Of CT Scans and Kings....

The upshot of going out in poor weather was that no one was in the hospital. Went through nice and quick.

Unsurprisingly, the typer-person messed up. While I always double-check the blood vial labels they have me give to the phlebotomist, the presence of three labels (instead of the normal two) spurred me into checking before I'd even got back to the waiting area. One was labelled "HCG Urine". Uh, no, wrong bodily fluid, thanks.

I turned around and returned to the desk. I explained things, and it took a bit of insisting that there was something wrong before she did something about it. Had she not got the point, I'd have brought up fact that she had ignored the Maternal Studies thing on her screen, when I'm pretty obviously not the type to be pregnant.

She consulted the other typey person, just back from wherever (thankfully). The words "qualitative" vs. "quantitative" were tossed back and forth, but in the end it came down to her punching HCG instead of BHCG into the machine. She tore up the urine one, printed off a new label, bringing my count back up to three. Still a bit suspicious, I looked them over again on my way back to the waiting area (again).

The AFP test was duplicated. (The new BHCG one was "BHCG/AFP", while the one formerly attached to the urine test label was just AFP.) But I was called in right away, so I just pointed it out to the phlebotomist, and she tore up the AFP one. I presume they can use the one blood sample for both tests.

The good thing being that this whole mess encouraged them to give me the paperwork back (slightly annotated), saving me the trouble of having to ask for it, as my oncologist told me to way back when.

The results? Nothing wrong. We'll be finding out about that suspicious lymph node soon enough, at my next CT scan.

Having a half hour before my scan, I decided to take the elevator to the eleventh floor and see if I could get my bloodwork done. After stops at floors 3, 4, 5, 7, 9 and 10, I swore to myself that next time I had to go to the 11th floor just as people were coming in for work, I'd take the stairs. In the end, it was a waste of time anyway, as there was a person ahead of me and the phlebotomist going on coffee break, so I went back down. (Taking the elevator again, which was a much faster trip.)

Colorful Dress Lady again recognized me: "Leonard! You're not supposed to be here!" (Looks at paper.) "Yes you are!"

We chatted for a while about the French language and our shared inability to speak it. Colorful Dress Lady wishes she were bilingual - "Oh, well, maybe my next life." Me, I'm pretty much okay with my Grade 9 level French (Parisian dialect, I think) and Quebecois profanity.

At least the third dose of Gastrografin went down easier. A sign of promise! The guy who led me to the pre-scan IV-setup nook was new (to me, at least), and the length of time he spent looking for a ripe vein didn't lend him any aura of experience. I started lapsing into my "Brace yourself, he's incompetent!" frame of mind, which includes tensing up and teeth gritting. He noticed and asked if I was prone to passing out when jabbed. I said no, and quietly made note that if I did, he'd better not be there when I wake up.

He did well, though, much better than I expected. He was even bright enough to put the last piece of tape on my watch instead of my arm. I thanked him.

The scan was generally uneventful, but the dye went into my arm sloooooooooooooooooooowly. So I got the wonderful extended-play DVD version of the flaming bowel of death feeling. It's hard to explain if you've never felt it, but after about 30 seconds, the warm feeling starts to gain... texture. The general feeling of warmth is augmented by stronger lines of heat radiating outward from the center of the warm sensation. Soon after, small trails of heat begin to wend their way along the skin. It would have been a very cool experience, if not for the fact that the odd growing-hot feeling creeping along the crack of my ass made it feel infinitely more like I had sprung a leak from a part of my body I hope never leaks.

The post-scan tape-pull (like a tractor pull, only with less hydrocarbons) was agony, but at least the technician was bright enough to pull all three pieces of it at once! He might've been a newbie, but he was good at what he did. Book by its cover.

I was rather more of a bleeder this time, as I had to sit with my hand on the gauze for 5 minutes before being free to get dressed and make a break for it.

It was time to go up to the 11th floor again. True to my word, I took a glimpse at the packed elevator nexus (Rush hour, bah - why couldn't it be rush minute?) and made for the stairs. Feeling nine degrees of manly, I ran up the first 5.

Feeling somewhat less manly, I walked up the next 2.

Feeling not very manly at all, I pulled myself up the last 2.

So now she's on coffee break. Half an hour after she was apparently going to go. Fate's got it in for me this month.

Downstairs (elevator this time), I went to the clinic blood collection. While waiting, the ceiling-mount speaker flared to life: "Zoobza zoo zoo zoo six." None of the six or so waiting people could figure it out, beyond perhaps "Booth six." Collectively, we decided just to pretend it didn't happen. No one was screaming and running from a fire, bomb, suspicious vial of powder, or any of the other things one might run from in a hospital, so we figured it probably wasn't that important an announcement.

Bloodwork was fairly fast - not a bleeder this time. Oh, and both the CT tech and phlebotomist commented on my impending birthday. Yay! My inevitable death, a nightmare-filled circus of despair and terror, grows closer!

Good news moves much faster than bad in a cancer clinic, mostly because no one wants to give the bad. So it wasn't long before I heard that the lymph node they were worried about hasn't done anything. It's still the same. Bigger than it was a year ago, but no larger than it was 4 months ago.

I was informed that my doctor was in a meeting (and had been for at least an hour more than expected) and would be seeing me "soon". Hopefully. In the meantime, another doctor would come in and see me. In an effort to have more time to see the expanding roster of patients*, the oncologists are leaving some of the gruntwork of examining patients to GPs. You'll recall that one of the many trainee doctors I've seen by now was a nephrologist retraining for just that.

(* Recent newspaper headline: "Cancer killing seven of us [Nova Scotians] a day".**)

(** Recent tourism ad: Nova Scotia is the place to live if you want to make it past 100.)

Well, this doctor wasn't that nephrologist, though she was strongly reminiscient. A woman of similar age and height, the most telling difference was her incredibly strong accent and occasionally shaky grasp on the language. Likely Russian, but possibly from another Eastern European country.

