1. Your oncologist’s administrative assistant knows the correct pronunciation of your 28 letter, German-Croatian, hyphenated last name, the correct spelling of your first name (it's with an "-ie," not a "-y"), and she calls you on your birth date to wish you a happy b-day.
2. You know the occupations of all the spouses of your infusion nurses. On good days, you remember the names and ages of all their children, too.
3. You suspect that your oncologist purposefully sends her under-achieving medical students to your exam room to practice their medical interviewing skills. They ask you to spell the names of your medications, describe why you're taking them, and explain their side effects.
A-R-I-M-I-D-E-X.
Generic name: Aromasin.
Function: aromotase inhibitor/estrogen blocker.
Possible side effects: hot flashes, arthritis, and insomnia (to name a few).
Z-O-M-E-T-A
Generic name: Zolendronic Acid.
Function: bisphosphonate/bone strengthener
Possible side effects: flu-like symptoms, bone pain, headaches, renal failure, osteonecrosis of the jaw, and insomnia (to name a few).
A-M-B-I-E-N CR, 12.5 mg (not 6.25 mg - that stuff’s for babies)
Function: treatment of the above-mentioned insomnia caused by Arimidex and Zometa. If you aren't familiar with this drug, you need to go back to med school or watch some pharmacutical commercials on TV. They just installed a bunch of flat screen TVs in the new infusion room. I'm sure they wouldn't mind if you used one, especially if you tell than that you're conducting "research."
Possible side effects: eating, emailing, posting crazy things that you don't remember the next day on facebook, and giving your self a ‘hair cut,’ all while sleeping; morning grogginess otherwise known as getting ready in 20 minutes. (Yes, you can have 5 more minutes to sleep. Goodness, take 10! There’s no shame in applying eyeliner and mascara on the metro; just don‘t poke yourself in the eye. No need to blow-dry your hair, either. Frizzy 80’s hair might come back into fashion, along with a wrinkled pencil skirt and button down shirt.)
“Wait, can you repeat the spelling of that med again?” the boy with too-long bangs says as he scribbles with his stub of a pencil in a little notebook that fits neatly into his white medical coat, his name (Owen) stitched neatly in navy blue letters above the pocket. Only, he doesn’t look much like an Owen.
Would he be insulted if you recommend that being a doctor might not be the best career path for him? Maybe he could be a physician’s assistant or a pharmacist instead.
At the end of the exam, as you shake his sweaty hand, you ask, “Is your name really Owen?”
He shakes his head, no.
“Do you even go to school here?" you ask, but you don't want to know the answer, because he just finished fingering your armpits, looking for swollen lymph nodes, and then touched your face, apologizing for not washing his hands in between. Your deoderant has now become makeup.
4. The medical students that follow your oncologist around like puppies ask you if you have the results of your most recent blood test.
“No-o-o,” you say slowly. “I was expecting that you would give me the results."
“Well, Dr. Oncologist said that you always get your results ahead of time and we can’t find them in your file. She said that you know how to work the system.” Pause. Eye-roll.
“You’ve got me,” you admit. “I called for the results last week but they weren’t in yet. I'll fax them over to you as soon as I get them and then you can add them to my file.”
5. While the med student prepares to draw blood from your chemo-fried arm veins (no one knows how to use a medi-port anymore except for the infusion nurses!), you sneak a piece of gauze and hide it up your sleeve.
Is it just you or are these medical students getting younger? This one looks like he’s no older than 12.
He instructs you to squeeze a stress ball as he fingers your largest, bluest vein in the crevice of your inner elbow.
“This one looks pretty good,” he says, giving it a loud slap just for good measure.
“Is this your first time drawing blood?” you ask.
“No, I’m a third year (med student),” he says, his face now as red as the stripes on his socks.
“Oh, well, you’re doing a good job,” you say between gritted teeth. “I can hardly feel the needle.”
After he retracts the syringe, you gracefully mop up the blood that spurts out of your vein with the piece of gauze you stole earlier.
