Surgeon #1

The first step after getting diagnosed with breast cancer was not to go and see an oncologist. Instead, my primary care provider gave me the card for a local surgeon.

Dr. H is not a breast cancer specialist, or even a cancer specialist, as far as I remember. But, he is a very well-respected surgeon. My N.P., whom I trust completely, thinks very highly of him. My landlady, who is a pharmacist and therefore plugged in to the medical community here, also thinks well of him. He’s a really nice man, and very smart, and good at what he does. They both assured me of this.

Because he’s so great, he’s also very busy. When I called to schedule an appointment, they gave me one for two weeks away. It seemed like such a long time. I was so anxious to find out what the next step would be, and what my treatment plan would look like. I knew every minute up until my appointment would be torture, and I wanted there to be as few of them as possible.

“Please,” I said, “Is there any way he can see me earlier?” There wasn’t.

“Well then, can you put me on a list of people to call in case you get a cancellation? My schedule is wide open right now. I can get there with hardly any notice at all.”

They could, but it didn’t sound like it would help me get in any sooner. His schedule was booked. They seemed to think I was lucky to be getting in as early as two weeks from now.

I gave up on the scheduling issue and asked about the appointment itself. I still felt so traumatized and abused from my biopsy experience. I was desperate not to put myself in that situation again. I wanted to be fully informed about everything I was agreeing to.

“What is going to happen at this appointment?”

“Nothing, it’s just a consultation.”

“There won’t be any kind of procedure?”

“No. It’s just a consultation.”

“No procedures at all?”

“Really. We just start out with a consultation. We’ll schedule your procedures after you’ve talked to the doctor.”

Just a consultation. Just talking to the doctor. I could agree to that. I thanked the scheduler, hung up the phone, and came down with a summer flu that kicked my butt for the next 7 days.

Then, the very best part of having cancer happened. My mom arrived from the East Coast. She came to take care of me, and accompany me to my doctor’s appointments, and keep me emotionally grounded. Thank GOD for my mom. She arrived just in time to go with me and meet Dr. H.

I wish I could say I'm not sexist, but it would be a lie. I'm biased against men. It's true. I don't feel as safe with them as I do with women. I don't trust them as easily or feel as comfortable being naked with them. Maybe this is just common sense, I don't know. I do know that male doctors need to work harder to convince me that I can believe what they are saying and that they care about my perspective. This probably isn't fair to them, but it's also not fair that I got breast cancer...so we're even.

When Dr. H entered the exam room and found my mom and me sitting there together, both looking worried and stressed, he paused and looked troubled. He fumbled over his words, trying to figure out which one of us was the patient.

Now, my mom is gorgeous and very young -looking for her age. But, I don't think she looks 35. The fact that he couldn't tell us apart meant he hadn't even looked at my chart yet. Maybe that is standard procedure, but I felt dissapointed. Just 30 seconds on the other side of the door spent looking at my chart would have given him the basic information he needed in order to appear like he cared enough to familiarize himself with my case before meeting me.

He's a big round guy; not huge, but solid looking. He's attractive too, and has a friendly looking face. He was wearing blue scrubs.

After I raised my hand to tell him I was the patient, he stepped briskly into the room, squeezed past Mom and bent in towards me for a hug. Being a well-conditioned social hugger, I half rose from my chair without thinking about it first and let him wrap his arms around me. When his mouth was closest to my ear he murmered something with the word "Baby," in it. I don't remember if it was, "Oh Baby," or "Poor Baby," but I remember very clearly that this man I'd never met before, who hadn't even looked at my chart, hugged me and called me "Baby."

I was on my guard after that. I'm sure this is the opposite of the response he expected, but I can only imagine it's common one. What woman in her right mind is comforted when a complete stranger hugs her and calls her "baby" out of the blue? If another woman did that to me, it would seem odd. When a big man does it, it sets off all the alarm bells in my head. "Watch out! Watch out!" This is not the kind of mental noise I want going on as I am talking with the person who is going to cut me open with a knife while I am unconcious.

After the hug, he sat down and opened my file.

I asked him a question or made some comment referring to my self as a breast cancer patient.

He didn't look up from the paper-work, but he made a little motion with his hand like he was brushing something away from his personal space and said, "You don't have breast cancer."

