Of CT Scans and Kings....

(Year Three)

February 24, 2003 AD - December 10, 2003 AD: Year one of my misadventures in oncology.
January 20, 2004 AD - December 12, 2004: Year two of my misadventures in oncology.
March 9, 2005 AD: My first trip of year 3 is fraught with danger. Okay, not danger, just lots of inconvenience.
June 14, 2005 AD: My second trip was commemorated by having almost everything done to me twice. Not looking forward to number three.
September 21, 2005 AD: Trip #3 was mostly mundane, until I got my bloodwork back.
October 17, 2005 AD: My second shot at providing a healthy bloodwork sample, this time in Antigonish. Featuring an Educational Moment on enzymes.
December 13, 2005 AD: And Year Three closes on an off note, but not before a flu shot detour.
????, 2006 AD: Year four is finally upon us.

Ah, what an interesting trip this was. Interesting like the Chinese curse.

March 8th, a day before my supposed scan, I got a call from Colorful Dress Lady of the CT Scan department. Apparently the scanner was broken, and I wouldn't be getting my scan and they'd reschedule for later in the week. Easy for them to say, they don't live four hours away. As it was, at least I got out of drinking the vile Gastrografin, though that wasn't to last for long....

No matter, I decided. I had to go in that day anyway for bloodwork, and would just ask my oncologist's nurse what to do. Maybe this time would be a chest x-ray, not a CT scan.

First stop, CT scan department. The scanner is indeed broken. The woman behind the registration desk (not Colorful Dress Lady) says tomorrow is a possibility.

Second stop, 11th floor. My oncologist isn't in today, but her nurse is. Thing is, she's not on Victoria 11, she's in the cancer center on Dickson ground floor. Whee! More elevator rides! But first I got my blood taken in the pleasant and wait-free confines of the 11th floor blood collection room. One elevator shaft and one hall later, I took a number and waited my turn. I explained everything to the registration desk person, after a few false starts.

It started simply enough, with the desk person asking, "How can I help you?" I told her who I needed to speak to. "That doctor isn't here today."

"I know, but I was told her nurse is."

"Yes, she's here."

"Can I speak to her?"

"She's not here today."

"Er, what?"

"I said, she's not here today."

"Not the doctor, the nurse. Can I speak to her?"

"Yes. Oh, wait, she's probably on lunch. So no. You'll have to wait." Fortunately, before I could beat my head against the desk, she did me the favor of phoning someone and finding out where the nurse was. As she dialed, she asked me "What did you say your name was?", but was cut off repeatedly by someone who kept switching between her and another person:

"What did you say.... Yes. No. Okay.... What did you say your name.... Yes. I need to find someone. Yes. What did.... 1643? Okay." She hung up the phone. She started dialing again. "I'll get it out yet. What did you say your name wa.... Yes, I'll hold." Finally, I blurted my name out. After some more talking to random people, the registration person said, "She's on the eleventh floor?"

I collected my jaw off the floor and insisted "They said she was here!"

Some more talking and the registration person hung up. "She is on the eleventh floor. You missed her."

Back down the hall and up the elevator, I got to the main desk at 11 Victoria again. After waiting my turn, I heard "You just missed her!"

"This time or last time?" (If it's this time I'm sitting on the desk and waiting it out.)

"Last time. I'll go get her."

Fortunately, she'd been briefed on what had happened by the time she saw me, and explained, "I phoned the doctor and asked her. She says to wait and see if the scanner's fixed tomorrow. We'll see if we can get you an early appointment. The only problem is that means you have to drink that Gastro-" She stopped and grimaced. Either she's great at empathy or she's had it before. I nodded, said I'd get some from downstairs, and take it that night.

The only catch is that I can't eat for four hours before my scan. Since I didn't know the time of the scan, I couldn't eat from four hours before I expect to arrive at the hospital, at 9 AM. So much for breakfast! Oh well, I've skipped it before and I'll no doubt skip it again.

I also had to procure a measuring device so I could sort out a 20 ml dose from the bottle I'd taken. Trivial enough, though all the local drugstore had was a child's medicine spoon. Hey, whatever works.

Incidentally, I took the twisty-turny stairs down from 11 Victoria North after meeting the nurse, since whenever I use that elevator down it seems like people need to stop at floors 5-9 inclusive. The stairs only get twisty and turny one floor away from the ground floor; everything else is fine. Though I did notice that most of the odd numbered floor doors are sealed off - you could get into the stairs, but not back out. One floor (one of the few with a window in the door) also seemed to open onto an office, rather than a hall like the others. Two people (a doctor and secretary, it seemed) sat chatting, oblivious to the crazy rantist peering at them through the door.

The next morning was fun. High winds (branches over the road swinging dangerously - they'll never cut them down, Haligonians like the "atmosphere" even if it means people get killed) and snow combined to drop visibility down to a block. Oh, and for some reason some of the traffic lights were out with no police performing traffic control. Not a crisis, except this was three of the heaviest-travelled blocks in rush hour. (One intersection has FIVE roads leading into it.) Took half an hour to make it the three blocks without getting hit by something. (And pedestrians were blithely weaving through the mess like it was nothing. No wonder people get killed in crosswalks so often.)

Finally at the hospital, I checked on the CT scanner. Still down. Colorful Dress Lady walked in and patted me on the shoulder "Hello Leonard!"

Desk person and Colorful Dress Lady again insisted they'd reschedule. Nearing the end of my proverbial rope, I said "For about three months from now." and took my leave without elaborating.

11 North waiting room, 9 AM; 40 minutes before my appointment. I was waiting to speak to my oncologist's nurse, intent on explaining the mess and getting an x-ray requisition. Much to my annoyance, the window was stuck open and blowing 60km/h -5 Celsius winds into the room. Much to my surprise, my oncologist showed up at 9:05 and said "My first appointment didn't show up. Want to wait around a few minutes and get finished early?" Who was I to argue with that? "Oh, and about your CT scan: We could just get a chest x-ray done, or I could get you an appointment at St. Martha's. The radiology is very good down there."

I ruminated on my last misadventure there for a split second. Between the ReadiCat (more vile than Gastrografin), the Esophotrast (the demon marshmallow that violates your throat with vanilla), the two-month waiting period, and my mounting desire to get this mess over with, I decided it just wasn't worth it. Faking up a more palatable response, I said, "I'd prefer the x-ray. Besides, I've had quite enough Gastrografin for the month."

She nodded, laughed, and vanished. Well, walked away, but she moves at quite the clip.