“It’s okay,” you say. “I’m not afraid of blood. Here, hold this gauze on my arm while I tape it in place. Don't forget to apply pressure. Now, take a deep breath. Sit down and put your head between your legs if you think you're going to pass out. Yes, that's it.”
6. On Thursday nights, you hold seminars on “Patient Relations” and “Medical Ethics” in the alley behind the modular unit (trailor) that serves as the MRI “department.” The jackhammer sound of the MRI machine is your office “radio.” Sometimes, if you’re in a good mood, you let the med students feel your breast lump so that they know what one feels like.
“Rubbery,” says the kid whose bangs always seem to fall in his eyes.
“No, smooth like a marble,” says the girl in too-high heals. She has not yet discovered those ugly yet very functional orthopedic clogs.
“Happy New Year,” says the visiting nun from China, training to be a nurse. Then, she bows, smiling.
“Yes, happy New Year to you, too,” you say, even though it's August.
7. You recognize every other doctor in the hallway of the hospital, although they don’t always recognize you. At least not your face. Maybe if you flash your medi-port or sexy lung scan images they might remember you.
“Have you lost weight? You know, those ports are known to slide from the chest down to the abdomen if you lose more than 20 lbs. I don’t want to have to fish that thing out of your spleen. Although, I might sedate you if we have to do that, but only after I start the incision and you tell me that you can feel the scaple. Just for old times sake, right? Ha, ha.”
“Ah, yes, the girl with the lesions in 30% of your left lower left lung. How’s the wheezing? Can you still do your Darth Vader impression? Yes? Oh, that’s too bad. It probably means that your cancer is progressing, but it's such a good impression! I love Star Wars!”
8. You run into Dr. Internal Medicine at your yoga studio, but it seems to throw him off a little when you talk to him like he's your best friend. You watch his face turn red, as he realizes that his hospital and yoga worlds are slowly colliding.
9. You submit a revised CT scan report to the Medical Records Department with grammatical edits denoted in red ink after every scan. After all, someone needs to teach those radiologists proper grammar and sentence structure!
"Please work on your subject-verb agreement," you demand to no one in particular, punching the desk with your fist for emphasis.
“Right here, you state that my stroma are unremarkable, which wouldn't necessarily be incorrect, only, I’ve had an oopherectomy. So, I don‘t have any stroma. I have the little scars to prove it, unless that silly surgeon removed the wrong organs."
“Also, I noticed that you said there's an amputation of my left lower lung lobe. As far as I know, I still have one of those, but maybe it’s hiding behind all those enlarged mediastinal lymph nodes.”
“When do you think you can have the revised report back to me with your edits? If Thursday works well, let's meet to discuss it behind the MRI trailer. That's where I hold my office hours.”
During office hours, Owen is the only one to show up.
"Wait, I thought you weren't really a doctor," you say.
"I'm not," he reminds you. "Can I practice giving another breast exam? I kind of liked the first one."
"No, but I can teach you how to give one to yourself," you say.
He pauses and then says, "Okay."
10. You're getting good at guessing the treatment plans that your onocologist will prescribe. During your most recent medical exam, before Dr. Oncologist even has the chance to speak, you give instructions to the nurse and oncology fellow: "We're going to need a 3 month supply of zometa and arimidex, orders for a CTC blood test every month, and re-staging scans in 3 months to verify that the lung nodules in the left lower lobe are stable."
"Can I hire you as a med student?" Dr. Oncologist says. "We're short staffed this weekend and I don't like this Owen fellow who keeps hanging around."
"No," you say, "Unfortunately, that would be a conflict of interest, according to this semester's medical ethics course."
11. And, last but not least, you decide that instead of hitching a ride with Mr. Crazy Cab Driver (who always complains about traffic) to the hospital once a month, you'll just learn how to access and flush your own port and set up the drip machine to administer your zometa infusion at home. Now, where can you buy infusion tubing and what's the recipe for mixing up a batch of zometa?
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