The Way We Talk

How do you want to hear the bad news?

There’s no good way to be told you have cancer.

Some ways are definitely better than others. Some ways are definitely worse than others.

But there’s no good way. Granted, I haven’t heard every way of being told you have cancer, but the way I was told I have cancer wasn’t great.

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Coming out of anesthesia kind of rules. It’s this gradual ramp back up to consciousness. First you become aware of your corporeal form, then your eyes open and you remember where you are. You feel every pixel of clarity returning. You’ve been unconscious for a second and a lifetime simultaneously.

When I woke up, I was looking around the recovery area of the hospital. I was still sort of laying on my side in a semi-fetal position, and a slight soreness in my bottom reintroduced itself, causing me to remember that I had been there for a colonoscopy ordered by my gastroenterologist.

Looking out into what felt like the vast openness of the recovery area, I saw the friendly young nurse who had complimented my Lululemon face mask and it’s mauve color. She called it a “dusty rose.” I said that’s a good name for a baseball player. She said, “It’s a good name for something else, too.” I laughed. I like joking around with medical professionals because I am very nervous around them. I figure if I can diffuse the situation by making myself and others laugh, maybe it will win me some sort of karmic points and offset bad news that otherwise might be delivered if I were cold or neutral.

Anyway, when this nice nurse passed by either 20 yards or 5 feet away, she smiled and waved. I gave a thumbs up. I felt like the king of the recovery area. The doctor who had performed the colonoscopy walked up next.

Still swimming out of the anesthesia, but more comfortably treading water in this particular area of semi-lucidity, I ask the doc, “How’d we do?” I’m honestly not sure what I expected. Well, actually, that’s not true. I know exactly what I expected. After 29 years of doctors telling me I am perfectly healthy and there’s nothing to worry about, I expected more of that. Maybe some minor infection or inflammation or something that caused the issues that sent me there, but nothing a little R&R and over-the-counter meds wouldn’t clear up. Maybe some sort of irritable bowl syndrome that I could manage with diet. As the protagonist of my own movie, nothing bad could actually happen to me.

Instead, the doctor-shaped figure looked at me and said, “We found a mass in your colon. I’ll be right back.”

“Wait,” I said. “What? How big?”

He first made his hands into a circle, demonstrating the normal size of my colon, and then made his hands into a slightly smaller circle, demonstrating how big the mass was. There wasn’t a huge difference.

And then he left, and I was alone now, my brain still grappling with whether it should feel comfortable given the anesthesia still working through my system but acknowledging the weight that was just dropped on me.

I can’t say how long I was alone, but eventually my normal gastroenterologist, a much kinder woman I’d say in her 50s, came and sat next to me. The sitting already felt like a more compassionate thing to do. This is the “bedside manner” they talk about. 

She told me that my girlfriend, Michele, would be coming back in a second. When she arrived, I asked her if she had heard from the doctors. She had. At this point I was briefed by my much more humane doctor about what this news meant for the present and future. It’s hard to fully grasp the seriousness of being told you’ll likely need radiation and/or chemo and/or surgery while you’re still rightfully rocking a “Fall Risk” bracelet due to the disconnect between your brain and your extremities.

I don’t know that the news fully set in that day. I think it has since then, but I think there was still a numbness on the day. This was almost three weeks ago. I’m officially in the midst of treatment, I’ve been given answers to many of the questions that first presented themselves, and I’ve had plenty of other opportunities to talk to medical professionals both in and out of anesthesia.

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It’s funny the way we talk about things like this. And I mean actually funny in some instances. I have colon cancer. That’s in your ass! I have cancer, one of the S-Tier scary things in the world, a thing that they make entire HBO shows and movies about dealing with, but it’s in my ass!

In order to get this far, where I could have a cold-blooded gastroenterologist stick a camera into me to find and tell me that I have cancer and that he’d be right back, I had to get through a couple of general practice appointments first.

The thing about explaining your symptoms when it relates to digestion is that there’s no way to do it and sound good. The way I see it, you have three options: You can be formal, juvenile or vulgar. 

For example:

“Feces” and “bowel movement” are formal. Sterile language. No one really talks like this in normal conversation. It feels too scientific.

“Poop” and “pooping” are juvenile. People talk like this in real life, but it feels beneath the seriousness of a doctor’s office and the situation at hand. 

“Shit” and “shitting” are vulgar. That’s probably the most common vernacular, but it’s crass and rude to the doctor who has to discuss bowel movements/poop/shit with at least a few more patients today.

And that’s to say nothing of “rectum” versus “butt” versus “ass.” Can I say “pain in the ass” as a joke? How many times can I get away with that before it overstays its very limited welcome?

The only way to really avoid all three of these options is to rely on clever wordplay or metaphor. Like I said, I suddenly try to be the wittiest man in the hospital when I’m nervous, so that’s what I relied on. 

“Well, I experienced some pain but it was sort of as a result of, uh, executing business.”

“When you relieved yourself after that spell of constipation, what was it like?”

“Like … consistency?”

“Amount.”

“Oh. Yeah, it was, uh, definitely making up for lost time.”

At the end of the day, it probably doesn’t matter what you say or how you say it. Nurses and doctors and radiology techs and every member of the hospital staff is so desensitized to this whole thing. That’s not to say that they treat you as if you’re just some anonymous number on a chart, but to get caught up in every visitor’s language choice would be an unwise use of precious mental bandwidth in that job field.

