Anonymiss in DC











{November 17, 2010}   A trip to the doctor’s

About a month ago, I was changing into my jammies when my hand grazed my breast and a jolt of fear shot down my spine. WHAT is THAT? I reached back up, gave myself a friendly little grab, and confirmed it:  a lump. Wonderful. Just what I need.

So I did what any normal, bottom-of-the-totem-pole young person living in a major Metropolitan area would do:  I went to work the next day, abandoned my cube, snuck into an unmanned office with my cell phone, shut the door, and dialed my humongous medical-plex style doctor’s office to make an Urgent Care appointment.

After hitting several menu buttons and waiting on hold for about five minutes (which isn’t bad for early in the week, actually), someone picks up, asks me my name, my date of birth, and has me spell out my entire address (including my zip code). Then she asks me when I want to come in. I say ASAP.

“Ummmm….I don’t have anything today. Tomorrow?”

“I’d really rather not wait.”

“Why do you want to come in?”

“Well, I appear to have a lump in my breast.”

“Oh, ok.”

“Yeah, so I’m kind of freaking out right now. You know? I don’t know what it is or why it’s there…”

About a minute later, she concedes that someone can see me around 3, and reminds me cordially not to forget my insurance card, photo identification, and copayment.  Hoorah! Sister solidarity! (Sort of.)

So I show up. And after telling my best friend that if a male resident walks in with a medical student, I’ll throw a fit, I find myself sitting on an exam table when some guy walks in. He says “Hi Anonymiss” and introduces himself as Dr. New Guy (obviously, not really, but that’s what I’m going to call him.)

(I don’t mean to be difficult, but Dr. New Guy is about five years older than me. Max. Absolute max.  If I have to call him “Dr.”  New Guy, couldn’t he at least call me Ms. Anonymiss? Anyway. Whatever.  Did I mention he’s a guy?)

Since I don’t feel like being difficult, I suck it up.  Dr. New Guy calmly explains to me that he is going to go get his attending, Dr. Hot Shot, and the two of them will conduct a breast exam together to avoid repetition. I agree, realizing that they’re not trusting this young gun to catch breast cancers yet.

So I sit tight for a couple minutes until there’s a knock on the door.

Observation Number 1: Dr. Hot Shot is also a man. Of course.

Observation Number 2: Dr. Hot Shot is visibly psyched that he has this textbook teachable moment to share with Dr. New Guy.

After introducing himself to me and washing his hands in front of me (a gesture I actually appreciate this time of year, even if it’s conspicuously written on those hand washing suggestion cards for doctors and no doctors ever seem to do it), Dr. Hot Shots turns to Dr. New Guy and says something to the effect of  “Dr. New Guy, would you like to explain what we’re going to do today?” Dr. New Guy gives me the 411: they need to check this thing out. They then leave me to strip from the waist up and put on one of those gynormous faux gowns that are actually made of paper, and an extra paper blanket.  Then they conspicuously pull a curtain around the door so no one will see me when they open the door. (I find all this kind of silly.  I don’t really need privacy to “change” when I’m just going to strip anyway. But I guess I should be happy they’re sensitive?)

About two minutes later, they come in, and announce that the first thing they want to do is look at both breasts together to see if they look different.  I consider making a crack about this and telling them I’m going to make their day or something, but manage to keep a straight face as I pull open the faux gown.

And then, there I am, watching as two men silently, but not at all inconspicuously, stare at  my chest- for a good minute.  (Seriously, not snorting with laughter was difficult.) Finally, they pronounce that they don’t see anything, so Dr. New Guy starts putting on rubber gloves to do an exam.

“Actually,” says Dr. Hot Shot, “I suggest you do the exam without gloves, so you can get a better feel.” (Again, I try not to laugh. What am I, twelve?)

Dr. New Guy looks visibly embarrassed that he did not think of this himself, and he quickly sheds the gloves and asks me if I would please lay down and tuck my arms under my head. I almost feel sorry for him.  It’s like he’s taking a test. A super awkward test at that.  He rather apologetically pulls back one side of my gown…

I cannot believe this is happening to me.

