, more medical fun, an x-ray this time. I went in to the NS Cancer Centre (first floor of the Dickson building, where the oncologist's offices are) and picked up the needed forms. Except they weren't there. Some fishing in a back office by one of the secretaries turned them up. I notice that the x-ray one was written out by Dr. Petrie - that is indeed the correct spelling - from my last visit. She's a lot more verbose than my regular doctor. She fit my entire medical history onto the 3 lines alotted for instructions. Heavy abbreviating.

While waiting to register (On number 00, I have 15....), I started reading a Michael Moorcock story. Man, I pick up one of his things and invariably regret it.

Finally, they call number fourteen. No one shows. They call number fifteen. I stand up and, as I do, a woman appears out of nowhere brandishing the little paper reading "14". The secretary checks it, and waves me back to my seat. I smile and nod, but at this point the anomaly of a person getting up and being turned back has drawn attention to me. Not wanting to provide the bored waiting room audience with entertainment, I just sat down and waited, trying to be as immobile as possible.

After being registered, I headed down the Long Hallway of Doubting the Directions Given. But I've been here before, so it was just the Long Hallway With Lots of Doors. I took the time to admire the spots that I realized matched up with the hallway one level down, like the staircases.

I got to the desk and said "Hi, I'm here for a chest x-ray."

Evidently the computer system here isn't down. She glanced at a screen and said, "Is your name Leonard?" Some efficient setup they got there, since it took less than a minute for me to walk the hall from the diagnostic imaging registration desk to the chest x-ray registration desk.

After I finished removing and stashing my outer jacket and dress shirt, I sit down. While waiting for my turn - a few people went ahead of me, meaning they were for various clinics in the building, just as I was - an older woman came out of the x-ray room with an oxygen tank. A young bored-looking male, looked to be in his early twenties, took the tank from her and started to wheel it out. Evidently he had more faith in the physical skill of an old woman on oxygen than he had any right to. That, or he was an inconsiderate twerp, because he went so far ahead that she ran out of tubing slack and almost had the mask ripped from her face. The woman treated this as a mere accident, assuming the young male had forgot he had someone older and slower following. Everyone else in the waiting room followed suit, smirking a bit, giggling lightly or somesuch. (I admit to accidentally doing something similar in my past when I forgot I had someone slower following me and we were carting attached loads.)

Then the kid went and did it again. The audience had a slightly less pleasant reaction, even more so when he pretty much started dragging the poor woman along by her oxygen tube. All in all, it's probably good he moved so fast, else someone would have made the young punk waddle out with the oxygen cylinder shoved up his ass.

Some time later, my turn came up. The woman called me simply as "Leonard". Since by now I was the only male waiting for a scan, except for an older man just coming in, I figured it was me. When I walked into the x-ray room, the technician lowered her voice to a conspiratorial whisper and said "How do you pronounce your last name?"

I spelled and spoke it for her, and she seemed happy with that. (It was in green on the side of the machine, all my vital stats. I still like that.)

The x-ray was similar to last time, but this technician was more, er, sing-songy. Very sing-song voice. She also told me to breathe the instant I was allowed after the x-ray took the picture, so I wasn't left in any doubt that I could at least inhale while nearly hugging a large noisy machine. The fact that the spin down of the machine sounds faintly like a slow klaxon revving up doesn't make one comfortable, especially when pushing your chest and shoulders up against said machine while your hands rest lightly on your hips. I felt like some kind of round-shouldered fashion model, and I wouldn't want to try a round-shouldered fashion model holding their breath.

Two pictures and my street clothes later, I was getting my bloodwork done. I was told by the people in the cancer center to go straight to "booth 6" without registering in the front. Here's where my squeamishness backfired. Someone was getting blood taken in booth 6, so I averted my eyes. In doing so, I missed the tray set up INSIDE the booth and the sign that reads "Put bloodwork requisition form on this tray, face down."

I sat in the booth six waiting room and waited quietly, not sure how to proceed, if they called "next" and let people sort it out themselves, or what. Ten minutes of waiting and a young woman came in, dropped a bloodwork form in the tray (which I couldn't see from my vantage point, but she clearly dropped the form into something) so I got up and went to investigate. Just as I got close enough to drop my own form in (and see the sign), someone in a lab coat came along and grabbed the tray and started to leave. I stopped her and put my form in the tray as well. She looked at me like I'd grown a second head, I guess because I was coming from the waiting room, not the main lobby. Figuring the whole convoluted reason for not putting the form in the tray on my way in would be something of a mishmash, I laughed self-effacingly and said, "It's not my day. I completely forgot to put my form here."

Now, she looked at me like I not only sprung a second head, but the second head started singing an aria from "La Traviata". So I've hit a person with an inability to cope with a newbie. Okay.... I explained things again, slowly and carefully, and finally got through. I sat back down.

The person next to me took the moment to sigh loudly. If she was frustrated at my vast incompetence or just tired of waiting, I don't know. She got called next anyway, so it's not like my confusing the paperwork drone did her much harm.

Some unknown number of minutes later, I'm called in for my bloodwork. Evidently my veins were a bit sluggish today (sometimes they are, one month the person asks if it always takes me a long time to get blood taken and then the next month it's over before I notice), so I had time to have a surprisingly long chat with the technician. Nice lady. She knew someone who had testicular cancer. Oddly enough, some aspects of the conversation would be repeated later when speaking to a nurse and a resident. See below.

Bloodwork done, time for me to have my appointment with the oncologist.

They have two NT 4 PCs for cancer patient use there. I tried to see if Blaster had hit either one, but registry editing - to figure out if msblast.exe or its cousins were running - was disabled, along with a couple of other features I could have used. Man, people install spyware on this (let's see, something brought Gator along...) and you think disabling registry editing is gonna help things?

While sitting at the PC, a nurse came out from the hall leading to the exam rooms and said "Leonard?"

I walked up to her and said "Yes?"

She seemed kind of shocked by this. A few seconds passed with both of us staring confusedly at each other.

"Uhhh...." I said, "Are you looking for a patient named Leonard? That's my name."

This kicked her into gear and she realized what happened. Seems she was trying to get the attention of a completely different Leonard. This is why last names are so important.

10 minutes of waiting more and another nurse, this one I recognized, came along and said "We're ready for you, Leonard."

Figuring this one was for me, I got up. No one else did. So far, so good. I'm 2 for 3.

We have the regular weighing (I've dropped half a pound. Now that I'm back at a weight I'm happy with, I'm exercising a bit. Seems to be working.) and such. I was asked various questions relating to my physical health, as always. They keep pretty good tabs on my psychological condition, so they asked how my job hunting was going. I explained that it wasn't going well, that I had several offers from my previous employer, to come back (they're in something of a manpower crunch, judging by the perennial help wanted ads I see on job sites - hey, don't screw over the current employees so bad and you won't need to find more in the future) but that I couldn't go back now, due to what happened last time....

* * *

Allow me to digress briefly. I'm here to tell you a story about a person, who - for legal reasons - may or may not be me. Feel free to try this person's shoes on for size: Imagine it's January. You had surgery three weeks ago, just before Christmas, to cut a probably-cancerous tumor out of your body. The incision has healed into a scar, but your mind isn't doing so well. Your first day back at work, after 3 weeks sick leave, is the same day you learn that the biopsy is back and that it was a cancerous tumor. What happens from here, your surgeon isn't qualified to say: he's a urologist, not an oncologist. He's setting up an appointment with an oncologist for you and will get back to you.

You spend a week and a half working. You weren't greatly fond of the job - technical support for Deskjet printers - to begin with, and the questions about if you're going to need chemotherapy or radiation or surgery or what are doing little for your mental health. You have regular crying jags in the washroom. You spend about half your time off the phones helping other phone support people with their tough problems - you are, after all, one of the most experienced agents on the floor who hasn't been promoted (partly because you stopped applying for promotions when this whole cancer thing started in November). You also teach some of them how to do their jobs better. That isn't officially your job, but you're good at it, and it's enjoyable. Besides, it's either do this half the day or go psycho on some caller who's whining about how life-ruining their busted printer is while you're wondering if you're going to have to get chemo or radiation or if the cancer's spread to your lymph nodes and how far it could have got....

Finally, you really can't take it anymore. One more day, you feel, and you're going to snap. Someone is going to severely regret something, though you're not sure who or what yet. You tell your supervisor, in private, that you can't handle it and your job performance is plainly going downhill. However, you would like to keep working for the company if at all possible and would gladly take to a lower-pressure (and a lower-wage) job, or some sort of half-and-half job where you do some phone work and something - anything - else.

Well, you are told that isn't possible. Fine, if the work's not there it's not there. So you ask for, as company policy allows you to ask for, an unpaid leave of absence. Your supervisor says, quite simply, that if you did that you might need retraining (on new printers) when you got back and that was too large an expense to incur. So, if you want time off you could quit. "You know where the door is."

Forcing a person to quit, especially because they have a disease, is illegal, and dreams of violent vigilante justice float through your head. But killing people is illegal too, and it's obvious that this person, who's been working at the company only as long as you have, isn't worth getting arrested over. Hell, he's not worth getting your hands dirty over.

A god of patience blesses you, though, for you manage to keep your voice level and act as if he hasn't said something obscenely offensive and hurtful to you. He follows this up by making assumptions about your religion, entirely incorrect assumptions in fact, but you leave it slide because you're not going to spend one more minute talking to this person.

(I would like to point out now that the highly callous and illegal behavior of one person does not necessarily reflect the opinion of an employer as a whole, including but not limited to the legal department.)

After another five minutes of debating company policy and managing to not collapse into a madman right there, you get five days vacation - five days of your own vacation time - off to "think things over".

During that time off, your surgeon calls and helps you get things straightened out with the oncologist - appointments and such. He also explains that you had four (of a possible four) different kinds of cancer*, including an uncommon and agressive one.

You speak to some people in the company and a few of them seem to sense you're not in a good mood, even though you don't mention specifically what your supervisor did. They leave you on the payroll (unpaid, but with benefits) and ask you very politely to come back for a nice half-and-half job like you asked for weeks ago but were turned down out of hand for. This surprises you a bit, since you never told them the specifics of the encounter with your supervisor. Either they know, or it was just coincidence. You decide to write it off to coincidence, since adding yet another person to your personal want-to-hurt list is just too much trouble.

Sick of the entire fiasco, you quit, but not before scaring the wits out of a few people who could have legal responsibility for what the supervisors do.

*As I like to call it, "The Nonseminoma Variety Pack: Four dangerous diseases for the price of one!". (You can read up on all four on the linked page, in the section called "Nonseminomas". However, there is a detailed diagram of the male anatomy on the same page, so you've been warned.)

(I would like to point out again, for legal reasons, that this story does not necessarily reflect what happened. However, it might.)

* * *

But, anyway, I told a story similar to the one detailed above to the nurse. Her eyes widened around the line "You know where the door is."

I also said, "You have my medical records. Look at my weight when I first started coming here. I might have lost some of that from the stress of the cancer, but I lost most of it to the stress at work."

She began to say something but her eyes skimmed over the papers in her hand. She blinked and said "Wow!" I presume she did see the 30+ pound difference. Have no appetite for five days a week, that happens.

