Life after cancer becomes a project of milestones to achieve. My profession as a management consultant is partly responsible for the analogy, but there’s still a lot of truth to it. Once declared in remission, a long period follows (with any luck) of check-ups with the doctors who treated me. In my case, the recommendation is seven years of milestone check-ups. The first year, the check-ups were quarterly. Successful milestones means the appointments become further apart.
I received the declaration earlier this month that my cancer remains in remission. After over three years of being in remission, it’s not a statement I necessarily take for granted. I experienced the surprise of a cancer diagnosis once. I don’t think once you’ve had this surprise, it’s possible to be surprised again. No matter how healthy you feel, you can always receive unexpected news. So, when my oncologist made the declaration, I received it with the appropriate satisfaction and relief of someone who understands how easily he might make the other declaration.
I have found no way to prepare myself for an upcoming milestone check-up. Despite my continued good health, I tend to procrastinate in making the appointment in the prescribed month. Once I’ve made the appointment (usually a few weeks in advance), I tend not to give it too much thought during that first week of waiting. But then in the second week, signs of my anxiety about the upcoming check-up appear. At first, they are so subtle that I’m not aware of the cause. After a day or two, though, and I recognise reluctantly the source. There’s not much I can do about it. I’ve tried to express my anxiety to Maja but prefer not to make her anxious too about the check-up. I’ve found it better to keep it to myself.
When the day comes, I tend to be distracted. It’s not that I’m actually dwelling on the potential outcome; it’s more of a non-specific anxiety humming below the surface of my obvious emotions and behaviours – it’s a bit of white noise in my otherwise reasonably focused mind. I usually manage to get some work done and usually manage to be punctual for the appointment, as well (I’m not normally punctual for appointments I’m not keen in attending). At some point during the day, I will break down and reveal my anxiety about the check-up to someone but then brush off any concern shown for me. It seems to be relief enough just to have said it.
Having had tongue cancer means the check-up follows a consistent pattern of question and answer, visual inspection of my mouth and tongue, an endoscopy through a nasal passage, followed by a physical examination of my neck. The visual inspection also includes a finger pressing my tongue and the floor of my mouth, and the physical examination is a gentle series of pressure points beneath my chin and around the back of my neck and behind my ears. Surprisingly, I have become relatively accustomed to the endoscopy. It’s a long slender tube that slides in through my left nostril and down the back of my throat. It’s awkward and uncomfortable but not painful.
At my last check-up, for the first time, my endoscopy was displayed on a monitor for three interns to view the examination. I watched it through the corner of my eye but was too fixated on the face of my oncologist to watch the screen. It had always been my habit to observe his expression, seeking for the first signs of concern. But, of course, he is the consummate professional, and I’ve always known this. But for me, with this rubber tube fed into my throat through my nose, where else am I going to look? Anxiety and, now, habit compels me to watch him. His expression remains a fixed smile. He makes a few subdued comments in language weighted heavily with terminology. But I trust him, and I am reassured.
His smile broadens slightly, and he relaxes when he tells me everything looks fine. He deftly extracts the tube from my nose and an intern hands me a paper towel. I smile, wiping, immensely relieved and a little uncertain at how to adjust so quickly to my continued good luck. The examination of my neck and the glands beneath my chin are anticlimactic. The declaration soon follows, and we shake hands. There is both mutual relief and shared success in that handshake.
The next milestone check-up will be with my surgeon and now six months away, instead of four. When the oncologist told me he will see me in a year, there was a ring of certainty in it that I like to believe I heard. It makes the prospect of future milestones even more rewarding.
