Dog Lived (and So Will I) (14 page)

A week later, I took another afternoon off work and returned to the cancer clinic for Seamus’s follow-up appointment.

Dr. Dutelle sat on the floor facing Seamus. She petted him and rubbed his head, scratching behind his ears as she did so. She remembered to give him his green biscuit, and he howled at her for another.

“How’d he do?”

“Great with the pills. No issues at all. Except, as you can see, the weight gain.”

“That should start to go down as we get him off the steroids. He’s almost done.”

I liked the sound of that so much; I hesitated to point out the new bump.

“Yeah, that will be great. I…uh…I…wanted you to look at that growth on his eyelid.”

“I see that. Let’s take a look.”

Dr. Dutelle lifted Seamus onto the exam table. Seamus immediately turned away from her and sat down. He was not letting her anywhere near his rear end. Dr. Dutelle and I both laughed. Smart dog. I held him while she looked at his eyelid.

“Dr. Davis prescribed an ointment. I’ve been applying it for about a week. I think it’s getting better.” I wanted that to be true.

“If this were any other dog, meaning a dog that did not have a history of mast cell tumor, I’d tell you this was likely a meibomian gland inflammation. But we need to be sure this isn’t a recurrence.”

“So this could be another cancer?”

“I really don’t think it is. But I’m going to recommend that we do a fine needle aspiration and a cytology workup.”

I stroked Seamus’s head. “I don’t know how I’d pay to do this all over again.”

“No, no, no. I’m not saying this is cancer and we have to do everything over again. Not at all. I just want to make sure we know what we’re dealing with.”

Fifteen minutes and $240.75 later, Seamus and I returned home and awaited the results.

Dr. Dutelle called me at work the next day and used a lot of big words like “probably meibomian hyperplasia versus meibomian gland adenoma,” which, she explained, meant the tumor was benign. She wanted me to continue to use the ointment Dr. Davis had given Seamus and if that did not resolve the mass, she recommended removal. If Dr. Dutelle had been any less caring and sincere and genuine, I would have begun to think she had a lot of student loans to pay off, and Seamus and I were going to be helping for a long, long time. I decided not to think about whether another surgery might be necessary, however minor.

A week later, as Seamus snuggled up against me and I rubbed his belly and petted him, I felt a lump. Jelly-like, and not big, but definitely palpable and under the skin. I felt around to see if it seemed attached to anything, but I couldn’t tell—nor did I know what it might mean if it was attached.

Our regular checkup (and yes, by now, I was a patient too—this was every bit my health issue as well) was a week away, on Chris’s birthday. For both reasons, I’d already scheduled an afternoon off work.

This time Seamus weighed in at 38.6. He’d only gained one-tenth of a pound. After she examined the eyelid bump and declared improvement, I showed Dr. Dutelle where I had felt the new lump.

“That’s great that you found that. It’s good that you examine him for bumps and lumps and changes.”

I pet Seamus. A lot. He insists on it. It’s good to know there’s a medical purpose to all that petting. I’m Seamus’s first line of defense, I suppose and it seemed he needed a lot of defending.

“So what do you think?”

“If this were any other dog—” I no longer heard what followed this statement. I knew that what followed meant more expensive tests and treatments.

This time the cytology and ultrasound-guided aspirate, along with a re-staging cytology, got me $503.25 in airline miles on my credit card. Attached to the bill was a notice that nutrition consultations with a certified clinical nutritionist were now available. In case I hadn’t done enough, I could now get a customized dietary plan to address Seamus’s specific nutritional needs.

Dr. Dutelle called promptly, as was her custom, and gave me the news.

“It’s a fatty tumor. And his eyelid is fine. His test results came back perfect. Congratulations. Seamus is in complete remission.”

Complete. Remission.

I couldn’t believe I was hearing the words.

I hung up the phone and squealed in excitement. I annoyed Seamus that evening with all of my hugging and kissing on him. Chris was equally excited and grilled steaks for all three of us, though only two of us had champagne. In honor of Seamus’s remission, we did not retire to the hot tub out of reach of the dog. We stayed on the couch, with Seamus happily between us.

In the days and months to come, of course, I still worried. I checked his skin constantly and monitored his behavior, watching for a decreased appetite, increased thirst, decreased energy—any change at all. He never changed. He was steadfastly Seamus.

