Friday, June 11, 2010

Inside My Head

That was the physical.

The emotional is harder to pin down.

I am predisposed to fear, because of the death of Natalie. That is a fact.

But this process has made me think a lot about medicine, about technology, and about not knowing.

I do know now that I do not have breast cancer. That is nice. And I know for people whose breast cancer was not caught--they would envy the care and diligence with which my doctors paid attention to me. Indeed, I know that I was afforded the luxury of these tests precisely because I have the best of insurance and my insurance would pay for them. If my insurance had not paid, I do not know that the doctors would have made the same decisions. My great insurance entitled me to more expensive and invasive tests.

But here was the side-effect. For six weeks I was in hell--either at appointments, waiting for appointments, being tested, or waiting for results. Even with the best insurance there is to offer I will pay a lot of money, and the bills will keep filtering in for the next year and a half.

I was told the procedure would be non-invasive. I now question what that means.

For three days afterwards I could not close my eyes without imagining I was back in that room with the machine drilling into me and the blood everywhere. I could not sleep. I read terrifying mysteries to soothe myself. My doctors said this would all be nothing. In fact, so many doctors handled this process I feel like a piece of meat floating down a conveyor belt. I do not even know who I would talk to if I wanted to say, "Hey. That was really unpleasant. You should alert people that this could be emotional--even beyond the fear of having cancer."

I have recovered well. I am not infected. I am not ill. But my breast is huge and swollen and emotionally I am a wreck. Even knowing I am OK, I feel violated, and angry. My body is strong. But my mind is feeble and fragile. One friend estimated it will take me three weeks to feel normal.

I feel that because machines have trouble with dense breasts like mine, I must undergo more extensive testing. Is that right?

MRIs are notorious for way over-enhancing--in other words many things that enhance are not cancer. They are also good because in the process of over-identifying enhanced spots, they catch tiny cancers that no other technology can catch. If I had cancer I know I would be grateful.

I now have a scarred and swollen breast that will have a permanent lump. The experience was so unpleasant I think I may opt for the European model and wait until I am 50 for my next mammogram. I feel betrayed by a medical system that grossly underplayed the physical and emotional trauma that having a foreign body--however small--drill into you, has on the psyche.

I wonder if our medical system relies too much on its technology. I wonder if it teaches people to put too much faith in technology that is still often wrong. I wonder if we love our technology so much that we order people who have only a minute chance of having a disease to undergo tests to take the possibility of disease down to zero. I wonder if I should be part of that decision. I wonder if we underestimate the trauma of tests and overestimate the peace of mind and accuracy that tests bring.

An I wonder how the tests themselves will alter how I am treated in the future--even though the best doctors and technology have never found any cancer in my body.

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