A Funny Thing Happened on the Way to the Jury Room …

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The Plaintiff, in "distress", captur...

The juror, in distress, captures the sympathy of the judge and jury. (Photo credit: Wikipedia)

If you’ve ever served on a jury, you know that it involves a lot of waiting, an occasional rush of activity, and intense listening and observation. I received a summons to report for jury duty recently, and, after several hours, I was among 12 individuals seated for a trial. The waiting and selection process had dragged on so long that it was one o’clock before the judge recessed the court for lunch. We had only one hour before we must report back to court so the trial could begin.

If you’ve ever suffered through a gallbladder attack, you know that it’s a most uncomfortable and unpleasant experience. Eating usually triggers it—especially eating in a rushed manner. On the day I was selected to serve on a jury, I endured what would be my third gallbladder attack in four months. It was, by far, the worst, and that’s saying a lot, since the other two meant trips to the emergency room.

The sickness began to hit me as I walked back to the courts building following a rushed lunch. By the time I reached the jury room, I felt truly ill, but willed myself to persevere. With my 11 compatriots, I sat through the Commonwealth of Virginia’s presentation of evidence and witnesses’ testimony. The discomfort, which came in waves, seemed bearable, especially since what I was hearing and seeing was so riveting.

When the prosecution rested its case, the judge called a brief recess, after which the defense would present its side.

Back in the crowded jury room, with nothing other than waiting to keep my mind occupied, the illness took hold in a most dramatic way. The other jurors were visibly concerned; a kindly gentleman watched me return to my seat at the table and asked what was wrong.

“You look gray,” he said.

“I’m having a gallbladder attack,” I replied, wetting a paper napkin in my cup of water and applying it to my neck. “I’m supposed to have surgery in less than three weeks.”

What happened next is not to be believed; if you saw this in a movie you’d criticize the screenwriter for crafting such a contrivance.

I’m a gallbladder surgeon,” he said. “My name is Dr H.”

“You’re kidding?! Are you really? My surgeon is Dr. R; do you know her?”

“She’s in my practice.”

By this time the jurors were as transfixed by the jury room drama as they had been by anything they’d heard in the courtroom. But of course I had to make light of things:

“Well, we’ve got a pretty large table here and lots of light; why don’t you help me out? Cut this thing out of me and we’ll get back to the trial.”

Then followed another wave of pain.

The court deputy had entered the room. I looked at him wanly and told him I was ill. He asked me to write my name on a legal pad, ripped out the sheet of paper, and left immediately to speak with the judge.

I’m deeply embarrassed by what happened next. The judge called me into the court room to question me about my health. He was aware that Dr. H was on the jury, and asked if I minded whether or not he spoke to him about my situation. Dr. H joined me in the otherwise empty jury gallery. The rest of the trial’s participants looked on.

“She’s a very sick woman,” Dr. H remarked. “This is an acute case.”

I pleaded to stay on; I was sure I’d be fine. Perhaps someone could call my husband and he could bring me my pain medication? I did not want to be the reason for a delay in the justice system, although looking back, I can’t help but wonder why the parties did not seat an alternate juror.

The judge sent Dr. H and me back to the jury room so he could discuss the situation with the attorneys. After a few moments, he called the entire jury back in.

“How do you feel?” the judge asked me. “Do you think you can proceed?”

“I want to try.”

“Well, I appreciate your dedication, but I’ve already decided to end the trial. The jury is dismissed.”

Dismayed, I started to cry. Even though the defense attorney assured me that these things happen and I shouldn’t feel bad, justice was delayed, and I was the reason why.

Dr H and the court deputy walked me to my car; Dr H offered to drive me home, but I thought I could manage it. (I did.) Once home, I took a pain pill and an anti-nausea pill. I fell fast asleep.

But my story does not end here. Oh no. Here’s where it gets interesting.

The next morning, a Friday, I met with my gastroenterologist, with whom I’d had a long-standing appointment. I relayed what happened the previous day. Here’s what he said:

“You’re not going to make it to the 21st. I want you to have this operation as soon as we can find a surgeon to do it.”

My surgeon, Dr R, was not back yet from vacation. Dr. V asked his assistant to begin calling through the roster. Of the surgeons she called, one was not taking new patients, and the others would not agree to operate on me without an initial consult, which would delay things; Dr. V wanted this to happen as soon as possible. Only one doctor said he’d be willing to perform the surgery, but it had to be that afternoon, since he was leaving for vacation on Sunday.

I drove myself to the surgery center and got myself admitted. John had left work and was on his way.

I was in pre-op, hooked to an IV and wearing one of those lovely print hospital gowns, when my surgeon walked into the room.

“Dr H,” I said. “We’ve got to stop meeting like this.”