A few minutes later, the nurse showed up. I was weighed (down a few pounds, thanks to the flu killing my appetite for a week). Despite commenting on my weight being a bit high last time, she seemed disappointed that it was down, saying it was fine as it was. (Though perhaps it was due to the method of loss, rather than the loss itself.) No pleasing some people.

My oncologist showed up post-haste. She explained the CT scanner problem in more detail. She mentioned there were approximately three machines in the area. One is the broken one. Another is swamped with work and only taking urgent and emergency cases (though there's no emergency service at this hospital, long story). The third is an older one one door down from the broken one (I KNEW there was a second one there, given that I'd sometimes return to the waiting room to find other people were scanned while I was on the machine). The catch is that it doesn't do lymph nodes well, and that's what my oncologist is most interested in. (It's also why I've never even seen this second machine before.) So it would be a waste of time.

Tagging along with the oncologist was a doctor in training. Two years away from finishing her training, in fact. I don't know exactly what the subtle differences are between "intern" and "trainee" and such, so I'm just going to call her an intern-type-person and pretend it's right. If I remembered her name, it'd be even easier. She didn't exactly do much, though. After my oncologist examined my neck lymph nodes, she asked me if I'd mind if the intern-type-person checked my neck as well. Well, if she went through the trouble of coming down the hall to see me, why not? Not only was she substantially less rough about it, she quickly focused on my left side. She said to my oncologist, "Can you take a look at this?"

"Where? Point to it," my oncologist replied.


"Hmmm." I was briefly throttled in the name of science. "Oh, that's nothing. It's just that he's muscular."

Now, "muscular" isn't an accusation I hear that often, since the push-ups I do when the spirit takes me (not often, lately) aren't exactly known for gifting people with the neck muscles of Lou Ferrigno. (And this is the first time my muscles were a problem.)

I had to know what was going on. "Uhhhh.... 'Muscular?'"

My oncologist picked up on my surprise and said, "It's because you're a healthy young male. Most of the people a beginning doctor sees these days are emergency room patients, who are often old and infirm. When I was training you'd find a lot more people in an emergency room who probably didn't need to be there. Bad in a way, but it was great for us because we'd get used to dealing with patients with simple problems first. Now, you have to sort out chronic problems from what they're in for, or what they're waiting for tests to come back on.... You know, if you lived closer, I'd ask you to come in and get interviewed by the new doctors."

"Shame," I said. "I wouldn't mind having the, er, paperwork looked over by as many eyes as possible."

"Funny you should mention that. Someone I know once had a case where he thought the patient had an undiagnosed case of depression. But since everything is supposed to be confidential, if you tell his regular doctor then you're breaking confidentiality...."

"And opening up a whole new can of worms with the other doctor." (She didn't confirm or deny this one. But I know people well enough to know that some doctors don't like their work being second-guessed.)

Incidentally, the rest of the examination was going on during this. Intern-type-person has already positioned herself so my oncologist will be in the way of, ahem, the scenery once I lowered my pants. Much better preparation than the nephrologist.

As I was getting dressed, my oncologist pawned off the x-ray requisition-filling off on the intern-type-person. (Ah, interns. Though she wrote out the bloodwork requisition for my next trip up herself.)

I went to the main desk, where they scheduled my appointment wrong (must fix that) and I didn't notice because I was too busy worrying about the still-deteriorating weather conditions.

Since I've taken the 11 South stairs before (previous updates) and 11 North before, I decided to take the 11 West stairs. These ones, for reasons I fail to understand, start twisty turny at floor 12 and straighten up on the way down. Whoever designed these things didn't do well on consistency.

Down to the 3rd floor, I walked up the Long Hall and grabbed a number at diagnostic imaging registration. It was packed. They were on #40, I was #57. I skipped off in search of a bathroom. And another flight of stairs. For different reasons.

Back a few minutes later, they were only on #42. I read a poster on PET scanners to amuse myself. Unfortunately, it had less on the technology than I already knew, and more on fundraising.

After registering, I tromped down the Long Hall (between this and the hall one floor below it, that's about the 7th time in two days) and tried to hand my requisition to the person there. She was more interested in chatting a coworker up about last night's reality shows. I proceeded to wave my paper, clear my throat, and otherwise annoy her into getting rid of me. She gave me the most perfunctory set of instructions and then proceeded to ignore me. I went down the hall and took off my jacket and dress shirt.

A number of people were ahead of me. Notably, when one fellow's name was called, he was nowhere to be found. Turns out he was in the main hallway waiting. Since he was in full hospital duds (down to the funny slippers that feel like stretchy styrofoam), I suspect he was an admitted patient. Meaning Lil' Ms. Reality Show at the front desk probably ignored him completely since she didn't have to take any paperwork off him, even to the point that she didn't tell him where he was supposed to sit.

My x-ray was quick. Strangely, the tech vanished just before the patient ahead of me was called and was replaced by someone who came seemingly out of nowhere. I asked this new tech if the radiopaque Gastrografin would mess anything up. She said "no, that should all be in your stomach and intestines now, unless you inhaled it". Wow, snorting Gastrografin. Sounds like no fun whatsoever.

This done, I (thankfully) left for home. Other than seeing two eighteen-wheelers off the road on the way back (told you the weather was bad), it was an uneventful trip. And once out of the immediate Halifax area, even the weather was nice.

And once more into the breach. I managed to get through the previous night's Gastrografin fairly easily. Kicked back, turned on some mindless action film on TV and made a drinking game out of it. Every time someone grimaced, winced, moaned, or screamed, I took a drink and proceeded to grimace, wince, moan, or scream (well, a strangled gurgle, anyway) along with them. Given the rapid and repetitive content of action flicks, I was done my third of a litre (Americans: my cup and a half) well before the scene was over.

(The second drink the next day would've been more appetizing had a bug not decided it was a good place to land. Stupid bugs, you'd think they'd realize the container of liquid held by the human is about the single worst place to land that doesn't have the words "bug zapper" in its name.)

It was the afternoon June 14th when I showed up in the Victoria building to be subjected to my regularly scheduled pincushioning. Unbeknownst to be, I was going to have 50% more pin for my cushion.

First stop, up to the 11th floor for some quickie bloodwork. The elevator was empty when I got on, and had no stops on the way up. Amazing. Except the phlebotomist (ooh, big word, big word) was on the phone and I had to wait anyway. I sat myself in the chemo waiting room, which was suspiciously desolate - only one person there, and she seemed to be waiting for someone.

