Wednesday, January 6, 2010


It is all too familiar by now, the stark yellow walled consultation room in the Medical Oncology department of Princess Margaret Hospital.

Linda and I sit on the room's two patient's chairs and wait for the knock on the door that will alert us that the oncologist is about to enter. And deliver her verdict on my most recent CT Scan. I use the term "recent" loosely. The scan was actually completed on December 17th, but with the winter break I am only now getting feedback.

"What do you bet," I ask Linda. "Staff, Fellow or Resident?"

There are four medical oncologists on Staff at PMH, each with their own team of doctors and nurses. It is impossible to know which member of the team will come today with the results of the scan and the revised plan for my future.

"Staff," said Linda.

"Okay, then I'll choose the Fellow."

We waited. Finally a knock came on the door and a Resident entered.

Linda and I both looked at each other and smiled. We were both wrong.

The Resident introduced herself. She was young and had just spent the past half hour immersing herself in the detail of my case. Then, being merely a Resident, had run her conclusion past the Staff doctor, the head of the team.

"I have, possibly, some good news for you," She began.

I smiled. Good news would be a novel experience.

"The CT Scan show no substantial change in your cancer. So it appears the chemo is holding the spread of your disease at bay."

Let me translate that for you. With esophageal cancer at this stage doctors are not permitted to use words like "cure" or "remission" because this cancer never stops growing. And seldom dies. Think of a hungry pacman who just goes on eating forever. What chemo tries to do is knock the cancer back to a lower level where it has to start growing all over again. Hence the Resident's use of the term "holding your disease at bay."

"That's possibly good news," I agreed.

And let me translate that for you. The CT Scan can only detect 3 of the 7 cancerous hot spot in my bones. To see the 4 other smaller and deeper cancers would require another round of radiation scanning and that is just too dangerous. So when the resident talks about no substantial change she is talking about less that half the cancers she knows I have. What is happening with the other 4 is anybody's guess.

Well, that is not quite right, it is the Resident's guess, supported by the Staff doctor, that if the chemo is halting the spread of the cancers we can see, it is likely doing the same to the cancers we can't see.

"So your reward for that success, is that we have scheduled three more cycles of chemo," the resident went on. "One this Thursday, the next at the end of January and a final one late in February. Then we will do another CT and decide about further treatments at that time."

It was the best news we could have expected and we drove home pleased with the way 2010 was shaping up.

Unfortunately, when we got home we discovered Linda's car wouldn't start. I tried boosting it with a couple of jumper cables but still couldn't get it to turn over.

"Must be your battery", I said, stating the obvious.

And called a tow truck. He arrived half an hour later and with his more powerful cables was able to get the car started. I took it up to the dealer who confirmed she needed a new battery. The car was also over due for winterization. So we had them do both.

Then they charged us $275 and the tow truck driver charged an additional $50.

Just can't have a day of unalloyed pleasure, not even in 2010.