Marge & Sally’s Make-You-Feel-Better Meatloaf

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When you’re recovering from an illness or surgery, there’s really nothing like a home-cooked meal to warm your heart and hasten your journey on the road to wellness. John, the Midlife Second Husband, made me a wonderful meal of pork chops, gravy, and egg noodles. My neighbor Marge brought over the meatloaf you see here.

Everyone has a recipe for meatloaf in their files, right? My own, which includes chunks of cheddar cheese, has been my default setting for ages. But Marge’s version of this comfort food has inspired me to vary my repertoire. It was delicious—just the right balance of sweetness and tang. I enjoyed several meatloaf sandwiches for lunches the week after my surgery, with nothing other than ketchup to adorn the bread. I’m craving it even as I type this.

Marge tells me that her daughter Sally really gets the credit for this concoction. By virtue of a happy accident, she once erred by adding sweetened condensed milk instead of simple canned milk to the mix. It was such a hit that she changed the recipe to include her mistake. (Marge tinkered further by splitting the difference to reduce the sweetness factor, as you’ll see below.)

Marge, thanks for bringing this to us during my recovery, and for allowing me to share the recipe on the blog. And Sally, thanks for misreading the recipe!

Marge & Sally’s Make-You-Feel-Better Meatloaf

1-1/2 pounds hamburger
3 tablespoons onion, minced
1/2 cup sweetened condensed milk
1/2 cup evaporated milk
3/4 cup oatmeal
1/2 teaspoon salt
1/4 teaspoon pepper

Mix meat mixture with hands or fork and form into a loaf pan.

Topping:
Combine a splash of cider vinegar with
1/3 cup ketchup

Pour topping over meatloaf and bake at 350-degrees for one hour. Serve with
homemade mashed potatoes or egg noodles. Delicious cold, sliced in a sandwich.

Editor’s note: Sally (of Marge & Sally) tells me that the recipe originated from the kitchen of a former First Lady of Virginia—Edwina Dalton, wife of the late Governor John N. Dalton, who served as the Commonwealth’s 63rd governor, from 1978 to 1982.

Thank God it was a Horse and not a Zebra

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A zebra eating grass.

It was not this … (Photo credits: Wikipedia)

Finnhorse stallion Turon Myrsky at the age of ...

… but this. Thank God.

Regular readers of the blog are familiar with my medical memoir, My Right Eye, published in serial form on this bandwidth. After concluding the series, I was certain I’d exhausted the topic; I certainly hoped to give you a respite from reading about my health issues. But hoping doesn’t always get us what we want now, does it?

A week ago today, I had surgery to remove my gallbladder. I knew this was coming; an operation was scheduled for May 21. But my body wasn’t having any of that. Telling your body to wait while you finish doing something or other is rather like telling a baby that she can’t be born just yet because you’re right in the middle of getting a pedicure. Or telling your gallbladder to settle down and behave because you have an article about Sissy Spacek to write and you’re on deadline.

As a cancer survivor, any future health issue—especially one involving chronic pain and a need for surgery—raises the uncomfortable specter of whether or not the cancer has returned. I discussed this with the surgeon who was originally to have done my cholecystectomy. Her response was terrific, and it has become my new mantra:

When you hear hooves in the distance, expect to see a horse, not a zebra.

Gallbladder cancer is rare; but then so was the cyst in my right eye. Still, I repeated her axiom to myself each time I found myself growing worried about the possibilities. Which was often.

The story surrounding my surgery is worthy of its own blog post, and I’ll write about it another time, when I’m feeling stronger. But for now I just wanted to check in with all of you to say that my unexpected expected operation last Friday is the reason you haven’t heard from me in more than a week. And to shout from the blogosphere rooftop that today, my surgeon’s assistant was able to tell me that the result of my pathology report is good—my gallbladder was not cancerous.

The moral of this story? I think you know it already, but it feels good to write it down: Sometimes hoping does get us what we want. I was hoping for a pony, and I got one.

Have a great—and healthy—weekend.

On a Thin Gold Chain, Mementos from Sissy Spacek’s Extraordinary Life

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My Extraordinary Ordinary Life
Sissy Spacek with Maryanne Vollers
288 pages, Hyperion, $26.99

One of the reasons I took a brief sabbatical from the blog is because I was given the distinct honor of interviewing Academy Award-winning actress Sissy Spacek for the Richmond Times-Dispatch. I met her at Selba, a Richmond restaurant, for our interview. Afterwards, we were standing and chatting when I noticed a necklace she was wearing—a thin gold chain from which hung a cluster of charms. I asked her to tell me about them, and I’m awfully glad I did; her answer gave me the lede for my article. The story, “Sissy’s Way,” appears in today’s newspaper (which has a few extras that don’t appear in the online version). I’m pleased to share a link to it here so that you can read about this extraordinary artist. You might also like to check out Jay Strafford’s review of Ms. Spacek’s heartfelt new memoir, My Extraordinary, Ordinary Life.