She was very thorough, I do admit, if perhaps a bit too intent on getting me into a support group. Eventually I had to lie about my family and exaggerate the number of relatives with whom I regularly communicate just to get her off my back. This is the second time in about three weeks that someone's pried into my past and taken the response "I keep my own company very well." as a desperate cry for help. I do so dislike attracting people looking for more crosses to bear and happy to grab at mine. They're not that heavy, I've got 'em, thanks. (Her diagnosis that I'm a "very private person" was a bit amusing, considering that in the back of my mind I was processing the conversation for use on a website.)

However, as I said, she was thorough. I got a mostly-complete physical and a chance to relate my entire medical history. Every major blemish from my torso on up was stared at and questioned. I did notice an odd trait the doctor had - before asking a question she perceived as embarrasing or otherwise difficult to answer, she would state "I am going to ask a question." and pause before asking it. Such questions ranged from (in my opinion) fairly innocuous questions about how many relatives I've lost to cancer to discussions of my sex life (or lack thereof, as would be a more accurate description).

Despite her accent, I had very little trouble understanding her until she asked about "ahoo". Hmmm? She repeated it. "Ahoho."

This didn't bode well. "I'm sorry, but I'm completely lost."

So she tried to spell it. "E-T-O-H..."

The only thing that came to mind was the Japanese company C. Itoh, but that hardly seemed relevant.

So she wrote it down. Took her two tries even then, but finally a coherent word emerged. "Alcohol."

Alcohol! "Oh, no, I don't drink."

"Not even wine?" She paused. "Oh, if I'd said 'wine' you would have understood me!"

"Yes I would have, and no, not even wine." Before she could ask I told her I didn't take any illegal drugs, either. Or legal drugs.

I was then subjected to the 'physical' portion of my surprise physical. I was:
Poked, including my chest; the doctor wanted to know if I was also checking my chest for lumps, in the style of a female breast self-exam. (Answer: No, but now that you've mentioned it....)
Prodded.
Had lights shone on me.
Had my arms moved in various ways (not entirely unlike a reverse slow-motion Macarena) after I mentioned a pain I thought was in one of my chest muscles.

After that portion of Inquisition Lite was over, it was time for the event which has struck fear into the hearts of even dedicated medical doctors and other staunch protectors of the body human: The dreaded check of my testicle.

I was treated to a slightly broken English version of the lengthy disclaimer (the language didn't help the length) I've heard countless times before. Since she'd already asked for details about my recent sex partners, I don't see why seeing the actual bits would be an issue, but whatever. Professional detachment seems to be the sort of thing it takes time to cultivate, leaving me in a more capable place than most of the interns and other trainees I've met.

During the examination, the doctor said "You can look the other direction." and pointed at the wall. Given her nervousness, I took this as more of a request than a suggestion and examined the slightly interesting oxygen and air valves. (Generally I look at the ceiling. I mean, I'm lying down on my back anyway, don't see why I should crane my neck when I'm perfectly comfortable just lying there. If I'm tired I close my eyes and spend time convincing myself not to fall asleep.)

After this, she excused herself to go get my oncologist, whenever she should happen to appear. I started reading a short story in a book I'd brought - the story's only about 10 pages - and finished about a minute before she showed up. It was brief meeting, with as much small talk (about what I'm doing to remedy my lack of employment) as medical talk. (No wonder, the eight(ish) exam rooms must have been packed with her patients.)

So, next appointment for September (she's taking a well-deserved vacation in August), with an x-ray and other other usual hijinks. No interim bloodwork this time (which I'm heartbroken about, really, my wild dancing is no indicator of my mood), so it looks like I'll have a blessed summer free of all the needle pricks not directly related to my inability to sew.

See you on the other side of the solstice!

I remember sitting on a school bus, almost ten years ago, watching my high school appear from behind a nest of buildings, rises, and turns. It was a cool and breezy June day, and as that boxy gray and brown edifice loomed, I realized that this was the last time I'd ever sit on a bus and go to school. Post-secondary education beckoned, but that would be very different than this odd ritual I'd gone through for thirteen years.

Doing something for what is probably the last time is little better. One tries to prepare for both a change and a lack of change, and likely fails at preparing for either.

It was with these thoughts in my head that I walked into the Dickson building on the 13th. You see, there's a chance - two days ago I would have said "very good chance", but the more it seems events should be settling down, the faster things change - I'll be moving soon. Possibly to Edmonton, but wherever it is it will be out of province and away from all my doctors.

Still, chaos of an uncertain future or no, I had a job to do.

I went into the blood collection area and, before I could even reach booth 6 and drop my paper off, someone appeared and offered to take my paper. Unfortunately, that meant I didn't have it ready, and, grabbing at the first one I found in my Envelope of Unending Forms, I didn't hand over the right one. It was a bloodwork form, yes, with the same tests, but with a note to make a copy and return the original to the patient. Seemed like a waste, given that I had two and I might never need one again.

The wait was short, and the technician skilled. The jab was no worse than those I invariably get while sewing.

My x-ray was somewhat more interesting. I registered, as normal, but wasn't told to go down the Long Hall. I had to go to a small waiting area (for another test, some kind of bone scan) just across the Long Hall, rather than down it. I was told to wait for someone who was inadequately described. The reason for this change in protocol was only slightly clearer: "renovations to the x-ray area".

I sat down, grabbed a copy of InStyle, and started reading. So engrossed was I in it (Hey, it was a Sela Ward interview and I'd read a shopping list if it included a cute picture of her.) that when someone matching Ms. Inadequately Described appeared, I didn't even notice. Thankfully, someone else was also looking for her, and snapped me back to reality. Inadequately Described took my paperwork and told me to go wait halfway down the Long Hall.