I amused myself by reading titles of books left in the room's large bookshelf/tv stand, as what was on television (a soap) was so vapid that even the abused spine of an L. Ron Hubbard novel was more entertaining. (L. Ron Hubbard's actual abused spine would probably have been more entertaining.)

Some time later, I was called in. As I rolled up my sleeve, I realized that I'd forgotten to shave my other arm the night previous. Well, my electric razor was 4 hours away, so might as well prepare for the discomfort.

First the standard ritual of confirming my identity, then I was poked and blood was drawn. After this, the person taking the blood paused and said, "Wait, why did it print two of these labels?" Looking over the original paper, she realized it had printed two labels because two vials of blood were needed. So, I had to get poked again for another vial of blood. I tried to remain in good spirits about it, as the phlebotomist was very apologetic, but it's tricky to keep sounding upbeat when someone tells you that you have to - through no fault of your own - relive the discomfort you just went through.

Just so you know, due to the size and proximity of the two needlemarks, my arm now bears something that looks disturbingly like a colon. (The typographical mark ":", not the organ.)

(For the sake of confusing the reader with the unvarnished truth.... In actuality, I get three vials of blood drawn each time. However, there seems to be pre-treated vials for certain tests. Thus, I needed one of one type of vial and two of another type. It was the second vial of the other type she missed.)

My arm cushioned with multiple cotton balls, I headed downstairs for my date with a CT scanner.

Standing in front of the door to the registration room was an older couple (as in, older than I am, though not that old) debating about where they were supposed to go. I walked around them and into the registration room, and the female of the pair made annoyed-sounding noises. Well, since it's entirely by schedule and not by first-come-first-served, I didn't feel too bad about not waiting for them to determine what they were doing and where they were supposed to be to do it. I also didn't pay her any mind when she proceeded to come into the registration room and stand next to me, as if that could bother me. She didn't realize that I have no shame and thus attempting to shame me into doing something is useless. Eventually, she left.

(In unrelated news, that's my favorite of the many irrefutable proofs - outside of the metaphysical crap - that John Titor was talking a complete load of bull. He claimed to be from a future in which everyone pulled their weight because if they didn't, they were shamed into working. Shame is a horrible motivator. I've seen college students. Hand most people Titor's world of endless verdant gardens and high speed Internet and they'll never work again.)

I was a bit disappointed that the typing person was neither colorful dress lady nor her regular replacement.

Here, there was far less waiting than my bloodwork - it's usually the other way around - as the technician came to get me from the waiting room while I was still stowing my street clothing in a locker. I might've been finished sooner, but a frayed cord on the robe's built-in 'belt' gave and I had to stop to retie it as best I could. I suppose I could have left it, as I wouldn't have exposed much by leaving the robe open - I had a johnny shirt under it - but it's an outfit designed to maximize one's suceptibility to drafts, and I didn't want to make it any worse.

The technician of the day was the male who I'd dealt with before. Nice guy. With him was a trainee (I suspect, as they never wear lab coats - the regular techs always do).

The IV was quick, and done with my arm positioned out of my sight. It didn't hurt much. However, while he was getting the part that goes into my arm attached to the machine, I must have bled substantially, because after a moment I felt an alcohol-soaked wipe being rubbed down my arm in exactly the path leaking blood under the influence of gravity would take.

The trainee (much to the technician's chagrin) gave the game away when he said, "Wow, you bleed a lot!" Er, if it's not life-threatening, don't need to know that, thanks. Intern and technician discussed at length techniques for attaching the connector rapidly so the patient doesn't bleed, but the technician's voice suggested he didn't like a trainee attempting to give him advice, particularly after letting me hear that bleeding comment.

I was loaded into the machine and the laser caught my (closed) eye again. I got curious (you know what that did to the cat), shifted my shoulders and head a bit, and opened my eyes. From what I could see, the laser was actually multiple beams, forming a cross of ruby light on my face, currently centered right on my nose. I felt like a sniper target in a movie. The tech and his young charge vanished.

(Incidentally, they don't use those in real life, folks. Rather gives the sniper away to have a giant red mark on his intended victim.)

My first trip through the machine was uneventful, except the "Breathe in.... Breathe out.... Breathe in.... Breathe out.... Breathe in and hold." message was a shorter, more relaxed "Breathe in and hold your breath." with far less imperative on the "hold".

The trainee reappeared and asked repeatedly about any pain at the injection site, showing his training is fresh and no bad habits have (yet) developed, even if he's a bit light on tact. He mentioned that I had two more trips through the machine (two?). After he vanished again, I got the "Breathe in and hold." message, followed by the bowels of Hell feeling, particularly long and drawn out this time. The machine stopped halfway through, and after a minute of waiting and slowly letting my breath out, the more relaxed "hold your breath." message came on. I quickly inhaled - I was ready for it, for once - and I was moved the rest of the way out of the machine. What I wasn't ready for was the surprising return of the flaming bowel feeling, which had faded to nothing while I waited. Evidently someone in the control room started the IV pump again for good measure. How nice.

I know, I probably shouldn't complain. After all these times, I'm tolerant of the feeling (though not used to it, you never get used to the feeling of impending horrible diarrhea that never arrives), but I'm not tolerant of expecting it to be over and suddenly starting all over again.

Between this and the bloodwork needles, one gets slightly paranoid. You know, if this weren't reality (though, given my writing, 'reality' is a highly subjective concept to begin with) I'd suspect someone was trying to set up a theme here by repeatedly putting me into situations were I thought the worst was over... and then it all starts again.

The scan looked good (in quality - a medical diagnosis takes a day), so the trainee came back in and ripped the tape off my arm with surprisingly little pain. (Though when I examined the piece they used to affix a cottonball my arm after taking the IV out, it seemed a bit less sticky than normal. So perhaps I just lucked out with a weak tape batch.)

Paranoid that I was going to get put through the big surprise ringer the next day, I went up to 11 Victoria feeling slight apprehension. The desk person did try to get me to get more bloodwork done, an idea I quickly squelched before proceeding to the waiting room for a long wait.

After the weighing (one pound up from last time) and the inevitable string of questions I expected, it was time to see the doctor. It wasn't long before I heard the familiar rapid left-right beat of her shoes hitting the floor.

Except it wasn't her. It was an intern (or whatever they're called), who had already picked up the habit of rapid walking. A very nice young lady, we spoke at length about some of the things the nurse had asked about, including such minutiae as regular self-examinations (can't stress this enough, guys - self-exam your testicles once a month, it's how I found my tumor).