I'd spent the last two weeks totally freaked out because I had breast cancer. I'd read up on ductal carcinoma in situ and learned that it was described as Breast Cancer: Stage Zero. I knew that I was going to need some kind of surgery, perhaps a complete mastectomy, and probably radiation therapy if not chemo. My life felt totally turned upside down. My mother had taken a month off work and flown all the way across the county to help me through this serious health event. This sudden dismissal of my cancer status made me feel like I'd just been knocked off my chair.

Maybe he thought this lighter view of my condition would be soothing to me. Maybe, like the hug, he thought it would help relax me. "You have pre-cancer," he explained with a smile. Again, I had the opposite response. If he wasn't taking my disease seriously, how much effort or attention would he apply to my treatment? If he couldn't consider the emotional impact of his words before he spit them out, did I want him to be the person advising me about my health? If he was calling "pre-cancer" the disease that all the literature I'd read called "cancer," did he even have any idea what he was talking about. According to the local medical community, he's great with a knife. Fine. Other than than...he might be a total crackpot!

He went on to briefly describe the lumpectomy he would be performing, before he sent me over to the radiation oncologist for follow-up treatment. Then he pulled a large peice of folded blue paper from a drawer and asked me to put it on.

"I'm sorry," I said, "I'm not prepared to have any procedures today. I was just expecting to talk to you."

"A manual exam is part of the consultation," he informed me.

Noting my reluctant expression, he added, "You don't have to do it if you don't want to, but we'll just have to schedule it for another day." He gave me that dangerous look that said he was about to start thinking of me as an irrational, high-maintenance, problem patient.

"I understand that it would be more convienient to do it today," I said, hoping to ward off his negative judgement. "But, I've had some bad experiences recently and it's really important to me that I feel completely prepared before each appointment. I wasn't prepared to have an exam done today."

I really expected him to understand my reluctance, and maybe even ask what my bad experience was, so that he could be better able to avoid repeating it. Instead, he seemed to take my explanation as a personal criticism.

"You were prepared," he insisted. "A manual exam is standard procedure during a consultation with a surgeon." He drew the word surgeon out, like it was so self-evident.

What was I thinking? How on earth could a surgeon do his job if he wasn't allowed to touch the body he was going to be cutting? I should have know this. I should have been able to figure this out. Since I'd been too stupid to realize this obvious fact, I should make up for my stupid error by being a good girl (baby) and taking my shirt off like he wanted. Instead, I tried again to get him on my side.

"Yes. I can see that it makes sense to do a manual exam as part of the consultation. But I didn't realize that, so I wasn't prepared to do it today. It's really important to me that I feel prepared for everything that happens during my appointments."

I feel a little guilty for putting this dialouge in quotes. This conversation happened 3 months ago and I'm sure I don't remember it verbatum. I try to be fair, and report things as true to the way they really happened as possible, but I'm sure I make some mistakes. I am not, however, mistaken about the next thing he said. These are his exact words, I would bet my left breast on it.

"I disagree," he said. "You were prepared."

I don't remember what else he said after disagreeing with my feelings. I know he didn't apologize for his front desk staff not explaining the appointment to me in more detail. I know he didn't offer to institute a new office policy so that future patients would know, without having to figure it out for themselves, that a consultation included a manual exam. I know he didn't suggest rescheduling the exam or promise to keep me better informed for my future appointments with him.

But I know what I said and did.

"I can't deal with this," I mumbled with an angry sigh, as I stood up and walked out of the room. Mom, my loyal companion, grabbed her purse and followed me out the door. I didn't look back, so I can't guess what Dr. H was doing or thinking.

In the car, I collapsed. I had waited 2 weeks for this appointment, and I'd just ruined my chance to be treated by this man that every one respected as one of the best surgeons in the area. Now I would have to call around and find another one. I would probably have to wait two weeks or more to see the next doctor, and there was no guarantee I would like him either. Mom had taken all this time off work to help me through these medical adventures, and I'd just wasted two weeks of her time. I felt terrible.

And I was pissed off. I'm sure he wasn't as bad as I felt he was, but I was really struggling emotionally with the impact of being diagnosed and fired so recently. I was super-sensitive and responding harshly to even slight offenses. I'm usually a loving, compassionate, look-on-the-bright-side kind of person, but that day I was wretched. The whole way home I chanted out loud, "I hate him I hate him I hate him I hate him I hate him I hate him I hate him!"