Дуглас Кеннеди: Five Days

‘Hey, even the best fighter pilots lose their nerve from time to time.’

‘I’m hardly a fighter pilot.’

‘But you’re the best RT on the staff. Everyone knows that.’

Except me. And certainly not now, positioning myself in front of the bank of computer screens, staring out at Jessica on the table, her eyes tightly shut, a discernible tremor on her lips, her face wet with tears. A big part of me wanted to run in and comfort her. But I also knew it would just prolong the agony; that it was best to get this behind her. So clicking on the microphone that is connected to a speaker in the scan room, I said:

‘Jessica, I know this is all very spooky and strange. But I promise you that the rest of the procedure will be painless — and it will all be over in just a few minutes. OK?’

She nodded, still crying.

‘Now shut your eyes and think about Tuffy and. ’

I hit the button that detonated the automatic injection system. As I did so a timer appeared on one of the screens — and I turned my vision immediately to Jessica, her cheeks suddenly very red as the iodine contrast hit her bloodstream and raised her body temperature by two degrees. The scan program now kicked in, as the bed was mechanically raised upwards. Jessica shuddered as this first vertical movement startled her. I grabbed the microphone:

‘Nothing to worry about, Jessica. Just please keep very still.’

To my immense relief she did exactly as instructed. The bed reached a level position with the circular hoop. Twenty-four seconds had elapsed. The bed began to shift backwards into the hoop. Thirty-two seconds when it halted, the hoop encircling her small head.

‘OK, Jessica — you’re doing great. Just don’t move.’

Thirty-six seconds. Thirty-eight. My finger was on the scan button. I noticed it trembling. Forty-one. And.

I pressed it. The scan had started. There was no accompanying noise. It was silent, imperceptible to the patient. Instinctually I shut my eyes, then opened them immediately as the first images appeared on the two screens in front of me, showing the left and right spheres of the brain. Again I snapped my eyes shut, unable to bear the shadow, the discoloration, the knotty tubercle that my far too-trained eye would spot immediately and which would tear me apart.

But professionalism trumped fear. My eyes sprang open. And in front of me I saw.

Nothing.

Or, at least, that’s what my first agitated glance showed me.

Nothing.

I now began to scrutinize the scan with care — my eyes following every contour and hidden crevasse in both cerebral hemispheres, like a cop scouring all corners of a crime scene, looking for some hidden piece of evidence that might change the forensic picture entirely.

Nothing.

I went over the scan a third time, just to cover my tracks, make certain I hadn’t overlooked anything, while simultaneously ensuring that the contrast was the correct level and the imaging of the standard that Dr Harrild required.

Nothing.

I exhaled loudly, burying my face in my hand, noticing for the first time just how rapidly my heart was pounding against my chest. The relief that Jessica’s brain showed no signs of anything sinister was enormous. But the very fact that my internal stress meter had shot into the deep red zone. this troubled me. Because it made me wonder: Is this what happens when, over the years, you’ve forced yourself to play a role that you privately know runs contrary to your true nature; when the mask you’ve worn for so long no longer fits and begins to hang lopsidedly, and you fear people are going to finally glimpse the scared part of you that you have so assiduously kept out of view?

Nothing.

I took another steadying breath, telling myself I had things to be getting on with. So I downloaded this first set of scans to Dr Harrild — whose office was just a few steps away from the CT room. I also simultaneously dispatched them into the PACS system — that’s the Picture Archiving and Communication System — which is the central technological storage area in Portland for our region of the state (known by its code name, Maine 1). All scans and X-rays must, by law, be kept in a PACS system for future reference and to ensure they are never mixed up, misplaced, assigned to the wrong patient. It also means that if a radiologist or oncologist needs to call up a specific set of patient scans — or compare them with others on file — they can be accessed with the double-click of a mouse.

The images dispatched, I began running a second set of scans to have as back-up, to compare contrast levels, and to double-check that the imaging hadn’t missed anything. Usually, if the scans in the first set are clear, I relax about the second go-around. But today I heard a little voice whispering at me: ‘Say you got it all wrong the first time. say you missed the tumor entirely.’

I grabbed the mike.

‘Just a few more minutes, Jessica. And you have been just terrific. So keep lying still and. ’

The second scan now filled the two screens. I stared ahead, fully expecting to see proof of my corroding professionalism in front of me as a concealed nodule appeared in some ridge of her cerebellum. But again.

Nothing.

That’s the greatest irony of my work. Good news is all predicated on the discovery of nothing. It must be one of the few jobs in the world where ‘nothing’ provides satisfaction, relief, the reassertion of the status quo.

A final scan of the scan.

Nothing.

I hit the ‘send’ button. Off went this second set of scans to Dr Harrild and the PACS storage centre. I picked up the mike again and told Jessica we were done, but she would have to remain very still as the bed was brought back to ground level again.

Ten minutes later, dressed again and sucking on a lollipop, Jessica was reunited with her father. As I brought her into the waiting room, where he sat slumped, anxious, he was immediately on his feet, trying to read me the way a man on trial tries to read the faces of the jurors filing back into court with a verdict already cast in stone. Jessica ran over to him, throwing her arms around him.

‘Look, I got four lollipops,’ she said, holding up the three untouched ones in her hand and pointing to the one in her mouth.

‘You deserve them,’ I said, ‘because you were such a brave, good patient. You would have been proud of her, sir.’

‘I’m always proud of my daughter,’ he said, picking her up and putting her on a bench, asking her to sit there for a moment, ‘while this nice lady and I have a talk.’

Motioning for me to follow him outside into the brisk autumn morning, he asked me the question I always know is coming after a scan:

‘Did you see anything?’

‘I’m certain the diagnostic radiologist, Dr Harrild, will be in contact with your primary-care physician this afternoon,’ I said, cognizant of the fact that I also sounded like a scripted automaton.

‘But you saw the scans, you know—’

‘Sir, I am not a trained radiologist — so I cannot offer a professional opinion.’

‘And I don’t design the ships I work on, but I can tell when something’s wrong if I see it in front of me. Because I have years of on-the-job experience. Just like you. So you now know, before anyone, if there is a tumor in my daughter’s head.’

‘Sir, you need to understand — I can neither legally nor ethically offer my opinion on the scans.’

‘Well, there’s a first time for everything. Please, ma’am. I’m begging you. I’ve got to know what you know.’

‘Please understand, I am sympathetic. ’

‘I want an answer.’

‘And I won’t give you one. Because if I tell you good news and it turns out not to be good news. ’

That startled him.