As a bonus, Ms. Spacek shared a little secret with me. She’s been married to film production designer and art director Jack Fisk for 38 years, so of course you know I just had to ask: “What’s the secret to a happy marriage?” Here’s what she told me:

“Marryin’ the right guy!”

Enjoy the article!

Orzo with Roasted Vegetables — A ‘Barefoot Contessa’ Recipe

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Cookbook author Ina Garten is my hero. I discovered her years ago on her Food Network program, The Barefoot Contessa, and was immediately captivated not only by the delicious-looking food she prepared, but also by her warmth and hospitality. So many cooking programs give you the impression of having been invited into the host’s kitchen to learn a cooking tip or two; with Ina, you get the sense that she’d invite you to stay after—not to help her clean up, necessarily (although I’d gladly do so), but to chat over coffee and dessert. A decadent, incredible dessert.

The first Ina Garten book I ever purchased (there are four on my shelf) was Barefoot Contessa Parties!. I’ve made my favorites from this book so often that the dog-eared, stained pages have retained their place-memory. The recipe I’m sharing here is found on page 174, and I’d like to thank the publisher, Clarkson Potter/Random House, for giving me permission to do so.

With farmers’ markets opening up for the season, this is the perfect time—and the perfect way—to enjoy the bounties of your region. This is truly one of my favorite dishes to make, and it garners raves each time it appears on my table. (The dressing is so delicious and easy to prepare that it has become my default salad dressing.) I promise you: if you’ve never tried one of Ina’s recipes, this one will get you hooked. You’ll soon start your own collection of Barefoot Contessa cookbooks.

Orzo with Roasted Vegetables
Copyright © 2001 by Ina Garten. All rights reserved. Used with permission of the publisher.
—Serves 6

1 small eggplant, peeled and 3/4-inch diced
1 red bell pepper, 1-inch diced
1 yellow bell pepper, 1-inch diced
1 red onion, peeled and 1-inch diced
2 garlic cloves, minced
1/3 cup good olive oil
1-1/2 teaspoons kosher salt
1/2 teaspoon freshly ground black pepper
1/2 pound orzo

For the dressing:
1/3 cup freshly squeezed lemon juice (2 lemons)
1/3 cup good olive oil
1 teaspoon kosher salt
1/2 teaspoon freshly ground black pepper

To assemble:
4 scallions, minced (white and green parts)
1/4 cup pignolis, toasted (see note below)
3/4 pound good feta, 1/2-inch diced (not crumbled)
15 fresh basil leaves, cut into chiffonade

Preheat the oven to 425 degrees. Toss the eggplant, bell peppers, onion, and garlic with the olive oil, salt, and pepper on a large baking sheet. Roast for 40 minutes, until browned, turning once with a spatula.

The vegetables, all minced and seasoned and ready to roast

Meanwhile, cook the orzo in boiling salted water for 7 to 9 minutes, until tender. Drain and transfer to a large serving bowl.

Add the roasted vegetables to the pasta, scraping all the liquid and seasonings from the roasting pan into the pasta bowl.

For the dressing, combine the lemon juice, olive oil, salt, and pepper and pour on the pasta and vegetables. Let cool to room temperature, then add the scallions, pignolis, feta, and basil. Check the seasonings, and serve at room temperature.

TO TOAST PIGNOLIS:

To toast pignolis, place them in a dry sauté pan and cook over medium heat for about 4 minutes, until evenly browned, tossing frequently.

Where in the World is the Midlife Second Wife?

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MorgueFile Photo (Credit: Reto Stöckli, NASA Earth Observatory --NASA Goddard Space Flight Center)

What do bloggers do when they’re not blogging? Do they travel to Antarctica, where Internet connections are spotty? (I’m assuming this is the case. I’ve never been to Antarctica.) Do they assume new identities and start life anew with a clean blackboard slate in the analog world? Do they suffer from blog withdrawal?

In my case, the last statement is true. But there’s a good reason I haven’t been posting.

I’ve been on assignment for the Richmond Times-Dispatch. As a special correspondent for the paper (which is a nice way of saying that I’m a freelancer and therefore not on staff drawing a reliable salary), I’m working on a high-profile feature article. It’s kept me pretty busy, what with research, preparation, and an hour-long interview with my subject last Saturday. I’m now keeping my head down and my fingers on the keyboard, writing and writing. And writing. I expect the article to come out sometime in May, and I’ll post a link on the blog once it’s been published.

In the meantime, I see we’ve now surpassed 18,000 visitors to the Midlife Second Wife. Thanks for reading, y’all!

Finally, a word about something different you might have noticed about the site. There are a couple of banner ads now appearing on the Midlife Second Wife, and here’s why: My blog is part of an exclusive group approved by WordPress to help beta test their new WordAds program. I hope you don’t find the ads too distracting. In fact, I hope you’ll click on them, because if I understand the idea behind AdChoices correctly, this allows you to have a say in the kind of ads you want to see on the web through interest-based advertising.