When I came home from work late one evening and saw that he was limping, I refrained from rushing him to urgent care. The next day I took him to Dr. Davis and together we decided for once we would treat Seamus like “any other dog.” We’d see if the limp resolved itself in a few days with Seamus on anti-inflammatory medication before we x-rayed and tested for bone cancer. Seamus was walking normally in less than twenty-four hours.

And later, when Seamus scooted his rear end on the floor, eventually I recognized he needed his remaining anal gland expressed (thank goodness for groomers) and was not signaling the return of cancer. Cancer, it should be noted, does not itch.

Not long after, Chris moved in with me. I was confident this would last. This thing we had, whatever it was we called it or anybody else called it, had a future. I felt that most strongly when I found myself referring to Seamus as “our dog.” When Chris had picked up Seamus from his surgery, he was picking up my dog. When he took him for checkups in the months and year after treatments were completed, he was taking our dog to our vet. Despite my plans for that alphabet life, “L” for love had leapfrogged to the front of all else. Chris and Seamus and I were a family of three, happy together in our sleek and elegant cougar den. We thought our largest problem was Chris’s damaged relationship with his parents.

We couldn’t have been more wrong.

Seamus’s lump was discovered in a doggie spa. Mine was found in the shower.

My left hand brushed over the upper side of my right breast while I was shaving my underarm. Something felt unusual, thick.

If I were a better cook, I would have known that something thickening will soon harden. But ever since Chris moved in, he’d taken over doing all of the cooking in our house. When I got out of the shower, I put my right breast in his face.

“Does this feel strange to you? Like a lump?”

Undaunted by my approach, Chris spent several minutes in careful examination of the specimen presented, while I tried to focus him on the upper right side in a less preferred area near my armpit.

“I can feel what you’re talking about, but it doesn’t feel like a lump.”

“No, it doesn’t. But it’s weird. I think I better watch it.”

“Probably a good idea.”

Over the next couple of weeks, I watched it. Every so often in the shower and in the morning lying in bed I’d run my fingers across the area. I pressed. I poked. And I hoped it would go away, but I knew that it wasn’t. I tried to focus on work, particularly since the last quarter of the year is typically the busiest in my practice. And my law office was particularly important now. Having a happy and stable home life had given me the courage to take a huge step professionally earlier that year. I’d left my law partnership and opened a new solo law office. The first ten months had been exhilarating and the office looked to be a success. I couldn’t afford to be distracted. But however determined I was to stay focused, my thoughts ricocheted from the logical “I should get to the doctor’s office” to the classic “I’m way too busy right now” to the reassuring “I just had a clean mammogram less than four months ago.”

That was in early November. By December the thickening was an unmistakable hard lump. No chefs were needed. I was going to the doctor. In December.

The first appointment I could get was December 18, the same day as my office Christmas party (and one day off from the anniversary of Seamus’s first chemo treatment, I couldn’t help but note). I had a certain atmosphere in mind for this dinner, and it didn’t include a dark cloud of disease.

My new solo law office had opened on January 2 of that year. My plans were big and modest at the same time. I called it “The Teresa Rhyne Law Group, A Professional Corporation” even though it was just me, Michelle (my extremely capable administrative assistant), Laureen (my part-time, very efficient, and sharp paralegal), and the ever-flexible Chris to help with the bookkeeping and manly stuff (lifting water bottles, moving furniture, scaring off door-to-door solicitors, and even, for a while, taking out the trash). And of course there was Seamus, who could now come to work with me on most days. He had a bed and toys in one corner near my desk, although he preferred curling up in the guest chairs directly across from me, as though he had an appointment and urgent matters to howl about. (
More fookin’ food! Seriously, people. I need more foooooooooooood!!
)

I loved my office. For the past year, I’d worked long days and nights and weekends establishing an estate planning practice in just the way I wanted. It had been a pretty good start, but I had a lot more I wanted to do. A whole lot more.

While my former partners, in the splintered groups we had become, had moved into nice offices with much of the same customized furniture and artwork of our old offices, I had chosen to start small and build slowly. I rented a less than “Class A” office space with four simple rooms on a ground floor so my elderly clients could reach us easily. My furniture came from Staples. We painted the walls a vivid green and tangerine orange in an effort to give some personality to our little box. My one splurge was a painting for the reception area—a dog coming in a door, stepping jovially over a “Welcome” mat.

When one of the splinter groups of my former partners gave their law firm a new name that resulted in the acronym RCK, we quickly dubbed them “The Rock.” My office had the acronym TRLG. Looking around our tiny, bright, happy ground-floor office that was no longer downtown and much, much smaller and simpler than our prior space, I dubbed us the “Trailer Law Group.” A joke among ourselves of course. We generally tried not to say that in front of the clients we were trying to impress.