Now they are both standing there, discussing how conducting a breast exam can be done via different techniques… like I care…and then it gets eerily quiet, as if they expect my lump to emit sonar or something.

“Is this what you feel?” Dr. New Guy says finally, sounding a bit relieved that he found something.

“Yup,” I say, realizing I was sort of hoping he’d say “Well, maybe you HAD a lump yesterday, but now you don’t!”

“Oh, well, that could be a little lymph node.”

I don’t say anything, but I can tell he’s looking at Dr. Hot Shot to see if he noticed that he memorized those lymphatic system diagrams. He carefully covers that boob up and switches to the other, nothing (a little smugly, I might add) that he feels something similar on the other side.

(In spite of myself, I’ve suddenly gone from wishing that he wouldn’t be able to find it to hoping that Dr. Hot Shot tells this guy he’s done a crap job.  Just ’cause I don’t like  Dr. New Guy insinuating that I’m paranoid.)

Dr. Hot Shot says ok, it’s his turn, and begins demonstrating his slightly different breast examination methodology. (Again, like I care.)  He finds the spot, says something scholarly like “Hmmm” and then announces in his best teacher voice that he understands why Dr. New Guy felt something similar on the other side, but that on this side the bump is “much more defined.”  Perhaps a little too quickly, Dr. New Guy agrees.  “Yeah, it was more pronounced.”

I feel like being like “HA!”…when it occurs to me that two doctors  just confirmed I have a lump in my breast that’s not obviously a lymph node or..you know, nothing.

So they cover me back up, tell me I can sit up, and, relieved that that’s all done with and I’m back to being a person instead of a pair of boobs, I say something like “Well? What is it? And where would it come from? And why do I have it?”

Ah ha. But now I’m “frightened patient in need of reassurance.”

Dr. Hot Shot smiles knowingly like he’s just eating up this opportunity to exhibit his bedside manner, nods, and says “Dr. New Guy, would you like to answer that?”

(I’m sort of back to feeling sorry for the guy at this point.)

Dr. New Guy starts explaining that I’m young, with no real family history of breast cancers, so it is highly unlike that I have cancer.  Dr. Hot Shot nods like he’s checking boxes off his “What to say to young upset female with breast lump” checklist.

“Well that’s good,” I say. “But what is it?”

Dr. Hot Shot looks at Dr. New Guy expectantly. (Ugh.)

“Well, it’s possible that it is a cyst, or a small growth caused by hormone fluctuations, in which case, it could just go away.”

Dr. Hot Shot nods again.

“But breast cancer is still totally on the table.”

Dr. Hot Shot stops nodding for a second, and I know he’s making a mental note to tell Dr. New Guy after I’ve gone that he probably shouldn’t say things like “But breast cancer is still totally on the table” to frightened women with breast lumps.

“So, what do we do now?” I say.

Dr. New Guy starts fumbling on about how they will make detailed notes in my medical record about this, and that I should come back in about two weeks and they can look at it again. He says they try to balance early intervention with subjecting patients to unnecessary medical procedures. The next step, if needed, would be a referral for an ultrasound.

“But, is it really a good idea to wait?” I ask, finding myself looking not at Dr. New Guy, but at Dr. Hot Shot, even if he is a little smug.  (Don’t judge me! I can’t help it. The guy actually appears to know what he’s doing, and like it or not, I’m the helpless patient in this situation.) “If it’s cancer, I don’t really want to sit and let it grow for two weeks before I come back, and then wait another two weeks for an ultrasound appointment.”

Seizing the opportunity to demonstrate good things to say to calm a distressed patient, Dr. Hot Shot starts out by saying, “If you were my sister…” (nice one!) …”I would say it’s a good idea to wait a couple of weeks and see what happens.  In two weeks, it may just disappear. Let’s make a follow-up appointment in two weeks. Would you also like us to give you a referral for an ultrasound appointment in three weeks, so you can book it, and then cancel it if you don’t end up needing it??”

Awww. They’re placating me. And I’m takin’ it.

“Yes, actually; I think that’s a good plan.”



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