In the interest of full disclosure (and revealing my self-interest), I earn a little something each time a visitor clicks on an ad on my site. It might not fund a trip to Antarctica, but it could go a long way to helping me fund this blog. And pay the Internet bill.

I’ll be back soon with new articles, new recipes, and—as promised—a link to my article when it comes out. In the meantime, enjoy beautiful weather, wherever you are.

Love,
The Midlife Second Wife

The Conclusion of My Right Eye: A Blogger’s Journey Through Cancer

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Self-portrait of my right eye, nearly six years after surgery

Before and Aftereffects
For weeks I’d been responding to email by typing with one hand; the other held the magnifying glass from my compact edition of the Oxford English Dictionary so I could make out what I was seeing. I’d not been able to read a book or my beloved New Yorker and New York Times for a month, but by the end of December the world was clear and whole again. Dr. S, my eye surgeon, removed the bandage contact lens from my right eye and the three stitches that remained. D took me in for that appointment, holding tight to my hand while marveling at the steadiness of the surgeon’s.

Winter turned to spring. I was regaining my strength after the two surgeries, adjusting to the vagaries of my hormone-replacement medication, and traveling to the lab for regular blood work to check my levels of TSH (thyroid-stimulating hormone). I was also back at work.

Since I had decided to proceed with the radioactive Iodine-131 treatment, I had to prepare myself by becoming completely hypothyroid. This meant that for two weeks, I stopped taking Synthroid and instead took an alternate hormone therapy. After that weaning process, I had to stop cold, taking no hormone replacement medication at all. In addition, I went on a highly restricted diet to ensure that there were no traces of iodine in my system.

These are some of the foods I had to avoid:

  • Iodized salt and sea salt
  • Seafood and sea products, and foods containing sea-based additives
  • Dairy products
  • Eggs
  • Commercial bakery products
  • Beans, soybeans, and soy products

I could eat fresh meats in limited portions (no more than five ounces per day), grains, cereals, and rice.

I could also enjoy fresh fruits and vegetables (except, for some reason, potato skins); unsalted nuts and unsalted nut butters; sugar, jelly, and maple syrup; vegetable oils; and, surprisingly, sodas, coffee, tea, beer, wine, and other alcohol. Homemade foods were permitted, and the Thyroid Cancer Survivors’ cookbook offered a host of recipes, including those for baking bread without iodized salt.

I hope that no one reading this ever has to go through this ordeal. The last two weeks before taking the radioactive pill were agony. I had absolutely no energy, my thinking was fuzzy, and I hated the limited diet. On the upside, my former boyfriend loved to bake. He baked a delicious bread for me using a recipe from the cookbook. In fact, several of the recipes I tried were so good that I still make one of them to this day,  happily adding salt. I even included one of them (for Greek Grilled Chicken) in the “Food for Thought” section of the blog.

I was so lethargic and logy by the time it came to get to the Clinic to take the nuclear pill, D basically had to drag me there.

I felt a certain amount of trepidation, walking into the nuclear medicine section of the Clinic. I put on a gown and someone escorted me to a room at the end of a long corridor. I sat behind a screen while a technician pulled out what looked like a small safe deposit box. Inside was the pill I was to swallow. I was warned not to let it linger in my mouth; I was to get it down as quickly as I could. I was afraid my throat would close up and I’d struggle to swallow the pill, but I managed to get it down. And that was that.

Here’s an excerpt from an email I wrote on May 21, 2007:

Dear all,

Please forgive another mass email, but my energy level is pretty low, and this is easier for me right now.…

I do have good news: today’s scan (done with a gamma camera for you science buffs) indicates that the thyroid cancer did not spread elsewhere! I did, however, need to have the therapeutic dose of radioactive iodine, so I’m afraid I’ll be lollygagging around the house until Thursday. [Apparently, this was the date when I could resume my regular medication and a normal diet.] My doctor is extremely pleased with the way things are progressing, and especially pleased that she insisted on such an aggressive protocol.

It is now almost five years since my cancer treatment. Periodic ultrasounds of my neck show that the cancer has not returned. Other than having to use eye drops several times a day, I’ve not had any problems with my right eye. Or my left one, for that matter.

I’m reading a beautifully written book, a “biography of cancer” by oncologist Siddhartha Mukherjee called The Emperor of All Maladies. He says that all patients begin as storytellers, as narrators of suffering. They are travelers who have visited the “kingdom of the ill.” In the days following my eye cancer diagnosis, I attempted to write an essay called “My Right Eye.” I knew how I wanted it to begin—with the nightmare I’d had as a baby that you’ll recall is the first installment in this series. But I couldn’t get much farther than cursory research into conjunctival sarcoma. I was frightened, busy with medical appointments, and far, far too close to what was happening to me to really be able to narrate my suffering. That essay lay unfinished for years, until the daily blogging challenge on BlogHer presented me with an opportunity to take it up again. And that is how I ended up writing this series.