I spent the next half hour in my t-shirt and jeans sitting in one of four chairs ("four too few chairs", judging by the crowd that soon assembled) in the Long Hall, whose slight draftiness became more apparent as time went on. If you'll recall, about halfway up the Hall's length is a door directly to the x-ray room, which leads to the closet-sized niche where the tech stands. It seemed this was currently the only access to the x-ray room.

One advantage of being in the hall was that it made it easy to eavesdrop on passers-by. One disadvantage was that most of these conversations were either utterly banal or esoterically technical, or both. But I did glean that the renovations were less about prettying the place up and more about moving a new MRI machine in. Since the halls were never made for a machine that big, most of the moving requires one to knock down a series of walls, move the machine, then painstakingly rebuild the walls. Preferably without taking out anything load-bearing.

I also learned that watching a group of three guys who average six-foot-four walk by makes me feel inadequate. When I was a child, my GP guestimated that I'd end up six-foot-two. It had a profound affect on me - Goodness, I was going to be TALL! - and when I stalled at five-eleven-and-a-half (six in my shoes, as I'm quick to point out) I felt for years that I'd somehow failed to fulfil to my destiny.

But I'm digressing. Now to digress on something else entirely: My waiting-room fare (McLeans) reminded me of one of the things I'll leave behind by moving. It noted in passing that Canada doesn't get HBO. This shocked me, as I'd been watching C-Band satellite stations - including HBO - for so long that I'd forgotten that some channels are supposed to be exclusively American. Shame you can't strap a dish with a 10+ foot diameter to your back while travelling. (Heavens, I'll miss Adult Swim.)

The x-ray technician on duty was competent, though her voice - which was loud enough to carry well into the hall - had an odd quality to it. It sounded almost condescending, but without negative intent. It's as if she just spoke in a tone similar to condescension without ever realizing it.

After an extremely long wait, including a stint where the technician vanished while a rather annoyed man in hospital clothes sat around waiting for her to do something (annoyed, perhaps, because the bag of medical papers he had looked like a large purse). Presumably a doctor had to look at the x-rays before he was allowed to leave. I took the time to read a fascinating article about how some playgrounds are actually not all rounded edges and foam rubber anymore - miracle of miracles.

However, eventually I did get to travel through the little booth and into the x-ray room (that booth was not made for two people who don't know each other fairly well). The x-ray went well, though the technician was a real stickler for making things just so. Before stepping into the booth to trigger the machine, she'd not only spend a full minute getting me into place (this is about normal), but she'd take the time to smooth out the wrinkles in my shirt! Front view took two shots again, due to my lungs being long. Or, I suppose, the machine being short.

After the scan, I put my outer layers back on and left for the day.

Our conversation was pleasant but short - bloodwork looks good - mostly focused on moving. Turns out she has family out in the western half of Canada and they said what just about everyone who's gone out West has said. "You go there, you find work, you settle down, you don't want to come back."

Soon after she left, the oddest thing happened: I met the ugliest female intern you've ever seen. Broad shoulders, deep voice, excessive facial hair.... Hey, wait a second. This is a guy.

(Climbs to top of mountain.) THEY'RE MAKING MALE INTERNS NOW!

So, after about three and a half years of female oncologists and interns, my possibly-final trip is heralded by a male intern. (Final year: His ID badge had "Dr." before his name.) I'm kind of disappointed. I had a good streak going there.

Like many of his sort, he went through my entire medical history post-cancer with me. He noted that I used to be a patient of Dr. Reyno. I agreed, and pointed out that that had been the last time I'd seen a male oncological doctor or intern before now. He didn't seem to feel special. I mean, hey, I'm trying to work up a brotherhood here. Us stubbly guys gotta stick together.

He also asked me the standard things. All the fun things, like if the waterworks was working (must've picked that turn of phrase up from the nurse), or if my breasts were getting feminine or tender. (If ever I grow breasts - which, if my current male chest fat is any baseline, are going to be at least C cups - I am not waiting for my regular examination to get it dealt with. Though I might wait a day to get the fondling out of my system. I mean, hey, boobs constantly within arm's reach, that's tempting.)

Then, he asked about my AFP and HCG levels before my surgery. Though my chin was fuzzy, my memory was a bit fuzzier. "I think my AFP was normal but my HCG was up.... Does 30 sound right? Somewhere around there."

He made noncommittal but doubtful noises and kept looking for the info in my papers. When he found it I noticed that my HCG way back when was 34. (I still got it.)

After this, he did the standard battery of medical tests. Stethoscope to the back (breathe in and out through mouth), stethoscope to the front (don't breathe, breathe), tapping on various parts of my stomach that he found interesting. Unfortunately, he didn't lift his fingers like most doctors who when moving from spot to spot, dragging them along the skin. I'm far too ticklish for that sort of thing, and started to giggle. I explained why, but he didn't seem to believe me, writing it off to his cold hands. Cold they were, but I don't see how cold could make someone giggle.

And now, the moment you've all been waiting for, the testicular examination. The doctor asked me to lower my pants, in that way some of them have of asking while trying to avoid the actual phrase. He also used the expression "family jewels" at one point.

"Jewel," I pointed out. (Though I suppose it depends on what bits one considers a jewel. I wouldn't know - I'm not letting a lapidary near the hardware. Oh, and incidentally, old habits are hard to break: Even years removed, the only time I refer to my testicle in the singular is when I use the word "testicle". The assorted slang words are still used in the plural - doesn't sound right otherwise.)

He also had me stand up during the actual procedure, which is something most of the doctors I've dealt with don't bother with. The last one, as far as I can recall, was Dr. Rayson waaaaaaaaaay back when I first started getting this done. I don't think I'll go so far as to imply this is a gender issue, I just find that odd.

But, back to the present. I was standing on a footstool, evidently for more convenient access to my bits. (I've been trying to think of a way to frame that that doesn't sound rather sexual, but there's no way. What am I going to say? That if I were lying down, he wouldn't have to bend over?)

