People with their throats cut generally look dead; my first death

I never saw anyone with their throat cut but what they looked the worse for wear; in fact, they looked dead and they didn’t die smiling either. Judy (that would be Doctor Judy) says not to worry, that she cuts two and three throats a week sometimes. What I want to know is how she finds that many people who (a) need their throats cut and (b) are willing to let someone do it.

I had my first serious surgery about eight years ago. It was such a new and unusual procedure that I had to drive 110 miles to the Oregon Health Sciences University to see the one doctor in Oregon who knew how to do it. Dr. Hwang was so young, and little, and smart, and cute—not to mention caring—that I would have adopted him in a heartbeat. He suggested that I have the surgery in two parts to minimize the risk, but I wanted it ASAP, and I had no qualms about trusting him to do it up right. The morning he was to operate, the anesthesiologist came in first (as they always do), and offered to give me a little something for anxiety. I told him I wasn’t the least bit anxious—I was just enthusiastic. He thought I was putting him on, and we got into an argument about whether I was anxious. When he saw that he couldn’t win that one, he left. I thought he might hold it against me, but he and Hwang both did bang up jobs in surgery and, what with being awake but stoned out of my gourd, I enthused all over the place about what great doctors they were.

God, but I miss those days when trust was a given and surrender came easily. By now I know the routine well—the pre-dawn drive to the hospital, the forms to sign, the wrist-bracelet, the humiliating gown, the hasty “vitals,” the endless questions from the endless procession of nurses about why I am there and when I last ate, Peggy’s attempt at casualness, the anesthesiologist’s visit, the trip to the bathroom with a nurse carrying my IV, the stretcher ride to the holding area with the lights passing overhead and the curious strangers looking down at me, the inevitable crashes at corners, and finally into surgery. There, the many people in masks and gowns, the perfunctory courtesy, the move from the stretcher to the operating table, my diseased fingers turning white from the cold, my arms being stretched to either side like the crucified Jesus, the additional warm blankets that are never enough, feeling helpless and exposed, waiting eagerly for an injection of happy juice. Then recovery. I will have stayed awake for surgery if possible, so I pass the time listening to other patients moan and puke, and trying to recollect everything that happened. If the surgeon gives a shit, he comes by to tell me how it went.

Is recovery where I’ll be told if I have cancer? Probably not. I’ll be put to sleep this time, so I’ll be among the moaners and pukers. Probably Peggy will know first, and probably Peggy will be alone. Then again, maybe no one will know. The surgeon said that calcification might make an early diagnosis impossible. If this is so, and if I have cancer, it will mean a second surgery to replace the bone. Or not. I’m not going balls-to-the-wall unless I have a decent chance of survival.

I used to wonder how a doctor tells a patient he has cancer. I thought they would have learned some special words in medical school. I’ve had four doctors this year (three in October and one in January when I had hernia surgery) throw out the possibility, and I was struck by their casualness. The neurologist who brought it up in October told me over the phone. Phone calls from a doctor usually mean bad news, but I wasn’t expecting anything like what I heard. “It might be cancer, and if it is, it would have spread from someplace else—possibly the prostate. You need to see your internist about what to do next. Good bye and good luck.”

If someone who didn’t know English had tried to judge the nature of the call from the tone of the caller, he might have thought that Blockbuster was telling me I had a movie overdue. I imagined that this doctor never gave me or my problem another thought after he hung up. And why should he?

I first watched a man die when I was a fourteen-year-old ambulance attendant. The call came at 7:30 on a Sunday night, right in the middle of Mission Impossible. We found the man alone and unconscious on his partially mopped kitchen floor, and he died as we lifted him into the white Ford station wagon that passed as a Mississippi ambulance. CPR hadn’t been invented, and when I started to apply an oxygen mask, the boss laughed and told me not to waste his money.

As we drove back through town, the streetlights were still burning, the man at the filling station was still pumping gas, and people were still leaving church. I had expected the world to stop, and it hadn’t even slowed down. That was forty-five years ago. My belief that my kind was the center of the universe and the pinnacle of God’s creation also died that day.

If only I have enough time to finish editing my journals, I will be grateful. If I don’t have cancer at all, maybe my other problems won’t seem quite as bad.