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6/8/06

Today was a day of small setback.

The endoscopic ultrasound found that my tumor has invaded the muscle layer (muscularis propria) to adventitia (outermost layer) and has seemingly spread to nearby lymph nodes, even though the GI surgeon could not take the biopsy from there because it was positioned right behind my tumor.

“ …So, it is T3.”
“ So as far as the stage goes, it is …?”
“II”
“ Isn’t there two subcategories for the II?”
“ Are you a medical professional, or did you read a lot?”
“I read a little.”
“Yes, well unfortunately, I think that you are at the stage IIB.”

That means that I have to go through chemo/X-ray in addition to the surgery. Even though I was secretly hoping miraculously good news, I cannot be disappointed. From the beginning, my oncologist was talking about adding chemo/X-ray to the surgery. Nothing has changed. It only means that this was not a best-case scenario.

The poem “Lost” by an American Native Indian elder, translated by David Wagoner, again comes back to my mind:

Stand still.
The trees ahead and the bushes beside you are not lost.
Wherever you are is called Here.
and you must treat it as a powerful stranger,
must ask permission
to know it and be known.
The forest breathes . . . Listen.
It answers,
I have made this place around you.
If you leave it you may come back again, saying Here.
No two trees are the same to Raven.
no two branches are the same to Wren.
If what a tree or a bush does is lost on you,
you are surely lost.
Stand still.
the forest knows where you are.
You must let it find you.

What makes you happy most?

This morning we left home at 8:00 to be at the BWH at 10:00 for 10:30 appointment. Through my commuting experience to Boston over the years, I was confident that two hours would be more than enough to make the appointment. However, the traffic was terrible on I 495 as well as the Mass Pike. From the on ramp to the exit, it was bumper to bumper, stop-and-go traffic. We were sure that we could not make the appointment at 9:00, and called the endoscopy center. They told me to call at 10:00 with an update. At 9:40, the traffic stalled completely, and I called them again. Even though Mark suggested asking for another appointment, I did not want to give up. If they cannot do this examination today, we will not be able to have a meaningful consultation with the surgeon next Monday. I do not want to delay the treatment any longer.

“ I do not think I can make it at 10:30, but is it possible to have the exam even though we are late? We will try our best”
“ We will wait for you. Please drive carefully.”

The words, “ We will wait for you” were both assuring and distressing. When I got there at 10:15 (the traffic cleared suddenly after the phone call), every single person who I dealt with said “ you made it!” At BWH endoscopy center, they still treat the patient as an individual, even though they conduct 60-90 endoscopies a day. This reminded me of the hematologist’s phrase “focused factory” describing BWH.