The meeting ended uneventfully, with the nurse asking if I minded being examined by a resident named Heather. I said I was fine with it. One gets used to being a floor show after a while.

Ah, now the interminable waits between seeing people. While waiting, I amused myself by examining the sharps container. Very elegant design. Efficent, minimizes chances of getting poked. Hmmm? It's made by Tyco! You know, "Tyco! That's how you spell R/C!" The ones who make radio-controlled toy cars! They have a medical division. (Looks around Internet.) And they sell UPSs! Damn! They're big! Sigh. First the people who made my electric razor made the CT scanner I use, now the people who made my remote-controlled childhood toys make containers for possibly-diseased needles.

About five minutes later, a young woman walks in and says "Hello, Leonard!" Three for four, it seems. She says her name is Heather. Okay, sounds good so far.

We go through a question and answer thing similar to what I did with Dr. Petrie last month, though the resident seems more interested in the, er, nuts and bolts of things. When the tumor was found, when it was operated on, what doctors I've seen, etc.

Then, the examination. Heather warned me about her cold hands, and boy, was it needed. Apparently her first patient shrank away from her touch, and she thought she was hurting him. But then he told her that her hands were bloody cold! Man, if I could have loaned her mine (I seem to generate a high level of body heat and have fairly high tolerance for temperature changes.) but she was just going to be feeling my testicle anyway and my hands spend enough time doing that by themselves.

I found out what that pushing-on-my-stomach thing was. Heather wasn't as rough about it, I will say. (Though she might just be more afraid of hurting people.:) When she pushes on the right, she's looking for my liver. When she pushes on my left, she's looking for my spleen. Sometimes they can feel them through the abdomen. However, often they can't. Seems more like it was just a general-examination thing, rather than a cancer-symptom thing.

Her beeper went off. She checked it and shrugged. "Ah, it can wait."

She's also the first person since Reyno (months ago) to ask about my ankles. (If they swell, could be a sign of lymphatic problems, if I remember correctly.)

I'm going to get a bit excessive in references to the parts of my body that I'd be arrested for showing in public. If you don't like this, skip it.

Now that all the deviants are left....

Amusingly, this is the first female doctor (well, soon-to-be-doctor, anyway) who didn't give me the speech about being a female examining one of my male-specific bits. Maybe they're getting to know me. She did ask if I preferred having my testicle examined while I was standing up or lying down. Hell of a question, no? I answered "Whatever, I've had both done, doesn't matter." (Though, now that I think about it, I felt kind of silly when it was done while I was standing up. I feel like I'm Michelangelo's "David", while being assaulted by a weird art historian.)

A bit later in the examination, just before checking my stomach, she did mention the issue of being a female doctor working on male patients. I just shrugged off any worries about the gender difference with "Hey, a pair nurses mistook my radical orchidectomy for a bilateral and turned me into something of spectacle looking for a scrotal incision when I had a big pile of gauze on my front. It gives you a laissez-faire attitude towards these things. A diploma's the only price of admission for this floor show."

"Well, I don't have the diploma yet. It's still a few months away. I have diplomas, yeah, but I'm only going to be an MD in the spring."

"The spring? Hey, congratulations."

I guess half-naked men don't congratulate her often. It surprised her, but she said "Thanks."

She also asked me if I wanted to, after my stomach examination, put my shirt back on before lowering my pants. I've actually heard male doctors ask a similar question, so there's got to be some kind of institutionalized thinking behind it. I don't get it. If you're going to be spending the next 20 seconds feeling my testicle for strange bumps, I don't see what the hell difference my shirt makes. Perhaps some people worry more about amount of surface area exposed than the specifics of the surface area, but I just don't get it.

Indeed, even though I wasn't bothered, she took the "johnny shirt" that was left in the room (some doctors prefer you to change into one before examination) and used it as a makeshift blanket, covering as much as she could without making the examination more difficult for herself. Which is to say she wound up covering pretty much only my knees before it was over. (Again, this is why I think it's silly.)

I admit to having a hard time keeping from giggling during this part. She started asking questions about my health and how often I examine my testicle myself. When she started asking, she pulled the 'blanket' back up to my stomach. Then she had to keep examining, so she pulled it back down. Then she thought of another question, so she pulled it back up, but then she needed to finish the exam, so she pulled it back down.... It was probably to make me more comfortable with speaking during the examination, but all it did was force me to fight a temptation to ask if my genitals were distracting her and if so, what part specifically.

Now, it's not that I'm going to show my business to everyone, it's just that once I've decided a person can see me naked (or at least various parts that generally are only shown when naked), I don't concern myself with being naked in front of that person. About the only thing that could unnerve me after that would be hysterical laughter or words like 'stirrups' or 'speculum'. (Did you know that the plural of 'speculum' is both 'specula' and 'speculums'? My question: At what point did it become necessary to bring up more than one speculum in conversation?)

Another amusing thing did happen. When she was checking some lymph nodes in the general area of the incision, she noticed the surgical scar. "Oh, and there's the scar."

"Hmmm? Oh, yeah. I don't notice it that much."

"I can see why. The area is kind of... uh... kind of... uh...." (Embarrassed pause.)


"Well, uh... yeah."

The specifics of the visit are actually difficult to remember, since everything seems the same after a few times around the mulberry bush. I bet few guys ever figure that having a different woman checking their sex organs every two months would get boring, huh?:)

Oh, that does remind me. Heather did mention one thing. Evidently one of her classmates had the misfortune of getting testicular cancer. He shared this anecdote with the class. He woke up after surgery, hoping that maybe his surgeon would be there to say hello and tell him all went well. Nope. First thing he heard upon coming back to consciousness was two nurses discussing him, possibly not expecting him to be awake yet. One thing he clearly remembers is one of them saying was "His was the smallest we'd ever seen!" He's hoping they meant the tumor, and not anything else.:)

I mentioned that my first memories of post-surgery were all of people saying "You're finally awake!" and "The anesthetic threw you for quite a loop." because I was out for 2.5-3 times normal.

She said she'd rather too much anesthetic than too little. I tried to point out that both of them are Bad Things. Too little and you wake up mid-surgery. Too much and you overdose and never wake up again. She didn't seem to understand what I was getting at, though I admit to being a bit vague, trying to lead her to the conclusion without coming right out and explain it. (I don't want to go around looking like I'm trying to outdo the doctor examining me!) Well, I'm hoping she's not gonna be a surgical oncologist.

If you remember last month's adventures, you'll remember that I was told I might grow boobs. Well, I asked Heather if they just meant gynecomastia or if there was any risk of galactorrhea. She didn't remember which term was which, so I explained it and a bit about where the word "galaxy" comes from. (Think "Milky Way". Now look at the word "galactorrhea" again. Yep. The word "galaxy" comes from the Greek for "milk".) She said she didn't know (I like a doctor who can admit he/she doesn't know something.) and would ask my oncologist. She left and came back with my doctor in tow.

My doctor explained that no, I didn't have to worry about lactation. Just growing boobs. And even that was on the outside. My beta HCG level was at a high of 35 (or 36, I can't remember for sure) and my normal since surgery has been 2. (I presume that's in mIU/mL.) Excessive HCG causes breast enlargement. Thing is, the HCG level where that happens is different for every person. At this point, we know I don't get breast enlargement at 36 mIU/mL, so my 'magic number' is higher than that. Since it didn't happen to me the last time, it probably won't happen if the cancer comes back, unless my HCG level hits whatever magic number is right for me. That's why they use tumor markers. If my HCG level goes up to 10 mIU/mL, I won't have any external symptoms, even though that's five times normal for me. (And is perfectly normal for some men.) A blood test will catch that.

The examination turned into something of a class at this point. My oncologist told Heather that some doctors also do LDH (lactate dehydrogenase) blood tests, but I didn't need it. I piped in with "I heard that was predominantly for cases that are further advanced than mine."

My oncologist said, "Well, sort of. It's a prognosticative test. If your LDH level is less than ten times normal, your chances of recovery are fairly good. If it's over ten times normal, they're, well, not very good."

It's moments like this that I think about the other people oncologists see in a day. The men with testicular cancer who do have high LDH levels. Kids who are sick. People of every age with 20% chances of survival. Or less.

It's also moments like this that I remember why I couldn't do this job for all the money in the world.

Oh, and one more thing. My oncologist mentioned that she was glad I was so willing to speak to other doctors and residents, because mixed germ cell nonseminomas (at least, this particular mix) are apparently fairly rare - hey, one of my cancers is called "rare and agressive" - and they like to have their people to have seen as many different cases as possible. Probably part of the reason they're watching me so closely. Oh, well, I'm not complaining. If you've got something that might come back in your brain, bones, or lungs, might as well be put under a magnifying glass.

Ironically, being put under the magnifying glass of a bunch of curious doctors is something of a family tradition. My mom was 40 when I was born, and I'm her only child. Back then, a 40 year old having her first child was incredibly rare (my mom's always been ahead of the curve:) and a small cadre of doctors were jockeying for a chance to witness the birth. Well, I wasn't in the mood for a show - I had got myself wedged in the womb sideways and there was no way to get me out BUT a c-section. Man, were those doctors mad at my mother for being so audacious as to require a c-section!

As an epilogue to my trip, I also met a very nice lady at the radiation desk (I don't need radiation, but one kind of booking is done through that desk). There's some really wonderful people working in the NS Cancer Centre up in Halifax.

(One of the people working at the rad desk - or a friend of same - had a newborn there when I was there. It was cute as a button and so tiny, less than 2 weeks old. Though I question the wisdom of taking a baby to a hospital unless needed. There's so many diseases crawling around....)

Nothing next month. Due to scheduling conflicts, my next CT scan will end up only being in six weeks instead of the standard four, meaning after I update the page. If I haven't already, I might write something to tide things over; it would be a short account of my ultrasound, almost a year ago, that was the first diagnostic work (besides physical examination) I got that lead me down this particular path.

Turns out that, due to my lousy math, I had this one written in time for the month's upload. Maybe that wasn't for the best: This one's a bit of a horror story. If you're squeamish, close your eyes as you read....

Arrive at 12:15. CT scan is at 1:10. This leaves me an hour to pick up my bloodwork paper and get that done. Simple, right? Ha-ha!

I go into the cancer center in the Dickson building and ask for my papers. The receptionist looks for them and frowns. Not there. She calls up my file, says everything's been transferred to the chemo department on the 11th floor. I panic internally for a moment, before remembering that they currently know as much about my health as I do, so it's either a mixup or someone's bright idea of reorganizing. Since I figure my doctor is a medical oncologist, perhaps being in the chemo area is a good idea from their point of view. I leave. It's now 12:30.

I decide that going up and possibly fighting over paperwork isn't the best thing to do with this limited a timeframe, and I don't know if the iodine marker for the CT scan is going to mess things up on the bloodwork, so I decide to pull an older paper I had stashed in my luggage and use that. It's not the most prudent thing to do, as it's short-circuiting the doctor's desires should she have decided to do some other test, but if I spent my entire life worrying about what other people want I'd never get anything done.

