A Little Background...

I want to back up a bit and give you some relevant details about my earliest encounter with cancer, and through cancer with our medical and para-medical establishments.

Over 15 years ago now, I discovered a small pea-like lump directly under the nipple of my right breast. I was maybe 35 years old.  My mother and maternal aunt had both had bouts of post-menopausal breast cancer-- as had an unusually high number of women of their generation living in our commercial farming community located downwind and downriver from the Hanford Nuclear Reservation.

I went to the only doctor I had in Seattle at that time-- she was a naturopath.  She concurred that this lump was worthy of suspicion, and suggested I go for a mammogram. But where should I go?  I had no health insurance.  I called the various "Women's Clinics" abundant in Seattle to find out how much this procedure would cost.  No one from any doctor's office could give me that information.  NO ONE KNEW.   They knew the insurance code, but clearly most people did not pay for this out of pocket, and getting anyone to give me a price-- much less enough information to compare prices-- well, I am pretty sure that never happened.  I think I just picked a clinic near me and hoped for the best.

It was in a tall office building on what is called Pill Hill in Seattle.  I rode up in a cushy elevator.  I entered an office clogged with ferns and shades of pink and mauve. Fancy!  Pink coffee cups.   Mauve curtained dressing rooms.  Attendants in rose-colored scrubs.  A wrap-around gown in-- you guessed it--mauve.  I was shocked out of this plummy dream by my first ever mammogram.  (Jesuz-ouch!  That old adage about having one's tit in a vice is no joke...)  I was told not to get dressed yet.  The Dr wanted an ultra-sound.  Uh, and how much would that cost?   They didn't know.  Was it necessary?  The Dr. thought so, and, after all, he's the Dr!

I lay down in another room next to what looked like a large TV monitor.  The Dr, a large white-haired man in a large white coat, swept into the room.  He was clearly in a hurry. ( Imagine the long line of women in mauve gowns awaiting his attention.)  Maybe he introduced himself to me -- I was in such foreign territory, I might have missed it.  He squirted this nasty cold gel on my bare breast and squished something hard into and all around the nipple.  He said,  Just as I thought.  This is nothing.  A clogged milk duct.   

And with that I was dismissed.  There was no further discussion.  I got a bill for several hundred dollars in the mail.  Oh, and they encouraged me to return next year to do the whole thing all over again.  Ah, no, thanks.

There was NOTHING about the experience that I felt good about.  I did not trust him.  I did not like the place.  But here was a Dr, a specialist, with all this special equipment, and he said it was nothing, so it must be nothing, right?  After all, just because I didn't like it, doesn't mean they don't know what they're doing.  And, besides, it cost a lot of money.  Especially to find out it was nothing.

So, for at least a year or two after that, when I got a breast exam as part of my annual check-up at the free clinic, I told the doctors that I had a clogged milk duct in my right breast, that I had been to a specialist, and had been told it was nothing to worry about.

Then one year, the doctor who had done my previous year's exam said,  Hmmm, this feels different to me.  I think you should get another mammogram.

I am eternally grateful for her vigilance. And I am grateful to my friend Kim for forcefully encouraging me try yet another therapist, and I am grateful to that therapist for persistently encouraging me to try an anti-depressant, and I am grateful to Zoloft for getting me to a place where I could even consider getting annual exams...  As I used to say, Thank God I was not depressed when I discovered I had breast cancer.  I might not have lived to tell this tale.


When I told my free clinic doctor, with some perturbation, that this was the exact same lump that the special breast Dr had told me was nothing, she said, Well, we can't be sure it is the same lump.


But I can be sure.  It is my breast.  I have felt this lump at least once a month for at least two years now.  I am familiar with it-- so familiar that I did not notice its subtle changes like you did having examined it only once a year.  This guy got it wrong.  Really, really wrong.  Shouldn't he at least be told?  Doesn't he have any responsibility?


The short answer is no.  He does not.

The unspoken answer is that doctors do not tell tales on other doctors.

And the final answer is that one must trust one's instinct, and do one's best not to be persuaded by fear or by desire.  I wanted to believe this guy-- even though everything, every single thing about him, the place, the procedure, the event felt wrong wrong wrong to me.  I wanted to believe in his big white coat, in his authority, in the idea that he knew something I did not know about my body even though he hardly bothered to take either me or my body into his busy circle of attention.

This lesson has not been lost on me.  I am willing to partner with all kinds of medical/health practitioners, but I have never again abdicated my responsibility for the decisions I make about the care of my body.  I am glad for the expertise each brings-- grateful that they know more than I do-- but I no longer seek comfort in trusting their authority.  I ask a lot of questions.  Some practitioners can work with that, some can not.  I find the ones who are willing to partner with me.  I try to keep my mind and my eyes open.

I am no longer impressed by anyone's big white coat.