In keeping with the crude humor theme, I'd like to spend a moment pointing out one of the finer details of my then-current situation. Standing on a raised platform, in front of an examination table.

The examination table was in front of a window. An open window. A gentle breeze was quietly spiralling through the forest of my hirsute backside, and the parking lot bordering South Park street was getting an interesting view, should they happen to look up.

Vital facts:
My last appointment was supposed to be in August.
My last appointment was actually in September, because my oncologist was absent.
I'm supposed to be going for an examination every four months.
Starting next year, I'm supposed to be going every six.
I usually go every December, since my surgery was in December, and the natural progression of visits each year (every month, then every two months, then every three, then every four, then every six) all divide twelve neatly with no remainder. (First year, 12 visits ending in month of surgery. Second, 6 visits ending in month of surgery. Third, 4 visits ending in month of surgery. Fourth, 3 visits ending in month of surgery. Fifth, 2 visits ending in month of surgery.)

So I should be there every December.

Now, I've occasionally commented on my oncologist's habit of missing vital facts when dealing with me. As you can see from the list of facts just presented, this is a minefield. Math time!

August (when my appointment was supposed to be) + 4 months = December, like always.

September (when appointment was) + 6 months = March.

No points for guessing when my next appointment is.

Now, my oncologist might have her own reasons for doing this, but I suspect she just didn't remember things right. Problem is, if I move, it'll be in the spring. Probably not March, granted, but I was cutting it close with this last one and I don't relish doing it again. I had to arrange my time spent packing and getting my affairs in order around this gaping two-day hole in my schedule, and it was a bit of an annoyance.

So I called, explained things to a nice receptionist, and was told I'd be called back in ten minutes.

Three days later, I decided their ten minutes were up and called back. (This is why I don't relish doing things over the phone. I'm easier to forget about and I've got to pay seven cents a minute for the privilege.)

In the end, the phone tag ended with the oncologist's note saying the appointment was to be in March. (That's another thing I don't like about this kind of fone phun. It puts too many layers between me and the person I wish to speak to.)

And there's still no word on a CT scan appointment. I'll have to call about that, too.

So, in my dispute between my logic and a Post-It Note, the Post-It won. Next - and very likely final for Halifax - trip in March.

March 28, 2006 AD: It was late January, I believe. I picked up the phone and started dialing, reluctantly. And I was quite literally dialing - I was using an old (but reliable) stuck-to-the-wall rotary phone. It gives you more time to think about things as the dial spins back to default position.

I was making my last appointment with my GP before leaving the province - yep, like the Village People song, I'm going west, at the end of April. While my concentration focused on dialing, the back of my mind was turning over thoughts about how he'd been my GP since I was born - I was born c-section, and he was in the operating room (not a common procedure, but he's not a common doctor). He's known me since before I had a navel. Leaving someone like that behind is, well, damn near impossible.

The call connected. I explained to the office secretary that I wanted an appointment, and for which of the three doctors in the office I wanted it.

"Well, " she said, "it will have to be soon."

"Huh?"

"Dr. Acker is retiring in the middle of April."

"Really...?" I knew he wasn't a young man anymore, and that he'd been slowing down and taking more days off of late, but this was still surprising. And yet, he'd be retiring a mere fortnight before I was scheduled to leave the province.... My largest qualm about leaving had suddenly become an inevitability, whether I leave or not. A weight was lifted from me. It's only one of many I'm carrying right now, but it was a large one.

Fortunately, I needed my appointment for the end of March. I worked the details out, thanked the secretary, hung up, and had a good laugh.

I couldn't be losing my doctor at a better time.

The Gastrografin - I had an emergency bottle onhand - was vile, as always.

But life doesn't work like that. As I walked up the parking lot to the Victoria General, I thought of my previous trips here, and I thought about my mother. My first memories of this place were as a child with my parents, accompanying my mom on the follow-up visits to her surgeon, after her cancer surgery. She returned the favor when I started my trips to my oncologist. Then we wound up accompanying each other to various appointments after her cancer returned. Finally, I travelled without her after the disease claimed her life.

I wanted this to be a quiet and contemplative affair, at least until I got to my first stop at CT registration. The chapel I passed even had a service going, which I'd never seen before. It all seemed perfect.... And then my digestive tract reminded me about how, no matter want I want to do or need to do, it can rearrange my priorities in a heartbeat.

So my first stop was the washroom.

While I don't think anyone cares to hear about this sort of thing, I just have to say how much I hate those autoflush toilets. Because they invariably flush at a time which is neither timely nor expected. This becomes relevant later.

Okay, not relevant, but this is a warning to expect more toilet discussion.

I also have to say I just noticed that the four-digit room number of the men's room (marked on the top of the door casing) in the Dickson building lobby is identical to the last four digits of my home phone number. Silly how things like that can be right there in front of you for years and you never notice, huh?

I mentioned my impending move and we spoke about prospects out there. She said, "There's a lot of jobs, but the cost of living is a lot higher."

"Well, I'm unemployed right now, so the cost of living is high here, too!"

She laughed and agreed, handing me my fashionable hospital duds and wishing me well before leaving.

"Thanks. Oh, and I just realized" (Well, okay, no I didn't, it had been on my mind for a good ten minutes.) "that I don't know your name."

She seemed both surprised and amused. "Catherine." (And I probably just misspelled that.)

I smiled. "A very pretty name." I bid Catherine farewell and headed for the changing rooms.

The scan itself was an exercise in waiting. (That's what I get for showing up early.) After I finally got into the back room and into the needle-pokey-poke chair, I found out the waiting wasn't done - someone on a stretcher had been sent down and of course they take priority. I was told this by the (fairly young, unfamiliar, cute) woman who set up the IV. She was impressed that I had shaved my arm. I was impressed that I'd actually remembered. But I had this nagging suspicion I was forgetting something important.

Unfortunately, my desire to not look at the needle gave the technician pause. "Don't like needles?"