A brief note about the process: With the exception of the first installment, which I edited fairly extensively from that aborted essay, I wrote every part in this series directly on WordPress’ editor mode. I tried writing it out in Word first, but that seemed an impediment; I found it easier to just type and write, type and write, as I went along here in WordPress. I’d re-read a draft before posting, doing surface edits or rearranging a sentence or paragraph, but what you’ve been reading is pretty close to how it just came out of me. No one read any drafts before I hit “publish.” I did refer to old notes and emails from the period—I’m so glad I kept them! But I wish I could remember in greater detail all I went through. I guess the mind knows what it can best manage to hold on to.

In the course of my writing, I learned a few things. Most distressingly, I learned that the woman I had called at the suggestion of my eye surgeon—the patient of his who’d had the same eye cancer surgery as me, died in 2010. I came across her work email in my files; when I Googled her name and the name of her company, I found her obituary. Although the cause of death wasn’t stated, she apparently had been in hospice; the family had requested that in lieu of flowers, a memorial contribution be made to a palliative care center. L was so kind and reassuring the one time I spoke with her—upbeat, optimistic, and encouraging. She was one of many flowers that I found along the rocky path I walked in the months from November 2006 through May 2007.

In researching the series, I discovered that there might be an alternative for Synthroid that no doctor had ever told me about—desiccated thyroid, an old therapy made from porcine thyroid glands. There seems to be a lot of controversy surrounding it, but then there are doubts about the efficacy of the synthetic drug that I’ve taken for nearly six years. It bears looking into, at the very least.

A comment sent by a reader reminded me about a book by television journalist Betty Rollin that helped me when I was going through my first medical crisis—the tumor and cyst leading to my oophorectomy in 1977. After I replied with the name of the book, First, You Cry, it occurred to me to try to locate Betty, to thank her for sharing the story that helped me so much. I’m fairly relentless when it comes to research; I found a Manhattan telephone number that I thought could be hers. When I dialed it, a woman answered. I asked if I could please speak with Betty Rollin, and to my delight, it was she on the other end of the line. She told me about her most recent book, Here’s the Bright Side: Of Failure, Fear, Cancer, Divorce, and Other Bum Raps, to let me know that there is a flip side to the terrible things we endure. After we got off the phone, I went to the library and checked it out. I’m reading it now. Here’s something for us all to think about:

I woke up one morning and realized I was happy. This struck me as weird. Not that I didn’t have all kinds of things to be happy about—love, work, good health, enough money, the usual happy-making stuff. The weird part is, when I thought about it, I realized that the source of my happiness was of all things, cancer—that cancer had everything to do with how good the good parts of my life were. …It turns out there is often … an astonishingly bright side within darkness.…There are even studies, scientific studies (!) that show that people often say they have benefited from the terrible things that have happened to them.

Having lived the life I’ve lived since one erroneous cancer diagnosis and one all too accurate cancer diagnosis, I know this is true. At midlife, remarried to a wonderful man, I’m happier than I’ve ever been.

There’s a dividing line between health and cancer. (Or between divorce and remarriage, or any other dichotomy you can think of.) In my case, I found that there’s a lot to be said for thinking you’re going to die—it makes you appreciate each bright, pulsing, living moment that comes after that dividing line. The poet Wallace Stevens wrote that “death is the mother of beauty.” I understood his meaning in the abstract when I first read “Sunday Morning.” I even wrote my own poem about it, conflating my uncle’s death from cancer with my father’s death from heart disease. But now I have lived it. Now I really get it.

Life is beautiful.

The Complete Series:

Part 1: The Baby’s Nightmare
Part 2: The Nightmare Returns
Part 3: Room 101 and the Masquerading Marauder
Part 4: The Eye as Metaphor
Part 5: The Back Story
Part 6: It’s Nature’s Way
Part 7: Help From the Man on the Street
Part 8: A DES Daughter?
Part 9: Speak, Memory
Part 10: The Needle and the Damage Done
Part 11: Can I Get a Discount?
Part 12: A Call During Dinner
Part 13: First There is a Cancer, Then There is no Cancer, Then There Is
Part 14: Through a Glass, Far Too Brightly
Part 15: Anatomy of an Eye Operation
Part 16: At Peace
Part 17: Redux: First There is a Cancer, Then There is no Cancer, Then There Is
Part 18: The Rising Tide of Thyroid Cancer


© 2012 Marci Rich
All rights reserved.

My Right Eye: A Blogger’s Journey Through Cancer — Part 18

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Self-portrait of my right eye, nearly six years after surgery

The Rising Tide of Thyroid Cancer
A headline in Parade earlier this month jumped off the page as soon as I saw it:

“Thyroid Cancer: Why Is It on the Rise?”