The blood collection waiting room is packed. Oh, well, no problem! I'm going to the clinic blood collection in back! Ha-ha!

Of course, that's packed too. I drop my form in the tray and sit in the one free chair. I wait. I check my watch every five minutes.

1:00, or T-minus 10 minutes to my CT scan. I'm getting nervous. But they've picked up the forms and getting it back now would likely be impossible.

1:05 A woman starts to speak to a black man she seems to know, sitting across the room from her. Being a small waiting room, it means that I hear all of the conversation. He mentions that he works as a prison guard. The woman says "Oh, and you look just like that guy in The Green Mile!" The guy nods very politely, but he seemed sick of the comment. I can understand why. I mean, so he was a bald black man who had something to do with a prison. In my opinion, that's where the resemblance ended. I'm a white guy with hair who had something to do with EDS. By that logic, I look like both founder Ross Perot and ousted CEO Dick Brown, AKA "Brown Dick" for the rank-and-file's opinion of his treatment of employees.

1:07 My name is called. Things move fast from here.

1:10 I hustle for the CT registration room. This means jogging the hall from the Dickson to the Victoria building, then jogging Victoria's halls for almost as far, until I get to the Centennial building. Which I do.

1:12 I arrive. There's three people waiting outside registration. The waiting room is packed. I find out that they're an HOUR behind. Oh, well, so much for rushing!

1:30 I register. The woman who was wearing the red-and-yellow-starry dress is dressed in somber slacks and a lab coat. But the collar of a brightly-colored blouse is peeking out from under the coat. She asks when I took my second shot of Gastrografin. I say "about five after twelve... noon". She seems disappointed. I say "I was supposed to get this at 1:10. I took it about one hour before the scan." She seems to accept this.

I asked her if I could, since the waiting room's packed anyway and they're doing the 12:00-1:00 appointments first, go up to the 11th floor and get some paperwork settled. I promise to be back in fifteen minutes no matter what. She looks at me funny and says "Get them to set up an IV."

I say "Pardon?" because I didn't think I heard that right.

"Get them to set up an IV."

I figure it's a joke due to how busy they are and laugh lightly. She cuts me off. "I'm serious! They do chemo up there! Get them to set up an IV! It'll save us time." I say I'll ask them to if they're not busy and leave.

The elevators are back at the Victoria/Dickson hall junction. I'm in street clothes. So lemme get this straight: I'm gonna sort the paperwork, hunt down and ask someone who should be giving chemo to wire me up to a saline IV for a procedure going on nine floors down where they have their own IV people; THEN carry the IV and my jacket and outer shirt (since I can't remove them afterwards, I'd have to remove them before) through the 11th floor, down the elevator, across a busy inter-building nexus and down a hall, AND remove my jeans and change into a johnny shirt, all while holding an IV bottle. Suuuuure I am.

On my way up, I'm temporarily taken back to the hours just before my surgery, when I spotted an elevator door by itself in a corner of the surgery registration office. The Victoria's elevators have a rear door - one elevator even has its own rear door button panel and a strict warning for only medical personnel to use it. (April 20, 2004 Update: Though I've been there since and I haven't seen the panel again. Am I going nuts or has it been removed?) It's a stretcher door, which probably opens onto a quieter room like the office I was in before my surgery. Neat, but I otherwise hate the Victoria elevators. Unlike the Dickson's, they start with a strong lurch and have a fast acceleration/deceleration phase. Oh, and there's some kind of odd WHOOOOOOOOOM noise when the elevator moves, loud enough to cause misunderstandings in normal speech.

So, anyway, I go up to floor 11, seems the entire thing is devoted to chemo. The chemo registration desk is right there when you leave the elevator. It would be in the middle of the floor if this area was built like the main floor nexus. I didn't see a directory on the wall like on the other levels I've been to. If you need to find something, the chemo desk is the only obvious place to get it. So I explain things to the woman there. She gets a bloodwork paper. I skim it and notice that there's a few things odd about it. Most of my forms are completely unchecked, with "Beta HCG" and "AFP" written in at the bottom. Here, "HCG (Quant)" is checked off, "Beta HCG" is NOT written in. "AFP" is written in. "LD" (LDH) is checked, despite my doctor's assertion to a resident last month that I don't need it.

Between that and the haste with which the woman got the paper makes me wonder if she didn't just grab a blank one and check off the checkboxes some list said were for testicular cancer. I fold up the paper and thank her. I turn and head for the elevator bank. She stops me and tells me I can get the blood taken up here. Okay, I've had one hole in me so far, I'm getting another for the CT scan, so I'm not looking for three. I explain why I want the paper. (So I won't be without one next month and have to run to the 11th floor in a hurry.) And I meet another person with absolutely NO ability to comprehend a change to the routine. So I explain myself carefully and I think I get through. I leave. Back down on the main floor, I go back and collect my hospital duds. I change.

Some time later, I'm called. I'm set up for an IV before going in to use the machine. Apparently the machine was only running at half speed all morning, despite being new this year and serviced this month. Peachy. Remind me never to buy a Phillips CT scanner. (But in all fairness, they probably ran it heavily to make up what time they lost during power interruptions in the week after Hurricane Juan hit Halifax and felled all the precious trees that the people of Halifax insist on keeping despite being knotted in the power lines.)

So, the woman who sets me up tells me that she likes my shaved arm. (At first she thought I had some disease. Not that any disease takes out a patch of hair this neatly. I had to explain why my arm was hairless. No ability to accept change....) I shaved it about from my elbow halfway to my wrist because the third strip of tape is higher than the first two, which are near at the crease of my 'inner' elbow.

She's a bit clumsy getting the tape ready. Oh, well, we're all human.

"You're gonna feel a little bite." More like a tiger trying to get my marrow. It hurt like a real bitch. (I'm not given to using profanity, but I had my moments here. And I'll have them again in recalling it.) Thing is, the pain didn't stop. After standing it for as long as I figured I could I gave a nervous laugh - because it was either that or scream - and said "Are you done yet?"

(This part is somewhat bloody and has some cussing. You may want to skip it.)

"No. It's amazing. Either the needle is really blunt or your veins are really tough! I think I need to push again."

"Well, couldya just do it?"


Another murderous blast of pain. I had to grit my teeth. The last time I gritted my teeth over physical pain was during an incredibly unpleasant experience which I won't bother to recount. Let me just say that I almost passed out during that misadventure. I like to think I have a high threshold of pain, but this was BAD. I can count the memories of this kind of pain on one hand. My surgical incision was not half this sore. Had it been, I wouldn't have been coherent enough to even ask for morphine.

But finally it subsided to a dull throbbing with (relatively) light spikes of pain keeping time with the throbs. So she says "I'm gonna hook up the saline now. And here.... Uh-oh."

The last bloody goddamn thing I wanted to hear was "uh-oh". Between sharp breaths I say, "What do you mean by that?"

"I forgot the saline!"

"You forgot the what?"

"Could I have your good hand?"

What was I to do? I gave her my good hand. And she moved my hand so I was HOLDING THE FUCKING NEEDLE! This needle....
Which was in my arm and STILL causing me some pain.
Which I was currently inclined to rip out if not for the fact that it meant doing this all over again.
Which did I mention was BURIED IN MY ARM!

She says, ever so lightly, "Okay, that's good, now don't move it much!" She vanishes around the corner.

You know how the harder you try to not move something, the more you move it? You start trying to correct incidental twitches and overcorrect, making it worse? I have often, when doing delicate things, remembered this bit of trivia from my days as a kid watching Mr. Wizard. So I did now what I'd done all those other delicate times: Forced myself into as Zen-like a state as I possibly could, watching the needle - I couldn't take my damn eyes from it! - but not trying to adjust. Deep breaths. Pay attention for any new pain, and only try to adjust if that happens by reversing - gently - however the needle just moved. Never mind that the needle seems to be moving. Know how it moves, but don't try moving it. Don't try to think about the movement, even as you observe it carefully. Breathe. Relax.

Hear the broad LAUGHING in the other room. Maybe she's doing something productive with her hands, but all I hear is her chatting. Say, as calmly as I possibly can, "Could you (breathe) hurry it up (breathe) please?"

She comes back a few seconds later. (Subjectively it felt like ten minutes.) "Oh, good! You didn't move it!"

Did I have a choice?! Other than ripping it out and storming out, I mean?

She starts to hook it up. "If you start to get faint, let me know."

I turned my head away for a moment, but then she said "Oh! Don't worry about that." Her voice gained a hint of pride all of a sudden. "I put gauze there."

I look back. She's got the end off the IV needle thing but hasn't put anything back on it. So I'm bleeding. Not just bleeding, but alternately bleeding slowly and quickly in time with my heartbeat. Bleeding onto the gauze she's thoughtfully laid so my arm - and the chair arm - won't get all messy with my blood. How effing thoughtful, give her the damn Nobel Prize for thinking of it.

She says, "If you're squeamish, you might not want to look." I notice she's got the saline ready, so I grit my teeth again and close my eyes. One more blast of pain, less than the others but still unwelcome, and she starts taping me up.

Then she says, "Oh, I'm going to have to tape your hair anyway!"

I'm in no mood for games. "Why?"

"Well, I have to tape it up here." Just below my wrist. "You see, if I just tape it down there, and there's any pull on the tube, it'll pull on the nee-"

"Yeah, I understand that, but I've had about five of these things. No one has ever put the tape that high on my arm."


"No. That's why I'm shaved halfway up my arm. So there's room for the thir-"

"But we always put the third tape-"

"Yes, but not that high."

She taped it up there anyway. I notice that if she'd taped my wrist, she'd have missed a lot of the hair. But no, she taped the thicket just below it.

"Do you have any questions?"

Yeah, who the hell certified YOU? But all I asked was where I could pick up some Gastrografin for my next visit and where my third dose of Gastrografin for this scan was.

She frowned. "You've only had two?"

Well, I wouldn't ask for a third if I'd had three, now would I? "Yes. Two. One last night and one a while ago."

She told me where to get the stuff after I was done and left to get my third drink. When she got it back she told me to drink it quickly. I did. She said, as I drank, that the best way to do that was to do it quickly. That's not the only thing I want done quick.

I'm loaded into the scanner. I notice they didn't put me all the way in. My head wasn't past the lasers. My arms were also rather odd, sort of like I was doing a Heil Hitler with my right (IV) hand and waving to someone else entirely at the same time with my left. But I realized by now that it didn't work to argue with genius here, so I take some small comfort in the fact that it makes the first scan faster.

Between scans she told me, kind of sadly "Your doctor wants us to use the iodine." Oh, yeah, blame it on her. "That's why we started the IV." No, I thought you did that for a joke.

Of course, she also took to apprising me on how fast the iodine marker was pumping into my bloodstream. "Wow, it's really going fast! Your arm's probably feeling sore right now." Well, you've had me keep both of them over my bleeding HEAD for the past five minutes, the one without the IV hurts almost as much!

She also showed me the iodine holder as she was unloading it. It's only slightly smaller than a can of soda. Gee, I really needed to know that, thanks.

Anyway, second scan was fast. Tape ripping was slow. She lost hold of it first time halfway through and then stopped to say "You know, this isn't easy." Yeah, I don't really give a fetid disease-ridden crap if it's easy, hard or bleeding impossible, it's MY GODDAMN ARM! GET THIS OVER WITH!

