{"id":602,"date":"2024-12-19T08:44:03","date_gmt":"2024-12-19T13:44:03","guid":{"rendered":"https:\/\/www.davidhowardpsychologist.com\/blog\/?p=602"},"modified":"2024-12-19T08:44:03","modified_gmt":"2024-12-19T13:44:03","slug":"big-c","status":"publish","type":"post","link":"https:\/\/www.davidhowardpsychologist.com\/blog\/?p=602","title":{"rendered":"Big C"},"content":{"rendered":"

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 \u2014 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. \u00a0<\/span><\/p>\n

\"\"<\/a>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 \u2014 landing back on one\u2019s feet, barely missing a stride. Fall was a season \u2014 a noun, not a verb.\u00a0<\/span><\/p>\n

A few decades on, and hurrying along the icy, January sidewalk \u2014 late for an opera in Toronto\u2019s downtown, it became a verb. Flat-out face plant \u2014 well more a knee scuff \u2014 but shame-worthy nonetheless. Then the streets of Venice, and racing to catch a train, the cobbles had their way \u2014 twice actually. A pattern was starting to emerge. I\u2019ve never been a clumsy guy. But. . .<\/p>\n

\u201cWell it\u2019s not Lou Gehrig\u2019s.\u201d 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 \u2018rule outs\u2019, working its way toward a \u2018probably. . . but won\u2019t know for sure without a biopsy\u2019. And wrapping up with a \u201995% certainty\u2019. Aside a stubborn case of acne as a grade niner and a need to shop in the \u2018husky boy\u2019 sections of Eatons, I\u2019d 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 \u2018skinny dude\u2019 \u2014 but this other. . . well, it was here to stay.\u00a0<\/span><\/p>\n

I\u2019ve had a, let\u2019s call it, \u2018atypical\u2019 relationship with urology. Working in a general hospital setting for 25 years in a community that could generously be called a \u2018small city\u2019, I knew most all of the docs. At the time, that meant having a nodding acquaintance with the town\u2019s only such specialist. Highly eclectic guy who played jazz guitar as part of a pick up band on the main drag on weekends \u2014 then did, well, what these guys do to put bread on the table for the rest of his week.\u00a0<\/span><\/p>\n

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 \u2014 and the opportunity to gaze up at the (clinically dispassionate) faces of doc and nurse assistant. It also left one fully able to \u2018eavesdrop\u2019 on the banter passing between these two. Jazz was going to be forestalled in favour lint rollering the new, red velvet couch, cat\u2019s hair being the iron filings to couch\u2019s 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.\u00a0<\/span><\/p>\n

What you don\u2019t know, can\u2019t hurt you<\/i>, 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 \u2018get checked out\u2019. What\u2019s PSA and, more to the point, what does a reading of 14 mean? Evidently it means \u2018go see the 2024 version\u2019 (of the jazz playing, cat owner). So, having assumed the position, the cryptic \u2018Hmm. . .\u2019 that followed begged a little broader explanation. \u2018Feels normal\u2019 was<\/i> the \u2018full version\u2019 \u2014 along with a bit of relief (for any number of reasons) \u2014 but also accompanied by a post-it note with a date for a biopsy! Seems \u2018normal\u2019 has a different connotation at 78.\u00a0<\/span><\/p>\n

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\u2019ll call her Melinda whose resume is more about short skirts and obedience: \u2018David dear I have your results. . .\u2019 Turns out it\u2019s a bad news, good news scenario: cancer, but contained and Dr. T (for taciturn) would like to review.<\/p>\n

As Dr. T proceeded to rule out a variety of options \u2014 all reserved for \u2018younger candidates\u2019, he gave the Reader\u2019s Digest version of treatment: essentially radiation (I had a choice of \u2018high\u2019 or \u2018low\u2019 \u2014 another \u2018hmm\u2019, this time on my end) coupled with \u2018hormone therapy\u2019, the euphemism for triggering male menopause. Turns out prostate cancer cells snack of choice is testosterone. So, ipso facto<\/i>, starve the little buggers by changing their diet. A second post-it note was the where and when all this would happen: London\u2019s oncology clinic (because \u2018that\u2019s where we refer\u2019).\u00a0<\/span><\/p>\n

I\u2019ve gained a new respect for Nicola\u2019s capacity for self-regulation over the past several months. London Health Sciences is roughly twice the driving distance as Kitchener\u2019s equivalent facility, the Grand River Cancer Care centre, a consideration when the plan involved daily trips for multiple weeks. And Dr. T\u2019s \u2018review\u2019, generously, could be called succinct, the information formatted to fit the ten minutes allotted to providing \u2018answers\u2019 to next steps, etc. etc.\u00a0<\/span><\/p>\n

Nicola maintained composure throughout the drive-by appointment, neither speaking nor pulling out a sidearm. She was merely going to leave, do the research \u2014 her ammunition for the metaphoric Glock \u2014 and formulate the actual plan. Suffice it to say the Rottweiler had been awakened.\u00a0<\/span><\/p>\n

