Humans of Oncology

When you are diagnosed with Cancer, you enter a world that has its own unique atmosphere, its major and minor characters, its landmarks, and definitely its own emotional ‘vibe’. Much like we might think of New York City, Chicago, or Philly; each with its own quirks, famous foods, particular atmospheres and personality. We might tend to stereotype a city. The rude cabby, the fast talkin’ New Yorker, where every Philly Steak Sandwich has no equal outside the city limits. Through movies especially, we may get a very different picture of a place - rather one dimensional, in fact - until we actually visit and realize it is far more nuanced “in persona”. That is why I have always loved the Humans of…. series of books; where in a moment of inspiration, some lovely writer came up with the brilliant idea to stop random people on the sidewalk in a major city and simply ask them to tell their story. And suddenly a place is not a one dimensional caricature of itself. It is filled with individuals - men and women who have particular stories which fill out our sketchy understanding of the “big city” we think we knew but perhaps did not. I love the surprise of it. Thinking in particulars, and not in generalizations, always brings the satisfying reward of a genuine human experience.

As I travel the streets of Cancer, I am beginning to see that this world can also be heavily caricatured. The plethora of doctor shows on television attest to this fact. I used to wonder why my Dad, who was a doctor, always laughed out loud after watching about ten minutes of any medical drama. The reality was far more mundane, sleep deprived, and matter of fact, he said, and definitely less well dressed with beautifully coifed people in starched white coats over designer clothes. “Drama” was a word he never used about the goings on at the hospital. Sore feet and a need for fresh air after a long surgery was about as dramatic as it got. Everyone was too practically minded and busy for drama. It’s true, alas, for I must confess that I have never once encountered Dr McDreamy roaming the halls of my local hospital haloed in mysterious back lighting, cavalierly jumping from one major brain surgery to another without a hair out of place or a black circle under the eye….. or desperately in need of coffee.

Oncology, though, was a word that seemed rife with importance and gravity. It gave me a wrench in the pit of my stomach. I thought: sterile, machine-like, grave. If it had a smell it would be overpowered with antiseptic doom. The doctors professional, impersonal, rather lost in their worlds of research, new trials, and technology. And me a veritable, glorified guinea pig. No time for bedside manners. I pictured the first meeting to be in an office lined with medical journals and a grave face on the other side of the desk about to pronounce my doom with an unemotional precision as stiff as his white starched shirt. Have I mentioned caricatures?

The day I met Doctor R. was to change all that. That was the day I decided to write down my impressions of Oncology-World and the people who inhabited it along with me. Doctor R was definitely the element of surprise I wasn’t at all expecting.

I do have a history of staring at people. I have been given carte blanche to do so, mind you, by my great friend Flannery O’Connor who said quite plainly: “The writer should never be ashamed of staring. There is nothing that does not require his attention.” It has become my motto for navigating and comprehending whatever world I find myself in. Cancer is that world at the moment, and this has become my project: Humans of Oncology. Doctor R was to be my first - em - stare.

At my first appointment, when I was ushered from the waiting room to the ‘back’, I had my first surprise. We passed an open door which revealed a desk and piles of books inhabiting a very tiny office in a way that comforted me immediately. It was much like my own office at home, but…smaller. It did not look like the office of one who had starched shirts. I discovered later that it belonged to Doctor R, and unassumingly inhabited the same hall that led to all the equally small exam rooms - a hall not unlike a rabbit warren. These rooms were clean, clear and uncluttered….but with a pleasant, humble quality that speaks low overhead. I did not feel dwarfed. The whole place seemed to hold me up with its close fitting walls, which is the only way I can explain it. It was comforting.

While waiting, I felt this rising anxiety about having to sit trapped, passively receiving the ponderous diagnosis. I did not want to cry or fall apart like they do in the movies, but I wondered. I had never done this before. As is my way, I did not want the doctor to feel awkward telling me the news. So, I rehearsed possible scenarios in my head. In the middle of one said scenario, I heard outside in the hall an approaching animated conversation - about lunch, and a visiting wife and baby boy - there was definite gushing going on. And in walks this duo of nurse and doctor filling up the room with joy like so much conversational confetti. She tells me: Doctor R’s baby came to visit him today. Doctor R. stands in the doorway and smiles from ear to ear declaring that said baby was now 13 months old - his first! This is the most delightfully unassuming entrance I have ever seen a doctor make.

He reaches out his hand to shake mine and then my husband’s. It’s a confident handshake. He has on scrubs and pink, scuffy cancer awareness tennis shoes. He suddenly and without warning zeroes in on MY shoes. “Ahhh, niccce. Nordic socks with Doc Martins. I like it.” I smile a bit incredulously but with no small amount of delight. This was clearly not the script in any of my scenarios. But I recognize a fellow shoe hound when I see one. We talked cool socks and gushed over Doc Martin’s shoes for about five minutes. My husband just stared half in amusement, half mystified. Dr R also quickly reached celebrity status in my mind that day when he knew who William Morris was, and was openly impressed that I had socks with his designs. My oncologist had me at Morris! Who woulda thunk it?!

