Daniel Menaker

Onconversations XXVII-Part One

Monday, February 20, 2012

(After completion of two courses of radiation, I go to see the radiologist, for a routine follow-up appointment. He does this with all his patients four to six weeks after their treatments are over, he has told me–assuming, I assume, that they are still with us, ambulatory: follow-upable.  But before I go in to see him, I wait for fifteen or twenty minutes in an inner waiting room, more comfortably appointed than the outer one, where people are scheduled for treatment and don’t have a doctor’s appointment. Where I wait is like business class.  In it today, besides me,  are a young Ukrainian woman and another, older one who is probably her mother–which one has cancer?–a very portly, red-faced man with a woman who appears to be his wife, and the Thin Man, whom I had met before in the men’s changing room. This time he is wheeling a portable oxygen tank, like this–http://bit.ly/xm4ACL –but silver in color. A clear tube goes from the tank up to his face, where it forms a circle, called a cannula, with two hollow prongs to deliver oxygen into the nostrils.)

THIN MAN: (waves to portly man and his wife): Hi.  (to the other two women): How are things in the Ukraine?
PORTLY: Hey–how you doin’?
THIN: Well, just take a look.
PORTLY:  You look good anyway.
THIN: I need this thing because I walk two blocks and I get winded. But what are you going to do, you know?
PORTLY: That’s too bad.
THIN: Two blocks! You know that that means? New York is all divided into sections of twenty blocks each, if you think of it that way. Because twenty blocks is a mile. Uptown and downtown blocks. Crosstown blocks are about two blocks. That’s what I can walk.
PORTLY:  You mean, without the oxygen, right?
THIN: Yeah. And do the math and it means I can’t walk a tenth of a mile without getting winded.
PORTLY: Well, hang in there.
THIN: Yeah.
PORTLY (to wife): I’m going to call _______ and see if we can’t get you on regular Medicare disability instead of going through all this HMO business–they keep telling us that they won’t process the claims for us here. (Takes out cell phone)
WIFE: No, don’t. I don’t want to change anything. Don’t. Stop!
PORTLY: Nah, we’ve gotta do this.
PORTLY (talks on the phone, explaining situation, refers to woman as his wife) So yeah, just let me ask her. (Asks his wife for some ID number)
WIFE (loudly): No–stop. Don’t change anything. I don’t want to give out any information.
PORTLY: We have to do this.
WIFE:  (much more quietly gives out some numbers)
PORTLY: What’s the address again?
WIFE:  You know–it’s a shelter. I don’t know the address.
ME (to myself): They’re married but she’s in a shelter.
PORTLY: What’s the name of the place?
WIFE (becoming more upset): I don’t know. I don’t know.
PORTLY (into phone): OK–listen, I have to call you back.
WIFE (begins to cry.)
THIN MAN: Hey, it’s OK. You’re in the best place in the world for this.
PORTLY: We have some troubles, is all.
THIN: If they can’t take care of you here, then…you know…
ME (to myself): Yes, we all know.
PORTLY:  She’s just upset.
THIN: Right. I guess we all are.
PORTLY:  See, this is her last radiation appointment, and she gets a double treatment today.
THIN: Oh, you don’t need to worry about that. It’s Monday.
PORTLY: What does that have to do with anything?
THIN: They never fry anyone on Monday. Didn’t you know that?
ME (out loud): What day do they do the frying, then?
THIN: Tuesdays! Don’t ever come in for a treatment on Tuesday! You’ll come out all crispy.
ME: But tender.
THIN: Nah. Dry as hay.
PORTLY (To wife, who has stopped crying and is smiling): See–I told you you’d be OK. It’s Monday.
ME (to Thin Man): What about Wednesday?
THIN: You don’t want to know.
(A nurse comes in to escort the Thin Man. He gets up slowly and walks away with her, wheeling his cart, waving goodbye.)
PORTLY (quietly, to Ukrainian mother and daughter waiting for treatment and to me): That man is a billionaire, you know.
ME: Really?
PORTLY: Yeah–some kind of investment scheme. He told us about it once. Didn’t you see how he was dressed? Expensive.
ME: I didn’t notice.
PORTLY: Yeah–very, very rich. I guess it just goes to show you, huh? I’m just sayin’.
ME: Right.

