AN APOLOGY

I have been absent from this blog for a while, and I have also been very dilatory in responging to emails.  This post is a general apology.  I have just been through the worst five days of my life, and although life looks a good deal brighter now, I am still not able to function normally.

Last Wednesday, troubled by my inability to throw off what I thought was a bad flu, I went to the Same Day clinic at UNC Health Services, and was seen by a young Doctor Vance.  After listening to my heart and lungs, he ordered some blood work, an ekg, and a chest x-ray.  The blood work showed a slight anemia.  The ekg was normal.  But the chest x-ray revealed what is called a pleural effusion -- fluid in the bottom of my left lung.   The next morning, Thursday, I went to the Pulomonary Clinic of UNC Memorial Hospital, where a young specialist named Dr. Bice hooked me up to a variety of monitors and inserted a catheter into my lung, withdrawing 360 ml of fluid.  When he saw that the fluid was bloody, he said there was a 50% chance that I had lung cancer.  He said he would order a CT scan, while the lab examined the fluid.  My primary care physician, by phone, told me there was a 70% chance that I had stage 4 lung cancer, which is incurable.  He started talking to me about making my remaining time as qualitatively valuable as possible.

I was devastated.  I have spent my entire life protecting myself against stroke or heart attack by diet, exercise, and medication.  I had before me always the image of my father, who died at 79 of emphysema, obese, alcoholic, and a chain smoker.  I swore that I would not lead my final years as he had led his, and now it seemed I probably would not live even to be as old as he was when he died.

My entire world contracted sharply, so that it included only Susie, my two sons, my sister, and Susie's two sons, all of whom, especially Susie, were imm ediately supportive and helpful.  Nothing else -- politics, philosophy, my blog -- mattered at all.  I was numb -- not really with fear, but with a dead feeling.  I even lost four pounds rather rapidly, apparently because I was not eating very much.

I waited all day Thursday for a call setting up the CT scan.  On Friday, I called the pulmonary unit and was told that Dr. Bice had scheduled the scan for the following Friday!  I was outraged.  I desperately needed some definitive word on the cancer, even if it was, as I fully expected, bad news, so that I could start making plans to make sure that Susie would be taken care of.  I told the secretary who informed me abou the appoitment that that date was unacceptable.  She fussed a bit and said she had rescheduled it for Wednesday.  Not good enough, I said,  What about this afternoon [it was then about 3:45 p.m.]  Well, she allowed, she would have to transfer me to the Radiology lab.  Fine, I replied, do so.  The Radiology lab said they could take me right then.  By 4:00 p.m., Susie and I were sitting in Women's Hospital, where the Radiology lab is, waiting to be admitted.  By 4:15 p.m., we were in the basement, waiting to be called.  I had to wait for more than an  hour, but then I went in and had a CT scan "with contrast" [they inject a fluid through an IV, which makes it easier to see things on the scan.]  The med tech, who was very, very nice, told me that as an outpatient, I would be at the end of the line for reading the results, but that if my doctor called and asked, they would read the scan and give him the results.  I had already called Dr DeWalt's secretary, while I was waiting for the scan, asking her to send him an email requesting that he get the results.

The next morning, at 6 a.m., I sent DeWalt an email, repeating the request.  Later that monring, he called back.  It seems that he had not only the CT scan results but also the results of the tests on the fluids.  The results?  NO SIGN OF ANY TUMORS ON THE CT SCAN, AND NO SIGN OF ANY CANCER CELLS IN THE FLUID.  Dr. DeWalt said that they still did not know what was making me sick, and therefore cancer of some sort was still a possibility, but he agreed that stage 4 lung cancer seemed ruled out.  There was also no sign in the CT scan of a pulmonary embolism [blood clot], a secondary possibility they were considering.

If I had not insisted on having the CT scan immediately, I would still right now, and until next Friday, be living with a diagnosis of incurable terminal cancer.

I am sure all of you will understand that everything else -- emails, inquiries about the Paris apartment, politics -- has simply not been on my mind.

I don't know what is wrong with me.  I awoke this morning at 4:30 a.m. drenched in sweat.  My body is fighting something, but it will be a while before the doctors figure out what, if indeed they ever figure it out.