Wednesday, February 6, 2019

Radiation routine

The twenty-six appointments to destroy my cancerous prostate gland are scheduled for three o'clock at the cancer center, but I always arrive early because they can often take me earlier. This may be because others' procedures go more quickly than the schedulers anticipated, or other patients were unable to come. I get to the parking building by 2:15. It's dark, gloomy and dirty, leaks on all floors when it rains, and though it has many handicapped parking spaces it's always hard to find one. There are many cigarette butts near the elevators. This sort of makes sense: People with unhealthy lifestyles are more likely to be at a place like this or have friends who are. But still ... smoking at a cancer hospital?
As I sit in the car I drink the sixteen ounces of water I've brought with me in a thermos. They want my bladder to be full before the treatment so I'm to drink at least twenty minutes before it. The drive there takes fifty minutes and now, nearly at the end of the treatments, that region of my anatomy is so inflamed that I have to urinate often and with tremendous urgency. Getting to the nearest restroom after the drive is always a priority. So far, I've made it without incident. 
reception area waiting room
The reception area waiting room.

The radiation oncology floor is a level down from the entrance level. On crutches (now and forever), I take the elevator. At the check-in desk Beverly puts a hospital bracelet on my left wrist. We greet each other on friendly terms. She uses "Mr." and my surname. I told her early on that she was welcome to call me by my first name, but she demurred. I get that. I used to work in a hospital and I know that they are nearly as hierarchal as the military. Also, making the sort of pseudo-friendship with people many tend to do may not be a good idea at a hospital that treats cancer patients exclusively; it's easier to say, "Mr. Smith died" than "John died."
The waiting room at the front desk for new patients is large. Told where to go my first day, I know to head for Waiting Room C, down the long, wide hall and on my left. I go there and enter one of the two small dressing rooms, where I strip from the waist down, put my clothes in a locker, and put on a hospital gown. When ready, I enter the waiting room.
The waiting room has a dozen chairs but I've never seen more than three patients in it. Unlike me, most of them are accompanied by a family member or friend, so talk between them and me is infrequent. 
There are large stacks of old magazines and a television tuned to ABC. I don't watch TV anymore and if I did it wouldn't be daytime TV. If I'm there before 2:30, Who Wants to be a Millionaire is on. The show's pattern is always the same. Easy first questions with jokey answers, then one or two at a normal trivia level, and then ludicrously difficult ones, something like, "Of these four nations admitted to the United Nations in the nineteen sixties, which was last?" That show's followed by Right This Minute, the most irritating kind of show there is: People sit at monitors and comment on clips that have become popular on the internet. There are four of them and their comments are supposed to be funny or thought provoking but never are. They often repeat the clip several times, as though the viewer can't comprehend visually what happened the first time like they have, or that viewers really want to see video of people slipping on ice and falling down again and again. As stupid a show as it is, it's both visually and auditorially noisy, making it hard not to glance at the screen now and then during it.
radiation oncology waiting area
Radiation oncology waiting area.
I'm often called before this show is well underway.
The technicians who perform the procedure are friendly and polite. They are usually women. Although I go to the same room daily, one of two rooms that does this procedure, I seldom have the same two technicians because some of them work part time. The room is darkened, which is calming. I sit on the table, one takes my crutches and puts them aside, and I lie back. I raise my pelvis and one puts the mold that was made of that area under me. They put a cloth over my lower pelvis and pull up my gown before telling me to lower myself. The cloth is about the size of a dishtowel and it covers my genitals. That's as good for them as for me—I hate getting naked in front of strangers, even in a medical setting.
Having my pelvis properly aligned is important, so I had three small tattoos before I began this. Next, they raise the table I'm on and then, with one on either side of me, tug on the large cloth I'm lying on to align the tattoos and the laser. "I need a two," one will say to the other. Tug, tug. "Three." Tug. During this, I relax and remain passive, like a lump of clay being thrown on a potter's wheel, a crooked picture being adjusted. When they're done, they go into their control center. The big machine goes around me, taking a low-resolution MRI of my pelvis to make the alignment perfect, which it does by moving the table millimeters in whatever direction is necessary. This feels like I'm in bed and a dog jumps up on it, or that I'm lying on a floor during a mild earthquake. 
After this, one of the technicians says over a speaker, "Beginning treatment." I never know if I should say anything or not. How loud should I speak if I do? I trying to keep my breaths shallow, so I don't respond. Again, the machine circles from below around me clockwise for one minute, pauses for a few seconds, then circles back again counterclockwise, again, for a minute. As it does this it emits an electronic sustained "la." The entire procedure last just minutes. Music from a Spotify account plays in the room and once, the whole procedure fit into the length of just one song, though that song was over eight minutes long (Don McLean's American Pie). 
hospital hallway

The procedure isn't at all bad, but I've disliked the process. The drive, the parking, the undressing and dressing, the waiting. These are complaints other cancer patients would gladly trade for their own. Years ago, when I was a newspaper reporter, I interviewed a woman with brain cancer who had undergone extensive chemotherapy. "Ever cell in my body hurt more than you can imagine," she said. She later died from the disease. In my case, the sarcoma I also have is likely to kill me pretty soon, meaning that the prostate cancer treatment will have been unnecessary.
When the procedure is over, I rush to the dressing room and then to a bathroom as by now my bladder is ready to burst. The drive to the turnpike is winding, suburban-like. I head west, toward home. 
The afternoon sun highlights a surprising number of jets and their contrails in the sky as the jets also head west. The jets are close to one another, sometimes just half a mile or so apart, but at different altitudes. I think about the hundreds of people on them. They're heading toward or away from family members and friends, joyous or sad events, different jobs or business ventures, vacations, experiences. New lives.

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