The brief item, by health and nutrition journalist Camille Noe Pagán, addresses the fact that for reasons which remain unclear, thyroid cancer diagnoses rose a staggering 173 percent between 2002 and 2012, making it one of the fastest-growing types of cancer in the United States. I received my diagnosis in 2006.

Noe Pagán interviewed Dr. Robert Smallridge, chair of the division of endocrinology at the Mayo Clinic in Jacksonville, Florida. He attributes part of the increase to better screening and detection, but points out that “research suggests other factors must be at play.”

What could those other factors be? Radiation exposure, such as the type found in dental X-rays, is a known cause of thyroid cancer. Because I’m an ounce-of-prevention girl, I get my teeth cleaned and checked regularly. I’m sure, though, that I’ve had no more than the recommended allotment of dental X-rays; I can’t believe that a lifetime of systematic devotion to dental hygiene caused my thyroid cells to mutate. Or did it?

And here’s something else to think about: The thyroid is an endocrine gland. So are the ovaries. A benign tumor and cyst obliterated my ovaries 30 years earlier. Did that have anything to do with what was now happening to my thyroid gland?

The nodular cyst on my right eye was clearly an anomaly, an interloper in the perverse parade of cellular dysfunction traipsing through my body for more than half my life.

These are some of the questions and observations I had for Dr Y, a young and personable endocrinologist from Romania. Not surprisingly, she had no answers. But she did amplify the nature of my cancer:

“The pathology report actually showed two malignancies. Yours is papillary thyroid carcinoma, and if you have to have cancer, that’s the kind to have because it has such a high cure rate—80 to 90 percent survive ten years after diagnosis. And your tumors were small and encapsulated. The prognosis for patients with these types of tumors is very good.”

“So what do we do for treatment? Chemotherapy?”

“No, not chemo. I want to stress that Dr. M did a wonderful job removing your thyroid—surgery would have been the first step. But as good a job as she did cleaning out your thyroid, there’s always the chance that some thyroid tissue remains. These emit chemical signals that can confuse the results of future tests. And, despite the fact that your tumors were encapsulated, there’s always the possibility that a rogue cell could migrate to any remaining bits of tissue.”

“Okay, so I had the surgery and the thyroid is gone. That’s a good thing. The cancer’s out of me. But if I don’t have chemo, what do I do? Radiation?”

“Not what you normally think of as radiation. You need to know that I presented your case to all of my colleagues in the department. I had my own idea of how we should proceed, but I wanted to get their opinions first. These guys are the best at what they do, and our consensus is that we proceed aggressively. And that was my inclination.”

“What do you mean by ‘aggressively’? Are you suggesting another operation to make sure everything’s gone?”

“No. Look, there are really only two options. The first is to do nothing, to trust that the surgery got all the cancer, and not worry about any likely or unlikely remaining bits of tissue. The second option is to kill off whatever remaining bits of tissue exist with a single, low-dosage treatment of radioactive Iodine-131.”

“How does that work?”

“In about five to six months, you return here to the Clinic, to the Nuclear Medicine Department, after preparing yourself to take the pill. You prepare by stopping your Synthroid and going on an alternate hormone-replacement therapy for two weeks, followed by no hormone-replacement therapy at all. You’ll also have to be on a completely iodine-free diet. The Thyroid Cancer Survivors’ Association has the list of foods to avoid and a cookbook to help you with recipes for what you can eat. You can find all that on the Internet. It’s important to be completely, totally iodine-free when you take the radioactive pill, because if there’s even a trace of iodine in your system, the radiation will zero in on it, doing more harm than good.”

This was a lot to take in. I tried to process all she was saying: No additional surgery. No chemo. No radiation per se, but a radioactive pill instead. This sounded promising, but I couldn’t get past the prohibition on medication. I’ve never been what you’d call a dynamo. Now, without my trusty pills to keep me on an even keel, I could see myself sleeping all the time.

“How will I function? I won’t have any energy if I stop taking my Synthroid.”

“It is difficult, it will be difficult. But you get through it. You get through it because you have to. We really believe this is the best course of treatment for you. It’s aggressive, and we think we really need to be aggressive.”

I was glad D was with me. I wasn’t sure I was following any of this, and I knew he was taking good notes. I also didn’t have to decide on the spot. Dr Y told me to go home, get some rest, and think about it.

By now I’d dodged so many bullets. Maybe taking one bullet-sized radioactive pill wouldn’t be so bad. As risk-averse as I am, it sounded better than the alternative, which was to do nothing.

And I’m not a “do nothing” kind of girl.