Two timely and highly clarifying oncological consults later (at Grand River!) \u2014 offering a full palette of treatment choices (despite my advanced age!) \u2014 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 \u2018nap\u2019 the day following with all the other post-surgical niceties.<\/p>\n

Brachytherapy, the procedure that would happen while I was sawing logs, sounded a bit like surgical alchemy \u2014 literally turning one\u2019s prostate to gold \u2014 if only briefly \u2014 before\u00a0 <\/span>the haul is reclaimed and sold back to the local jewelry store (the gold, not the prostate). In my layman\u2019s 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 \u2018treasure map\u2019 in this case identified the \u2018dig here\u2019 sites for said salting, a quick zap, then reversing the whole thing \u2014 all hopefully without setting off any \u2018explosions\u2019. 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!\u00a0<\/span><\/p>\n

Day surgery being what it is (day<\/i> surgery), a post-procedure visit from surgeon and anesthetist, staff reassurance that I could actually pee \u2018successfully\u2019, and we (Uber Nic, as she would become over the ensuing three weeks and I) were headed home. Side bar: the sleep doc, I\u2019d say, at a guess, my age peer, had offered his version: \u2018long, bit boring procedure\u2019 . . . seems boring<\/i> translates into lots of sitting around as the surgeon does his video-gaming magic (and obviously preferred to complicated, <\/i>or exciting)<\/i>, long <\/i>being <\/i>shorthand for his second such four-hour shift of the day. \u00a0<\/span><\/p>\n

\"\"<\/a>And so commenced \u2018the drill\u2019 and a surprisingly intimate connection with Waiting Room \u2018C\u2019. What begins with a visit to Grand River\u2019s \u2018tattoo parlour\u2019 and all the uncertainty of first steps into unfamiliar territory, gradually morphs into a comfortable (or at least, familiar) routine, repeated daily, briefly, painlessly \u2014 supported by a dozen or so dedicated folks, from volunteers to\u00a0 <\/span>nurses to technicians to specialists . . .and, of course, the \u2019customers\u2019. What could easily have become a clinical, insular, dehumanizing regimen to be tolerated became a profoundly human experience \u2014 and the opportunity to connect, albeit fleetingly, with a cross-section of folks joined by a single, common thread.<\/p>\n

Welcomed on arrival by one of an amazingly available (and legion) coterie of volunteers \u2014 B____ as it turns out is a neighbour \u2014 always smiling, polite, and ready to direct as needed (and it was<\/i> 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 (\u2018drink your litre?\u2019) \u2014 helpful, supportive (literally), and ever respectful as they lined up the three little tat targets for a \u2018clean shot\u2019. The twice clockwise, then counter revolutions of magical, mysterious \u2018barrels\u2019 of equipment, carefully compliant with the directive to \u2018not move\u2019, caught in the crosshairs of the green laser beam. Then, the dash to jettison the liquid preload!\"\"<\/a><\/p>\n

One of the most abiding memories of these three weeks is of the occupants of Waiting Area C. I\u2019ve 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. \u00a0<\/span><\/p>\n

Not true in \u2018C\u2019. The encounters had a kind of rhythm about them. Perhaps, with repeated meetings, a shared \u2018reason\u2019 for being there, the brevity of the contacts (15 minute \u2018commando raids\u2019), and a certainty about the upcoming \u2018procedure\u2019, the ice was broken in some unspoken way \u2014 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 \u2014 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 \u2018club\u2019 that required no additional explanation, no elaboration.\u00a0<\/span><\/p>\n

So did it all work? To quote a friend: \u2018ask that question in another five years. . . and then we\u2019ll know\u2019. For now, suffice it that this very significant part of our medical system,\u00a0 <\/span>membership, and community does work. . . and very well indeed. \"\"<\/a><\/span><\/p>\n","protected":false},"excerpt":{"rendered":"

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 \u2014 this was late September, the kids were […]<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":[],"categories":[1],"tags":[],"_links":{"self":[{"href":"https:\/\/www.davidhowardpsychologist.com\/blog\/index.php?rest_route=\/wp\/v2\/posts\/602"}],"collection":[{"href":"https:\/\/www.davidhowardpsychologist.com\/blog\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.davidhowardpsychologist.com\/blog\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.davidhowardpsychologist.com\/blog\/index.php?rest_route=\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/www.davidhowardpsychologist.com\/blog\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=602"}],"version-history":[{"count":3,"href":"https:\/\/www.davidhowardpsychologist.com\/blog\/index.php?rest_route=\/wp\/v2\/posts\/602\/revisions"}],"predecessor-version":[{"id":609,"href":"https:\/\/www.davidhowardpsychologist.com\/blog\/index.php?rest_route=\/wp\/v2\/posts\/602\/revisions\/609"}],"wp:attachment":[{"href":"https:\/\/www.davidhowardpsychologist.com\/blog\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=602"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.davidhowardpsychologist.com\/blog\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=602"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.davidhowardpsychologist.com\/blog\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=602"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}