We three jogged out of the parking lot of at a local conservation area, single-filing it onto a narrow track. The eight or so kilometres of trail led around a man-made lake that, for southern Ontario, boasted surprisingly woodsy surroundings. Normally full of day hikers and kids — this was late September, the kids were back in school, and we had the route to ourselves. What we also had were wet, muddy, now overgrown pathways . . .and slippery footing.
There was a time when the trip or slip was just a predictable part of these slick runs. Getting dirty was part of the fun. We all took pride in the shoulder roll after a tumble — landing back on one’s feet, barely missing a stride. Fall was a season — a noun, not a verb.
A few decades on, and hurrying along the icy, January sidewalk — late for an opera in Toronto’s downtown, it became a verb. Flat-out face plant — well more a knee scuff — but shame-worthy nonetheless. Then the streets of Venice, and racing to catch a train, the cobbles had their way — twice actually. A pattern was starting to emerge. I’ve never been a clumsy guy. But. . .
“Well it’s not Lou Gehrig’s.” Hard to know what passes for reassurance in the hallowed hallways of internal medicine. The conversation continued on for a bit, with a few other ‘rule outs’, working its way toward a ‘probably. . . but won’t know for sure without a biopsy’. And wrapping up with a ’95% certainty’. Aside a stubborn case of acne as a grade niner and a need to shop in the ‘husky boy’ sections of Eatons, I’d entered the world of real medical stuff for the first time. The acne went on its way, a compulsive running routine and a pay check to pay check budget transformed me into the ‘skinny dude’ — but this other. . . well, it was here to stay.
I’ve had a, let’s call it, ‘atypical’ relationship with urology. Working in a general hospital setting for 25 years in a community that could generously be called a ‘small city’, I knew most all of the docs. At the time, that meant having a nodding acquaintance with the town’s only such specialist. Highly eclectic guy who played jazz guitar as part of a pick up band on the main drag on weekends — then did, well, what these guys do to put bread on the table for the rest of his week.
Abiding memory of dealings with him professionally was that of a Friday afternoon check in to get vasectomized in my late thirties. Not sure how these things happen nowadays, but it used to be a local anaesthetic — and the opportunity to gaze up at the (clinically dispassionate) faces of doc and nurse assistant. It also left one fully able to ‘eavesdrop’ on the banter passing between these two. Jazz was going to be forestalled in favour lint rollering the new, red velvet couch, cat’s hair being the iron filings to couch’s magnet. Not sure I actually voiced the thought, but could you two maybe just focus on the job at hand (as it were) and plan the weekend later? Suffice it that these prior urological dealings had a bit of a twinkle and chuckle associated. Snip, snip and no heavy lifting for 24 hours.
What you don’t know, can’t hurt you, a rework of the sixteenth century aphorism, comes undone with distressing frequency as we tack on the decades. So this was the year to uncross the fingers and ‘get checked out’. What’s PSA and, more to the point, what does a reading of 14 mean? Evidently it means ‘go see the 2024 version’ (of the jazz playing, cat owner). So, having assumed the position, the cryptic ‘Hmm. . .’ that followed begged a little broader explanation. ‘Feels normal’ was the ‘full version’ — along with a bit of relief (for any number of reasons) — but also accompanied by a post-it note with a date for a biopsy! Seems ‘normal’ has a different connotation at 78.
To frame the current iteration (of urologist) as a man of few words is understatement. Biopsy done, complete with a dozen or so needle jabs in the gland of interest, the call came from, we’ll call her Melinda whose resume is more about short skirts and obedience: ‘David dear I have your results. . .’ Turns out it’s a bad news, good news scenario: cancer, but contained and Dr. T (for taciturn) would like to review.
As Dr. T proceeded to rule out a variety of options — all reserved for ‘younger candidates’, he gave the Reader’s Digest version of treatment: essentially radiation (I had a choice of ‘high’ or ‘low’ — another ‘hmm’, this time on my end) coupled with ‘hormone therapy’, the euphemism for triggering male menopause. Turns out prostate cancer cells snack of choice is testosterone. So, ipso facto, starve the little buggers by changing their diet. A second post-it note was the where and when all this would happen: London’s oncology clinic (because ‘that’s where we refer’).
I’ve gained a new respect for Nicola’s capacity for self-regulation over the past several months. London Health Sciences is roughly twice the driving distance as Kitchener’s equivalent facility, the Grand River Cancer Care centre, a consideration when the plan involved daily trips for multiple weeks. And Dr. T’s ‘review’, generously, could be called succinct, the information formatted to fit the ten minutes allotted to providing ‘answers’ to next steps, etc. etc.
