Who knew a trip to a DMV could create so much emotional turmoil? As I was sifting through the mail two weeks ago, I noticed that the reminder for my driver’s license renewal had arrived in mail and I needed to go in and do my vision screening. I kept the envelope aside as I went through the stack of solicitations, reminders for medical conferences and the latest issues of Psychiatric journals in duplicate. My husband is also a psychiatrist and we receive two copies of everything. And that is a lot of mail.
Today I had nothing on my calendar so I decided that I will go in and get my license renewed before its expiration next month over lapping with my birthday. Birthdays after metastatic cancer are achievements in themselves. Since last year, I can roll out of bed and post on social media, “I got through another day and I am still breathing “and my wall floods with congratulations and support. Just staying alive has taken on a special role in my life. Before I had to make major accomplishments, receive awards and trophies and then someone would say, “Well done!” and now I say “Look I am standing up” and it is seen as an inspirational statement. Such is life with its ever-changing perspective and appreciation. Being alive every day and living it to the fullest no matter how cliché it becomes remains the center of my universe.
I wear a black shirt since I want to wear something with a collar for the License picture. I remember last time wearing an Ann Taylor suit to the DMV in March 2013. I was a working mom of two kids, 2 and 5 with a part time psychiatric practice recently recertified by the American Board of Psychiatry and Neurology. I was fit and fully in the competitive game of life. I remember chatting with the receptionist and her discussion with me about her antidepressants and how much they had helped her. People are willing to share a lot when they find a doctor in social settings. I think she was on Lexapro.
I stand in line looking around the office. A sign says “Senior citizens, Expectant mothers and persons with disabilities” can move in front of the line. I have been an expectant mother and currently a person with disability, a life threatening disability I might add and then I stared at the words “Senior Citizen” which seemed so far away and inaccessible. Even though I get told that I will be the statistic of my own, the median three year survival puts me nowhere close to the senior citizen line, EVER. The gentleman ahead of me is being told by the clerk that he will be 75 soon and will need to repeat a driving test again. As they say old age is a privilege denied to many, I see needing to be alive for another 30 years to be in his shoes. I try and distract myself and look at the people in the waiting area. It’s a busy place, filled with people of all ages and ethnicities. Music is blasting taking the edge of this depressing experience.
I get a number and sit down. Numbers are being called at the counters and this reminds me of the American consulate in Islamabad twenty years ago.
A young physician, wanting to go to the US and get psychiatric training. Wanting to be the best psychiatrist that she could, clenching her degree from an institution known for its academic excellence and waiting for her turn. Exactly twenty years later, sitting in the DMV, unemployed and disabled, waiting for her vision test. Another form sits on her desk, renewal of DEA number as in her prescribing privileges, a fees of 735 dollars and she contemplated if she should renew it or not.
I look at the infinite number of posters and signs pasted on the wall behind the counters. A poster with a little kids in the cape “Be my superhero, donate an organ today”. I whisper to myself, I am so sorry, I cannot be your superhero, my dear, and I have cancer. My organs have betrayed my own body, how can they ever be helpful to you?
I had learned after a discussion with few physician colleagues that those with metastatic cancer cannot be organ donors. Another wave of grief rises and subsides in my heart. I look around, numbers are being called out and people are responding.
A mother walks in with her teenage son and they sit down together barely looking at each other, both on their phones but it appeared that she had brought him for his driving test. I envied her, sitting next to her son and my heart broke for my children and mentally I created a picture of my son and his father sitting chatting with each other as he waited his turn. I want that turn too, to bring my son and daughter here someday for their driving test. It has been only two days since my daughter and I have been trying to help her ride the bicycle without training wheels. May be she will remember that too if I am not there to take her for her driving test, maybe she will.
Finally B222 gets called at Counter 7. The pleasant middle aged lady is anxious to get done with me. She sees a healthy young woman standing in front of her. Her questions to me about having a disability or medical condition are a mere formality unknowing how it is my overarching reality. She has no idea that I have metastatic cancer. She quickly checks marks no on all the questions and I ace my vision test. She then asks me if I still wanted to be an organ donor and I meekly reply, I don’t think I can be. She doesn’t bother much to explore that further. She asks me if I was still the weight I was four years ago. I could have explained to her why I am not, why I am carrying the extra menopausal weight and why I am unable to exercise to the fullest but instead I gave her a number that I remain unhappy with, the number at which my Ann Taylor Suit no longer fits.
She then, asks me to go to the cashier.
It was two days ago that I survived the anniversary of my metastatic diagnosis. My heart still raw from the anniversary reaction. A year plagued by dreams reworked, goals adjusted, pain, scans and heart ache had just ended. I wonder if I will ever be back here to renew my license again. Four years seems a long time.
The cashier is swift and quick and I step up to the Camera waiting area.
I am feeling emotional exhausted by this time. I had not realized how much grief this visit would trigger. Dates and years and expirations have become painful to deal with. Planning the future is illusive, a “what if” follows me in all my plans. I have had stable disease for the last year but I wonder, what if, I wonder, what if.