But, because of that, I think little opportunities for humanity do slip away if they’re not properly pounced upon.

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The day after I was quickly told that there was a mass in my colon and it was about this big and that I’ll be right back, I was at a different hospital receiving a CT scan to see if there was any spread to other organs or bones.

After one of the many IV’s I’m now accustomed to, I was taken back to the room with the circular machine, which I was pretty afraid of at first, but it turned out to look like a giant essential oils diffuser complete with a full spectrum of color-changing lights, which the tech told me was something the German designers thought would be nice. It was, until it turned red. Then it felt like I was in Hell.

The small radiologist told me that, once I was thrust inside the machine, a voice would tell me to hold my breath and release. I assumed it would come from her, a kind older woman who looked just like Holly from “The Office,” from in the other room. Instead, I heard cross talk in the background of the recording, and a voice told me to “Take a deep breath and hold it,” and then in what I can only describe as a tone of absolute disdain, “You can breathe.” I honestly expected the voice to say “You can breathe now. GOD. What else do you fucking want?”

The radiologist explained how a, let’s say prickly, South Philly nurse who works there recorded this and no one wants to rock the boat and tell her it’s off-putting. 

The radiologist tells me she’s from Maryland—my ancestral home–and moved up here recently, and that a few of her new neighbors have that very abrupt way of speaking. Maryland, in my experience, always felt like this calm place full of nice suburbs and my grandparents and cousins and Christmas. When I got older I went there for concerts and trips to the aquarium with my friends. Maryland was a happy place, and I could tell it was for her, too. Maybe she grew up in these same nice Christmas towns where my family memories existed, and the blunt force of South Philadelphia and the medical professionals who need to work on their voice recording skills affected her, too. She might have her own difficulty with the way people talk to her around here. I felt like we bonded over that in some way.

When I left into the lobby, I looked around for Michele. She came in through the automatic doors leading to Penn’s campus, and asked if I asked the radiologist what she saw. I said no. The idea hadn’t even crossed my mind. That would be crazy. Torture. I was still only about 24 hours removed from being told I have cancer. I wasn’t really ready to face hearing that it had spread to some vital organ(s). 

I looked at her to say, “No. I didn’t ask. I couldn’t do with more bad news two days in a row, especially since I was back there alone. And even though the very nice radiologist from Maryland and I had built up a nice rapport, I just want to end my day with a nice walk to pick up the cat’s meds from the nearby vet office and head home. Maybe we could walk for a few blocks toward home since it’s so nice out.”

What I did say was “No, I didn’t want to.” 

And she said, “What do you want to do?” 

And I got to that next part, but the details of my new reality and all of the scary uncertainties and possibilities came rushing in, and I started fighting back tears as I left the still-crowded lobby of the hospital.

So, I used my index and middle finger to pantomime “walk.”

So we walked, and I didn’t say much.

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A couple of days later, Michele told me that the CT scan did come up with some spots on my liver and lymph nodes, indicating spread. The next few days were spent discussing treatment options with different oncologists and surgeons, with scary things like “stage IV” being written on hospital-branded notepads and scary words like “operable or inoperable” being thrown around over diagrams of the liver and abdomen. 

My parents knew the full story, my friends knew the full story, and I was at a point where I think I accepted all of this. It could have been a numbness of some sort, but I was strangely zen about the whole thing by this point. Nothing I could do about it anyway, right? I just had to wait to receive results from the much more high-definition MRI and PET scan that I had scheduled that week to find out the full extent of things. I frequently repeated a phrase my parents threw around a lot when I was growing up: “We’ll cross that bridge if we come to it.”

A few days after that, I was taking a bath (something I have been doing a lot lately) when Michele called me as she walked home. For the previous week, ever since that first bomb in the recovery room dropped, she had been my buffer for all health updates. It’s cowardly on my part, sure, and indicates that I wasn’t so zen and accepting as I might have let on. But I prefer to hear bad news from someone I love and trust and know will be there for me rather than someone who says, “We found a mass in your colon. I’ll be right back.”

“Hey, I have news,” she said in a tone that did not give away any emotion or indication as to what kind of call this would be. “Do you want me to wait until I get home or tell you now?”

I didn’t say anything before she added, “It’s good news.”

“Tell me right now!”

“So, those spots in your liver aren’t cancer. There’s no spread to your liver or bones.”

No spread to my liver or bones! I could’ve danced in the bath tub if it weren’t such a slip hazard. I’ve had enough of being a fall risk, after all. After a week-plus of getting new and scary information nearly on a daily basis, telling my friends and extended family and gearing up for eventual treatment, this was the first real bit of good news I had received. I felt so good that I tweeted about it, and then felt weird about tweeting it and deleted it a couple hours later.

I told her to always, always lead with good news and don’t wait. Good news I can handle without any fanfare.

You can even say you’ll be right back after you tell me. I won’t care.

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Today’s Snakes and Sparklers musical guest is Dr. Money.

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I understand that this was a little different than previous posts. I’ll still write about music and funny things, but when content opportunities like this knock, you have to answer, right? There will be more of this in the future, but I’ll try to keep it balanced with more lighthearted material. If you do like this, though, consider subscribing or telling a friend about it.