Every year as the holiday season thrusts itself upon us I drive to my annual cancer check-up at the Dana-Farber Cancer Center in Boston. Although last Wednesday marks the eighth time I have participated in this ritual since moving back from London in 2015, I nonetheless marvel at the DFCI building looming in the distance. I approach this behemoth as a patient. And that continues to seem weird.
It is more or less the same deal every time. I park, which takes longer than expected, because they have every imaginable cancer specialty so lots of people with cancer equals lots of cars in the parking lot. I check in, go up to the breast unit on the ninth floor, get a tracker and a bracelet and have my parking validated. I take a seat in the waiting area and glance around the room. I spot a wig or really short haircuts indicative of recent or ongoing treatment. But I am just here to tick the box until next year. So mostly I don’t look around too hard and keep to myself.
The tech calls me in for weight, blood pressure, temperature and to ask whether I have any pain. No, I say. Then I go back out and wait to be called in to see the nurse practitioner for the physical exam. Once in the room I strip from the waist up and put on a gown and then she comes in, asks some questions and does a very brief exam to check lymph nodes and the implants.
And that’s it. I think this year we spent almost as much time talking about my outfit and in particular how cute my new boots are.
No blood work, no scan, just that and then I am done until next December.
But this year was a little different. In July I stopped taking a medication called Tamoxifen which is given to premenopausal women for ten years following some hormone receptor positive breast cancers. My ten years were up and so I went off it and I am now at long last, legitimately, a graduate of breast cancer treatment that involves putting any chemicals, medications or radiation into my body.
You may congratulate me on the ten year mark but guess what? It is a sham because the risk of cancer does not actually decrease until fifteen years out. So the ten year mark is kind of bullshit. I ask the NP about this and she confirms. And then throws a curve ball. She tells me that after ten years I don’t have to come back for check-ups anymore. “I am not pushing you out,” she assures, “but you should think about it.” I ask whether that is a little odd considering the actual risk shift and the answer is just that this is the policy of the DFCI. By the way, even after fifteen years the risk doesn’t go away completely, which is sort of obvious but, you know…
Huh, I think. Do I want to graduate now? Or do I want to come again in a year, or for the next four years, or forever? I put it to her. So what exactly do you other than ask some questions, feel me up and check lymph nodes? Nada. I think about it. I tell her I am not sure whether I want to come again or not. So I check out, return my tracker, and make the appointment for December 2023. I will, in fact, think about it. Whether I am ready to graduate. For now I won’t decide one way or the other.
Still I consider the reasons for returning. What if there is something I might miss that she would pick up on a routine check-up, I wonder. And then on the other hand would continuing to come be silly, like being a professional student because you can’t decide what to do with yourself.
The answer is that I don’t fucking know. The deeper answer is that no one fucking knows. At this point I reckon I am leaning toward not going. Maybe just so I can add that credential to my current list of graduations. High school, check. College, check. Law school, check. Interior design certificate program, check.
Cancer patient, check.