Wednesday, November 22, 2006

It's not just about the statistics...

I met my radiologist on Monday. Michael is younger than Suzanne and Mitchell, but shares the same clarity and compassion that seems to characterise the team at the Mercy. He had also been at the practice meeting about my case. We talked about the clinical trial of the twofold hormone therapies, and the decision not to have chemotherapy. He pulled a little phone/palm-pilot thing from his breast pocket and showed me how it could calculate my chances of recurrence, given the details from the pathology report, and the success of the surgery, my age and general good health. With the standard hormone treatments, chemotherapy would add just 1% to my chances of going the magical ten years without a recurrence. Chemotherapy also brings its own risks of course, including about a 1% chance of developing leukemia later in life. Well, let's be brutally honest here: all the cancer treatments bring unpleasant side effects and risks of various kinds. For example, I will lose about 5% of capacity in one lung over the 33 radiation treatments to come, as that part of the lung becomes scar tissue.

But the medical statistics, truly, are only part of the story. I am slowly realising what an emotional ride this is. Physically, I'm stronger and stronger every day as I wait for the adjuvant treatments to begin. Today I took myself down to the beautiful heated outdoor Fitzroy pool and swam 16 x 50m laps in its crystalline waters under blue skies and warm sun. Well, it's true that some of these were just with the kickboard, but stretching out my arm till it hurts (Michael's expression) is the best way of regaining strength. I still have a few patches along my arm and side where it still feels as if I am wearing a layer of sandpaper under the skin, but it is now just a fine grade, as opposed to the coarse grade that suddenly appeared a few weeks ago when the total numbness started to disappear.

I've had my CT scan and been tattooed (truly: three minuscule dots!), in readiness for the radiotherapy to start next Tuesday. That was fine, but there was a delay the next day when Danielle, the research associate, was ill, and wasn't able to enter me into the database and "randomise" me for the trial. Without this research protocol, the hormone therapy could not begin for another week. The news threw me badly, as I had prepared myself emotionally for this new chemical intervention into the body. I came home (Tash, the nurse, and Mitchell himself had both phoned me but I hadn't checked my mobile for messages), and felt teary and unable to read or do anything much for the rest of the day.

I find I have to pace myself, then, in terms of social interactions. I have not been accustomed to thinking of myself as emotionally frail or fragile, but am finding that the only place I want to be, most days, is at home. My son suggested I think of myself as hibernating while the treatments are going on; and it is one of the most helpful pieces of advice I have been given.

One of the reasons I write so much about the doctors is because I am fascinated with their understanding of professional practice. I am lucky to be in the hands of people who clearly, simply love their jobs. I have never felt rushed, or patronised by them. One time, about a week after surgery, I was in at the clinic having my wounds checked by the nurse, and Suzanne came in to see how I was going. She just stood there quietly and listened to me talk. Then the three of us would sit or stand in silence, and I would think of something else I wanted to say or ask. Suzanne would respond; and then we would all wait quietly a bit longer, and I would think of something else. This happened a few times.

Sometimes I am bright and cheery with the doctors and we converse as professionals, swapping stories about lecturing or research protocols or music (Mitchell is a pianist); other times I am serious and anxious, wanting lots of reassurance. I think I may have something to learn from them about how to supervise students. I don't mean I want to medicalise them! But rather to be more open to listening to the mood that they are in and how they are feeling. It's not just about the body and the statistics; it's not just about the thesis.

Another inspiring model to contemplate is Larry, my tennis coach. (I can see how far I've come physically this last week, as I not only rode my bike for the first time on Sunday; I also had a gentle hit at tennis.) Last year we asked Larry to teach our son to play; and then I started joining in to share the lessons, since I had never learned. Then my partner, who is an excellent player, joined in for coaching tips; and then our neighbour Alan, who introduced us to Larry in the first place, also joined in. So for an hour on Sundays, Larry manages an 11 year old, two 48 year olds (one beginner; one expert), and an 82 year old veteran. Through his own passion for the game, he somehow teaches all of us with grace, wisdom and good humour, tailoring the advice and the level of play for what we all need. He coaches just a few streets from where he grew up, and still lives. There are many, many worse ways to live.

2 comments:

Pavlov's Cat said...

Tennis is such a lovely game. Summer season coming up, too; if you're hibernating you'll be able to watch the Australian Open not only with a clear conscience but with a new appreciation for the game.

I am filled with admiration (I was going to say speechless admiration, but that is clearly not the case, n'est-ce pas?) for your determination to get fit and strong in general, and for the swimming in particular, which must hurt. At the same time I remember swimming-as-physiotherapy and I found it wonderfully calming and enabling just being in the water. From your description of the pool, you do too.

Stephanie Trigg said...

There is also ... ahem ... the cricket. Apologies to any English readers; and yes, I do remember what happened after the first test in the previous series...