During my physical examination, I mentioned the whole "healthy patient" thing my oncologist had made reference to last time. She agreed that beginners often had a hard time with that. After spending time listening to a doctor explain what a damaged-lung wheeze or a heart murmur sounds like through a stethoscope, you either misinterpret the (inadequate) description or get paranoid, and start hearing wheezes and murmurs in healthy organs.

Unlike previous interns - and some doctors - this one wasn't particularly squeamish about male gentialia. Nice to see someone in the medical field who doesn't hide behind a person or object whenever they see someone's bits.

After the examination, we continued our conversation on the mishaps a beginning doctor faces. During this, I learned an interesting thing. In the last four years of training, they do different things each year for their internship. Different responsibilities I'd expected, but they also do the internships in different places each year. This woman, in year three, was working at a hospital near her place of education. Year four, she will go to another province for her internship. Helps a person learn about the different ways things work elsewhere, not the least among those differences the provincial health insurance system.

I mentioned that from what I heard, the fourth-year intern in question sometimes sets up permanent shop where he or she travels to, particularly if he/she finds something or someone worth staying for. Case in point being my GP's daughter, who liked the working environment - and really liked a "nice young fellow" whom she later married.

The intern I was speaking to perked up substantially at this last part, asking followup questions on the nature of the fellow and then saying quietly, "So it really does happen...." I sensed that I might have stumbled upon a story circulated amongst interns about their new-doctor friends-of-friends, a wistful daydream of travelling to a new place and finding not just the final phase of training, but also a young and attractive doctor to bind fates with.

She left to get my oncologist while I dressed. Still suspecting another visitation from the do-it-again fairy that had visited me repeatedly the day before, I left my dress shirt and jacket off and tried to pretend the cool room didn't bother me in my cotton t-shirt.

Not long after I heard the stereophonic left-right of two people moving at full clip down the hall. Guess who it was.

My oncologist picked the oddest chair in the room - a footstool. There were other chairs that remained empty after the intern and I sat down, so I still don't understand this. However, her questions to me did take an almost accusatory tone at one point (long story, had to do with my hunt for a job) so I wonder if she deliberately picked a seat that forced her to look up at me to balance out the more agressive line of questions. Then again, maybe she was just in the mood to wedge her knees up under her chin.

Little else she said was news, which was good: No news is good news. Tumor markers same, radiologist report not in but CT scan looked good, etc.

A last note of interest was that my next visit will be back down in the cancer center on the Dickson main floor. Last time I was down there for an appointment was late November of 2003. Seems like so long ago - things were very different back then, for both good and ill.

And since I don't have anywhere snappy to end this month's comments, I'll just end it. I'll be seeing you, my regular readers, again in three months. Thanks for your e-mails; I hope your own medical journeys are as easy and painless as possible.

Be well.

I'll be upfront: Some not-good news this time. Not bad news, mind, but not good, either. You may wish to skip to it and come back.

I made the mistake of going downstairs for the bloodwork, to the clinic blood collection. Took a while to go through. (Why is it when the front non-clinic blood collection is the least busy that the back-room clinic blood collection is the most busy?) And it felt like the needle was still in my arm for hours afterwards. Hurt a lot. An auspicious beginning, to be sure.

X-ray took even longer - one guy must've been in there 15 or 20 minutes. Then, a rush job came through for a person in a wheelchair on oxygen, though it didn't take much longer than normal. (Hey, with all that wrong with them, feel free to go ahead - I've got it pretty good in comparison.) Then the x-ray person seemed to go on break soon after, so the room steadily filled up while we waited.

X-ray oddity 1:

An attractive young lady (alas, the robe she had to change into covered more of her than her dress did, but considering some of the unattactive males in the room who were equally well-covered in their robes, I think it was a fair tradeoff) was putting her clothes in a locker. Since I was sitting in the hall overflow next to said lockers, I had a good seat from which to look at her. I was, to be perfectly honest, 'checking her out' while she was paying attention to the locker. Thing is, the locker she opened was full, so she closed it and then looked around, presumably to see if anyone noticed her mistake (or was coming to question why she was looking at their clothes). And I, not expecting this, got caught red-handed. I was a touch self-concious, so I looked away until her attention was diverted by another locker. Then I, unrepentant male that I am, looked back. Now, anyone thinking straight would realize that, if the waiting room is full then logically the odds of hitting a second occupied locker are pretty good.

Logic has nothing to do with the thought processes of the male when a pretty girl is involved.

The second locker was full, and again she looked around. And again I got caught.

Third time's a charm, right? Well, this time I think she looked just to see if I was looking. I was, though was at least slightly less obvious about it - though with any pretense of cover long since blown, I don't think it worked. Her lack of a negative response was heartening, though. Fourth locker was empty, and she sat down in a recenty-vacated chair afterwards.

X-ray oddity 2:

Someone followed an old man out of the bone scan area and said "Mr. (so-and-so), you forgot your disk!" She handed the old man what looked to be a CD-R in one of those older, larger, jewel cases. "You have to keep this with you, it contains all your reports. And if you lose it, it will cost you $40 to replace!" WTF? $40 to find the backups and re-burn ONE CD? I'm still trying to figure out if this is incentive to not lose critical medical data or a cash cow.

When I finally got my x-ray done, I had to do an extra shot to get all my lungs in. Apparently the machine can do broad-chested people and long-chested people but not both at the same time. First time I've been accused of being broad-chested. (Though I've come to realize that a twentysomething male with no major chronic problems or obesity issues is considered "muscular" by medical professionals, not so much because he is, but because everyone else isn't.)

Next morning's examination:

Down to the Dickson first floor area for the first time in a while. Where, after waiting five minutes, they told me I was supposed to be upstairs like normal and they had no idea why I'd been told otherwise.

Four people in the elevator, again it only stopped at floor 11. This is depressing. An older man got off the elevator just behind me and walked towards the desk. The secretary/receptionist/whatever was otherwise occupied, so we stood by, waiting. He caught my eye gestured at something on the reception desk. I looked at it. Seemed to be a sign-in sheet. It meant little to me, though I suspected it had to do with chemo. I backed away from it a bit, even though I wasn't really blocking his access to it, then went back to waiting. He caught my eye again. "You got here first, you sign the sheet first."

Well, 'first' only by virtue of being last into the elevator. That seems even more trivial to me than a pair of identical twins arguing over who's 'older' because of who horned his way out of the womb first. Still, the point was moot. "Is that for chemo?"


"I'm not here for chemo. Just a checkup."

The older man nodded. "Oh. One of the lucky ones."

