Pre-dead

The human condition

This was, I cannot emphasize enough, supposed to be the summer of George. Everything’s going as well as it might professionally—I have not been reborn a person with marketable skills, but I have a job and side jobs I enjoy and am deeply suited to, as well as a contract to write the book I’ve wanted to since time immemorial. We’d finally planned the first trip back to Belgium to see my in-laws since not just pre-Covid but pre-kids. My kid doing food allergy immunotherapy just reached the end of that nearly year-long process, meaning that we can now worry less about reactions, as well as do things like buy bread from a bakery without checking about cross-contamination.

I didn’t know if in Canada they even let you get mammograms starting at 40, but it keeps going back and forth, 40 no 50, 50 no 40, and I thought, if it’s 40 I should go, right? I assumed—I was so young—that a mammogram is useful because you learn you’re 100% fine or, conversely, that it’s death’s-door-city. Spoiler: I am between 98 and 99% fine. Whatever that means. That is what this newsletter shall walk you through if you’re curious.

So my doctor referred me for a mammogram, at my request, and… the appointment date straight-up came and went and I only remembered after it had passed because I guess this is the one medical establishment I have yet encountered that doesn’t do follow-ups and I am apparently crap with keeping track of such things if they are about me and not my kids and aren’t work-related. I had this thought that I was meant to have my first-ever mammogram in April, and it was the end of April and had surely missed it. So I rebooked, which they graciously let me do, and went, and thought, this will be like it always is in Canada, where if a test shows nothing, they just never let you know the result unless you call to ask.

A day passed and no call so I made some remark about how I guess I’m not about to die—not from breast cancer, at least—and went along with my life.

Then they called the day after that and said I had to come back for an additional mammogram because something was not normal, and I could come back in on Monday for this recheck. This was on Friday and Friday is the start of the weekend so I would say I spent the whole weekend a wreck, and this would be accurate, but also I didn’t have the luxury of leaning into the wreckishness, given little kids needing to be supervised and entertained and brought to classes and whatnot. I would sort of forget then remember it all over again, as if it were new information.

I am not posting my medical records to the internet, but the thing is I am able to access them so in the time I was meant to be resting sleeping whatever, and that I wasn’t getting ahead on work in light of this appointment on Monday, I looked up everything I could about this clearly imminently fatal condition that had been lurking inside me all this time. I know that people are hypochondriacs but this was an actual thing, an actual worrying area! From what I was Googling, there was a 40% chance they’d found cancer. No a 17% chance. No, it wasn’t likely. No, it was the only possible explanation for something phrased as this was phrased.

I am, wild I know, going to die one day. I’m unique in this regard.

At last Monday arrived. The day when they were going to something-or-other to see what was going on. I vowed to write about this experience whether it was something or wasn’t, not to do the thing of only writing if it goes well, ala every infertility article ending with a baby, and stood there at the streetcar stop thinking about how I’d phrase it in one case or the other, because this is, I suppose, what I do to calm down.

What I hadn’t considered was a third possibility. The recheck showed that I’m in a category where they’re almost certain you don’t have cancer but there’s a small chance you do so they follow up in 6 months rather than the usual year to check. I don’t have breast cancer. Probably. Unless I do. The same could on some level be said about everyone—not just all women!—but rarely is it so stark. And it is obviously different to be in this less than 2% chance category than to be popped into the 0% chance category where whatever they thought they saw turned out to be nothing. That qualifies as a health scare. Does this?

There is a name for this on recheck mammograms: Birads 3. It apparently drives people insane, to the point that if you google it, a lot that comes up is basically about mental health. There’s even some study (what have I not Googled, I ask you) showing that in Turkey they tried out some protocol on women in this situation where they remove the not-a-tumor, due to the women’s anxiety. None of the women in this (small) study actually turned out to have breast cancer. I don’t want to have unnecessary surgery that could cause its own complications. I am not that anxious.

I also have these dark thoughts about how any of my not immediately needed organs that could go malignant should be chucked asap, leaving me like a disembodied defrosted head from one of those last Golden Girls episodes.

Any of us might have a disease we don’t know about, and only true hypochondriacs are tortured by this thought. But somehow being told that it’s nothing worrisome but also worrisome enough that you need to come back for another mammogram in 6 months rather than a year—and I have read about this! it does make sense!—has the capacity to make people who aren’t otherwise so inclined use their one precious time on this earth trying to read medical journal articles and having profound-feeling thoughts about knowing I mean knowing what it is that will get you in the end.

I first left the Monday recheck appointment feeling reassured. Then I thought about it and Googled the new results and wondered if relief was merited. Obviously everything you read online is from the people who hear it’s probably fine and it’s not, and indeed from the far smaller category of people who are led to believe they’re fine and are given not a diagnosis of treatable cancer (a phenomenon I well know exists, but try to tell that to my last-weekend self) but a week to live. And yes I am thinking about Madge from Benidorm, whose doctor tells her, she thinks, she has six months to live, but it was actually six months to leave, as in leave his practice because she’s so terrible. (I love Madge.)

I want this to be the blog post I might have found when I saw Birads 3 in the report, because all I did find, testimony-wise, was some woman saying that she’d foolishly allowed the doctors to assign her this when she was in fact very nearly dead and isn’t it important to listen to your gut on these things, and it’s like, my gut is telling me all sorts of things and is probably not as worth listening to as the radiologist who interpreted these scans.

And then I think, I am an asshole. There are plenty of people, including younger ones than I am, who get actual cancer diagnoses, none of this ‘under 2% chance’ stuff, or other life-threatening diagnoses, and just deal with it. If I were such a person I would read this and think, what an asshole, unless of course I was the lady whose Birads 3 assessment was false hope. Then I would read it and think, what a fool.

I am lucky, I think, to live in Canada, which has plusses and minuses but at least medical debt is not high on my list of concerns. Unless I’m an idiot and should have stayed in America where fine maybe I’d spend all my free time filling out insurance paperwork but they’d have done full-body scans by now and turned me into the defrosted disembodied head like Dorothy, Rose, and Blanche become in Rose’s postoperative haze.

I read about the horrors of war and the holding-forths about which governing entity or ideology is to blame for this and think here I am, a middle-aged asshole, wondering if I overuse plastic products or need to replace my nonstick pans more frequently, if that was what did it, the “it” being something that has a less than 2% chance of being anything, the “anything” being something that would be unpleasant to deal with but not in any sense the end of the world.

I remind myself that I think this sort of privilege-checking is silly (wrote the book on it and everything) and that it in no way brings about world peace for me to think along these lines.

Then I think, would I care this much if it were a less than 2% chance of some mole on my arm being malignant? And then I think, I’d just have the mole removed. And then I think, shut up Phoebe.

The ridiculous part is, this shouldn’t be shaking me up, given that there was a time when I was not in any ‘probably nothing to worry about’ zone. For the usual reasons (sort of), I had to be tested for the BRCA mutation, and had a 50% chance of having it, and I don’t have it. At the time I had a baby (not yet pregnant with the 2nd) and it was the start of Covid so I was sorting this out during lockdowns and I don’t remember being so bothered. I can hardly remember learning the results, even though it was, presumably, a relief. All a complete blur.

I almost think this had to do with the happenstance fact that I was on antidepressants for postpartum depression at the time. Well I’m not on anything now, apart from an iced cappuccino. I’m just a defrosted head taking it all in.