Radiation continues…

When you go to the hospital every day at the same time, you start noticing a lot. You know where the parking spots are typically open, who the valet guy is , who is the one over seeing hospital housekeeping, the schedule of the coffee runs.The crowd outside the OR with big books or e-readers prepared to wait for someone seem the same although its a different group every day. The rhythm of waiting rooms, the sounds of the hallways and the footsteps of the staff.

The radiation oncology waiting room is a collection of chairs next to a long hallway. The crowd remains the same every day albeit some minor variation…….the very anxious hispanic lady with her baseball cap ,always accompanied by a family member, the older guy with lung cancer and his occasionally present wife, the ukranian lady who wears a cape, the elderly guy in the wheel chair who flirts with the receptionists when he is not dozing off and the goth lady who talks mostly to the patients that wait for their MRI in the same area. We see each other every day and although there is no overt acknowledgment, we all know that we have the same enemy.

Today, there was a new guy, the patients weren’t moving in predictable fashion and it seemed that they were running behind. The new guy was approached by the technician who reported that he is getting late for his chemotherapy, the technician asked, “how long does that take you”, the new guy replied” Its my first one”there was a wave of palpable empathy in all sitting there, in that moment we all felt one, connected with this bond of experience that was common to all of us. Even the aloof ukranian lady sighed.

Daily appointments are draining , they are a daily reminder that you are sick and need help. Its taxing to the psyche, having to go in every day. Feeling good during treatment is deceptive because you feel well yet you are a patient. Dealing with cancer means rearranging a lot in your life including how you think about life. Feeling well is a blessing that needs to be appreciated daily, the day you don’t hurt, the day you arent exceptionally tired and feel clear in your head is a good day and should be appreciated as such. Gratitude needs to be the routine with every passing day. There is hope and sometimes it comes out of a machine in form of rays on a daily basis.

Operation Shake and Bake

My idea of relaxation is certainly not staring at a crooked poster on the ceiling of a hospital room with heavy radiation equipment around me. I don’t think the hole at the center of the poster through which the red laser is peeking can convince me or another patient that they are  looking at a scenic island with clear water and waterfalls. I ponder, if everyone believed in the same God, it could have been possible to have a heavenly image up there and then when a beam comes out of this hole, it would be more believable as a divine intervention and healing. I have no idea what is coming through here. Chemotherapy is something I saw and felt, had side effects to so felt more real. This, I just need to have faith.

Laying on the radiation machine with both hands up and breast exposed is not the most comforting positions. “Hands up” always evokes feeling of fear and unpredictability, and anxiety of what may happen. Our brain is fascinating at making associations and the association of both hands being up is that of being vulnerable. I am here to get radiation treatment with the desire to get any stubborn cancer cells that may have survived the surgeries and chemotherapies.

The ladies at the reception seem familiar with the crowd in the small tightly packed waiting area. They should be since radiation treatment is given five days a week for several weeks. They know patients by their first name and usually their accompanying friend or relative. When I declare, I am here for my shake and bake, they crack up. (My radiation oncologist is Dr. Sheikh). They are not used to chirpy cancer patients, and I notice that the chairs in the waiting room are occupied by humans with very depressed affect and sickly demeanor.

Radiation Oncology is a topic not much discussed in medical school unless you inherently are interested in finding more about it. It is usually a department tucked away in the basement of a medical center or in an area that many don’t pass through. So despite being a physician, I had no idea what goes on in there until I arrived there as a patient. The presence of equipment seems to have had some robotic effect on the staff too. Or is it that the principles of physics that over-arch the principles of empathy that is so prevalent in my world of psychiatric medicine. The appointment begins with changing into a gown…ah the dreaded hospital gown. This will be the routine for another 32 days. Being a sucker for unique products, I have acquired the “radiant wrap” which is a designer radiation gown for breast cancer patients. However that doesn’t really make the ordeal any better. I am neither more radiant nor more covered.

I walk into the radiation room, and its cold and dark. There is soft music from a radio channel that doesn’t add much to the ambiance. There are women in lab coats, i.e the technicians who quickly line you up in the right position. Of course the black marking on my chest with markers help them align the machine. Reminds me of the old embroidery machines that I used to watch with fascination at the street corner as a child. How the craftsman would line up the needle on the careful drawn on design and give the machine a whirl. Well, now facing me is a round disc attached to a huge machine arm emitting rays that intersect right at the spot where the “x” is on my chest. I can see my image in the glass. I also see, the machinery inside opening tiny metal doors with a disturbing screeching sound. I lay still, with my chin up since I don’t want my chin to get the radiation. Then I breathe. After few seconds the machine moves and now its angled to my side and I can see the darn poster again.

I am quite skilled at imagery and have taught it to my patients many times. But now as the radiation equipment moves around me,  I just can’t summon the power to imagine that I am basking in sun light on this island full of water falls. What I have gotten good at though, is believing that the little energy bundles that come out of the machine are hitting my skin and making sure that all rogue DNA is blasted away one by one. 32 more treatments to go, I softly pray, and hope for the healing rays to make me disease free. Then perhaps soon, I will vacation at a real island and won’t have an “x” mark on my chest.