Something about his tone rubbed me wrong. Not strong enough to be malice, but not weak enough to be envy. Too sharp for irony, too docile for resentment. Even his face didn't betray his emotional state, neutral with a shading of something that didn't seem entirely well-intentioned, but might have been.

Lacking a proper response, I just grunted. To fill the awkward silence before it developed fully, I noticed he still had a substantial amount of hair and asked "So, how's the chemo treating you?"

It lost something in the translation and the response was "Every day this week." Before I could rephrase, the woman at the desk finished her work and called me over. A few seconds later and I was heading down to the waiting room.

This had been the second person that day who commented on my medical state in such a way that it left me with vague feelings of unease. While I try not to be superstitious, these visits put me on edge enough that I caught myself wondering if it was an ill omen.

I saw the nurse and doctor early, I think because the doctor saw me in the hall and knew I was there. As I was ushered into the last waiting room at the end of the hall - one with a unique view of the parking area due to its position at the end of the hall - I mentioned that I'd never been in this particular room before. The nurse jokingly said, "Well, we have to give you the full tour!" I spoke with the nurse at length, mostly about completely nonmedical stuff like man's inhumanity to man.

Soon after she left, my oncologist showed up. No intern this month - perhaps I should've known something was up. I'll admit, my doctor doesn't flinch when it comes to bad news: about the first thing she said was that there was something she wanted to show me, while waving a large sheaf of papers. Seems one of the tumor markers - my beta HCG level - is elevated. Now, it's not as bad as it sounds, though it's not normal, either.

When I had the tumor, it was in the high 30s. Anything under 10 is considered normal for an adult male. Mine is currently at 4. However, my post-surgery HCG level has always been between "<1" and 2. So, for me, this is elevated. My oncologist was honest about things. "I'm not sure what this means. It could be a random jump, but we're going to be careful. I want you to get bloodwork done in one month. If it's still elevated, you'll come up here for a CT scan the next week. If it's back where it should be, you'll come up in early December like normal. Now, there's not much that changes a man's levels of beta HCG. Marijuana usage sometimes does, but..." - at this she paused to give me a look - "... I don't think I have to worry about that with you." I assured her she didn't. (What can I say? I look pretty straight-laced. Of course, so did Ted Bundy.)

Conversation during the physical examination of assorted lymph nodes was limited in scope (small wonder). My oncologist mentioned that I looked like I could take news like this without panicking. I agreed, and told a shorter version of that story when I first tricked the ultrasound technician into admitting my suspicious lump was solid (tumor-like) and how I didn't feel scared afterwards, but rather an odd sort of serenity in having extracted information I wanted from someone unwilling to give it.

Also during the examination, my doctor mentioned that everything else looked good. "The cancer you had can go two ways - to the blood vessels or to the lymph nodes." (By 'blood vessels' I think she meant the cardiovascular system as a whole.) "Now, it usually goes for the blood first, and that's why we do regular chest x-rays. And your x-ray was fine."

So, basically, no one knows what's going on. I have an HCG level that's normal for a male, but high for me personally. So, next month at the very least I'll be regaling you stories of how St. Martha's has changed and if their type-people are still mistaking me for a pregnant woman.

Under the circumstances, though, I'd rather I didn't have the stories to regale you with.

October 17, 2005 AD: On three hours of sleep, I headed out for my bloodwork. I suspect they will find my blood is tired.

In the parking lot of St. Martha's, I was parked across from a Toyota Avalon. This was good luck - last weekend's New York Times Sunday Crossword had the clue "Toyota model" and all I had was -V---N. "AVALON" fit perfectly.

Unless I've misremembered, they've moved the "take a number" thing since I've last been in for blood collection. It makes some more sense now as it's not on the far wall, but it's in a place where someone just walking into the waiting room might not see it, because it's obscured by the privacy wall they've erected between the typey-people and the waiting room. Is this an improvement...?

With all the seats (not much - about a dozen and a half) taken, I was left standing in the hall with a few others. Next to me were a clatch of women chatting and gossiping. Where I was leaning against the wall and doing my best to look broody, they were standing in the middle of the hall and forcing everyone walk around them. Unsurprisingly, when the clatch broke up, one member went into the waiting room and proceeded to collect a second group of chatters, who successfully blocked the door between the waiting room and the blood collection room.

My number still three away from being called, I wandered away to check out that "cardio-something" room I had, years previous, mistaken for an opthalmologist's office. It's a cardiorespiratory clinic. How the hell did I mistake "cardiorespiratory" for "opthamology"?

I returned and the number counter still hadn't moved. More depressing, no one had been called to have blood (or assorted other specimens) taken. No wonder the place was packed. About ten minutes later, my number finally came up for typing adventures. In that time, one person was called in to get jabbed.

After exchanging greetings, I handed over my pile of paperwork, health card, and slip of paper with my number on it. After confirming I was who the system thought I was, the woman started typing in the information on my requisition form. It appeared to take her a bit of time to acquaint herself with the Halifax-style form, and to dig up the names of the Halifax doctors on her computer, but she got up to speed. She seemed very competent, better than some of the ones I've seen.

I noticed that, after a short time, the machine started beeping when she typed and she was using alt-key combinations far more than she looked comfortable doing. She excused herself and went to talk to the people in the blood collection room. I considered leaning over the desk and confirming my suspicion that the phrase "Maternal Studies" was somewhere on this screen.

Instead, I waited quietly. When she came back she kept typing for a while, before stopping to grab a sheet from under her keyboard. "Beta HCG....", she mumbled.

Without missing a beat, I said, "BHCG." But she was faster than some of the others - she'd already found it.

"You're right! You've been down this road before a few times, haven't you?"

"You could say that, yes." She finished her work and printed off the labels (two, one for LDH and one for HCG and AFP), paperclipping them to my number slip and to my requisition before handing the pile to me. I skimmed the paper and asked, "It tried to send me to Maternity again, didn't it?"

"Oh, no, it just asked if the results should be sent to Maternal Studies." Well, close enough.

"That always happens. Believe me, I've got a few weird looks over it."

Evidently I'm more clever than I thought I was, because she laughed. I left to wait again. Eventually, a second phlebotomist came on duty and people started going through the blood collection room much faster. It didn't happen fast enough to keep me from becoming utterly bored, though. I read some of the other, unchecked, tests listed on my form. I guessed at a few chemicals with standardized names* and took particular interest in the section with items like "barbiturates" and "ethyl alcohol". Some evil part of me wanted to check those off, just to see what would happen.