Two clients of mine—a married couple—own a successful tile and granite business with customers like the Ritz-Carlton. I remember them telling me how they started in a pickup truck hauling tile around themselves. I liked that image, and I liked what they’d done with their business. Instead of a pickup truck, I had my trailer law group, and instead of tiles I had my books and my documents and my training—over twenty years at that point. And I was just about to make our first expansion move. I was in discussions with the landlord to double my office space to include the recently abandoned space next door at a now much reduced rental rate, thanks to the sinking economy. I was talking to another lawyer, a Georgetown law school graduate, about joining the firm as my first associate. The Christmas cards that held the staff’s holiday pay bonuses said “Deck the Double-Wide”—a reference to our expansion plans. It was a heady time, but for this one gathering cloud.

I wanted this office holiday dinner to be memorable. Although sentimentality, at least as far as humans go, is fairly foreign to me, I wanted my staff to know how much I valued all they’d been through with me in the past year and that I knew how hard everyone had worked. Spouses were joining us for the dinner. I wanted everyone to pause, relax, have fun, and really enjoy ourselves and our accomplishments. For once, I had actually wanted to celebrate the holidays.

I went to my doctor’s appointment alone without telling anyone but Chris and my assistant, Michelle. Chris offered to accompany me, but I declined. He needed to be home with Seamus, whose separation anxiety had only increased as he got used to Chris being readily available to him. Besides, if Chris came with me, that would mean this appointment was a big deal, and I was still hoping it wasn’t.

I lay on the exam table with my paper gown opened, still thinking about the office dinner that evening and reminding myself to sign the bonus checks. The physician’s assistant pressed around my right breast with her fingertips, concentration visible in her wrinkled brow as she looked ahead, above me.

“It’s over here,” I said, placing my own left index finger on the far right side of my breast, near my armpit.

She placed her fingers over mine, and I removed my hand.

“You have to press in a bit, but it’s there.”

She pressed. “Ah, yes. I feel it. You did well finding this.”

“Except I sort of wish there was nothing to find.”

She quieted, palpated my breast, and said the words that launched me out of my denial. “I don’t like this at all.”

Right. Me neither.

On the exam table, in my paper gown, with the jars of cotton balls, posters on medical issues, and sterile containers on laminate countertops, I recalled Dr. Davis’s “we really weren’t expecting this” comment after Seamus’s diagnosis. Does anyone really ever expect cancer? Is there ever a good time for cancer to appear? And was it not enough that I’d been through this with Seamus already?

Apparently not. I was given a referral slip and told to schedule a mammogram and an ultrasound immediately.

Back in my office I called the facility and learned the next available date was nearly two weeks away. I pressed further, insisting this was an emergency, but to no avail. Fortunately my doctor’s office intervened and got them to squeeze me in…or, more to the point, squeeze my breast in. A mammogram was scheduled for the following day, a Friday, with an ultrasound on Monday; it seemed even for the doctor they couldn’t fit me in for both procedures on the same day.

I went to my office party thinking I could keep my mind off the tests, the look on the P.A.’s face, or the lump itself. And I tried, although my closed office door earlier that afternoon was probably an indication something was up. I hoped they thought it had to do with holiday gifts. At the dinner everyone got a laugh out of the Airstream trailer wine-stoppers and charm that they got with their bonuses, and I don’t think anyone was aware anything was wrong (except my assistant Michelle, because she always knows what’s going on with me). But it wasn’t quite the dinner I had in mind. My mood had shifted.

I drove to the imaging center the next day for the mammogram and endured a painfully slow weekend until I could return again on Monday for the ultrasound. Neither was a particularly difficult procedure; in fact, the weekend between with plentiful time to overthink and worry was more difficult. But I could sense that both the technicians performing the procedures knew they were looking at cancer. There’s a distinct lack of eye contact. And no one ever said to me “85 percent of these things turn out to be nothing” as I’ve heard is frequently said to women who have irregular mammograms. No one ever said “cyst” or “fatty tissue” or “it could be nothing.”

No one said anything to me, except that my doctor would be calling me. I began to wish Chris was with me, talking and teasing me away from the precipice.

And the doctor did finally call—at 3:45 p.m. on December 23. I could have guessed the results just from the date. By then I was prepared for the news. As I like to say, my expectations are low and generally met.

