Yeah, it was a little rude, but let’s be fair: this guy just told me that I might not be alive in 10 years. I get that it’s not his fault, but that doesn’t make this any easier to swallow.
“We’d like to go ahead and get you started on your first course of chemotherapy right away,” he says. “That way, we’re on top of it, and it’ll be that much sooner before we can get a better idea which direction this is going to go.”
“Five days?” I ask. “I have to get back to work. I can’t sit here for the next five days while you pump toxic shit into my veins. I have things to do.”
“I really do think it’s best that we get on top of this as soon as we can,” he says. “That said, if you’d like to schedule a time in the coming days that would be better, like I said, this is a slow-growing tumor, so a few days shouldn’t make that great a difference.”
“You’re really inspiring that confidence,” I tell him. “The problem is that I don’t really think a few days is going to be enough of a wait. Why don’t we just all go back to our lives, you can give me a prescription for something that’s going to prevent any more seizures, and we can call that good?”
“I know you’re scared,” he says, “but the sooner we start your treatment, the sooner we’ll have some clearer answers. And I know that I’ve said a few times that this is a slow-growing tumor, but it’s already progressed far enough that you’re having seizures-”
“Seizure,” I interrupt, “singular. What you’re telling me is that I have a brain tumor that it’s in a place where you can’t just go and dig it out, and that even with chemotherapy, you’re not sure how much time I may or may not have left on this planet, so if it’s all the same to you, I think I’ll-”
“It’s your choice whether or not you consent to treatment,” Dr. Churchill says. “This is the best course, in my medical opinion. If we sit back and do nothing, your oligodendroglioma is going to continue to grow unabated, and yes, I’m going to prescribe you something to help prevent seizures, but that’s not going to treat the underlying cause. So, it’s up to you.”
“You know, you’re kind of sexy when you’re frustrated,” I tell him.
It’s a deflection, sure, but I don’t feel the slightest bit comfortable making this decision right now. I don’t know if I ever will be, but right now, I want to make him feel just as uncomfortable as I feel.
The problem is, that’s not really possible given the current situation.
“Thanks?” he says, looking to his colleague who, for some reason, hasn’t yet left the room. “But I think we should talk about your treatment.”
“You said oral chemotherapy, right?” I ask.
“That’s right,” he answers. “It comes in a capsule that you can take at home.”
“So, it’s less effective than the needle-in-the-arm stuff?” I ask.
“Not necessarily,” he answers.
“I thought people came to the hospital when they were taking chemo,” I retort. “Tell me it’s not my particularly rosy demeanor that’s made you decide to send me home instead.”
He smiles with a mouth full of straight, white teeth, saying, “That’s not it at all. I just think that this is the course that would be best in this situation.”
“Then why do other people come in when they get chemo treatment?” I ask.
“There are a few reasons,” he says. “First and foremost, when IVs are involved, it’s best to have as close to a sterile environment as possible. Outside of a sterile or mostly sterile environment, all kinds of nasty things can enter the system through the IV site, and especially with something like chemo that has a profound impact on the white blood cell count, that’s not a risk that’s really worth taking.”
“But oral chemotherapy doesn’t have that problem?” I ask. “I mean, I know there’d be no injection site or whatever, but the white blood cell count — that wouldn’t be knocked-”
“You’ll still want to be careful,” he interrupts. “Stay away from people who are sick, have recently been sick, or are at risk of getting sick — you know, like parents with sick kids and that sort of thing. There are some other things that you’ll want to know before we send you home, but first, I’d like to answer any other questions you may have.”
“Is the treatment any better than the disease?” I ask.
“We’ve found that chemotherapy can be very effective for people with oligodendroglioma,” he answers.
“You didn’t answer my question,” I tell him.
“Chemo’s not without its risks,” he says. “There are side effects, and you’ll need to contact me when or if they happen to you. That said, I’m confident in this course of treatment.”
“Is the treatment any better than the disease?” I ask again.
“With any treatment, it’s important to weigh the risks and the benefits,” he says. “In your case, I feel confident in this course.”
“Yeah, you’ve said that a few times,” I scoff. “You still haven’t answered my-”
“It’s not going to feel better,” he says. “Most people on chemo, oral or intravenous, have serious side effects, many of which are not very pleasant.”