I just said "Yeah, could you finish this up?"

She does. I beat a hasty retreat. Knowing I never see technicians again if I tell them "Be seeing you!" I give her a hearty "Be seeing you!"

I go to pick up some Gastrografin. When I ask for it, the woman (the one in the bright blouse) is listening to Kylie Minogue on the radio. Without even turning to face me, she points behind me and says something about it being in the drawer. I look. No drawer. I say so. She turns. She points at a cupboard and says it's in that drawer. Okay, fine. I take one and leave. I check the cap, it's snug.

But it doesn't seem to want to stay that way. Five minutes later, on my way into the hotel to register, I find it's leaked all over the inside of my jacket pocket. I try cleaning my now-drenched hand with tissue but this stuff sticks harder than superglue, so I wind up just covering my hands in bits of stuck tissue, like some mummy hand model.

Waiting in line at the hotel registration desk, I do the only thing I can think of. I work up a good bit of saliva and covertly spit in my hands. They finally come clean. Man, no wonder this stuff feels like white glue when it's coming out of me, it sticks like glue in its pure form!

3:45ish: I also have a doctor's appointment with my GP. I ask him about a pain in my back that's been around a month now (he thinks it's a pulled muscle). I also get a flu shot. More on that later. First, the perils of the Waiting Room Full of Strange People! Oooooh!

In the waiting room, waiting for another doctor, is a guy in a ratty outfit who keeps giving me dirty looks (to match his reek, eww). He also twitches and gets up every five minutes to demand of the receptionist, in a loud voice, "ISN'T SHE DONE YET?!". Finally he storms out. Thank God, I didn't like the idea of him between me and the exit. Not two minutes after his exit, the doctor comes out (she didn't look too clean herself, to be honest) and calls him. (I presume. No one answered and she went to the desk and spoke to the receptionist for a while.)

Then, as the office radio puts out some announcement of a charity effort to help victims of Hurricane Juan, some completely different person shouts - at the radio - "I DON'T WANT TO HEAR ABOUT THE STUPID HURRICANE!"

Funny, the other doctor isn't a psychiatrist. But she's younger and I suppose you have to put up with nuts when you're starting out.

The flu shot: My family doctor had wanted to give my mom a flu shot, because she had cancer and all that. I'd reminded her of this a week ago, when I saw a poster saying if you have asthma, cancer, or one of a bunch of other diseases, to get a shot. But it didn't occur to me that I fit into that group too until my doctor actually started talking about it. And he doesn't like saying "cancer". He named all the other diseases and sort of trailed off waiting for me to fill in the blank. I found out later that he did the same to my mom when he told her about it. She also mentioned that, when I told her about the flu shot poster, she thought I was saying it relating to myself. I still can't believe that it never occurred to me.

I also notice my family doctor has a speech ready that was given to all the patients he wanted to get the shot. Filled with very simple words. I cut in every now and then when he started using whole paragraphs of simple words to explain what I already knew.

Him: "I had one, because I see a lot of people in a day, and a lot of them are sick, some with diseases they can spread, and doctors think that-"

Me: "Basically, you're in a profession considered high risk for exposure to diseases, including influenza."

Him: "Yes. High risk." And then he keeps going.

Him, later: "And your body notices the proteins liberated from heating the flu virus.... the dead bits of the virus-"

Me: "The proteins trigger an immune response designed to destroy the invader so that if the body is later exposed to the real virus, there's already a stockpile of cells designed to fend off the attack."

Him: "Trigger an immune response, yes."

It depresses me that people need to be talked down so often that he was used to saying it just like some long mantra.

I did get the flu shot, by the way. After the bloodwork needle and that dig to China for the IV, I didn't even notice the flu needle. It was so pathetic I almost didn't expect it to be of any use. My arm was a bit cranky the next day, though I'm not sure if it was that pulled muscle or the flu shot.

More frightening was the number of bandages on my doctor's hands and fingers. Turns out that, when clearing fallen trees from his property after the hurricane, he tried using a chainsaw with a dull blade. It snapped and took a bite out of him instead of the tree. No major damage, more to his pride than anything. I should've made some wiseass comment about his days assisting in surgeries - he was present at the C-section that dragged me out into this world - but I wasn't quick enough.:)

My oncologist's appointment the next morning was more uneventful, though certainly not entirely uneventful. I was waiting in the tiny 11th floor waiting room across from a weird old lady. While we're there, she snaps at another cancer patient she clearly doesn't even know, telling her "What are YOU smiling at?" Woah. It's a bloody cancer ward. If you have something to smile about, you should be allowed.

Time for the weighing, with my oncologist's nurse (who seems to have moved up to the 11th floor as well). I'm down 3 pounds. Though I look like I'm up five. The scale probably didn't move and this one - or the old one - is off.

The exam room had an open window and the wind was blowing in at 90 miles an hour. And freezing. My oncologist, not having personally done an examination of me in about four months, forgot this was my "off month" and examined my testicle. No big deal, except it was freezing because the window was open and I seemed to be the only one who noticed. Of course, I was the only one with my pants at my knees and my sex organs trying to crawl up into my abdomen. Oh, and I hope the construction crew down below looked up, 'cause they would've got a nice floor show when I undressed. Naked hairy pasty white flesh. Wooo.

The doctor asked if they were having trouble with the CT scanner, because they only got my lower body, pelvis and a bit of chest. My entire upper chest was absent. I explained what happened, including the needle fiasco and how they didn't load me entirely into the machine. She seemed to find it amusing. Maybe it was the way I said it. But then, she wasn't the one left holding the damn needle.

My Trading Spaces $100,000 episode rant had come up in the span of my discussion with my oncologist's nurse. Turns out they're both fans, so the nurse told the doctor. (The nurse mentioned that her husband had gone over to the neighbor's to watch it on a bigscreen TV. Does he like home improvement or just Paige Davis? Or Laurie Smith? Or Amy Wynn Pastor? Or Doug.... No, won't go there.)

The doctor said (as a joke) when I was leaving, "If you ever get famous as a writer, don't forget us." I thought about this page and said to myself, "You have no idea...."

The doctor also gave me, without being asked, a new bloodwork form. The "LD" was checked on this one too, but she seemed to neither understand nor really care why. Oh well. There was also testosterone checked on it as well. Apparently this is standard about 1 year after surgery. (11 months. Close enough.)

On the way out of Halifax, I saw more of Hurricane Juan's handiwork. Halifax was without power for an ungodly amount of time due to the lines down from falling limbs. Some whole trees went down and so far only ones blocking roads have been collected. Downed wires - hopefully dead - are everywhere. And a full half the standing trees have loose limbs that WILL come down soon. Walking the sidewalk is running a gauntlet. And we're entering windy season. Good luck to all the Haligonians out there. You're gonna need it.

This morning I walked into the Dickson building, a rainy November 12th. (The weather around Remembrance Day is always lousy. Perhaps that's fitting.) I noticed that the main blood collection waiting room was pretty empty and decided to see if the clinic blood collection waiting room was as sparse. If so, I'd get my blood done nice and quick. I checked. It was packed. I left for the next floor up and my chest x-ray.

Waiting for my chosen number (10 away) to pop up, I found myself sitting a few seats down from a woman (late 20's?) and a young girl. The woman was holding some large and nondescript book, and was dressed in matching (in color) unpatterned light blue pants and shirt. The girl was in a stroller, though she seemed a bit too old for that. Of course, the stroller seemed a bit too large, like it was made to accommodate a child upwards of three or four. The child was asking the woman questions. The first one I heard tugged at my heart. She asked why her sleeve was pulled down over her "IV line". The thought that a child that young would have to know what an IV was pulled at me something fierce. Even more so when I took a closer look and realized she wasn't hooked to an IV. The line she was speaking about was a semi-permanent shunt, meaning IVs were a regular part of this girl's life. It's still choking me up, even during proofreading.

The woman said quietly, "Because if we let it get dirty while we're out you might need to get a new one put in. And I don't think you liked getting this one put in."

The girl said "No. I didn't like it."

Closer inspection revealed more. The woman was wearing matching pants and shirt because they were a light-blue uniform, similar to surgical scrubs. The large book was a folder containing (presumably) hospital records, and, most telling, she had an ID badge type affair on a band around her neck. The band read "ISAAC WALTON KILLAM", the name of the children's hospital a few blocks away. The woman was a pediatric nurse, the child her patient. Presumably the Dickson building has some hardware that the IWK lacks.

The large stroller made sense too. It's some sort of concession halfway between a baby stroller and an adult wheelchair. It allows protection from the elements like a stroller - and keeps the brake out of the rider's hands - but serves the same function as a wheelchair: Patient transport.

The girl asked a few more questions. Nothing amazing, just what sounds were. (Variously: A pathetic "ding" was the broken bell on one of the elevators. The occasional "beep" was the "now serving" sign changing to a new number. A loud rolling followed by a louder "BANG!" was a janitor accidentally banging his garbage cart into a wall while trying to get it through the elevator doors.)

This beat kept up until the girl simultaneously raised her voice and changed the subject. While I'd stopped listening, I clearly heard the words "poo" and "my bum". Tone of voice indicated importance, but it didn't seem to have the urgency that would denote desire to go. I figure it was pride in having already gone today. Depending on her medical problems, that could be quite the milestone.

The nurse, embarrassed, said quietly "You don't have to say that out here."

Most of the people in this corner of the waiting room had heard it, so we all got a bit of a laugh about it. (Though we were quiet about it - the same list of taboo topics that kids lack keeps us adults from showing explicit approval for such behavior, even if we did find it funny!)

Despite her evident embarrassment, the nurse was still as patient as ever. I was impressed.

They registered two people ahead of me. While the nurse was speaking to the receptionist, the girl took some interest in the stroller's "roof" retractor and variously shaded and unshaded her face from the stark fluorescent lighting.

Since I was handing my x-ray requisition form over to the other receptionist as they were leaving, I didn't see which way they left the waiting area and thus, which test they might be having done. (This area is the hub for the entire Diagnostic Imaging department: Ultrasounds, x-rays, bone scans, bone density scans, radiology.... Only CT scans don't seem to pass through here.)

Down the Long Hall With Lots of Doors, I hand my paperwork over. I hear a familiar voice, more quiet and seemingly wrapped up in conversation. Beside me at the desk is the nurse, filling out some form, and close by is the large stroller. The little girl is sitting in it, mumbling something to herself that she seemed to think was fairly important.

Since the IWK presumably has its own x-ray machines, I'm left thinking she might have been there for a bone density scan. Hell of a thing for a child.

The waiting room was fairly full. I sat down in the hall outside, near the lockers. I removed my jacket and dress shirt, leaving me in jeans and a t-shirt. Several male patients were similarly attired. The one who wasn't was in a johnny shirt and jeans and didn't seem too happy about the various dressed men. (Hint to the guys out there: If you're getting an x-ray or CT scan, wear a cotton t-shirt under your clothes and no jewelry. Depending on kind of the scan you're getting - and where you're getting it - you might be spared the annoyance of the johnny shirt. They'll ask you to remove chains or anything that'll interfere with the x-ray, and that's not something you want to misplace, so just skip the jewels and chains.)

