Thursday, July 5, 2012

I need all the help I can get

Me, towards the end of radiation treatment, hospital gown in hand. As you can see, I wasn't kidding about the Uggs-puffy vest-no bra-last night's ponytail combo. Stellar. Sorry, boys! She's taken!
On Monday, I went to see my GP. In order to meet with the oncologist to start Tamoxifen, I needed an official referral letter from the GP, so I made an appointment. (It's a Medicare billing thing, but anyway.)

I hadn't actually been back to see her since a visit right after my diagnosis, back in February. Over the last several months, we've been fortunate enough to be pretty healthy as a family, and the one time Nate was sick, Jason took him to the doctor.

In telling the story of how I found out I had breast cancer, I often tell people how, after that initial ultrasound, the radiologist who read the scan recommended that I return for a second scan in 6 months' time. That there were a few cysts, but nothing to be really concerned about. I would've followed that recommendation without worry; after all, I was only trying to be responsible in getting that ultrasound anyway.

But when I saw my GP the day after the scan, she read the report and then kind of stared into space for a second. "You know," she said, "I think you should consider getting an appointment at the breast clinic in the city, just to check it out and make sure everything is fine." And so I did, the next day. And you know the rest.

This past Monday, she and I chatted about my radiation treatment, while she printed off the letter I needed. I told her that I'd been wanting to thank her for that initial recommendation. It set off the chain of events that lead me to find that I had breast cancer in an early stage, instead of finding it much later and perhaps with a more grave prognosis. "I've often remarked to others," I told her, "how grateful I am that you referred me to the breast clinic, when you could've easily just told me to wait 6 months. So, thank you." (And as an aside, the remarkable thing to me is that nothing in that initial ultrasound turned out to be was a lump that wasn't even picked up in the original scan!)

She kind of shook her head and told me she couldn't believe it when she'd gotten the call from the breast clinic. "The thing is," she said, "I could've just as easily told you to get another scan in 6 months-I've certainly done that before. I don't know what made me recommend that you get it checked out."

Now, me being me...of course it's my belief that God graciously intervened in that whole scenario. I don't understand it, but I'm thankful all the same. But even besides that, I've been thinking since then about that little nagging voice, that sense of intuition, that gut instinct that people have when it comes to their particular field. My oncologist used this kind of language today when I asked him a question about an aspect of my treatment. He responded that there was wasn't a big body of research for this particular thing I was asking, then he said, "But my gut instinct is...". It's what Malcolm Gladwell talks about in that book Blink. (Which, incidentally, I've never read. Do you ever do that? Summarize books or movies you've never actually read or seen?)

But from what I understand, Gladwell talks about this idea of informed intuition. He calls it "thin-slicing", the ability to assess a situation from a very brief window of exposure to it. Where a person can have a hunch, a snap judgment, a feeling about something that feels spontaneous, but is actually fed by years of their own experience and study. So that, even though they can't necessarily articulate why they have the opinion they hold, they just do. That all those years of study and experience combine in a subconscious moment--a blink, I guess. Me being me again...I think there can definitely be a divine element at work here, too. Not some kind of magical voice necessarily, but a nudge when you need it. Gladwell's point is that we should all tune into this intuition...that we all have it in some way. At least, I think that's his point. I haven't read the book yet, you see.

I've found over the course of the last several months that I'm relying quite a bit on the intuition of these folks. Of course, there's more than that to back them up. Years of research, my own pathology reports, data from thousands of other cases, an established standard of care--it's not like we're operating on spit and fairy dust or something. But, I feel better knowing that they are applying their own "hunches" in taking care of me. In fact, I was talking with my radiation oncologist a few weeks ago about scheduling followup appointments with her. Along with my GP, there are 3 other doctors that are kind of managing different aspects of my treatment. She said something like, "I know it's a hassle to have all these appointments, but we'll space them out, and they'll lessen as time goes on." And I said, "No, I actually like it. The more smart, experienced people looking at me and my case, the better." Team Amy is always looking for more star players. Clearly, it takes a village of experts to keep me operating at full capacity. So we all need to keep our heads in the game. Got that?

I think I'm gonna read that book.