(* Lipase, for instance - obviously a fat [lipid] related enzyme [-ase**]. Proper definition from dictionary.com: "An enzyme secreted in the digestive tract that catalyzes the breakdown of fats into individual fatty acids that can be absorbed into the bloodstream".)

(** Short educational moment at end of item. Because I feel like it.)

I was called some time after reading the name of the number-slip dispenser company for the second time. Getting the blood taken was quick and almost painless. Kudos to the phlebotomist.

And now comes the waiting.

And to end on a slightly better note, a brief item on enzymes. They're organic catalysts. Like catalysts, the make chemical reactions 'easier' (lower the amount of energy it takes, etc.) without being changed themselves, so they can do it again and again. Pretty much every enzyme name ends with "ase", and the name is usually just a shorthand for what it does.

The one I get tested for is lactate dehydrogenase. The biggest difference between lactic acid (lactate) and pyruvate is a pair of hydrogen atoms. These enzymes (there are several) help remove the hydrogen from lactic acid to make pyruvate, or turn pyruvate back into lactic acid. With some cancers, there's more of this in one's blood.

The ones that build our DNA are polymerases. (DNA, after all, is a polymer - a long molecule built up of smaller bits called monomers.)

One without an obvious name is the enzyme diastase, which separates starch into dextrin and maltose. Its name comes from the Greek "diastasis", meaning "separation". It's the one from which we first got the "-ase" naming convention.

The one that copies RNA back into DNA, against the natural DNA->DNA and DNA->RNA 'flow', is called reverse transcriptase, and is responsible for a lot of HIV's trickery. Unlike a lot of diseases, HIV exists as RNA that is copied into DNA at the point of infection. HIV's reverse transcriptase is a lot glitchier than our polymerases, so HIV doesn't always copy properly into our DNA - in other words, HIV mutates, and it mutates a lot. The faster mutation rate allows it to adapt to external pressures (like anti-HIV drugs) rapidly, which is why patients with HIV take so many pills. You have to sledgehammer the disease with everything you have, else it will rapidly grow tolerant to any one treatment.

Whenever our DNA copies, the last few bits fall off - if DNA were a string, then it's like the string starts to fray. We have a defense against this, called telomeres - junk DNA that just exists so it can fray off without hurting the information contained within the DNA. The catch is, as we age, our DNA has copied so many times that eventually there's no more telomeres and the information does start getting damaged. Once that happens, the cell dies with no hope of repair. This is one of the things that causes our bodies to fail as we get older. There's an enzyme that rebuilds telomeres, called telomerase, that essentially stops the fraying from ever happening. (A funny thing - because telomerase's telomere 'blueprint' is RNA and not DNA, telomerase is also a reverse transcriptase.) Most cancers have 'relearned' how to generate and use telomerase, a trick only a few cells in our body can naturally do. (Stem cells, which need to divide a lot, have limited telomere regeneration.) Because of this telomerase, a lot of cancer cells are immune to the ravages of time. A prime example are the HeLa cells, cervical cancer cells from a woman named Henrietta Lacks, who died in 1951 in her 30's. Those cells are thus well over 80 years old and still multiplying as strong as the day they were first removed from her. It's a sick and subtle irony most cancer patients never know: The immortality we've sought for millennia is contained within the cancer cells that kill us. While a cancer cell can die from disease or chemicals or starvation just as a human can, it will almost never die from old age.

But who knows? Perhaps, with research and experimentation, this is the path down which the forging of our own immortality lies. Now that is an irony I could live with.

And, as another Christmas season passes, we have my final trip of Year Three.

The dodgy weather and poor roads made the trip a delay-fraught, soul-sucking, constitution-draining nightmare. I was also hoping for no more suspicious test results, but - alas - it was not to be.

The first (night-before-scan) Gastrografin dose went down easy, because I was watching something decent (.hack//SIGN - love the theme music) while drinking it. Helped take my mind off the taste. But the second was worse - choked down in a parking lot mere minutes before entering the hospital. I noticed that, for the second time in a row, there was a tiny bug in water. Since it hadn't been in the cup the night before, I'm at a loss for how it got there. Presumably the little devil snuck in when I put the cup down uncapped for a minute so I didn't have to fumble with a cup, a bottle, and a measuring spoon all at once. What is it about iodine that these damn things love?

Fighting the gag reflex, I finally managed to get it (sans bug) down and, a few burps later, was walking across the frigid parking lot and in the building. Since I was alone for this trip, I decided to get a bit of exercise and walked up to the 11th floor for bloodwork, taking the stairs in the Victoria's south wing that would let me out right at the door to the bloodwork room.

And they let me out at a door whose legend read "On break, back at 10:00." Who goes to break at 9:30 in the morning? No matter. I turned around and headed back down the stairs, at least providing me with some exercise. I had to suppress my heavy breathing a few times, as on the trip down I met two pretty girls, and I simply can't be seen as a weakling (or a heavy breather) in the presence of teh ladies.

As a side note: Floor 2 (ground) was where the stairs started. Floor 11 was where they stopped. There was an exit at every floor, plus one at floor 2.5 - well, 2.25, as some stairs down had been cut into the floor before it - on the opposite wall from all the others. Made me curious as to where it let off, but I've long since learned that you don't open unknown exits, no matter how tempting. I have a rough idea, it's a part of the exterior I've never seen before.

Down in clinic blood collection, it was surprisingly sparse, with only two people ahead of me and a tech who was both fast and low-pain. Meanwhile, the main blood collection waiting room was packed beyond capacity.

On my way to the CT scan registration room, I realized I'd lost my bloodwork paper envelope. I found it back in the blood collection cubicle. A funny thing: If it had a second bloodwork form or an x-ray form in it, I would've been paranoid about it and never have lost it. But because it was empty, I just stuffed it in a pocket and forgot about it. Then I forgot it was empty, so I went into panic mode when I realized I lost it.

Back to CT scan registration: Alas, it wasn't Colorful Dress Lady. I hadn't seen her in a while (March?). While that's mostly because I'm just not going as often, I was still left was wondering if something had happened to her. I didn't ask, though. I mean, "Hi, I'm wondering if Colorful Dress Lady still works here." isn't exactly a good way to inquire about someone.

In the waiting room, I kept my leather jacket and wallet on me (no one touches the leather). So, of course, they had the heaters working overtime. I'm sure that the sight of a guy in a johnny shirt, robe, and leather jacket was quite common around there (at least when they didn't run the heater so high), but I felt a bit odd.