The nurse rolled the stroller into the waiting room and took a seat. To help distract the young girl, she began quietly sing such standards as "Do-Re-Mi" and "Mary Had A Little Lamb". The girl joined in.

I don't know who this nurse was, but she clearly had a great love of her job. To spend all her time caring for children - very ill children, no less - and show such patience and genuine interest in their every question and concern is simply amazing. I salute her, whoever she is.

My own x-ray seemed almost boring in comparison.

My name was called, sort of. "Leonar..." - the technician's last syllables were lost on me. No one else got up, so I did. The little girl asked the nurse if it was their turn yet. (Hey, I'd have given up mine for them, but it doesn't work like that.)

Once inside, the technician - old enough to have gray hair but not old enough to look close to retirement, low 50's I'll say - said "Did I pronounce your name right?"

"Ummm, I don't know. How did you pronounce it again?"

She pronounced it wrong. In the ballpark, but she asked so I corrected her.

She pronounced it wrong again, though differently wrong this time, and at least a variation I've used myself when trying to get people to spell the darn thing right. I just nodded. "Close enough."

"I knew some of them, up in Sydney. Cape Breton Island. You from there?"

"Not Sydney, but elsewhere on Cape Breton." (A lot of the people roaming about Nova Scotia with my name are my nth cousins.)

"Oh!" My heritage seemed to make me part of some extended family, as her questions - as she had me do the round-shouldered fashion model pose against the machine - suddenly took on a haven't-seen-you-in-a-while tone. "So, what are you up to these days?"

"About six feet." (Well, five eleven and a quarter inch or so. Shoe heels bump me over, and some people seem to treat six feet as a lot taller than five eleven, so I declare myself to be "about six feet.")

She laughed and said, "Yes, you're very tall, aren't you?" She hit a button on the machine and it - along with the chin-rest on the top of it that I was using - rose up about two inches. Not that tall, obviously, as it was plainly uncomfortable. She bumped it back down an inch. (See what I mean?)

As she went back to her little leaded glass enclosure, she said "My husband - he's a Russian sailor - knows a guy on ship who's 6'7". Take a deep breath and hold, please.... Okay, you can breathe."

The second shot conversation was mostly about how tall six-foot-seven is. Though I had a bit of a time wrapping my mind around the whole sailor thing. I picture this burly rough-and-tumble guy with a Russian accent. Doesn't seem quite like someone who'd have a five-foot-and-a-few-inches somewhere-from-North-America wife who looks like she bakes good cookies. Ah, well, stereotypes are like that. Best thing to do is ignore them in public and then goggle in private if you must.

Due to the structure of the hallways, I have to walk by the hall entrance to the glass enclosure on my way out. I heard the technician telling the person who went in after me that he was done. So, by the time I got my outer clothes back on and walked partway down the hall, they were finished with one more person. They move fast on chest x-rays.

Back down for the bloodwork. Now the clinic blood collection was almost empty. I got that done quickly. I noticed they have color-coded tube caps for I presume different kinds of tests. Mine are orange and black camouflage. I barely felt the needle for this one, by the way.

The blood collection guy had a nice trick. Holding down the gauze post-needle-removal with his left hand, he signed paperwork for someone with his right, then taped the gauze up.

An hour and change of sitting around in the lobby, and on to my oncologist's office on the 11th floor. (The waiting room up there is cramped, so I stayed in the lobby general waiting area.)

I register. The secretary says, "Okay, you need to get bloodwork and a chest x-ray...."

"I've done that."


"I got the chest x-ray an hour and a half ago and the bloodwork about an hour ago."

She's not used to people who think ahead, as she was clearly thrown by this. She recovered fairly fast, though, so she's not that much of a paperwork drone. "Really? Oh! Well, then, just take a seat in the waiting room down the hall and we'll be with you in a little while."

While I was waiting, a volunteer came in with a snack and beverage tray. I didn't have anything. My stomach was still chewing on breakfast. Nice guy, though. Just a bit insistent without being pushy. Good sense of humor.

Eventually, the oncologist's nurse came and got me, weighed me (Up a few more pounds!) and showed me to an examination room. She handed me a new bloodwork paper, and a new x-ray paper. To make sure they weren't expecting me to go get an x-ray, I said "I won't need a new x-ray paper for another month."

The nurse just said "Well, we'll let the doctor decide." I never like the sound of that.

One of the problems with the oncologists in Nova Scotia (where I've seen them anyway) is that they have no conception of time management. I understand that I have to wait, but calling me in for 10:00 so I can talk to a nurse at 10:10 and then sit around in an exam room until 11:10 before seeing a doctor is a bit much. (Granted, today was a bad example, but I always have at least a twenty minute wait between seeing the nurse and a doctor.)

Since I had loaned the book I brought to someone I know who was also enduring the wait in the chemo waiting room - I don't have a terribly lucky circle of friends - I was left with the exam room fare. One Chatelaine, a Reader's Digest I'd read in another waiting room a month ago, and an old People featuring a Big Deal Exclusive interview with Rosie O'Donnell. O'Donnell recently admitted (in a half-assed way after being accused of it in court) that she said something like the following: "You know what happens to people who lie? They get sick and they get cancer. If they keep lying, they get it again."

And if that ain't a kicker, she said it to a woman recovering from breast cancer. I had a hard time resisting the temptation to pitch the magazine out the window and see how Rosie fared against gravity and the tender attentions of the parking lot. Instead, I just moved the magazine to the bottom of the stack and looked out the window at the parking lot below. The number of near misses is amazing. I also saw, by looking at the faded paint vs. newer paint, where the old spaces were shrunk so more cars could be fit. Even the handicapped spaces were shrunk from double-wides to normals with an extra white chevron-pattern "no parking here" bar about 2 feet wide every two spaces. Presumably the handicapped person could be, er, unloaded into the white chevron area.

I also realized that the 6th (?) floor of the Dickson is attached to an entirely different building (it's not the Bethune building... maybe the Mackenzie?) by a 30ish foot glass-enclosed catwalk type thing that goes over a section of the parking lot. Man, that must be a hell of a view. I'm higher up, but I don't have cars zipping under my feet.

For entertainment, I counted the stories of the building. Despite the elevator going up to 13, I'm on 11 and there only seems to be one floor above me - not that I stuck my head out the window and checked, I just looked at the spot where the building makes a right angle at the elevator nexus. There's a lot of bricked-up windows on the 12th floor, and a few on the lower ones. The spot for a door seems to have been roughly hacked out of one window to make an access to the roof of a presumably newer addition.

I also heard people referring to this area as 11 Victoria, implying it's the 11th floor of the Victoria building, not the Centennial. I'm confused as to which building is where now. I was sure it was Dickson-Centennial-Victoria. Unless the central elevator nexus is actually part of the Victoria and I've been getting all this wrong....

(December 17th, 2003 AD: I was getting it wrong. I've fixed the errors on this page, so the various directions mentioned in previous items are, as written now, correct.)

These buildings have grown into each other so much that it wouldn't surprise me if it switches from Victoria into the Centennial in the middle of a waiting room. Then again, I've been walking around there so darn long I can get to most of the cancer-related stuff without reading the signs. Maybe that's it: Link rot in my brain.

As I was thinking about this, I noted that my oncologist had run by three times so far. Man, no wonder she's a twig. The last time she said "Be right with you!"

About twenty minutes after "Be right with you!" I'm greeted by something of a surprise. Not my tall, rail-thin, thirtysomething doctor, but a shorter (but not short), less thin (but still thin), twentysomething doctor. Short dark hair, glasses, and a nice smile that she was showing off. "Hi, Leonard. Remember me?"

"You're the doctor with the name almost like mine. Dr.... Petrie?" Two bloody letters off my name and even I'm afraid of mispronouncing it. Which seems even dumber when you realize that she pronounces it "Pet-ree", which is pretty much how it's spelled. Though I was sure she pronounced it "Pit-re" last time. Ah, well, one of us is going nuts. Evidence points to me.

She nods. "Yeah, that's me." She closes the door as we engage in a typical meet-and-greet conversation. Soon after, we sit down and discuss the regular medical stuff (Bowel, bladder, lungs all working without any blood or mystery fluids in the mix, etc. etc. etc.) as always.

My x-ray was good, last month's blood was fine, she'd looked over the previous month's CT scan and that was good....

Okay, I'm going to get into some odd details of the male anatomy here. Skip it if you want. Or, you can skip almost all the mentions of that part of the examination. It might get a bit confusing later, but I'll try fill you in.

This is going to sound like a bad sex ed video, except for the really bad warm-and-fuzzy ones that seem to discuss self-esteem as much as they discuss the whole idea of, well, sex. I'm glad I got my sex ed training from a medical encyclopedia (followed with a bit of porn to bring a bit of, er, life to the dry descriptions). I mean, the school program was pathetic. Somehow I fail to see how a young man's feelings of self-worth relates to his ability to accurately use his penis. It's not a complex device that requires a lot of deep thought and focus to use. If it did I seriously doubt there'd be so many damn stupid people around. They'd have all died off and left no children.

But, anyway.... I think most guys (at least my age) suffer this occasional annoyance. (Not being most guys, I can't really vouch for anything past second-hand idle comments.) There are some days where any change in the wind brings about an erection. It's not tied to any feelings of arousal, it just happens. Teenagers (raging hormones and such) suffer this worse than adults, but there's no such thing as immunity to it, unless I suppose a person has impotence, but I'd rather the annoyance.

This was one of those days, so I was glad I wasn't getting the testicular exam. The odds of it hitting during an examination were low, but nonetheless I was fine keeping my pants on. But, since I'm telling you this, you probably have an idea of what's going to happen.

Formalities dispensed with, Dr. Petrie asks if I found any odd lumps in my self-exams. I said no. I mentioned that I had thought I'd found a very small lump about a month and a half ago, but it vanished not five minutes later when I checked for it again. It could've been just paranoia, but was probably a pimple or some such annoyance. My regular oncologist had checked me last month and hadn't found anything anyway, even double-checking the spot I thought I'd found it, so no big deal.

Dr. Petrie said, "Yes, but I think I'd better check anyway."

Well, I really appreciate the thoroughness, since I don't want to die, but I remembered that it was one of those change-in-the-wind days. Still, what are the odds? I mean, there's about nil chance of it hitting in an arbitrary one-minute span.

Also, the sharp contrast between this and how quickly she decided not to check me last time upon realizing it was my "off month" was so obvious to me that it was almost corporeal. Who knows, maybe my oncologist and the resident non-doctor were having a good laugh about my size and she wanted in on the gag.:) But, hey, whatever. An extra exam just means I'm sure I don't have a visible lump, plus it's good for some cheap copy for the perverts who read this page.

Anyway, the doctor rubs her hands together and, with a diabolical grin, says "Now it's time for the physical examination!"

My instincts tell me that such a look on a woman means one of three things:
1) The next ten minutes are going to be rough but very pleasant.
2) The next ten minutes are going to be rough and very unpleasant, possibly involving jumper cables being clamped to my genitals.
3) The doctor is being a bit silly.