"The pain isn't a big deal." (I hoped.) "I don't like watching them."

"I understand that. I can't watch someone set up an IV in my arm, and I do this for a living to other people."

There was probably a good joke in there about making sure she watched while she did her work, but I left it pass. I was still apprehensive that I was about to ride the merry-go-round of IV pain. Fortunately, she was as skilled as she was cute. (But if I had to, I'd trade the latter trait for the former any day of the week.)

I had a lot of time to get a last look at the back room. I thought I saw a newspaper clipping of Catherine dressed up in some sort of costume at a party. Unfortunately, it was down the short hall towards the CT scan room and to get closer to it I'd have needed to intrude on their work, and when someone's gonna be pumping chemicals into you, as a rule you don't want to make them mad.

I distracted myself for a moment by pushing the plunger on the saline syringe that I was hooked to, pumping a bit of saline into my bloodstream. It freaked me out - I'd make a terrible druggie.

Eventually, my turn came. One more time on the machine, one more time almost getting shot with that laser in the eye. The technician (also young and cute and female) tossed a cloth of some sort on my chest. Attached to the cloth was a paper or something else with writing on it. I hate situations like this; I'm not allowed to move, so I can't get at the paper in any way. It's at a tantalizingly poor angle, enough that I know something's there but not enough to actually read it. The CT scanner has a 4-inch wide glass strip, shaped like a cylinder, through which the spinning x-ray equipment gazes at (and into) me. I wound up using what little reflectivity it had to read the paper. After figuring out how the text was oriented and mirrored, I realized it was a room number and a string of digits I had no understanding of.

Since it was taking longer than normal to get the show on the road, I also did some crude estimating of how fast the machine spins. At speed, it's moving about 60 RPM. All these wires and mechanisms and support structures, perfectly balanced and moving somewhere between 5 and 10 feet per second in a circle around you.... If you think about it for any length of time, it's a bit unnerving.

Fortunately, the familiar "Breathe in and hold." recorded command came over the speakers, breaking me from my train of thought.

After the preliminary scan, I was wired for sound contrast medium and sent through two more times. It took a few more seconds than normal for me to board the flaming bowel express, but it also lasted longer. Not a good tradeoff, in my mind; it's something you want to get over with.

Afterwards, as my right hand was occupied applying pressure to the post-IV bandage on my left arm, I swung my legs off the scanning table I found the floor to not be where I expected it - the machine hadn't quite finished lowering me to the ground. My feet never gained the traction I was expecting and my arms weren't near anything I could grab, so I lost my balance. While I quickly recovered, I soon realized that in recovering I had instinctually braced my feet wherever I could get purchase, which meant my left foot was a good yard away from my right.

That, the short hospital clothes, and the position of the technician all combined to give her a good flash of my underwear.

My burgundy briefs, amazingly, didn't inflame her passions. (In reality, I'm just glad she didn't laugh at me.) I stood up, said my goodbyes - same as always, as these people change month to month anyway - and the remaining shreds of my dignity followed me out to collect my clothes.

On the way back I passed the IV technician explaining the contrast IV to an older lady in a wheelchair. She said, "It will feel warm...."

I resisted an evil urge to say "Warm as in change-your-underwear warm."

The woman at the desk was, as always, pleased to see me. She got me a form fairly quickly - while she seemed to think she was gone a while, after waiting about an hour total for my CT scan, it seemed like nothing.

11th floor blood collection was closed, so back downstairs. While there were about a dozen people waiting (9ish in the main area, 2 groups of 2 in the clinic blood collection area), the three phlebotomists were sitting around chatting. I was called second (Huh? Shouldn't I be third?) and led around back to the regular blood collection booths.

The phlebotomist was good, but whereas most will say "1, 2, 3" and then poke you, she poked me, then said "1, 2, 3". I suppose the surprise is good, but why count?

We chatted about how wonderful a spring day it was. Little did we know, the very next day winter would be making an encore appearance.

I didn't walk around back to leave, resulting in funny looks from the regular waiting room occupants as they see this guy who didn't enter that way leave that way.

And then, as I donned my jacket and left the stall, it flushed again.

I'm being mocked by a bathroom fixture.

My doctor and I took our seats on opposite sides of his desk. I looked out the window at the view of Spring Garden Road and Robie Street that he'd had for at least twenty years, probably more, then I took a good look at him. His hair was finally whiter than it was gray. I still can't get used to it. My mind pictures him as he was when he treated my ear infections and gave me my booster shots, 40-something and so very tall, not 65 and my height. The most important thing he probably ever did for me was getting me to a surgeon mere days after my tumor diagnosis four years ago, but the first memories that come to mind are always of the checkups back when I was a growing boy.

"So," my doctor asked, "did you see the announcement in the paper?"

"Er, what?" I responded.

"Of my retirement. An announcement was in the paper, about three weeks ago. Thursday through... Saturday, I think."

I read the local paper (and complain about the typos) but I never read the announcements; it's never someone I know. Except Thursday three weeks ago, I guess. "Oh, no. I called about a month and a half ago." He seemed surprised when I explained my moving plans, but he was amused, especially because he's moved his retirement a bit, to May 1st. His last day in the doctoring business, April 30th, is my last day in the province.

I asked, not really expecting a positive answer, if he knew any doctors up that way. He didn't. A number of years ago, yes, but not recently.

With no specific medical worries, I just got the basic blood pressure/stethoscope checkup. I closed my eyes and enjoyed that wonderful feeling of being taken care of.

We spent most of the 15-minute visit just talking about our respective futures, his ending of a lifelong career and my (hopeful) beginning of one. He's got young grandkids scattered across the continent now, and it pains him that they don't recognize him. There's also a lot of golf courses beckoning him. (A doctor that enjoys golfing, huh.)

