The Day Before Cancer: My Fine Needle Biopsy

Running out of miracles. It is exams week, and a day when I do not have to give my exam, but even with no responsibilities to fulfill I took the day off. My appointment would be at eleven. A fine needle biopsy. Jenny and I had looked up pictures and descriptions, none of which were comforting. A giant needle was going to be shoved into my neck. Oh well. I’d live, as long as they told me I was cancer-free. Since I am already on edge, I decide to spend the morning paying bills and sorting through my overloaded inbox.

My apartment is about a five-minute drive from the hospital, and that’s only because of traffic lights. You could walk there in ten minutes easy. I leave about twenty minutes before my appointment, then panic, realizing I have no idea which of the monstrous, towering beige buildings contains the radiology department. I circle the parking lots as quickly as I can without running over pedestrians, craning my neck upwards at the building numbers. It begins to rain. With ten minutes left, I park the car and run for the nearest building. Luckily these things come with posted indexes. I should be in the main hospital building, page 208. I run over curbs and down driveways, past the free valet parking (damn), and into the lobby of the hospital.

Behind the information desk are elderly ladies in green, one or two of which might escape notice. But to be confronted by six or seven deceptively identical white women with white hair wearing truly identical short green lab coats is rather unnerving. They are volunteers who speak in chorus and check with each of their cronies before delivering a definitive answer to anything. But nice and smiling and eager to help. This desk of greencoats send me downstairs to a second, smaller desk of greencoats, one of whom asks me if I have an appointment.

ME: Yes, I do. For a biopsy with radiology.
GC1: Hmm, yes. Radiology. And what is your name?
ME: Mary Noon.
GC1: Your last name, dearie?
ME: Noon.
GC1: (a bit impatiently now) Your name.
ME: Noon. N-o-o-n. Like 12 o’ clock.
GC1: Yes, but I want your name, sweetheart.
ME: (a bit impatiently as well) Yes. That is my name.
GC1: Noon? Noon is your name?
ME: Yes. My last name.
GC1: Not the time of your appointment? Oh dear. How funny. (Embarrassed laughter.) I thought you were telling me your appointment time.
ME: (a bit nicer now) No. Ha-ha. That’s my name. A bit strange, I guess.
GC1: (to another GC) Betty, this young lady’s name is Noon. Like 12 o’ clock. Isn’t that funny? I thought she was telling me the time of her appointment.
GC2: No kidding? Noon. How funny.

So the second group of greencoats are finally on board and have me fill out paperwork and then send me to registration where, thankfully, there are no greencoats.

Registration is much more efficient and helpful, except for the fact that I appear in the system twice and no one can figure out why. It doesn't occur to me until much later that the second Mary Noon could be my mother. The woman behind the counter claps me with my first hospital bracelet. One of those plastic wristlets you have to cut off with scissors. They used to give them out at water theme parks, but this one is customized with my name and birthday on it. The doctors use it as a cheat sheet while delivering memory and sanity tests: What is your name? What is your favorite color? What is the capital of Assyria?

Then they direct me to the radiology department. Unfortunately, they issue directions like disclaimers at the end of a commercial: go to the first stairwayonyourlefthenturnrightandyou’llseeanelevatortkaeittothebasementlevelandturnlefttwomoretimes. I end up wandering the hospital for the next seven minutes like Dorothy in Oz until my presence makes a staff member uncomfortable enough to help me.

The waiting room of Radiology. The tests begin again. They really go like this: A doctor picks up your wrist and asks you your name and birthday. You can still see them printed on your pretty new wrist-band, but you pretend not to and look away as you recite them perfectly, proudly. You pass the test. The doctor drops your wrist, scribbles something on a pad and wanders away. Five minutes later another doctor meanders by and does the same damn thing. You're baffled, but at least you know you will never forget these two important pieces of information ever again. You start listening to the tests being administered to the other patients in the waiting room and memorize their information, hoping that the doctors will try something more complex next time and you’ll blow them away with your super-knowledge of everyone in the room. But they don’t.

It is storming outside. I know this because the TV keeps fritzing out, a couple minutes on, most off. Heads turn back and forth like magnets to its belches of sound. I am sitting across the room from a large cantankerous-looking 80-something woman in a wheelchair and her 50-something daughter, the skinniest adult I’ve ever seen close up. I think, well this woman is an anorexic if there ever was one, but then I hear her voice. It’s like gravel in a blender, the unmistakable rasp of a life-long smoker. Her mother’s voice is identical. So perhaps she was just a really skinny smoker. Or a relation to Bon Scott. It is probable they are both much younger than they appear. This is the game I play in my mind while half-listening to their conversation. I am thankful to this woman for keeping me distracted until it is time for another identity test and my relocation to a procedure room.

For anyone facing a fine needle biopsy, here is what to expect:

I am placed on a typical exam table while I answer a more complex series of test questions, including a few about my now very relevant family history. The main nurse is very pleasant. I have discovered that all medical procedures are much more pleasant if you treat (and are treated in turn) every nurse, doctor, assistant, etc. like a new acquaintance you are trying to learn more about. I have shared a lot of teaching stories over these weeks, and been told many interesting stories in turn.

So I am having a pleasant conversation about the amazing prankster capacities of seventh-graders with the main nurse when a second nurse comes in to repeat the ultrasound portion of the exam. It is much like what you see on TV with pregnant women, only the cold goo is spread on your neck. This time they have the screen facing me so I can actually see the nodules as they scroll over them. In black-and-white they appeared nothing more than black fuzzy holes where apparently there should be white unadulterated tissue. Then my exam table is pumped very high in the air so that my extraordinarily tall doctor can perform the biopsy. Seriously, he must be almost seven feet tall. He is also pleasant and makes corny jokes about my name. There is a brief debate as to whether a nodule on the left side on my thyroid was one or two. (They decided two, but turned out to be wrong.)

Another woman appears and begins preparing slides that she will use to examine and prep the extracted tissues. I am given a local anesthetic and am told it will feel like a bee sting. It does, with one important distinction. The pain of a bee sting tends to last a long while. The pain of the anesthetic, while sharp, is brief, one second maximum, and thereby not at all something to be frightened of.

Then the doctor takes a very large needle with a very tiny point and presses it into my neck a few times. He biopsies two nodules and pumps the needle up and down about ten times for each one. All I feel is a slight pressure. No pain whatsoever. Also I am getting to watch the whole thing on TV, which proves an immensely entertaining distraction

As the biopsy doctor finishes, another doctor joins us (the 6x10 room is getting pretty crowded at this point). He introduces himself as my pathologist and checks the slides to make sure enough tissue has been extracted. This whole time, the only alert I have to something being wrong is the first doctor’s description of my thyroid as “strange” and rather “lumpy and bumpy.” Otherwise everyone remains upbeat and genial, like we are all a part of some product-testing focus group, trying to figure out how to make my thyroid more marketable. And so it is over. A bit inconclusive, but everyone hopeful that the bumps can be smoothed out. I will hear back in a day or two.

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