Number three seemed the safe bet, so I said, mock suspicion in my voice, "You look like you're going to enjoy this a bit too much."

She could tell the worry was theatrical (I'm a lousy actor) but said, "Nah. And I wouldn't want you to think we're forcing you into anything embarrassing here."

I said "No." and recounted my story about how two different nurses went looking for the mystery incision because they thought I'd been castrated instead of having some abdominal work done, despite the obvious gauze pile taped to my front. Her reaction reminded me of my surgeon's - amazement and confusion, with just a bit of frustration at the vast number of drones who believe paperwork and computers before (the rather blatant) reality.

(Which is rather amusing, since she reacted a lot more neutrally last time I recounted that. For some reason I'd entirely forgot I told her before - I had to check this page to find out. Hmm. Perhaps she's relaxed enough around me - or patients in general, though I'd doubt that - that she's being more expressive. Which is cool.)

I put my dress shirt and t-shirt on the chair I'd been sitting on, below the window. This is when the doctor noticed the window blinds were open and thoughtfully closed them for me. No show for the parking lot, 9 floors down. (This was on the 11th. The ground floor is the 2nd, for reasons I've probably already gone into. It has to do with building on a hill.)

I still had the bandage from the bloodwork on. Normally I sissy out and pull the bandage off carefully. But there was a woman present, so I of course did the manly thing and ripped it off with nary a flinch. (Mostly because it didn't hurt anyway. The paper tape had lost a good bit of its adhesiveness in the past two hours. You're not supposed to leave 'em on that long, anyway, but I always forget.)

We spoke for a bit on matters of embarrassment and cross-gender medical exams and I said again that I wasn't bothered. Of course, while I'm saying it I'm lowering my pants to my knees and lying down on the exam table - which was a hospital bed, actually - so the point was perhaps overdemonstrated. I said "You're a doctor, you've seen one of these before." I added, in a voice thick with boredom, "Wooo, it's a penis. Wooo."

I don't think she was expecting me to be so, for lack of a better word, unenthusiastic about my own manhood, or perhaps to mention it at all. Hey, I live with the darn thing. Familiarity breeds contempt. She's a doctor. She's probably seen cadavers better hung than I am.

She got a blanket from a convenient cabinet and covered me over, waist-down. Then she started checking the lymph nodes in my neck.

Lying in a bed, under a blanket, getting the sides of my neck rubbed, with less than six hours of sleep last night. In this situation, I do what's natural. I yawn. Thing is, I realize that this isn't the best thing to do right now, as my doctor might think she's hurting me, so I try stifling it. Which, not thinking, just makes it look worse, since the stifle looks like a grimace.

She pulled back pretty quickly and I wound up having to explain that the bed was too comfortable for my own good. She understood and kept going.

Now, remember that whole change-in-the-wind thing I mentioned before? I realize, as this is going on, that the wind is changing. Okay, this is a bad time for it. While it wasn't a proper erection, as an erection requires one's penis to be, well, erect, I realized I was feeling some blood retention and expansion. This could go either way. I was struck with two simultaneous thoughts....

The first thought was that I needed to not think of anything erotic, even though I wasn't thinking of anything erotic to begin with. Let me explain how that works: Don't think of an elephant.

Bet an image of an elephant popped into your head, didn't it? You weren't thinking of an elephant and POW! Now you're thinking of an elephant because I mentioned one. (If you aren't, make like you are anyway.)

In other words, despite not thinking of anything erotic and feeling an, er, reaction, to begin with, I was in a situation where actively avoiding thinking about it might just make it worse.

The second thought was that if I could figure out how to hold myself in this flaccid-yet-expanded state for any length of time, I could teach it to other men (for pay) for when they're in locker rooms and that, so they could look larger and inspire envy.

What the hell prompted the second thought, I don't know. I do still think it could be a viable business venture, though.

I was suddenly very grateful for the blanket.

I started trying to formulate a way to gracefully introduce a comment into the conversation about it, since I felt that it would've been unfair to just wait for her to, er, find it herself, but the best I got was "Hey, while you've had your hands on various parts of my body over the past few minutes, any erection I may happen to have has absolutely nothing to do with you. No offense, but I don't think about doctors like that."

But, being very thorough, it was a while before she got down even as far as my stomach (underarms, lungs, heart, etc.) and the wind, er, died back down. So I just kept quiet and pretended it never happened. I was still grateful for the blanket. Maybe that's what it's for.

That crisis averted, I had more time to focus on what's going on.

One thing I learned is that you're supposed to breathe through your mouth when they check your lungs. I guess the obscene phone call sound comes with the territory.

Just like the last time she checked me up, I had to do the thing where I breathe and she pushes on the spot just under my ribs. This time she hit something on the right. I didn't think much of it. It didn't hurt, and the resident had mentioned that my liver and spleen were thereabouts (one to a side) anyway. I was struck by the thought "Wow, I know exactly where my liver or spleen is. I need to find out which one is on the right." Location of my internal organs seems like something valuable to know. I can guess at the ones that move, like the stomach and heart, but the liver is just so quiet I forget it's there. Same with the kidneys.

She also checked the lymph nodes in my upper legs and groin. I had to suppress a giggle. More on that later.

Then she said "Now to check your testicles. Er, testicle."

I said "Yeah, the other one's probably in an incinerator somewhere."

I just realized that normally we (as in me and any doctor*) don't speak during this part of the examination. Like there was some unspoken rule to never talk of my late and barely lamented right testicle while she has her latex-covered fingers poking at my left. Even last month, when the oncologist asked me (during the examination) if I'd felt any lumps during my own examinations, she quite deliberately removed her hands from my body before speaking.

(*Except my urologist who tended to mumble observations out loud, oddly like a mechanic does when looking under the hood of a car or a computer person does when cracking a PC case. I found out some odd stuff about my genitals that day.)

After I got dressed, I mentioned something about when she checked the lymph nodes in my groin area. I recounted what happened when the not-quite-a-doctor resident, Heather, did that examination on me. (How about a flashback?)

When she was checking some lymph nodes in the general area of the incision, she noticed the surgical scar. "Oh, and there's the scar."

"Hmmm? Oh, yeah. I don't notice it that much."

"I can see why. The area is kind of... uh... kind of... uh...." (Embarrassed pause.)


"Well, uh... yeah."

Dr. Petrie got a good laugh about that one and said that one of the tricky parts of these examinations was striking the right balance. They want to put a person at ease, but for some people anything but very formal and serious is 'getting too friendly' and anything warmer than 'civil' just makes them more nervous, not more relaxed.

She said something like, "It's about the difference between being formal and being professional. You don't want anyone cracking jokes while doing that examination."

"Or laughing hysterically."

She smiled. "Yeah, that too."

I then mentioned the anecdote Heather told me about the doctor with testicular cancer whose greeting back to the land of the conscious (post-operation) was to hear a nurse say "His was the smallest we'd ever seen!" and how he really hoped it was the tumor they were talking about.

Dr. Petrie winced a bit in empathetic pain. "Ouch."

She went to get my oncologist. Another ten minute wait. Both of them came back.

Now, a word about my regular oncologist. She's smart and everything, but her memory seems to be capable of outsmarting her. Sometimes she forgets stuff. Hey, we're all human. But sometimes she figures she'll forget, then does whatever she intends to early. Problem is, then she doesn't forget it. She only forgets that it's already done, and she does it again.

So it was when she pointed out the bloodwork paper I'd been handed before. "It's the same as before, except we're doing a testosterone test."

"Like this month?", I asked.

"Come again?"

"Like this month...?"

She's clearly forgotten that she decided to do it a month early, which I thought was a safeguard in case she forgot to do it this month. "You got one this month?"


"It was checked on the form you used this month."


"Just like this."


Entire sitcoms have been written around dialogue like this. Not good ones, mind, but sitcoms nonetheless.

Eventually she writes a note to herself and says, "How about if we phone you with the results and if they're fine you can cross that one out?"

Fine by me. Details of when people are home and such are sorted out. Then she goes on to mention what the testosterone testing is for. She mentioned my fertility.

I said, "Well, that part I'm not worried about for the time being. I don't even have a girlfriend. Not easy to be fertile when you don't have girlfriend."

My doctor just said "That hasn't stopped some guys." All I could think of that fit that and wasn't illegal or involving surrogates was a sperm bank. Problem is, in thinking about a sperm bank, I missed the rest of what she said the testosterone testing was for.

I did some checking, and here's what I found could be the results of lower testosterone levels, from a legit-looking website:

1) Low libido. I seem to have a good reaction to all these women feeling me up....;) But seriously, no complaints. I'm not lusting uncontrollably, but then, I never did.

2) Depression. Nah, that's just my personality.

3) Loss of body and facial hair. Not with how often I shave. Hell, if I could be given loss of facial hair for free I'd take it.

4) Feeling lethargic. No more than normal.

5) Menopausal-like hot flashes. Dr. Petrie asked me about this one. Nope. (Though, in retrospect, how would I know what menopause feels like?)

6) Progressive decrease in muscle mass. Well, I've been lazy lately, so I can blame my weakling arms on that.

7) Impotence. Sometimes my body reacts even when I don't want the darn thing to. So no.

8) Semen containing little or no sperm. Kinda hard to tell by myself.

So I feel okay about my odds. Anyway, back to story.

The oncologist asked something I didn't quite catch due to unfamiliar terminology. Dr. Petrie responded "Yes, but...." and they started lowering their voices and using more Latin than is perhaps good for a conversation. This ticked me off a bit, since they were clearly talking about me. It's one thing to be stuck between two professionals talking shop, it's another thing altogether when that shop talk involves your chances of making it to your 30th birthday.

Suddenly Dr. Petrie turned back to me and asked "When I pushed on your stomach, you didn't notice anything odd, did you?"

"Like what? All I felt was my liver or something." I figured if I got it wrong they'd correct me. They didn't. (I've also checked an encyclopedia and my last few updates to this page. It's my liver on the right.)

Dr. Petrie looked at me a bit odd. "I thought you said you didn't feel anything."

"You asked me if it hurt. It didn't. I felt the pressure of you pushing down and I felt you hit something."

More mumbling and finally Dr. Petrie said, "Well, since your x-ray this month looked normal and your CT scan last month was fine, we won't worry about it." The issue was dropped there. I'm not fond of that, to be honest.

Seems my schedule of visits has changed yet again, thanks to some cryptic policy shift. Originally, it was going to be once a month for a year, then once every 3 months. Then they decided it would be once a month for 18 months. Now, it's once a month for the first year, once per two months for the second year, once per 3 or 4 months for the third.... Though this is all subject to change. As it has before.

To explain this, my oncologist said that "80% of recurrences occur in the first year". I'd heard that statistic before, so I didn't bother thinking much on it.

Suddenly Dr. Petrie pipes up. "What she means is that only about 20% of people have a recurrence. Of the 20% that do, 80% have it in the first year."

My oncologist frowns and looks at Dr. Petrie. "Why? What did I say?"

Dr. Petrie says "You just said that 80% of recurrences occur in the first year. You made it sound like it is going to recur."

"Oh! No! No! It only comes back in 20% of people."