(A very heavy, gray old man comes out of the examination-room area, escorted by another nurse. He has on gray pants, a red plaid shirt, and suspenders stretched out over his girth. I think, At least he isn’t wasting away. But he looks so tired. The older and younger Ukrainian women get up to help him. So neither of them has cancer–it’s the old man.)

OLD MAN: [Something in what I take to be Ukrainian.]
YOUNG WOMAN:  OK–we’ll take you home now. Just let me put your jacket on.
OLD MAN (sighs, sits down): [the same thing, in Ukrainian. I take it to mean “I’m so tired.”]

(When I get home, I Google “Ukrainian phrases” but at least on a cursory look, I can’t find “I’m tired.” I’m distracted from my search, and hugely cheered, when I find a site that gives some other standard sentences and responses but that ends with:

My hovercraft is full of eels
Моє судно на повітряній подушці наповнене вуграми
(Moje sudno na povitrianij podušci napovnene vuhrami)

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Onconversations XXVI

Tuesday, February 07, 2012

(I go for a full checkup to my regular internist–the guy who almost a year ago told me he would be much more scared than I seemed to be about a recurrence of cancer. I think that the three or four oncologists in my life are not paying enough attention to the Whole Man, and also that without another doctor’s appointment for an entire month, I feel lost.)

DOCTOR: You’re doing very well, Dan. We can just hope that the radiation has done its work, but there’s certainly no sign of this illness anywhere else. We’ll wait for the blood tests, of course. Now, do you want a PSA test? You’ll like this: it’s almost a philosophical question.
ME: I’ve read about it.
DOCTOR: So you know the issues.
ME: Yes–I read somewhere that a lot of doctors rate the test’s advisability as “D.”  As in “Don’t do it.”
DOCTOR: That’s right–and you understand why?
ME: Yes.
DOCTOR:  So it’s your choice.
ME: The curse of early detection and the disasters it can lead to!
DOCTOR: Right, but in your case, well, you do have cancer, so that might be a reason to ask for the test.
ME: I don’t get that logic. Because if someone does have early stage prostate cancer it still may be better not to treat it at all.
DOCTOR: It’s complicated.
ME: If you were me–but you know, still you but in my position; that’s what I mean; I mean, not really me me–what would you do?
DOCTOR: I sort of understood what you meant right off the bat. Well, I was going to say that because you have cancer already it might be a good idea to have the test, but if I really were in your position, I don’t know….
ME: I’ll skip it.
ME: If all your tests come out OK, would you certify my health for a freighter cruise?
ME:  To go for a cruise on a lot of freighters, if you’re over seventy, you have to have a doctor’s letter saying you’re healthy enough.
DOCTOR: Why do you want to go on a freighter?
ME: I want to have nothing to do but think and write for a week or two or three.  Also, we get our material in the strangest places.
DOCTOR: Writers?
ME: Yeah.
DOCTOR: Like doctors’ offices.
ME: Yeah. But that’s not very strange. I figure people who are at sea all the time are different.
DOCTOR: Are you going to use this?
ME: What?
DOCTOR: This conversation?
ME: Well, as of just now,  I don’t think I have much choice.
DOCTOR (laughs): Do you get seasick?
ME: I don’t think so.  Never have. I don’t think you have to certify anything about that.
DOCTOR:  You know, you can buy a kind of helicopter insurance, so that if you have to be treated, they fly in and take you away.
ME: I didn’t know that. I didn’t know that travel insurance ever covered that.
DOCTOR: It does.  I know someone who used it. It costs like three or four hundred dollars and can save you a fifty-thousand-dollar charge. Or even more.
ME:  Sounds worth it.
DOCTOR: Sometimes you have to pay more if you have certain pre-existing conditions.
ME: There’s no end to it, these days, is there?
DOCTOR: No, the days are over when you could just get onboard the Beagle and sail to South America and change the world forever.

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