To be continued …

Part 1: The Baby’s Nightmare
Part 2: The Nightmare Returns
Part 3: Room 101 and the Masquerading Marauder
Part 4: The Eye as Metaphor
Part 5: The Back Story
Part 6: It’s Nature’s Way
Part 7: Help From the Man on the Street
Part 8: A DES Daughter?
Part 9: Speak, Memory
Part 10: The Needle and the Damage Done
Part 11: Can I Get a Discount?
Part 12: A Call During Dinner
Part 13: First There is a Cancer, Then There is no Cancer, Then There Is
Part 14: Through a Glass, Far Too Brightly
Part 15: Anatomy of an Eye Operation
Part 16: At Peace
Part 17: Redux: First There is a Cancer, Then There is no Cancer, Then There Is

© 2012 Marci Rich
All rights reserved.

My Right Eye: A Blogger’s Journey Through Cancer — Part 17

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Self-portrait of my right eye, nearly six years after surgery

Redux: First There is a Cancer, Then There is no Cancer, Then There Is
When one is ill, one’s focus becomes oneself. That’s exhausting and debilitating. And boring. I wanted to think about other things and other people. I wanted to think about the wider world beyond the Cleveland Clinic. I wanted to engage in daily life again.

On a Wednesday in mid-December, I felt well enough (which is to say I had started tapering off the pain medication and was beginning to feel more like myself) to have a friend take me out to lunch. We stopped off first at my office so that I could see my colleagues and reorient myself for returning to work the following Monday. My first operation, to remove my thyroid, was on November 17. Allowing for the days before that surgery, when I had doctor appointments for my eye and preoperative testing, I had missed an entire month of work. Even after returning, I’d still need time off for postoperative doctor appointments. Then, with the holidays, our offices would be closed between Christmas and New Year’s. I wouldn’t be back on a bona fide work schedule until after the New Year. I missed the hectic, healthy pace of my job, filled with normal things to do and worry about.

Making the rounds of the different offices, being greeted by hugs and wrapped in love and concern, brought home to me how appreciated I was, and how missed. I had cancer, yes. But I was damn good at my job, and people kept telling me how they couldn’t wait for me to return. As re-entries go, this was a balm. I would soon have things to worry about other than cancer. They would pale in comparison, but my mind would be exercised in other areas again. That was a good thing.

I wore my sunglasses throughout the day, but showed off my thyroid surgeon’s beautiful handiwork to everyone who wanted to see. It was a perfect arc at the base of my throat, razor-thin and pale. I shared my jewelry joke with one colleague who promptly whipped open her bottom desk drawer and pulled out a choker. Made from strands of soft gray cloth and studded at the center with some pretty impressive (albeit fake) bling, she handed it to me.

You have to know M to know that it was not at all surprising that she, an elegant woman with impeccable taste and style, would happen to have some spare jewelry lying around in a desk drawer. Nor was it surprising that she gave it to me. With M, class went hand-in-hand with generosity.

I had amazing friends.

When I returned home late that afternoon, exhausted but content, the message light was blinking on my answering machine. My eye surgeon’s office had called to confirm my post-op appointment for the following morning.

D, who had arranged for another professor to cover his lecture, drove me in. After all of his help and support throughout this frightening experience—way above and beyond the call of duty for former boyfriends—it was appropriate that he was with me when my eye surgeon gave me the news:

“We’ve received the report from the pathologist, and it is excellent. The cyst we removed was benign.”

A cyst. And it was benign. I was shocked. Relieved, but shocked. He, one of the top experts in the country in his field, had told me that it was a tumor—not a cyst. He had examined me and said I had a malignancy. I’d just had 10 millimeters carved out of my eye; did I really even need to have the surgery?

Oh yes. I did. It turns out that I had a “nodular cyst” that presented, in every way, like eye cancer.

“This is a rare condition,” Dr. S said. “It required many cytological tests to pin it down. There is no question that we had to take it out; it was encroaching upon your cornea.”

Here’s the final diagnosis as it appeared on the surgical pathology report:

CONJUNCTIVAL TUMOR, CORNEOSCLERAL DISSECTION – BENIGN EPITHELIAL INCLUSION CYST. (SEE COMMENT)

— ACUTE AND CHRONIC INFLAMMATION AND REACTIVE EPITHELIAL CHANGES.

COMMENT
There is amorphous hyalinized collagen around the cyst. Congo red stain for amyloid is negative.

It’s only now, nearly six years later, that I’ve looked up the meaning of some of these terms. At the time, it was enough to hear the word “benign.” I knew what that meant. That was all I needed to know.

But how ironic! I had been living with a bump on my neck that I was told was not cancer, and it turned out that it was. Then, a bump on my eye that was supposed to be cancer wasn’t cancer after all.

My emotions were see-sawing. On the upswing, when the see-saw hoisted me toward the sun-filled sky, I didn’t mind the brightness at all. I was still in pain, my vision was still blurred, and I was extremely sensitive to the light, but I didn’t care. I did not have eye cancer. I did not need to have head scans to learn if a cancer that wasn’t there had spread to my brain. I was not going to go blind.

