From the category archives:

Finding a physician

Lucy Q from the Breast Care Center calls one week after their radiologist informed me that I have breast cancer.

“How are you sweetie?” She sounds young and perky. “Sorry I did not call you earlier, I have been on vacation.” She pauses and I expect her to tell me about her vacation.

“How are you doing?”

“Fine I guess.”

“Just wanted to see what is happening.” Her choice of words was those of a college girl checking on Friday afternoon with a girlfriend. “Any frat parties to attend? ”

“Have you picked a surgeon?”

“I have.  At the Medical School.”

“Oh no, not the Medical School, we don’t want to loose you!” Maybe realizing her unfortunate choice of words, she quickly adds: “Oh, it is very good place, but we would like to keep you here at our breast-care center.”

She launches into her marketing spiel (reading from the teleprompter?) Largest breast-care center in the Southeast, etc.

“Please reconsider,” she pleads.  “We have two excellent surgeons with wide-open schedules that would be the best for you. We want what was best for you. “

They have an open surgery schedule with two expensive surgeons twiddling their thumbs. I imagine it would also be advantageous for them, should I choose to come there.

“My plates are already at the Medical School.”

“No problem. I can work miracles and get them back. Just call me in the morning and we will set it up.  We have two surgeons I want you to see: Dr. L. and Dr. R. , both with wide-open schedules.”

Her tone, her perkiness, her sale’s pitch leaves me feeling empty. But I write down her phone number.

“Call me in the morning.” She promises to put a “care package” in the very next day. “Look at everything carefully.”

Susie Q. sounds like of a kindergarten teacher with her cheerful tone and her simple instructions.

I never call her back.

The care package arrives ten days later and turns out to be quite informative and useful. A friend with a surgeon husband tells me Dr. R. actually has a good reputation, but he is a general surgeon, not specialized in breast surgery and reconstruction.

When you look for a surgeon you want someone who has, if possible, done hundreds of the kind of procedure you are about to have.

Anyway, I have formed a mental block against the Breast Care Center. It took them ten years to discover my cancer. I have no plans to ever return there — not even for a mammogram. Especially not for a mammogram.

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“What are undifferentiated cells?” I ask my new gynecologist, Dr. Morte, as he reluctantly stumbles through my pathology report.

Undifferentiated cells sound pretty good to me. If cancer cells are no different from normal cells in my body, would that not be a good sign?

“You have to ask your oncologist. I don’t know the answer.” Dr. Morte slams the folder shut.

“You don’t know what that means?” I glare at him.

“You have to ask your oncologist.”

“I don’t have an oncologist.”

“Well, I am not an oncologist, so I cannot discuss this with you.”

We have clearly come to an impasse. My dislike for Dr. Morte is now intense.

“Why would I have an oncologist?”

I was proud to have found a surgeon already, but an oncologist? And what exactly do they do anyway? I assume they had something to do with chemotherapy.

Dr. Morte avoids eye contact. It scares me that he will not look at me and claims not to know anything about undifferentiated. His demeanor is weird and frightening.

Then he cleverly diverts my attention from the “undifferentiated” cells.

“Do you have a surgeon?” he asks. “If you don’t, I have someone I can recommend.”

“I already have a surgeon.” I cut him off, smug about being so resourceful.

“Who is your surgeon?”

“Dr. Guru at the Medical School.”

“Not familiar with him.” Dr. Morte shrugs. “Well, if you change your mind and need a name or referral, let me know.”

What is wrong with this man? He keeps talking about “my” oncologist, which I do not have, then he recommends a surgeon when I already have one. Why does he not give me the name of an oncologist? Why does he not explain some of the steps ahead? After all, he is a gynecologist and must run into patients with breast cancer all the time.

“Do you need me to fill any prescriptions?”

“Well, just the estrogen cream.”

He refuses, shakes that awkward head of his:

“No, now that you have breast cancer I cannot give it to you. You are at high risk for ovarian cancer, uterine cancer, and cancer of the colon,” he says.

“You have to make sure you take care of yourself now.”

“How do I do that? What do you suggest? ”

“Oh, you are doing it. You are arranging to have the breast cancer removed. Deal with that first.”

Before I leave, Dr. Morte reaches out to me, a hollow stiff arm, like a cardboard roll, slightly bent around my shoulder. He gives me an awkward pat.

“I hate doctor Morte,” I tell Marie. “First he will not tell me about undifferentiated cells. Then he scares me with bringing up ovarian, uterine and colon cancer. I am at risk for all of those.”

“I warned you, he is pretty thorough,” she says.

I disagree. Dr Morte personifies many traits of a bad physician:  He is steeped in his narrow specialty, ignorant or indifferent to anything outside his box. Pathetic communication skills.  An ass.

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My First–And Last–Visit with Dr. Morte, Part I

June 21, 2009

Doctor Morte, my new gynecologist, looks ascetic, with a largish, oval head on a thin neck stem. Thick accent. Is he Persian? I cannot place the accent, and it bothers me. I used to be good at identifying foreign accents and nationalities. He sits on a chair across from the awful examination table with the […]

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Grasping for a Cork in the Stormy Internet Sea

June 20, 2009

My friends Cecilia and Marie email me names of surgeons and oncologists. All of them are affiliated with the hospital closest to me. But this hospital is in a feud with Blue Cross Blue Shield, my insurance company. The news is all over the local papers. Given the insurance issue and Dr. Guru’s excellent CV, […]

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Breast Cancer is NEVER an Emergency!

June 20, 2009

Just before his office closes, I get an appointment for two weeks later with Dr. Guru, an oncology surgeon. “First available? Are you sure?” “Yes, that is the earliest. We want your x-rays from the Breast Care Center brought over here well before that, and we want your biopsy results faxed over right away. Then […]

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Finding an Oncology Surgeon on a Late-Summer Friday Afternoon

June 20, 2009

On my drive home from the office mulling over my new diagnosis, I try to think of names of doctors I can ask. My friend B’s husband is a vascular surgeon, he ought to know. But they have left for some medical conference on Corsica. My friend Elise’s husband Dan is a doctor. He teaches […]

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In a Moment of Crisis: Looking to Friends.

June 20, 2009

Thirty minutes earlier, I was told I have breast cancer. It is at moments like this you turn to your friends. I throw myself on the phone to call Marie and Cecilia. Normally, I don’t like to talk about anything personal on my office phone. I am in an office landscape and everyone hears and […]

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Lumpectomy Rhymes with Vasectomy. Must be a Piece of Cake.

June 20, 2009

Although the possibility that I may have cancer has loomed for weeks, months if you include the time I wasted after I discovered the lump, my diagnosis takes me by such a surprise that I do not have a single question for the radiologist when she calls and gives me the biopsy result. And she doesn’t […]

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