Wednesday, April 22, 2009

A day of no prizes

In the make-believe world in my head, I bit my nails all morning on Monday and waited for the Pulitzer committee to announce their prize winners for 2008.

In the far less glamorous real world, on Monday afternoon I sat in an exam room biting my nails and waiting for the doctor to tell me if he knew whether my cancer treatments succeeded.

OK, make that gumming my nails. I forgot that I have no teeth.

Monday's visit to Kaiser's Radiation Oncology Department was my third follow-up appointment since radiation and chemotherapy treatments concluded last month. But it was my first visit with Dr. Chen since he and the rest of the Cancer Board examined me in January and approved my course of cancer treatments.

The visit began on a clumsy note, before Dr. Chen even arrived. One of Dr. Chen's assistants pulled up a chair beside me and read from a chart on her clipboard.

She said that her chart showed that my treatments ended in November. No, I scribbled in my legal pad; my treatments ended March 25.

Then she said that her chart said that I had my trach surgery after my treatments were over. No, I wrote, I got the trach on January 14, before I even was aware that I had cancer.

A perplexed expression rose to the doctor's face. She flipped over her clipboard and held it up to my face.

"Is this you?" she asked, pointing to the name on her chart.

NO, I wrote. I lifted my I.D. badge from the office off my neck, and let her read my name.

She studied my badge, then looked at her chart, and looked again at my badge.

"Oh, I am so sorry!" she said, before rushing to the door and leaving me alone in the exam room.

Some time later, the door creaked open and she stepped inside again. "Good news, Mr. Serchia!" she announced. "We found your real chart!"

For a moment I wondered if my "real" chart might had gone missing in January and everything that has happened to me since should have happened to another Kaiser patient.

Then Dr. Chen's assistant snapped on her latex gloves and got down to the nitty gritty. First she stuck a tongue depressor in my mouth, and then her fingers went in.

Dr. Chen walked into the exam room just as I was beginning to drool. I hope Dr. Chen didn't think that I was drooling at him, but maybe word has gotten around the Kaiser campus that I cast all my doctors in an imaginary daytime soap opera that plays in my head.

Within seconds, Dr. Chen's fingers were in my mouth, too. It must be a rare treat for a doctor to examine a toothless patient's mouth and not need to fear being bitten or eaten.

In comparison to his assistant's slender digits, Dr. Chen's fingers felt like tree limbs in my mouth.

Then Dr. Chen said, "Let's go to the exam room next door." I knew what that meant.

The exam room next door was where the heavy artillery in the Radiation and Oncology Department is kept. Dr. Chen wanted to perform a nasopharyngoscopy.

A nasopharyngoscopy is a procedure where the doctor inserts a flexible fiberoptic scope up your nostril and keeps pushing it into your nasal cavity until you feel it bumping against the lining of your esophagus. While the nasopharyngoscopy is under way, a monitor displays video of your innards in live, gruesome color. And after the doctor is finished probing your innards, he slowly pulls the scope out of your nostril.

Dr. Chen's exams on Monday showed that it's too soon to draw conclusions about my cancer, but I am definitely still a big baby when it comes to have fiberoptic cameras shoved into my nose.

The swelling of my tongue has gone down, but it has a ways to go yet, and there are no guarantees that will happen. Dr. Chen ordered another MRI to get a closer look at what's going on, and wants me back for another follow-up in a month.

I drove back to the office not knowing if my cancer was caught by my treatments, and I still have no clear idea about when I'll be able to talk again and eat through my mouth.

When I sat at my computer, I went directly to the Pulitzer website to read the list of winners for 2009, which had been announced while I was seeing the doctor.

In the Pulitzer Prize ceremony in my head, I took top honors in three categories, was finalist in two others, and my editors and fellow journos celebrated with me by pouring Champagne down my G-tube and sticking cigars in my trach tube.

Back in the real world, I still have cancer and a tongue that swells. Well, there's always next month to look forward to.

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