“I’m sorry, but the results are highly suspicious of malignancy. I’m going to send you to a surgeon. You need to have the lump removed. We’re not even going to bother with a biopsy. This needs to be removed immediately,” the doctor said.

He gave me the name and number of a surgeon and told me to call the following morning. In the meantime they’d fax my records to the surgeon’s office.

I paused briefly. My thoughts went something like, “Wow. Okay, cancer. Probably. So there it is. First Seamus, and now me. A surgeon? Call a surgeon. Tomorrow…I don’t want to wait to call tomorrow, I want an appointment tomorrow. Tomorrow is Christmas Eve. No way will I reach a surgeon’s office on Christmas Eve. I’m calling right now.” And just about all of that thinking was correct.

I picked up the phone.

“Hello. Doctor Riverside Surgeon’s office.”

“Hi. I’ve been referred to you by Dr. Primary Care Guy. My mammogram and ultrasound were HIGHLY suspicious of MALIGNANCY and I need an appointment ASAP. I’d like to come in tomorrow.”

She didn’t bother to contain her chuckle. “We’re not open tomorrow. Or the rest of this week.”

Thanks. Thanks for your help. This marked the first moment I wanted to say “I have cancer” in a way that, oddly, uses it to my advantage. I didn’t. I said, “When can I get an appointment?”

“January 12 is my first opening.”

“I need something sooner. This is supposed to be ASAP. It’s HIGHLY. SUSPICIOUS. OF MALIGNANCY.”

“That’s all I’ve got.”

“Then I’ll need to get another referral. I can’t wait that long.”

“’Kay,” said the heartless, unhelpful, evil receptionist. And I could swear I heard her crack her gum. But that might have just been my brain exploding.

I called my doctor’s office, angry that he hadn’t given me more than one surgeon’s name in the first place, annoyed he didn’t know the surgeon they had sent me to wasn’t even open for the rest of the week, and fairly certain that at 4:15 p.m. on December 23, I was not going to reach him or a surgeon. I explained the situation to my doctor’s receptionist, and then again to the doctor’s exchange a half hour later, and again, the next morning, to a different person who answered the phone in the doctor’s office. No one called me back.

I left my office at noon on Christmas Eve and went to my hair appointment (oh, the irony). I was situated in the styling chair with the cape draped over me and my stylist behind me asking how much I wanted cut when my cell phone rang. My doctor was calling, at last. His office had been calling around to find a surgeon who could see me “stat.” The best they could do was a surgeon in the next town over with an available December 30 appointment. I took the appointment, with only mild trepidation as to how far down the list of “recommended” surgeons they went. Thus, Kelly, my hairstylist, became the next person to know what I was dealing with. Her best friend’s mother had recently passed away from breast cancer, so Kelly also became the first person to cry when she heard the news.

I chose not to tell anyone in my family what was happening, since most of them felt the same way I do about Christmas, and at this point there was nothing definitive to tell. I had an appointment with a surgeon, but that’s all that was certain. Besides, this year my family had a chance at a nice holiday.

My brother Jay and his wife, Jennifer, with their daughter, McKinzee, and son, Lucas, took a motor home trip to California from their home state of Missouri, and we’d all be together on December 26. This was the same brother who had been in the December motorcycle accident that put him in a coma and intensive care for weeks, but since he had no memory of that and, I’m sure, because he had children, he still enjoyed December. And we were all excited that his two kids and my younger sister’s two kids would be meeting for the first time.

Before that family get-together, though, Chris and I had another dinner to get through. Less than three hours from the doctor’s phone call, Chris and I were headed to Christmas dinner with his parents.

• • •

Christmas dinner would not be the first time we had seen Chris’s family since the blowup, but that didn’t mean I’d be comfortable—not under these circumstances or any other.

Chris and his parents had matched each other in stubbornness—neither had picked up the phone or even emailed for more than a year and a half. When Chris moved in with me, I asked if he was sending his new address to his parents. He said no, but he did send the information to his sisters and one of his aunts. And it was through that same aunt and, to a lesser degree, his sisters that there was any contact with his family.

As I had once gone nearly two years without speaking to or hearing from my mother, I knew how these things could happen. In both cases there was not a point where someone had yelled, “I’ll never speak to you again.” Rather, each side fumes silently and determines to “show” the other side until weeks, and then months, and then more than a year has passed. And how do you reconcile from there? How do you then pick up the phone? What do you say?