We said our goodbyes, and wished each other health and happiness as we started the next chapters of our lives. "Oh," he said with a smile, "call your dad in for me." Saved me the trouble of asking - they'd spoke briefly in the waiting room, but neither one seemed willing to end things without a proper goodbye.

The three of us spoke and joked around for a minute or two. "Oh, don't worry," he said with a smile, "I'll be talking about my patients from Cape Breton for a very long time." I'm sure my mom was included in that statement.

My father and my doctor exchanged their goodbyes and my father left. I lingered a few seconds. Normally I can look my doctor in the face as I speak to him. Now I couldn't. I looked over my shoulder, in his general direction. "I'm really gonna miss you."

He said something. I couldn't think of it five minutes later, but I remember it was appropriate. I left his office for the last time, turning back a moment to slowly, quietly, close the door.

The nurse, Pam, showed up to have me weighed fairly quickly. She looked at the magazine I carried and got some sticker shock from the price. (Import, you understand. But nostaligia's worth the price.) So shocked that she showed no signs of weighing me, so I did it myself. 80 kgs almost exactly - I'm creeping up very slowly. I suspect the stress of the move and employment will reverse that trend, fast.

I was led to one of the rooms overlooking the Dickson building entry area. We made small talk and spoke of how I was moving. And I found out there'd be a new intern this month. Let's see... another male, perhaps?

Yep. We went through the standard things - bloodwork fine, CT looks good but they're waiting for the official result. I said "You guys haven't been wrong yet." but got a confused reaction for my trouble. He tried to convince me to set up an open-ended appointment so if I was in town visiting I could come in for my examination, but I declined. An appointment like that assumes that I'll be visiting relatives in 2007 (I won't) and that I have relatives in Halifax (I don't). The rest of 2007 will see me either working or looking for work, and what little business I have left in Nova Scotia I have in Cape Breton, four hours away from Halifax.

The physical examination was fairly normal, both the stethoscope work and the quick feel about my remaining testicle, except for two things: the speed (despite taking about the same length of time, he seemed to be rushing through it) and the fact that he checked the lymph nodes in my upper thigh. I'm ticklish in my upper thigh (and really, almost everywhere else). I just barely managed to keep from giggling as he checked my legs near my groin. I think the speed partly contributed to this. I felt like I was in a factory getting worked over by one of those people who's done the same thing for 10 years and can debone a fish/sew a boot heel/assemble a complex component without even looking.

But soon it was finished and he left to get my oncologist.

The wait was longer this time, burning off any time advantage coming in early had provided. But I didn't mind. I had a magazine to read and it would turn out to provide the timing for the last event of the day - more on that later.

My oncologist and I traded pleasantries, then she got right to business. "To be honest, I don't think it's worth it for you to get another oncologist. You only have one visit left anyway before the five year mark, which is when you just go back to regular GP visits. So instead, six months from now - when's that?"

I looked at my watch. March, the third month. 3+6=9, and September 11th has unfortunately provided an easy mnemonic for remembering what the 9th month is. I said, "September."

As I spoke, the intern says, "December."

Now, my oncologist can be a bit weak on the numbers sometimes, but she knows that spring + 6 months = fall, not winter. We both looked at him. In response, he buried his head in my medical records and said "It'll be five years in December." Well, fair enough, but not the question on the table.

I decided not to explain why the two numbers clashed so bad. Didn't seem worth it to spend five minutes waving at a calendar, to be honest. Late November was decided on as a compromise (!). So I'm supposed to:

1) Try get a family doctor before then if at all possible
2) Call down with my updated address and nearest hospital
3) Use the bloodwork and x-ray requisition late November, the results of which will be faxed down.
4) Wait for results.

Oh, and try not to lose the papers.

The idea is a family doctor (GP) can do the physical exam, and they'll look over the test results in Halifax. Then I'll be finished.

That sorted out, I received various bits of well-wishing, shook hands with my oncologist, and she took her leave. The intern told me to wait for the nurse to come back with the paperwork. I did, and she did.

She re-explained things briefly, then gave me the papers. On the way down the hall towards the elevators, she gave me a hug (it was nice - I miss the occasional warm hug) and told me to take care of myself.

She said, "I hope someday I see you walking around a shopping mall." We made the obvious jokes about the West Edmonton Mall as she turned to enter an office just off the hall. "Best of luck to you out there."

"Same t-" I stopped short. "Would it be appropriate to use 'Same to you.' in this situation?"

"Sure," she said with a bit of a laugh. "I need all the luck I can get."

"Well then, best of luck to you. 'Bye." I bowed a bit, turned, and headed for the elevators.

Unfortunately, the woman at the desk was busy, and I couldn't say goodbye to her.

My typically procrastinating self has delayed on getting my end of November medical work done. Oh well, "End of November" would still be valid if November had 40 days.

Yesterday, December 5th, I started making phone calls. I learned two interesting things:

1) The walk-in clinics everyone mentions this place having a lot of? They don't self-advertise. There's about all of three in the entire city called walk-in clinics. Every other clinic, you call to find out.

Entering the mall was quite interesting. It was a mall, sure, but distinctly less retail-oriented. All the storefront windows opened on waiting rooms and reception areas - the ones that weren't frosted glass, anyway - except for a Shopper's Drug Mart (prescriptions + various hygiene and convenience store items) and a rather-out-of-place Zellers (big-box store) at one end. Essentially, someone had taken the mall paradigm and beat the medical industry over the head with it.

In contrast to the full parking lot, the building felt surprisingly empty. Most of the people were in the waiting rooms and not in the mall itself, unlike a real mall where there's usually heavy between-store traffic. It's quite a shock if you've just visited the West Edmonton Mall, where even on a weekday in winter you're dodging legions of people. (And don't get me started about the food court....)

