Douglas Kennedy: Five Days

I SAW THE cancer immediately. It was right there in front of me. As always, I found myself taking a sharp intake of breath as the realization hit: I am looking at the beginning of the end.

The cancer was shaped like a dandelion. Sometimes this sort of tumor looks like a cheap Christmas decoration — a five-and-dime star with ragged edges. This specific one was more like a minor-looking flower that had been denuded, stripped down to its seeds, but with an insidious, needle-like design. What radiologists call a ‘spiculated structure’.

Spiculated. When I heard that word for the first time I had to look it up. Discovered its origins were actually zoological: a spicule being ‘a small needle-like structure, in particular any of those making up the skeleton of a sponge’ (I’d never realized that sponges have skeletons). But there was an astronomical meaning as well: a short-lived jet of gas in the sun’s corona.

This last definition nagged at me for weeks. Because it struck me as so horribly apt. A spiculated cancer — like the one I was looking at right now — might have commenced its existence years, decades earlier. But only once it makes its presence known does it become something akin to the burst of flame that combusts everything in its path, demanding total attention. If the flame hasn’t been spotted and extinguished early enough, it will then decide that it isn’t a mere fiery jet stream; rather, a mini supernova which, in its final show of pyrotechnic force, will destroy the universe which contains it.

Certainly the spiculated species I was now looking at was well on its way to exploding — and, in doing so, ending the life of the person within whose lung it was now so lethally embedded.

Another horror to add to the ongoing catalog of horrors which are, in so many ways, the primary decor of my nine-to-five life.

And this day was turning out to be a doozy. Because, an hour before the spiculated cancer appeared on the screen in front of me, I had run a CT scan on a nine-year-old girl named Jessica Ward. According to her chart she’d been having a series of paralyzing headaches. Her physician had sent her to us in order to rule out any ‘neurological concerns’. which was doctor shorthand for ‘brain tumour’. Jessica’s dad was named Chuck; a quiet, hangdog man in his mid-thirties, with sad eyes and the sort of yellowing teeth that hint at a serious cigarette habit. He said that he was a welder at the Bath Iron Works.

‘Jessie’s ma left us two years ago,’ he told me as his daughter went into the dressing area we have off the cat scan room to change into a hospital gown.

‘She died?’ I asked.

‘I wish. The bitch — ’scuse my French — ran off with a guy she worked with at the Rite Aid Pharmacy in Brunswick. They’re livin’ in some trailer down in Bestin. That’s on the Florida Panhandle. Know what a friend of mine told me they call that part of the world down there? The Redneck Riviera. Jessie’s headaches started after her ma vanished. And she’s never once been back to see Jessie. What kind of mother is that?’

‘She’s obviously lucky to have a dad like you,’ I said, trying to somewhat undercut the terrible distress this man was in — and the way he was working so hard to mask his panic.

‘She’s all I got in the world, ma’am.’

‘My name’s Laura,’ I said.

‘And if it turns out that what she has is, like, serious. and doctors don’t send young girls in for one of these scans if they think it’s nothing. ’

‘I’m sure your physician is just trying to rule things out,’ I said, hearing my practiced neutral tone.

‘You’re taught to say stuff like that, aren’t you?’ he said, his tone displaying the sort of anger that I’ve so often seen arising to displace a great fear.

‘Actually, you’re right. We are trained to try to reassure and not say much. Because I’m a technologist, not a diagnostic radiologist.’

‘Now you’re using big words.’

‘I’m the person who operates the machinery, takes the pictures. The diagnostic radiologist is the doctor who will then look at the scan and see if there is anything there.’

‘So when can I talk to him?’

You can’t was the actual answer — because the diagnostic radiologist is always the behind-the-scenes man, analyzing the scans, the X-rays, the MRIs, the ultrasounds. But he rarely ever meets the patient.

‘Dr Harrild will be talking directly to Jessica’s primary-care physician — and I’m sure you’ll be informed very quickly if there is—’

‘Do they also teach you to talk like a robot?’

As soon as this comment was out of his mouth, the man was all contrite.

‘Hey, that was kind of wrong of me, wasn’t it?’

‘Don’t worry about it,’ I said, maintaining a neutral tone.

‘Now you’re all hurt.’

‘Not at all. Because I know how stressful and worrying this all must be for you.’

‘And now you’re reading the script again that they taught you to read.’

At that moment Jessica appeared out of the changing room, looking shy, tense, bewildered.

‘This gonna hurt?’ she asked me.

‘You have to get an injection that is going to send an ink into your veins in order for us to be able to see what’s going on inside of you. But the ink is harmless.’

‘And the injection?’ she asked, her face all alarmed.

‘Just a little prick in your arm and then it’s behind you.’

‘You promise?’ she asked, trying hard to be brave, yet still so much the child who didn’t fully understand why she was here and what these medical procedures were all about.

‘You be a real soldier now, Jess,’ her father said, ‘and we’ll get you that Barbie you want on the way home.’

‘Now that sounds like a good deal to me,’ I said, wondering if I was coming across as too cheerful and also knowing that — even after sixteen years as an RT — I still dreaded all procedures involving children. Because I always feared what I might see before anyone else. And because I so often saw terrible news.

‘This is just going to take ten, fifteen minutes, no more,’ I told Jessica’s father. ‘There’s a waiting area just down the walkway with coffee, magazines. ’

‘I’m goin’ outside for a bit,’ he said.

‘That’s ’cause you want a cigarette,’ Jessica said.

Her father suppressed a sheepish smile.

‘My daughter knows me too well.’

‘I don’t want my daddy dead of cancer.’

At that moment her father’s face fell — and I could see him desperately trying to control his emotions.

‘Let’s let your dad get a little air,’ I said, steering Jessica further into the scan room, then turning back to her father who had started to cry.

‘I know how hard this is,’ I said. ‘But until there is something to be generally concerned about. ’

He just shook his head and made for the door, fumbling in his shirt pocket for his cigarettes.

As I turned back inside I saw Jessica looking wide-eyed and afraid in the face of the CT scanner. I could understand Jessica’s concern. It was a formidable piece of medical machinery, stark, ominous. There was a large hoop, attached to two science-fiction-style containers of inky fluid. In front of the hoop was a narrow bed that was a bit like a bier (albeit with a pillow). I’d seen adults panic at the sight of the thing. So I wasn’t surprised that Jessica was daunted by it all.