Some time later, the male tech I've seen a few times before called me in. I was soon sitting in the IV setup chair, placed behind a partition in the back of the tech's control room. I asked if I could drink the lemon-and-Gastrografin cocktail I'd been carting around since I got changed. He said yes, and helpfully used a stir-stick (looked like a tongue depressor, actually) to mix up the drink and get rid of the ultra-lemon dregs at the bottom. Nice guy!

He asked which arm I wanted the IV in, I said I'd had blood work done in my right, which I pointed to - not that you could see much. My razor nicks from shaving my arms (both, as a precaution) were redder than the needle entry point.

He saw the irregularly-shaped tracts of hairlessness along my arms and asked if "the lab" had done that too. I explained that no, it was my idea. He pointed to his own fairly hirsute arms (most of the techs wear short-sleeved shirts) and said that's a good idea, he doesn't get the luxury because "They just come up and say 'We just discovered you were in contact with a person who had such-and-such disease, come down for bloodwork right away.'" Suddenly, I felt a bit strange. I never really wanted to be a CT tech, partly because of the whole needle-giving thing, but now I realized that I had a much better reason not to.

After the IV was (again, fairly painlessly) set up, I was left alone while the previous scan patient finished. While perhaps an invasion of privacy, I leaned forward in the IV setup chair and peeked around the partition. I couldn't really see the patient in the machine, but I didn't want to anyway. Instead, I watched the computer screens for a bit. Never ceases to amaze me how we've got technology to provide down-to-the-millimeter 3D models of a person's insides.

Soon after, it was my turn. Taken back out into the hall and back into the room through the other external door, I rested my jacket on a chair and got onto the machine. A female tech loaded me halfway into the machine and then called to the ones in the control room. She had to ask if I was also getting a chest scan. After yelling over the machine (and the tech's own chatter) with no success, she eventually started doing charades, beating her chest like Tarzan. Well, a one-armed Tarzan, anyway, as her other hand was still on the scanner's control panel. Before the image of a one-armed Tarzan gave me the giggles, I tried to stop her with "I think I am getting a chest scan."

The tech's answer must have came through around the time I said that, because I don't see why she'd believe me with no corroboration, and she loaded me the rest of the way into the machine.

I noticed something interesting while in the machine. The spindown between scans is controlled, not simply a motor stopping and letting friction slow the mechanism. I know this because I watched the electronics visible through the two-inch-wide glass section that forms the inner circle of the scanner's "donut" shape. It always stops with an aluminum-looking I-beam about a foot long right above me, and the beam looks to be roughly in the same place every time. (Yes, I entertained myself by watching it spin up and down.)

Scan 1 turned out fine. Scan 2 - the one with the magic happy flaming bowel feelings from the dye in the IV - stopped halfway through, paused 30 seconds, and restarted. I think they kept the radiopaque dye pumping all the way through, because that hot feeling stayed all the way through those interminable 30 seconds. Even worse, it started to spread out. The warmth reached deeper into my body and out to my skin, giving me an even more detailed feeling that I was crapping my pants.

But I didn't, as always. Though this time I do admit to checking while in the changing room.

I had some time to kill, so I roamed around. I went into the NS cancer center and poked about with the computers. One's been taken off the Internet (no wonder, after all the spyware that was on it last time) and the second one was covered in assorted warnings not to download programs.

Someone left it on a stock-checking site. My evil inner voice wanted to check the cookies for a login and have some fun playing day trader with someone else's money, but I decided against it. I checked a forum I was waiting for a response in, and then visited this page (well, it is cancer-related). Before leaving I deleted my forum visits from the history file. On a lark, I left my site there, in that rather annoying "Look at me! Don't look at me!" way that many of us Internet ranty types have.

Roaming further, I walked passed CT registration and heard Colorful Dress Lady humming a seasonal tune. I couldn't resist, I had to lean in and say "Hi."

She leaned out from around her PC - which completely obscured her, so I don't know what she was wearing - and replied, "Oh, hello Leonard!" (This woman is amazing.) "How are you doing?"

"Good. How are you?"

"I'm fine, thanks."

I finally said what had been nagging at me. "I haven't seen you in a while."

"That's a very good thing!"

I laughed. "I guess it is. Well, just wanted to see how you were. Merry Christmas!"

"You have a good Christmas, too!"


"Bye!" and she went back to her typing and humming.

While I didn't have a proper appointment, my MD had insisted I go in for a flu shot when I was in town. I got to his office around 12:45 (lunchhour) and had to wait for someone to unlock the door at 1:00. I entertained myself by roaming around the snaking halls of the Professional Centre. Rather strangely, the hall turns a corner and ends at a ladies' room. While I should have expected it - the men's room is a few feet away - it seems like an odd thing to terminate a hall with. Not an office (like the other end) or a dead end with doors off to the side. You turn the corner and a few feet more of hall just ends in the ladies' room door. Why not move the door up to the corner so the hall terminates at a dead end with the washrooms to the side?

Speaking of the washrooms, the other men's room on this floor was renovated recently. I walked in and had that panicked instant where I wondered if I'd stumbled into the women's restroom by mistake, before trekking forward and spotting the urinal. (I suppose I could've reopened the door and checked that, but then there'd be risk of someone in the hall seeing me. In retrospect that's not great logic, but after one accidental ladies' room trip in my life, the brain shorts out in this situation.)

I roamed back down the hall and waited some more. A doctor (not mine, but one in the same office) came by and helpfully unlocked the door for me five minutes early. I went in and spoke to the secretary. It took a good bit of effort to convince her that I was supposed to be there. Eventually I told her to ask the doctor. She did, and I guess he gave me the okay. I was led into a small room that I've seen him use for quick visits or as a second examination room. Judging by the soft toys and pictures of what babies can do (and look like) at 1-12 months on the walls, I suspect it's also an infant examination room.

Of course, that makes this one quit-smoking thing on the wall somewhat incongruous. It's aimed at the parents, perhaps, but you can't help but think it's meant for chain-smoking infants.

My doctor popped in a minute later and, after brief greetings, got the needle ready. He said it wouldn't be a long visit, but rather a "quick and painless" one. He also added that he prided himself on painless flu shots. Then he took the wrapper for the needle and tossed it at the garbage, missing by a wide mark. I said "I hope it's more painless than your aim is accurate. No, wait. Did I say that right? More painless... accurate.... Uhhh. Hmmm." It was somewhere during my attempts to untangle myself from the verbal mess I'd made that he jabbed my arm with the needle, and I was so involved in my thinking that I barely noticed. When I was a kid, he'd distract me by asking me about the colors of the suncatchers on his window. Now, I helpfully distract myself.

I finally gave up and said "You know what I mean." and noticed he was almost done packing everything up.

