Applied Radiology

Ms. Starr is the Director of the Tacoma chapter of the Foundation For Global Community, Tacoma, WA.

CAT scans! I have had many these past 16 months. It's the price I pay for survival; I go every 4 months to make sure the tumor has not returned. Here is the drill.

The night before and then the morning of, I have to swig 16 ounces of the most god-awful concoction, a viscous white liquid, piña colada flavored, that makes my intestines show up on the scan. It is a serious challenge to keep it down, so I have learned some tricks. Keep stirring, so that none of the blobby stuff has a chance to coagulate in the bottom. Find something distracting to do, such as talk on the phone, read e-mails, or write a letter. Have a glass of water or maybe a cup of peppermint tea on hand to dilute the impact. And then hope for the best. It actually gets worse each time; I think my system has developed a memory of the taste and texture. Or maybe I have less tolerance for tiresome experiences now that I am healthy. You learn to put up with things when you are sick that seem totally unacceptable otherwise.

Hospitals are notoriously impersonal places, filled with well-intended, but usually overworked staff. I remember to be friendly and make contact with each person that passes me through the system. Kirk (my husband, life partner, mate) and I always go together; even though it's supposed to be routine, it is not. Nothing is ever routine when cancer is involved. Nothing! So we check in, and I fill out the exact same forms every time, swearing that I have never had a bad reaction to the dye they are about to inject into my veins and that I have no conditions that would contraindicate the procedure. I absolve the clinic of all responsibility while under their roof, and I sit down to wait. Sometimes we hold hands, sometimes we laugh a little and talk, always we are brave, and a little bit scared. When my name is called, we head down the now familiar corridors to the prep room. There I get an IV administered and if I'm lucky, I get a nurse who knows how and where to stick.

Today is such a day. Susie is Filipina, small like me. Her English is careful and imperfect, her smile lights up the room. She asks if I am left-handed. She is the only one who ever asked, who is looking for the hand with the most prominent vein, and her stick is perfect. I of course tell her so and thank her profusely. I am not squeamish about needles, but I have learned to recognize the nurses who care enough to do the job well. Once I have been prepped, I get to drink one more beverage, a large styrofoam cup filled with a Tang-like substance. I ask if I may bring my own glass next time, unable to resist the opportunity to do a little environmental education. Fortunately, this aide has a sense of humor and nods in the affirmative. We talk about the nastiness of these drinks, and she is both sympathetic and matter of fact, qualities I greatly appreciate. She shares my incredulity over the selection of piña colada as the flavor of choice. We imagine someone in a lab somewhere who would rather be in Mexico or has an overwhelming craving for rum.

Finally, I am ready to be escorted across the hall to the scanning chamber. A new person takes over, someone I do not know. But it's okay because I see Diane working in the control room with all the computers, and she is my good luck charm. She has been there every time, and she has always been real and funny and totally positive. She is the one who told me the day the tumor showed up that I would be fine. She is one of the bright spots, and I am always glad to see her. I know that she likes to fish with her husband and doesn't care if she catches anything. She just likes being in the boat. Her children are grown and she loves her work. She went through menopause at 42, and she looks too young to have grownup children. She exclaims over my curly hair and says convincingly that I look well.

I breathe a little more easily as the new person positions me on the table. Her name is Katherine, and she is all business. I remember to engage her in conversation, instantly picking up on her southern accent. She is defensive until I tell her I grew up in Tennessee. The connection is made, and suddenly we are fast friends. She is here on loan for a month, and misses air conditioning but not the Texas heat. She also misses her three teenage sons and is glad to be going home on Friday. She makes sure I am comfortable, warm enough, and reminds me of what to expect. Then she leaves the room, and the surreal part begins.

My table moves into the open-ended tube where flashing lights are rotating rapidly in a neon arc, and brightly colored animal stickers have been pasted, to put kid patients at ease. I am rather partial to the silver dolphin, and I smile in spite of myself. My amusement is interrupted by a canned male voice that tells me intermittently to hold my breath and breathe. I always worry that I will blow it out too soon, but somehow I manage. I worry about heavy smokers and people with lung disease. I tell myself to relax, to center and ground. Katherine comes back in to inject the contrast dye, which will light up my liver and other organs that are fed by my blood vessels. The weirdest thing happens: first, I get a strange metallic taste in my mouth, and then seconds later, my crotch is on fire. I am surprised every time. A few seconds later the "man" tells me to hold my breath again, and my crotch is no longer of concern. And then, it is over. A total body scan in a matter of minutes. Katherine takes out the IV, I pull up my pants, breathe deeply, and go find Kirk.

Now we wait. We hang out with Diane and Katherine, joking about Katherine's southern accent. Diane fills her in about the "nice" big lymphoma I had in my chest wall. Nice is not a word I would use, but I let it pass. We are getting special treatment.

At this point, normal people have to go home to wait, sometimes for days, for the test results. Since Kirk is a pediatrician, the radiologist reads my pictures as soon as they come up. We have someone new today; she and Kirk know each other from phone consultations, but have never met. I like her quiet confident manner. She says how hard this must be, how she reads scans all day long but doesn't much think about the people whose insides she is perusing.

I am struck by how easy it is to disassociate, and I feel our presence may be a gift, a reminder of the lives she holds in her hands. I do not blame her for this distance; it only saddens me a bit. But I have my own problems to worry about. So I refocus, gazing at indeterminable shapes while she and Kirk exclaim over my appendix that glows sweetly, thanks to the piña colada/Tang infusion. She takes her time, looks closely, I stop breathing, and then she pronounces me healthy, no tumor in sight. Another reprieve. We shake hands, thank her profusely, as if she has the power to grant immunity, and say good-bye.

And then we are back in the corridor, holding one another for dear life. Holding and crying some as well. I wonder out loud that it does not seem to get easier over time. I repeat, it is never routine. Kirk believes the scan brings it all back in a rush; after all, it all started here, with the discovery.

We are breathing again, beginning to allow a sense of relief to sink in. We laugh a little as we walk into the sunlight, arm in arm. We are free for now; the fear recedes a bit, and off we go to celebrate.

Together.