When the see-saw jolted me back to earth, I remembered that I still did have cancer. I had thyroid cancer. And a few days later, my endocrinologist would tell me what we were going to do about it.

To be continued …

Part 1: The Baby’s Nightmare
Part 2: The Nightmare Returns
Part 3: Room 101 and the Masquerading Marauder
Part 4: The Eye as Metaphor
Part 5: The Back Story
Part 6: It’s Nature’s Way
Part 7: Help From the Man on the Street
Part 8: A DES Daughter?
Part 9: Speak, Memory
Part 10: The Needle and the Damage Done
Part 11: Can I Get a Discount?
Part 12: A Call During Dinner
Part 13: First There is a Cancer, Then There is no Cancer, Then There Is
Part 14: Through a Glass, Far Too Brightly
Part 15: Anatomy of an Eye Operation
Part 16: At Peace

© 2012 Marci Rich
All rights reserved.

My Right Eye: A Blogger’s Journey Through Cancer — Part 16

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Self-portrait of my right eye, nearly six years after surgery

At Peace
And so the waiting. The pathologist was on vacation; it would be two weeks before I’d get the report on my eye. In the meantime, I was still going back and forth to the Clinic for post-operative appointments—both for my eye and for my thyroid surgery.

The surgeon who operated on my neck was pleased with how well I was healing. She did a bit of clean-up around the incision, and it was barely noticeable. I joked that I’d just wear a lot of jewelry around my neck, but in truth it didn’t look as though it was going to require much camouflage at all. Around this time D sent another email update to my friends and family revealing new information from the thyroid pathology report:

… On the down side, when I looked at the written report I found that the thyroid malignancy was much larger than I had been told: It was 0.7 cm in diameter, not 0.07 cm, and the threshold for follow-up chemotherapy is typically 1.0 cm. Marci and her endocrinologist will have to consider the best course of action.

As they say, size matters.

This gave me quite a lot to think about. I did most of my thinking and reflecting at night, since I slept through much of the day to avoid the sunlight. When I came downstairs to rest, my preferred spot was a chaise lounge in a corner of my living room, with windows on both sides, which is why I turned to it at night. Nestled there in my cocoon of darkness, I prayed, of course. I might even have engaged in some bargaining with God. (It’s strange I don’t remember those negotiations.) But what I do remember, distinctly, was making my peace with death.

I think the fact that so much darkness surrounded me—I slept during the day and rested at night in the dark—helped me to accept my mortality. I didn’t want to die—that would not have been my first choice—but it didn’t seem frightening to me. There was something relaxing about the prospect. No longer being in pain seemed like a good trade-off to me. And being enfolded in the arms of a loving God. Just letting go and letting be…

I believed in God. I still do. In fact, there never has been a time when I doubted His existence. It’s easy to say that this was merely the indoctrination I’d received through years of Catholic schooling, but I knew there had to be more to it than dogma. Throughout all the turbulence of my life—my father dying when I was 13, experiencing a traumatic medical crisis at 21, losing my mother to Alzheimer’s, going through a divorce—I never felt as though I was utterly alone—even during the times when I really was alone. I always sensed something stronger than me was holding me up.

I had survived this long, hadn’t I? I had managed to make a go of things.

Now please don’t get the wrong impression of me. I’m a lackadaisical Christian. More often than not, church on Sunday morning for me has meant coffee and extra time with the newspaper. I admire people who have the discipline to express their faith outwardly and regularly—whatever that faith may be. My approach—my relationship with God, whom I believe is a God of love—has generally been more subdued. And I don’t think that’s wrong.

I’ve made mistakes, broken a few Commandments, but I’ve always felt His forgiveness. And as a result, I’ve tried even harder to be good.

I prayed a lot during this time. I prayed for God to help my son, to keep him safe and strong. More than anything else, my son was what weighed most heavily on my mind: how he would be, how he would manage, if the worst happened.

Although I was no longer a practicing Catholic, a wonderful priest who has known me since I was in high school came to visit me during this time. We spoke about these matters, he took my confession, and he gave me his blessing. I felt at peace.

To be continued …

Part 1: The Baby’s Nightmare
Part 2: The Nightmare Returns
Part 3: Room 101 and the Masquerading Marauder
Part 4: The Eye as Metaphor
Part 5: The Back Story
Part 6: It’s Nature’s Way
Part 7: Help From the Man on the Street
Part 8: A DES Daughter?
Part 9: Speak, Memory
Part 10: The Needle and the Damage Done
Part 11: Can I Get a Discount?
Part 12: A Call During Dinner
Part 13: First There is a Cancer, Then There is no Cancer, Then There Is
Part 14: Through a Glass, Far Too Brightly
Part 15: Anatomy of an Eye Operation

© 2012 Marci Rich
All rights reserved.