On Diagnosis (Attitude Part 1)

I get a lot of questions about my attitude toward having cancer. I don’t actually feel as though I am exercising an act of will, or being stoic, or heroic, or brave or anything else. These are clichés, as well illustrated by the Onion article “Loved Ones Recall Local Man’s Cowardly Battle With Cancer”:

“Most people, when they find out they’ve got something terrible like this, dig deep down inside and tap into some tremendous well of courage and strength they never knew they had,” said Judith Kunkel, Russ’ wife of 11 years. “Not Russ. The moment he found out he had cancer, he curled up into a fetal ball and sobbed uncontrollably for three straight weeks.”

That’s the thing, it actually takes more effort to run around screaming “oh shit oh shit oh shit!” than to simply, well, deal with it. (Though I guess I’ve never tried the running around screaming part, so I will have to defer to those who have more experience than I do).

So let’s start with the diagnosis. A cancer diagnosis, even a thyroid cancer diagnosis, is supposed to be devastating. To me, it was a relief.

I don’t know how cancer diagnoses work in other medical systems, but the medical culture here is that one does a test and either schedules a follow-up a few weeks later or gets a “we’ll call you by X date if there’s anything to worry about.” I had a biopsy in September and I had an appointment 3 weeks after the biopsy. Maybe 8 days after the biopsy, I get a phone call asking me to come in at 8:30 the following morning. You don’t need a PhD to figure that one out–they weren’t calling me in urgently to tell me it’s benign. So in a way, the phone call tells you.

Carrie and I spent that night worrying but we couldn’t really do anything, and there is still reasonable doubt since nobody has actually said the words “you have cancer” to me. I imagine that is one of the crappiest parts of the medical profession. I’ve had to dole out my share of bad news as professor and chair but it’s not life-and-death bad news. I remember the appointment only in pieces, and in fact could not tell you how I was told. But I do remember in vivid detail the surgeon going over the risks of surgery and its necessity. That’s where I first learned about the anatomy of my neck–the parathyroids, the thyroid lobes, and the recurrent laryngeal nerves (you’d think I would have come across that one in all that physiology reading for the Audible Past but since they weren’t ear-related, I more or less tuned it out).

In my case, the diagnosis turned out to be a relief, especially in retrospection. I had been feeling like crap for months, with a diffuse set of symptoms that were hard to explain and impossible to attribute to a cause. Some were outright bizarre. For instance, I had become incredibly sensitive to pressure changes. Some old farmers can predict the weather from their knees. I was able to predict the weather from my neck, and pressure changes made me feel pretty sick. Once the right lobe came out and the surgeon looked inside, it was clear that one of my major causes was that the tumor was essentially strangling me. If cancer had not been found and if the surgery would not have been performed, it might have eventually killed me. Though probably my diffuse symptoms would have become more and more acute and I would simply have wound up in a hospital in much more unfavorable conditions. Instead, I can no longer predict the weather. That’s what the internet is for, anyway.

With a thyroid cancer diagnosis, anyway, I went from not knowing what was wrong with me to understanding exactly what was wrong, and what it would take to make it right. Yet, cancer itself is incredibly abstract. In its advanced stages, it is intensely painful. But it is not causing me any physical pain. Nevertheless, I know it has to go.