The Meadowlark mall/medical center was a rough T shape, albeit one with a much longer crossbar than vertical bar, with me at the bottom and a large circular information desk at the junction. I walked to the info/lottery ticket desk (Free health directions or $2-a-pop economic misdirection, all in one place!) and waited behind an older man who was intently debating the merits of various scratch-off tickets. He picked one and turned to look over his shoulder as he started to scratch it. Realizing he was in the way of a developing line, he moved. I asked where x-rays and blood were taken, still fearful I would be told I was in the wrong place. But no! The bloodwork lab was halfway down the mall to my right, towards the incongruous Zellers. I thanked her and headed there, deciding that I should get that out of the way and then worry about where diagnostic imaging was later.

The bloodwork lab was busy, but not so busy-looking that it justified the large half hour wait sign. I handed in my form and Nova Scotia health card in and explained that I was still on that health plan until the end of the year. Some copious amount of writing and note taking later, I got my card back, and the rather confused woman at the desk asked me what my first name was. I found that odd, since it's on both the health card and the bloodwork paper, but that's the problem: I found out that my name was listed on the form in the rather illogical format.

Lastname
Firstname, Middlename

That comma is both superfluous and confusing. And this wasn't a one-off typo - it looked like some sort of stamp or transfer from raised type, marked in classic mimeograph ink purple. Sure enough, the x-ray form was the same. (As are some 2006 vintage spare bloodwork forms I have sitting before me as I type this. I presume the erroneous comma was a widespread phenomenon in the Victoria General in Halifax, and thus ignored. Strangely enough, my old VG hospital card, whose raised type looks like the perfect source for the transfer, is a different format: "Lastname, Firstname Middlename" all on one line.)

I sorted out the confusion and sat down. Approximately fifteen minutes later I was called back to the desk. The doctor's stereotype of bad handwriting was alive and well, as I had to read my oncologist's written full name to the woman at the desk. I went back to my seat but was summoned back to the desk just before my back hit the chair back.

The woman said to me, "It won't be long now, but we're having a bit of trouble with your form."

"What's wrong?" I queried. I leaned over the desk and peered at it.

"There's a test here we don't understand."

Feeling all sorts of smart, I assumed they got messed up over the handwritten AFP at the bottom of the form. "I've seen a lot of these forms in the past five years. Maybe I can help."

She showed me one of the checkboxes instead. "We don't know what is meant by 'Auto Diff'.I think it's a CBCC, do you know?"

And that is how I learned a woman's voice saying "CBCC" is the sound that indicates I'm out of my depth.

"Uhhhh, could be?" I equivocated.

"I think it's a complete blood cell count - white, red, and so on - because there's none listed on the sheet."

"Seems right," I said, shifting from equivocation right into prevarication.

Another woman came over and after a brief conversation she confirmed her colleague's suspicion that it was a complete blood cell count.

"Sounds good!" I said as I gleefully hid behind someone else's proclamation.

That sorted, I was told to go into back room, hang a right, and sit in the first free chair. I did, and the first chair was also the first free one, so I sat there and rolled up my sweater sleeve. I admired the setup, with the blood collection victimpatient's chair right next to the bloodwork-paraphernalia desk and four sliding cantilevered shelves jutting out of the side of the desk (taking the space under the desk that drawers in the front would usually occupy) so patients of different heights can rest their arms comfortably while getting jabbed. I had little time to admire before the woman arrived; seems that the phlebotomist do all the front desk work too. (Or they let a receptionist take my blood, but I doubt that.)

Our conversation was brief and polite. (And she was good at her work - no pain!) She asked if I had lived in Halifax where my doctor was. I explained that no, I was about four hours out of Halifax. She laughed and said "I'm originally from Newfoundland, where EVERYTHING is four hours away." (It might be worth noting that of the seven or eight people I've told my original address to since I was here, three were from Nova Scotia and two others were from elsewhere in the Atlantic provinces. One of the others was from Manitoba. Some days it seems like the hardest thing to find in Alberta is an Albertan.)

We discussed other things, like why I was there (work, natch) and she mentioned that there was a government office in the building where they had job postings. She also told me where the x-ray lab was. I thanked her and (four vials of blood having been drained from me and my arm gauzed up by this point) she said I was free to go and to remember where she worked when I made my first million. We shared a laugh and I left.

I was told to wait nearby (rather than in the waiting room), where they keep two wheelchairs and a phone for people to call taxis. I had to regularly move for people who needed the phone (well, for this one lady repeatedly), and moving thusly made me look like I was in line at reception, which confused everyone else waiting.

One mass of confusion later I was called back to the desk as "Mr. Leonard." I explained that the comma on the form was a typo. So the woman started calling me by my middle name. It was then and there that I realized that all three of my names are viable last names. Indeed, my given names are more common as last names than my actual last name! A few seconds of pointing at various parts of the form and saying "That's my last name." "That's my first name." and I finally got that sorted out. Unfortunately, that's the only thing that was sorted. They needed my doctor's Practitioner ID, and I didn't have that. The Alberta College of Physicians was, in the woman's own words, "useless" at finding it, though her tone hinted that they weren't much better when she needed a local doctor's Practitioner ID. After some confusion they realized they could fax a request to the same "fax results to" number as was on the form. I asked if they could use a phone number for the nursing desk. They could, but that was when I realized I'd left the VG hospital reminder card I had brought (two copies, actually) in the car. I went out to get it, braving the cold once again.

Back five minutes later, no progress had been made. They gladly took the card with phone numbers that I offered (the one with the instructions telling me to call once I moved). They asked if I needed it back, but I said no, because I had another. As it vanished from my sight I realized I never checked the back for further instructions. Oops, again.

Ten more minutes of confusion and I overheard a newcomer (older than the other women at reception) say "Nah, just put 'No known practitioner ID' in that box." I didn't know if I should laugh or cry.

I waited another five minutes and then asked if I needed to stay by the phone any longer. I didn't, so I moved into the waiting room before I missed my call to the x-ray room. Not long after I was one of about four people called (I'd probably have heard it from the reception desk, but all it takes is one soft-spoken announcer to screw everything up). We all followed the announcer person single file down the corridor crate maze until we reached a side office.

