The radiation technician executed her duties with the same bored detachment as an express lane cashier; I was yet another item to scan. A box of Fruit Loops. A head of lettuce. A side of bacon.
Regardless, we were scheduled to be together everyday, 5 days a week for 6 weeks. Repeatedly, I tried to catch her eye as she manipulated my body parts because I wanted her to acknowledge that the limbs she was adjusting were indeed attached to a human being. To me. But she refused to look me in the eye.
It’s tough to disguise when we hate our jobs, especially if our occupation demands human connection. The resentment leaks through our fingertips looking for a vulnerable place in the world to deposit the feelings of discontent. In the medical field, the dumping ground is the patient.
Admittedly, I was part of the problem. I expected radiation to be a breeze as the side effects are manageable and the time commitment is minimal. But, like every other aspect of breast cancer treatment, I was both naive and ignorant.
Radiation for the left breast presents a particular challenge given the positioning of the heart and lungs. In order to zap any remaining cancer cells without damaging these vital organs, respiratory-gating is performed. This process requires the patient to hold her breath while radiation is delivered in order to pull the organs closer to the back and further away from the treatment field, thus minimizing exposure. Precision is critical…the patient must take a breath that is not too shallow or too deep to accurately ensure that radiation is safely delivered.
“It’s not for everyone,” warned Dr. Xhue, my radiation oncologist. “Some people have a difficult time enduring the breathing patterns required for the procedure.”
What she meant was that some people cannot stand the sensation of suffocation. To measure and control breathing, a snorkel tube is placed in the patient’s mouth and a nose clip is placed on her nostrils. The patient's arms are lifted above her head and secured in support handles in order to open the chest wall.
I dissected a frog in 10th grade biology class that was placed in a similar position, sans snorkel tube and nose clip. It’s poor little arms were pinned tightly above it’s head to enable open access the chest. I felt so bad for the tiny creature, stripped so inhumanly of life and dignity in the name science.
Same idea. Except the radiation technician did not demonstrate an ounce of empathy towards me. Instead, she would bark 2-3 word commands at me:
“Hold your breath.”
Oh, and my favorite, “Let's be quiet.”
For the life of me, I could not remember her name. So by week 2 of our brief yet life-saving relationship, I started calling her derivations of Elizabeth.
“What’s up with these hospital gowns Lizzie?” I asked, “I feel like a Guantanamo Bay prisoner. You’d think the American Cancer Society could solicit Vera Wang to design something both functional and fashionable.”
“To be honest Ellie I’m secretly delighted to have my own plastic surgeon. It just makes me feel so Hollywood.”
“Hey Besty, shouldn’t you buy me a drink before you touch me there?”
Each time I extended an invitation to engage in conversation, she rejected it (me) with a dismissive shrug of her shoulders or an eyeball roll. Then she would gleefully shove the snorkel tube in my mouth, plug my nostrils, stick my arms in the braces, and retreat to the safety of the command room. I would be left alone in the cold, dark treatment room with NASA sized equipment pointed at my chest without even a goodbye.
What a boob, I thought.
Every warrior needs a loving wish before going into battle; it protects her from the debilitating whispers of fear. The fight for my life was not limited to the tangible arenas of the operating table or chemo chair. The disease is far more clever than that. The most savage attacks occured in the gallows of my own mind, a space where cancer finds the patient most vulnerable and medicine least effective. Sure, you can knock yourself out with a delusional elixir to get through a medical a procedure. But sooner or later, you will wake up and you will be alone. Then fear will try to eat you alive.
This is where humanity trumps medicine, even though it can’t be quantified or measured. You are shielded by the memory of a gift card that was left in your mailbox. Or protected by the thoughtfulness of your neighbors who scrubbed your toilets while you were in surgery. Yes, every call, every card, every prayer, every unique chicken casserole that is left on your front porch step matters. It matters BIG. Compassion is our greatest arsenal in the fight against cancer.
Since Ella did not seem to appreciate the value of human connection, I employed the cognitive avoidance strategy. I did not allow myself to associate radiation with scary things like atomic bombs and nuclear power plants during treatment. I also entertained myself by reciting song lyrics in my head.
Radioactive by Imagine Dragons
Harder to Breathe by Maroon 5
Or chanted Dory’s mantra from Finding Nemo:
Just Keep Swimming…Just Keep Swimming…
Periodically, Beatrice would interrupt the Games in My Head by bellowing commands over the intercom, speaking with the sharpness and authority of a middle school secretary dismissing a kid from algebra class:
“HOLD YOUR BREATH!!”
Throw out the damn machine, I thought. And remind me that I am stronger than my circumstances.
It was very stressful. If I did not inhale accurately, or if I could no longer hold my breath, the machine automatically shut off and treatment was not delivered. Then the whole process would have to start all over again.
When radiation was successfully delivered, it was announced by a flashing BEAM ON sign, as if I was a winning game show contestant on The Price is Right. But instead of feeling victorious, I would turn my head away from the light and think:
Someone needs to document this bullshit.
To me, the flashing neon sign symbolized the absurdity of cancer treatment. The irony of needing to torture yourself to earn the privilege of watching one more lacrosse game in the freezing, pouring rain. It’s crazy but you just have to do it.
“All done” reported Betty when she dutifully returned to scrape me off the table.
Silly Liza, I thought, cancer treatment is never done.
Fortunately though, neither is love.