The conversation started leaving me behind again. They started discussing odds more specifically, referring to studies and such. The main gist of it all was that the odds of it coming back are more like almost-none to 40%, averaging out to 20%. Each of three things boosts the odds:

1) High AFP level pre-operation. I didn't have this.
2) Lymphovascular invasion. Put simply, the cancer was spreading. I didn't have this either.
3) The most important: One of the cancers was embryonal carcinoma. Er, well, the song says two out of three ain't bad....

Feeling a little left out of the medical chatter, I cut in and said I knew I had that one, and I named the other three I had. They know them, of course, but I did it more to remind them that I wasn't entirely ignorant.

I also noticed that my oncologist pronounces "embryonal" not as "em-bree-on-al", or "em-bri-un-al" but as "em-bri-nal". According to my more exotic sources, this is valid, if not very common. But if I hadn't inferred the word from context, I would have made the serious faux pas of asking what brine had to do with this, because when she first said it I swear I thought she said "brine".

Eventually they stopped discussing the specifics and gave me flat 20% odds of having a recurrence before my first year ended. Then they remembered that was next month, so they bumped the odds to "pretty low".

The doctor didn't mention the x-ray form at all. I figure I'll just keep the form for next time, 3 months away.

My oncologist vanished again and left Dr. Petrie to set up the dates for my next appointments. However, she didn't say what specifically to set up, except for some comments on a CT scan sometime in December. So I wound up helping Dr. Petrie get the right dates for the requisition forms. Kind of feels silly when you have this person with more diplomas than I'll ever see and she's playing secretary to me. I'm staring at a calendar saying "The tenth is twenty-eight days away, so that's when my appointment here will be. So, the CT scan will be the ninth. Bloodwork can be done the same time, the results should be here for my appointment. Any idea if I can get a morning doctor's appointment?"

Some sorting out of things later and Dr. Petrie walked with me to the main desk. She handed the appointment papers over and wished me well. I bid her a good day and she left.

Of course, while in the exam room Dr. Petrie is more doctor than woman, but when she was walking away I felt free to let myself acknowledge her more as a woman than a doctor and took some appreciation in how well the skirt she wore complimented the way her lower body moved when she walked. Man, running around this place all day must be good exercise.

The secretary had finished typing the appointment info and said "Hmmm. That's a quick return appointment. We only have noon on that day open."

Oh, well. However, I wonder about the tight schedule. A few months ago I usually had my pick of three different appointments on the day. Since it's been moved up here, I need to grab the last one open. I said, "Seems to have got busy since my doctor moved here."

"Well, I think it's the time of year. Seems more people get cancer in November and December."

I sigh. "How ironic."

It took her a second, but she got my meaning. (Merry Christmas.)

She continued on "Okay, we'll try getting your CT scan for the ninth. It's not a sure thing, though."

Given the price of motels and eating out, I hope they can get it that day. I can't stay up there too long. "Well, they've done it about five times this year, here's hoping they'll do it again."

"Well, that's good. And you'll get bloodwork done. Try to be here around eleven AM for the bloodwork."

"Uhh.... How about if I get the bloodwork done the day before when I'm in for the CT scan?"

"Oh! Yes, that would be good! All you have to do is come here for the form...."

I held up the form. "Already got it."

She was plainly impressed. "Wow! You're really on top of things! That's great!"

I just thanked her, but she kept on going about how great I was while she finished writing out my appointment reminder card. Man, if I'm such a gem in the rough for doing this, how many morons do these people deal with in a day?

And, with that, I got out of town.

Ah, it's currently Wednesday, 10 Dec 2003. I've been staring at either a moving road or a stationary keyboard most of today. Please forgive any random wanderings of thought, or of tense.

I'm dropped off at the Dickson Building around 1:10 on the 9th. I realized a bit before this that I forgot to shave my arm. Uh-oh.

Since the hospital clothes are short on pockets, I've left my wallet with someone I trust, who will be picking me up later. All I have other than my clothes are a book (not a good one) and my health card. I felt kind of defenseless without my wallet. There's not much in it, but I still felt a bit lost without it.

My appointment's at 2:10. Plenty of time for bloodwork, especially since there were only two people in the clinic blood collection waiting room. It was a slow day overall, because one of the technicians came over from the other side (The normal blood collection and clinic blood collection areas are connected in back by a small hall - well, actually, a place where they didn't bother to put up a partition in what was once a larger room.) and started getting people. Meaning me. So, ten minutes later, I'm heading for the CT scan registration. It's a simple choice: Wait elsewhere fully clothed or wait there in hospital clothes and hope that someone cancelled and you can get in early.

Waiting to register, I think I finally see the Victoria/Centennial break, at least if wall color is any indication. And it almost DOES change in the middle of a waiting room. If you cut along the break, part of the CT scan waiting room would be cut as well. And yep, I've been switching the names of the two buildings. I've fixed all the offending errors for this upload, so I think everything's okay now.

I also hear a commotion from the waiting room. Sounds like an argument, with two people trying to talk over each other. But I can't make out any specific words.

It's a different person doing the registration today. In addition, they've moved the PC in registration from one section of the L-shaped desk (which is really a desk affixed to a similar-height wall cupboard) to the other. Now I have to look over or around it as I'm talking to the registration person. It's like watching a movie when behind someone with a tall hat. She asks what my chart number is. I recite what I think it is - I left my appointment reminder card with chart number on it in my wallet, since I knew when my appointment was - and tell her I'm just guessing. She tells me she wouldn't normally ask (they don't, usually), but then she showed me the faxed-in requisition form. My chart number was a string of blurs that could have been eights, sixes, or threes. (One elevator and hall away and they faxed it?) And by twist of fate, my chart number is nothing but sixes and threes. She wasn't too bothered that I was unsure about my number. She said "Well, if it's wrong, I'll hear about it."

I said "I bet." She laughed - a bit bitterly - and agreed with that.

I get my hospital clothes, and I go change. Putting my clothes in a waiting room locker, I realize that the argument wasn't an argument. It was two people who both evidently liked hearing themselves talk. Two males: a middle-aged Caucasian loudly speaking English and an elderly Asian loudly speaking a language I can't place beyond "from the continent of Asia". Shows you that loudmouths are universal.

I sit down in the far corner. A young blonde woman who registered just before me, my age or a bit younger, is a few seats over. College student - she's clearly reading a textbook. The room empties as patients and their spouses (like at least one of the loudmouths) leave. Eventually it's only me and the student. I half-consider saying something, but it's hard to be witty when you're feeling a draft up your johnny shirt. (Whatever scan she was getting, she kept her jeans on. I'm thinking chest or head scan.) She had read the same page a few times, looked like, so she gave up and put the textbook (which I then knew was a marketing textbook) in her backpack.

Hey, cute way to avoid the locker thing.

Around 2:30 a woman - the one who usually does the registering, wearing a surprisingly somber red sweater and black slacks - comes by. She smiles at me. I smile back. Nonverbal communication's not my style: I think I understand she wants me to follow her, but she has yet to actually make any indication that that's what she wants. She stands at the door a few more seconds. Okay, this isn't working. I point to myself. She nods. Seems like that's all I'm getting. I get up and follow. She gets me my third drink of gastrografin and takes me to the back room of the CT scan area. She asks questions about my allergies (I have none I know of) and my liver/kidney problems (I have none), then asks if I've done this before. I have, and I say so. I ask if I can drink yet. She goes to check with someone in the monitor-and-computer packed leaded glass control room, separated from here by a wall with a small doorway in it - similar to how the control room is separated from the CT scanner - then shouts back "Don't drink it!". Okay.

I spend about ten minutes waiting. The male technician I mentioned in June walks by. I wait some more. Meanwhile, the woman who normally does the registering was sitting in a small partitioned-off area, phoning various numbers and navigating through the "Press 1, Press 2" phone systems. (Speaker phone, I heard it all. She was punching through the menus as fast as you'd dial a number.) All while singing Christmas ditties along with the radio.

Another woman appears, whose age I can't fathom. (Her face looked 10 years older than she did, for lack of a better description.) She set up the IV. It wasn't bad, though it still hurt a bit. Fortunately, though, she did everything right as far as having the IV line ready to go was - indeed, everything but the needle itself was set up and ready to go when I got there. Also, she - without gauze - started the IV with my arm resting on a pillow and didn't get one drop of blood anywhere on the pillow. (As in my CT scan horror story, though that doesn't compare to a nurse I saw at the Strait Richmond last week who not only took 3 shots to get an IV going, but was spilling her own blood all over the place through an open hand cut. Real sanitary, that place.) After wiring me up, she put tape on my arm. The third piece, she did something genius with. Since this was my left arm, she put the third piece on my watch strap. I said that was a very good idea.

After she left, I kept reading my book. It's a feat to turn pages with one arm. While I'm reading, a paramedic-type person (woman, young, fairly small height/build) comes in and sees an unused stretcher in the corner. She asks the CT scan people if she can have it. They say yes. She tells me "You're going to get a bit of a show!" and leaves without elaborating. About five minutes later she comes back with another paramedic (woman, late 30s maybe, tall) and an older woman (a full 60 years older than I am, judging by some comments I heard) on a stretcher, the kind that goes in the back of an ambulance. So begins the show, where they grab hold of the sides of the bedsheet, lift the woman up - the smaller paramedic didn't look strong enough to, but was - and transfer her from one to the other. During this moving around, I notice that the woman's johnny shirt is riding up dangerously high. I was debating mentioning it, since it would be a bit embarrassing. I figured if they were going to take her out of the room like that, I'd say something, since the minor embarassment now is better than having her show her lower torso to the entire building. Eventually, though, they covered her over with a blanket (After she complained about how cold it was - between the cold room and the draft she must have been getting in a fairly delicate area, no wonder she was cold!) and wheeled her out.

(Mere instants after covering her, one of the paramedics had asked if she felt warmer. The woman responded with a "No!" She wasn't really angry, she was just a bit put off that they asked her that before they even had the blanket tucked in. They might warm blankets, but even so it takes a few seconds for the heat to sink in.)

Some time later, I'm called in by the male technician. They never take me through the control-room thing (I suppose I can't blame them). Instead, I was led back out into the hall and back into the room through the other door. I'm loaded into the machine, and the technician asks me if I've had a scan before. I said "Yeah, one every two months this year." He asked me if it'd be slowing down soon, and I said "Yep. I'm currently having monthly doctor's appointments" - I deliberately avoided the word "oncologist" - "but that'll be changing to once every two next year". By now I've been moved into the machine. Scan 1 (the shorter) goes like normal. The technician comes out and hooks me to the dye. And then he says "Uh-oh." I hate hearing that. The IV's not moving. Something in my arm seems to be blocking it. So, to try keep from having to redo it, he fiddles with it for a while and finally gets it going. "Now it's moving, er, like a river!"

Oh, what an image.

Someone calls him back behind the leaded glass. A minute later he comes back and tells me they'll need to repeat the scan, as my lower body isn't quite in scanning range. I move up a bit and get re-scanned. Now the guy comes out to stuff some more pillows under my immobile arm (which was nice) and finish explaining the dye thing. Then the machine starts the "breathe in/breathe out" recording before he was expecting it and he vanishes mid-sentence.