Nicola maintained composure throughout the drive-by appointment, neither speaking nor pulling out a sidearm. She was merely going to leave, do the research — her ammunition for the metaphoric Glock — and formulate the actual plan. Suffice it to say the Rottweiler had been awakened.
Two timely and highly clarifying oncological consults later (at Grand River!) — offering a full palette of treatment choices (despite my advanced age!) — I was slated for a pre-op intake. A couple of servings of my favourite vintage (Pico-Salax, straight up) with a side order of tea, jello, or (living on the edge) popsicles would see me prepped for an extended ‘nap’ the day following with all the other post-surgical niceties.
Brachytherapy, the procedure that would happen while I was sawing logs, sounded a bit like surgical alchemy — literally turning one’s prostate to gold — if only briefly — before the haul is reclaimed and sold back to the local jewelry store (the gold, not the prostate). In my layman’s terms, it was a combination of salting a claim (sprinkling just enough gold seeds to get the interest of the assay office, aka radiological wizards) and an afternoon-long game of Minesweeper. The ‘treasure map’ in this case identified the ‘dig here’ sites for said salting, a quick zap, then reversing the whole thing — all hopefully without setting off any ‘explosions’. Happy to have been asleep throughout! The irony of all this was not lost on me: the eve of my 78th, election day in the US, and Movember to boot!
Day surgery being what it is (day surgery), a post-procedure visit from surgeon and anesthetist, staff reassurance that I could actually pee ‘successfully’, and we (Uber Nic, as she would become over the ensuing three weeks and I) were headed home. Side bar: the sleep doc, I’d say, at a guess, my age peer, had offered his version: ‘long, bit boring procedure’ . . . seems boring translates into lots of sitting around as the surgeon does his video-gaming magic (and obviously preferred to complicated, or exciting), long being shorthand for his second such four-hour shift of the day.
And so commenced ‘the drill’ and a surprisingly intimate connection with Waiting Room ‘C’. What begins with a visit to Grand River’s ‘tattoo parlour’ and all the uncertainty of first steps into unfamiliar territory, gradually morphs into a comfortable (or at least, familiar) routine, repeated daily, briefly, painlessly — supported by a dozen or so dedicated folks, from volunteers to nurses to technicians to specialists . . .and, of course, the ’customers’. What could easily have become a clinical, insular, dehumanizing regimen to be tolerated became a profoundly human experience — and the opportunity to connect, albeit fleetingly, with a cross-section of folks joined by a single, common thread.
Welcomed on arrival by one of an amazingly available (and legion) coterie of volunteers — B____ as it turns out is a neighbour — always smiling, polite, and ready to direct as needed (and it was needed early days!). Technicians to a one introducing themselves, offering a bit of banter that would likely be repeated a dozen times or more as their day unfolded, and the unfailing query (‘drink your litre?’) — helpful, supportive (literally), and ever respectful as they lined up the three little tat targets for a ‘clean shot’. The twice clockwise, then counter revolutions of magical, mysterious ‘barrels’ of equipment, carefully compliant with the directive to ‘not move’, caught in the crosshairs of the green laser beam. Then, the dash to jettison the liquid preload!
One of the most abiding memories of these three weeks is of the occupants of Waiting Area C. I’ve spent time in the anterooms of enough professional offices over the decades to establish some expectations of what passes for defining demeanour: vacant, averted gaze, phone scrolling or disinterested magazine page thumbing, awkward, nervous silence, each content to remain isolated in ones own wee bubble.
Not true in ‘C’. The encounters had a kind of rhythm about them. Perhaps, with repeated meetings, a shared ‘reason’ for being there, the brevity of the contacts (15 minute ‘commando raids’), and a certainty about the upcoming ‘procedure’, the ice was broken in some unspoken way — and we were all free to engage and share. Too, this was an astoundingly eclectic group, testament that cancer plays no particular favourites. The Amish farmer, the airport security guard, the retired university professor, a contractor, a dreadlocked sometime hippy — some accompanied by partners, some on their own. Where one would expect a dour mood, the conversation was invariably (and, I believe, authentically) positive. The nod of acknowledgement as a familiar face entered; the congratulatory moment when a treatment cycle was nearing completion. The little ‘club’ that required no additional explanation, no elaboration.
So did it all work? To quote a friend: ‘ask that question in another five years. . . and then we’ll know’. For now, suffice it that this very significant part of our medical system, membership, and community does work. . . and very well indeed. 