“Do not go gentle into that good night.
Rage, rage against the dying of the light”
– Dylan Thomas
“Your family history hangs like a dark cloud over these test results. In circumstances like these, we recommend a biopsy. Just to be sure.”
The kind surgeon with gentle eyes smiled at me reassuringly. It was biopsy day, and he reviewed recent events with me, to ensure I was on board with the plan. I nodded my assent, and then he sent me back across the hall to gown up, and to wait for the radiologist in the ultrasound suite.
He was the fourth physician in 2 weeks to say the same thing: you need to have a biopsy. Once the biopsy was done, it was a few days’ wait until the lab results were in. And so, he expected that by the end of the week at the latest, I’d have an answer. The uncertainty was so heavy, and the mere prospect of an answer so soon helped calm me.
Ten minutes later, the radiologist arrived, another name and face that I expected I’d forget as soon as the biopsy was completed. I smiled back a greeting, and then waited as she applied that cold goopy gel, and began the ultrasound.
She was frowning, though. A few moments’ silence. And then, she said the most unexpected thing:
“I’m not going to be doing a biopsy today.”
Wait – what? Seeing my surprise, she explained that she could see the mass, but it wasn’t fixed. As she pressed down on it, it moved. In her professional opinion, the lump was not indicative of cancer: it was not hard, fixed, unmoving. So no biopsy today, thank you very much.
Part of my mind was frozen in shock. Another part, though, spoke of its own accord:
“I’m sure, doc, that you’re very very good at your job. But try to understand – another equally skilled, equally qualified physician did exactly the same test 7 days ago. And came to completely the opposite conclusion.”
“Well,” the radiologist responded quickly, “I am telling you that there is nothing to worry about.” She was taken aback by my resistance.
I turned my head to look at her directly. “Why on earth should I just take your word for it? Four doctors have recommended a biopsy, and you’re refusing to conduct one. Is this not a professional difference of opinion?”
“Well, yes,” she seemed puzzled that I would even bring this up.
“Then how do we resolve it?” I pushed.
“An MRI,” she stammered.
“Then book the damned MRI.” A moment of frozen silence, and then the back peddling began.
“You see, the biopsy isn’t necessary, because the tissue moves, see. And besides, your 3D mammogram came back clear. So…” And then she shrugged her shoulders.
It was the shoulder shrug that got me. I measured the distance between my own distress – the burden of not knowing if I would live or die – and her casual dismissive gesture. It was of little consequence to her, obviously, the one refusing to end my misery by just doing the damned biopsy. So I could stop wondering. So I could get down off this ledge and breathe again. So I would know in a few days’ time if I was going to move on with life, or face off against this disease.
She was just another completely, totally tone deaf doctor. Without a single word passing my lips, I tuned her up. A hot, white rage oozed off me. I’m sure, as they all watched me sit up, everyone thought it was the return of Linda Blair. The lab techs began to back away. The radiologist made one last attempt to control the situation:
“Well, I guess I could do one anyway. You know, if that is what your peace of mind requires.”
The stink eye I fixed on her silenced any more offers to “help.” I calmly asked one question of her, because I got the feeling she knew absolutely nothing about me, her patient, or the family history that everyone else involved in my case management was so very concerned about.
“You know it’s triple negative (TNBC), right?”
The slow and confused blink I got in return told me everything: she knew nothing about me. Or my history. She only knew that someone else had conducted a set of tests, and there were some concerns about that. Looking at the picture in the scanner, she used only her professional judgement to guide her decision- not the input from the four doctors who had weighed in on the next step – and certainly not with any insight into my specific health history. No, she’d looked at the prior scans, and had a suspicion that there was nothing to worry about before she even did the test. She’d said as much herself: the earlier 3D mammogram was clear. So this latest ultrasound? It told her what she expected to find.
That “family history that hung over me like a cloud?” She had no concern about any of that.
Clearly, I was supposed to just roll off the exam table, bow, scrape and say “Gee thanks Doc! You’re the best!”
But I did not. I did not say much of anything, except to decline the biopsy that was a pity gesture. Adrenaline was surging in my body so strongly there was no way I could sit still for a biopsy at this point anyway.
I got dressed in silence, left the clinic and returned to my car. I was back to waiting, back to whistling in the dark. Only this time, the fear was replaced by utter fury.