He asked "Painless?"

I smiled. "Painless. Of course, I just had an IV and bloodwork today, so I might be a touch biased. Flu shots are nothing."

"Speaking of bloodwork, you had a bit of a scare there."

"Yep, but it seems everything's okay now." (Unbeknownst to me, I was speaking too soon.)

"Yes, the interim bloodwork came back fine - I get copies of everything sent to your oncologist. These things happen sometimes, something will jump up but then go right back to normal. You're doing fine."

I thanked him and left.

It was the next morning, just as cold as the one previous, when I headed in for my physical examination. The Gastrografin was already complaining bitterly in my intestines, so I decided to take the stairs. I didn't relish the idea of fighting to the front of a crowded elevator in an emergency, and the bathrooms are usually near the west stairs, anyway. Unsurprisingly, this time I opted for the west stairs.

I walked to the top without thinking too much about the signs and, much to my surprise, found myself staring at a door labelled "FLOOR 12". Apparently, the west wing stairs go a floor higher than their southern counterparts. Back down a floor, I finally noticed the sign that said there was no exit above Floor 11. Well, there certainly was, but the door might not have opened from this side.

I walked out the Floor 11 access and found that all the jostling up and down had (illogically) quieted my guts substantially. Which was a good thing, as the front desk secretary saw me from down the hall and called me over. I don't like witnesses to my frenzied Gastrografin-charged rushes to the bathroom. (Another person who remembers me? I've hit the jackpot.)

"So," she said, "you took the stairs?"

"Yep." I said, managing to get it out between gasps.

"You're in better shape than a lot of us."

If I were in better shape, I thought, my legs wouldn't be filing for asylum on someone else's body.

Curiosity (and a newly-added television flooding the waiting room with Regis Philbin) encouraged me to try the 11 North stairs and see how far they went. I did. They didn't stop at 11. Nor 12. They stopped at 13, again with the warning that there was no exit above 11. So we have a staircase from 2-11, one from 2-12, and one from 2(?)-13. Who designed this place? and what the hell happens on those top two floors?

After a while in the waiting room, my oncologist's nurse showed up. Before I could react, she was pulled into a conversation with a couple who were in the waiting room a few seats down from me. They gave her a present of some sort, and hugged her. After the chat ended, the nurse told me to follow her.

Once out of the waiting room, I said, "I feel terrible. Christmas and I didn't buy you a thing!"

She gave me a look and said "No! Don't worry about that. I appreciate the things people give me, but I feel bad about it. I mean, I'm not working here for glory and gifts. My personal life is full."

I almost said, "My living room's cluttered, too." but I left it pass.

The nurse told me my bloodwork was fine, asked me all the regular questions. We picked up on the topic we were discussing last time, making the intervening three months one of the longer pauses in face-to-face conversation I've ever had.

A few minutes after the nurse left, my oncologist showed up. That's what happened with the funny bloodwork. I didn't like that.

After exchanging niceties, she sat down and showed me the newest bloodwork. "The irregular bloodwork from last time had your HCG at two when" (flip back through the previous 3 bloodwork results) "it's normally one or below. The interim bloodwork came back as" (flip) "0.1, which is very low. These things happen sometimes. If you take enough blood samples, eventually something will be elevated on one of them.

"But now," she continued, "there's this." She pulled out the radiologist report for my CT scan. I noted with some surprise that a paragraph of the report was stamped with a page-wide CAUTION stamp. She read through the report out loud, though she didn't pull any punches as far as the medical terms went, so I had a hard time following along. She stopped to explain one part carefully, though: I seem to have a triangular opacity on my lung. But it's apparently been there for a while, so it's nothing to panic about. I have to admit I wasn't listening as well as I should have been. Maybe that distractingly worrying CAUTION paragraph had something to do with it. (This is why they tell you to bring someone with you who can listen for you for your first few treatments.)

The caution paragraph was devoted to a lymph node in a Latin-named region which my doctor said roughly corresponds with my midriff. Apparently, in the six months between CT scans, one of my lymph nodes has grown from 1.0cm x 0.5cm to 1.1cm x 1.0cm, roughly a doubling in size along one dimension.

"Now, I don't think this is something to panic about. For one thing, you bloodwork is fine. For another, this lymph node is in your front, and the ones where we'd expect to see changes first are all in your back."

"Which is why some testicular cancer patients need that surgery where the surgeon puts their intestines in a sterile bag to get at everything in back. RP... uh...." My mind groped around in the dark for the last three letters of RPLND, but my oncologist did me one better:

"Retroperitoneal Lymph Node Dissection," she said, with the practiced ease of someone who knows what the peritoneum is.

"Yeah, that one."

Continuing to read the papers in her hand, my oncologist pointed out that radiologist report recommended a followup in three to six months. "Since you're moving to four months between visits, that's exactly what I think we should do. So next time you'll get another CT scan. And I want you to get bloodwork done at the two month mark, just in case. With what you had, I think anything that comes back will show up in the bloodwork very early."

She filled out a bloodwork paper and wrote two dates on it, one for February and one for April. "Now, when you take this to your local hospital, get it back from them for use your next time here." She suddenly looked off into the distance, her face tainted with a touch of uncharacteristic pensiveness. "You know, I should've been doing that all along."

I silently lamented the trees and took the proffered paper.

She snapped back to the present and looked at me. "We're going to watch you closely, but I don't think this is something to worry about. It's not in the right place, and well over 90% of recurrences in men like you have happened before Year Four." She gave my leg a slap. "And you're not going to be in the other ten percent, you hear me?"

I smiled. "I'll try my best not to be."

There's probably not a lot of guys in this world who can truthfully claim they have a professional relationship with a woman who slaps them around a bit and then gets them to take off their clothes. I'm one of them.

The physical examination was the same as all the others, but in keeping with the strange subject matter we sometimes discuss while I'm on the table, this month's chatter somehow got onto the topic of my social life.

"So there was this girl at work," I said as I was getting dressed, "who I thought was really cute. Had something of a crush on her, actually. So, I took a day working up the nerve to talk to her, and fifteen minutes later, I was ready to gnaw one of my own legs off to get away."

My oncologist tapped her head with a finger. "Nothing up here, huh?"


And with that moment over, I was dressed and ready to leave. We wished each other a merry Christmas, and went our seperate ways.

And that's year three post-surgery done. Looks like there'll be an update in two months as I get more interim bloodwork done. See you on the other side of the calendar change.

Best wishes to you and yours,
The Archon

Go back! Back I say!
Run along home.
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