Then seamlessly, he picked up my chart and looked it over. He did not beat around the bush. He came right to the point before I knew it. A tricky cancer, sometimes liked to travel about, unfortunately. Surgery was needed. Chemo in my near future. He unfolded all the facts in a businesslike manner that wasn’t unpleasant. He sometimes paused to look up at me, kindly seeking comprehension in my eyes before he went on. I asked questions, I think. I was looking for absolutes. There were none. In a way, he was teaching my brain how to walk through the mine fields he already knew like the back of his hand. It was never deep despair and it was never absolute certainty of a cure. When I tried to take him to either extreme, he pulled me back to the middle. We had to live in uncertainty for a while, he said. I would get used to it, he seemed to wordlessly add. He kept me emotionally steady in a scenario that could have toppled me. I was grateful. Oddly, I distinctly remember thinking, as he laid forth the plan, how proud his mother must be. What a nice son. You think strange things when you are in the city of Oncology.

That was the first visit. To my relief and surprise, I did not leave sobbing or terrified. I left filled with “what was sufficient for the day.” A plan. It was sealed with a very sincere hug before he briskly left the room. In its way, it was quite clever with its bit of open and kind genius delivering hard news. Not like Dr McDreamy, mind you. Let me attest that Doctor R was never, at any time, bathed in back lighting. But… he did shine.

Since then, I have had surgery. Doctor R was able to use a robotic arm machine, which is less invasive than regular surgery, though probably involved an impressive talent to perform it, which he had. I was never afraid. I asked Dr. R rather cheekily if he was a gamer when he was young and if that helped with guiding the arms of the robot. He laughed and said that yes, he was a gamer, but that was not a prerequisite in learning how to do robotic surgery - some of the best at it have never touched a joy stick - but he agreed it did have similarities with the eye hand intuitiveness part of gaming! The robot’s name was Da Vinci, he said. How apt. My son Ben was very impressed with that fact when I told him.

Recently, I have launched out into chemotherapy - a whole odyssey of symptoms which make cancer a real deal at all times. But through it all, Doctor R has remained this pleasant, firm, factual rock. He is always upbeat and annoyingly positive. There have been times I have just wanted to beg him, “pl-ease can you just feel SORRRRY for me? Only for five minutes?” But he never will. His constant belief in my perseverance, in my ability to handle chemo symptoms, as he pleasantly and maddeningly catches my tired eyes with his own and says, “You can DO it!” and I feel like no, I absolutely cannot and please wipe that smile off your face. It’s at those times I wonder if his mom ever wanted to give him a piece of her mind. Then he charms me by noticing how my chemo beanie matches my outfit perfectly and well, dear reader, I melt. Tony just laughs.

And you know, Doctor R is always correct. I can do it and I do. He always ends each visit with a bear hug that wordlessly says, “I’d be sorry for you but that would not be good for you.”

It leaves me thinking that this young man in his mid thirties, in the best of health, with a lovely wife and a new baby boy, and at the top of his game both in surgical skills and intelligence must also daily convince himself: “You can DO it”. Every day, every forty minutes or so, he must open a door and tell someone they have cancer. Mine was sad enough, but sometimes he must tell a young, newly married woman of 25 that she will never be able to have children and perhaps may die. He has to tell someone who almost reached their five years clear - that the cancer has come back. I can only imagine what that must be like, and how truly brave he is to have chosen this vocation. If he gave into sorrow for each one of us as I am sure he would be most capable of, he would not survive the emotional toll. Yet, I feel he is always in my corner. He expresses his emotion through action. Through a firm, unaffected kindness, through a positive push when you just want to be mule-ish. By pulling you away from too much thinking in one extreme or the other. By chuckling to himself when Tony and I banter back and forth. And by talking about socks. It’s a kind of genius, really.

At Christmas, I gave Dr. R the wildest pair of socks I could find. They were compression socks for surgery. I remembered that my own surgery was almost 6 hours long. I felt sorry for his poor legs, recalling my Dad’s lamentation about sore feet. When Dr R. opened the bag, he was suddenly a boy. He loved them and thanked me effusively. Yes, I smiled again, his Mom must love him so dearly. At my last appointment, he made a point of telling me that he wore the socks to surgery a few days before. We both got really and truly geeked out over the glory of compression socks, happily puzzling the rather stoic medical student hanging about that day.

Bonding over socks. This was never a scenario I imagined in my walk through Cancer. But it has filled me with a human joy I never want to lose even if I am traveling a dark and dreary road. That is what Dr R has shown me.

And I say, never underestimate the power of the bear hug. It doth good like a medicine. And who needs Dr McDreamy and back lighting, anyway. The truth is more beautiful than fiction among the humans of Oncology.

I do not feel inclined at this time to have a paid substack. But if we were together in a cafe discussing all these thoughts, I would not be opposed to you buying me a cup of coffee - with cream, of course. In that spirit, if any of my posts resonate with you and you feel so inclined, you can donate here: buymeacoffee.com/denise_trull