The scan was shorter than I expected. I opened my eyes. I was still in the machine. Before getting a grasp on things, the "breathe in/breathe out" recording started again (this is now the fourth time total). Finally, it's finished. The warm gonna-crap feeling lasted a lot longer than normal, as well.

When all was said and done, I was lowered back to floor level. The technician ripped both pieces of tape on my arm (not the watch one) off at once, very quickly (and without warning me) so that was at least thankfully brief. He helped me up and said that while it wasn't from the dye, some people got a bit woozy because they got up too fast. I told him that I was careful getting up, after a little run-in with vasovagal syncope where I got up from a chair and next thing I remember I was slamming headfirst into a door casing 6 feet away. (I found out later that I stumbled the entire way there, picking up speed as I did.) He said "Ouch!"

I said, "Well, a foot to the left and I'd've* been pitched into a television."

"Oh! I was about to say I couldn't think of something worse than hitting a door casing hard, but, uh, I guess there is." We exchanged pleasantries and I left to change.

(*Yeah, that's a double contraction of "I would have", combining "I'd" and "would've". Grammarians may now wail.)

I found out later from my wallet-holder that, when she arrived, the young woman asked who she was looking for. The young woman described me and said which locker my clothes were in. Despite getting in sometime after me, she was done, dressed, and gone before I was finished. I guess they have another scanner that I've never seen. I've been using the same one all the time.

When getting the Gastrografin for next time, both women (the regular register person and the one who was there today) are there. I ask for some, and the regular one tells me again to check the drawer. I go for the cupboard, but it's not there. Seems they took down the cupboard! Now it's in ANOTHER cupboard, placed inconveniently so I have to reach over the computer that one of them is using, open the cupboard by pulling the door towards me, reach in, (again, over the PC & monitor), then grab a bottle with a cap I hope isn't loose, take it, and close the door. I manage to get one, and the woman who was there just today asks if I need any help with the instructions. Before I have a chance to reply, the regular one says "Of course not! He's done this plenty of times before!" so stridently and suddenly that I think she scared both of us. I leave, wondering what the next day has in store for me.

I arrive bright and early for my 9:00 AM appointment. (Rescheduled from noon due to a sudden meeting the doctor had to be at.) The secretary-type at the registration desk looks over my paperwork and says "No bloodwork or tests for you today."

I was about to say "Because I got them yesterday." but she cut me off and asked me if I knew were the waiting room was. Still groggy and somewhat cranky from my 5 hours of sleep, I just answered "Yes." and went there.

Some time after nine the nurse comes and gets me. With her is a young woman who looks like a (stereo)typical doctor - lab coat, stethoscope, whole nine yards. Only thing to disprove this is the "RN" badge she's wearing. My oncologist's nurse introduces her to me as a trainee nurse who's tagging along with various people today. I offer my hand and say "Pleased to meet you." she didn't seem to expect it, as she gives me a surprised look before shaking my hand.

I'm still the same weight. My exercise (finally back on a daily schedule, starting slowly so I don't pull another muscle) is starting to pay off.

In the exam room, it's the same questions as usual (checking that I haven't started any new medications, bowel/bladder working fine, etc.), though I notice that the nurse is acting a bit different, presumably because of the trainee's presence. She usually says something like "Bowels working fine? No problems with the waterworks?" - the euphemism 'waterworks' is a constant with her. She's never used 'bladder' or 'urinary tract' that I can remember, and she's always referred individually to solid and liquid waste disposal. But this time she asked "Are all your bodily functions normal?" without elaborating.

After I mentioned that I didn't have any complaints, the nurse turned to the trainee and said "He's one of the good ones." Judging by her smile, it was meant as an in-joke. The nurse asked me if I'd done any Christmas shopping. I said no. She said "Oh. No time, huh?" I nodded. Get out of the CT scan department at 3:30, eat supper, go to a motel on the other side of Halifax and you don't have much time for shopping anywhere.

As they leave, the nurse tells me that I might be meeting with a new resident. However, maybe not. Turns out not: My oncologist, the trainee RN in tow, comes by. And only a few minutes after the nurse leaves. The haste surprised me.

After standard pleasantries, the doctor says that it's just about my one year anniversary. I weakly toss my hands up and give a flat "Yay." In a way it's good, I'll grant, because it means that I've been one year without the cancer coming back, but it also means that one year ago I had cancer! As I was sitting there, on the tenth of December at 9:45ish, it was my one-year anniversary of... (Clicks Windows calendar back to 2002.) Let's see. Surgery on the 17th. The urologist had wanted me to get the surgery "next Tuesday", so I saw him on Wednesday the 11th, I think. Meaning that in 2002, December the 10th, at 9:45 I was likely sitting in St. Martha's in Antigonish, waiting for my doctor to fax down a copy of the requisition form that St. Martha's had lost. I knew it was something serious, I presumed cancer. I'd also been party to an argument in the hospital elevator by this point. Hell of a thing to have an anniversary for, huh?

Doesn't seem like a year, though.

Anyway, back to the present: My oncologist tells me everything on the CT scan was fine. Since she didn't mention any oddness about it, I presume the whole double-scanning thing turned out okay.

Time for the physical examination. After I sat on the exam table and untucked my shirt, she put the stethoscope up the back of my undershirt and had me do the breathe-in-and-out thing. During this she said that "We've had some cancellations from around where you are. Is the weather that bad, or do they just not want to see me?"

After she finished up and had removed the stethoscope, I said "Well, it wasn't bad right where we were...." And it wasn't. The storm front that hit Nova Scotia had made a spontaneous direction change and missed us completely, sacking-in the northern half of the island instead. Even on the mainland, Antigonish, an hour and a half closer to Halifax, was buried a lot more than we were.

Before I could finish the thought, she cut me off and said "So you're saying they just didn't want to see me?"

She meant it as a joke, but I have this policy about never insulting a woman who might possibly have my remaining testicle in between her index finger and thumb in a few minutes. I hastily said "No! No! It's just that, er, the weather was kind of funny."

Lame, I know. But I'm running on 5 hours sleep here.

Then she asked me to lie down. She checked my liver but was not half as forceful as Dr. Petrie. No wonder she didn't hit anything. She asked me if I'd done any Christmas shopping. I started to say 'no', but she cut me off and said "No money, huh?"

Well, that threw me off. It was as true as what I told the nurse, I'll admit, but it wasn't something I was keen on admitting. (The economy sucks and getting a job where you have to take 2 days off every 28 days isn't easy in the best of times.) Still, I was so thrown that I just said "Yeah...." I wonder what the trainee, present for both my answers, thought.

Now, here's the odd thing. While I was still thrown from her money comment, my oncologist reached inside my jeans. Okay, this is new. But having been through this enough, I could tell by feel that she was checking my groin lymph nodes. (For those not in the medical know - one's 'groin' extends fairly high. As a rough estimate, if you have pubic hair there, it's your groin. So she was pushing on what most people would call my lower abdomen.)

So, she's got her hand wedged between my jeans and my underwear. I haven't even undone my belt, so it was a fairly snug fit, even given her thin arms. While I knew what she was doing, watching this going on was in some ways more embarrassing than if I'd just lowered my jeans. I wore clean underwear, just put on this morning. Hell, it was even brand-new. Never before worn by human butts. I had nothing to hide. (All my new underwear is saved for medical visits. After one or two medical trips, it's downgraded to "going out in public" underwear. Eventually the elastic starts perishing (going brittle) and it becomes "at home underwear".)

I said, "Um, do you want me to, you know, remove something to make this easier?"

She said, "No, I'm just checking your groin lymph nodes."

Oh, and if you're wondering where the trainee nurse is, she's sitting down watching this. Though, due to her position, even if I weren't wearing pants she couldn't see anything.

After my doctor finished with my groin, she checked my ankles (more lymph nodes). She asked about any strange lumps on my testicle - notice she was well clear of my groin before asking? I said "Nothing I couldn't write off to paranoia." I chose the phrasing to judge her reaction. Presumably the CT scan didn't show anything funny, because she just shrugged it off. Or she trusts me.

She had remembered the whole Trading Spaces thing from a few months ago. She asked me if I was very "crafty". She said she couldn't picture me with a glue gun. Well, no, I'm not very craft oriented. Especially since the last use of a glue gun on the show was when Hildi Santo-Tomas glued goose feathers to every square inch of the walls of a bedroom. It's almost an insult to intimate I'd brandish one of those things.

After all that was said and done, my doctor filled out my forms (another x-ray one, and a bloodwork one, and the next appointment one - my CT scans and x-rays are still going to be every two visits, so they're staggered to every four months now). She tried to set the appointment for eight weeks from now, but the cross-year thing messed up her already shaky calendar skills and she set it for nine weeks. I didn't complain. (As it was, the desk secretary, upon being given the form, with the date on it, either misread it or realized the mistake. She set it for eight weeks.)

My doctor spoke to the trainee nurse for a minute, saying something like "Cancer of the testes really requires a compliant patient, because of how high the surveillance is in the first year. Monthly visits, bimonthly CT scans, bimonthly chest x-rays."

Compliant? As in, someone who doesn't complain about coming in once a month and going through this? Or (more likely) someone who doesn't cancel or otherwise avoid going regularly?

The doctor continues, "Did you see any cases of this at the children's hospital?"

The trainee and I both give the doctor a funny look. While I can't vouch for why the trainee looked like that, I'll explain myself: Testicular cancer is uncommon to begin with and also a young man's disease. Some older men do get it, and some children do get it, but I'm smack-dab in the "normal" age group for it. And when children get it, if it's one of my four (teratoma, I think), it's not even malignant - it's considered benign. They remove it, sure, but they know it's not going to come back in the chest or anything. (I'd presume hormone changes during puberty gives it what it needs to get dangerous.) There's probably vanishingly few cases being treated by the IWK doctors, and the odds of this one nurse working with that one doctor during that one appointment are, by my estimates, low.

The trainee just said "No, I haven't."

My oncologist didn't mention the testosterone testing (which they never did phone me about) so I brought that up. She looked back at her papers. "The lowest it should be for an average male is eight point nine, and you're... seven point two. Not low enough to recommend supplements, but low enough that we should test again in three months. Oh, wait, we did this last month, so your next appointment is three months." She took back the bloodwork paper and checked off testosterone. "Thanks for reminding me."

"No problem."

As they were leaving, the doctor turned to the trainee and said "I have another patient who says that testosterone levels are higher in single men than married men - he reads stuff on the Internet - " (Here she shot me a funny look that left me mildly nonplused.) "and now that he's divorced, he's expecting a change. There's actually some data to back this up. The thing is, single men tend to be younger than married men, so their higher level most likely comes from that."

I used the break in the conversation to say "Ah, the wonders of mistaking correlation for causation." My doctor stopped mid-stride, turned back, and looked straight at me.

The look reminded me of what I'd expect of an immigrant, living in a country where no one speaks their mother tongue, who just heard words in their original language.

All she said to me was "Yes, that's exactly it."

I bowed slightly. She bid me a good day and left.

Go back! Back I say!
Run along home.
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