We were sent to a row of changing stalls at the back of the office and told to remove various bits of clothing and replace them with fashionable paper wear. I asked if I could get away with just using my cotton shirt, like they do at some places (cough cough). Nope, gotta wear the paper vest. To make matters worse, they'd run out of small and medium paper outfits, so they were giving everyone something two sizes too large. It seemed that even large people got ones too large for them, probably in an attempt to stave off depletion of their "large" supply.

Folded in my open-backed paper vest (which looked like it could fit someone about 50% heavier than I am) I found a strip of plastic similar in composition to a plastic grocery bag, about a foot long. Puzzling at its purpose, I finally realized it could perhaps be a sort of tie for the vest. Sure enough, it stretched enough to get around me without breaking. But it had shrunk from an inch wide to a quarter-inch wide in the process, and that revealed another problem: Tying a small and slippery strip of plastic like that is bloody well impossible. I stuffed it in my pocket, defeated. (When I removed it from my pocket five hours later, I found it had tied itself into a knot in almost exactly the right place. So I threw it away. I win!)

Another truck was in the no-parking spot, this one using its boosted suspension to hide the sign outright. I suppose that's fine unless someone exits through the door in a hurry and gets a back bumper in the stomach.

Freeing up a space for someone else to park, I returned to my apartment to call the VG and let them know I had the x-ray and bloodwork done.

1) I expected a painfully long wait ahead of me when I walked in and saw a waiting room with about 20 chairs full to the gills. Surprisingly, I was called in within minutes of sitting down, a good ten minutes before my appointment time. I felt the envy of the people who were waiting.

2) The secretary didn't seem to know who I went to see - on the way in the doctor's last name was Romano. On the way out it was Jackman. I'm currently wondering who the hell I ask for when I next make an appointment. Gonna go with the first one, seems the better bet. (What can I say, he looked more like a Romano than a Jackman.)

But the best part was that Doctor Whoever was very happy with my blood pressure and the various bits that he examined. So, yay!

She also admitted to an amusing near-faux pas. While she had called just after lunch Halifax time, which was right around the start of the working day here in Edmonton, one of her coworkers had stopped her halfway through dialing first thing in the morning Atlantic time - 6:00 AM Edmonton time!

I called to try get the whole Romano/Jackman thing sorted out. It was sorted out - so I thought - and I was officially Dr. Romano's patient. This feeling of assuredness lasted a few hours, until they called to schedule my referral appointment to see a dermatologist.

I don't need a dermatologist.

Turns out there's another patient there with a similar name to mine, and our records had been combined by the behind-the-desk braintrust. That guy is Dr. Romano's patient. So I still don't have a conclusive answer.

After a few days of trying to get it sorted out - glaciers return your calls faster than they do, and to my knowledge no glacier even has a phone - I gave up. I called the Halifax Cancer Center to tell them the whole story. It was the afternoon of the 21st (Friday), too late in the day to get a callback from a live person, but I was just looking for the answering machine anyway. Turns out they turn off the answering machine during non-work hours! The nonanswering machine said to call back when they opened on Monday.

Monday, the 24th, I called back. Got a new message telling me to call back Thursday after Christmas break. I stared at the phone for a little while, wondering why the hell they used a standard call-back-Monday weekend message if they weren't going to be in Monday anyway.

On Thursday the 27th, I called again. Finally got through to an attentive machine and explained everything. I told them to fax everything to Dr. Romano (still say he looks like a Romano) and hope it would sort itself out. (Oh, me of too much faith.)

I waited a bit, then called the GP's office to confirm. They promised to check and get back to me when they had a free minute. They must be working hard 24/7, as it's been a whole day and nothing. (Sigh.)

I know I'll get it sorted out, it's just that I was no good at tag when I was a kid. Playing it on the phone - with an added dash of the waiting game - has not improved my success rate.

December 17, 2007 AD Redux: Well, it's been a hell of a half-decade. Five years ago to the minute as I type this, I was still a bit groggy from the anesthetic I'd taken a stronger-than-entirely-necessary dose of. I was also learning what you can't do without pain when you've got a freshly-sewed-up scalpel cut in your abdomen. (Lesson 1: Walking at any rate of speed. Lesson 2: Laughing. Lesson 3: It involves bowel movements, so not going into details.)

Now, after countless x-rays and CT scans and a presumed oil drum of blood extracted, it's - hopefully - over. I'm well on my way to becoming the good kind of statistic, the kind that survived the five years until they stop keeping track.

For the most part my long and sometimes lunatic trip has reached its conclusion. From now on, it's just my self-examinations and a few more minutes tacked on to my yearly checkup (and very likely yearly bloodwork). I'll post anything interesting that happens on those little forays, but they will be annual postings, few and far between.

It's been a hell of a trip. Take care, my long-suffering readers. I appreciate the e-mails and all the good mojo I've received, and send some your way if needed. Unless it gets deleted by a spam and/or mojo filter. Those things happen.

Health and happiness,
Len Pitre

The doctor said, "You're going to need some bloodwork."

"Sure," I responded. "Standard stuff? AFP, Beta HCG? There's one I'm missing...." It's been too long; some things have been shifted into long term storage and my recall is no longer instant. "Lactate.... No, wait, that one's not a regular one for me anyway."

"LDH? No, it isn't." (I thought more and remembered that LDH - lactate dehydrogenase - was, as my oncologist said, "a prognosticative test", meant for people who've just recently been diagnosed as a way of better determining their odds.)

Unfortunately, my knowledge of acronyms had made the doctor assume I possessed far more medical knowledge than I have. He told me every test he was having me get, a long string of acronyms that were all entirely lost on me. I didn't have the heart - or a durable-enough ego - to ask him to dumb it down, so I let him go on. But the universe wasn't going to let me get off that easy; it had something else in store, and was going to play that card later.